NURSING LICENSURE
BSN HESI 246 Health Assessment V2 Exam – 2026/2027 Actual Exam –
Nightingale College 2026/2027
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED ASSESSMENT DOMAINS RATIONALES INCLUDED
CATEGORIES
General Survey, Vital Signs, and Pain Assessment (Q1-Q15)
HEENT and Neurological Assessment (Q16-Q30)
Respiratory and Cardiovascular Assessment (Q31-Q45)
Abdominal, Musculoskeletal, and Peripheral Vascular Assessment (Q46-Q60)
Skin, Breast, Genitourinary, and Special Populations (Q61-Q75)
STUVIAACTUALEXAM
,EXAM INTRODUCTION
This examination assesses comprehensive health assessment knowledge and clinical reasoning for the BSN learner,
covering general survey through system-specific examination techniques and special populations. Each question is worth
one mark. A minimum score of 80 percent is required to pass. Select the single best answer.
SECTION 1: GENERAL SURVEY, VITAL SIGNS, AND PAIN ASSESSMENT
Q1
A nurse is performing a general survey on an older adult client who enters the examination room slowly using a walker.
The client appears thin, has poor eye contact, and responds to questions with delayed speech. Which component of
the general survey is the nurse primarily assessing when noting the client's gait and use of a walker?
A. Mental status and level of consciousness only
B. Mobility and physical appearance as part of overall functional status
C. Nutritional status exclusively based on body habitus
D. Hygiene and grooming independent of mobility aids
Correct Answer: B
Rationale:
Gait and assistive-device use are key elements of the mobility component of the general survey and contribute to overall functional
assessment. Mental status, nutrition, and hygiene are assessed separately.
Q2
A nurse measures a client's blood pressure and obtains 168/96 mm Hg in the right arm while the client is seated. The
nurse waits two minutes and repeats the measurement in the left arm, obtaining 164/94 mm Hg. What is the most
appropriate next nursing action?
A. Document both readings and immediately start an intravenous antihypertensive
B. Recheck the blood pressure after the client has rested, ensure correct cuff size, and report the findings
C. Average the two readings and record only the lower value as the official pressure
D. Dismiss the elevations because the two arms differ by less than 10 mm Hg
Correct Answer: B
Rationale:
Elevated readings require verification of technique, rest, and cuff size before clinical decisions. Both arms should be documented;
treatment decisions follow provider evaluation of confirmed elevations.
Q3
A client rates abdominal pain as 7 out of 10 on a numeric scale and describes it as sharp and constant. The nurse
notes guarding and facial grimacing. Which additional assessment best characterizes the quality and associated
features of the pain?
A. Asking only whether the pain is new or chronic without further descriptors
B. Using the PQRST or OLDCARTS framework to explore provocation, quality, radiation, severity, and timing
C. Measuring the pain solely by observing vital-sign changes without client input
D. Assuming the pain is surgical because the client is postoperative
Correct Answer: B
Rationale:
Structured pain assessment frameworks capture multidimensional features needed for accurate diagnosis and management.
Observation alone or single questions provide incomplete data.
BSN HESI 246 Health Assessment V2 - 2026/2027 Page 2
, Q4
A nurse is preparing to measure a client's temperature. The client has just finished drinking hot coffee. Which site and
timing are most appropriate?
A. Oral temperature immediately after the beverage
B. Oral temperature after waiting 15 to 30 minutes, or an alternate site such as axillary or temporal
C. Rectal temperature without lubrication to obtain the most accurate core value
D. Tympanic temperature while the client is chewing gum
Correct Answer: B
Rationale:
Hot liquids falsely elevate oral readings; waiting or using another validated site avoids error. Rectal measurement requires
lubrication; tympanic technique is affected by ear canal conditions.
Q5
During a general survey the nurse observes that a middle-aged client has a rounded face, truncal obesity, and thin
extremities. The client also reports easy bruising. Which endocrine-related finding is most consistent with this
appearance?
A. Hypothyroidism with generalized myxedema only
B. Cushing syndrome features such as moon face and central obesity
C. Addison disease with weight loss and hyperpigmentation
D. Hyperthyroidism with weight loss and lid lag
Correct Answer: B
Rationale:
Moon face, central obesity, and thin extremities are classic of cortisol excess. The other endocrine patterns produce different
body-habitus and skin findings.
Q6
A nurse assesses an apical pulse for a full minute and counts 52 beats. The radial pulse counted simultaneously is 48.
What is the pulse deficit and what does it suggest?
A. Deficit of 4; may indicate dysrhythmia with some beats not reaching the periphery
B. Deficit of 52; indicates normal sinus rhythm
C. Deficit of 0; the two rates are considered identical for clinical purposes
D. Deficit of 100; indicates severe aortic regurgitation
Correct Answer: A
Rationale:
Pulse deficit equals apical minus radial rate. A deficit suggests that not all apical beats produce a palpable peripheral pulse, often
due to dysrhythmia.
Q7
A client reports pain that is 3 out of 10 at rest but increases to 8 out of 10 with walking and is relieved within minutes of
rest. The pain is located in the calves. Which type of pain pattern is most consistent with this description?
A. Neuropathic pain from diabetic peripheral neuropathy
B. Intermittent claudication related to peripheral arterial disease
C. Visceral pain from mesenteric ischemia at rest
D. Somatic pain from an acute ankle sprain
Correct Answer: B
Rationale:
Activity-induced calf pain relieved by rest is classic intermittent claudication from arterial insufficiency. Neuropathic pain is typically
burning or tingling; visceral mesenteric pain is often postprandial.
BSN HESI 246 Health Assessment V2 - 2026/2027 Page 3
BSN HESI 246 Health Assessment V2 Exam – 2026/2027 Actual Exam –
Nightingale College 2026/2027
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED ASSESSMENT DOMAINS RATIONALES INCLUDED
CATEGORIES
General Survey, Vital Signs, and Pain Assessment (Q1-Q15)
HEENT and Neurological Assessment (Q16-Q30)
Respiratory and Cardiovascular Assessment (Q31-Q45)
Abdominal, Musculoskeletal, and Peripheral Vascular Assessment (Q46-Q60)
Skin, Breast, Genitourinary, and Special Populations (Q61-Q75)
STUVIAACTUALEXAM
,EXAM INTRODUCTION
This examination assesses comprehensive health assessment knowledge and clinical reasoning for the BSN learner,
covering general survey through system-specific examination techniques and special populations. Each question is worth
one mark. A minimum score of 80 percent is required to pass. Select the single best answer.
SECTION 1: GENERAL SURVEY, VITAL SIGNS, AND PAIN ASSESSMENT
Q1
A nurse is performing a general survey on an older adult client who enters the examination room slowly using a walker.
The client appears thin, has poor eye contact, and responds to questions with delayed speech. Which component of
the general survey is the nurse primarily assessing when noting the client's gait and use of a walker?
A. Mental status and level of consciousness only
B. Mobility and physical appearance as part of overall functional status
C. Nutritional status exclusively based on body habitus
D. Hygiene and grooming independent of mobility aids
Correct Answer: B
Rationale:
Gait and assistive-device use are key elements of the mobility component of the general survey and contribute to overall functional
assessment. Mental status, nutrition, and hygiene are assessed separately.
Q2
A nurse measures a client's blood pressure and obtains 168/96 mm Hg in the right arm while the client is seated. The
nurse waits two minutes and repeats the measurement in the left arm, obtaining 164/94 mm Hg. What is the most
appropriate next nursing action?
A. Document both readings and immediately start an intravenous antihypertensive
B. Recheck the blood pressure after the client has rested, ensure correct cuff size, and report the findings
C. Average the two readings and record only the lower value as the official pressure
D. Dismiss the elevations because the two arms differ by less than 10 mm Hg
Correct Answer: B
Rationale:
Elevated readings require verification of technique, rest, and cuff size before clinical decisions. Both arms should be documented;
treatment decisions follow provider evaluation of confirmed elevations.
Q3
A client rates abdominal pain as 7 out of 10 on a numeric scale and describes it as sharp and constant. The nurse
notes guarding and facial grimacing. Which additional assessment best characterizes the quality and associated
features of the pain?
A. Asking only whether the pain is new or chronic without further descriptors
B. Using the PQRST or OLDCARTS framework to explore provocation, quality, radiation, severity, and timing
C. Measuring the pain solely by observing vital-sign changes without client input
D. Assuming the pain is surgical because the client is postoperative
Correct Answer: B
Rationale:
Structured pain assessment frameworks capture multidimensional features needed for accurate diagnosis and management.
Observation alone or single questions provide incomplete data.
BSN HESI 246 Health Assessment V2 - 2026/2027 Page 2
, Q4
A nurse is preparing to measure a client's temperature. The client has just finished drinking hot coffee. Which site and
timing are most appropriate?
A. Oral temperature immediately after the beverage
B. Oral temperature after waiting 15 to 30 minutes, or an alternate site such as axillary or temporal
C. Rectal temperature without lubrication to obtain the most accurate core value
D. Tympanic temperature while the client is chewing gum
Correct Answer: B
Rationale:
Hot liquids falsely elevate oral readings; waiting or using another validated site avoids error. Rectal measurement requires
lubrication; tympanic technique is affected by ear canal conditions.
Q5
During a general survey the nurse observes that a middle-aged client has a rounded face, truncal obesity, and thin
extremities. The client also reports easy bruising. Which endocrine-related finding is most consistent with this
appearance?
A. Hypothyroidism with generalized myxedema only
B. Cushing syndrome features such as moon face and central obesity
C. Addison disease with weight loss and hyperpigmentation
D. Hyperthyroidism with weight loss and lid lag
Correct Answer: B
Rationale:
Moon face, central obesity, and thin extremities are classic of cortisol excess. The other endocrine patterns produce different
body-habitus and skin findings.
Q6
A nurse assesses an apical pulse for a full minute and counts 52 beats. The radial pulse counted simultaneously is 48.
What is the pulse deficit and what does it suggest?
A. Deficit of 4; may indicate dysrhythmia with some beats not reaching the periphery
B. Deficit of 52; indicates normal sinus rhythm
C. Deficit of 0; the two rates are considered identical for clinical purposes
D. Deficit of 100; indicates severe aortic regurgitation
Correct Answer: A
Rationale:
Pulse deficit equals apical minus radial rate. A deficit suggests that not all apical beats produce a palpable peripheral pulse, often
due to dysrhythmia.
Q7
A client reports pain that is 3 out of 10 at rest but increases to 8 out of 10 with walking and is relieved within minutes of
rest. The pain is located in the calves. Which type of pain pattern is most consistent with this description?
A. Neuropathic pain from diabetic peripheral neuropathy
B. Intermittent claudication related to peripheral arterial disease
C. Visceral pain from mesenteric ischemia at rest
D. Somatic pain from an acute ankle sprain
Correct Answer: B
Rationale:
Activity-induced calf pain relieved by rest is classic intermittent claudication from arterial insufficiency. Neuropathic pain is typically
burning or tingling; visceral mesenteric pain is often postprandial.
BSN HESI 246 Health Assessment V2 - 2026/2027 Page 3
