BSN 315 Pharmacology HESI Review | Nightingale College | 2026–
2027 Edition | 100+ Exam-Style Q&S
1. The nurse is performing a thoracic assessment on a client with chronic asthma and
hyperinflation of the lungs. Which finding should be expected for this client?
Answer: Barrel chest.
Rationale: Chronic hyperinflation from asthma increases the anterior-posterior chest
diameter, giving the chest a rounded “barrel” shape. This results from air trapping and loss of
elastic recoil over time.
2. The nurse is assessing a postmenopausal client who has a BMI of 32. The client has a
chest measurement of 42 inches, waist measurement of 45 inches, and hip measurement
of 50 inches. What important message should the nurse explain to the client to promote
health promotion?
Answer: “A waist circumference greater than 35 inches in women puts you at higher risk for
type 2 diabetes and heart disease.”
Rationale: Waist circumference >35 inches in women indicates central obesity, a strong
independent risk factor for metabolic syndrome, cardiovascular disease, and type 2 diabetes,
regardless of overall BMI.
3. The nurse is assessing bowel sounds for a hospitalized client. The nurse has heard
bowel sounds in the right upper quadrant. What action should the nurse take next?
Answer: Note the character and frequency of bowel sounds.
Rationale: After confirming bowel sounds are present, the nurse must document their
quality (e.g., high-pitched, gurgling) and rate before moving to other quadrants to complete
the assessment accurately.
4. During inspection of a client's mouth and pharynx, the nurse places a tongue blade
on the back of the tongue which causes the client to gag. After removing the tongue
,blade, what action should the nurse take?
Answer: Document an intact gag reflex.
Rationale: Gagging in response to posterior pharyngeal stimulation indicates normal
function of cranial nerves IX (glossopharyngeal) and X (vagus). This is a protective reflex
and should be recorded as an expected finding.
5. 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?
Answer: Upper outer quadrant.
Rationale: The upper outer quadrant contains the most glandular tissue and is the most
common site for breast malignancies. It also extends toward the axilla (tail of Spence),
making careful inspection there critical.
6. The nurse performs a physical assessment on an older female client. Which change
from the prior exam may be an indication of osteoporosis?
Answer: Height reduction of 1.5 inches.
Rationale: A height loss of more than 1 inch in older adults—especially postmenopausal
women—strongly suggests vertebral compression fractures from osteoporosis, caused by
progressive weakening of the spinal vertebrae.
7. While conducting an interview to obtain a health history, the nurse notices that the
client pauses frequently and looks at the nurse expectantly. Which response is best for
the nurse to provide?
Answer: Sit quietly to allow the client to respond comfortably.
Rationale: Some clients need extra time to process questions or formulate answers.
Allowing silence without interrupting encourages the client to continue at their own pace and
reduces anxiety, promoting more accurate information.
8. A client is in the clinic for a yearly physical examination. Which action should the
nurse take when preparing to examine the client's abdomen?
,Answer: Ask the client to urinate before beginning the examination.
Rationale: A full bladder can distort abdominal contours, make palpation difficult and
uncomfortable, and obscure underlying structures. Emptying the bladder improves accuracy
and client comfort.
9. Which respiratory condition should the nurse document after measuring a
respiratory rate of 8 breaths/minute?
Answer: Bradypnea.
Rationale: Bradypnea is defined as a respiratory rate below 12 breaths/min in adults. This
abnormally slow rate may indicate neurological depression, metabolic disorders, or
medication effects such as opioid sedation.
10. Which procedure should the nurse use to assess for a pulse deficit?
Answer: Measure the apical pulse and compare it to the peripheral pulse.
Rationale: A pulse deficit exists when the apical (heart) rate exceeds the radial (peripheral)
rate, meaning some heartbeats do not generate a palpable peripheral pulse. This is common
in atrial fibrillation and indicates reduced stroke volume or cardiac output.
11. A client has been diagnosed with bilateral lower lobe atelectasis. What percussion
sound should the nurse expect to hear when percussing over the client's lower lobes?
Answer: Dull, thud-like.
Rationale: Atelectasis collapses lung tissue, replacing air with denser tissue or fluid.
Dullness on percussion reflects solid or fluid-filled tissue rather than air-filled, healthy lung.
12. A client is being assessed upon admission to the medical-surgical unit. The nurse is
preparing to complete a head-to-toe assessment and will begin at the head of the client.
Which technique should the nurse use to begin the assessment?
Answer: Inspect the hair and skin.
Rationale: The head-to-toe approach starts with inspection at the head. Beginning with the
, hair and scalp provides baseline data on color, texture, distribution, lesions, or infestations
before proceeding to other structures.
13. The nurse is assessing a healthy young adult during an annual physical
examination. Which assessment technique should the nurse implement when palpating
the abdominal aorta?
Answer: Deep palpation above and to the left of the umbilicus.
Rationale: The abdominal aorta lies in the midline, slightly left of the umbilicus. Deep
palpation at this site allows assessment of its pulsation and width; a widened, pulsatile mass
could indicate an abdominal aortic aneurysm.
14. The nurse is conducting a family history as part of the assessment interview. Which
action should the nurse take to ensure that sufficient information about the client's
blood relatives is obtained?
Answer: Document at least 3 generations of the client's family medical history.
Rationale: A three-generation pedigree (grandparents, parents, and siblings/children) helps
identify inherited conditions, genetic predispositions, and familial patterns of disease across
generations.
15. The nurse is testing the client's shoulders for range of motion. What should the
nurse document to record normal internal rotation?
Answer: Range of 90 degrees when the hands are placed at the small of the back.
Rationale: Normal internal rotation of the shoulder is approximately 90 degrees. Placing the
hands behind the back toward the small of the back is the standard movement used to assess
internal rotation.
16. A client presents with a rash along the occipital area of the hairline and reports
intense itching. How should the nurse begin the objective part of the examination?
Answer: Inspect the scalp looking for nits.
Rationale: Intense itching and a rash at the occipital hairline are classic signs of head lice
2027 Edition | 100+ Exam-Style Q&S
1. The nurse is performing a thoracic assessment on a client with chronic asthma and
hyperinflation of the lungs. Which finding should be expected for this client?
Answer: Barrel chest.
Rationale: Chronic hyperinflation from asthma increases the anterior-posterior chest
diameter, giving the chest a rounded “barrel” shape. This results from air trapping and loss of
elastic recoil over time.
2. The nurse is assessing a postmenopausal client who has a BMI of 32. The client has a
chest measurement of 42 inches, waist measurement of 45 inches, and hip measurement
of 50 inches. What important message should the nurse explain to the client to promote
health promotion?
Answer: “A waist circumference greater than 35 inches in women puts you at higher risk for
type 2 diabetes and heart disease.”
Rationale: Waist circumference >35 inches in women indicates central obesity, a strong
independent risk factor for metabolic syndrome, cardiovascular disease, and type 2 diabetes,
regardless of overall BMI.
3. The nurse is assessing bowel sounds for a hospitalized client. The nurse has heard
bowel sounds in the right upper quadrant. What action should the nurse take next?
Answer: Note the character and frequency of bowel sounds.
Rationale: After confirming bowel sounds are present, the nurse must document their
quality (e.g., high-pitched, gurgling) and rate before moving to other quadrants to complete
the assessment accurately.
4. During inspection of a client's mouth and pharynx, the nurse places a tongue blade
on the back of the tongue which causes the client to gag. After removing the tongue
,blade, what action should the nurse take?
Answer: Document an intact gag reflex.
Rationale: Gagging in response to posterior pharyngeal stimulation indicates normal
function of cranial nerves IX (glossopharyngeal) and X (vagus). This is a protective reflex
and should be recorded as an expected finding.
5. 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?
Answer: Upper outer quadrant.
Rationale: The upper outer quadrant contains the most glandular tissue and is the most
common site for breast malignancies. It also extends toward the axilla (tail of Spence),
making careful inspection there critical.
6. The nurse performs a physical assessment on an older female client. Which change
from the prior exam may be an indication of osteoporosis?
Answer: Height reduction of 1.5 inches.
Rationale: A height loss of more than 1 inch in older adults—especially postmenopausal
women—strongly suggests vertebral compression fractures from osteoporosis, caused by
progressive weakening of the spinal vertebrae.
7. While conducting an interview to obtain a health history, the nurse notices that the
client pauses frequently and looks at the nurse expectantly. Which response is best for
the nurse to provide?
Answer: Sit quietly to allow the client to respond comfortably.
Rationale: Some clients need extra time to process questions or formulate answers.
Allowing silence without interrupting encourages the client to continue at their own pace and
reduces anxiety, promoting more accurate information.
8. A client is in the clinic for a yearly physical examination. Which action should the
nurse take when preparing to examine the client's abdomen?
,Answer: Ask the client to urinate before beginning the examination.
Rationale: A full bladder can distort abdominal contours, make palpation difficult and
uncomfortable, and obscure underlying structures. Emptying the bladder improves accuracy
and client comfort.
9. Which respiratory condition should the nurse document after measuring a
respiratory rate of 8 breaths/minute?
Answer: Bradypnea.
Rationale: Bradypnea is defined as a respiratory rate below 12 breaths/min in adults. This
abnormally slow rate may indicate neurological depression, metabolic disorders, or
medication effects such as opioid sedation.
10. Which procedure should the nurse use to assess for a pulse deficit?
Answer: Measure the apical pulse and compare it to the peripheral pulse.
Rationale: A pulse deficit exists when the apical (heart) rate exceeds the radial (peripheral)
rate, meaning some heartbeats do not generate a palpable peripheral pulse. This is common
in atrial fibrillation and indicates reduced stroke volume or cardiac output.
11. A client has been diagnosed with bilateral lower lobe atelectasis. What percussion
sound should the nurse expect to hear when percussing over the client's lower lobes?
Answer: Dull, thud-like.
Rationale: Atelectasis collapses lung tissue, replacing air with denser tissue or fluid.
Dullness on percussion reflects solid or fluid-filled tissue rather than air-filled, healthy lung.
12. A client is being assessed upon admission to the medical-surgical unit. The nurse is
preparing to complete a head-to-toe assessment and will begin at the head of the client.
Which technique should the nurse use to begin the assessment?
Answer: Inspect the hair and skin.
Rationale: The head-to-toe approach starts with inspection at the head. Beginning with the
, hair and scalp provides baseline data on color, texture, distribution, lesions, or infestations
before proceeding to other structures.
13. The nurse is assessing a healthy young adult during an annual physical
examination. Which assessment technique should the nurse implement when palpating
the abdominal aorta?
Answer: Deep palpation above and to the left of the umbilicus.
Rationale: The abdominal aorta lies in the midline, slightly left of the umbilicus. Deep
palpation at this site allows assessment of its pulsation and width; a widened, pulsatile mass
could indicate an abdominal aortic aneurysm.
14. The nurse is conducting a family history as part of the assessment interview. Which
action should the nurse take to ensure that sufficient information about the client's
blood relatives is obtained?
Answer: Document at least 3 generations of the client's family medical history.
Rationale: A three-generation pedigree (grandparents, parents, and siblings/children) helps
identify inherited conditions, genetic predispositions, and familial patterns of disease across
generations.
15. The nurse is testing the client's shoulders for range of motion. What should the
nurse document to record normal internal rotation?
Answer: Range of 90 degrees when the hands are placed at the small of the back.
Rationale: Normal internal rotation of the shoulder is approximately 90 degrees. Placing the
hands behind the back toward the small of the back is the standard movement used to assess
internal rotation.
16. A client presents with a rash along the occipital area of the hairline and reports
intense itching. How should the nurse begin the objective part of the examination?
Answer: Inspect the scalp looking for nits.
Rationale: Intense itching and a rash at the occipital hairline are classic signs of head lice
