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.
Questions 1–20 (Respiratory & Thoracic)
1. A nurse assesses a respiratory rate of 8 breaths/minute. How should this be documented?
A) Tachypnea
B) Bradypnea
C) Apnea
D) Hyperventilation
Correct: B) Bradypnea
Explanation: Bradypnea is <12 breaths/min. Tachypnea >20, apnea is absence, hyperventilation is
rapid/deep.
2. Which percussion note is expected over a normal adult lung?
A) Dull
B) Flat
C) Resonant
D) Tympanic
Correct: C) Resonant
Explanation: Resonant is normal over healthy lung tissue. Dull = consolidation, flat = bone/mass,
tympanic = stomach.
3. A client with chronic asthma and hyperinflation is expected to have which chest shape?
A) Pectus excavatum
B) Pectus carinatum
C) Barrel chest
D) Funnel chest
Correct: C) Barrel chest
Explanation: Increased AP diameter from chronic air trapping. Pectus excavatum = sunken sternum.
4. The nurse hears high-pitched whistling sounds on expiration. This is:
A) Crackles
B) Rhonchi
,C) Wheezes
D) Stridor
Correct: C) Wheezes
Explanation: Wheezes are continuous musical sounds from narrowed airways. Stridor is upper airway.
5. Bilateral lower lobe atelectasis produces which percussion sound?
A) Hyperresonance
B) Tympany
C) Dullness
D) Resonance
Correct: C) Dullness
Explanation: Atelectasis (collapsed airless lung) produces dullness. Hyperresonance = hyperinflated
lung.
6. A client has absent breath sounds at the left base. This suggests:
A) Asthma
B) Pneumothorax or pleural effusion
C) Bronchitis
D) Normal finding
Correct: B) Pneumothorax or pleural effusion
Explanation: Air or fluid in pleural space prevents sound transmission. Asthma causes wheezing.
7. During auscultation, the nurse hears coarse crackles that clear after coughing. This is:
A) Pulmonary edema
B) Bronchitis (rhonchi)
C) Fibrosis
D) Pneumonia
Correct: B) Bronchitis (rhonchi)
Explanation: Coarse crackles/rhonchi that clear with cough suggest secretions. Pulmonary edema
crackles don't clear.
8. A client with COPD has a prolonged expiratory phase. This indicates:
A) Normal lung function
B) Air trapping
,C) Restrictive disease
D) Pneumothorax
Correct: B) Air trapping
Explanation: Prolonged expiration (>4 sec) indicates obstruction and air trapping (COPD/asthma).
9. The nurse palpates decreased tactile fremitus over the right lower lobe. This suggests:
A) Lobar pneumonia
B) Pleural effusion
C) Asthma exacerbation
D) Normal finding
Correct: B) Pleural effusion
Explanation: Fluid decreases fremitus. Pneumonia increases fremitus (consolidation).
10. Stridor is heard best over which area?
A) Lung bases
B) Trachea (neck)
C) Apices
D) Posterior chest
Correct: B) Trachea (neck)
Explanation: Stridor is a harsh, high-pitched sound from upper airway obstruction (croup, foreign
body).
11. A client’s SpO2 is 88% on room air. The nurse should first:
A) Apply oxygen
B) Call rapid response
C) Reposition client
D) Check another finger
Correct: A) Apply oxygen
Explanation: SpO2 <90% is hypoxemia. Apply O2 first, then assess further.
12. Which finding is abnormal on respiratory inspection?
A) Symmetrical chest expansion
B) Retractions
C) AP: lateral ratio 1:2
D) Quiet breathing
, Correct: B) Retractions
Explanation: Retractions indicate increased work of breathing (respiratory distress). Normal AP ratio is
1:2.
13. A client with pleuritic chest pain should be assessed further for:
A) Pulmonary embolism
B) COPD
C) Asthma
D) Bronchitis
Correct: A) Pulmonary embolism
Explanation: Pleuritic pain (worse with inspiration) suggests PE, pericarditis, or pneumonia.
14. Egophony (E-to-A change) is heard in:
A) Asthma
B) Consolidation (pneumonia)
C) Pleural effusion
D) Pneumothorax
Correct: B) Consolidation (pneumonia)
Explanation: Egophony occurs when sound travels through consolidated lung tissue.
15. A client’s respiratory rate is 28 with shallow breaths. This is:
A) Bradypnea
B) Tachypnea
C) Hyperpnea
D) Cheyne-Stokes
Correct: B) Tachypnea
Explanation: Tachypnea = >20 breaths/min. Hyperpnea is deep breathing. Cheyne-Stokes is cyclic.
16. Which breath sound is normally heard over the trachea?
A) Vesicular
B) Bronchovesicular
C) Bronchial
D) Absent
Correct: C) Bronchial
Explanation: Bronchial (hollow, tubular) is normal over trachea. Vesicular over peripheral lung.
2026 Update – Essential Review for Nursing Students Preparing for the HESI Exit Exam.
Questions 1–20 (Respiratory & Thoracic)
1. A nurse assesses a respiratory rate of 8 breaths/minute. How should this be documented?
A) Tachypnea
B) Bradypnea
C) Apnea
D) Hyperventilation
Correct: B) Bradypnea
Explanation: Bradypnea is <12 breaths/min. Tachypnea >20, apnea is absence, hyperventilation is
rapid/deep.
2. Which percussion note is expected over a normal adult lung?
A) Dull
B) Flat
C) Resonant
D) Tympanic
Correct: C) Resonant
Explanation: Resonant is normal over healthy lung tissue. Dull = consolidation, flat = bone/mass,
tympanic = stomach.
3. A client with chronic asthma and hyperinflation is expected to have which chest shape?
A) Pectus excavatum
B) Pectus carinatum
C) Barrel chest
D) Funnel chest
Correct: C) Barrel chest
Explanation: Increased AP diameter from chronic air trapping. Pectus excavatum = sunken sternum.
4. The nurse hears high-pitched whistling sounds on expiration. This is:
A) Crackles
B) Rhonchi
,C) Wheezes
D) Stridor
Correct: C) Wheezes
Explanation: Wheezes are continuous musical sounds from narrowed airways. Stridor is upper airway.
5. Bilateral lower lobe atelectasis produces which percussion sound?
A) Hyperresonance
B) Tympany
C) Dullness
D) Resonance
Correct: C) Dullness
Explanation: Atelectasis (collapsed airless lung) produces dullness. Hyperresonance = hyperinflated
lung.
6. A client has absent breath sounds at the left base. This suggests:
A) Asthma
B) Pneumothorax or pleural effusion
C) Bronchitis
D) Normal finding
Correct: B) Pneumothorax or pleural effusion
Explanation: Air or fluid in pleural space prevents sound transmission. Asthma causes wheezing.
7. During auscultation, the nurse hears coarse crackles that clear after coughing. This is:
A) Pulmonary edema
B) Bronchitis (rhonchi)
C) Fibrosis
D) Pneumonia
Correct: B) Bronchitis (rhonchi)
Explanation: Coarse crackles/rhonchi that clear with cough suggest secretions. Pulmonary edema
crackles don't clear.
8. A client with COPD has a prolonged expiratory phase. This indicates:
A) Normal lung function
B) Air trapping
,C) Restrictive disease
D) Pneumothorax
Correct: B) Air trapping
Explanation: Prolonged expiration (>4 sec) indicates obstruction and air trapping (COPD/asthma).
9. The nurse palpates decreased tactile fremitus over the right lower lobe. This suggests:
A) Lobar pneumonia
B) Pleural effusion
C) Asthma exacerbation
D) Normal finding
Correct: B) Pleural effusion
Explanation: Fluid decreases fremitus. Pneumonia increases fremitus (consolidation).
10. Stridor is heard best over which area?
A) Lung bases
B) Trachea (neck)
C) Apices
D) Posterior chest
Correct: B) Trachea (neck)
Explanation: Stridor is a harsh, high-pitched sound from upper airway obstruction (croup, foreign
body).
11. A client’s SpO2 is 88% on room air. The nurse should first:
A) Apply oxygen
B) Call rapid response
C) Reposition client
D) Check another finger
Correct: A) Apply oxygen
Explanation: SpO2 <90% is hypoxemia. Apply O2 first, then assess further.
12. Which finding is abnormal on respiratory inspection?
A) Symmetrical chest expansion
B) Retractions
C) AP: lateral ratio 1:2
D) Quiet breathing
, Correct: B) Retractions
Explanation: Retractions indicate increased work of breathing (respiratory distress). Normal AP ratio is
1:2.
13. A client with pleuritic chest pain should be assessed further for:
A) Pulmonary embolism
B) COPD
C) Asthma
D) Bronchitis
Correct: A) Pulmonary embolism
Explanation: Pleuritic pain (worse with inspiration) suggests PE, pericarditis, or pneumonia.
14. Egophony (E-to-A change) is heard in:
A) Asthma
B) Consolidation (pneumonia)
C) Pleural effusion
D) Pneumothorax
Correct: B) Consolidation (pneumonia)
Explanation: Egophony occurs when sound travels through consolidated lung tissue.
15. A client’s respiratory rate is 28 with shallow breaths. This is:
A) Bradypnea
B) Tachypnea
C) Hyperpnea
D) Cheyne-Stokes
Correct: B) Tachypnea
Explanation: Tachypnea = >20 breaths/min. Hyperpnea is deep breathing. Cheyne-Stokes is cyclic.
16. Which breath sound is normally heard over the trachea?
A) Vesicular
B) Bronchovesicular
C) Bronchial
D) Absent
Correct: C) Bronchial
Explanation: Bronchial (hollow, tubular) is normal over trachea. Vesicular over peripheral lung.
