BSN 246 HESI Health Assessment Exam V1 (2025/2026 Update) –
100% Correct Questions and Verified Answers | Grade A –
Nightingale
Instructions
This document contains 80 unique multiple-choice questions tailored for the BSN 246 HESI
Health Assessment Exam V1 (2025/2026 Update). Each question aligns with Nightingale’s
clinical evaluation criteria, covering comprehensive health assessment skills including phys-
ical examination, history-taking, and diagnostic reasoning. Questions include four answer
options, with the correct answer verified and supported by a detailed rationale. This PDF-
ready resource is designed to prepare students for the exam and enhance clinical competency.
Practice Questions
Question 1:
While performing a cardiovascular assessment, the nurse notes a low-pitched, rumbling mur-
mur at the apex of the heart. This finding is most consistent with which condition?
(A) Aortic stenosis
(B) Mitral stenosis
(C) Pulmonic regurgitation
(D) Tricuspid regurgitation
Correct Answer: B
Rationale:
A low-pitched, rumbling murmur at the apex is characteristic of mitral stenosis, heard best
during diastole due to turbulent flow across a narrowed mitral valve. Aortic stenosis (A)
produces a systolic murmur at the right sternal border, pulmonic regurgitation (C) is heard
at the left upper sternal border, and tricuspid regurgitation (D) is heard at the lower left
sternal border. Nightingale’s criteria emphasize precise auscultation locations for accurate
diagnosis.
Question 2:
The nurse is assessing cranial nerve VIII (vestibulocochlear). Which test should be per-
formed?
(A) Whisper test for hearing
(B) Snellen chart for vision
1
, (C) Tongue movement assessment
(D) Shoulder shrug against resistance
Correct Answer: A
Rationale:
Cranial nerve VIII controls hearing and balance. The whisper test assesses hearing by
whispering words at a distance, aligning with Nightingale’s emphasis on sensory function
evaluation. The Snellen chart (B) tests cranial nerve II, tongue movement (C) tests cranial
nerve XII, and shoulder shrug (D) tests cranial nerve XI.
Question 3:
A patient presents with left upper quadrant pain that worsens with deep inspiration. Which
organ is most likely involved?
(A) Liver
(B) Spleen
(C) Pancreas
(D) Gallbladder
Correct Answer: B
Rationale:
Left upper quadrant pain exacerbated by inspiration suggests splenic irritation, possibly
due to splenomegaly or rupture. Liver (A) and gallbladder (D) pain are right-sided, and
pancreatic (C) pain is epigastric with radiation to the back. Nightingale’s criteria prioritize
localizing pain to specific anatomical regions for differential diagnosis.
Question 4:
During a respiratory assessment, the nurse notes dullness to percussion over the right lower
lobe. This finding is most suggestive of which condition?
(A) Pneumothorax
(B) Pleural effusion
(C) Emphysema
(D) Asthma
Correct Answer: B
Rationale:
Dullness to percussion indicates fluid or consolidation, as in pleural effusion, where fluid
accumulates in the pleural space. Pneumothorax (A) causes hyperresonance, emphysema (C)
produces hyperresonance due to air trapping, and asthma (D) is associated with wheezing,
2
,not percussion changes. Nightingale’s assessment standards highlight percussion as a key
diagnostic tool.
Question 5:
The nurse is performing a cerebellar assessment. Which action should the patient perform?
(A) Touch their nose with alternating fingers
(B) Clench their teeth
(C) Follow a light with their eyes
(D) Identify a scent
Correct Answer: A
Rationale:
The finger-to-nose test assesses cerebellar coordination and accuracy of movement. Clenching
teeth (B) tests cranial nerve V, eye movement (C) tests cranial nerves III, IV, and VI, and
scent identification (D) tests cranial nerve I. Nightingale’s curriculum emphasizes targeted
neurological testing for specific brain regions.
Question 6:
A patient has a blood pressure of 180/100 mmHg and reports a headache. Which assessment
finding is most concerning?
(A) Papilledema on fundoscopic exam
(B) Pitting edema in the ankles
(C) Hyperactive bowel sounds
(D) Clear lung fields
Correct Answer: A
Rationale:
Papilledema, swelling of the optic disc, indicates increased intracranial pressure, a hyperten-
sive emergency complication. Edema (B) suggests fluid overload, hyperactive bowel sounds
(C) are nonspecific, and clear lungs (D) are normal. Nightingale’s criteria prioritize identi-
fying life-threatening findings in hypertensive patients.
Question 7:
During a skin assessment, the nurse notes a 3 cm, non-blanching, purple lesion on the leg.
This finding is most consistent with which condition?
(A) Ecchymosis
(B) Erythema
(C) Petechiae
3
, (D) Telangiectasia
Correct Answer: A
Rationale:
A non-blanching, purple lesion of 3 cm is an ecchymosis, indicating subcutaneous bleeding.
Erythema (B) is blanching redness, petechiae (C) are small (<3 mm) non-blanching spots,
and telangiectasia (D) are dilated superficial vessels. Nightingale’s skin assessment standards
emphasize lesion size and blanching for diagnosis.
Question 8:
The nurse is assessing a patient’s peripheral vascular system and notes a 1+ pulse in the
posterior tibial artery. What does this indicate?
(A) Normal pulse strength
(B) Bounding pulse
(C) Diminished pulse
(D) Absent pulse
Correct Answer: C
Rationale:
A 1+ pulse is diminished, indicating reduced arterial flow, possibly due to peripheral artery
disease. Normal pulse strength (A) is 2+, bounding (B) is 4+, and absent (D) is 0. Nightin-
gale’s criteria stress grading pulses to assess vascular integrity.
Question 9:
A patient reports sudden onset of floaters and flashes of light in one eye. Which condition
is most likely?
(A) Glaucoma
(B) Retinal detachment
(C) Cataracts
(D) Conjunctivitis
Correct Answer: B
Rationale:
Floaters and flashes of light suggest retinal detachment, a medical emergency where the
retina pulls away from the choroid. Glaucoma (A) causes peripheral vision loss, cataracts
(C) cause cloudy vision, and conjunctivitis (D) causes redness. Nightingale’s curriculum
emphasizes urgent referral for acute visual changes.
Question 10:
4
100% Correct Questions and Verified Answers | Grade A –
Nightingale
Instructions
This document contains 80 unique multiple-choice questions tailored for the BSN 246 HESI
Health Assessment Exam V1 (2025/2026 Update). Each question aligns with Nightingale’s
clinical evaluation criteria, covering comprehensive health assessment skills including phys-
ical examination, history-taking, and diagnostic reasoning. Questions include four answer
options, with the correct answer verified and supported by a detailed rationale. This PDF-
ready resource is designed to prepare students for the exam and enhance clinical competency.
Practice Questions
Question 1:
While performing a cardiovascular assessment, the nurse notes a low-pitched, rumbling mur-
mur at the apex of the heart. This finding is most consistent with which condition?
(A) Aortic stenosis
(B) Mitral stenosis
(C) Pulmonic regurgitation
(D) Tricuspid regurgitation
Correct Answer: B
Rationale:
A low-pitched, rumbling murmur at the apex is characteristic of mitral stenosis, heard best
during diastole due to turbulent flow across a narrowed mitral valve. Aortic stenosis (A)
produces a systolic murmur at the right sternal border, pulmonic regurgitation (C) is heard
at the left upper sternal border, and tricuspid regurgitation (D) is heard at the lower left
sternal border. Nightingale’s criteria emphasize precise auscultation locations for accurate
diagnosis.
Question 2:
The nurse is assessing cranial nerve VIII (vestibulocochlear). Which test should be per-
formed?
(A) Whisper test for hearing
(B) Snellen chart for vision
1
, (C) Tongue movement assessment
(D) Shoulder shrug against resistance
Correct Answer: A
Rationale:
Cranial nerve VIII controls hearing and balance. The whisper test assesses hearing by
whispering words at a distance, aligning with Nightingale’s emphasis on sensory function
evaluation. The Snellen chart (B) tests cranial nerve II, tongue movement (C) tests cranial
nerve XII, and shoulder shrug (D) tests cranial nerve XI.
Question 3:
A patient presents with left upper quadrant pain that worsens with deep inspiration. Which
organ is most likely involved?
(A) Liver
(B) Spleen
(C) Pancreas
(D) Gallbladder
Correct Answer: B
Rationale:
Left upper quadrant pain exacerbated by inspiration suggests splenic irritation, possibly
due to splenomegaly or rupture. Liver (A) and gallbladder (D) pain are right-sided, and
pancreatic (C) pain is epigastric with radiation to the back. Nightingale’s criteria prioritize
localizing pain to specific anatomical regions for differential diagnosis.
Question 4:
During a respiratory assessment, the nurse notes dullness to percussion over the right lower
lobe. This finding is most suggestive of which condition?
(A) Pneumothorax
(B) Pleural effusion
(C) Emphysema
(D) Asthma
Correct Answer: B
Rationale:
Dullness to percussion indicates fluid or consolidation, as in pleural effusion, where fluid
accumulates in the pleural space. Pneumothorax (A) causes hyperresonance, emphysema (C)
produces hyperresonance due to air trapping, and asthma (D) is associated with wheezing,
2
,not percussion changes. Nightingale’s assessment standards highlight percussion as a key
diagnostic tool.
Question 5:
The nurse is performing a cerebellar assessment. Which action should the patient perform?
(A) Touch their nose with alternating fingers
(B) Clench their teeth
(C) Follow a light with their eyes
(D) Identify a scent
Correct Answer: A
Rationale:
The finger-to-nose test assesses cerebellar coordination and accuracy of movement. Clenching
teeth (B) tests cranial nerve V, eye movement (C) tests cranial nerves III, IV, and VI, and
scent identification (D) tests cranial nerve I. Nightingale’s curriculum emphasizes targeted
neurological testing for specific brain regions.
Question 6:
A patient has a blood pressure of 180/100 mmHg and reports a headache. Which assessment
finding is most concerning?
(A) Papilledema on fundoscopic exam
(B) Pitting edema in the ankles
(C) Hyperactive bowel sounds
(D) Clear lung fields
Correct Answer: A
Rationale:
Papilledema, swelling of the optic disc, indicates increased intracranial pressure, a hyperten-
sive emergency complication. Edema (B) suggests fluid overload, hyperactive bowel sounds
(C) are nonspecific, and clear lungs (D) are normal. Nightingale’s criteria prioritize identi-
fying life-threatening findings in hypertensive patients.
Question 7:
During a skin assessment, the nurse notes a 3 cm, non-blanching, purple lesion on the leg.
This finding is most consistent with which condition?
(A) Ecchymosis
(B) Erythema
(C) Petechiae
3
, (D) Telangiectasia
Correct Answer: A
Rationale:
A non-blanching, purple lesion of 3 cm is an ecchymosis, indicating subcutaneous bleeding.
Erythema (B) is blanching redness, petechiae (C) are small (<3 mm) non-blanching spots,
and telangiectasia (D) are dilated superficial vessels. Nightingale’s skin assessment standards
emphasize lesion size and blanching for diagnosis.
Question 8:
The nurse is assessing a patient’s peripheral vascular system and notes a 1+ pulse in the
posterior tibial artery. What does this indicate?
(A) Normal pulse strength
(B) Bounding pulse
(C) Diminished pulse
(D) Absent pulse
Correct Answer: C
Rationale:
A 1+ pulse is diminished, indicating reduced arterial flow, possibly due to peripheral artery
disease. Normal pulse strength (A) is 2+, bounding (B) is 4+, and absent (D) is 0. Nightin-
gale’s criteria stress grading pulses to assess vascular integrity.
Question 9:
A patient reports sudden onset of floaters and flashes of light in one eye. Which condition
is most likely?
(A) Glaucoma
(B) Retinal detachment
(C) Cataracts
(D) Conjunctivitis
Correct Answer: B
Rationale:
Floaters and flashes of light suggest retinal detachment, a medical emergency where the
retina pulls away from the choroid. Glaucoma (A) causes peripheral vision loss, cataracts
(C) cause cloudy vision, and conjunctivitis (D) causes redness. Nightingale’s curriculum
emphasizes urgent referral for acute visual changes.
Question 10:
4
