,BSN HESI 246 Health Assessment FINAL
Exam – Actual Exam – Nightingale College
Question 1
The first step in a physical assessment is:
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Answer: B
Rationale: Inspection provides baseline visual information before touching the patient. This is
always the first step in physical assessment. Palpation, percussion, and auscultation follow
inspection in a systematic head-to-toe approach .
Question 2
The normal adult respiratory rate is:
A) 8-10 breaths/min
B) 12-20 breaths/min
C) 20-30 breaths/min
D) 30-40 breaths/min
Answer: B
Rationale: The normal adult respiratory rate is 12-20 breaths per minute. Rates below 12
indicate bradypnea; rates above 20 indicate tachypnea and may signal respiratory distress or
other underlying conditions .
Question 3
Normal adult heart rate is:
A) 40-60 bpm
B) 60-100 bpm
,C) 100-120 bpm
D) 120-140 bpm
Answer: B
Rationale: Normal adult pulse rate ranges from 60-100 beats per minute. Bradycardia is <60
bpm; tachycardia is >100 bpm. Both may indicate underlying conditions requiring further
assessment .
Question 4
Normal oxygen saturation is:
A) 85-90%
B) 90-94%
C) 95-100%
D) 100-105%
Answer: C
Rationale: Normal SpO₂ is 95-100% in healthy adults. Values below 92% indicate hypoxemia
requiring intervention. SpO₂ of 88% or below is a medical emergency .
Question 5
Cyanosis indicates:
A) Infection
B) Hypoxia
C) Fever
D) Hypertension
Answer: B
Rationale: Cyanosis indicates inadequate oxygenation and is a medical emergency. It reflects
hypoxemia that can rapidly become life-threatening. Peripheral cyanosis may be seen in nail
beds; central cyanosis appears in mucous membranes .
Question 6
An early sign of hypoxia is:
, A) Cyanosis
B) Restlessness
C) Bradycardia
D) Coma
Answer: B
Rationale: Restlessness is an early compensatory response to low oxygen levels. As hypoxia
worsens, the patient may become confused, lethargic, and eventually comatose. Cyanosis is a
late sign of hypoxia .
Question 7
A late sign of hypoxia is:
A) Anxiety
B) Cyanosis
C) Headache
D) Tachycardia
Answer: B
Rationale: Cyanosis is a late indicator of severe oxygen deprivation, appearing when oxygen
saturation drops below 85%. Early signs include restlessness and tachycardia .
Question 8
Blood pressure is calculated as:
A) Cardiac output minus peripheral resistance
B) Cardiac output times peripheral resistance
C) Stroke volume plus heart rate
D) Pulse pressure divided by heart rate
Answer: B
Rationale: Blood pressure is the product of cardiac output and peripheral vascular resistance.
Changes in either factor affect blood pressure readings .
Question 9
The best indicator of pain is:
Exam – Actual Exam – Nightingale College
Question 1
The first step in a physical assessment is:
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Answer: B
Rationale: Inspection provides baseline visual information before touching the patient. This is
always the first step in physical assessment. Palpation, percussion, and auscultation follow
inspection in a systematic head-to-toe approach .
Question 2
The normal adult respiratory rate is:
A) 8-10 breaths/min
B) 12-20 breaths/min
C) 20-30 breaths/min
D) 30-40 breaths/min
Answer: B
Rationale: The normal adult respiratory rate is 12-20 breaths per minute. Rates below 12
indicate bradypnea; rates above 20 indicate tachypnea and may signal respiratory distress or
other underlying conditions .
Question 3
Normal adult heart rate is:
A) 40-60 bpm
B) 60-100 bpm
,C) 100-120 bpm
D) 120-140 bpm
Answer: B
Rationale: Normal adult pulse rate ranges from 60-100 beats per minute. Bradycardia is <60
bpm; tachycardia is >100 bpm. Both may indicate underlying conditions requiring further
assessment .
Question 4
Normal oxygen saturation is:
A) 85-90%
B) 90-94%
C) 95-100%
D) 100-105%
Answer: C
Rationale: Normal SpO₂ is 95-100% in healthy adults. Values below 92% indicate hypoxemia
requiring intervention. SpO₂ of 88% or below is a medical emergency .
Question 5
Cyanosis indicates:
A) Infection
B) Hypoxia
C) Fever
D) Hypertension
Answer: B
Rationale: Cyanosis indicates inadequate oxygenation and is a medical emergency. It reflects
hypoxemia that can rapidly become life-threatening. Peripheral cyanosis may be seen in nail
beds; central cyanosis appears in mucous membranes .
Question 6
An early sign of hypoxia is:
, A) Cyanosis
B) Restlessness
C) Bradycardia
D) Coma
Answer: B
Rationale: Restlessness is an early compensatory response to low oxygen levels. As hypoxia
worsens, the patient may become confused, lethargic, and eventually comatose. Cyanosis is a
late sign of hypoxia .
Question 7
A late sign of hypoxia is:
A) Anxiety
B) Cyanosis
C) Headache
D) Tachycardia
Answer: B
Rationale: Cyanosis is a late indicator of severe oxygen deprivation, appearing when oxygen
saturation drops below 85%. Early signs include restlessness and tachycardia .
Question 8
Blood pressure is calculated as:
A) Cardiac output minus peripheral resistance
B) Cardiac output times peripheral resistance
C) Stroke volume plus heart rate
D) Pulse pressure divided by heart rate
Answer: B
Rationale: Blood pressure is the product of cardiac output and peripheral vascular resistance.
Changes in either factor affect blood pressure readings .
Question 9
The best indicator of pain is:
