HESI Health Assessment Exam – 2026
Updated 200 NCLEX-Style Questions with
Answers & Rationales
1. A nurse is preparing to assess a client's blood pressure. Which factor can
cause a falsely low reading?
A. Cuff is too narrow
B. Cuff is too wide
C. Arm is below heart level
D. Deflating the cuff too slowly
Answer: B
Rationale: A cuff that is too wide gives a falsely low reading. A cuff that is too
narrow gives a falsely high reading. Arm below heart level gives falsely high.
Deflating too slowly gives falsely high diastolic.
2. A nurse is assessing a client's respiratory rate. The client is breathing
regularly at 22 breaths per minute. The nurse should document this as:
A. Bradypnea
B. Tachypnea
C. Eupnea
D. Hyperventilation
Answer: B
Rationale: Normal adult respiratory rate is 12–20 breaths per minute. Rate
>20 is tachypnea; <12 is bradypnea.
3. A nurse is assessing a client's heart sounds. The nurse hears a "lub-dub"
sound. The "lub" sound is caused by:
A. Closure of the semilunar valves
,B. Closure of the atrioventricular valves
C. Opening of the atrioventricular valves
D. Blood turbulence in the ventricles
Answer: B
Rationale: S1 ("lub") is caused by closure of the mitral and tricuspid (AV)
valves. S2 ("dub") is caused by closure of the aortic and pulmonic
(semilunar) valves.
4. A nurse is assessing a client's skin turgor. The nurse pinches the skin on
the client's forearm and it remains tented for several seconds. This finding
suggests:
A. Normal hydration
B. Dehydration
C. Edema
D. Jaundice
Answer: B
Rationale: Poor skin turgor (skin remains tented) indicates dehydration.
Normal skin returns to position immediately.
5. A nurse is assessing a client's pupils. Which finding is normal?
A. Pinpoint pupils
B. Dilated pupils
C. Pupils equal and reactive to light
D. Asymmetric pupils
Answer: C
Rationale: Normal pupils are equal, round, and reactive to light (PERRL).
Pinpoint pupils may indicate opioid use; dilated pupils may indicate
sympathetic stimulation.
,6. A nurse is assessing a client's breath sounds. Which sound is considered
normal in the peripheral lung fields?
A. Bronchial
B. Bronchovesicular
C. Vesicular
D. Tracheal
Answer: C
Rationale: Vesicular breath sounds are soft, low-pitched, and heard over
most peripheral lung fields. Bronchial sounds are heard over the trachea.
7. A nurse is assessing a client's abdomen. In which order should the nurse
perform abdominal assessment?
A. Palpation, auscultation, inspection, percussion
B. Inspection, auscultation, percussion, palpation
C. Percussion, palpation, inspection, auscultation
D. Auscultation, inspection, percussion, palpation
Answer: B
Rationale: Abdominal assessment order: Inspection, Auscultation,
Percussion, Palpation. Palpation last because it can alter bowel sounds.
8. A nurse is assessing a client's peripheral pulses. Which pulse site is used to
assess circulation to the foot?
A. Popliteal
B. Posterior tibial
C. Femoral
D. Radial
Answer: B
Rationale: Posterior tibial and dorsalis pedis pulses assess circulation to the
foot. Popliteal is behind the knee; femoral is in the groin.
, 9. A nurse is assessing a client's jugular veins. The nurse notes jugular venous
distention (JVD) when the client is sitting upright at 45 degrees. This finding
suggests:
A. Dehydration
B. Hypovolemia
C. Right-sided heart failure
D. Pneumothorax
Answer: C
Rationale: JVD at 45 degrees indicates increased central venous pressure,
often due to right-sided heart failure, fluid overload, or pulmonary
hypertension.
10. A nurse is assessing a client's mental status. The nurse asks the client to
identify the current year, season, and month. This assesses:
A. Attention span
B. Memory
C. Orientation
D. Judgment
Answer: C
Rationale: Orientation to time (year, season, month) assesses cognitive
function. Memory is assessed by asking about recent or remote events.
11. A nurse is assessing a client's cranial nerve I (olfactory). Which action
tests this nerve?
A. Ask client to identify a familiar scent (coffee, orange) with eyes closed
B. Ask client to read a Snellen chart
C. Ask client to follow a finger with eyes
D. Ask client to smile and frown
Updated 200 NCLEX-Style Questions with
Answers & Rationales
1. A nurse is preparing to assess a client's blood pressure. Which factor can
cause a falsely low reading?
A. Cuff is too narrow
B. Cuff is too wide
C. Arm is below heart level
D. Deflating the cuff too slowly
Answer: B
Rationale: A cuff that is too wide gives a falsely low reading. A cuff that is too
narrow gives a falsely high reading. Arm below heart level gives falsely high.
Deflating too slowly gives falsely high diastolic.
2. A nurse is assessing a client's respiratory rate. The client is breathing
regularly at 22 breaths per minute. The nurse should document this as:
A. Bradypnea
B. Tachypnea
C. Eupnea
D. Hyperventilation
Answer: B
Rationale: Normal adult respiratory rate is 12–20 breaths per minute. Rate
>20 is tachypnea; <12 is bradypnea.
3. A nurse is assessing a client's heart sounds. The nurse hears a "lub-dub"
sound. The "lub" sound is caused by:
A. Closure of the semilunar valves
,B. Closure of the atrioventricular valves
C. Opening of the atrioventricular valves
D. Blood turbulence in the ventricles
Answer: B
Rationale: S1 ("lub") is caused by closure of the mitral and tricuspid (AV)
valves. S2 ("dub") is caused by closure of the aortic and pulmonic
(semilunar) valves.
4. A nurse is assessing a client's skin turgor. The nurse pinches the skin on
the client's forearm and it remains tented for several seconds. This finding
suggests:
A. Normal hydration
B. Dehydration
C. Edema
D. Jaundice
Answer: B
Rationale: Poor skin turgor (skin remains tented) indicates dehydration.
Normal skin returns to position immediately.
5. A nurse is assessing a client's pupils. Which finding is normal?
A. Pinpoint pupils
B. Dilated pupils
C. Pupils equal and reactive to light
D. Asymmetric pupils
Answer: C
Rationale: Normal pupils are equal, round, and reactive to light (PERRL).
Pinpoint pupils may indicate opioid use; dilated pupils may indicate
sympathetic stimulation.
,6. A nurse is assessing a client's breath sounds. Which sound is considered
normal in the peripheral lung fields?
A. Bronchial
B. Bronchovesicular
C. Vesicular
D. Tracheal
Answer: C
Rationale: Vesicular breath sounds are soft, low-pitched, and heard over
most peripheral lung fields. Bronchial sounds are heard over the trachea.
7. A nurse is assessing a client's abdomen. In which order should the nurse
perform abdominal assessment?
A. Palpation, auscultation, inspection, percussion
B. Inspection, auscultation, percussion, palpation
C. Percussion, palpation, inspection, auscultation
D. Auscultation, inspection, percussion, palpation
Answer: B
Rationale: Abdominal assessment order: Inspection, Auscultation,
Percussion, Palpation. Palpation last because it can alter bowel sounds.
8. A nurse is assessing a client's peripheral pulses. Which pulse site is used to
assess circulation to the foot?
A. Popliteal
B. Posterior tibial
C. Femoral
D. Radial
Answer: B
Rationale: Posterior tibial and dorsalis pedis pulses assess circulation to the
foot. Popliteal is behind the knee; femoral is in the groin.
, 9. A nurse is assessing a client's jugular veins. The nurse notes jugular venous
distention (JVD) when the client is sitting upright at 45 degrees. This finding
suggests:
A. Dehydration
B. Hypovolemia
C. Right-sided heart failure
D. Pneumothorax
Answer: C
Rationale: JVD at 45 degrees indicates increased central venous pressure,
often due to right-sided heart failure, fluid overload, or pulmonary
hypertension.
10. A nurse is assessing a client's mental status. The nurse asks the client to
identify the current year, season, and month. This assesses:
A. Attention span
B. Memory
C. Orientation
D. Judgment
Answer: C
Rationale: Orientation to time (year, season, month) assesses cognitive
function. Memory is assessed by asking about recent or remote events.
11. A nurse is assessing a client's cranial nerve I (olfactory). Which action
tests this nerve?
A. Ask client to identify a familiar scent (coffee, orange) with eyes closed
B. Ask client to read a Snellen chart
C. Ask client to follow a finger with eyes
D. Ask client to smile and frown
