SN 246 HESI Health Assessment
B
Exam V1 ACTUAL EXAM 2026/2027 |
Version V1 | Health Assessment HESI
| Verified Q&A | Pass Guaranteed - A+
Graded
ART A – MULTIPLE CHOICE (Q1-65)
P
Q1 (Health history – OLDCARTS): A nurse is interviewing a patient who reports chest pain.
Using the OLDCARTS mnemonic, which question best assesses the "T" component?
A. "How long does the pain typically last?"
B. "Does anything make the pain better or worse?"
C. "On a scale of 0-10, how severe is the pain?"
D. "Is the pain sharp, dull, or pressure-like?"
[CORRECT] A
Rationale: The HESI Health Assessment blueprint identifies OLDCARTS as the standard
symptom analysis framework, where "T" stands for Timing (duration, frequency, onset). "How
long does the pain typically last?" directly assesses duration, which is the timing component.
Distractor B assesses "A" (Alleviating/Aggravating factors), C assesses "S" (Severity), and D
assesses "D" (Description). HESI Tip: Memorize OLDCARTS completely—Onset, Location,
Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, and Severity—to quickly
eliminate wrong options on symptom analysis questions.
Q2 (Communication – therapeutic techniques): A patient newly diagnosed with diabetes states,
"I don't think I can manage this disease." Which response demonstrates the best therapeutic
communication technique?
A. "Don't worry, many people live normal lives with diabetes."
B. "Tell me more about what concerns you most about managing your diabetes."
C. "You should be grateful it's not something more serious."
D. "Have you talked to your doctor about your concerns?"
[CORRECT] B
Rationale: The HESI blueprint and NCLEX-RN test plan emphasize open-ended questions and
active listening as core therapeutic communication techniques. "Tell me more about what
concerns you most" is an open-ended response that encourages the patient to express feelings
and promotes trust. Distractor A is false reassurance (non-therapeutic), C minimizes the
patient's feelings, and D redirects to the physician rather than exploring the patient's concerns.
HESI Tip: On communication questions, select the option that encourages patient expression;
avoid false reassurance, advice-giving, or changing the subject.
, 3 (Mental status – PHQ-9): A patient scores 12 on the PHQ-9 depression screening tool. How
Q
should the nurse interpret this score?
A. Minimal depression
B. Mild depression
C. Moderate depression
D. Severe depression
[CORRECT] C
Rationale: The 2026/2027 HESI blueprint includes mental health screening tools, and the
PHQ-9 scoring is: 1-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, and 20-27
severe depression. A score of 12 falls within the moderate range (10-14). Distractor A (1-4), B
(5-9), and D (15-19) represent incorrect scoring ranges. HESI Tip: Memorize PHQ-9 cutoffs—10
is the critical threshold for moderate depression requiring treatment evaluation, and 15+
indicates more severe pathology.
Q4 (Vital signs – orthostatic hypotension): A nurse measures a patient's blood pressure: supine
124/78 mmHg, sitting 110/72 mmHg, standing 98/68 mmHg with dizziness. What is the priority
nursing action?
A. Document the findings and continue routine monitoring
B. Assist the patient back to a supine position immediately
C. Administer a fluid bolus per protocol
D. Notify the provider of suspected orthostatic hypotension
[CORRECT] B
Rationale: The HESI blueprint and safety standards prioritize patient safety above all else.
Orthostatic hypotension is defined as a drop of ≥20 mmHg systolic or ≥10 mmHg diastolic upon
standing, with symptoms. The immediate priority is to prevent syncope and injury by returning
the patient to a supine position. Distractor A delays necessary intervention, C requires a
provider order, and D is appropriate but secondary to immediate safety. HESI Tip: On HESI
safety questions, always select the action that directly protects the patient from immediate harm
before assessment, notification, or documentation.
Q5 (Pain assessment – PQRST): A nurse is assessing a patient with abdominal pain. Which
question addresses the "Q" component of the PQRST pain assessment?
A. "Does the pain radiate anywhere?"
B. "What makes the pain better or worse?"
C. "How would you describe the quality of the pain?"
D. "When did the pain first start?"
[CORRECT] C
Rationale: The HESI Health Assessment blueprint and evidence-based pain assessment
guidelines use PQRST where "Q" stands for Quality (description of the pain—sharp, dull,
burning, cramping). "How would you describe the quality of the pain?" directly addresses this
component. Distractor A assesses "R" (Radiation/Region), B assesses "P"
(Provocative/Palliative), and D assesses "T" (Timing). HESI Tip: PQRST stands for
Provocative/Palliative, Quality, Region/Radiation, Severity, Timing—master this mnemonic as it
appears frequently on HESI pain assessment questions.
Q6 (Physical assessment – percussion sounds): During abdominal percussion, the nurse hears
a loud, high-pitched, drum-like sound over the stomach. This sound is classified as:
, . Resonance
A
B. Dullness
C. Tympany
D. Flatness
[CORRECT] C
Rationale: The HESI blueprint includes percussion technique and sound interpretation, where
tympany is a loud, high-pitched, drum-like sound heard over air-filled structures such as the
stomach and intestines. Distractor A (resonance) is heard over normal lung tissue, B (dullness)
over solid organs or fluid, and D (flatness) over very dense tissue or bone. HESI Tip: Associate
tympany with "Tympani drums"—both are loud, musical, and air-filled; this auditory association
helps recall the correct percussion sound.
Q7 (Skin assessment – lesion identification): A patient presents with a raised, solid lesion
measuring 0.8 cm in diameter on the forearm. This lesion is best described as a:
A. Macule
B. Papule
C. Vesicle
D. Pustule
[CORRECT] B
Rationale: The HESI blueprint and Jarvis/Weber guidelines classify skin lesions by
characteristics: a papule is a raised, solid lesion less than 1 cm in diameter. Distractor A
(macule) is flat and non-palpable, C (vesicle) is a fluid-filled blister less than 1 cm, and D
(pustule) contains purulent exudate. HESI Tip: For lesion questions, remember "Papules are
Palpable" (both start with P) and "Macules are Macular/flat" (non-palpable); size thresholds (<1
cm vs. >1 cm) also determine classification.
Q8 (Head/neck – thyroid palpation): When palpating the thyroid gland, the nurse should stand:
A. Behind the patient with fingers placed on either side of the trachea
B. In front of the patient with thumbs placed on the thyroid cartilage
C. To the right of the patient using the dominant hand only
D. Facing the patient with fingertips placed over the cricoid cartilage
[CORRECT] A
Rationale: The HESI blueprint and evidence-based health assessment (Jarvis) recommend the
posterior approach for thyroid palpation, where the examiner stands behind the patient, places
fingers on either side of the trachea below the thyroid cartilage, and asks the patient to swallow.
Distractor B describes an anterior approach that is less optimal for full gland assessment, C is
incomplete and unsafe, and D places fingers too low at the cricoid cartilage. HESI Tip: On
thyroid palpation questions, remember "posterior is preferred" for comprehensive assessment;
the swallowing maneuver helps the gland move upward for better palpation.
Q9 (Eyes – PERRLA): During pupillary assessment, the nurse notes that the patient's pupils are
equal, round, and reactive to light and accommodation. The acronym for this finding is:
A. PERRLA
B. EOMI
C. PERLA
D. PERRL
[CORRECT] A
, ationale: The HESI blueprint and standard documentation use PERRLA (Pupils Equal, Round,
R
Reactive to Light and Accommodation) as the complete acronym for normal pupillary findings.
Distractor B (EOMI) refers to extraocular movements intact, C (PERLA) omits the second "R" for
round, and D (PERRL) omits accommodation. HESI Tip: PERRLA is the most complete and
current documentation standard; HESI often tests the full acronym including accommodation,
especially in neurological assessment questions.
Q10 (Ears – Rinne test): A nurse performs the Rinne test and finds that air conduction (AC) is
greater than bone conduction (BC) in the right ear. This result indicates:
A. Conductive hearing loss in the right ear
B. Sensorineural hearing loss in the right ear
C. Normal hearing in the right ear
D. Mixed hearing loss in the right ear
[CORRECT] C
Rationale: The HESI blueprint includes the Rinne test interpretation, where AC > BC (positive
Rinne) indicates normal hearing or sensorineural loss, as sound is conducted better through air
than bone in a normal ear. Distractor A (conductive loss) would show BC > AC (negative Rinne),
B is incorrect because sensorineural loss also shows AC > BC but with reduced overall hearing,
and D requires additional Weber test confirmation. HESI Tip: Remember "AC > BC = Air
Conduction is Better than Bone Conduction = Normal or Sensorineural"; BC > AC indicates
conductive loss. Always pair Rinne with Weber for complete diagnosis.
Q11 (Ears – Weber test): During the Weber test, a patient reports that the sound lateralizes to
the left ear. This finding suggests:
A. Conductive hearing loss in the left ear or sensorineural loss in the right ear
B. Sensorineural hearing loss in the left ear or conductive loss in the right ear
C. Normal hearing bilaterally
D. Bilateral conductive hearing loss
[CORRECT] A
Rationale: The HESI blueprint and Weber test principles state that sound lateralizes to the
affected ear in conductive hearing loss (due to reduced ambient noise) and to the unaffected ear
in sensorineural loss. Therefore, lateralization to the left suggests conductive loss in the left ear
OR sensorineural loss in the right ear. Distractor B reverses the pathology, C would show no
lateralization, and D would produce inconsistent results. HESI Tip: Use the mnemonic "COWS"
for Weber—Conductive loss = Opposite ear affected (sound goes TO affected ear),
Sensorineural = Weber goes to Unaffected ear (Same side = conductive).
Q12 (Thorax/lungs – breath sounds): A nurse auscultates the lungs and hears soft, low-pitched
sounds during inspiration and soft, shorter sounds during expiration over the peripheral lung
fields. These are:
A. Bronchial breath sounds
B. Bronchovesicular breath sounds
C. Vesicular breath sounds
D. Tracheal breath sounds
[CORRECT] C
Rationale: The HESI blueprint and respiratory assessment guidelines define vesicular breath
sounds as soft, low-pitched, rustling sounds heard over peripheral lung fields, with inspiration
B
Exam V1 ACTUAL EXAM 2026/2027 |
Version V1 | Health Assessment HESI
| Verified Q&A | Pass Guaranteed - A+
Graded
ART A – MULTIPLE CHOICE (Q1-65)
P
Q1 (Health history – OLDCARTS): A nurse is interviewing a patient who reports chest pain.
Using the OLDCARTS mnemonic, which question best assesses the "T" component?
A. "How long does the pain typically last?"
B. "Does anything make the pain better or worse?"
C. "On a scale of 0-10, how severe is the pain?"
D. "Is the pain sharp, dull, or pressure-like?"
[CORRECT] A
Rationale: The HESI Health Assessment blueprint identifies OLDCARTS as the standard
symptom analysis framework, where "T" stands for Timing (duration, frequency, onset). "How
long does the pain typically last?" directly assesses duration, which is the timing component.
Distractor B assesses "A" (Alleviating/Aggravating factors), C assesses "S" (Severity), and D
assesses "D" (Description). HESI Tip: Memorize OLDCARTS completely—Onset, Location,
Duration, Character, Aggravating/Alleviating factors, Radiation, Timing, and Severity—to quickly
eliminate wrong options on symptom analysis questions.
Q2 (Communication – therapeutic techniques): A patient newly diagnosed with diabetes states,
"I don't think I can manage this disease." Which response demonstrates the best therapeutic
communication technique?
A. "Don't worry, many people live normal lives with diabetes."
B. "Tell me more about what concerns you most about managing your diabetes."
C. "You should be grateful it's not something more serious."
D. "Have you talked to your doctor about your concerns?"
[CORRECT] B
Rationale: The HESI blueprint and NCLEX-RN test plan emphasize open-ended questions and
active listening as core therapeutic communication techniques. "Tell me more about what
concerns you most" is an open-ended response that encourages the patient to express feelings
and promotes trust. Distractor A is false reassurance (non-therapeutic), C minimizes the
patient's feelings, and D redirects to the physician rather than exploring the patient's concerns.
HESI Tip: On communication questions, select the option that encourages patient expression;
avoid false reassurance, advice-giving, or changing the subject.
, 3 (Mental status – PHQ-9): A patient scores 12 on the PHQ-9 depression screening tool. How
Q
should the nurse interpret this score?
A. Minimal depression
B. Mild depression
C. Moderate depression
D. Severe depression
[CORRECT] C
Rationale: The 2026/2027 HESI blueprint includes mental health screening tools, and the
PHQ-9 scoring is: 1-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, and 20-27
severe depression. A score of 12 falls within the moderate range (10-14). Distractor A (1-4), B
(5-9), and D (15-19) represent incorrect scoring ranges. HESI Tip: Memorize PHQ-9 cutoffs—10
is the critical threshold for moderate depression requiring treatment evaluation, and 15+
indicates more severe pathology.
Q4 (Vital signs – orthostatic hypotension): A nurse measures a patient's blood pressure: supine
124/78 mmHg, sitting 110/72 mmHg, standing 98/68 mmHg with dizziness. What is the priority
nursing action?
A. Document the findings and continue routine monitoring
B. Assist the patient back to a supine position immediately
C. Administer a fluid bolus per protocol
D. Notify the provider of suspected orthostatic hypotension
[CORRECT] B
Rationale: The HESI blueprint and safety standards prioritize patient safety above all else.
Orthostatic hypotension is defined as a drop of ≥20 mmHg systolic or ≥10 mmHg diastolic upon
standing, with symptoms. The immediate priority is to prevent syncope and injury by returning
the patient to a supine position. Distractor A delays necessary intervention, C requires a
provider order, and D is appropriate but secondary to immediate safety. HESI Tip: On HESI
safety questions, always select the action that directly protects the patient from immediate harm
before assessment, notification, or documentation.
Q5 (Pain assessment – PQRST): A nurse is assessing a patient with abdominal pain. Which
question addresses the "Q" component of the PQRST pain assessment?
A. "Does the pain radiate anywhere?"
B. "What makes the pain better or worse?"
C. "How would you describe the quality of the pain?"
D. "When did the pain first start?"
[CORRECT] C
Rationale: The HESI Health Assessment blueprint and evidence-based pain assessment
guidelines use PQRST where "Q" stands for Quality (description of the pain—sharp, dull,
burning, cramping). "How would you describe the quality of the pain?" directly addresses this
component. Distractor A assesses "R" (Radiation/Region), B assesses "P"
(Provocative/Palliative), and D assesses "T" (Timing). HESI Tip: PQRST stands for
Provocative/Palliative, Quality, Region/Radiation, Severity, Timing—master this mnemonic as it
appears frequently on HESI pain assessment questions.
Q6 (Physical assessment – percussion sounds): During abdominal percussion, the nurse hears
a loud, high-pitched, drum-like sound over the stomach. This sound is classified as:
, . Resonance
A
B. Dullness
C. Tympany
D. Flatness
[CORRECT] C
Rationale: The HESI blueprint includes percussion technique and sound interpretation, where
tympany is a loud, high-pitched, drum-like sound heard over air-filled structures such as the
stomach and intestines. Distractor A (resonance) is heard over normal lung tissue, B (dullness)
over solid organs or fluid, and D (flatness) over very dense tissue or bone. HESI Tip: Associate
tympany with "Tympani drums"—both are loud, musical, and air-filled; this auditory association
helps recall the correct percussion sound.
Q7 (Skin assessment – lesion identification): A patient presents with a raised, solid lesion
measuring 0.8 cm in diameter on the forearm. This lesion is best described as a:
A. Macule
B. Papule
C. Vesicle
D. Pustule
[CORRECT] B
Rationale: The HESI blueprint and Jarvis/Weber guidelines classify skin lesions by
characteristics: a papule is a raised, solid lesion less than 1 cm in diameter. Distractor A
(macule) is flat and non-palpable, C (vesicle) is a fluid-filled blister less than 1 cm, and D
(pustule) contains purulent exudate. HESI Tip: For lesion questions, remember "Papules are
Palpable" (both start with P) and "Macules are Macular/flat" (non-palpable); size thresholds (<1
cm vs. >1 cm) also determine classification.
Q8 (Head/neck – thyroid palpation): When palpating the thyroid gland, the nurse should stand:
A. Behind the patient with fingers placed on either side of the trachea
B. In front of the patient with thumbs placed on the thyroid cartilage
C. To the right of the patient using the dominant hand only
D. Facing the patient with fingertips placed over the cricoid cartilage
[CORRECT] A
Rationale: The HESI blueprint and evidence-based health assessment (Jarvis) recommend the
posterior approach for thyroid palpation, where the examiner stands behind the patient, places
fingers on either side of the trachea below the thyroid cartilage, and asks the patient to swallow.
Distractor B describes an anterior approach that is less optimal for full gland assessment, C is
incomplete and unsafe, and D places fingers too low at the cricoid cartilage. HESI Tip: On
thyroid palpation questions, remember "posterior is preferred" for comprehensive assessment;
the swallowing maneuver helps the gland move upward for better palpation.
Q9 (Eyes – PERRLA): During pupillary assessment, the nurse notes that the patient's pupils are
equal, round, and reactive to light and accommodation. The acronym for this finding is:
A. PERRLA
B. EOMI
C. PERLA
D. PERRL
[CORRECT] A
, ationale: The HESI blueprint and standard documentation use PERRLA (Pupils Equal, Round,
R
Reactive to Light and Accommodation) as the complete acronym for normal pupillary findings.
Distractor B (EOMI) refers to extraocular movements intact, C (PERLA) omits the second "R" for
round, and D (PERRL) omits accommodation. HESI Tip: PERRLA is the most complete and
current documentation standard; HESI often tests the full acronym including accommodation,
especially in neurological assessment questions.
Q10 (Ears – Rinne test): A nurse performs the Rinne test and finds that air conduction (AC) is
greater than bone conduction (BC) in the right ear. This result indicates:
A. Conductive hearing loss in the right ear
B. Sensorineural hearing loss in the right ear
C. Normal hearing in the right ear
D. Mixed hearing loss in the right ear
[CORRECT] C
Rationale: The HESI blueprint includes the Rinne test interpretation, where AC > BC (positive
Rinne) indicates normal hearing or sensorineural loss, as sound is conducted better through air
than bone in a normal ear. Distractor A (conductive loss) would show BC > AC (negative Rinne),
B is incorrect because sensorineural loss also shows AC > BC but with reduced overall hearing,
and D requires additional Weber test confirmation. HESI Tip: Remember "AC > BC = Air
Conduction is Better than Bone Conduction = Normal or Sensorineural"; BC > AC indicates
conductive loss. Always pair Rinne with Weber for complete diagnosis.
Q11 (Ears – Weber test): During the Weber test, a patient reports that the sound lateralizes to
the left ear. This finding suggests:
A. Conductive hearing loss in the left ear or sensorineural loss in the right ear
B. Sensorineural hearing loss in the left ear or conductive loss in the right ear
C. Normal hearing bilaterally
D. Bilateral conductive hearing loss
[CORRECT] A
Rationale: The HESI blueprint and Weber test principles state that sound lateralizes to the
affected ear in conductive hearing loss (due to reduced ambient noise) and to the unaffected ear
in sensorineural loss. Therefore, lateralization to the left suggests conductive loss in the left ear
OR sensorineural loss in the right ear. Distractor B reverses the pathology, C would show no
lateralization, and D would produce inconsistent results. HESI Tip: Use the mnemonic "COWS"
for Weber—Conductive loss = Opposite ear affected (sound goes TO affected ear),
Sensorineural = Weber goes to Unaffected ear (Same side = conductive).
Q12 (Thorax/lungs – breath sounds): A nurse auscultates the lungs and hears soft, low-pitched
sounds during inspiration and soft, shorter sounds during expiration over the peripheral lung
fields. These are:
A. Bronchial breath sounds
B. Bronchovesicular breath sounds
C. Vesicular breath sounds
D. Tracheal breath sounds
[CORRECT] C
Rationale: The HESI blueprint and respiratory assessment guidelines define vesicular breath
sounds as soft, low-pitched, rustling sounds heard over peripheral lung fields, with inspiration
