BSN 246 HESI HEALTH ASSESSMENT V1/ACTUAL EXAM –
NIGHTINGALE COLLEGE
CORE DOMAINS
• Foundations of Health Assessment & Interviewing
• General Survey, Vital Signs, and Pain Assessment
• Physical Examination Techniques & Body Systems
• Special Populations & Health Promotion
INTRODUCTION
This comprehensive examination guide is designed for Bachelor of Science
in Nursing (BSN) students at Nightingale College preparing for the HESI
Health Assessment Exam V1. It assesses foundational knowledge of health
history interviewing, physical examination techniques, and body system
assessments. The examination employs multiple-choice and scenario-
based questions that mirror the actual HESI format. Emphasis is placed on
therapeutic communication, cultural humility, clinical reasoning, and priority-
setting. Each question is accompanied by a verified answer and detailed
rationale to support learning and exam readiness.
SECTION ONE: FOUNDATIONS OF HEALTH ASSESSMENT &
INTERVIEWING (Questions 1-15)
1. A nurse is conducting an initial health history interview with a
patient who just arrived on the unit. Which question best
demonstrates therapeutic communication and encourages the patient
to share more information?
A. "Do you have any pain today?"
B. "Tell me more about how you've been feeling lately."
C. "Your blood pressure is elevated, so you must be stressed."
D. "You don't smoke or drink alcohol, right?"
B. "Tell me more about how you've been feeling lately."
RATIONALE: Open-ended questions invite the patient to tell their story
,in their own words, which builds rapport and often reveals the real concerns
behind the chief complaint. Yes-or-no questions shut down conversation
and can make patients feel like they're being interrogated rather than
heard. Options C and D are judgmental or leading, which can impair trust
and communication .
2. A patient who recently immigrated from Vietnam speaks limited
English. During the health history, the patient's teenage daughter
offers to translate. What is the nurse's best action?
A. Accept the daughter's offer because she knows the patient's medical
history
B. Use a professional medical interpreter and explain that family members
should not translate
C. Ask the patient to write down their symptoms instead
D. Proceed with simple yes-or-no questions that require minimal translation
B. Use a professional medical interpreter and explain that family
members should not translate
RATIONALE: A professional interpreter ensures accurate medical
terminology and protects patient confidentiality. Family members can omit
details, add their own interpretations, or feel burdened translating sensitive
information. Most facilities have phone or video interpreter services
available .
3. During a review of systems, the patient reports occasional
headaches, mild dizziness, and difficulty falling asleep. The nurse
recognizes that the review of systems primarily serves which
purpose?
A. To document the patient's vital signs from previous visits
B. To screen for symptoms across all body systems that the patient may
not have mentioned
C. To record the physical examination findings in a systematic order
D. To list the patient's current medications and allergies
, B. To screen for symptoms across all body systems that the patient may
not have mentioned
RATIONALE: The review of systems is a safety net that catches
symptoms the patient might have dismissed or forgotten to bring up when
asked about the chief complaint. It is a quick head-to-toe symptom screen
that often uncovers issues that would not have been found otherwise .
4. A nurse enters the room to assess a patient who appears anxious,
is sitting rigidly at the edge of the bed, and avoids eye contact. Which
initial action best demonstrates cultural humility and establishes
rapport?
A. Immediately begin asking structured assessment questions to stay
efficient
B. Sit at eye level, introduce yourself, and ask the patient their preferred
name and pronouns
C. Tell the patient they have nothing to be nervous about and to relax
D. Proceed quickly with the examination so the patient can rest
B. Sit at eye level, introduce yourself, and ask the patient their preferred
name and pronouns
RATIONALE: Meeting the patient at eye level and asking how they want
to be addressed sends a powerful message of respect and cultural humility,
helping to reduce anxiety and establish trust .
5. During a health history interview, a patient provides information
that seems inconsistent with their physical appearance. What is the
best action by the nurse?
A. Document the inconsistency and move on
B. Confront the patient about the discrepancy
C. Validate the information by asking clarifying questions in a non-
judgmental manner
D. Assume the patient is being dishonest and notify the provider
C. Validate the information by asking clarifying questions in a non-
judgmental manner
, RATIONALE: Inconsistencies may arise from misunderstanding,
memory issues, or deliberate omission. The nurse should seek clarification
without assuming dishonesty, using open-ended questions to explore
discrepancies respectfully .
6. A patient reports a family history of breast cancer. Which additional
information is most important for the nurse to obtain?
A. The patient's personal dietary habits
B. The age of onset of breast cancer in affected relatives and degree of
relation
C. Whether the patient has had a recent mammogram
D. The patient's exercise routine
B. The age of onset of breast cancer in affected relatives and degree of
relation
RATIONALE: Early onset (less than 50 years) and first-degree relatives
(mother, sister, daughter) significantly increase genetic risk. Age and
relationship help assess hereditary breast-ovarian cancer syndrome and
need for genetic counseling .
7. The nurse is assessing a patient who uses an interpreter. Which
technique ensures accurate communication?
A. Speak directly to the interpreter and use complex medical terms
B. Speak directly to the patient, not the interpreter, and use short sentences
C. Speak loudly and slowly to the patient
D. Provide written instructions only
B. Speak directly to the patient, not the interpreter, and use short
sentences
RATIONALE: Direct eye contact and addressing the patient maintains
respect and therapeutic alliance. Short sentences reduce interpretation
errors and allow the interpreter to convey meaning accurately .
8. A patient denies any health problems but appears malnourished
and disheveled. What is the nurse's priority?
NIGHTINGALE COLLEGE
CORE DOMAINS
• Foundations of Health Assessment & Interviewing
• General Survey, Vital Signs, and Pain Assessment
• Physical Examination Techniques & Body Systems
• Special Populations & Health Promotion
INTRODUCTION
This comprehensive examination guide is designed for Bachelor of Science
in Nursing (BSN) students at Nightingale College preparing for the HESI
Health Assessment Exam V1. It assesses foundational knowledge of health
history interviewing, physical examination techniques, and body system
assessments. The examination employs multiple-choice and scenario-
based questions that mirror the actual HESI format. Emphasis is placed on
therapeutic communication, cultural humility, clinical reasoning, and priority-
setting. Each question is accompanied by a verified answer and detailed
rationale to support learning and exam readiness.
SECTION ONE: FOUNDATIONS OF HEALTH ASSESSMENT &
INTERVIEWING (Questions 1-15)
1. A nurse is conducting an initial health history interview with a
patient who just arrived on the unit. Which question best
demonstrates therapeutic communication and encourages the patient
to share more information?
A. "Do you have any pain today?"
B. "Tell me more about how you've been feeling lately."
C. "Your blood pressure is elevated, so you must be stressed."
D. "You don't smoke or drink alcohol, right?"
B. "Tell me more about how you've been feeling lately."
RATIONALE: Open-ended questions invite the patient to tell their story
,in their own words, which builds rapport and often reveals the real concerns
behind the chief complaint. Yes-or-no questions shut down conversation
and can make patients feel like they're being interrogated rather than
heard. Options C and D are judgmental or leading, which can impair trust
and communication .
2. A patient who recently immigrated from Vietnam speaks limited
English. During the health history, the patient's teenage daughter
offers to translate. What is the nurse's best action?
A. Accept the daughter's offer because she knows the patient's medical
history
B. Use a professional medical interpreter and explain that family members
should not translate
C. Ask the patient to write down their symptoms instead
D. Proceed with simple yes-or-no questions that require minimal translation
B. Use a professional medical interpreter and explain that family
members should not translate
RATIONALE: A professional interpreter ensures accurate medical
terminology and protects patient confidentiality. Family members can omit
details, add their own interpretations, or feel burdened translating sensitive
information. Most facilities have phone or video interpreter services
available .
3. During a review of systems, the patient reports occasional
headaches, mild dizziness, and difficulty falling asleep. The nurse
recognizes that the review of systems primarily serves which
purpose?
A. To document the patient's vital signs from previous visits
B. To screen for symptoms across all body systems that the patient may
not have mentioned
C. To record the physical examination findings in a systematic order
D. To list the patient's current medications and allergies
, B. To screen for symptoms across all body systems that the patient may
not have mentioned
RATIONALE: The review of systems is a safety net that catches
symptoms the patient might have dismissed or forgotten to bring up when
asked about the chief complaint. It is a quick head-to-toe symptom screen
that often uncovers issues that would not have been found otherwise .
4. A nurse enters the room to assess a patient who appears anxious,
is sitting rigidly at the edge of the bed, and avoids eye contact. Which
initial action best demonstrates cultural humility and establishes
rapport?
A. Immediately begin asking structured assessment questions to stay
efficient
B. Sit at eye level, introduce yourself, and ask the patient their preferred
name and pronouns
C. Tell the patient they have nothing to be nervous about and to relax
D. Proceed quickly with the examination so the patient can rest
B. Sit at eye level, introduce yourself, and ask the patient their preferred
name and pronouns
RATIONALE: Meeting the patient at eye level and asking how they want
to be addressed sends a powerful message of respect and cultural humility,
helping to reduce anxiety and establish trust .
5. During a health history interview, a patient provides information
that seems inconsistent with their physical appearance. What is the
best action by the nurse?
A. Document the inconsistency and move on
B. Confront the patient about the discrepancy
C. Validate the information by asking clarifying questions in a non-
judgmental manner
D. Assume the patient is being dishonest and notify the provider
C. Validate the information by asking clarifying questions in a non-
judgmental manner
, RATIONALE: Inconsistencies may arise from misunderstanding,
memory issues, or deliberate omission. The nurse should seek clarification
without assuming dishonesty, using open-ended questions to explore
discrepancies respectfully .
6. A patient reports a family history of breast cancer. Which additional
information is most important for the nurse to obtain?
A. The patient's personal dietary habits
B. The age of onset of breast cancer in affected relatives and degree of
relation
C. Whether the patient has had a recent mammogram
D. The patient's exercise routine
B. The age of onset of breast cancer in affected relatives and degree of
relation
RATIONALE: Early onset (less than 50 years) and first-degree relatives
(mother, sister, daughter) significantly increase genetic risk. Age and
relationship help assess hereditary breast-ovarian cancer syndrome and
need for genetic counseling .
7. The nurse is assessing a patient who uses an interpreter. Which
technique ensures accurate communication?
A. Speak directly to the interpreter and use complex medical terms
B. Speak directly to the patient, not the interpreter, and use short sentences
C. Speak loudly and slowly to the patient
D. Provide written instructions only
B. Speak directly to the patient, not the interpreter, and use short
sentences
RATIONALE: Direct eye contact and addressing the patient maintains
respect and therapeutic alliance. Short sentences reduce interpretation
errors and allow the interpreter to convey meaning accurately .
8. A patient denies any health problems but appears malnourished
and disheveled. What is the nurse's priority?
