HESI HEALTH ASSESSMENT EXAM 2 QUESTIONS
Objective. - Answers -During the interview portio of the health assessment, a nurse
notes the person's posture, physical appearance, and ability to converse. How should
the nurse document these findings?
4th intercostal space, right midclavicular line. Correct - Answers -The nurse is assessing
a client's middle lung lobe. What is the best location for the nurse to place a
stethoscope diaphragm to hear normal lung sounds in this lobe?
Document a normal finding. - Answers -While performing a head-to-toe assessment, the
nurse assesses the client's pupillary accommodation. During the second portion of the
test, the nurse notes that the client's pupils constrict and there is convergence of the
axes of the eyes. What action should the nurse implement next?
Seek the assistance of a healthcare team member who speaks the client's preferred
language. - Answers -The nurse is conducting an interview with a client who speaks
limited English. What action should the nurse implement?
Document at least 3 generations of the client's family medical history. Correct - Answers
-The nurse is conducting a family history as part of the assessment interview. Which
action should the nurse take to ensure that sufficient information about the client's blood
relatives is obtained?
Verbal descriptor scale. - Answers -An older client has just returned to the room
following a surgical procedure. Which pain scale should the nurse use when assessing
the client's pain level?
Nocturia. - Answers -Which term should the nurse use to document the condition of a
client who reports waking up frequently during the night to urinate?
Measure the apical pulse and compare it to the peripheral pulse. - Answers -Which
procedure should the nurse use to assess for a pulse deficit?
Ask the client to urinate before beginning the examination. - Answers -A client is in the
clinical for a yearly physical examination. Which action should the nurse take when
preparing to examine the client's abdomen?
Friction rub. - Answers -Which term should the nurse use to document in the client's
medical record for a high-pitched scratchy sound during auscultation of the heart?
Inspect the hair and skin. - Answers -A client is being assessed upon admission to the
medical-surgical unit. The nurse is preparing to complete a head-to-toe assessment and
will begin at the head of the client. Which technique should the nurse use to begin the
assessment?
Objective. - Answers -During the interview portio of the health assessment, a nurse
notes the person's posture, physical appearance, and ability to converse. How should
the nurse document these findings?
4th intercostal space, right midclavicular line. Correct - Answers -The nurse is assessing
a client's middle lung lobe. What is the best location for the nurse to place a
stethoscope diaphragm to hear normal lung sounds in this lobe?
Document a normal finding. - Answers -While performing a head-to-toe assessment, the
nurse assesses the client's pupillary accommodation. During the second portion of the
test, the nurse notes that the client's pupils constrict and there is convergence of the
axes of the eyes. What action should the nurse implement next?
Seek the assistance of a healthcare team member who speaks the client's preferred
language. - Answers -The nurse is conducting an interview with a client who speaks
limited English. What action should the nurse implement?
Document at least 3 generations of the client's family medical history. Correct - Answers
-The nurse is conducting a family history as part of the assessment interview. Which
action should the nurse take to ensure that sufficient information about the client's blood
relatives is obtained?
Verbal descriptor scale. - Answers -An older client has just returned to the room
following a surgical procedure. Which pain scale should the nurse use when assessing
the client's pain level?
Nocturia. - Answers -Which term should the nurse use to document the condition of a
client who reports waking up frequently during the night to urinate?
Measure the apical pulse and compare it to the peripheral pulse. - Answers -Which
procedure should the nurse use to assess for a pulse deficit?
Ask the client to urinate before beginning the examination. - Answers -A client is in the
clinical for a yearly physical examination. Which action should the nurse take when
preparing to examine the client's abdomen?
Friction rub. - Answers -Which term should the nurse use to document in the client's
medical record for a high-pitched scratchy sound during auscultation of the heart?
Inspect the hair and skin. - Answers -A client is being assessed upon admission to the
medical-surgical unit. The nurse is preparing to complete a head-to-toe assessment and
will begin at the head of the client. Which technique should the nurse use to begin the
assessment?
