NURS 5220 Midterm Exam (pdf) | 2026/2027 | Advanced
Health Assessment Q&A | Nursing
1. A nurse practitioner is conducting a comprehensive health history. Which component should
be collected first?
A) Chief complaint
B) Past medical history
C) Biographical data
D) Review of systems
Correct Answer: Biographical data
Rationale: The comprehensive health history begins with biographical data, which establishes the
patient's identity and context. This includes name, age, gender, occupation, and referral source. The
chief complaint follows, then history of present illness, past medical history, and review of systems.
Beginning with biographical data ensures proper identification before clinical data collection begins.
2. What does the "R" represent in the PQRST mnemonic for pain assessment?
A) Relief—what relieves the pain
B) Radiation—does the pain radiate
C) Rating—rate the pain on a scale
D) Rhythm—is the pain constant
Correct Answer: Radiation—does the pain radiate
Rationale: The PQRST mnemonic includes Provocation/Palliation, Quality, Region/Radiation, Severity,
and Timing. The "R" specifically addresses region and radiation of pain. Relief is part of "P"
(Provocation/Palliation), rating is "S" (Severity), and rhythm is part of "T" (Timing). Correctly
identifying radiation helps determine the underlying cause and urgency of the pain.
3. A nurse practitioner is interviewing a 17-year-old patient and asks questions about home,
education, activities, drugs, sexuality, and suicide/depression. This technique is best
described as:
A) CAGE assessment
B) HEADSS assessment
C) OLDCARTS assessment
D) PHQ-9 screening
Correct Answer: HEADSS assessment
Rationale: The HEADSS assessment is a psychosocial screening tool designed for adolescents. It
addresses Home, Education/Employment, Activities, Drugs, Sexuality, and Suicide/Depression. This
comprehensive framework facilitates non-judgmental exploration of sensitive topics. CAGE screens
for alcohol use, OLDCARTS analyzes symptoms, and PHQ-9 screens for depression severity.
, 4. Which statement is true regarding the relationship of physical characteristics and culture?
A) Physical characteristics should be used to identify members of cultural groups
B) There is a difference between distinguishing cultural characteristics and distinguishing physical
characteristics
C) To be a member of a specific culture, an individual must have certain identifiable physical
characteristics
D) Gender and race are the two essential physical characteristics used to identify cultural groups
Correct Answer: There is a difference between distinguishing cultural characteristics and
distinguishing physical characteristics
Rationale: Culture is a learned set of beliefs and behaviors, whereas physical characteristics such as
race or gender are biological. While some physical traits may be common within certain cultural
groups, they do not define culture itself. Conflating physical characteristics with cultural identity leads
to stereotyping and inaccurate assessment. Providers must distinguish between these dimensions to
deliver culturally competent care.
5. An image of any group that rejects its potential for originality or individuality is known as
a(n):
A) Acculturation
B) Norm
C) Stereotype
D) Ethnos
Correct Answer: Stereotype
Rationale: A stereotype is a fixed, overgeneralized belief about a particular group that ignores
individual differences and unique characteristics. Acculturation refers to cultural adaptation, a norm
is a standard of behavior, and ethnos relates to cultural identity. Stereotyping undermines patient-
centered care by imposing assumptions rather than eliciting individual patient perspectives.
6. The motivation of the healthcare professional to "want to" engage in the process of
becoming culturally competent, not "have to," is called:
A) Cultural knowledge
B) Cultural awareness
C) Cultural desire
D) Cultural skill
Correct Answer: Cultural desire
Rationale: Cultural desire is the pivotal construct of cultural competence, representing intrinsic
motivation to be open, flexible, and committed to cultural humility. Cultural knowledge involves
learning about other cultures, awareness involves self-examination of biases, and skill involves
applying culturally appropriate techniques. Desire drives the provider to genuinely engage rather
than merely comply with requirements.
, 7. Mr. Marks is a 66-year-old patient presenting for a physical examination. Which question has
the most potential for exploring his cultural beliefs related to a health problem?
A) How often do you have medical examinations?
B) What is your age, race, and educational level?
C) What types of symptoms have you been having?
D) Why do you think you are having these symptoms?
Correct Answer: Why do you think you are having these symptoms?
Rationale: Asking for the patient's own explanation of illness (the Explanatory Model) reveals cultural
perspective, fears, and expectations. This open-ended question allows the patient to express beliefs
about causation and meaning. Demographic questions and symptom inventories do not explore
cultural interpretation of illness. Understanding the patient's explanatory model guides negotiation
of a mutually acceptable treatment plan.
8. A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids
eye contact and answers questions only by saying "Yeah," "No," or "I guess so." Which
response is most appropriate?
A) We will be able to communicate better if you look at me
B) It's hard for me to gather useful information because your answers are so short
C) Are you uncomfortable talking with me?
D) Does your religion make it hard for you to answer my questions?
Correct Answer: Are you uncomfortable talking with me?
Rationale: This open-ended, non-judgmental question addresses the communication barrier directly
and allows the patient to express discomfort. Cultural norms regarding eye contact vary, and older
patients may have different expectations regarding gender and age dynamics. Directing blame or
making assumptions about religion can further alienate the patient. Exploring discomfort preserves
therapeutic rapport.
9. A nurse practitioner asks a patient to describe abdominal pain that awakens him at night.
Which response facilitates the interview process?
A) Constipation can cause abdominal pain
B) Do you need a sleeping medication?
C) Pain is always worse at night, isn't it?
D) Tell me what you mean by "often"
Correct Answer: Tell me what you mean by "often"
Rationale: Asking the patient to clarify the meaning of "often" is an open-ended technique that
encourages elaboration without leading the response. Options A, B, and C are closed-ended, leading,
or suppositional questions that discourage detailed disclosure. Clarifying vague terms ensures
accurate symptom characterization and supports diagnostic reasoning.
, 10. During an interview, the patient describes problems associated with an illness and begins to
cry. What is the best action?
A) Stop the interview and reschedule for another time
B) Allow the patient to cry, then resume when the patient is ready
C) Change the topic to something less upsetting
D) Continue the interview while the patient cries to get through it quickly
Correct Answer: Allow the patient to cry, then resume when the patient is ready
Rationale: Emotional expression is a natural part of discussing illness. Allowing the patient to cry
respects the patient's emotional process and builds trust. Stopping the interview prematurely,
changing the subject, or continuing while ignoring the emotion can suppress disclosure and damage
rapport. The provider should allow emotion to proceed at the patient's pace before resuming.
11. Which behavior is most important in establishing a connection with the patient?
A) Documenting data using direct patient quotes
B) Phrasing questions clearly and explicitly
C) Avoiding the trap of giving advice during an interview
D) Listening intently while observing nonverbal cues
Correct Answer: Listening intently while observing nonverbal cues
Rationale: Establishing connection requires active listening and attention to nonverbal
communication. While clear phrasing and appropriate documentation are important, the core of
therapeutic connection lies in being fully present with the patient. Observing nonverbal cues provides
additional clinical information and demonstrates respect. Advice-giving during an interview can
undermine patient autonomy.
12. The comprehensive health history begins with which component?
A) Chief complaint
B) Biographical data
C) Past medical history
D) Review of systems
Correct Answer: Biographical data
Rationale: Biographical data establishes patient identity and context before clinical data collection.
This includes name, age, gender, race, occupation, and referral source. Beginning with biographical
data ensures proper identification and sets the stage for the interview. The chief complaint follows,
then history of present illness and review of systems.
13. What is the most frequent cause of serious hypertension in children?
A) Renal disease
B) Coarctation of the aorta
Health Assessment Q&A | Nursing
1. A nurse practitioner is conducting a comprehensive health history. Which component should
be collected first?
A) Chief complaint
B) Past medical history
C) Biographical data
D) Review of systems
Correct Answer: Biographical data
Rationale: The comprehensive health history begins with biographical data, which establishes the
patient's identity and context. This includes name, age, gender, occupation, and referral source. The
chief complaint follows, then history of present illness, past medical history, and review of systems.
Beginning with biographical data ensures proper identification before clinical data collection begins.
2. What does the "R" represent in the PQRST mnemonic for pain assessment?
A) Relief—what relieves the pain
B) Radiation—does the pain radiate
C) Rating—rate the pain on a scale
D) Rhythm—is the pain constant
Correct Answer: Radiation—does the pain radiate
Rationale: The PQRST mnemonic includes Provocation/Palliation, Quality, Region/Radiation, Severity,
and Timing. The "R" specifically addresses region and radiation of pain. Relief is part of "P"
(Provocation/Palliation), rating is "S" (Severity), and rhythm is part of "T" (Timing). Correctly
identifying radiation helps determine the underlying cause and urgency of the pain.
3. A nurse practitioner is interviewing a 17-year-old patient and asks questions about home,
education, activities, drugs, sexuality, and suicide/depression. This technique is best
described as:
A) CAGE assessment
B) HEADSS assessment
C) OLDCARTS assessment
D) PHQ-9 screening
Correct Answer: HEADSS assessment
Rationale: The HEADSS assessment is a psychosocial screening tool designed for adolescents. It
addresses Home, Education/Employment, Activities, Drugs, Sexuality, and Suicide/Depression. This
comprehensive framework facilitates non-judgmental exploration of sensitive topics. CAGE screens
for alcohol use, OLDCARTS analyzes symptoms, and PHQ-9 screens for depression severity.
, 4. Which statement is true regarding the relationship of physical characteristics and culture?
A) Physical characteristics should be used to identify members of cultural groups
B) There is a difference between distinguishing cultural characteristics and distinguishing physical
characteristics
C) To be a member of a specific culture, an individual must have certain identifiable physical
characteristics
D) Gender and race are the two essential physical characteristics used to identify cultural groups
Correct Answer: There is a difference between distinguishing cultural characteristics and
distinguishing physical characteristics
Rationale: Culture is a learned set of beliefs and behaviors, whereas physical characteristics such as
race or gender are biological. While some physical traits may be common within certain cultural
groups, they do not define culture itself. Conflating physical characteristics with cultural identity leads
to stereotyping and inaccurate assessment. Providers must distinguish between these dimensions to
deliver culturally competent care.
5. An image of any group that rejects its potential for originality or individuality is known as
a(n):
A) Acculturation
B) Norm
C) Stereotype
D) Ethnos
Correct Answer: Stereotype
Rationale: A stereotype is a fixed, overgeneralized belief about a particular group that ignores
individual differences and unique characteristics. Acculturation refers to cultural adaptation, a norm
is a standard of behavior, and ethnos relates to cultural identity. Stereotyping undermines patient-
centered care by imposing assumptions rather than eliciting individual patient perspectives.
6. The motivation of the healthcare professional to "want to" engage in the process of
becoming culturally competent, not "have to," is called:
A) Cultural knowledge
B) Cultural awareness
C) Cultural desire
D) Cultural skill
Correct Answer: Cultural desire
Rationale: Cultural desire is the pivotal construct of cultural competence, representing intrinsic
motivation to be open, flexible, and committed to cultural humility. Cultural knowledge involves
learning about other cultures, awareness involves self-examination of biases, and skill involves
applying culturally appropriate techniques. Desire drives the provider to genuinely engage rather
than merely comply with requirements.
, 7. Mr. Marks is a 66-year-old patient presenting for a physical examination. Which question has
the most potential for exploring his cultural beliefs related to a health problem?
A) How often do you have medical examinations?
B) What is your age, race, and educational level?
C) What types of symptoms have you been having?
D) Why do you think you are having these symptoms?
Correct Answer: Why do you think you are having these symptoms?
Rationale: Asking for the patient's own explanation of illness (the Explanatory Model) reveals cultural
perspective, fears, and expectations. This open-ended question allows the patient to express beliefs
about causation and meaning. Demographic questions and symptom inventories do not explore
cultural interpretation of illness. Understanding the patient's explanatory model guides negotiation
of a mutually acceptable treatment plan.
8. A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids
eye contact and answers questions only by saying "Yeah," "No," or "I guess so." Which
response is most appropriate?
A) We will be able to communicate better if you look at me
B) It's hard for me to gather useful information because your answers are so short
C) Are you uncomfortable talking with me?
D) Does your religion make it hard for you to answer my questions?
Correct Answer: Are you uncomfortable talking with me?
Rationale: This open-ended, non-judgmental question addresses the communication barrier directly
and allows the patient to express discomfort. Cultural norms regarding eye contact vary, and older
patients may have different expectations regarding gender and age dynamics. Directing blame or
making assumptions about religion can further alienate the patient. Exploring discomfort preserves
therapeutic rapport.
9. A nurse practitioner asks a patient to describe abdominal pain that awakens him at night.
Which response facilitates the interview process?
A) Constipation can cause abdominal pain
B) Do you need a sleeping medication?
C) Pain is always worse at night, isn't it?
D) Tell me what you mean by "often"
Correct Answer: Tell me what you mean by "often"
Rationale: Asking the patient to clarify the meaning of "often" is an open-ended technique that
encourages elaboration without leading the response. Options A, B, and C are closed-ended, leading,
or suppositional questions that discourage detailed disclosure. Clarifying vague terms ensures
accurate symptom characterization and supports diagnostic reasoning.
, 10. During an interview, the patient describes problems associated with an illness and begins to
cry. What is the best action?
A) Stop the interview and reschedule for another time
B) Allow the patient to cry, then resume when the patient is ready
C) Change the topic to something less upsetting
D) Continue the interview while the patient cries to get through it quickly
Correct Answer: Allow the patient to cry, then resume when the patient is ready
Rationale: Emotional expression is a natural part of discussing illness. Allowing the patient to cry
respects the patient's emotional process and builds trust. Stopping the interview prematurely,
changing the subject, or continuing while ignoring the emotion can suppress disclosure and damage
rapport. The provider should allow emotion to proceed at the patient's pace before resuming.
11. Which behavior is most important in establishing a connection with the patient?
A) Documenting data using direct patient quotes
B) Phrasing questions clearly and explicitly
C) Avoiding the trap of giving advice during an interview
D) Listening intently while observing nonverbal cues
Correct Answer: Listening intently while observing nonverbal cues
Rationale: Establishing connection requires active listening and attention to nonverbal
communication. While clear phrasing and appropriate documentation are important, the core of
therapeutic connection lies in being fully present with the patient. Observing nonverbal cues provides
additional clinical information and demonstrates respect. Advice-giving during an interview can
undermine patient autonomy.
12. The comprehensive health history begins with which component?
A) Chief complaint
B) Biographical data
C) Past medical history
D) Review of systems
Correct Answer: Biographical data
Rationale: Biographical data establishes patient identity and context before clinical data collection.
This includes name, age, gender, race, occupation, and referral source. Beginning with biographical
data ensures proper identification and sets the stage for the interview. The chief complaint follows,
then history of present illness and review of systems.
13. What is the most frequent cause of serious hypertension in children?
A) Renal disease
B) Coarctation of the aorta
