BSN 246 HESI Health Assessment Exam V1
– Academic Year 2026/2027 –
Comprehensive Examination
ACTUAL QUESTIONS
Domain 1: Health Promotion and Disease Prevention
Question 1. A nurse is counseling a 45-year-old client about primary
prevention strategies. Which activity best exemplifies primary prevention?
A. Screening mammography for early detection of breast cancer
B. Cardiac rehabilitation after myocardial infarction
C. Administration of the annual influenza vaccine
D. Physical therapy for residual stroke deficits
Correct Answer: C
Rationale: Primary prevention aims to prevent disease before it occurs.
Immunization is a classic primary prevention intervention that reduces the risk of
influenza infection in susceptible individuals.
Question 2. According to current health-promotion guidelines, at what age
should average-risk adults begin routine colorectal cancer screening with
colonoscopy?
A. 45 years
B. 30 years
C. 55 years
D. 65 years
Correct Answer: A
Rationale: Updated guidelines recommend initiating average-risk colorectal cancer
screening at age 45. Earlier screening is reserved for individuals with increased
risk factors such as family history or inflammatory bowel disease.
Question 3. A client asks about the most effective behavioral intervention for
reducing cardiovascular risk. Which recommendation has the strongest
evidence base?
A. Taking a multivitamin daily
B. Restricting all dietary fat to less than 10% of calories
,C. Drinking red wine nightly
D. Achieving and maintaining a healthy body weight through diet and regular
physical activity
Correct Answer: D
Rationale: Weight management combined with regular aerobic activity produces
the greatest reduction in cardiovascular risk factors, including blood pressure, lipid
profile, and insulin sensitivity.
Question 4. Which immunization is recommended for all adults aged 65 years
and older to reduce the risk of invasive pneumococcal disease?
A. Human papillomavirus (HPV) vaccine
B. Pneumococcal conjugate or polysaccharide vaccine according to current
schedule
C. Measles-mumps-rubella (MMR) booster every 10 years
D. Hepatitis A vaccine series
Correct Answer: B
Rationale: Adults aged 65 and older should receive pneumococcal vaccination
(PCV20 or PCV15 followed by PPSV23) to protect against Streptococcus
pneumoniae infections.
Question 5. A nurse is teaching a group of older adults about fall prevention.
Which instruction is most important to include?
A. "Avoid all physical activity to prevent falls."
B. "Use a cane or walker only if you feel unsteady."
C. "Review your medications with your provider to identify those that may cause
dizziness."
D. "Keep the lights dim at night to avoid glare."
Correct Answer: C
Rationale: Polypharmacy and medications that cause sedation, orthostatic
hypotension, or dizziness are major modifiable risk factors for falls. Medication
review is a critical preventive intervention.
Question 6. Which screening is recommended for all adults regardless of risk
factors to detect hypertension?
A. Blood pressure measurement at every healthcare encounter
B. Annual electrocardiogram
C. Serum lipid panel every 5 years
D. Routine echocardiogram
,Correct Answer: A
Rationale: The USPSTF recommends screening for hypertension with blood
pressure measurement at every healthcare encounter for all adults 18 years and
older.
Question 7. A 50-year-old client with a BMI of 32 asks about health risks.
What is the most appropriate nursing response?
A. "Your BMI is within normal limits."
B. "Obesity increases your risk for type 2 diabetes, hypertension, and
cardiovascular disease."
C. "You only need to worry about your weight if you have symptoms."
D. "BMI is not a useful indicator of health."
Correct Answer: B
Rationale: A BMI of 32 falls into the obese class I category, which is associated
with an increased risk of multiple chronic conditions including type 2 diabetes,
hypertension, and cardiovascular disease.
Question 8. Which intervention is an example of secondary prevention?
A. Administering the HPV vaccine
B. Providing smoking cessation counseling
C. Performing a Pap smear for cervical cancer screening
D. Offering a support group for cancer survivors
Correct Answer: C
Rationale: Secondary prevention focuses on early detection of disease through
screening. A Pap smear detects precancerous or cancerous changes early, allowing
for timely intervention.
Question 9. A nurse is assessing a client's readiness to quit smoking. Which
stage of change is the client in if they state, "I know I should quit, but I enjoy
smoking too much"?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
Correct Answer: B
Rationale: In the contemplation stage, the client is aware of the problem and
considering change but is ambivalent. The nurse should help explore the pros and
cons of quitting.
, Question 10. Which dietary recommendation is most appropriate for a client
with hypertension?
A. Increase sodium intake to prevent dehydration
B. Follow the DASH diet, rich in fruits, vegetables, and low-fat dairy
C. Avoid all carbohydrates
D. Increase red meat consumption
Correct Answer: B
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet is clinically
proven to lower blood pressure.
Question 11. A 70-year-old client asks about the shingles vaccine. What is the
recommended schedule for the recombinant zoster vaccine (RZV)?
A. One dose
B. Two doses, 2 to 6 months apart
C. Three doses, 6 months apart
D. Annual booster
Correct Answer: B
Rationale: The recombinant zoster vaccine (Shingrix) is administered in two doses,
2 to 6 months apart, for adults aged 50 and older.
Question 12. What is the primary purpose of a health risk assessment?
A. To diagnose acute illnesses
B. To identify modifiable risk factors and guide preventive interventions
C. To prescribe medications
D. To document past medical history only
Correct Answer: B
Rationale: Health risk assessments identify behaviors and conditions that increase
the risk of disease, guiding tailored preventive counseling and screening.
Question 13. A client reports a sedentary lifestyle. Which recommendation is
most appropriate?
A. "You should run a marathon within 6 months."
B. "Start with 150 minutes of moderate-intensity aerobic activity per week,
gradually."
C. "Exercise only on weekends."
D. "Avoid exercise until you lose weight."
Correct Answer: B
Rationale: Current guidelines recommend at least 150 minutes of moderate-
– Academic Year 2026/2027 –
Comprehensive Examination
ACTUAL QUESTIONS
Domain 1: Health Promotion and Disease Prevention
Question 1. A nurse is counseling a 45-year-old client about primary
prevention strategies. Which activity best exemplifies primary prevention?
A. Screening mammography for early detection of breast cancer
B. Cardiac rehabilitation after myocardial infarction
C. Administration of the annual influenza vaccine
D. Physical therapy for residual stroke deficits
Correct Answer: C
Rationale: Primary prevention aims to prevent disease before it occurs.
Immunization is a classic primary prevention intervention that reduces the risk of
influenza infection in susceptible individuals.
Question 2. According to current health-promotion guidelines, at what age
should average-risk adults begin routine colorectal cancer screening with
colonoscopy?
A. 45 years
B. 30 years
C. 55 years
D. 65 years
Correct Answer: A
Rationale: Updated guidelines recommend initiating average-risk colorectal cancer
screening at age 45. Earlier screening is reserved for individuals with increased
risk factors such as family history or inflammatory bowel disease.
Question 3. A client asks about the most effective behavioral intervention for
reducing cardiovascular risk. Which recommendation has the strongest
evidence base?
A. Taking a multivitamin daily
B. Restricting all dietary fat to less than 10% of calories
,C. Drinking red wine nightly
D. Achieving and maintaining a healthy body weight through diet and regular
physical activity
Correct Answer: D
Rationale: Weight management combined with regular aerobic activity produces
the greatest reduction in cardiovascular risk factors, including blood pressure, lipid
profile, and insulin sensitivity.
Question 4. Which immunization is recommended for all adults aged 65 years
and older to reduce the risk of invasive pneumococcal disease?
A. Human papillomavirus (HPV) vaccine
B. Pneumococcal conjugate or polysaccharide vaccine according to current
schedule
C. Measles-mumps-rubella (MMR) booster every 10 years
D. Hepatitis A vaccine series
Correct Answer: B
Rationale: Adults aged 65 and older should receive pneumococcal vaccination
(PCV20 or PCV15 followed by PPSV23) to protect against Streptococcus
pneumoniae infections.
Question 5. A nurse is teaching a group of older adults about fall prevention.
Which instruction is most important to include?
A. "Avoid all physical activity to prevent falls."
B. "Use a cane or walker only if you feel unsteady."
C. "Review your medications with your provider to identify those that may cause
dizziness."
D. "Keep the lights dim at night to avoid glare."
Correct Answer: C
Rationale: Polypharmacy and medications that cause sedation, orthostatic
hypotension, or dizziness are major modifiable risk factors for falls. Medication
review is a critical preventive intervention.
Question 6. Which screening is recommended for all adults regardless of risk
factors to detect hypertension?
A. Blood pressure measurement at every healthcare encounter
B. Annual electrocardiogram
C. Serum lipid panel every 5 years
D. Routine echocardiogram
,Correct Answer: A
Rationale: The USPSTF recommends screening for hypertension with blood
pressure measurement at every healthcare encounter for all adults 18 years and
older.
Question 7. A 50-year-old client with a BMI of 32 asks about health risks.
What is the most appropriate nursing response?
A. "Your BMI is within normal limits."
B. "Obesity increases your risk for type 2 diabetes, hypertension, and
cardiovascular disease."
C. "You only need to worry about your weight if you have symptoms."
D. "BMI is not a useful indicator of health."
Correct Answer: B
Rationale: A BMI of 32 falls into the obese class I category, which is associated
with an increased risk of multiple chronic conditions including type 2 diabetes,
hypertension, and cardiovascular disease.
Question 8. Which intervention is an example of secondary prevention?
A. Administering the HPV vaccine
B. Providing smoking cessation counseling
C. Performing a Pap smear for cervical cancer screening
D. Offering a support group for cancer survivors
Correct Answer: C
Rationale: Secondary prevention focuses on early detection of disease through
screening. A Pap smear detects precancerous or cancerous changes early, allowing
for timely intervention.
Question 9. A nurse is assessing a client's readiness to quit smoking. Which
stage of change is the client in if they state, "I know I should quit, but I enjoy
smoking too much"?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
Correct Answer: B
Rationale: In the contemplation stage, the client is aware of the problem and
considering change but is ambivalent. The nurse should help explore the pros and
cons of quitting.
, Question 10. Which dietary recommendation is most appropriate for a client
with hypertension?
A. Increase sodium intake to prevent dehydration
B. Follow the DASH diet, rich in fruits, vegetables, and low-fat dairy
C. Avoid all carbohydrates
D. Increase red meat consumption
Correct Answer: B
Rationale: The DASH (Dietary Approaches to Stop Hypertension) diet is clinically
proven to lower blood pressure.
Question 11. A 70-year-old client asks about the shingles vaccine. What is the
recommended schedule for the recombinant zoster vaccine (RZV)?
A. One dose
B. Two doses, 2 to 6 months apart
C. Three doses, 6 months apart
D. Annual booster
Correct Answer: B
Rationale: The recombinant zoster vaccine (Shingrix) is administered in two doses,
2 to 6 months apart, for adults aged 50 and older.
Question 12. What is the primary purpose of a health risk assessment?
A. To diagnose acute illnesses
B. To identify modifiable risk factors and guide preventive interventions
C. To prescribe medications
D. To document past medical history only
Correct Answer: B
Rationale: Health risk assessments identify behaviors and conditions that increase
the risk of disease, guiding tailored preventive counseling and screening.
Question 13. A client reports a sedentary lifestyle. Which recommendation is
most appropriate?
A. "You should run a marathon within 6 months."
B. "Start with 150 minutes of moderate-intensity aerobic activity per week,
gradually."
C. "Exercise only on weekends."
D. "Avoid exercise until you lose weight."
Correct Answer: B
Rationale: Current guidelines recommend at least 150 minutes of moderate-
