2025 Pass the HESI Physical Assessment Exam with 120
These Proven Practice Questions and Step-by-Step
Solutions
1. What does a goniometer measure?
A. Muscle strength
B. Joint stability
C. Cranial nerve function
D. Angles of extension and flexion ✅
Correct Answer: D. Angles of extension and flexion
Rationale: A goniometer is an instrument used to measure the range of motion (ROM) in
joints. It helps assess limitations in movement by providing an exact angle of flexion and
extension, which is useful in musculoskeletal evaluations.
2. Which of the following techniques is used to assess muscle strength in a patient?
A. Apply an opposing force or resistance. ✅
B. Observe the patient at rest.
C. Percuss the muscle.
D. Palpate the muscle.
Correct Answer: A. Apply an opposing force or resistance.
Rationale: Assessing muscle strength involves asking the patient to contract a muscle while
the examiner applies opposing resistance. This determines the patient's ability to overcome
force, a key part of strength grading. Observation, palpation, and percussion help in
assessment but do not evaluate strength directly.
3. Neck flexion and extension should be:
A. 90 degrees B.
70 degrees
C. 30 degrees
,D. 45 degrees ✅
Correct Answer: D. 45 degrees
Rationale: Normal range of motion for both neck flexion and extension is about 45 degrees.
Any significant deviation may suggest issues with musculoskeletal alignment, neurological
impairment, or soft tissue injury.
4. Which of the following findings in a musculoskeletal assessment would be considered
abnormal?
A. Nodules
B. Bogginess
C. Symmetry
D. Both A and B ✅
Correct Answer: D. Both A and B
Rationale: Nodules and bogginess are abnormal findings. Nodules may suggest arthritis or
gout, and bogginess can be indicative of inflammation or joint effusion. Symmetry, in
contrast, is a normal finding.
5. What is an increased thoracic curvature, common in older adults, called?
A. Scoliosis
B. Lordosis
C. Kyphosis ✅
D. Swayback
Correct Answer: C. Kyphosis
Rationale: Kyphosis is a forward rounding of the back, typically in the thoracic spine,
commonly seen in older adults due to degenerative changes, osteoporosis, or poor posture.
6. Which finding in a preschooler during a cardiovascular system examination is abnormal?
1. Heart rate of 106 beats/min
2. Failure to gain weight because of fatigue while eating ✅
2. Continuous low-pitched vibrations heard over the jugular vein
3. Pulse increasing on inspiration and decreasing on expiration
, Correct Answer: 2. Failure to gain weight because of fatigue while eating Rationale: This
is a red flag in a pediatric cardiovascular assessment. It may indicate heart failure or a
congenital cardiac anomaly that causes poor perfusion and energy depletion during feeding.
The other findings can be normal variants in children.
7. During a musculoskeletal assessment, crepitus is best described as:
A. A dull ache in the joints.
B. A clicking sound during movement.
C. A feeling of warmth over the joint.
D. A grating or crackling sound with joint movement. ✅
Correct Answer: D. A grating or crackling sound with joint movement.
Rationale: Crepitus refers to a palpable or audible crunching/grating sensation caused by
friction between bone and cartilage. It is often found in degenerative joint diseases like
osteoarthritis.
8. Which of the following findings is normal when assessing the spine?
A. Lateral curvature
B. Smooth and symmetric alignment
C. Pain upon palpation
D. Thoracic tenderness
✅ Correct Answer: B. Smooth and symmetric alignment
Rationale: A healthy spine should appear straight and symmetric with no lateral deviation
(which may indicate scoliosis) and no tenderness. Pain or curvature can signal structural
issues.
9. Which cranial nerve is tested when assessing the strength of neck muscles?
A. Cranial Nerve IX (Glossopharyngeal)
B. Cranial Nerve X (Vagus)
C. Cranial Nerve XI (Spinal Accessory)
D. Cranial Nerve VII (Facial)
✅ Correct Answer: C. Cranial Nerve XI (Spinal Accessory)
, Rationale: CN XI controls the sternocleidomastoid and trapezius muscles, which are
responsible for head rotation and shoulder elevation. Testing includes asking the patient to
shrug shoulders against resistance.
10. When percussing over bone, the expected sound is:
A. Dull
B. Tympanic
C. Flat ✅
D. Resonant
✅ Correct Answer: C. Flat
Rationale: Percussion over a bone produces a flat sound due to its solid density. Resonance is
heard over normal lung tissue, dullness over organs, and tympany over air-filled structures
like the stomach.
11. What is a common cause of lordosis in children?
A. Pregnancy
B. Osteoporosis
C. Muscular dystrophy
D. Weak abdominal muscles ✅
✅ Correct Answer: D. Weak abdominal muscles
Rationale: In children, lordosis (exaggerated lumbar curve) often results from weak core
muscles and tight lower back muscles. In adults, pregnancy or obesity can also contribute.
12. What is the most accurate method to assess edema in the lower extremities?
A. Palpate for warmth
B. Inspect for color changes
C. Press firmly over a bony prominence for pitting ✅
D. Ask the patient if their shoes feel tight
Correct Answer: C. Press firmly over a bony prominence for pitting Rationale: Edema is
best assessed by applying pressure over areas like the tibia or ankle to check for indentation
(pitting). This helps grade the severity on a scale from 1+ to 4+.
These Proven Practice Questions and Step-by-Step
Solutions
1. What does a goniometer measure?
A. Muscle strength
B. Joint stability
C. Cranial nerve function
D. Angles of extension and flexion ✅
Correct Answer: D. Angles of extension and flexion
Rationale: A goniometer is an instrument used to measure the range of motion (ROM) in
joints. It helps assess limitations in movement by providing an exact angle of flexion and
extension, which is useful in musculoskeletal evaluations.
2. Which of the following techniques is used to assess muscle strength in a patient?
A. Apply an opposing force or resistance. ✅
B. Observe the patient at rest.
C. Percuss the muscle.
D. Palpate the muscle.
Correct Answer: A. Apply an opposing force or resistance.
Rationale: Assessing muscle strength involves asking the patient to contract a muscle while
the examiner applies opposing resistance. This determines the patient's ability to overcome
force, a key part of strength grading. Observation, palpation, and percussion help in
assessment but do not evaluate strength directly.
3. Neck flexion and extension should be:
A. 90 degrees B.
70 degrees
C. 30 degrees
,D. 45 degrees ✅
Correct Answer: D. 45 degrees
Rationale: Normal range of motion for both neck flexion and extension is about 45 degrees.
Any significant deviation may suggest issues with musculoskeletal alignment, neurological
impairment, or soft tissue injury.
4. Which of the following findings in a musculoskeletal assessment would be considered
abnormal?
A. Nodules
B. Bogginess
C. Symmetry
D. Both A and B ✅
Correct Answer: D. Both A and B
Rationale: Nodules and bogginess are abnormal findings. Nodules may suggest arthritis or
gout, and bogginess can be indicative of inflammation or joint effusion. Symmetry, in
contrast, is a normal finding.
5. What is an increased thoracic curvature, common in older adults, called?
A. Scoliosis
B. Lordosis
C. Kyphosis ✅
D. Swayback
Correct Answer: C. Kyphosis
Rationale: Kyphosis is a forward rounding of the back, typically in the thoracic spine,
commonly seen in older adults due to degenerative changes, osteoporosis, or poor posture.
6. Which finding in a preschooler during a cardiovascular system examination is abnormal?
1. Heart rate of 106 beats/min
2. Failure to gain weight because of fatigue while eating ✅
2. Continuous low-pitched vibrations heard over the jugular vein
3. Pulse increasing on inspiration and decreasing on expiration
, Correct Answer: 2. Failure to gain weight because of fatigue while eating Rationale: This
is a red flag in a pediatric cardiovascular assessment. It may indicate heart failure or a
congenital cardiac anomaly that causes poor perfusion and energy depletion during feeding.
The other findings can be normal variants in children.
7. During a musculoskeletal assessment, crepitus is best described as:
A. A dull ache in the joints.
B. A clicking sound during movement.
C. A feeling of warmth over the joint.
D. A grating or crackling sound with joint movement. ✅
Correct Answer: D. A grating or crackling sound with joint movement.
Rationale: Crepitus refers to a palpable or audible crunching/grating sensation caused by
friction between bone and cartilage. It is often found in degenerative joint diseases like
osteoarthritis.
8. Which of the following findings is normal when assessing the spine?
A. Lateral curvature
B. Smooth and symmetric alignment
C. Pain upon palpation
D. Thoracic tenderness
✅ Correct Answer: B. Smooth and symmetric alignment
Rationale: A healthy spine should appear straight and symmetric with no lateral deviation
(which may indicate scoliosis) and no tenderness. Pain or curvature can signal structural
issues.
9. Which cranial nerve is tested when assessing the strength of neck muscles?
A. Cranial Nerve IX (Glossopharyngeal)
B. Cranial Nerve X (Vagus)
C. Cranial Nerve XI (Spinal Accessory)
D. Cranial Nerve VII (Facial)
✅ Correct Answer: C. Cranial Nerve XI (Spinal Accessory)
, Rationale: CN XI controls the sternocleidomastoid and trapezius muscles, which are
responsible for head rotation and shoulder elevation. Testing includes asking the patient to
shrug shoulders against resistance.
10. When percussing over bone, the expected sound is:
A. Dull
B. Tympanic
C. Flat ✅
D. Resonant
✅ Correct Answer: C. Flat
Rationale: Percussion over a bone produces a flat sound due to its solid density. Resonance is
heard over normal lung tissue, dullness over organs, and tympany over air-filled structures
like the stomach.
11. What is a common cause of lordosis in children?
A. Pregnancy
B. Osteoporosis
C. Muscular dystrophy
D. Weak abdominal muscles ✅
✅ Correct Answer: D. Weak abdominal muscles
Rationale: In children, lordosis (exaggerated lumbar curve) often results from weak core
muscles and tight lower back muscles. In adults, pregnancy or obesity can also contribute.
12. What is the most accurate method to assess edema in the lower extremities?
A. Palpate for warmth
B. Inspect for color changes
C. Press firmly over a bony prominence for pitting ✅
D. Ask the patient if their shoes feel tight
Correct Answer: C. Press firmly over a bony prominence for pitting Rationale: Edema is
best assessed by applying pressure over areas like the tibia or ankle to check for indentation
(pitting). This helps grade the severity on a scale from 1+ to 4+.
