NR 509 Advanced Physical Assessment
Final Exam
Exam Questions with Answers| Latest Update-Guaranteed Pass
,1. During a health history interview, the patient says, "I've just been feeling
really tired lately." Which response best uses the OLDCARTS mnemonic to
explore this symptom?
A. "Are you depressed?"
B. "When did the tiredness start, and has it changed over time?"
C. "You should get more sleep."
D. "Let's move on to your past medical history."
Answer: B
Rationale: OLDCARTS (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Radiation, Timing, Severity) guides symptom
exploration. Asking about onset and progression is an open-ended, symptom-
focused question; the other options are premature, judgmental, or avoid the
symptom.
2. Which type of question is best to begin a symptom-focused interview?
A. Closed-ended question
B. Open-ended question
C. Leading question
D. Multiple-choice question
Answer: B
Rationale: Open-ended questions (e.g., "Tell me about your pain") allow the
patient to describe symptoms in their own words and yield richer information;
closed-ended questions are better used later to clarify specific details.
3. A patient reports using an herbal supplement not disclosed at the last visit.
What is the best approach to eliciting complete medication history?
A. Assume the patient is being truthful without further questions
B. Ask specifically about prescription drugs, OTC medications, herbal products,
and supplements
C. Only document prescribed medications
D. Skip this section if the patient seems rushed
Answer: B
Rationale: A thorough medication history must explicitly ask about
prescription, over-the-counter, herbal, and supplement use, since patients
often do not volunteer non-prescription products unless specifically asked.
,4. When obtaining a family history, which finding is most significant for
cardiovascular risk stratification?
A. A maternal grandmother with osteoarthritis at age 80
B. A father who had a myocardial infarction at age 45
C. A sibling with seasonal allergies
D. A cousin with migraines
Answer: B
Rationale: Premature cardiovascular disease in a first-degree relative (father,
MI before age 55 in men or 65 in women) is a significant, independent risk
factor that should be documented and factored into risk assessment.
5. A patient becomes tearful when discussing a recent diagnosis. What is the
best interviewer response?
A. Continue with the review of systems immediately
B. Acknowledge the emotion and pause before continuing (e.g., "This seems
difficult to talk about")
C. Tell the patient not to worry
D. Leave the room to give privacy
Answer: B
Rationale: NURS (Naming, Understanding, Respecting, Supporting) and similar
empathy techniques call for acknowledging emotion before proceeding, which
builds trust and yields a more complete history.
6. Which is an example of a leading question that should be avoided during
history taking?
A. "How would you describe the pain?"
B. "You don't smoke, do you?"
C. "When did the pain start?"
D. "What makes the pain better or worse?"
Answer: B
Rationale: Leading questions suggest the expected answer and bias patient
responses. "You don't smoke, do you?" presumes a negative answer, which
can suppress honest disclosure.
, 7. During the review of systems (ROS), the patient denies all symptoms in each
system. How should the nurse practitioner document this?
A. Leave the section blank
B. Document pertinent negatives for each system reviewed
C. Write "normal" for the entire ROS without detail
D. Only document positive findings
Answer: B
Rationale: Pertinent negatives should be explicitly documented for each
system reviewed (e.g., "denies chest pain, palpitations, orthopnea") to
demonstrate that specific symptoms were assessed and ruled out, supporting
the differential diagnosis.
8. Which technique is most appropriate when interviewing a patient through a
professional medical interpreter?
A. Speak directly to the interpreter, not the patient
B. Speak in short segments and address the patient directly, maintaining eye
contact with the patient
C. Use family members instead when available
D. Speak faster to save time
Answer: B
Rationale: Best practice is to speak in short segments, face and address the
patient directly (not the interpreter), and use a trained medical interpreter
rather than family members, who may filter or misinterpret sensitive
information.
9. A 16-year-old patient is being interviewed about sexual activity and
substance use. What is the most appropriate approach?
A. Always have a parent present for accuracy
B. Interview the adolescent privately, without a parent present, after
explaining confidentiality limits
C. Skip these questions for minors
D. Only ask the parent about these topics
Answer: B
Final Exam
Exam Questions with Answers| Latest Update-Guaranteed Pass
,1. During a health history interview, the patient says, "I've just been feeling
really tired lately." Which response best uses the OLDCARTS mnemonic to
explore this symptom?
A. "Are you depressed?"
B. "When did the tiredness start, and has it changed over time?"
C. "You should get more sleep."
D. "Let's move on to your past medical history."
Answer: B
Rationale: OLDCARTS (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Radiation, Timing, Severity) guides symptom
exploration. Asking about onset and progression is an open-ended, symptom-
focused question; the other options are premature, judgmental, or avoid the
symptom.
2. Which type of question is best to begin a symptom-focused interview?
A. Closed-ended question
B. Open-ended question
C. Leading question
D. Multiple-choice question
Answer: B
Rationale: Open-ended questions (e.g., "Tell me about your pain") allow the
patient to describe symptoms in their own words and yield richer information;
closed-ended questions are better used later to clarify specific details.
3. A patient reports using an herbal supplement not disclosed at the last visit.
What is the best approach to eliciting complete medication history?
A. Assume the patient is being truthful without further questions
B. Ask specifically about prescription drugs, OTC medications, herbal products,
and supplements
C. Only document prescribed medications
D. Skip this section if the patient seems rushed
Answer: B
Rationale: A thorough medication history must explicitly ask about
prescription, over-the-counter, herbal, and supplement use, since patients
often do not volunteer non-prescription products unless specifically asked.
,4. When obtaining a family history, which finding is most significant for
cardiovascular risk stratification?
A. A maternal grandmother with osteoarthritis at age 80
B. A father who had a myocardial infarction at age 45
C. A sibling with seasonal allergies
D. A cousin with migraines
Answer: B
Rationale: Premature cardiovascular disease in a first-degree relative (father,
MI before age 55 in men or 65 in women) is a significant, independent risk
factor that should be documented and factored into risk assessment.
5. A patient becomes tearful when discussing a recent diagnosis. What is the
best interviewer response?
A. Continue with the review of systems immediately
B. Acknowledge the emotion and pause before continuing (e.g., "This seems
difficult to talk about")
C. Tell the patient not to worry
D. Leave the room to give privacy
Answer: B
Rationale: NURS (Naming, Understanding, Respecting, Supporting) and similar
empathy techniques call for acknowledging emotion before proceeding, which
builds trust and yields a more complete history.
6. Which is an example of a leading question that should be avoided during
history taking?
A. "How would you describe the pain?"
B. "You don't smoke, do you?"
C. "When did the pain start?"
D. "What makes the pain better or worse?"
Answer: B
Rationale: Leading questions suggest the expected answer and bias patient
responses. "You don't smoke, do you?" presumes a negative answer, which
can suppress honest disclosure.
, 7. During the review of systems (ROS), the patient denies all symptoms in each
system. How should the nurse practitioner document this?
A. Leave the section blank
B. Document pertinent negatives for each system reviewed
C. Write "normal" for the entire ROS without detail
D. Only document positive findings
Answer: B
Rationale: Pertinent negatives should be explicitly documented for each
system reviewed (e.g., "denies chest pain, palpitations, orthopnea") to
demonstrate that specific symptoms were assessed and ruled out, supporting
the differential diagnosis.
8. Which technique is most appropriate when interviewing a patient through a
professional medical interpreter?
A. Speak directly to the interpreter, not the patient
B. Speak in short segments and address the patient directly, maintaining eye
contact with the patient
C. Use family members instead when available
D. Speak faster to save time
Answer: B
Rationale: Best practice is to speak in short segments, face and address the
patient directly (not the interpreter), and use a trained medical interpreter
rather than family members, who may filter or misinterpret sensitive
information.
9. A 16-year-old patient is being interviewed about sexual activity and
substance use. What is the most appropriate approach?
A. Always have a parent present for accuracy
B. Interview the adolescent privately, without a parent present, after
explaining confidentiality limits
C. Skip these questions for minors
D. Only ask the parent about these topics
Answer: B
