BSN 246 HESI HEALTH ASSESSMENT
EXAM V2 QUESTIONS AND ANSWERS
1. When performing an abdominal assessment, in which order should the nurse perform the
physical examination techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Auscultation, Inspection, Palpation, Percussion
C. Palpation, Percussion, Auscultation, Inspection
D. Inspection, Auscultation, Percussion, Palpation
Answer: D
Conceptual Explanation: For the abdomen, the order is modified to avoid altering bowel
sounds through manipulation. Therefore, auscultation follows inspection.
2. A nurse is assessing a patient for pitting edema and notes a deep pit (6mm) that remains
for several seconds after pressure is released. How should this be documented?
A. 1+ Edema
B. 2+ Edema
C. 4+ Edema
,D. 3+ Edema
Answer: D
Conceptual Explanation: 3+ edema is characterized by a deep indentation (6mm) that
remains for a short time.
3. Which cranial nerve is being tested when the nurse asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN XI (Spinal Accessory)
C. CN X (Vagus)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: The Spinal Accessory nerve (CN XI) innervates the trapezius and
sternocleidomastoid muscles.
4. During a cardiac assessment, where is the best location to auscultate the mitral valve area?
A. Fifth intercostal space, left midclavicular line
B. Second intercostal space, left sternal border
C. Fourth intercostal space, left sternal border
D. Second intercostal space, right sternal border
, Answer: A
Conceptual Explanation: The mitral valve (apex of the heart) is best heard at the 5th
intercostal space, left midclavicular line.
5. While assessing a patient’s lungs, the nurse hears high-pitched, musical sounds primarily
during expiration. These are documented as:
A. Crackles
B. Pleural friction rub
C. Wheezes
D. Rhonchi
Answer: C
Conceptual Explanation: Wheezes are high-pitched musical sounds caused by air
squeezing through narrowed airways, common in asthma.
6. The nurse uses the ‘Snellen chart’ to assess which cranial nerve?
A. CN I
B. CN IV
C. CN III
D. CN II
Answer: D
EXAM V2 QUESTIONS AND ANSWERS
1. When performing an abdominal assessment, in which order should the nurse perform the
physical examination techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Auscultation, Inspection, Palpation, Percussion
C. Palpation, Percussion, Auscultation, Inspection
D. Inspection, Auscultation, Percussion, Palpation
Answer: D
Conceptual Explanation: For the abdomen, the order is modified to avoid altering bowel
sounds through manipulation. Therefore, auscultation follows inspection.
2. A nurse is assessing a patient for pitting edema and notes a deep pit (6mm) that remains
for several seconds after pressure is released. How should this be documented?
A. 1+ Edema
B. 2+ Edema
C. 4+ Edema
,D. 3+ Edema
Answer: D
Conceptual Explanation: 3+ edema is characterized by a deep indentation (6mm) that
remains for a short time.
3. Which cranial nerve is being tested when the nurse asks the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN XI (Spinal Accessory)
C. CN X (Vagus)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: The Spinal Accessory nerve (CN XI) innervates the trapezius and
sternocleidomastoid muscles.
4. During a cardiac assessment, where is the best location to auscultate the mitral valve area?
A. Fifth intercostal space, left midclavicular line
B. Second intercostal space, left sternal border
C. Fourth intercostal space, left sternal border
D. Second intercostal space, right sternal border
, Answer: A
Conceptual Explanation: The mitral valve (apex of the heart) is best heard at the 5th
intercostal space, left midclavicular line.
5. While assessing a patient’s lungs, the nurse hears high-pitched, musical sounds primarily
during expiration. These are documented as:
A. Crackles
B. Pleural friction rub
C. Wheezes
D. Rhonchi
Answer: C
Conceptual Explanation: Wheezes are high-pitched musical sounds caused by air
squeezing through narrowed airways, common in asthma.
6. The nurse uses the ‘Snellen chart’ to assess which cranial nerve?
A. CN I
B. CN IV
C. CN III
D. CN II
Answer: D
