,Nightingale BSN 246 Exam 3 | Concepts of Nursing I HESI Health
Assessment (2026) Q&A
1. A nurse is obtaining a symptom history using the OLDCARTS framework. When the
patient states, "The pain started about 3 days ago after I lifted a heavy box," the
nurse recognizes this statement addresses which component of OLDCARTS?
A) Location
B) Character
C) Onset
D) Aggravating factors
Correct Answer: Onset
Rationale: The patient's statement "started about 3 days ago" directly describes
when the symptom began, which defines the Onset component of OLDCARTS. Onset
always answers the question "When did it start?" while Aggravating factors answer
"What makes it worse?"
2. A patient recently diagnosed with breast cancer states, "I don't know how I'm
going to tell my children." Which response by the nurse demonstrates the most
therapeutic communication?
A) "Don't worry, children are resilient and will understand."
B) "You should wait until after your surgery to tell them."
C) "Tell me more about what concerns you most about sharing this news."
D) "Many patients feel this way; you'll figure out the right time."
Correct Answer: "Tell me more about what concerns you most about sharing this
news."
,Rationale: This response uses an open-ended, patient-centered approach that
invites elaboration without imposing the nurse's values. It encourages the patient to
express their feelings, which is a key therapeutic communication technique. Giving
advice or false reassurance is non-therapeutic.
3. A 78-year-old patient scores 22/30 on the Mini-Mental State Examination (MMSE).
How should the nurse interpret this result?
A) Normal cognitive function
B) Severe cognitive impairment
C) Moderate cognitive impairment
D) Mild cognitive impairment
Correct Answer: Mild cognitive impairment
Rationale: MMSE scoring typically categorizes 24-30 as normal, 20-23 as mild
cognitive impairment, 10-19 as moderate, and less than 10 as severe. A score of
22/30 falls within the mild cognitive impairment range.
4. When teaching a client how to perform a monthly breast self-assessment, the
nurse should tell the client that it is most important to assess which part of the breast
more closely for changes?
A) Inner quadrant
B) Lower inner quadrant
C) Upper outer quadrant
D) Nipple area
Correct Answer: Upper outer quadrant
, Rationale: The upper outer quadrant of the breast is where most breast tumors are
found, making it crucial for self-assessment. This area should be examined carefully
for any changes during monthly breast self-exams.
5. The nurse is assessing a postmenopausal client who has a BMI of 32. The client has
a chest measurement of 42 inches, a waist measurement of 45 inches, and a hip
measurement of 50 inches. What important message should the nurse explain to the
client to promote health promotion?
A) Focus on increasing physical activity levels.
B) It is important to lose weight to achieve a BMI of 25.
C) A waist circumference greater than 35 inches in women puts you at higher risk for
type 2 diabetes and heart disease.
D) Ask rapid-fire questions to keep the conversation going.
Correct Answer: A waist circumference greater than 35 inches in women puts you at
higher risk for type 2 diabetes and heart disease.
Rationale: A waist circumference greater than 35 inches in women and greater than
40 inches in men is associated with an increased risk of type 2 diabetes,
hypertension, and cardiovascular disease. This is an important health promotion
teaching point.
6. Which assessment technique should the nurse perform first during a physical
examination?
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Correct Answer: Inspection
Assessment (2026) Q&A
1. A nurse is obtaining a symptom history using the OLDCARTS framework. When the
patient states, "The pain started about 3 days ago after I lifted a heavy box," the
nurse recognizes this statement addresses which component of OLDCARTS?
A) Location
B) Character
C) Onset
D) Aggravating factors
Correct Answer: Onset
Rationale: The patient's statement "started about 3 days ago" directly describes
when the symptom began, which defines the Onset component of OLDCARTS. Onset
always answers the question "When did it start?" while Aggravating factors answer
"What makes it worse?"
2. A patient recently diagnosed with breast cancer states, "I don't know how I'm
going to tell my children." Which response by the nurse demonstrates the most
therapeutic communication?
A) "Don't worry, children are resilient and will understand."
B) "You should wait until after your surgery to tell them."
C) "Tell me more about what concerns you most about sharing this news."
D) "Many patients feel this way; you'll figure out the right time."
Correct Answer: "Tell me more about what concerns you most about sharing this
news."
,Rationale: This response uses an open-ended, patient-centered approach that
invites elaboration without imposing the nurse's values. It encourages the patient to
express their feelings, which is a key therapeutic communication technique. Giving
advice or false reassurance is non-therapeutic.
3. A 78-year-old patient scores 22/30 on the Mini-Mental State Examination (MMSE).
How should the nurse interpret this result?
A) Normal cognitive function
B) Severe cognitive impairment
C) Moderate cognitive impairment
D) Mild cognitive impairment
Correct Answer: Mild cognitive impairment
Rationale: MMSE scoring typically categorizes 24-30 as normal, 20-23 as mild
cognitive impairment, 10-19 as moderate, and less than 10 as severe. A score of
22/30 falls within the mild cognitive impairment range.
4. When teaching a client how to perform a monthly breast self-assessment, the
nurse should tell the client that it is most important to assess which part of the breast
more closely for changes?
A) Inner quadrant
B) Lower inner quadrant
C) Upper outer quadrant
D) Nipple area
Correct Answer: Upper outer quadrant
, Rationale: The upper outer quadrant of the breast is where most breast tumors are
found, making it crucial for self-assessment. This area should be examined carefully
for any changes during monthly breast self-exams.
5. The nurse is assessing a postmenopausal client who has a BMI of 32. The client has
a chest measurement of 42 inches, a waist measurement of 45 inches, and a hip
measurement of 50 inches. What important message should the nurse explain to the
client to promote health promotion?
A) Focus on increasing physical activity levels.
B) It is important to lose weight to achieve a BMI of 25.
C) A waist circumference greater than 35 inches in women puts you at higher risk for
type 2 diabetes and heart disease.
D) Ask rapid-fire questions to keep the conversation going.
Correct Answer: A waist circumference greater than 35 inches in women puts you at
higher risk for type 2 diabetes and heart disease.
Rationale: A waist circumference greater than 35 inches in women and greater than
40 inches in men is associated with an increased risk of type 2 diabetes,
hypertension, and cardiovascular disease. This is an important health promotion
teaching point.
6. Which assessment technique should the nurse perform first during a physical
examination?
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Correct Answer: Inspection
