HESI V2 HEALTH ASSESSMENT
EXAM
(Questions with 100% Correct
Answers) (Verified by Experts) Latest
Update
1. A 29 year old male client informs the nurse that he
came to the clinic to see if, "Maybe I have lung cancer or
something," and wants to get checked out since, "I can't
seem to get rid of this body-wracking dry cough that has
been hanging around for the last six weeks." Which
computer documentation of this client's concerns should
the nurse enter?
A. Presents with a hacking non-productive cough of 6
weeks duration.
B. Describe having a "body-wracking dry cough" of 6
weeks duration.
C. Expresses concern of "lung cancer" symptoms for last
6 weeks.
,D. Young adult male presents with fears that he has "lung
cancer"
Correct Answer
is B, as assessment process includes chief complaint
which is how the patient describe why he is here in the
hospital or clinic and can't include diagnosis.
2. A 75-year-old client with a recent history of a
cerebrovascular accident (CVA) presents with right
hemiparesis. The nurse tests the deep tendon reflexes on
the right side and elicits a brisk 4+ response. Which
interpretation of this
finding is accurate?
A. A normal reflex response.
B. Absent or sluggish response consistent with a lower
motor neuron lesion.
C. Flaccid paralysis.
D. Hyperactive response consistent with an upper motor
neuron disorder
Correct Answer is D, brisk 4+ response is correlated with
hyperactive response.
,3. The nurse examines a client's abdomen. Which finding
indicates an abnormal response when palpating the
spleen?
A. Pain notes when palpating McBurney's point.
B. Tip of spleen palpable when client is asked to forcefully
exhale.
C. Rebound tenderness with compression over right upper
quadrant. D. Firm
mass palpated at bottom of le rib cage
Correct Answer is D. McBurney's point is related to
appendicitis and not spleen.
4. In auscultating for the presence of a carotid artery
bruit, the nurse places the bell of the stethoscope at
which location?:
*under mandible towards lymph nodes.
transverse
to trachea
5. A male client arrives at the clinic for follow-up health
assessment after recent antibiotic treatment for
pneumonia without hospitalization. Which technique
, should the nurse implement to assess for adventitious
lung sounds?
A. Use the bell of the stethoscope to listen to the lung
fields over lower lobes.
B. Have the client lay flat while listening to the anterior
surface of the chest.
C. Press the stethoscope's diaphragm firmly on the skin
over each lung field.
D. Shave all chest hair that may distort sounds heard
through the diaphragm.-
Correct Answer is C. The nurse should listen to all lungs
fields during assessment and
move from side to side during
auscultation.
6. A client with streptococcus pharyngitis reports high
fever, difficulty swallowing and a muffled voice. Which
complication should the nurse suspect?
A. Foreign body obstruction.
B. Laryngeal polyps.
EXAM
(Questions with 100% Correct
Answers) (Verified by Experts) Latest
Update
1. A 29 year old male client informs the nurse that he
came to the clinic to see if, "Maybe I have lung cancer or
something," and wants to get checked out since, "I can't
seem to get rid of this body-wracking dry cough that has
been hanging around for the last six weeks." Which
computer documentation of this client's concerns should
the nurse enter?
A. Presents with a hacking non-productive cough of 6
weeks duration.
B. Describe having a "body-wracking dry cough" of 6
weeks duration.
C. Expresses concern of "lung cancer" symptoms for last
6 weeks.
,D. Young adult male presents with fears that he has "lung
cancer"
Correct Answer
is B, as assessment process includes chief complaint
which is how the patient describe why he is here in the
hospital or clinic and can't include diagnosis.
2. A 75-year-old client with a recent history of a
cerebrovascular accident (CVA) presents with right
hemiparesis. The nurse tests the deep tendon reflexes on
the right side and elicits a brisk 4+ response. Which
interpretation of this
finding is accurate?
A. A normal reflex response.
B. Absent or sluggish response consistent with a lower
motor neuron lesion.
C. Flaccid paralysis.
D. Hyperactive response consistent with an upper motor
neuron disorder
Correct Answer is D, brisk 4+ response is correlated with
hyperactive response.
,3. The nurse examines a client's abdomen. Which finding
indicates an abnormal response when palpating the
spleen?
A. Pain notes when palpating McBurney's point.
B. Tip of spleen palpable when client is asked to forcefully
exhale.
C. Rebound tenderness with compression over right upper
quadrant. D. Firm
mass palpated at bottom of le rib cage
Correct Answer is D. McBurney's point is related to
appendicitis and not spleen.
4. In auscultating for the presence of a carotid artery
bruit, the nurse places the bell of the stethoscope at
which location?:
*under mandible towards lymph nodes.
transverse
to trachea
5. A male client arrives at the clinic for follow-up health
assessment after recent antibiotic treatment for
pneumonia without hospitalization. Which technique
, should the nurse implement to assess for adventitious
lung sounds?
A. Use the bell of the stethoscope to listen to the lung
fields over lower lobes.
B. Have the client lay flat while listening to the anterior
surface of the chest.
C. Press the stethoscope's diaphragm firmly on the skin
over each lung field.
D. Shave all chest hair that may distort sounds heard
through the diaphragm.-
Correct Answer is C. The nurse should listen to all lungs
fields during assessment and
move from side to side during
auscultation.
6. A client with streptococcus pharyngitis reports high
fever, difficulty swallowing and a muffled voice. Which
complication should the nurse suspect?
A. Foreign body obstruction.
B. Laryngeal polyps.
