BSN 246 HESI HEALTH ASSESSMENT
EXAM (LATEST 2026/2027 UPDATE) –
NIGHTINGALE QUESTIONS AND
VERIFIED ANSWERS |100% CORRECT|
GRADE A+ NIGHTINGALE
1. When performing an abdominal assessment, what is the correct sequence of examination
techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Percussion, Palpation, Inspection, Auscultation
Answer: C
Conceptual Explanation: In the abdomen, auscultation is performed before percussion
and palpation because manual manipulation of the bowel can alter bowel sounds.
2. A nurse is assessing a patient’s visual acuity using a Snellen chart. The patient is recorded
as having 20/40 vision. What does this indicate?
A. The patient can see at 40 feet what a normal eye sees at 20 feet.
B. The patient has 20% vision in the right eye and 40% in the left.
,C. The patient can see at 20 feet what a normal eye sees at 40 feet.
D. The patient has normal vision in both eyes.
Answer: C
Conceptual Explanation: The numerator (20) represents the distance the patient is
standing from the chart, while the denominator (40) is the distance at which a person with
normal vision could read that line.
3. During a cardiac assessment, the nurse hears a high-pitched, scratchy sound at the left
lower sternal border that persists when the patient holds their breath. This likely indicates:
A. Pleural friction rub
B. Pericardial friction rub
C. Mitral valve prolapse
D. Aortic regurgitation
Answer: B
Conceptual Explanation: A pericardial friction rub is high-pitched and scratchy. If the
sound continues while the patient holds their breath, it is cardiac (pericardial) rather than
respiratory (pleural).
4. Which cranial nerve is being tested when the nurse asks the patient to shrug their
shoulders against resistance?
A. Cranial Nerve XI (Spinal Accessory)
, B. Cranial Nerve IX (Glossopharyngeal)
C. Cranial Nerve X (Vagus)
D. Cranial Nerve XII (Hypoglossal)
Answer: A
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; shrugging tests the trapezius strength.
5. While assessing a patient with suspected pneumonia, the nurse notes increased tactile
fremitus over the right lower lobe. This finding is consistent with:
A. Lung consolidation
B. Pleural effusion
C. Pneumothorax
D. Emphysema
Answer: A
Conceptual Explanation: Tactile fremitus increases with lung consolidation (liquid or
solid mass) because sound travels better through solid/liquid than air.
6. A 70-year-old patient presents with a ‘hunchback’ appearance of the upper thoracic spine.
The nurse documents this as:
A. Lordosis
B. Scoliosis
EXAM (LATEST 2026/2027 UPDATE) –
NIGHTINGALE QUESTIONS AND
VERIFIED ANSWERS |100% CORRECT|
GRADE A+ NIGHTINGALE
1. When performing an abdominal assessment, what is the correct sequence of examination
techniques?
A. Inspection, Palpation, Percussion, Auscultation
B. Auscultation, Inspection, Palpation, Percussion
C. Inspection, Auscultation, Percussion, Palpation
D. Percussion, Palpation, Inspection, Auscultation
Answer: C
Conceptual Explanation: In the abdomen, auscultation is performed before percussion
and palpation because manual manipulation of the bowel can alter bowel sounds.
2. A nurse is assessing a patient’s visual acuity using a Snellen chart. The patient is recorded
as having 20/40 vision. What does this indicate?
A. The patient can see at 40 feet what a normal eye sees at 20 feet.
B. The patient has 20% vision in the right eye and 40% in the left.
,C. The patient can see at 20 feet what a normal eye sees at 40 feet.
D. The patient has normal vision in both eyes.
Answer: C
Conceptual Explanation: The numerator (20) represents the distance the patient is
standing from the chart, while the denominator (40) is the distance at which a person with
normal vision could read that line.
3. During a cardiac assessment, the nurse hears a high-pitched, scratchy sound at the left
lower sternal border that persists when the patient holds their breath. This likely indicates:
A. Pleural friction rub
B. Pericardial friction rub
C. Mitral valve prolapse
D. Aortic regurgitation
Answer: B
Conceptual Explanation: A pericardial friction rub is high-pitched and scratchy. If the
sound continues while the patient holds their breath, it is cardiac (pericardial) rather than
respiratory (pleural).
4. Which cranial nerve is being tested when the nurse asks the patient to shrug their
shoulders against resistance?
A. Cranial Nerve XI (Spinal Accessory)
, B. Cranial Nerve IX (Glossopharyngeal)
C. Cranial Nerve X (Vagus)
D. Cranial Nerve XII (Hypoglossal)
Answer: A
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; shrugging tests the trapezius strength.
5. While assessing a patient with suspected pneumonia, the nurse notes increased tactile
fremitus over the right lower lobe. This finding is consistent with:
A. Lung consolidation
B. Pleural effusion
C. Pneumothorax
D. Emphysema
Answer: A
Conceptual Explanation: Tactile fremitus increases with lung consolidation (liquid or
solid mass) because sound travels better through solid/liquid than air.
6. A 70-year-old patient presents with a ‘hunchback’ appearance of the upper thoracic spine.
The nurse documents this as:
A. Lordosis
B. Scoliosis
