University of Pennysylvania2025 HESI
Assessment Exam Practice: 100 Comprehensive
Review with High-Yield Questions, Rationales,
and Test-Taking Strategies for Guaranteed
Success
1. Cushing Syndrome Clinical Manifestations
Question: A client is admitted with a diagnosis of Cushing syndrome. Which clinical
manifestations should the nurse expect the client to exhibit? Select all that apply.
Choices:
1. Polyuria
2. Weakness ✅
3. Hypertension ✅
4. Truncal obesity ✅
5. Intermittent tonic spasms
Rationale:
• Weakness, hypertension, and truncal obesity are classic signs of Cushing
syndrome due to excess corticosteroids.
• Polyuria and tonic spasms are not typical.
2. Conservation Exercises in a 6-Year-Old
Question: Which conservation exercises should the nurse include in the assessment
process of a child who is 6 years of age? Select all that apply.
Choices:
1. Comparing the mass of two balls ✅
2. Comparing the weight of two balls
3. Comparing the length of pencils ✅
4. Comparing the volume in two cups
, 5. Comparing the number of marbles ✅
Rationale:
• Conservation tasks involving mass, number, and length are developmentally
appropriate for a 6-year-old, according to Piaget’s concrete operational stage.
3. Client Unable to Cope with Divorce
Question: A nurse completes the assessment of a female client who cannot function
because of an impending divorce. What is the most effective nursing intervention at this
time?
Answer: 2. Assisting her in exploring new coping abilities ✅
Rationale:
• Encouraging new coping strategies helps the client actively manage emotional
distress. Other options focus too much on analysis rather than action.
4. Heart Sounds - Audio Clue
Question: Listening to a client's heart sounds, the nurse hears a characteristic sound.
What should the nurse document?
Answer: 4. Pericardial friction rubs ✅
Rationale:
• A pericardial friction rub produces a high-pitched, scratchy sound associated
with pericarditis.
5. Wound Dressing Asepsis
Question: Which statement by a new nurse about wound dressing indicates the need
for further teaching?
Answer: 2. "I should take the cotton swab placed on the table." ✅
Rationale:
• Once a cotton swab is placed on a non-sterile surface, it is no longer sterile.
6. Malaria Clinical Indicators
, Question: Which clinical indicators are important in a client with malaria? Select all
that apply.
Choices:
1. Polyuria
2. Leukopenia
3. Hyperthermia ✅
4. Splenomegaly ✅
5. Erythrocytosis
Rationale:
• Hyperthermia (due to fever) and splenomegaly (due to RBC destruction) are
common in malaria.
7. Very Low Birth Weight (VLBW)
Question: What birth weight indicates that the infant is VLBW?
Answer: 1. 900 g ✅
Rationale:
• VLBW is defined as a birth weight less than 1500 grams.
8. Caput Succedaneum Explanation
Question: A newborn has caput succedaneum. What is the cause?
Answer: 2. Swelling of soft tissue from labor pressure ✅
Rationale:
• Caput is soft tissue swelling that crosses suture lines due to pressure during
vaginal delivery.
9. Burns - Most Concerning Finding
Question: A child rescued from a fire has burns. What is most concerning?
Answer: 3. Burns around the mouth ✅
Rationale:
• This suggests possible inhalation injury, which is life-threatening.
Assessment Exam Practice: 100 Comprehensive
Review with High-Yield Questions, Rationales,
and Test-Taking Strategies for Guaranteed
Success
1. Cushing Syndrome Clinical Manifestations
Question: A client is admitted with a diagnosis of Cushing syndrome. Which clinical
manifestations should the nurse expect the client to exhibit? Select all that apply.
Choices:
1. Polyuria
2. Weakness ✅
3. Hypertension ✅
4. Truncal obesity ✅
5. Intermittent tonic spasms
Rationale:
• Weakness, hypertension, and truncal obesity are classic signs of Cushing
syndrome due to excess corticosteroids.
• Polyuria and tonic spasms are not typical.
2. Conservation Exercises in a 6-Year-Old
Question: Which conservation exercises should the nurse include in the assessment
process of a child who is 6 years of age? Select all that apply.
Choices:
1. Comparing the mass of two balls ✅
2. Comparing the weight of two balls
3. Comparing the length of pencils ✅
4. Comparing the volume in two cups
, 5. Comparing the number of marbles ✅
Rationale:
• Conservation tasks involving mass, number, and length are developmentally
appropriate for a 6-year-old, according to Piaget’s concrete operational stage.
3. Client Unable to Cope with Divorce
Question: A nurse completes the assessment of a female client who cannot function
because of an impending divorce. What is the most effective nursing intervention at this
time?
Answer: 2. Assisting her in exploring new coping abilities ✅
Rationale:
• Encouraging new coping strategies helps the client actively manage emotional
distress. Other options focus too much on analysis rather than action.
4. Heart Sounds - Audio Clue
Question: Listening to a client's heart sounds, the nurse hears a characteristic sound.
What should the nurse document?
Answer: 4. Pericardial friction rubs ✅
Rationale:
• A pericardial friction rub produces a high-pitched, scratchy sound associated
with pericarditis.
5. Wound Dressing Asepsis
Question: Which statement by a new nurse about wound dressing indicates the need
for further teaching?
Answer: 2. "I should take the cotton swab placed on the table." ✅
Rationale:
• Once a cotton swab is placed on a non-sterile surface, it is no longer sterile.
6. Malaria Clinical Indicators
, Question: Which clinical indicators are important in a client with malaria? Select all
that apply.
Choices:
1. Polyuria
2. Leukopenia
3. Hyperthermia ✅
4. Splenomegaly ✅
5. Erythrocytosis
Rationale:
• Hyperthermia (due to fever) and splenomegaly (due to RBC destruction) are
common in malaria.
7. Very Low Birth Weight (VLBW)
Question: What birth weight indicates that the infant is VLBW?
Answer: 1. 900 g ✅
Rationale:
• VLBW is defined as a birth weight less than 1500 grams.
8. Caput Succedaneum Explanation
Question: A newborn has caput succedaneum. What is the cause?
Answer: 2. Swelling of soft tissue from labor pressure ✅
Rationale:
• Caput is soft tissue swelling that crosses suture lines due to pressure during
vaginal delivery.
9. Burns - Most Concerning Finding
Question: A child rescued from a fire has burns. What is most concerning?
Answer: 3. Burns around the mouth ✅
Rationale:
• This suggests possible inhalation injury, which is life-threatening.
