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NSG 6020 Midterm Study Guide

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1. For which of the following patients would a comprehensive health history be appropriate? A) A new patient with the chief complaint of “I sprained my ankle” B) An established patient with the chief complaint of “I have an upper respiratory infection” C) A new patient with the chief complaint of “I am here to establish care” D) A new patient with the chief complaint of “I cut my hand” 2. Is the following information subjective or objective? Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse with activity and relieved by rest. A) Subjective B) Objective 3. Is the following information subjective or objective? Mr. M. has a respiratory rate of 32 and a pulse rate of 120. A) Subjective B) Objective 4. The following information is recorded in the health history: “Patient denies chest pain, palpitations, orthopnea, and paroxysmal nocturnal dyspnea.” Which category does it belong to? A) Chief complaint B) Present illness C) Personal and social history D) Review of systems 5. A patient presents for evaluation of a sharp, aching chest pain which increases with breathing. Which anatomic area would you localize the symptom to? A) Musculoskeletal B) Reproductive C) Urinary D) Endocrine 6. A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is new, located in the wrists and fingers bilaterally, with some subjective fever. The patient denies a rash; she also denies recent travel or camping activities. She has a family history significant for rheumatoid arthritis. Based on this information, which of the following pathologic processes would be the most correct? A) Infectious B) Inflammatory C) Hematologic D) Traumatic 7. A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and nonproductive cough. Which is the most likely pathologic process? A) Infection B) Inflammation C) Allergic D) Vascular 8. You are seeing an elderly man with multiple complaints. He has chronic arthritis, pain from an old war injury, and headaches. Today he complains of these pains, as well as dull chest pain under his sternum. What would the order of priority be for your problem list? A) Arthritis, war injury pain, headaches, chest pain B) War injury pain, arthritis, headaches, chest pain C) Headaches, arthritis, war injury pain, chest pain D) Chest pain, headaches, arthritis, war injury pain 9. Suzanne, a 25 year old, comes to your clinic to establish care. You are the student preparing to go into the examination room to interview her. Which of the following is the most logical sequence for the patient–provider interview? A) Establish the agenda, negotiate a plan, establish rapport, and invite the patient's story. B) Invite the patient's story, negotiate a plan, establish the agenda, and establish rapport. C) Greet the patient, establish rapport, invite the patient's story, establish the agenda, expand and clarify the patient's story, and negotiate a plan. D) Negotiate a plan, establish an agenda, invite the patient's story, and establish rapport. 10. Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The pain is a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an 8 at the worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and goes, and it seems to be worse a couple of hours after eating. She has noticed that it starts after eating greasy foods, so she has cut down on these as much as she can. Initially it occurred once a week, but now it is occurring every other day. Nothing makes it better. From this description, which of the seven attributes of a symptom has been omitted? A) Setting in which the symptom occurs B) Associated manifestations C) Quality D) Timing

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NSG 6020
Midterm Study Guide




1. For which of the following patients would a comprehensive health history be
appropriate?
A) A new patient with the chief complaint of “I sprained my ankle”
B) An established patient with the chief complaint of “I have an upper respiratory
infection”
C) A new patient with the chief complaint of “I am here to establish care”
D) A new patient with the chief complaint of “I cut my hand”


2. Is the following information subjective or objective?
Mr. M. has shortness of breath that has persisted for the past 10 days; it is worse with
activity and relieved by rest.
A) Subjective
B) Objective


3. Is the following information subjective or objective?
Mr. M. has a respiratory rate of 32 and a pulse rate of 120.
A) Subjective
B) Objective


4. The following information is recorded in the health history: “Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea.”
Which category does it belong to?
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems

, NSG 6020
Midterm Study Guide

5. A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine


6. A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is
new, located in the wrists and fingers bilaterally, with some subjective fever. The patient
denies a rash; she also denies recent travel or camping activities. She has a family
history significant for rheumatoid arthritis. Based on this information, which of the
following pathologic processes would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic


7. A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week
history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and
nonproductive cough. Which is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular


8. You are seeing an elderly man with multiple complaints. He has chronic arthritis, pain
from an old war injury, and headaches. Today he complains of these pains, as well as
dull chest pain under his sternum. What would the order of priority be for your problem
list?
A) Arthritis, war injury pain, headaches, chest pain
B) War injury pain, arthritis, headaches, chest pain
C) Headaches, arthritis, war injury pain, chest pain
D) Chest pain, headaches, arthritis, war injury pain

, NSG 6020
Midterm Study Guide

9. Suzanne, a 25 year old, comes to your clinic to establish care. You are the student
preparing to go into the examination room to interview her. Which of the following is
the most logical sequence for the patient–provider interview?
A) Establish the agenda, negotiate a plan, establish rapport, and invite the patient's
story.
B) Invite the patient's story, negotiate a plan, establish the agenda, and establish
rapport.
C) Greet the patient, establish rapport, invite the patient's story, establish the agenda,
expand and clarify the patient's story, and negotiate a plan.
D) Negotiate a plan, establish an agenda, invite the patient's story, and establish
rapport.


10. Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The
pain is a dull ache, located in the right upper quadrant, that she rates as a 3 at the least
and an 8 at the worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a
time, it comes and goes, and it seems to be worse a couple of hours after eating. She has
noticed that it starts after eating greasy foods, so she has cut down on these as much as
she can. Initially it occurred once a week, but now it is occurring every other day.
Nothing makes it better. From this description, which of the seven attributes of a
symptom has been omitted?
A) Setting in which the symptom occurs
B) Associated manifestations
C) Quality
D) Timing


11. A 23-year-old graduate student comes to your clinic for evaluation of a urethral
discharge. As the provider, you need to get a sexual history. Which one of the following
questions is inappropriate for eliciting the information?
A) Are you sexually active?
B) When was the last time you had intimate physical contact with someone, and did
that contact include sexual intercourse?
C) Do you have sex with men, women, or both?
D) How many sexual partners have you had in the last 6 months?

, NSG 6020
Midterm Study Guide

12. On a very busy day in the office, Mrs. Donelan, who is 81 years old, comes for her usual
visit for her blood pressure. She is on a low-dose diuretic chronically and denies any
side effects. Her blood pressure is 118/78 today, which is well-controlled. As you are
writing her script, she mentions that it is hard not having her husband Bill around
anymore. What would you do next?
A) Hand her the script and make sure she has a 3-month follow-up appointment.
B) Make sure she understands the script.
C) Ask why Bill is not there.
D) Explain that you will have more time at the next visit to discuss this.


13. When you enter your patient's examination room, his wife is waiting there with him.
Which of the following is most appropriate?
A) Ask if it's okay to carry out the visit with both people in the room.
B) Carry on as you would ordinarily. The permission is implied because his wife is in
the room with him.
C) Ask his wife to leave the room for reasons of confidentiality.
D) First ask his wife what she thinks is going on.


14. You are performing a young woman's first pelvic examination. You make sure to tell
her verbally what is coming next and what to expect. Then you carry out each
maneuver of the examination. You let her know at the outset that if she needs a break or
wants to stop, this is possible. You ask several times during the examination, “How are
you doing, Brittney?” What are you accomplishing with these techniques?
A) Increasing the patient's sense of control
B) Increasing the patient's trust in you as a caregiver
C) Decreasing her sense of vulnerability
D) All of the above


15. A 15-year-old high school sophomore and her mother come to your clinic because the
mother is concerned about her daughter's weight. You measure her daughter's height and
weight and obtain a BMI of 19.5 kg/m2. Based on this information, which of the
following is appropriate?
A) Refer the patient to a nutritionist and a psychologist because the patient is anorexic.
B) Reassure the mother that this is a normal body weight.
C) Give the patient information about exercise because the patient is obese.
D) Give the patient information concerning reduction of fat and cholesterol in her diet
because she is obese.
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