University of Pennsylvania 2025 Health
Assessment HESI Exam Review: Practice
Questions, Rationales, and Study Guide for
Nursing Students to Ace the HESI
1. Eye Muscle Weakness Assessment
Question:
The nurse is testing for extraocular muscle weakness. Which technique should be
used?
A. Test the corneal reflexes
B. Test the 6 cardinal positions of gaze
C. Test visual acuity with a Snellen chart
D. Test sensory function by asking the patient
Correct Answer: B
Rationale: The 6 cardinal positions of gaze test the function of the extraocular muscles
and cranial nerves III, IV, and VI, allowing assessment of any muscle weakness.
2. Positive Brudzinski’s Sign
Question:
A nurse elicits a positive Brudzinski’s sign in a patient. Which finding indicates this?
A. Rigid arm extension with plantar flexion
B. Leg flexion followed by pain during leg extension
C. Passive hip/knee flexion in response to neck flexion
D. Flexed arms with extended and rotated legs
Correct Answer: C
Rationale: A positive Brudzinski’s sign occurs when passive neck flexion causes
involuntary flexion of the hips and knees, indicating meningeal irritation.
3. Sensorineural Hearing Loss Cause
Question:
What is the primary cause of sensorineural hearing loss?
A. Wax impaction
B. Otitis media
C. Defect in cochlea, CN VIII, or brain
,D. Obstruction in ear canal
Correct Answer: C
Rationale: Sensorineural hearing loss is due to damage in the cochlea, auditory nerve
(CN VIII), or auditory pathways in the brain.
4. Erythema
Question:
What is the medical term erythema best defined as?
A. Pale skin
B. Bruising
C. Redness
D. Yellowish hue
Correct Answer: C
Rationale: Erythema refers to redness of the skin caused by increased blood flow, often
due to inflammation or infection.
5. Cover Test
Question:
What does the cover test assess?
A. Corneal clarity
B. Peripheral vision
C. Eye alignment
D. Visual acuity
Correct Answer: C
Rationale: The cover test assesses for ocular misalignment by detecting subtle
deviations in eye position when one eye is covered.
6. Corneal Light Reflex Test
Question:
What does the corneal light reflex test examine?
A. Intraocular pressure
B. Eye strain
C. Parallel alignment of the eyes
D. Reaction to dim light
Correct Answer: C
Rationale: The test determines whether the eyes are aligned by observing light
reflection on the cornea of each eye.
,7. Confrontation Test
Question:
The confrontation test is used to assess:
A. Color vision
B. Depth perception
C. Peripheral vision
D. Night vision
Correct Answer: C
Rationale: This test compares the client’s peripheral vision to the examiner’s, helping
detect peripheral vision loss.
8. Rinne Test
Question:
Which hearing assessment compares air conduction to bone conduction?
A. Weber test
B. Rinne test
C. Whisper test
D. Tympanic test
Correct Answer: B
Rationale: The Rinne test evaluates hearing by comparing air conduction (near the ear)
with bone conduction (on the mastoid).
9. Weber Test
Question:
Where is the tuning fork placed in a Weber test?
A. On the mastoid process
B. Over the temporal artery
C. In the midline of the skull
D. Behind the ear
Correct Answer: C
Rationale: The Weber test assesses lateralization of sound by placing a tuning fork on
the skull midline.
10. Romberg Test
, Question:
A positive Romberg sign is indicated by:
A. Swaying with eyes open
B. Significant swaying with eyes closed
C. Rigid posture with arms crossed
D. Nystagmus on gaze
Correct Answer: B
Rationale: The Romberg test assesses proprioception. A positive sign (swaying with
eyes closed) indicates balance dysfunction.
11. Rhonchi
Question:
What adventitious lung sound is described as low-pitched and snoring?
A. Crackles
B. Wheezes
C. Rhonchi
D. Stridor
Correct Answer: C
Rationale: Rhonchi are coarse, low-pitched sounds often heard in chronic bronchitis
due to airway secretions.
12. S1 and S2 Heart Sounds
Question:
Which heart sound represents the closure of AV valves?
A. S1 – "Lub"
B. S2 – "Dub"
C. S3 – gallop rhythm
D. S4 – atrial kick
Correct Answer: A
Rationale: S1 corresponds with the closure of the mitral and tricuspid valves, marking
the beginning of systole.
13. Bruit
Question:
A bruit is best described as:
A. A rubbing friction sound
B. A swishing vascular sound
Assessment HESI Exam Review: Practice
Questions, Rationales, and Study Guide for
Nursing Students to Ace the HESI
1. Eye Muscle Weakness Assessment
Question:
The nurse is testing for extraocular muscle weakness. Which technique should be
used?
A. Test the corneal reflexes
B. Test the 6 cardinal positions of gaze
C. Test visual acuity with a Snellen chart
D. Test sensory function by asking the patient
Correct Answer: B
Rationale: The 6 cardinal positions of gaze test the function of the extraocular muscles
and cranial nerves III, IV, and VI, allowing assessment of any muscle weakness.
2. Positive Brudzinski’s Sign
Question:
A nurse elicits a positive Brudzinski’s sign in a patient. Which finding indicates this?
A. Rigid arm extension with plantar flexion
B. Leg flexion followed by pain during leg extension
C. Passive hip/knee flexion in response to neck flexion
D. Flexed arms with extended and rotated legs
Correct Answer: C
Rationale: A positive Brudzinski’s sign occurs when passive neck flexion causes
involuntary flexion of the hips and knees, indicating meningeal irritation.
3. Sensorineural Hearing Loss Cause
Question:
What is the primary cause of sensorineural hearing loss?
A. Wax impaction
B. Otitis media
C. Defect in cochlea, CN VIII, or brain
,D. Obstruction in ear canal
Correct Answer: C
Rationale: Sensorineural hearing loss is due to damage in the cochlea, auditory nerve
(CN VIII), or auditory pathways in the brain.
4. Erythema
Question:
What is the medical term erythema best defined as?
A. Pale skin
B. Bruising
C. Redness
D. Yellowish hue
Correct Answer: C
Rationale: Erythema refers to redness of the skin caused by increased blood flow, often
due to inflammation or infection.
5. Cover Test
Question:
What does the cover test assess?
A. Corneal clarity
B. Peripheral vision
C. Eye alignment
D. Visual acuity
Correct Answer: C
Rationale: The cover test assesses for ocular misalignment by detecting subtle
deviations in eye position when one eye is covered.
6. Corneal Light Reflex Test
Question:
What does the corneal light reflex test examine?
A. Intraocular pressure
B. Eye strain
C. Parallel alignment of the eyes
D. Reaction to dim light
Correct Answer: C
Rationale: The test determines whether the eyes are aligned by observing light
reflection on the cornea of each eye.
,7. Confrontation Test
Question:
The confrontation test is used to assess:
A. Color vision
B. Depth perception
C. Peripheral vision
D. Night vision
Correct Answer: C
Rationale: This test compares the client’s peripheral vision to the examiner’s, helping
detect peripheral vision loss.
8. Rinne Test
Question:
Which hearing assessment compares air conduction to bone conduction?
A. Weber test
B. Rinne test
C. Whisper test
D. Tympanic test
Correct Answer: B
Rationale: The Rinne test evaluates hearing by comparing air conduction (near the ear)
with bone conduction (on the mastoid).
9. Weber Test
Question:
Where is the tuning fork placed in a Weber test?
A. On the mastoid process
B. Over the temporal artery
C. In the midline of the skull
D. Behind the ear
Correct Answer: C
Rationale: The Weber test assesses lateralization of sound by placing a tuning fork on
the skull midline.
10. Romberg Test
, Question:
A positive Romberg sign is indicated by:
A. Swaying with eyes open
B. Significant swaying with eyes closed
C. Rigid posture with arms crossed
D. Nystagmus on gaze
Correct Answer: B
Rationale: The Romberg test assesses proprioception. A positive sign (swaying with
eyes closed) indicates balance dysfunction.
11. Rhonchi
Question:
What adventitious lung sound is described as low-pitched and snoring?
A. Crackles
B. Wheezes
C. Rhonchi
D. Stridor
Correct Answer: C
Rationale: Rhonchi are coarse, low-pitched sounds often heard in chronic bronchitis
due to airway secretions.
12. S1 and S2 Heart Sounds
Question:
Which heart sound represents the closure of AV valves?
A. S1 – "Lub"
B. S2 – "Dub"
C. S3 – gallop rhythm
D. S4 – atrial kick
Correct Answer: A
Rationale: S1 corresponds with the closure of the mitral and tricuspid valves, marking
the beginning of systole.
13. Bruit
Question:
A bruit is best described as:
A. A rubbing friction sound
B. A swishing vascular sound
