NSG 121 Health Assessment HESI Final
Exam, HESI 1 and 2 Remediation
packages, NSG 261 Final HESI, Health
Assessment HESI Exam Questions and
Verified Answers
Open Ended Question
When obtaining a nursing history, use the open-ended question technique to allow the patient
a wide range of possible responses.
Interpreter
Person who can translate between languages.
For patients who do not speak English, use an interpreter whenever possible
Interrupting Client
Do not interrupt clients, in health care settings, it is better to listen than to talk and to ask good
questions rather than have all of the right answers.
,BMI Risk Assessment
An assessment of risk factors includes questions about past medical and surgical histories,
medication and supplement use, family history, food and fluid intake patterns, and the patient's
psychosocial profile
Low BMI
Below 18.5
Normal BMI
18.5-24.9
Nutritional Assessment
Risk factors to review in a nutritional assessment include medical history, abnormal weight
history, appetite or taste changes, gastrointestinal symptoms, food allergies or intolerances,
changes in eating or fluid patterns, poor food habits, inability to cook, social isolation, multiple
medications, inappropriate supplements or lack of supplements, and alcohol or drug use.
Consider a board range of influences on patient's food choices
Mental Orientation
Person, Place, Time, Situation
,CAGE
CAGE is a self report questionnaire used as an assessment tool for drugs and alcohol. Yes to two
or more of the questions indicate a potential problem
Cutdown,Annoyed,Guilty,Eye Opener
Abstract Thinking
Assessment of thought processes:
Patient's thoughts are easy to follow, logical, coherent, relevant, goal directed, consistent, and
abstract
Abstract Thinking: Ability to understand concepts that are real
Referred Pain Appendicitis
Referred pain originates from a specific site, but the person experiencing it feels the pain at
another site along the innervating spinal nerve
It will "refer" pain often to the mid upper abdomen, the epigastrium. Because the appendix is a
piece of intestine, it follows a similar referral pattern.
Nail Ridges in Geriatric Patients
Longitudinal ridging is common in aging patients
Skin Turgor Assessment
, Assess skin turgor. Gently grasp a fold of the patient's skin between your fingers and pull up,
then release. Below clavicle
Tenting indicates dehydration, poor skin turgor is also associated with aging
Clubbing Oxygen Saturation
Clubbing of the nails indicates chronic hypoxia. Clubbing is identified when the angle of the nail
to the finger is more than 160º
Emphysema or congestive heart failure
Pallor Dark Skin
Normal skin color is pink, noting the usual undertones present with even dark skin. The tongue,
lips, nail beds, and buccal mucosa are less pigmented areas and may be the best indicators of
pallor or cyanosis. Patients with darker skin may normally have hypopigmented skin on the
palms and soles
Lesion Assessment & Primary vs. Secondary Lesion
Primary Lesion: arise from previously normal skin
Secondary Lesion: follow primary lesions (scare tissue)
If observed, note the shape and measure the length, width, and depth with a ruler. If a wound is
deep or tunneled, insert a cotton applicator to measure depth.
Goiter Assessment
Palpation of Thyroid, Unilateral Bulging
Exam, HESI 1 and 2 Remediation
packages, NSG 261 Final HESI, Health
Assessment HESI Exam Questions and
Verified Answers
Open Ended Question
When obtaining a nursing history, use the open-ended question technique to allow the patient
a wide range of possible responses.
Interpreter
Person who can translate between languages.
For patients who do not speak English, use an interpreter whenever possible
Interrupting Client
Do not interrupt clients, in health care settings, it is better to listen than to talk and to ask good
questions rather than have all of the right answers.
,BMI Risk Assessment
An assessment of risk factors includes questions about past medical and surgical histories,
medication and supplement use, family history, food and fluid intake patterns, and the patient's
psychosocial profile
Low BMI
Below 18.5
Normal BMI
18.5-24.9
Nutritional Assessment
Risk factors to review in a nutritional assessment include medical history, abnormal weight
history, appetite or taste changes, gastrointestinal symptoms, food allergies or intolerances,
changes in eating or fluid patterns, poor food habits, inability to cook, social isolation, multiple
medications, inappropriate supplements or lack of supplements, and alcohol or drug use.
Consider a board range of influences on patient's food choices
Mental Orientation
Person, Place, Time, Situation
,CAGE
CAGE is a self report questionnaire used as an assessment tool for drugs and alcohol. Yes to two
or more of the questions indicate a potential problem
Cutdown,Annoyed,Guilty,Eye Opener
Abstract Thinking
Assessment of thought processes:
Patient's thoughts are easy to follow, logical, coherent, relevant, goal directed, consistent, and
abstract
Abstract Thinking: Ability to understand concepts that are real
Referred Pain Appendicitis
Referred pain originates from a specific site, but the person experiencing it feels the pain at
another site along the innervating spinal nerve
It will "refer" pain often to the mid upper abdomen, the epigastrium. Because the appendix is a
piece of intestine, it follows a similar referral pattern.
Nail Ridges in Geriatric Patients
Longitudinal ridging is common in aging patients
Skin Turgor Assessment
, Assess skin turgor. Gently grasp a fold of the patient's skin between your fingers and pull up,
then release. Below clavicle
Tenting indicates dehydration, poor skin turgor is also associated with aging
Clubbing Oxygen Saturation
Clubbing of the nails indicates chronic hypoxia. Clubbing is identified when the angle of the nail
to the finger is more than 160º
Emphysema or congestive heart failure
Pallor Dark Skin
Normal skin color is pink, noting the usual undertones present with even dark skin. The tongue,
lips, nail beds, and buccal mucosa are less pigmented areas and may be the best indicators of
pallor or cyanosis. Patients with darker skin may normally have hypopigmented skin on the
palms and soles
Lesion Assessment & Primary vs. Secondary Lesion
Primary Lesion: arise from previously normal skin
Secondary Lesion: follow primary lesions (scare tissue)
If observed, note the shape and measure the length, width, and depth with a ruler. If a wound is
deep or tunneled, insert a cotton applicator to measure depth.
Goiter Assessment
Palpation of Thyroid, Unilateral Bulging
