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BSN 246 HESI HEALTH ASSESSMENT EXAM V2
Actual Exam 2026/2027 Complete Questions and
Verified Answers with Detailed Rationales 100%
Correct Grade A Pass Guaranteed - A+ Graded
SECTION 1: HEALTH HISTORY AND INTERVIEWING (Questions 1-20)
Q1: A 68-year-old female describes her knee pain as "sharp, stabbing, like a knife" that worsens
with climbing stairs. Using OLDCARTS, which elements are documented?
A. Character and Aggravating factors [CORRECT]
B. Location and Duration
C. Severity and Timing
D. Onset and Relieving factors
Rationale: "Sharp, stabbing, like a knife" describes the Character (quality) of pain. "Worsens
with climbing stairs" describes Aggravating factors. The question does not provide information
about when it started (Onset), how long it lasts (Duration), what helps (Relieving), or numerical
rating (Severity).
Q2: During a health history, a patient pauses for 30 seconds after being asked about alcohol use.
Which therapeutic communication technique is most appropriate?
A. Immediately ask a different, less threatening question
B. State "I notice you paused. Take your time—this information helps me care for you safely"
[CORRECT]
C. Document that the patient denied alcohol use
D. Explain the dangers of alcohol to fill the silence
Rationale: Silence often indicates processing, embarrassment, or reluctance. Acknowledging the
pause non-judgmentally allows the patient to gather thoughts. Changing the topic misses data,
assuming denial is inaccurate, and lecturing creates defensiveness.
Q3: A nurse is obtaining a family history and learns the patient's father died of colon cancer at
age 52 and paternal grandfather had colon cancer at age 70. The maternal aunt had breast cancer
at age 45. Which tool best represents these relationships?
A. Pedigree chart using standardized symbols [CORRECT]
B. Narrative paragraph description
,2
C. List of diseases by organ system
D. Flowchart of genetic inheritance only
Rationale: A pedigree (genogram) uses standardized symbols (squares for males, circles for
females, shaded for affected, slash for deceased) to visualize three generations, relationships, and
heritable conditions. This identifies patterns suggesting hereditary cancer syndromes (Lynch
syndrome, BRCA) requiring genetic counseling.
Q4: A patient states they drink "a few beers on weekends." Which screening tool should the
nurse use to assess for alcohol use disorder?
A. CAGE questionnaire [CORRECT]
B. Mini-Mental State Examination
C. Geriatric Depression Scale
D. Braden Scale
Rationale: The CAGE (Cut down, Annoyed, Guilty, Eye-opener) is a validated 4-question
screening tool for alcohol use disorder. MMSE assesses cognition, GDS assesses depression, and
Braden Scale assesses pressure ulcer risk.
Q5: When interviewing a patient whose cultural background values indirect communication, the
nurse should:
A. Ask only yes/no questions to avoid confusion
B. Use open-ended questions and allow time for responses [CORRECT]
C. Speak loudly to ensure understanding
D. Insist on direct eye contact to establish trust
Rationale: Cultures with indirect communication styles (many Asian, Native American, and
Middle Eastern cultures) may pause before answering, use context-dependent speech, or find
direct questions intrusive. Open-ended questions respect this style. Loud speech is
condescending, and forced eye contact may violate cultural norms.
Q6: A patient describes pain as "burning, radiating from my chest to my jaw, 8/10, worse with
exertion, better with rest." Which PQRST components are present?
A. Provocative, Quality, Region/Radiation, Severity, Timing
B. Quality, Region/Radiation, Severity, Provocative/Palliative [CORRECT]
C. Palliative, Quality, Severity, Timing only
D. All PQRST components
,3
Rationale: "Burning" = Quality; "chest to jaw" = Region/Radiation; "8/10" = Severity; "worse
with exertion" = Provocative; "better with rest" = Palliative. Timing (when it started, constant vs.
intermittent) is not mentioned.
Q7: When using motivational interviewing to encourage medication adherence, which statement
demonstrates "Reflection"?
A. "You mentioned forgetting doses when busy. It sounds like your schedule makes consistency
challenging" [CORRECT]
B. "Taking your medication daily will prevent heart attacks"
C. "On a scale of 1-10, how important is taking this medication?"
D. "I can see you've been trying to remember your pills"
Rationale: Reflection mirrors the patient's statement to show understanding and explore
ambivalence. Option A reflects the barrier (schedule). Option B is advising, C is assessing
readiness, and D is affirmation. OARS = Open-ended questions, Affirmations, Reflections,
Summarizing.
Q8: A patient becomes tearful when discussing a recent job loss. The nurse's best response is:
A. "Don't cry—things will get better"
B. "I can see this is difficult. Would you like to talk about how this affects your health?"
[CORRECT]
C. "Let's focus on your physical symptoms"
D. "Have you applied for unemployment?"
Rationale: Acknowledging emotion and connecting it to health allows psychosocial assessment.
Dismissing feelings, redirecting prematurely, or problem-solving immediately minimizes the
patient's experience and may miss relevant health impacts (stress, depression, insurance loss).
Q9: When calculating pack-years for a patient who smoked 1 pack daily for 15 years, then half a
pack for 10 years:
A. 15 pack-years
B. 20 pack-years [CORRECT]
C. 25 pack-years
D. 30 pack-years
, 4
Rationale: Pack-years = (packs/day × years). Calculation: (1 × 15) + (0.5 × 10) = 15 + 5 = 20
pack-years. This quantifies exposure for cancer/COPD screening eligibility (e.g., annual low-
dose CT for lung cancer screening in 20+ pack-year smokers).
Q10: A patient with limited English proficiency nods "yes" to all questions including "Do you
have chest pain?" and "Do you have a headache?" The nurse should:
A. Accept the responses as accurate
B. Use a professional interpreter and teach-back [CORRECT]
C. Speak louder and slower in English
D. Ask the family member to translate
Rationale: Nodding may indicate politeness or partial understanding rather than accurate
responses. Professional interpreters ensure accurate health history. Family members may filter
information, violate confidentiality, or mistranslate medical terms. Teach-back verifies
understanding.
Q11: Which question best assesses health literacy?
A. "Do you understand your medication instructions?"
B. "Please show me how you would take this medication on a typical day" [CORRECT]
C. "Would you like written instructions?"
D. "Have you taken this before?"
Rationale: Demonstration (show-back) reveals true comprehension better than self-reported
understanding. Health literacy assessment requires patients to perform or explain tasks in their
own words, identifying gaps in comprehension that yes/no questions miss.
Q12: During review of systems, a patient mentions "blood in my stool yesterday." This should be
documented in which system?
A. Gastrointestinal [CORRECT]
B. Cardiovascular
C. Hematologic
D. Integumentary
Rationale: Hematochezia (bright red blood per rectum) is a gastrointestinal symptom requiring
investigation (hemorrhoids, diverticulosis, colorectal cancer, inflammatory bowel disease). While
blood is involved, the source determines the system. This finding requires immediate provider
notification.
BSN 246 HESI HEALTH ASSESSMENT EXAM V2
Actual Exam 2026/2027 Complete Questions and
Verified Answers with Detailed Rationales 100%
Correct Grade A Pass Guaranteed - A+ Graded
SECTION 1: HEALTH HISTORY AND INTERVIEWING (Questions 1-20)
Q1: A 68-year-old female describes her knee pain as "sharp, stabbing, like a knife" that worsens
with climbing stairs. Using OLDCARTS, which elements are documented?
A. Character and Aggravating factors [CORRECT]
B. Location and Duration
C. Severity and Timing
D. Onset and Relieving factors
Rationale: "Sharp, stabbing, like a knife" describes the Character (quality) of pain. "Worsens
with climbing stairs" describes Aggravating factors. The question does not provide information
about when it started (Onset), how long it lasts (Duration), what helps (Relieving), or numerical
rating (Severity).
Q2: During a health history, a patient pauses for 30 seconds after being asked about alcohol use.
Which therapeutic communication technique is most appropriate?
A. Immediately ask a different, less threatening question
B. State "I notice you paused. Take your time—this information helps me care for you safely"
[CORRECT]
C. Document that the patient denied alcohol use
D. Explain the dangers of alcohol to fill the silence
Rationale: Silence often indicates processing, embarrassment, or reluctance. Acknowledging the
pause non-judgmentally allows the patient to gather thoughts. Changing the topic misses data,
assuming denial is inaccurate, and lecturing creates defensiveness.
Q3: A nurse is obtaining a family history and learns the patient's father died of colon cancer at
age 52 and paternal grandfather had colon cancer at age 70. The maternal aunt had breast cancer
at age 45. Which tool best represents these relationships?
A. Pedigree chart using standardized symbols [CORRECT]
B. Narrative paragraph description
,2
C. List of diseases by organ system
D. Flowchart of genetic inheritance only
Rationale: A pedigree (genogram) uses standardized symbols (squares for males, circles for
females, shaded for affected, slash for deceased) to visualize three generations, relationships, and
heritable conditions. This identifies patterns suggesting hereditary cancer syndromes (Lynch
syndrome, BRCA) requiring genetic counseling.
Q4: A patient states they drink "a few beers on weekends." Which screening tool should the
nurse use to assess for alcohol use disorder?
A. CAGE questionnaire [CORRECT]
B. Mini-Mental State Examination
C. Geriatric Depression Scale
D. Braden Scale
Rationale: The CAGE (Cut down, Annoyed, Guilty, Eye-opener) is a validated 4-question
screening tool for alcohol use disorder. MMSE assesses cognition, GDS assesses depression, and
Braden Scale assesses pressure ulcer risk.
Q5: When interviewing a patient whose cultural background values indirect communication, the
nurse should:
A. Ask only yes/no questions to avoid confusion
B. Use open-ended questions and allow time for responses [CORRECT]
C. Speak loudly to ensure understanding
D. Insist on direct eye contact to establish trust
Rationale: Cultures with indirect communication styles (many Asian, Native American, and
Middle Eastern cultures) may pause before answering, use context-dependent speech, or find
direct questions intrusive. Open-ended questions respect this style. Loud speech is
condescending, and forced eye contact may violate cultural norms.
Q6: A patient describes pain as "burning, radiating from my chest to my jaw, 8/10, worse with
exertion, better with rest." Which PQRST components are present?
A. Provocative, Quality, Region/Radiation, Severity, Timing
B. Quality, Region/Radiation, Severity, Provocative/Palliative [CORRECT]
C. Palliative, Quality, Severity, Timing only
D. All PQRST components
,3
Rationale: "Burning" = Quality; "chest to jaw" = Region/Radiation; "8/10" = Severity; "worse
with exertion" = Provocative; "better with rest" = Palliative. Timing (when it started, constant vs.
intermittent) is not mentioned.
Q7: When using motivational interviewing to encourage medication adherence, which statement
demonstrates "Reflection"?
A. "You mentioned forgetting doses when busy. It sounds like your schedule makes consistency
challenging" [CORRECT]
B. "Taking your medication daily will prevent heart attacks"
C. "On a scale of 1-10, how important is taking this medication?"
D. "I can see you've been trying to remember your pills"
Rationale: Reflection mirrors the patient's statement to show understanding and explore
ambivalence. Option A reflects the barrier (schedule). Option B is advising, C is assessing
readiness, and D is affirmation. OARS = Open-ended questions, Affirmations, Reflections,
Summarizing.
Q8: A patient becomes tearful when discussing a recent job loss. The nurse's best response is:
A. "Don't cry—things will get better"
B. "I can see this is difficult. Would you like to talk about how this affects your health?"
[CORRECT]
C. "Let's focus on your physical symptoms"
D. "Have you applied for unemployment?"
Rationale: Acknowledging emotion and connecting it to health allows psychosocial assessment.
Dismissing feelings, redirecting prematurely, or problem-solving immediately minimizes the
patient's experience and may miss relevant health impacts (stress, depression, insurance loss).
Q9: When calculating pack-years for a patient who smoked 1 pack daily for 15 years, then half a
pack for 10 years:
A. 15 pack-years
B. 20 pack-years [CORRECT]
C. 25 pack-years
D. 30 pack-years
, 4
Rationale: Pack-years = (packs/day × years). Calculation: (1 × 15) + (0.5 × 10) = 15 + 5 = 20
pack-years. This quantifies exposure for cancer/COPD screening eligibility (e.g., annual low-
dose CT for lung cancer screening in 20+ pack-year smokers).
Q10: A patient with limited English proficiency nods "yes" to all questions including "Do you
have chest pain?" and "Do you have a headache?" The nurse should:
A. Accept the responses as accurate
B. Use a professional interpreter and teach-back [CORRECT]
C. Speak louder and slower in English
D. Ask the family member to translate
Rationale: Nodding may indicate politeness or partial understanding rather than accurate
responses. Professional interpreters ensure accurate health history. Family members may filter
information, violate confidentiality, or mistranslate medical terms. Teach-back verifies
understanding.
Q11: Which question best assesses health literacy?
A. "Do you understand your medication instructions?"
B. "Please show me how you would take this medication on a typical day" [CORRECT]
C. "Would you like written instructions?"
D. "Have you taken this before?"
Rationale: Demonstration (show-back) reveals true comprehension better than self-reported
understanding. Health literacy assessment requires patients to perform or explain tasks in their
own words, identifying gaps in comprehension that yes/no questions miss.
Q12: During review of systems, a patient mentions "blood in my stool yesterday." This should be
documented in which system?
A. Gastrointestinal [CORRECT]
B. Cardiovascular
C. Hematologic
D. Integumentary
Rationale: Hematochezia (bright red blood per rectum) is a gastrointestinal symptom requiring
investigation (hemorrhoids, diverticulosis, colorectal cancer, inflammatory bowel disease). While
blood is involved, the source determines the system. This finding requires immediate provider
notification.
