NNR509 PHYSICAL ASSESSMENT
UPDATED ACTUAL EXAM QUESTIONS
AND CORRECT ANSWERS
The nurse practitioner (NP) is completing a comprehensive assessment of Anita, a new client in a
primary care facility. Which assessment finding(s) reported by Anita are related to social determinants of
health? Select all that apply. - Correct answer.occasionally running out of food, being discriminated
against in the workplace, has a great amount of smog in their community, having difficulty making the
rent payment
Focused assessment: - Correct answer.- addresses focused concerns or symptoms
-used for established clients during routine or urgent care visits
- health history and physical exams are focused on the problem
-Includes: brief history of present illness, only the system related to the problem in the ROS
comprehensive assessment: - Correct answer.- used for new clients
-provides personalized information about the client
-strengthens the clinician-client relationship
-provides a baseline for future assessments
-provides an opportunity for health promotion education and counseling
includes: extended history of the present illness, at least two area of PMhx, family hx, social hx, at least
10 ROS
subjective data - Correct answer.Subjective data includes symptoms that the client describes such as a
sore throat, headache, or pain. It also includes the client's feelings, perceptions, and concerns
objective data - Correct answer.Objective data includes the physical examination findings or signs
observed. Information obtained from the client during any part of the health history is considered
subjective data. All physical examinations, laboratory information, and test data are considered objective
data
,initial encounter - Correct answer.-review the clinical record
-ensure the client is comfortable
-clarify the goals/agenda for the encounter
-establish rapport
-identify client's preferred title, name, and gender pronouns
-use "people first" language (i.e. hearing loss, wheelchair)
-identify the c/o
-open-ended approach for client's story
-gather information about the client's perspective of the illness using the FIFE (feelings, ideas, function,
expectations)
-conduct health history interview
-gather information about PMHx, meds, allergies, family, personal and social, ROS
"How would you describe your sexual identity?"
"How would you describe your gender identity?"
"What is the sex on your original birth certificate?" - Correct answer.
Basic Interviewing Skills - Correct answer.-active listening-closely attending to what the pt is
communicating, connect to pt's emotional state, use verbal and nonverbal skills
-empathy- the capacity to identify with the pt and feel the pt's pain as your own
-guided questioning- allows for interviewer to facilitate full communications
-validating- affirm legitimacy of pt's emotional experience
-empowerment; encourage pt to ask questions
-partnering; express your commitment to ongoing relationship
-transitioning; inform your pt when you are changing directions
-reassuring; help the pt feel that their problems have been heard
- summarizing; giving a summary of the pt's story to communicate that you have been carefully listening
-nonverbal communication
, -people first language --> ex. patient with diabetes instead of diabetic
history of present illness - Correct answer.The history of the present illness is a concise, clear, and
chronological description of the chief complaint which prompted the client's visit. A symptom analysis
guided by the mnemonic OLD CARTS will reveal information regarding the onset, location, duration,
characteristics, aggravating factors, relieving factors, treatments, and severity of the symptoms. There
are other mnemonics and variations of OLD CARTS that may also be used to guide in gathering
information about the chief complaint.
personal and social history - Correct answer.The Five P's:
-partners
-practices
-protection from STIs
-Past hx of STIs
-Pregnancy plans
-Plus-- assess for trauma, violence, sexual health concerns, provide support for sexual orientation and
gender identity
assessment questions with the related symptom attribute - Correct answer.onset, location, duration,
characteristics, aggravating factors, relieving factors, treatments, severity of symptoms
pack-year cig calculations - Correct answer.A pack-year calculation is used to measure a person's
exposure to tobacco and assess their risk of developing lung cancer or other diseases related to tobacco
use. The pack year is calculated by multiplying the number of packs of cigarettes (1 pack=20 cigarettes)
smoked per day by the number of years the person has smoked. The U.S. Preventive Services Task Force
Links to an external site.(2021) recommends health care providers ask all adults about tobacco use,
advise them to stop, and provide interventions for smoking cessation
social determinants of health - Correct answer.-Social determinants of health are the conditions in the
environments where people are born, live, and work that affects health, well-being, and quality of life
- examples: economic stability, education access and quality, healthcare access and quality,
neighborhood and built environment, social and community context
UPDATED ACTUAL EXAM QUESTIONS
AND CORRECT ANSWERS
The nurse practitioner (NP) is completing a comprehensive assessment of Anita, a new client in a
primary care facility. Which assessment finding(s) reported by Anita are related to social determinants of
health? Select all that apply. - Correct answer.occasionally running out of food, being discriminated
against in the workplace, has a great amount of smog in their community, having difficulty making the
rent payment
Focused assessment: - Correct answer.- addresses focused concerns or symptoms
-used for established clients during routine or urgent care visits
- health history and physical exams are focused on the problem
-Includes: brief history of present illness, only the system related to the problem in the ROS
comprehensive assessment: - Correct answer.- used for new clients
-provides personalized information about the client
-strengthens the clinician-client relationship
-provides a baseline for future assessments
-provides an opportunity for health promotion education and counseling
includes: extended history of the present illness, at least two area of PMhx, family hx, social hx, at least
10 ROS
subjective data - Correct answer.Subjective data includes symptoms that the client describes such as a
sore throat, headache, or pain. It also includes the client's feelings, perceptions, and concerns
objective data - Correct answer.Objective data includes the physical examination findings or signs
observed. Information obtained from the client during any part of the health history is considered
subjective data. All physical examinations, laboratory information, and test data are considered objective
data
,initial encounter - Correct answer.-review the clinical record
-ensure the client is comfortable
-clarify the goals/agenda for the encounter
-establish rapport
-identify client's preferred title, name, and gender pronouns
-use "people first" language (i.e. hearing loss, wheelchair)
-identify the c/o
-open-ended approach for client's story
-gather information about the client's perspective of the illness using the FIFE (feelings, ideas, function,
expectations)
-conduct health history interview
-gather information about PMHx, meds, allergies, family, personal and social, ROS
"How would you describe your sexual identity?"
"How would you describe your gender identity?"
"What is the sex on your original birth certificate?" - Correct answer.
Basic Interviewing Skills - Correct answer.-active listening-closely attending to what the pt is
communicating, connect to pt's emotional state, use verbal and nonverbal skills
-empathy- the capacity to identify with the pt and feel the pt's pain as your own
-guided questioning- allows for interviewer to facilitate full communications
-validating- affirm legitimacy of pt's emotional experience
-empowerment; encourage pt to ask questions
-partnering; express your commitment to ongoing relationship
-transitioning; inform your pt when you are changing directions
-reassuring; help the pt feel that their problems have been heard
- summarizing; giving a summary of the pt's story to communicate that you have been carefully listening
-nonverbal communication
, -people first language --> ex. patient with diabetes instead of diabetic
history of present illness - Correct answer.The history of the present illness is a concise, clear, and
chronological description of the chief complaint which prompted the client's visit. A symptom analysis
guided by the mnemonic OLD CARTS will reveal information regarding the onset, location, duration,
characteristics, aggravating factors, relieving factors, treatments, and severity of the symptoms. There
are other mnemonics and variations of OLD CARTS that may also be used to guide in gathering
information about the chief complaint.
personal and social history - Correct answer.The Five P's:
-partners
-practices
-protection from STIs
-Past hx of STIs
-Pregnancy plans
-Plus-- assess for trauma, violence, sexual health concerns, provide support for sexual orientation and
gender identity
assessment questions with the related symptom attribute - Correct answer.onset, location, duration,
characteristics, aggravating factors, relieving factors, treatments, severity of symptoms
pack-year cig calculations - Correct answer.A pack-year calculation is used to measure a person's
exposure to tobacco and assess their risk of developing lung cancer or other diseases related to tobacco
use. The pack year is calculated by multiplying the number of packs of cigarettes (1 pack=20 cigarettes)
smoked per day by the number of years the person has smoked. The U.S. Preventive Services Task Force
Links to an external site.(2021) recommends health care providers ask all adults about tobacco use,
advise them to stop, and provide interventions for smoking cessation
social determinants of health - Correct answer.-Social determinants of health are the conditions in the
environments where people are born, live, and work that affects health, well-being, and quality of life
- examples: economic stability, education access and quality, healthcare access and quality,
neighborhood and built environment, social and community context
