HEALTH ASSESSMENT – HESI EXAM TEST BANK 2026–2027 | 300+
VERIFIED QUESTIONS WITH CORRECT ANSWERS, DETAILED
RATIONALES, AND EXPLANATIONS (GRADED A+)
Following abdominal auscultation of a client who is admitted for signs of
splenomegaly, which additional assessment should the nurse use to verify
splenomegaly?
Rebound tenderness.
Percussion.
Deep palpation.
Inspection. – ANSWER
When splenomegaly is suspected, percussion of the spleen produces a dull sound
and is a safe method of verifying enlargement. A normal-sized spleen is positioned
above the percussion point even when it descends during inspiration, and the
percussion tone is tympanic on both expiration and inspiration.
The nurse is assessing a healthy young adult during an annual physical
examination. Which assessment technique should the nurse implement when
palpating the abdominal aorta?
Deep palpation above and to the left of the umbilicus.
Palpation of the abdomen as the client completes a deep breath. With the
client standing, compress the abdomen as the nurse stands behind the client.
With the palm of one hand, compress the abdomen 2 fingerbreaths below xiphoid
process. - ANSWER>>Deep palpation above and to the left of the umbilicus.
,Deep palpation above and to the left of the umbilicus is effective in sensing the
pulsation of the aorta.
During a health history interview, a male client reports that he smokes cigarettes
and does not plan to quit. Which action is most important for the nurse to take?
Document the client's statement verbatim. Calculate
the client's pack year history. Express support for
the client's right to choose.
Ask about family history of lung cancer. - ANSWER>>Calculate the client's pack
year history
Calculation of cigarette pack year history provides useful screening data regarding
the client's risk for health problems, which serves as the basis for the plan of care.
How should the nurse assess for lower extremity edema in a client who has been
diagnosed with heart failure?
Measure bilateral ankle circumference with a non-stretchable tape
measure.
Press skin over the tibia and report edema according to the grading scale. Ask if
the client feels the bilateral edema has changed and to what extent. Inspect the
lower extremities together to compare the amount of swelling. -
ANSWER>>Measure bilateral ankle circumference with a non-stretchable tape
measure.
An accurate assessment of lower extremity edema is required when a client is
treated for heart failure. Measuring ankle circumference is more accurate than
other objective measures that can rely on individual interpretation, such as
measuring pitting edema.
The nurse is assessing a client's range of motion as the client bends the right knee
up to the chest while keeping the left leg straight, but is unable to keep the left thigh
on the table. The assessment is repeated for the left knee, and the client is unable to
keep the right thigh on the table. How should the nurse document this finding?
,Flexion contraction that indicates muscle atrophy.
Limited internal rotation of the hips that suggests degeneration. A
normal left and right hip flexion with expected range of motion.
A flexion deformity referred to as a positive Thomas test. - ANSWER>>A
flexion deformity referred to as a positive Thomas test.
Flexion flattens the lumbar spine, and the opposite thigh should remain on the
table. The inability to perform the hip range of motion (ROM) as expected
indicates flexion deformity referred to as a positive Thomas test.
As a part of a routine health assessment, the nurse assesses the kidneys as part of
the abdominal assessment. Which assessment finding should the nurse conclude is
normal when palpating the client's right kidney?
A round smooth mass that slides between the fingers. The
right kidney is palpated higher than the left kidney.
The kidney slides forward and has movable nodules throughout.
A vibration is felt slightly left of the abdominal midline. - ANSWER>>A
round smooth mass that slides between the fingers.
Occasionally, when assessing the adult kidneys, the nurse may feel the lower pole
of the right kidney as a round, smooth mass that slides between the fingers - or the
nurse will feel nothing at all. Either condition is normal. The nurse should search
for the right kidney by placing hands together in a "duck-bill" position at the
client's right flank. The nurse should then press two hands together firmly and ask
the client to take a deep breath. In most people, the nurse will feel no change.
Which procedure should the nurse use to assess for a pulse deficit?
Compare the brachial pulse and femoral pulse.
Document the observed pulse rate and quality.
Obtain the systolic blood pressure and subtract the apical pulse. Measure the
apical pulse and compare it to the peripheral pulse. -ANSWER>>Measure the
apical pulse and compare it to the peripheral pulse.
A pulse deficit is a palpable difference between the apical pulse at the point of
maximal impulse and the radial pulse palpated at the wrist. The nurse should
measure the apical pulse and compare it to the peripheral pulse to
, assess for a pulse deficit. If the pulse number is different from the apical pulse,
then the radial pulse rate should be subtracted from the apical pulse and the
remaining number is the number that should be recorded for the pulse deficit.
The nurse observes peristaltic movement in the left lower quadrant of a client's
abdomen. Which further assessment of the area should the nurse perform?
Observe the direction of movement.
Auscultate the area of movement. Lightly
palpate the area of movement.
Percuss the area of movement. - ANSWER>>Observe the direction of
movement
Increased peristaltic movements are occasionally seen in very thin clients and may
indicate the presence of intestinal obstruction. In addition to noting the quadrant of
origin, the nurse should also note the direction of the peristaltic flow and report
these findings to the healthcare provider.
The nurse is assessing for the presence of a hernia. Which action should the
nurse ask the client to perform while lying supine?
Bring the knees toward the chest.
Place the chin onto the chest. Roll
from one side to the other.
Use abdominal muscles to sit up. - ANSWER>>Use abdominal muscles to sit up.
Engaging the abdominal muscles can reveal a protruding hernia. When assessing
for the presence of a hernia, the nurse should ask the client to use the abdominal
muscles to sit up without hand support.
During a skin assessment, the nurse notes, round and discrete lesions that are dark
red in color and will not blanch. The lesions range from 1 to 3 mm in size. What is
the first question the nurse should ask the client?
"Have you noticed any unusual bleeding?"
"Have you fallen recently?"
"How often do you drink alcohol?"
VERIFIED QUESTIONS WITH CORRECT ANSWERS, DETAILED
RATIONALES, AND EXPLANATIONS (GRADED A+)
Following abdominal auscultation of a client who is admitted for signs of
splenomegaly, which additional assessment should the nurse use to verify
splenomegaly?
Rebound tenderness.
Percussion.
Deep palpation.
Inspection. – ANSWER
When splenomegaly is suspected, percussion of the spleen produces a dull sound
and is a safe method of verifying enlargement. A normal-sized spleen is positioned
above the percussion point even when it descends during inspiration, and the
percussion tone is tympanic on both expiration and inspiration.
The nurse is assessing a healthy young adult during an annual physical
examination. Which assessment technique should the nurse implement when
palpating the abdominal aorta?
Deep palpation above and to the left of the umbilicus.
Palpation of the abdomen as the client completes a deep breath. With the
client standing, compress the abdomen as the nurse stands behind the client.
With the palm of one hand, compress the abdomen 2 fingerbreaths below xiphoid
process. - ANSWER>>Deep palpation above and to the left of the umbilicus.
,Deep palpation above and to the left of the umbilicus is effective in sensing the
pulsation of the aorta.
During a health history interview, a male client reports that he smokes cigarettes
and does not plan to quit. Which action is most important for the nurse to take?
Document the client's statement verbatim. Calculate
the client's pack year history. Express support for
the client's right to choose.
Ask about family history of lung cancer. - ANSWER>>Calculate the client's pack
year history
Calculation of cigarette pack year history provides useful screening data regarding
the client's risk for health problems, which serves as the basis for the plan of care.
How should the nurse assess for lower extremity edema in a client who has been
diagnosed with heart failure?
Measure bilateral ankle circumference with a non-stretchable tape
measure.
Press skin over the tibia and report edema according to the grading scale. Ask if
the client feels the bilateral edema has changed and to what extent. Inspect the
lower extremities together to compare the amount of swelling. -
ANSWER>>Measure bilateral ankle circumference with a non-stretchable tape
measure.
An accurate assessment of lower extremity edema is required when a client is
treated for heart failure. Measuring ankle circumference is more accurate than
other objective measures that can rely on individual interpretation, such as
measuring pitting edema.
The nurse is assessing a client's range of motion as the client bends the right knee
up to the chest while keeping the left leg straight, but is unable to keep the left thigh
on the table. The assessment is repeated for the left knee, and the client is unable to
keep the right thigh on the table. How should the nurse document this finding?
,Flexion contraction that indicates muscle atrophy.
Limited internal rotation of the hips that suggests degeneration. A
normal left and right hip flexion with expected range of motion.
A flexion deformity referred to as a positive Thomas test. - ANSWER>>A
flexion deformity referred to as a positive Thomas test.
Flexion flattens the lumbar spine, and the opposite thigh should remain on the
table. The inability to perform the hip range of motion (ROM) as expected
indicates flexion deformity referred to as a positive Thomas test.
As a part of a routine health assessment, the nurse assesses the kidneys as part of
the abdominal assessment. Which assessment finding should the nurse conclude is
normal when palpating the client's right kidney?
A round smooth mass that slides between the fingers. The
right kidney is palpated higher than the left kidney.
The kidney slides forward and has movable nodules throughout.
A vibration is felt slightly left of the abdominal midline. - ANSWER>>A
round smooth mass that slides between the fingers.
Occasionally, when assessing the adult kidneys, the nurse may feel the lower pole
of the right kidney as a round, smooth mass that slides between the fingers - or the
nurse will feel nothing at all. Either condition is normal. The nurse should search
for the right kidney by placing hands together in a "duck-bill" position at the
client's right flank. The nurse should then press two hands together firmly and ask
the client to take a deep breath. In most people, the nurse will feel no change.
Which procedure should the nurse use to assess for a pulse deficit?
Compare the brachial pulse and femoral pulse.
Document the observed pulse rate and quality.
Obtain the systolic blood pressure and subtract the apical pulse. Measure the
apical pulse and compare it to the peripheral pulse. -ANSWER>>Measure the
apical pulse and compare it to the peripheral pulse.
A pulse deficit is a palpable difference between the apical pulse at the point of
maximal impulse and the radial pulse palpated at the wrist. The nurse should
measure the apical pulse and compare it to the peripheral pulse to
, assess for a pulse deficit. If the pulse number is different from the apical pulse,
then the radial pulse rate should be subtracted from the apical pulse and the
remaining number is the number that should be recorded for the pulse deficit.
The nurse observes peristaltic movement in the left lower quadrant of a client's
abdomen. Which further assessment of the area should the nurse perform?
Observe the direction of movement.
Auscultate the area of movement. Lightly
palpate the area of movement.
Percuss the area of movement. - ANSWER>>Observe the direction of
movement
Increased peristaltic movements are occasionally seen in very thin clients and may
indicate the presence of intestinal obstruction. In addition to noting the quadrant of
origin, the nurse should also note the direction of the peristaltic flow and report
these findings to the healthcare provider.
The nurse is assessing for the presence of a hernia. Which action should the
nurse ask the client to perform while lying supine?
Bring the knees toward the chest.
Place the chin onto the chest. Roll
from one side to the other.
Use abdominal muscles to sit up. - ANSWER>>Use abdominal muscles to sit up.
Engaging the abdominal muscles can reveal a protruding hernia. When assessing
for the presence of a hernia, the nurse should ask the client to use the abdominal
muscles to sit up without hand support.
During a skin assessment, the nurse notes, round and discrete lesions that are dark
red in color and will not blanch. The lesions range from 1 to 3 mm in size. What is
the first question the nurse should ask the client?
"Have you noticed any unusual bleeding?"
"Have you fallen recently?"
"How often do you drink alcohol?"
