HESI A2 Anatomy & Physiology
2025/2026, Real Exam Questions with
Correct Answers
Questions 1-10: Integumentary, Skeletal, and Muscular Systems
Question 1: Integumentary System
A client with severe sunburn presents with redness, pain, and blistering on the arms after 2 hours
of unprotected sun exposure. This reaction primarily involves damage to which layer of the skin,
where melanocytes and sensory receptors are located?
A. Stratum corneum
B. Stratum spinosum
C. Hypodermis
D. Dermis
B. Stratum spinosum
Rationale: The stratum spinosum (prickle cell layer) contains keratinocytes and desmosomes for
strength; UV damage here triggers inflammation and blistering via cytokine release, per
dermatology guidelines emphasizing barrier function.
Question 2: Integumentary System
During a physical exam, a nurse notes a client's skin turgor is poor, with tenting lasting >2
seconds on the forearm. This finding suggests dehydration affecting which physiological
function of the integumentary system?
A. Thermoregulation
B. Hydration status indicator
C. Vitamin D synthesis
D. Sensation
B. Hydration status indicator
,Rationale: Skin turgor assesses extracellular fluid volume; delayed recoil indicates dehydration,
guiding fluid resuscitation to maintain electrolyte balance and prevent hypovolemic shock.
Question 3: Skeletal System
A 65-year-old client complains of lower back pain after a minor fall, with X-ray showing
vertebral compression. This injury commonly affects which type of bone tissue most abundant in
the axial skeleton?
A. Compact bone
B. Cancellous (spongy) bone
C. Cartilage
D. Periosteum
B. Cancellous (spongy) bone
Rationale: Spongy bone in vertebrae provides shock absorption via trabeculae; osteoporosis
weakens it, increasing fracture risk—early DEXA screening recommended for prevention.
Question 4: Skeletal System
In a pediatric client with rickets, the nurse explains that bowed legs result from impaired
mineralization of the epiphyseal plates. This involves deficiency in which vitamin essential for
calcium absorption?
A. Vitamin A
B. Vitamin D
C. Vitamin K
D. Vitamin C
B. Vitamin D
Rationale: Vitamin D promotes intestinal calcium/phosphate uptake for osteoid calcification;
deficiency softens bones (osteomalacia in kids), treated with 2,000 IU/day supplementation per
AAP.
Question 5: Muscular System
A client post-workout experiences muscle soreness due to microtears in fibers, repaired via
satellite cell proliferation. This process primarily occurs in which type of muscle tissue?
A. Cardiac muscle
, B. Skeletal muscle
C. Smooth muscle
D. Involuntary muscle
B. Skeletal muscle
Rationale: Skeletal muscle (striated, voluntary) hypertrophies via myofibril addition; eccentric
exercise causes DOMS, managed with rest/NSAIDs to support repair without rhabdomyolysis.
Question 6: Muscular System
During a neuro exam, a client exhibits involuntary, rhythmic contractions of the quadriceps when
the patellar tendon is tapped. This reflex tests integrity of which muscle component?
A. Tendon
B. Muscle spindle
C. Motor end plate
D. Sarcoplasmic reticulum
B. Muscle spindle
Rationale: Stretch reflex arc via Ia afferents from spindles excites alpha motor neurons;
hyperreflexia signals UMN lesions, guiding CNS assessment.
Question 7: Integumentary System
A burn victim with partial-thickness injury shows weeping blisters and capillary refill delay.
Healing involves regeneration from which skin layer, where stem cells reside?
A. Epidermis
B. Basal layer (stratum basale)
C. Dermis
D. Subcutaneous
B. Basal layer (stratum basale)
Rationale: Stratum basale keratinocytes migrate upward for re-epithelialization; wound care
with silver sulfadiazine prevents infection during 7-14 day granulation phase.
Question 8: Skeletal System
2025/2026, Real Exam Questions with
Correct Answers
Questions 1-10: Integumentary, Skeletal, and Muscular Systems
Question 1: Integumentary System
A client with severe sunburn presents with redness, pain, and blistering on the arms after 2 hours
of unprotected sun exposure. This reaction primarily involves damage to which layer of the skin,
where melanocytes and sensory receptors are located?
A. Stratum corneum
B. Stratum spinosum
C. Hypodermis
D. Dermis
B. Stratum spinosum
Rationale: The stratum spinosum (prickle cell layer) contains keratinocytes and desmosomes for
strength; UV damage here triggers inflammation and blistering via cytokine release, per
dermatology guidelines emphasizing barrier function.
Question 2: Integumentary System
During a physical exam, a nurse notes a client's skin turgor is poor, with tenting lasting >2
seconds on the forearm. This finding suggests dehydration affecting which physiological
function of the integumentary system?
A. Thermoregulation
B. Hydration status indicator
C. Vitamin D synthesis
D. Sensation
B. Hydration status indicator
,Rationale: Skin turgor assesses extracellular fluid volume; delayed recoil indicates dehydration,
guiding fluid resuscitation to maintain electrolyte balance and prevent hypovolemic shock.
Question 3: Skeletal System
A 65-year-old client complains of lower back pain after a minor fall, with X-ray showing
vertebral compression. This injury commonly affects which type of bone tissue most abundant in
the axial skeleton?
A. Compact bone
B. Cancellous (spongy) bone
C. Cartilage
D. Periosteum
B. Cancellous (spongy) bone
Rationale: Spongy bone in vertebrae provides shock absorption via trabeculae; osteoporosis
weakens it, increasing fracture risk—early DEXA screening recommended for prevention.
Question 4: Skeletal System
In a pediatric client with rickets, the nurse explains that bowed legs result from impaired
mineralization of the epiphyseal plates. This involves deficiency in which vitamin essential for
calcium absorption?
A. Vitamin A
B. Vitamin D
C. Vitamin K
D. Vitamin C
B. Vitamin D
Rationale: Vitamin D promotes intestinal calcium/phosphate uptake for osteoid calcification;
deficiency softens bones (osteomalacia in kids), treated with 2,000 IU/day supplementation per
AAP.
Question 5: Muscular System
A client post-workout experiences muscle soreness due to microtears in fibers, repaired via
satellite cell proliferation. This process primarily occurs in which type of muscle tissue?
A. Cardiac muscle
, B. Skeletal muscle
C. Smooth muscle
D. Involuntary muscle
B. Skeletal muscle
Rationale: Skeletal muscle (striated, voluntary) hypertrophies via myofibril addition; eccentric
exercise causes DOMS, managed with rest/NSAIDs to support repair without rhabdomyolysis.
Question 6: Muscular System
During a neuro exam, a client exhibits involuntary, rhythmic contractions of the quadriceps when
the patellar tendon is tapped. This reflex tests integrity of which muscle component?
A. Tendon
B. Muscle spindle
C. Motor end plate
D. Sarcoplasmic reticulum
B. Muscle spindle
Rationale: Stretch reflex arc via Ia afferents from spindles excites alpha motor neurons;
hyperreflexia signals UMN lesions, guiding CNS assessment.
Question 7: Integumentary System
A burn victim with partial-thickness injury shows weeping blisters and capillary refill delay.
Healing involves regeneration from which skin layer, where stem cells reside?
A. Epidermis
B. Basal layer (stratum basale)
C. Dermis
D. Subcutaneous
B. Basal layer (stratum basale)
Rationale: Stratum basale keratinocytes migrate upward for re-epithelialization; wound care
with silver sulfadiazine prevents infection during 7-14 day granulation phase.
Question 8: Skeletal System
