BSN 246 HESI Health Assessment V1 Exam Updated
Questions And Correct Answers
Section I: Health History & Interviewing Techniques
1. The nurse is conducting a health history interview with a patient who speaks limited
English. Which approach best demonstrates cultural humility and ensures accurate data
collection?
A. Speak loudly and slowly in English to enhance comprehension
B. Use a certified medical interpreter and observe nonverbal cues
C. Ask a family member to translate medical terminology
D. Provide written materials in the patient's primary language only
Correct Answer: B
Rationale: Using a certified medical interpreter ensures accurate translation of medical terminology and
preserves the integrity of the health history data. Speaking loudly does not improve comprehension of a
language barrier, and family members may omit, modify, or misinterpret critical clinical information.
Written materials alone cannot substitute for interactive, two-way communication necessary for a
thorough health interview. Observing nonverbal cues alongside interpreter-mediated communication
provides additional assessment data about the patient's comfort and understanding.
2. During a health history, the patient states, 'I get this sharp pain in my chest when I walk up
stairs, but it goes away after I rest for a few minutes.' Which OLDCARTS component does
'when I walk up stairs' best represent?
A. Onset
B. Provoking factor
C. Quality
D. Timing
Correct Answer: B
Rationale: In the OLDCARTS mnemonic, 'when I walk up stairs' identifies the provoking factor — the
activity or circumstance that brings on the symptom. Onset refers to when the symptom first began,
quality describes the character of the pain (sharp), and timing refers to the duration or pattern of the
symptom. Understanding provoking and relieving factors is essential for differential diagnosis, as
exertional chest pain relieved by rest is a classic presentation of angina pectoris.
3. Which interviewing technique uses open-ended questions to encourage the patient to share
their health concerns in their own words?
A. Closed-ended questioning to obtain specific data points
B. Funneling from broad to focused questions
C. Leading questions to guide patient responses
D. Directive interviewing to maintain clinician control
Correct Answer: B
Rationale: The funneling technique begins with open-ended, broad questions that allow patients to describe
their concerns in their own words, then progressively narrows to more focused questions. This approach
yields richer, patient-centered data compared to closed-ended or directive techniques, which limit the
patient's narrative. Leading questions introduce clinician bias and may distort the patient's actual
experience. Evidence-based interviewing literature consistently supports funneling as the gold standard for
comprehensive health history collection.
4. A nurse is obtaining a health history from an older adult who provides lengthy, tangential
responses. Which action best balances rapport and data collection efficiency?
A. Interrupt the patient and redirect to the next question immediately
B. Allow the patient to finish, then summarize and refocus the interview
C. Switch entirely to closed-ended questions for the remainder
, D. Document only the clinically relevant portions the patient mentions
Correct Answer: B
Rationale: Allowing the patient to finish demonstrates respect and preserves therapeutic rapport, while
summarizing and refocusing redirects the conversation without dismissing the patient's input. Interrupting
or switching to only closed-ended questions can damage the nurse-patient relationship and may cause the
patient to withhold important information. Selective documentation risks omitting contextual data that
may prove clinically significant. This balanced approach honors both communication quality and clinical
efficiency.
5. When assessing a patient's health literacy, which method is most appropriate for the nurse
to use during the interview?
A. Ask the patient directly, 'Can you read?'
B. Administer a formal intelligence quotient test
C. Use the Teach-Back method to confirm understanding
D. Assume adequate literacy if the patient completed high school
Correct Answer: C
Rationale: The Teach-Back method asks patients to explain in their own words what they have understood,
providing a respectful and effective way to assess health literacy without causing embarrassment. Directly
asking about reading ability can feel judgmental and does not assess functional health literacy specifically.
, Formal intelligence testing is outside the scope of a health interview and does not measure health literacy.
Educational attainment is an unreliable proxy for health literacy, as many individuals with formal
education still struggle with medical terminology and healthcare navigation.
6. The PQRST mnemonic is used to assess pain. What does the 'R' represent?
A. Radiation
B. Relief
C. Region
D. Rate
Correct Answer: A
Rationale: In the PQRST pain assessment mnemonic, R stands for Radiation — the path or spread of pain
from its origin to other body areas. This distinction is clinically important because radiating pain patterns
help differentiate conditions; for example, chest pain radiating to the left arm is strongly associated with
myocardial infarction, while non-radiating localized pain may suggest musculoskeletal etiology. Relief and
Region are important assessment components but are not represented by the R in PQRST. Rate refers to
pain scoring scales, not the mnemonic.
7. A patient avoids eye contact and provides one-word answers during the health history.
Which interpretation and action by the nurse is most appropriate?
A. The patient is being noncompliant; document refusal to cooperate
B. The patient may be anxious or from a culture where eye contact is disrespectful; adjust
approach
C. The patient has a cognitive impairment; proceed with family interview only
D. The patient is hiding information; use confrontation to obtain data
Correct Answer: B
Rationale: Avoidance of eye contact and brief responses may reflect cultural norms, anxiety, fear, or
discomfort rather than noncompliance or cognitive impairment. Many cultures consider direct eye contact
disrespectful, particularly with authority figures. The nurse should adjust the approach by creating a more
comfortable environment, using a softer tone, and allowing silence. Assuming noncompliance or cognitive
impairment without further assessment is premature and potentially harmful. Confrontation damages
rapport and is contraindicated as an initial strategy.
8. Which component of the health history includes information about the patient's current
medications, past surgeries, and allergies?
A. History of present illness
B. Past medical history
C. Family history
D. Review of systems
Correct Answer: B
Rationale: The past medical history component encompasses prior diagnoses, surgical procedures,
hospitalizations, current medications, and allergies. The history of present illness focuses specifically on the
current chief complaint and its associated details. Family history documents health conditions among
blood relatives to identify genetic and environmental risk factors. The review of systems is a systematic
inquiry about symptoms across each body system. Each component serves a distinct purpose in building a
comprehensive patient profile.
9. During a mental health assessment interview, the nurse observes that a patient displays
flight of ideas. This finding is most consistent with which condition?
A. Major depressive disorder
B. Generalized anxiety disorder
C. Bipolar disorder manic episode
D. Schizophrenia negative symptoms
Correct Answer: C
Rationale: Flight of ideas — rapid, loosely connected thoughts that shift from one topic to another with little
logical progression — is a hallmark finding in bipolar disorder during a manic episode. Major depressive
Questions And Correct Answers
Section I: Health History & Interviewing Techniques
1. The nurse is conducting a health history interview with a patient who speaks limited
English. Which approach best demonstrates cultural humility and ensures accurate data
collection?
A. Speak loudly and slowly in English to enhance comprehension
B. Use a certified medical interpreter and observe nonverbal cues
C. Ask a family member to translate medical terminology
D. Provide written materials in the patient's primary language only
Correct Answer: B
Rationale: Using a certified medical interpreter ensures accurate translation of medical terminology and
preserves the integrity of the health history data. Speaking loudly does not improve comprehension of a
language barrier, and family members may omit, modify, or misinterpret critical clinical information.
Written materials alone cannot substitute for interactive, two-way communication necessary for a
thorough health interview. Observing nonverbal cues alongside interpreter-mediated communication
provides additional assessment data about the patient's comfort and understanding.
2. During a health history, the patient states, 'I get this sharp pain in my chest when I walk up
stairs, but it goes away after I rest for a few minutes.' Which OLDCARTS component does
'when I walk up stairs' best represent?
A. Onset
B. Provoking factor
C. Quality
D. Timing
Correct Answer: B
Rationale: In the OLDCARTS mnemonic, 'when I walk up stairs' identifies the provoking factor — the
activity or circumstance that brings on the symptom. Onset refers to when the symptom first began,
quality describes the character of the pain (sharp), and timing refers to the duration or pattern of the
symptom. Understanding provoking and relieving factors is essential for differential diagnosis, as
exertional chest pain relieved by rest is a classic presentation of angina pectoris.
3. Which interviewing technique uses open-ended questions to encourage the patient to share
their health concerns in their own words?
A. Closed-ended questioning to obtain specific data points
B. Funneling from broad to focused questions
C. Leading questions to guide patient responses
D. Directive interviewing to maintain clinician control
Correct Answer: B
Rationale: The funneling technique begins with open-ended, broad questions that allow patients to describe
their concerns in their own words, then progressively narrows to more focused questions. This approach
yields richer, patient-centered data compared to closed-ended or directive techniques, which limit the
patient's narrative. Leading questions introduce clinician bias and may distort the patient's actual
experience. Evidence-based interviewing literature consistently supports funneling as the gold standard for
comprehensive health history collection.
4. A nurse is obtaining a health history from an older adult who provides lengthy, tangential
responses. Which action best balances rapport and data collection efficiency?
A. Interrupt the patient and redirect to the next question immediately
B. Allow the patient to finish, then summarize and refocus the interview
C. Switch entirely to closed-ended questions for the remainder
, D. Document only the clinically relevant portions the patient mentions
Correct Answer: B
Rationale: Allowing the patient to finish demonstrates respect and preserves therapeutic rapport, while
summarizing and refocusing redirects the conversation without dismissing the patient's input. Interrupting
or switching to only closed-ended questions can damage the nurse-patient relationship and may cause the
patient to withhold important information. Selective documentation risks omitting contextual data that
may prove clinically significant. This balanced approach honors both communication quality and clinical
efficiency.
5. When assessing a patient's health literacy, which method is most appropriate for the nurse
to use during the interview?
A. Ask the patient directly, 'Can you read?'
B. Administer a formal intelligence quotient test
C. Use the Teach-Back method to confirm understanding
D. Assume adequate literacy if the patient completed high school
Correct Answer: C
Rationale: The Teach-Back method asks patients to explain in their own words what they have understood,
providing a respectful and effective way to assess health literacy without causing embarrassment. Directly
asking about reading ability can feel judgmental and does not assess functional health literacy specifically.
, Formal intelligence testing is outside the scope of a health interview and does not measure health literacy.
Educational attainment is an unreliable proxy for health literacy, as many individuals with formal
education still struggle with medical terminology and healthcare navigation.
6. The PQRST mnemonic is used to assess pain. What does the 'R' represent?
A. Radiation
B. Relief
C. Region
D. Rate
Correct Answer: A
Rationale: In the PQRST pain assessment mnemonic, R stands for Radiation — the path or spread of pain
from its origin to other body areas. This distinction is clinically important because radiating pain patterns
help differentiate conditions; for example, chest pain radiating to the left arm is strongly associated with
myocardial infarction, while non-radiating localized pain may suggest musculoskeletal etiology. Relief and
Region are important assessment components but are not represented by the R in PQRST. Rate refers to
pain scoring scales, not the mnemonic.
7. A patient avoids eye contact and provides one-word answers during the health history.
Which interpretation and action by the nurse is most appropriate?
A. The patient is being noncompliant; document refusal to cooperate
B. The patient may be anxious or from a culture where eye contact is disrespectful; adjust
approach
C. The patient has a cognitive impairment; proceed with family interview only
D. The patient is hiding information; use confrontation to obtain data
Correct Answer: B
Rationale: Avoidance of eye contact and brief responses may reflect cultural norms, anxiety, fear, or
discomfort rather than noncompliance or cognitive impairment. Many cultures consider direct eye contact
disrespectful, particularly with authority figures. The nurse should adjust the approach by creating a more
comfortable environment, using a softer tone, and allowing silence. Assuming noncompliance or cognitive
impairment without further assessment is premature and potentially harmful. Confrontation damages
rapport and is contraindicated as an initial strategy.
8. Which component of the health history includes information about the patient's current
medications, past surgeries, and allergies?
A. History of present illness
B. Past medical history
C. Family history
D. Review of systems
Correct Answer: B
Rationale: The past medical history component encompasses prior diagnoses, surgical procedures,
hospitalizations, current medications, and allergies. The history of present illness focuses specifically on the
current chief complaint and its associated details. Family history documents health conditions among
blood relatives to identify genetic and environmental risk factors. The review of systems is a systematic
inquiry about symptoms across each body system. Each component serves a distinct purpose in building a
comprehensive patient profile.
9. During a mental health assessment interview, the nurse observes that a patient displays
flight of ideas. This finding is most consistent with which condition?
A. Major depressive disorder
B. Generalized anxiety disorder
C. Bipolar disorder manic episode
D. Schizophrenia negative symptoms
Correct Answer: C
Rationale: Flight of ideas — rapid, loosely connected thoughts that shift from one topic to another with little
logical progression — is a hallmark finding in bipolar disorder during a manic episode. Major depressive
