, NSG 6020 3P Exam – advaNcEd PhySical aSSESSmENt – South
uNivErSity collEGE of NurSiNG aNd hEalth SciENcES – 2026/2027
acadEmic yEar – 100 QuEStioNS aNd aNSwErS covEriNG four corE
domaiNS || juSt rElEaSEd .
The following 100 questions are organized into four primary content domains aligned with the
official NSG 6020 Advanced Physical Assessment (3P Series) course objectives. Each question
includes four answer choices, the correct answer, and a detailed rationale grounded in evidence-
based physical assessment techniques, diagnostic reasoning, and advanced practice nursing
standards.
Domain 1: Advanced Health History and Interviewing (Questions 1–25)
Question 1: A 72-year-old patient presents with a new onset of confusion and memory
problems. Which component of the health history is most critical to obtain first?
• A) Family history of dementia
• B) Medication list, including over-the-counter and herbal supplements
• C) Social history including alcohol use
• D) Review of systems
corrEct aNSwEr: B
ratioNalE: In an older adult with new-onset confusion, medication review is critical.
Polypharmacy, drug interactions, and anticholinergic medications are common causes of
cognitive changes in the elderly. While family history, social history, and ROS are important,
medication review is the priority.
Question 2: A patient reports "feeling tired all the time." Which OLDCARTS question would be
most helpful in differentiating between depression, anemia, and hypothyroidism?
• A) "When did the fatigue first start?"
• B) "How would you describe the fatigue?"
, • C) "What makes the fatigue better or worse?"
• D) "How severe is the fatigue?"
corrEct aNSwEr: B
ratioNalE: The character or quality of fatigue (OLDCARTS - "C" for Character) helps
differentiate causes. Depression-related fatigue is often described as "heavy" or "overwhelming";
anemia-related fatigue is described as "weakness" or "tiredness with exertion"; hypothyroidism-
related fatigue is described as "sluggishness."
Question 3: When taking a sexual history, which is the most appropriate opening question?
• A) "Are you sexually active?"
• B) "Do you have any concerns about your sexual health?"
• C) "How many sexual partners have you had?"
• D) "Do you use contraception?"
corrEct aNSwEr: A
ratioNalE: The most appropriate opening question for a sexual history is a general, non-
judgmental question such as "Are you sexually active?" This allows for a broad range of
responses and opens the conversation. More specific questions should follow based on the
patient's response.
Question 4: A patient with limited English proficiency is being interviewed. Which action is most
appropriate?
• A) Use a family member as an interpreter
• B) Use a qualified medical interpreter
• C) Speak slowly and loudly in English
• D) Have the patient complete a written questionnaire
corrEct aNSwEr: B
ratioNalE: A qualified medical interpreter should be used to ensure accurate communication.
Family members should not be used as interpreters due to potential bias, confidentiality
concerns, and lack of medical terminology knowledge.
, Question 5: A patient reports a history of "blacking out" after standing up quickly. Which
question would be most helpful in differentiating between orthostatic hypotension and cardiac
syncope?
• A) "How long does the episode last?"
• B) "Do you have any chest pain with the episodes?"
• C) "What do you do immediately after the episode?"
• D) "Do you have a history of diabetes?"
corrEct aNSwEr: A
ratioNalE: The duration of the episode helps differentiate: orthostatic hypotension usually
resolves quickly upon lying down (seconds to minutes); cardiac syncope may last longer and be
associated with other cardiac symptoms. Chest pain (B) suggests cardiac etiology, but duration
is a more distinguishing factor.
Question 6: The acronym "PQRST" is used to assess which component of the health history?
• A) Past medical history
• B) Family history
• C) Pain or symptom characteristics
• D) Review of systems
corrEct aNSwEr: C
ratioNalE: PQRST (Provocation/Palliation, Quality, Region/Radiation, Severity, Timing) is used
to assess the characteristics of a patient's pain or symptom. It is a framework for the History of
Presenting Illness (HPI).
Question 7: A patient is reluctant to discuss mental health symptoms. Which approach is most
therapeutic?
• A) "Mental health is an important part of your overall health. Many people experience
these symptoms."
• B) "You don't have to discuss this if you're uncomfortable."
• C) "I'll need to document your refusal to discuss this."
• D) "Why are you hesitant to discuss this?"
uNivErSity collEGE of NurSiNG aNd hEalth SciENcES – 2026/2027
acadEmic yEar – 100 QuEStioNS aNd aNSwErS covEriNG four corE
domaiNS || juSt rElEaSEd .
The following 100 questions are organized into four primary content domains aligned with the
official NSG 6020 Advanced Physical Assessment (3P Series) course objectives. Each question
includes four answer choices, the correct answer, and a detailed rationale grounded in evidence-
based physical assessment techniques, diagnostic reasoning, and advanced practice nursing
standards.
Domain 1: Advanced Health History and Interviewing (Questions 1–25)
Question 1: A 72-year-old patient presents with a new onset of confusion and memory
problems. Which component of the health history is most critical to obtain first?
• A) Family history of dementia
• B) Medication list, including over-the-counter and herbal supplements
• C) Social history including alcohol use
• D) Review of systems
corrEct aNSwEr: B
ratioNalE: In an older adult with new-onset confusion, medication review is critical.
Polypharmacy, drug interactions, and anticholinergic medications are common causes of
cognitive changes in the elderly. While family history, social history, and ROS are important,
medication review is the priority.
Question 2: A patient reports "feeling tired all the time." Which OLDCARTS question would be
most helpful in differentiating between depression, anemia, and hypothyroidism?
• A) "When did the fatigue first start?"
• B) "How would you describe the fatigue?"
, • C) "What makes the fatigue better or worse?"
• D) "How severe is the fatigue?"
corrEct aNSwEr: B
ratioNalE: The character or quality of fatigue (OLDCARTS - "C" for Character) helps
differentiate causes. Depression-related fatigue is often described as "heavy" or "overwhelming";
anemia-related fatigue is described as "weakness" or "tiredness with exertion"; hypothyroidism-
related fatigue is described as "sluggishness."
Question 3: When taking a sexual history, which is the most appropriate opening question?
• A) "Are you sexually active?"
• B) "Do you have any concerns about your sexual health?"
• C) "How many sexual partners have you had?"
• D) "Do you use contraception?"
corrEct aNSwEr: A
ratioNalE: The most appropriate opening question for a sexual history is a general, non-
judgmental question such as "Are you sexually active?" This allows for a broad range of
responses and opens the conversation. More specific questions should follow based on the
patient's response.
Question 4: A patient with limited English proficiency is being interviewed. Which action is most
appropriate?
• A) Use a family member as an interpreter
• B) Use a qualified medical interpreter
• C) Speak slowly and loudly in English
• D) Have the patient complete a written questionnaire
corrEct aNSwEr: B
ratioNalE: A qualified medical interpreter should be used to ensure accurate communication.
Family members should not be used as interpreters due to potential bias, confidentiality
concerns, and lack of medical terminology knowledge.
, Question 5: A patient reports a history of "blacking out" after standing up quickly. Which
question would be most helpful in differentiating between orthostatic hypotension and cardiac
syncope?
• A) "How long does the episode last?"
• B) "Do you have any chest pain with the episodes?"
• C) "What do you do immediately after the episode?"
• D) "Do you have a history of diabetes?"
corrEct aNSwEr: A
ratioNalE: The duration of the episode helps differentiate: orthostatic hypotension usually
resolves quickly upon lying down (seconds to minutes); cardiac syncope may last longer and be
associated with other cardiac symptoms. Chest pain (B) suggests cardiac etiology, but duration
is a more distinguishing factor.
Question 6: The acronym "PQRST" is used to assess which component of the health history?
• A) Past medical history
• B) Family history
• C) Pain or symptom characteristics
• D) Review of systems
corrEct aNSwEr: C
ratioNalE: PQRST (Provocation/Palliation, Quality, Region/Radiation, Severity, Timing) is used
to assess the characteristics of a patient's pain or symptom. It is a framework for the History of
Presenting Illness (HPI).
Question 7: A patient is reluctant to discuss mental health symptoms. Which approach is most
therapeutic?
• A) "Mental health is an important part of your overall health. Many people experience
these symptoms."
• B) "You don't have to discuss this if you're uncomfortable."
• C) "I'll need to document your refusal to discuss this."
• D) "Why are you hesitant to discuss this?"
