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Nightingale College PN 106 HESI Fundamentals Exam |
Study Guide | Practice Questions & Answers | Latest Update
2026
1. A 29-year-old male client informs the nurse that he came to the clinic to see if, "Maybe I have
lung cancer or something," and wants to get checked out since, "I can't seem to get rid of this body-
wracking dry cough that has been hanging around for the last six weeks." Which computer
documentation of this client's concerns should the nurse enter?
A) Client reports possible lung cancer with persistent cough
B) Client complains of severe coughing for six weeks, fears malignancy
C) Describe having a "body-wracking dry cough" of 6 weeks duration
D) Client states "I can't seem to get rid of this body-wracking dry cough"
Correct Answer: C) Describe having a "body-wracking dry cough" of 6 weeks duration
Rationale: Documentation should use the client's exact words in quotation marks to maintain accuracy
and objectivity. This preserves the client's description without adding interpretation or assumptions about
potential diagnoses.
2. A 75-year-old client with a recent history of a cerebrovascular accident (CVA) presents with right
hemiparesis. The nurse tests the deep tendon reflexes on the right side and elicits a brisk 4+
response. Which interpretation of this finding is accurate?
A) Normal response for an elderly client with previous CVA
B) Hypoactive response consistent with lower motor neuron disorder
C) Hyperactive response consistent with an upper motor neuron disorder
D) Expected finding indicating peripheral nerve damage
Correct Answer: C) Hyperactive response consistent with an upper motor neuron disorder
Rationale: A 4+ deep tendon reflex is hyperactive and indicates an upper motor neuron disorder, which is
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consistent with the client's history of CVA. Upper motor neuron lesions typically cause spasticity and
hyperreflexia.
3. The nurse examines a client's abdomen. Which finding indicates an abnormal response when
palpating the spleen?
A) Spleen not palpable below the left costal margin
B) Firm mass palpated at bottom of left rib cage
C) Tympany noted over the gastric bubble
D) Soft consistency in the left upper quadrant
Correct Answer: B) Firm mass palpated at bottom of left rib cage
Rationale: A palpable spleen (splenomegaly) is abnormal and may indicate conditions such as infection,
portal hypertension, or hematologic disorders. The normal spleen should not be palpable below the left
costal margin.
4. In auscultating for the presence of a carotid artery bruit, the nurse places the bell of the
stethoscope at which location?
A) Place bell of stethoscope over the jugular vein
B) Place bell of stethoscope over carotid artery
C) Place bell of stethoscope over the thyroid gland
D) Place bell of stethoscope over the temporal artery
Correct Answer: B) Place bell of stethoscope over carotid artery
Rationale: The bell of the stethoscope is used to detect low-pitched sounds such as bruits. It should be
placed gently over the carotid artery in the neck, avoiding excessive pressure that could occlude the
artery.
5. A male client arrives at the clinic for follow-up health assessment after recent antibiotic treatment
for pneumonia without hospitalization. Which technique should the nurse implement to assess for
adventitious lung sounds?
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A) Lightly place the stethoscope bell over each lung field
B) Press the stethoscope's diaphragm firmly on the skin over each lung field
C) Auscultate only the posterior lung fields
D) Have the client hold their breath during auscultation
Correct Answer: B) Press the stethoscope's diaphragm firmly on the skin over each lung field
Rationale: The diaphragm of the stethoscope is designed to detect high-pitched sounds such as breath
sounds and adventitious sounds. Firm pressure ensures adequate skin contact and transmission of sound.
6. A client with streptococcus pharyngitis reports high fever, difficulty swallowing and a muffled
voice. Which complication should the nurse suspect?
A) Acute epiglottitis
B) Peritonsillar abscess
C) Laryngitis
D) Sinusitis
Correct Answer: B) Peritonsillar abscess
Rationale: Peritonsillar abscess (quinsy) is a complication of tonsillitis or pharyngitis characterized by
high fever, severe sore throat, difficulty swallowing, and a muffled "hot potato" voice. It requires prompt
medical intervention.
7. The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While
interviewing the client, which assessment technique should the nurse use when asking about the
client's use of illegal drugs and alcohol?
A) Ask generally if the client uses any substances
B) Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts
C) Avoid asking about illegal substances to maintain rapport
D) Ask only about prescription medications
Correct Answer: B) Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts
Rationale: Direct, specific questioning about substance use provides the most accurate information.
Naming specific substances helps the client understand what information is being sought and increases
the likelihood of obtaining complete data.
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8. The nurse applies pressure over an area of the lower abdomen where the client reports pain. The
client denies pain upon palpation, but reports pain when the pressure is released. What action
should the nurse implement?
A) Document the finding as a normal response
B) Notify the healthcare provider of the rebound tenderness
C) Apply heat to the area for comfort
D) Reassess in 30 minutes
Correct Answer: B) Notify the healthcare provider of the rebound tenderness
Rationale: Rebound tenderness (pain upon release of pressure) is a sign of peritoneal irritation and may
indicate appendicitis, peritonitis, or other abdominal emergencies requiring immediate medical
evaluation.
9. The nurse is assessing an ulcer on a client's lower extremity, which is likely the result of either
venous or arterial insufficiency. Which assessment technique should the nurse use to differentiate
the pathophysiology causing the ulcer?
A) Palpate the temperature of the surrounding skin
B) Observe the specific location and appearance of the ulceration
C) Assess the client's pain level
D) Measure the circumference of the extremity
Correct Answer: B) Observe the specific location and appearance of the ulceration
Rationale: Venous ulcers typically occur on the medial lower leg above the ankle with irregular borders
and surrounding skin changes, while arterial ulcers occur on the feet, toes, or heels with well-defined
borders and pale appearance. Location and appearance provide key differentiation.
10. The nurse is conducting a physical assessment of a young adult. Which information provides the
best indication of the individual's nutritional status?
A) Height and weight measurements
B) Condition of hair, nails, and skin
Nightingale College PN 106 HESI Fundamentals Exam |
Study Guide | Practice Questions & Answers | Latest Update
2026
1. A 29-year-old male client informs the nurse that he came to the clinic to see if, "Maybe I have
lung cancer or something," and wants to get checked out since, "I can't seem to get rid of this body-
wracking dry cough that has been hanging around for the last six weeks." Which computer
documentation of this client's concerns should the nurse enter?
A) Client reports possible lung cancer with persistent cough
B) Client complains of severe coughing for six weeks, fears malignancy
C) Describe having a "body-wracking dry cough" of 6 weeks duration
D) Client states "I can't seem to get rid of this body-wracking dry cough"
Correct Answer: C) Describe having a "body-wracking dry cough" of 6 weeks duration
Rationale: Documentation should use the client's exact words in quotation marks to maintain accuracy
and objectivity. This preserves the client's description without adding interpretation or assumptions about
potential diagnoses.
2. A 75-year-old client with a recent history of a cerebrovascular accident (CVA) presents with right
hemiparesis. The nurse tests the deep tendon reflexes on the right side and elicits a brisk 4+
response. Which interpretation of this finding is accurate?
A) Normal response for an elderly client with previous CVA
B) Hypoactive response consistent with lower motor neuron disorder
C) Hyperactive response consistent with an upper motor neuron disorder
D) Expected finding indicating peripheral nerve damage
Correct Answer: C) Hyperactive response consistent with an upper motor neuron disorder
Rationale: A 4+ deep tendon reflex is hyperactive and indicates an upper motor neuron disorder, which is
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consistent with the client's history of CVA. Upper motor neuron lesions typically cause spasticity and
hyperreflexia.
3. The nurse examines a client's abdomen. Which finding indicates an abnormal response when
palpating the spleen?
A) Spleen not palpable below the left costal margin
B) Firm mass palpated at bottom of left rib cage
C) Tympany noted over the gastric bubble
D) Soft consistency in the left upper quadrant
Correct Answer: B) Firm mass palpated at bottom of left rib cage
Rationale: A palpable spleen (splenomegaly) is abnormal and may indicate conditions such as infection,
portal hypertension, or hematologic disorders. The normal spleen should not be palpable below the left
costal margin.
4. In auscultating for the presence of a carotid artery bruit, the nurse places the bell of the
stethoscope at which location?
A) Place bell of stethoscope over the jugular vein
B) Place bell of stethoscope over carotid artery
C) Place bell of stethoscope over the thyroid gland
D) Place bell of stethoscope over the temporal artery
Correct Answer: B) Place bell of stethoscope over carotid artery
Rationale: The bell of the stethoscope is used to detect low-pitched sounds such as bruits. It should be
placed gently over the carotid artery in the neck, avoiding excessive pressure that could occlude the
artery.
5. A male client arrives at the clinic for follow-up health assessment after recent antibiotic treatment
for pneumonia without hospitalization. Which technique should the nurse implement to assess for
adventitious lung sounds?
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A) Lightly place the stethoscope bell over each lung field
B) Press the stethoscope's diaphragm firmly on the skin over each lung field
C) Auscultate only the posterior lung fields
D) Have the client hold their breath during auscultation
Correct Answer: B) Press the stethoscope's diaphragm firmly on the skin over each lung field
Rationale: The diaphragm of the stethoscope is designed to detect high-pitched sounds such as breath
sounds and adventitious sounds. Firm pressure ensures adequate skin contact and transmission of sound.
6. A client with streptococcus pharyngitis reports high fever, difficulty swallowing and a muffled
voice. Which complication should the nurse suspect?
A) Acute epiglottitis
B) Peritonsillar abscess
C) Laryngitis
D) Sinusitis
Correct Answer: B) Peritonsillar abscess
Rationale: Peritonsillar abscess (quinsy) is a complication of tonsillitis or pharyngitis characterized by
high fever, severe sore throat, difficulty swallowing, and a muffled "hot potato" voice. It requires prompt
medical intervention.
7. The nurse is obtaining a health history for a client prior to a scheduled cholecystectomy. While
interviewing the client, which assessment technique should the nurse use when asking about the
client's use of illegal drugs and alcohol?
A) Ask generally if the client uses any substances
B) Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts
C) Avoid asking about illegal substances to maintain rapport
D) Ask only about prescription medications
Correct Answer: B) Ask specifically about alcohol, marijuana, cocaine, heroin, and amounts
Rationale: Direct, specific questioning about substance use provides the most accurate information.
Naming specific substances helps the client understand what information is being sought and increases
the likelihood of obtaining complete data.
, Page 4 of 95
8. The nurse applies pressure over an area of the lower abdomen where the client reports pain. The
client denies pain upon palpation, but reports pain when the pressure is released. What action
should the nurse implement?
A) Document the finding as a normal response
B) Notify the healthcare provider of the rebound tenderness
C) Apply heat to the area for comfort
D) Reassess in 30 minutes
Correct Answer: B) Notify the healthcare provider of the rebound tenderness
Rationale: Rebound tenderness (pain upon release of pressure) is a sign of peritoneal irritation and may
indicate appendicitis, peritonitis, or other abdominal emergencies requiring immediate medical
evaluation.
9. The nurse is assessing an ulcer on a client's lower extremity, which is likely the result of either
venous or arterial insufficiency. Which assessment technique should the nurse use to differentiate
the pathophysiology causing the ulcer?
A) Palpate the temperature of the surrounding skin
B) Observe the specific location and appearance of the ulceration
C) Assess the client's pain level
D) Measure the circumference of the extremity
Correct Answer: B) Observe the specific location and appearance of the ulceration
Rationale: Venous ulcers typically occur on the medial lower leg above the ankle with irregular borders
and surrounding skin changes, while arterial ulcers occur on the feet, toes, or heels with well-defined
borders and pale appearance. Location and appearance provide key differentiation.
10. The nurse is conducting a physical assessment of a young adult. Which information provides the
best indication of the individual's nutritional status?
A) Height and weight measurements
B) Condition of hair, nails, and skin
