NR603 Week 1 to Week 7 Exam Collections
(Q& A , Study Guides, Assignments, Case
Study, etc.)(NEWEST, 2021) : Chamberlain
College of Nursing
Section 1: Diagnostic Reasoning & Assessment Foundations
1. A patient presents to the clinic with a chief complaint of "dizziness." Which of the following
is considered subjective data when documenting this encounter?
A. Blood pressure 138/86 mmHg
B. Patient states "the room is spinning"
C. Positive Dix-Hallpike maneuver
D. Heart rate 88 beats per minute
Correct Answer: B. Patient states "the room is spinning"
Rationale: Subjective data includes symptoms the patient reports, such as sensations,
feelings, and descriptions of their experience. The sensation of the room spinning (vertigo) is a
symptom reported by the patient. Blood pressure, heart rate, and physical exam maneuvers are
objective findings measured or observed by the clinician .
2. Which acronym is most useful for structuring the History of Present Illness (HPI) during a
patient encounter?
A. SOAP
B. OLDCARTS
C. PQRST
D. ABCDE
Correct Answer: B. OLDCARTS
Rationale: OLDCARTS (Onset, Location, Duration, Characteristics, Aggravating/Alleviating
factors, Related symptoms, Treatments tried, Severity) is the standard framework for a
comprehensive HPI. SOAP is a note format, PQRST is often used for pain assessment specifically,
and ABCDE is used for emergency assessments .
,3. A 68-year-old patient presents with sudden onset of confusion and disorientation. Which
assessment finding would most strongly suggest delirium rather than dementia?
A. Gradual onset over several months
B. Fluctuating level of consciousness
C. Memory loss that is stable over time
D. Preserved attention and alertness
Correct Answer: B. Fluctuating level of consciousness
Rationale: Delirium is characterized by an acute onset with fluctuating levels of
consciousness and attention deficits. Dementia typically has an insidious onset with stable,
progressive memory loss and relatively preserved alertness until late stages .
4. Which of the following is considered a "red flag" in the evaluation of a headache that
warrants urgent neuroimaging?
A. Headache that improves with ibuprofen
B. Headache that is bilateral and throbbing
C. Sudden onset of "the worst headache of my life"
D. Headache that occurs after stress at work
Correct Answer: C. Sudden onset of "the worst headache of my life"
Rationale: A thunderclap headache with maximal intensity at onset requires urgent
evaluation to rule out subarachnoid hemorrhage. The other options describe characteristics
more consistent with primary headache disorders like tension or migraine .
5. A 19-year-old male presents with a first-degree sunburn over his entire torso. Using the
Rule of Palms, the patient's palm represents approximately what percentage of total body
surface area?
A. 1%
B. 2%
C. 4%
D. 9%
Correct Answer: A. 1%
, Rationale: The Rule of Palms estimates that the patient's palm (including fingers) represents
approximately 1% of their total body surface area. This is useful for quickly estimating burn size .
6. A patient presents with a unilateral, throbbing headache accompanied by nausea and
photophobia. Which of the following is most consistent with a diagnosis of migraine?
A. Bilateral pressure sensation that resolves with rest
B. Unilateral throbbing pain lasting 4-72 hours
C. Headache triggered by neck movement
D. Headache with associated fever and neck stiffness
Correct Answer: B. Unilateral throbbing pain lasting 4-72 hours
Rationale: Migraine headaches are typically unilateral, throbbing, and last 4-72 hours. They
are often accompanied by nausea, photophobia, and phonophobia. Bilateral pressure is more
consistent with tension headache, and fever/neck stiffness suggests meningitis .
7. Which of the following is considered objective data when assessing a patient with vertigo?
A. Patient reports "I feel like the room is spinning"
B. Patient describes a sense of imbalance when walking
C. Nystagmus observed during a Dix-Hallpike maneuver
D. Patient states dizziness worsens when turning the head
Correct Answer: C. Nystagmus observed during a Dix-Hallpike maneuver
Rationale: Objective data is measurable or observable by the clinician. Nystagmus observed
during a positional maneuver is an objective finding. The other options are symptoms reported
by the patient (subjective data) .
8. A 72-year-old patient presents with acute onset of confusion. Which of the following is the
most important initial diagnostic step?
A. CT scan of the head
B. Assessment of oxygen saturation and glucose
C. Lumbar puncture
D. MRI of the brain
Correct Answer: B. Assessment of oxygen saturation and glucose
, Rationale: Before ordering neuroimaging, initial assessment of delirium should rule out
quickly reversible causes such as hypoxia and hypoglycemia. Point-of-care glucose and pulse
oximetry are rapid, non-invasive initial steps .
9. Which cranial nerves are minimally assessed when evaluating a patient presenting with
headache?
A. CN I, II, VIII
B. CN III, IV, VI
C. CN IX, X, XII
D. CN V, VII, XI
Correct Answer: B. CN III, IV, VI
Rationale: Assessment of CN III (oculomotor), IV (trochlear), and VI (abducens) evaluates
pupillary response, eye movement, and extraocular muscle function, which can be affected by
increased intracranial pressure or other serious pathology causing headache .
10. A patient reports a headache that began after a recent fall. Which of the following findings
would be most concerning for a subdural hematoma?
A. Headache that resolves with acetaminophen
B. Headache that worsens when lying flat
C. Gradual onset of confusion and drowsiness
D. Bilateral temporal tenderness
Correct Answer: C. Gradual onset of confusion and drowsiness
Rationale: A subdural hematoma often presents with a gradual onset of neurologic
deterioration, including confusion, drowsiness, and headache that may worsen over time.
Headache that worsens when lying flat could suggest increased ICP but the progressive altered
mental status is more specific to hematoma .
11. A 55-year-old patient presents with symptoms of BPPV. Which maneuver is used to
diagnose this condition?
A. Romberg test
B. Dix-Hallpike maneuver
(Q& A , Study Guides, Assignments, Case
Study, etc.)(NEWEST, 2021) : Chamberlain
College of Nursing
Section 1: Diagnostic Reasoning & Assessment Foundations
1. A patient presents to the clinic with a chief complaint of "dizziness." Which of the following
is considered subjective data when documenting this encounter?
A. Blood pressure 138/86 mmHg
B. Patient states "the room is spinning"
C. Positive Dix-Hallpike maneuver
D. Heart rate 88 beats per minute
Correct Answer: B. Patient states "the room is spinning"
Rationale: Subjective data includes symptoms the patient reports, such as sensations,
feelings, and descriptions of their experience. The sensation of the room spinning (vertigo) is a
symptom reported by the patient. Blood pressure, heart rate, and physical exam maneuvers are
objective findings measured or observed by the clinician .
2. Which acronym is most useful for structuring the History of Present Illness (HPI) during a
patient encounter?
A. SOAP
B. OLDCARTS
C. PQRST
D. ABCDE
Correct Answer: B. OLDCARTS
Rationale: OLDCARTS (Onset, Location, Duration, Characteristics, Aggravating/Alleviating
factors, Related symptoms, Treatments tried, Severity) is the standard framework for a
comprehensive HPI. SOAP is a note format, PQRST is often used for pain assessment specifically,
and ABCDE is used for emergency assessments .
,3. A 68-year-old patient presents with sudden onset of confusion and disorientation. Which
assessment finding would most strongly suggest delirium rather than dementia?
A. Gradual onset over several months
B. Fluctuating level of consciousness
C. Memory loss that is stable over time
D. Preserved attention and alertness
Correct Answer: B. Fluctuating level of consciousness
Rationale: Delirium is characterized by an acute onset with fluctuating levels of
consciousness and attention deficits. Dementia typically has an insidious onset with stable,
progressive memory loss and relatively preserved alertness until late stages .
4. Which of the following is considered a "red flag" in the evaluation of a headache that
warrants urgent neuroimaging?
A. Headache that improves with ibuprofen
B. Headache that is bilateral and throbbing
C. Sudden onset of "the worst headache of my life"
D. Headache that occurs after stress at work
Correct Answer: C. Sudden onset of "the worst headache of my life"
Rationale: A thunderclap headache with maximal intensity at onset requires urgent
evaluation to rule out subarachnoid hemorrhage. The other options describe characteristics
more consistent with primary headache disorders like tension or migraine .
5. A 19-year-old male presents with a first-degree sunburn over his entire torso. Using the
Rule of Palms, the patient's palm represents approximately what percentage of total body
surface area?
A. 1%
B. 2%
C. 4%
D. 9%
Correct Answer: A. 1%
, Rationale: The Rule of Palms estimates that the patient's palm (including fingers) represents
approximately 1% of their total body surface area. This is useful for quickly estimating burn size .
6. A patient presents with a unilateral, throbbing headache accompanied by nausea and
photophobia. Which of the following is most consistent with a diagnosis of migraine?
A. Bilateral pressure sensation that resolves with rest
B. Unilateral throbbing pain lasting 4-72 hours
C. Headache triggered by neck movement
D. Headache with associated fever and neck stiffness
Correct Answer: B. Unilateral throbbing pain lasting 4-72 hours
Rationale: Migraine headaches are typically unilateral, throbbing, and last 4-72 hours. They
are often accompanied by nausea, photophobia, and phonophobia. Bilateral pressure is more
consistent with tension headache, and fever/neck stiffness suggests meningitis .
7. Which of the following is considered objective data when assessing a patient with vertigo?
A. Patient reports "I feel like the room is spinning"
B. Patient describes a sense of imbalance when walking
C. Nystagmus observed during a Dix-Hallpike maneuver
D. Patient states dizziness worsens when turning the head
Correct Answer: C. Nystagmus observed during a Dix-Hallpike maneuver
Rationale: Objective data is measurable or observable by the clinician. Nystagmus observed
during a positional maneuver is an objective finding. The other options are symptoms reported
by the patient (subjective data) .
8. A 72-year-old patient presents with acute onset of confusion. Which of the following is the
most important initial diagnostic step?
A. CT scan of the head
B. Assessment of oxygen saturation and glucose
C. Lumbar puncture
D. MRI of the brain
Correct Answer: B. Assessment of oxygen saturation and glucose
, Rationale: Before ordering neuroimaging, initial assessment of delirium should rule out
quickly reversible causes such as hypoxia and hypoglycemia. Point-of-care glucose and pulse
oximetry are rapid, non-invasive initial steps .
9. Which cranial nerves are minimally assessed when evaluating a patient presenting with
headache?
A. CN I, II, VIII
B. CN III, IV, VI
C. CN IX, X, XII
D. CN V, VII, XI
Correct Answer: B. CN III, IV, VI
Rationale: Assessment of CN III (oculomotor), IV (trochlear), and VI (abducens) evaluates
pupillary response, eye movement, and extraocular muscle function, which can be affected by
increased intracranial pressure or other serious pathology causing headache .
10. A patient reports a headache that began after a recent fall. Which of the following findings
would be most concerning for a subdural hematoma?
A. Headache that resolves with acetaminophen
B. Headache that worsens when lying flat
C. Gradual onset of confusion and drowsiness
D. Bilateral temporal tenderness
Correct Answer: C. Gradual onset of confusion and drowsiness
Rationale: A subdural hematoma often presents with a gradual onset of neurologic
deterioration, including confusion, drowsiness, and headache that may worsen over time.
Headache that worsens when lying flat could suggest increased ICP but the progressive altered
mental status is more specific to hematoma .
11. A 55-year-old patient presents with symptoms of BPPV. Which maneuver is used to
diagnose this condition?
A. Romberg test
B. Dix-Hallpike maneuver
