University of Pennsylvania HESI Assessment Practice Test 2025: WITH 300 Comprehensive Review with High-Yield Questions, Detailed Rationales, and Exam Strategies for Guaranteed Nursing Exam Success

University of Pennsylvania HESI Assessment
Practice Test 2025: WITH 300 Comprehensive
Review with High-Yield Questions, Detailed
Rationales, and Exam Strategies for Guaranteed
Nursing Exam Success

1. Chest Assessment: Fine Crackles and Associated Respiratory Disorders

Question: During chest assessment of a client with idiopathic pulmonary fibrosis, the
nurse hears short, discontinuous, high-pitched sounds in the bilateral lower lobes.
Which respiratory disorders may also manifest these sounds as a pathophysiological
sign? (Select all that apply)

• A. Croup

• B. Atelectasis

• C. Cystic fibrosis

• D. Bronchospasm

• E. Pulmonary edema

Correct Answers: B, E
Rationale: Fine crackles are indicative of conditions such as idiopathic pulmonary
fibrosis, atelectasis, and pulmonary edema. Croup, cystic fibrosis, and bronchospasm
are characterized by different breath sounds.



2. Early Signs of Hypoxia

Question: Which assessment finding is considered the earliest sign of decreased tissue
oxygenation?

• A. Cyanosis

• B. Cool, clammy skin

• C. Unexplained restlessness

• D. Retraction of interspaces on inspiration

,Correct Answer: C
Rationale: Unexplained restlessness is the earliest sign of hypoxia. The others are
considered late signs.



3. Emergency Chest Injury Protocol

Question: According to the emergency assessment protocol, which are the nursing
actions for a client with a chest injury? (Select all that apply)

• A. Palpating for bony crepitus

• B. Auscultating bowel sounds

• C. Examining the neck for stiffness

• D. Assessing for external signs of injury

• E. Observing the rate, depth, and effort of breathing

Correct Answers: A, D, E
Rationale: These are specific to chest injuries. Bowel sounds relate to abdominal
injuries and neck stiffness relates to neurological issues.



4. Fluid Volume Overload

Question: The client is receiving high-flow IV fluid replacement therapy. Which findings
are consistent with fluid volume overload? (Select all that apply)

• A. Pulse quality

• B. Pulse pressure

• C. Bounding pulse

• D. Dependent edema

• E. Neck vein distention in upright position

Correct Answers: C, D, E
Rationale: These findings suggest fluid overload. Pulse quality and pressure are used to
monitor, not directly diagnose overload.



5. Diplopia and Misalignment

Question: A client reports double vision and the nurse notes a misalignment of the right
eye. What is the most likely cause?

, • A. Myasthenia gravis

• B. Strabismus

• C. Periorbital tumor

• D. Subconjunctival hemorrhage

Correct Answer: B
Rationale: Strabismus, or misalignment due to extraocular muscle abnormalities, often
leads to diplopia.



6. Signs of Meningitis

Question: Which assessment finding in a post-brain surgery patient supports a
diagnosis of meningitis?

• A. Glasgow Coma Score 15

• B. Brudzinski sign

• C. Sluggish pupil response

• D. Positive Kernig sign

Correct Answer: D
Rationale: A positive Kernig sign is a classic indicator of meningitis.



7. Cranial Nerve III Dysfunction

Question: The nurse observes that a client's pupil remains dilated when light is shone.
Which cranial nerve is most likely affected?

• A. CN V

• B. CN III

• C. CN VII

• D. CN VIII

Correct Answer: B
Rationale: CN III (oculomotor) controls pupillary constriction.



8. Hypocalcemia

Question: Which finding indicates mild hypocalcemia?

, • A. Seizures

• B. Hand spasms

• C. Severe muscle cramps

• D. Numbness around the mouth

Correct Answer: D
Rationale: Numbness and tingling indicate early hypocalcemia; others are more severe
manifestations.



9. Wound Abscess Indicators

Question: The nurse detects potential abscess formation in a surgical wound. Which
findings support this? (Select all that apply)

• A. Necrosis of skin edges

• B. Swelling of incision line

• C. Purulent drainage

• D. Erythema >1 cm

• E. Localized fluctuance

Correct Answers: C, E
Rationale: Purulent drainage and fluctuance indicate abscess; others suggest cellulitis
or wound dehiscence.



10. Herpes Zoster Identification

Question: Which virus causes a linear rash with vesicles on an erythematous base
along a dermatome?

• A. Papillomavirus

• B. Epstein-Barr virus

• C. Varicella-zoster virus

• D. Herpesvirus 8

Correct Answer: C
Rationale: Herpes zoster (shingles) is caused by the varicella-zoster virus.