1
Nightingale College BSN 246 HESI Actual
Exam Questions and Answers with
Rationales 2026/2027 | Complete Health
Assessment Exam Prep | Pass Guarantee
Q001: A 68-year-old Hispanic male with a 20-year history of type 2 diabetes
mellitus and hypertension presents for his annual health assessment. He reports
intermittent chest pressure when walking uphill, occasional nocturnal leg cramps,
and tingling in both feet. His vital signs are BP 148/92 mmHg, HR 78 bpm, RR
18/min, Temp 98.6°F, SpO2 94% on room air. During the health history interview,
he mentions his father died of a "heart attack" at age 55 and his mother has chronic
kidney disease. Which assessment approach is most appropriate for this patient's
chief concerns?
Options:
A. Focus only on cardiovascular symptoms and defer peripheral neuropathy
screening
B. Conduct a comprehensive health history followed by system-specific
examinations including cardiovascular, peripheral vascular, and neurological
assessments
C. Prioritize only the nocturnal leg cramps and refer to cardiology for chest
pressure
D. Document only vital signs and schedule a separate appointment for detailed
history taking
ANSWER: B
Q002: A 55-year-old African American female presents to the clinic complaining
of persistent headaches for three weeks, blurred vision, and dizziness. She has a
BMI of 32 kg/m² and reports a family history of stroke. During history taking, she
becomes tearful when discussing recent stressors. Which communication technique
should the nurse use to gather more information about her psychosocial status?
, 2
Options:
A. "Tell me more about what's been causing your stress lately."
B. "Headaches are usually not serious; have you tried over-the-counter
medication?"
C. "We need to focus on your physical symptoms first before discussing emotions."
D. "Everyone experiences stress—let's move on to your medication list."
ANSWER: A
Q003: A 14-year-old male adolescent arrives for a sports physical required for
basketball participation. He denies any chronic health conditions but admits to
occasional wheezing during intense exercise and using his friend's inhaler "once or
twice." His father states, "He's perfectly healthy—just out of shape." Which
component of the health history is most critical before clearing him for sports?
Options:
A. Family history only
B. Social history including substance use only
C. Detailed history of exertional symptoms and objective respiratory assessment
with spirometry
D. Musculoskeletal examination exclusively
ANSWER: C
Q004: A 29-year-old pregnant female at 28 weeks gestation presents for prenatal
assessment. She reports swelling in her legs, occasional heartburn, and difficulty
sleeping on her back. Her blood pressure is 136/84 mmHg. Which assessment
finding would require immediate reporting to the provider?
Options:
A. Mild bilateral pedal edema that resolves with elevation
B. Heartburn after spicy meals
C. Blood pressure of 146/92 mmHg on repeat measurement with frontal headache
, 3
D. Back discomfort when supine
ANSWER: C
Q005: A 77-year-old widowed Caucasian male living independently reports feeling
"down" since his wife's death six months ago, decreased appetite, and forgetting
appointments. During the functional assessment, he scores 24/30 on the Mini-
Mental State Examination (MMSE). Which assessment tool should be used next to
evaluate his mood and suicide risk?
Options:
A. Confusion Assessment Method (CAM)
B. Geriatric Depression Scale (GDS)
C. CAGE questionnaire
D. Morse Fall Scale
ANSWER: B
Q006: A 42-year-old female nurse reports chronic fatigue, joint pain, and
intermittent low-grade fevers for six months. She has a history of hypothyroidism
managed with levothyroxine. Her vital signs are stable, but she appears anxious.
Which critical element must be included in her health history to guide the physical
examination?
Options:
A. Occupational exposure history and detailed review of systems
B. Childhood immunizations only
C. Focused musculoskeletal exam only
D. Family history of mental illness only
ANSWER: A
Q007: A 6-month-old infant is brought to the pediatric clinic for a well-baby check.
The mother reports the baby feeds every 4 hours, has 6-8 wet diapers daily, and is
meeting developmental milestones. Which assessment finding would be considered
a red flag requiring immediate intervention?
, 4
Options:
A. Anterior fontanelle measuring 2 cm × 2 cm
B. Absence of Moro reflex
C. Weight gain of 1 lb since last visit (1 month ago)
D. Posterior fontanelle closed
ANSWER: B
Q008: A 50-year-old transgender female on hormone replacement therapy presents
for routine health screening. She is taking estradiol and spironolactone. Which
preventive screening should be prioritized based on current guidelines?
Options:
A. Prostate-specific antigen (PSA) screening only
B. Breast cancer screening and bone density assessment
C. Cervical cancer screening
D. Testicular examination only
ANSWER: B
Q009: An 18-year-old college freshman presents for a health screening before
dormitory move-in. He reports occasional binge drinking on weekends, denies
tobacco use, and states he is "stressed about grades." He has a BMI of 19 kg/m².
Which screening tool is most appropriate for this age group?
Options:
A. Mini-Cog
B. AUDIT-C (Alcohol Use Disorders Identification Test-Concise)
C. PHQ-9
D. CAGE-AID
ANSWER: B
Nightingale College BSN 246 HESI Actual
Exam Questions and Answers with
Rationales 2026/2027 | Complete Health
Assessment Exam Prep | Pass Guarantee
Q001: A 68-year-old Hispanic male with a 20-year history of type 2 diabetes
mellitus and hypertension presents for his annual health assessment. He reports
intermittent chest pressure when walking uphill, occasional nocturnal leg cramps,
and tingling in both feet. His vital signs are BP 148/92 mmHg, HR 78 bpm, RR
18/min, Temp 98.6°F, SpO2 94% on room air. During the health history interview,
he mentions his father died of a "heart attack" at age 55 and his mother has chronic
kidney disease. Which assessment approach is most appropriate for this patient's
chief concerns?
Options:
A. Focus only on cardiovascular symptoms and defer peripheral neuropathy
screening
B. Conduct a comprehensive health history followed by system-specific
examinations including cardiovascular, peripheral vascular, and neurological
assessments
C. Prioritize only the nocturnal leg cramps and refer to cardiology for chest
pressure
D. Document only vital signs and schedule a separate appointment for detailed
history taking
ANSWER: B
Q002: A 55-year-old African American female presents to the clinic complaining
of persistent headaches for three weeks, blurred vision, and dizziness. She has a
BMI of 32 kg/m² and reports a family history of stroke. During history taking, she
becomes tearful when discussing recent stressors. Which communication technique
should the nurse use to gather more information about her psychosocial status?
, 2
Options:
A. "Tell me more about what's been causing your stress lately."
B. "Headaches are usually not serious; have you tried over-the-counter
medication?"
C. "We need to focus on your physical symptoms first before discussing emotions."
D. "Everyone experiences stress—let's move on to your medication list."
ANSWER: A
Q003: A 14-year-old male adolescent arrives for a sports physical required for
basketball participation. He denies any chronic health conditions but admits to
occasional wheezing during intense exercise and using his friend's inhaler "once or
twice." His father states, "He's perfectly healthy—just out of shape." Which
component of the health history is most critical before clearing him for sports?
Options:
A. Family history only
B. Social history including substance use only
C. Detailed history of exertional symptoms and objective respiratory assessment
with spirometry
D. Musculoskeletal examination exclusively
ANSWER: C
Q004: A 29-year-old pregnant female at 28 weeks gestation presents for prenatal
assessment. She reports swelling in her legs, occasional heartburn, and difficulty
sleeping on her back. Her blood pressure is 136/84 mmHg. Which assessment
finding would require immediate reporting to the provider?
Options:
A. Mild bilateral pedal edema that resolves with elevation
B. Heartburn after spicy meals
C. Blood pressure of 146/92 mmHg on repeat measurement with frontal headache
, 3
D. Back discomfort when supine
ANSWER: C
Q005: A 77-year-old widowed Caucasian male living independently reports feeling
"down" since his wife's death six months ago, decreased appetite, and forgetting
appointments. During the functional assessment, he scores 24/30 on the Mini-
Mental State Examination (MMSE). Which assessment tool should be used next to
evaluate his mood and suicide risk?
Options:
A. Confusion Assessment Method (CAM)
B. Geriatric Depression Scale (GDS)
C. CAGE questionnaire
D. Morse Fall Scale
ANSWER: B
Q006: A 42-year-old female nurse reports chronic fatigue, joint pain, and
intermittent low-grade fevers for six months. She has a history of hypothyroidism
managed with levothyroxine. Her vital signs are stable, but she appears anxious.
Which critical element must be included in her health history to guide the physical
examination?
Options:
A. Occupational exposure history and detailed review of systems
B. Childhood immunizations only
C. Focused musculoskeletal exam only
D. Family history of mental illness only
ANSWER: A
Q007: A 6-month-old infant is brought to the pediatric clinic for a well-baby check.
The mother reports the baby feeds every 4 hours, has 6-8 wet diapers daily, and is
meeting developmental milestones. Which assessment finding would be considered
a red flag requiring immediate intervention?
, 4
Options:
A. Anterior fontanelle measuring 2 cm × 2 cm
B. Absence of Moro reflex
C. Weight gain of 1 lb since last visit (1 month ago)
D. Posterior fontanelle closed
ANSWER: B
Q008: A 50-year-old transgender female on hormone replacement therapy presents
for routine health screening. She is taking estradiol and spironolactone. Which
preventive screening should be prioritized based on current guidelines?
Options:
A. Prostate-specific antigen (PSA) screening only
B. Breast cancer screening and bone density assessment
C. Cervical cancer screening
D. Testicular examination only
ANSWER: B
Q009: An 18-year-old college freshman presents for a health screening before
dormitory move-in. He reports occasional binge drinking on weekends, denies
tobacco use, and states he is "stressed about grades." He has a BMI of 19 kg/m².
Which screening tool is most appropriate for this age group?
Options:
A. Mini-Cog
B. AUDIT-C (Alcohol Use Disorders Identification Test-Concise)
C. PHQ-9
D. CAGE-AID
ANSWER: B
