BSN 246 HESI HEALTH ASSESSMENT EXAM V1 –
NIGHTINGALE COLLEGE – 2025/2026 – 200 VERIFIED QUESTIONS
WITH 100% CORRECT ANSWERS – A+ RATED
The nurse is interviewing a client who reports having a persistent, productive cough during the
winter caused by bronchitis. Which additional finding should the nurse assess for bronchitis?
Phlegm production and wheezing.
The nurse is assessing the posterior pharynx during a physical examination. Which technique
should the nurse use?
Press the tongue down one side at a time with a tongue depressor.
The nurse is assessing a client who has a history of mitral stenosis. How should the nurse assess
this client with a stethoscope to listen for this condition?
Place the bell on the 5th intercostal space, lef t midclavicular line.
Which statement is accurate about assessing the spleen?
It must be enlarged at least three times normal size for it to be palpable.
https://www.stuvia.com/user/LUCIDWISE
,During an external examination of the eyes, the nurse gently palpates the eyes while the client's
eyelids are closed. The eyes are both very firm and resist movement back into the orbit. How
should the nurse document this finding?
Abnormal finding.
Which tool should the nurse use when assessing the neurological status of a client with
traumatic brain injury?
Glasgow Coma Scale.
The nurse is assessing a client with liver disease who is jaundice and exhibits scleral edema.
During the health assessment, the nurse should implement which technique to determine
evidence of hepatomegaly?
Use a bouncing motion to tap the middle finger placed within boundaries of the liver.
What is the best nursing response to an older client who has not mentioned incontinence
during a genitourinary assessment?
Ask the client specifically about any leakage of urine.
https://www.stuvia.com/user/LUCIDWISE
,The registered nurse (RN) is caring for an Asian client who refuses to make eye contact during
conversations. How should the RN assess this client's response?
The client is treating the nurse with respect.
The nurse is assessing a client for a hip flexion contracture. Which finding indicates a negative
Thomas test when the client's right knee is brought toward the chest?
The left leg remains on the table
*The Thomas test is performed by having the client bring one knee toward the chest while the
other leg remains extended on the table. A positive Thomas test is elicited when the extended
leg rises off the table when the opposite leg's knee is brought up to the client's chest,
indicating hip flexor contracture. If the extended leg (the left leg, in this example) remains on
the table, the test is negative.
The nurse is assessing a client who has a history of aortic regurgitation. Where should the nurse
place the stethoscope diaphragm to listen for this condition?
2nd intercostal space along the right sternal border.
The nurse is assessing a client who has experienced a sudden onset of hearing loss in the right
ear. Which finding should alert the nurse to a potentially serious medical condition that requires
further evaluation?
There is no sign of associated infection.
https://www.stuvia.com/user/LUCIDWISE
, Which information should the nurse obtain to identify the client's self-perception of health
status?
Health history
During the initial assessment, the nurse notes that a client has blurred vision with cloudy lenses.
Which condition should the nurse document?
Cataracts.
Which condition is indicated by a fluorescent, yellow-green color when the nurse uses a Wood's
lamp toexamine a client's skin lesions?
Fungal infection.
A client with dark skin is reporting a painful and itching area on the lower left leg. What should
the nurse look for when assessing this client's skin for inflammation?
Change in consistency.
https://www.stuvia.com/user/LUCIDWISE
NIGHTINGALE COLLEGE – 2025/2026 – 200 VERIFIED QUESTIONS
WITH 100% CORRECT ANSWERS – A+ RATED
The nurse is interviewing a client who reports having a persistent, productive cough during the
winter caused by bronchitis. Which additional finding should the nurse assess for bronchitis?
Phlegm production and wheezing.
The nurse is assessing the posterior pharynx during a physical examination. Which technique
should the nurse use?
Press the tongue down one side at a time with a tongue depressor.
The nurse is assessing a client who has a history of mitral stenosis. How should the nurse assess
this client with a stethoscope to listen for this condition?
Place the bell on the 5th intercostal space, lef t midclavicular line.
Which statement is accurate about assessing the spleen?
It must be enlarged at least three times normal size for it to be palpable.
https://www.stuvia.com/user/LUCIDWISE
,During an external examination of the eyes, the nurse gently palpates the eyes while the client's
eyelids are closed. The eyes are both very firm and resist movement back into the orbit. How
should the nurse document this finding?
Abnormal finding.
Which tool should the nurse use when assessing the neurological status of a client with
traumatic brain injury?
Glasgow Coma Scale.
The nurse is assessing a client with liver disease who is jaundice and exhibits scleral edema.
During the health assessment, the nurse should implement which technique to determine
evidence of hepatomegaly?
Use a bouncing motion to tap the middle finger placed within boundaries of the liver.
What is the best nursing response to an older client who has not mentioned incontinence
during a genitourinary assessment?
Ask the client specifically about any leakage of urine.
https://www.stuvia.com/user/LUCIDWISE
,The registered nurse (RN) is caring for an Asian client who refuses to make eye contact during
conversations. How should the RN assess this client's response?
The client is treating the nurse with respect.
The nurse is assessing a client for a hip flexion contracture. Which finding indicates a negative
Thomas test when the client's right knee is brought toward the chest?
The left leg remains on the table
*The Thomas test is performed by having the client bring one knee toward the chest while the
other leg remains extended on the table. A positive Thomas test is elicited when the extended
leg rises off the table when the opposite leg's knee is brought up to the client's chest,
indicating hip flexor contracture. If the extended leg (the left leg, in this example) remains on
the table, the test is negative.
The nurse is assessing a client who has a history of aortic regurgitation. Where should the nurse
place the stethoscope diaphragm to listen for this condition?
2nd intercostal space along the right sternal border.
The nurse is assessing a client who has experienced a sudden onset of hearing loss in the right
ear. Which finding should alert the nurse to a potentially serious medical condition that requires
further evaluation?
There is no sign of associated infection.
https://www.stuvia.com/user/LUCIDWISE
, Which information should the nurse obtain to identify the client's self-perception of health
status?
Health history
During the initial assessment, the nurse notes that a client has blurred vision with cloudy lenses.
Which condition should the nurse document?
Cataracts.
Which condition is indicated by a fluorescent, yellow-green color when the nurse uses a Wood's
lamp toexamine a client's skin lesions?
Fungal infection.
A client with dark skin is reporting a painful and itching area on the lower left leg. What should
the nurse look for when assessing this client's skin for inflammation?
Change in consistency.
https://www.stuvia.com/user/LUCIDWISE
