BSN 246 HESI Health Assessment: 150 Practice Questions & Answers with Detailed Rationales for the
2026 Update – Essential Review for Nursing Students Preparing for the HESI Exit Exam.
VERSION 1 (Questions 1–150)
Questions 1–20 (Respiratory & Thoracic – V1)
1. A nurse is assessing a client’s respiratory rate and finds it to be 8 breaths/minute. How should this
be documented?
A) Tachypnea
B) Bradypnea
C) Apnea
D) Hyperventilation
Correct Answer: B) Bradypnea
Explanation: Bradypnea is a respiratory rate <12 breaths/min in adults. Tachypnea is >20, apnea is
absence of breathing, hyperventilation is rapid deep breathing.
2. During a breast exam, the nurse palpates a nontender, solitary, round, firm, mobile mass. This is
most consistent with:
A) Breast cancer
B) Fibrocystic changes
C) Fibroadenoma
D) Mastitis
Correct Answer: C) Fibroadenoma
Explanation: Fibroadenomas are benign, mobile, painless, and well-circumscribed. Malignant tumors
are often irregular and fixed.
3. Which finding indicates a negative Thomas test for hip flexion contracture?
A) Opposite leg lifts off table
B) Opposite leg remains on table
C) Hip pain on flexion
D) Knee unable to extend
Correct Answer: B) Opposite leg remains on table
Explanation: A negative Thomas test means the extended leg stays flat, indicating no hip flexion
contracture.
,4. The nurse places a vibrating tuning fork midline on the client’s head. This describes which test?
A) Rinne test
B) Weber test
C) Romberg test
D) Whisper test
Correct Answer: B) Weber test
Explanation: Weber test assesses for lateralization of sound. Rinne compares air to bone conduction.
5. A client has bilateral lower lobe atelectasis. What percussion tone is expected?
A) Hyperresonance
B) Tympany
C) Dullness
D) Flatness
Correct Answer: C) Dullness
Explanation: Atelectasis (collapsed lung) produces dullness. Hyperresonance occurs in emphysema,
tympany over stomach.
6. Which cranial nerve is being tested when a client identifies a scent with eyes closed?
A) CN II (Optic)
B) CN I (Olfactory)
C) CN V (Trigeminal)
D) CN VIII (Vestibulocochlear)
Correct Answer: B) CN I (Olfactory)
Explanation: Olfactory nerve is tested with familiar odors (coffee, vanilla). Optic is vision, trigeminal is
facial sensation.
7. The nurse assesses a pulse deficit. How is this done?
A) Compare radial pulse to brachial pulse
B) Compare apical pulse to radial pulse
C) Compare carotid pulse to femoral pulse
D) Compare left radial to right radial
Correct Answer: B) Compare apical pulse to radial pulse
Explanation: A pulse deficit (difference in rate) indicates atrial fibrillation or other dysrhythmias.
,8. A client with chronic asthma and lung hyperinflation is expected to have which chest shape?
A) Pectus excavatum
B) Pectus carinatum
C) Barrel chest
D) Funnel chest
Correct Answer: C) Barrel chest
Explanation: Chronic air trapping increases AP diameter → barrel chest. Pectus excavatum is sunken
sternum.
9. During a health history, the client pauses frequently and looks at the nurse. Best response?
A) Ask “Are you finished?”
B) Repeat the last question
C) Sit quietly and wait
D) Move to next question
Correct Answer: C) Sit quietly and wait
Explanation: Silence allows the client to organize thoughts. Interrupting can block important
information.
10. A postmenopausal female (BMI 32, waist 45 inches) should be advised:
A) Weight is normal for age
B) Waist >35 inches increases heart disease and diabetes risk
C) Only BMI matters, not waist
D) No health risks are present
Correct Answer: B) Waist >35 inches increases heart disease and diabetes risk
Explanation: Central obesity (waist >35 in women, >40 in men) is a metabolic syndrome risk factor
regardless of BMI.
11. What does a positive Romberg test indicate?
A) Cerebellar dysfunction
B) Normal aging
C) CN I damage
D) Hearing loss
Correct Answer: A) Cerebellar dysfunction
Explanation: Romberg tests proprioception. Swaying with eyes closed indicates dorsal column or
cerebellar issue.
, 12. The nurse auscultates a bruit over the carotid artery. This suggests:
A) Normal finding
B) Atherosclerotic narrowing
C) Hyperthyroidism
D) Heart failure
Correct Answer: B) Atherosclerotic narrowing
Explanation: A bruit indicates turbulent blood flow from plaque. Never compress both carotids at once.
13. Which percussion sound is heard over a normal lung?
A) Dull
B) Flat
C) Resonant
D) Tympanic
Correct Answer: C) Resonant
Explanation: Resonant is normal over healthy lung. Dull = consolidation, flat = bone/fluid, tympanic =
stomach.
14. A client reports chest pain that worsens with deep breathing and lying flat. Most likely cause?
A) Pericarditis
B) Myocardial infarction
C) Pneumothorax
D) GERD
Correct Answer: A) Pericarditis
Explanation: Pericarditis causes pleuritic pain, relieved by leaning forward. MI pain is not positional.
15. To assess for ascites, the nurse should:
A) Palpate the liver
B) Percuss for shifting dullness
C) Auscultate bowel sounds
D) Inspect for jaundice
Correct Answer: B) Percuss for shifting dullness
Explanation: Shifting dullness on percussion indicates free fluid in the peritoneal cavity (ascites).
16. A client’s capillary refill is 5 seconds. This indicates:
A) Normal perfusion
2026 Update – Essential Review for Nursing Students Preparing for the HESI Exit Exam.
VERSION 1 (Questions 1–150)
Questions 1–20 (Respiratory & Thoracic – V1)
1. A nurse is assessing a client’s respiratory rate and finds it to be 8 breaths/minute. How should this
be documented?
A) Tachypnea
B) Bradypnea
C) Apnea
D) Hyperventilation
Correct Answer: B) Bradypnea
Explanation: Bradypnea is a respiratory rate <12 breaths/min in adults. Tachypnea is >20, apnea is
absence of breathing, hyperventilation is rapid deep breathing.
2. During a breast exam, the nurse palpates a nontender, solitary, round, firm, mobile mass. This is
most consistent with:
A) Breast cancer
B) Fibrocystic changes
C) Fibroadenoma
D) Mastitis
Correct Answer: C) Fibroadenoma
Explanation: Fibroadenomas are benign, mobile, painless, and well-circumscribed. Malignant tumors
are often irregular and fixed.
3. Which finding indicates a negative Thomas test for hip flexion contracture?
A) Opposite leg lifts off table
B) Opposite leg remains on table
C) Hip pain on flexion
D) Knee unable to extend
Correct Answer: B) Opposite leg remains on table
Explanation: A negative Thomas test means the extended leg stays flat, indicating no hip flexion
contracture.
,4. The nurse places a vibrating tuning fork midline on the client’s head. This describes which test?
A) Rinne test
B) Weber test
C) Romberg test
D) Whisper test
Correct Answer: B) Weber test
Explanation: Weber test assesses for lateralization of sound. Rinne compares air to bone conduction.
5. A client has bilateral lower lobe atelectasis. What percussion tone is expected?
A) Hyperresonance
B) Tympany
C) Dullness
D) Flatness
Correct Answer: C) Dullness
Explanation: Atelectasis (collapsed lung) produces dullness. Hyperresonance occurs in emphysema,
tympany over stomach.
6. Which cranial nerve is being tested when a client identifies a scent with eyes closed?
A) CN II (Optic)
B) CN I (Olfactory)
C) CN V (Trigeminal)
D) CN VIII (Vestibulocochlear)
Correct Answer: B) CN I (Olfactory)
Explanation: Olfactory nerve is tested with familiar odors (coffee, vanilla). Optic is vision, trigeminal is
facial sensation.
7. The nurse assesses a pulse deficit. How is this done?
A) Compare radial pulse to brachial pulse
B) Compare apical pulse to radial pulse
C) Compare carotid pulse to femoral pulse
D) Compare left radial to right radial
Correct Answer: B) Compare apical pulse to radial pulse
Explanation: A pulse deficit (difference in rate) indicates atrial fibrillation or other dysrhythmias.
,8. A client with chronic asthma and lung hyperinflation is expected to have which chest shape?
A) Pectus excavatum
B) Pectus carinatum
C) Barrel chest
D) Funnel chest
Correct Answer: C) Barrel chest
Explanation: Chronic air trapping increases AP diameter → barrel chest. Pectus excavatum is sunken
sternum.
9. During a health history, the client pauses frequently and looks at the nurse. Best response?
A) Ask “Are you finished?”
B) Repeat the last question
C) Sit quietly and wait
D) Move to next question
Correct Answer: C) Sit quietly and wait
Explanation: Silence allows the client to organize thoughts. Interrupting can block important
information.
10. A postmenopausal female (BMI 32, waist 45 inches) should be advised:
A) Weight is normal for age
B) Waist >35 inches increases heart disease and diabetes risk
C) Only BMI matters, not waist
D) No health risks are present
Correct Answer: B) Waist >35 inches increases heart disease and diabetes risk
Explanation: Central obesity (waist >35 in women, >40 in men) is a metabolic syndrome risk factor
regardless of BMI.
11. What does a positive Romberg test indicate?
A) Cerebellar dysfunction
B) Normal aging
C) CN I damage
D) Hearing loss
Correct Answer: A) Cerebellar dysfunction
Explanation: Romberg tests proprioception. Swaying with eyes closed indicates dorsal column or
cerebellar issue.
, 12. The nurse auscultates a bruit over the carotid artery. This suggests:
A) Normal finding
B) Atherosclerotic narrowing
C) Hyperthyroidism
D) Heart failure
Correct Answer: B) Atherosclerotic narrowing
Explanation: A bruit indicates turbulent blood flow from plaque. Never compress both carotids at once.
13. Which percussion sound is heard over a normal lung?
A) Dull
B) Flat
C) Resonant
D) Tympanic
Correct Answer: C) Resonant
Explanation: Resonant is normal over healthy lung. Dull = consolidation, flat = bone/fluid, tympanic =
stomach.
14. A client reports chest pain that worsens with deep breathing and lying flat. Most likely cause?
A) Pericarditis
B) Myocardial infarction
C) Pneumothorax
D) GERD
Correct Answer: A) Pericarditis
Explanation: Pericarditis causes pleuritic pain, relieved by leaning forward. MI pain is not positional.
15. To assess for ascites, the nurse should:
A) Palpate the liver
B) Percuss for shifting dullness
C) Auscultate bowel sounds
D) Inspect for jaundice
Correct Answer: B) Percuss for shifting dullness
Explanation: Shifting dullness on percussion indicates free fluid in the peritoneal cavity (ascites).
16. A client’s capillary refill is 5 seconds. This indicates:
A) Normal perfusion
