NR 509 / NR509 Advanced Physical Assessment Final
Exam | Chamberlain | Questions & Answers |
2025/2026
Section 1: Health History and Interviewing
Q1. A nurse practitioner is obtaining a health history from a 72-year-old patient who speaks
limited English. A bilingual family member is present and offers to interpret. What is the most
appropriate action?
A. Accept the family member's offer to interpret to put the patient at ease
B. Use a certified medical interpreter and speak directly to the patient in short segments
C. Ask the family member to interpret but confirm all answers with the patient
D. Proceed with the interview without an interpreter since a family member is present
Rationale: Best practice requires using a trained medical interpreter, not family members, to
ensure accuracy and confidentiality. The NP should speak directly to the patient (not the
interpreter) and use short, simple segments to facilitate verbatim translation. Family members
may edit, omit, or bias information and may not have medical terminology proficiency.
Q2. A 45-year-old man presents with chest pain. Using the OLDCARTS mnemonic, which letter
corresponds to "radiating to the left arm"?
A. O
B. A
C. R
D. T
Rationale: OLDCARTS: O = Onset, L = Location, D = Duration, C = Character, A =
Aggravating/Alleviating, R = Radiation, T = Timing, S = Severity. Radiation specifically addresses
whether symptoms travel to other areas.
Q3. During a new patient visit, which component of the health history is documented as the
patient's own words describing the reason for the visit?
A. History of Present Illness
B. Chief Complaint
C. Review of Systems
D. Past Medical History
, Rationale: The Chief Complaint is documented as a direct quotation from the patient,
capturing their primary reason for seeking care. The HPI expands on this using the seven
attributes of a symptom. The ROS is a systematic review of body systems, and PMH includes
prior illnesses and conditions.
Q4. A patient reports "I've been having headaches." Which follow-up question best elicits the
"Timing" component of the OLDCARTS mnemonic?
A. "Where exactly do you feel the headache?"
B. "How often do they occur, and is there a pattern?"
C. "On a scale of 0 to 10, how severe is the pain?"
D. "Does anything make them better or worse?"
Rationale: Timing asks about frequency, duration, and pattern of symptoms. Location asks
"where," Severity asks "how bad," and Aggravating/Alleviating asks "what makes it better or
worse."
Q5. Which of the following is considered subjective data?
A. Blood pressure reading of 148/92 mm Hg
B. Patient's report of nausea after eating
C. Observation of a 3 cm scar on the left forearm
D. Auscultation of crackles in the lung bases
Rationale: Subjective data are what the patient reports or describes—symptoms that
cannot be directly measured by the examiner. Objective data include measurable findings such
as vital signs, visible scars, and auscultated breath sounds.
Q6. A 28-year-old woman reports she has "no health problems" but mentions she takes
levothyroxine daily. What is the most appropriate next action?
A. Document "no health problems" and move on
B. Ask specifically about the condition for which levothyroxine is prescribed
C. Assume she has hypothyroidism and document it
D. Tell her that levothyroxine contradicts her statement
Rationale: Patients often do not consider chronic conditions "health problems" if managed
by medication. The NP should explore medication use to identify underlying diagnoses.
Assuming without confirmation is inappropriate.
Q7. Which interview technique is most effective for encouraging a quiet, reserved patient to
share concerns?
,A. Yes/no questions
B. Open-ended questions with silence to allow reflection
C. Multiple questions asked rapidly to cover more ground
D. Leading questions that suggest expected answers
Rationale: Open-ended questions invite narrative responses and silence gives the patient
time to formulate thoughts. Rapid-fire or leading questions can inhibit disclosure and introduce
bias.
Q8. A patient reports a family history of colon cancer. Which additional information is most
important to obtain?
A. The affected relative's relationship and age at diagnosis
B. The affected relative's dietary habits
C. The patient's insurance coverage for screening
D. Whether the relative received chemotherapy
Rationale: Family history significance depends on degree of relation and age of onset. First-
degree relatives with early-onset cancer carry substantially higher risk than distant relatives
with late-onset disease. This information guides screening recommendations.
Q9. Which mnemonic is specifically designed for rapid alcohol screening?
A. PHQ-9
B. CAGE
C. GAD-7
D. OLDCARTS
Rationale: CAGE (Cut down, Annoyed, Guilty, Eye-opener) is a validated four-question
screen for alcohol use disorders. PHQ-9 screens for depression, GAD-7 for anxiety, and
OLDCARTS characterizes a symptom.
Q10. A new patient is reluctant to discuss sexual history. What approach best facilitates this
conversation?
A. Ask detailed sexual questions in the first minute of the visit
B. Explain why the information is relevant and normalize the questions
C. Document "patient declined" and avoid the topic entirely
D. Have a staff member ask the questions instead
, Rationale: Explaining the clinical relevance of sexual history and normalizing the inquiry ("I
ask all my patients about...") reduces embarrassment and increases disclosure. Avoiding the
topic may result in missed health risks.
Q11. During a Review of Systems, the patient reports "sometimes I feel my heart racing." This
finding should be documented under which system?
A. Cardiovascular
B. Respiratory
C. Neurologic
D. Psychiatric
Rationale: Palpitations are a cardiovascular symptom. The ROS systematically reviews each
body system for symptoms that may not have been mentioned in the chief complaint or HPI.
Q12. Which of the following is an example of objective data?
A. Patient describes his pain as "sharp and stabbing"
B. Patient reports feeling "dizzy when standing"
C. Temperature is 101.4°F orally
D. Patient states he has been "more tired lately"
Rationale: Objective data are observable and measurable by the examiner. A temperature
reading is objective. The other options are subjective reports from the patient.
Q13. A 68-year-old patient with a history of coronary artery disease reports new onset of
fatigue with minimal exertion. What is the most important question to ask next?
A. "What did you eat for breakfast?"
B. "Does the fatigue occur with chest pain or shortness of breath?"
C. "Have you had your vision checked recently?"
D. "How many hours do you sleep at night?"
Rationale: New-onset fatigue in a patient with CAD may represent anginal equivalent.
Associated symptoms such as chest pain or dyspnea are critical to identify cardiac ischemia.
Other options are less directly relevant to the acute concern.
Q14. Which component of the health history should be obtained before the physical
examination?
A. Review of Systems
B. Chief Complaint and History of Present Illness
Exam | Chamberlain | Questions & Answers |
2025/2026
Section 1: Health History and Interviewing
Q1. A nurse practitioner is obtaining a health history from a 72-year-old patient who speaks
limited English. A bilingual family member is present and offers to interpret. What is the most
appropriate action?
A. Accept the family member's offer to interpret to put the patient at ease
B. Use a certified medical interpreter and speak directly to the patient in short segments
C. Ask the family member to interpret but confirm all answers with the patient
D. Proceed with the interview without an interpreter since a family member is present
Rationale: Best practice requires using a trained medical interpreter, not family members, to
ensure accuracy and confidentiality. The NP should speak directly to the patient (not the
interpreter) and use short, simple segments to facilitate verbatim translation. Family members
may edit, omit, or bias information and may not have medical terminology proficiency.
Q2. A 45-year-old man presents with chest pain. Using the OLDCARTS mnemonic, which letter
corresponds to "radiating to the left arm"?
A. O
B. A
C. R
D. T
Rationale: OLDCARTS: O = Onset, L = Location, D = Duration, C = Character, A =
Aggravating/Alleviating, R = Radiation, T = Timing, S = Severity. Radiation specifically addresses
whether symptoms travel to other areas.
Q3. During a new patient visit, which component of the health history is documented as the
patient's own words describing the reason for the visit?
A. History of Present Illness
B. Chief Complaint
C. Review of Systems
D. Past Medical History
, Rationale: The Chief Complaint is documented as a direct quotation from the patient,
capturing their primary reason for seeking care. The HPI expands on this using the seven
attributes of a symptom. The ROS is a systematic review of body systems, and PMH includes
prior illnesses and conditions.
Q4. A patient reports "I've been having headaches." Which follow-up question best elicits the
"Timing" component of the OLDCARTS mnemonic?
A. "Where exactly do you feel the headache?"
B. "How often do they occur, and is there a pattern?"
C. "On a scale of 0 to 10, how severe is the pain?"
D. "Does anything make them better or worse?"
Rationale: Timing asks about frequency, duration, and pattern of symptoms. Location asks
"where," Severity asks "how bad," and Aggravating/Alleviating asks "what makes it better or
worse."
Q5. Which of the following is considered subjective data?
A. Blood pressure reading of 148/92 mm Hg
B. Patient's report of nausea after eating
C. Observation of a 3 cm scar on the left forearm
D. Auscultation of crackles in the lung bases
Rationale: Subjective data are what the patient reports or describes—symptoms that
cannot be directly measured by the examiner. Objective data include measurable findings such
as vital signs, visible scars, and auscultated breath sounds.
Q6. A 28-year-old woman reports she has "no health problems" but mentions she takes
levothyroxine daily. What is the most appropriate next action?
A. Document "no health problems" and move on
B. Ask specifically about the condition for which levothyroxine is prescribed
C. Assume she has hypothyroidism and document it
D. Tell her that levothyroxine contradicts her statement
Rationale: Patients often do not consider chronic conditions "health problems" if managed
by medication. The NP should explore medication use to identify underlying diagnoses.
Assuming without confirmation is inappropriate.
Q7. Which interview technique is most effective for encouraging a quiet, reserved patient to
share concerns?
,A. Yes/no questions
B. Open-ended questions with silence to allow reflection
C. Multiple questions asked rapidly to cover more ground
D. Leading questions that suggest expected answers
Rationale: Open-ended questions invite narrative responses and silence gives the patient
time to formulate thoughts. Rapid-fire or leading questions can inhibit disclosure and introduce
bias.
Q8. A patient reports a family history of colon cancer. Which additional information is most
important to obtain?
A. The affected relative's relationship and age at diagnosis
B. The affected relative's dietary habits
C. The patient's insurance coverage for screening
D. Whether the relative received chemotherapy
Rationale: Family history significance depends on degree of relation and age of onset. First-
degree relatives with early-onset cancer carry substantially higher risk than distant relatives
with late-onset disease. This information guides screening recommendations.
Q9. Which mnemonic is specifically designed for rapid alcohol screening?
A. PHQ-9
B. CAGE
C. GAD-7
D. OLDCARTS
Rationale: CAGE (Cut down, Annoyed, Guilty, Eye-opener) is a validated four-question
screen for alcohol use disorders. PHQ-9 screens for depression, GAD-7 for anxiety, and
OLDCARTS characterizes a symptom.
Q10. A new patient is reluctant to discuss sexual history. What approach best facilitates this
conversation?
A. Ask detailed sexual questions in the first minute of the visit
B. Explain why the information is relevant and normalize the questions
C. Document "patient declined" and avoid the topic entirely
D. Have a staff member ask the questions instead
, Rationale: Explaining the clinical relevance of sexual history and normalizing the inquiry ("I
ask all my patients about...") reduces embarrassment and increases disclosure. Avoiding the
topic may result in missed health risks.
Q11. During a Review of Systems, the patient reports "sometimes I feel my heart racing." This
finding should be documented under which system?
A. Cardiovascular
B. Respiratory
C. Neurologic
D. Psychiatric
Rationale: Palpitations are a cardiovascular symptom. The ROS systematically reviews each
body system for symptoms that may not have been mentioned in the chief complaint or HPI.
Q12. Which of the following is an example of objective data?
A. Patient describes his pain as "sharp and stabbing"
B. Patient reports feeling "dizzy when standing"
C. Temperature is 101.4°F orally
D. Patient states he has been "more tired lately"
Rationale: Objective data are observable and measurable by the examiner. A temperature
reading is objective. The other options are subjective reports from the patient.
Q13. A 68-year-old patient with a history of coronary artery disease reports new onset of
fatigue with minimal exertion. What is the most important question to ask next?
A. "What did you eat for breakfast?"
B. "Does the fatigue occur with chest pain or shortness of breath?"
C. "Have you had your vision checked recently?"
D. "How many hours do you sleep at night?"
Rationale: New-onset fatigue in a patient with CAD may represent anginal equivalent.
Associated symptoms such as chest pain or dyspnea are critical to identify cardiac ischemia.
Other options are less directly relevant to the acute concern.
Q14. Which component of the health history should be obtained before the physical
examination?
A. Review of Systems
B. Chief Complaint and History of Present Illness
