NSG 500 Exam 1 Actual Exam V1 | NSG 500 Advanced Health
Assessment (NSG500 Exam 1) [PDF] | Wilkes University
1. A 45-year-old male presents with acute chest pain. The clinician asks, ‘Can you describe the
pain for me?’ This is an example of which interviewing technique?
A. Closed-ended questioning
B. Facilitation
C. Open-ended questioning
D. Reflection
Answer: C
Rationale: Open-ended questions allow the patient to provide a narrative description of
their symptoms in their own words. This technique is essential during the initial stages of a
health history to gather comprehensive subjective data. It prevents the clinician from
leading the patient and helps uncover details that might be missed with specific ‘yes/no’
queries.
2. During a general survey, the nurse practitioner notices a patient is sitting in a ‘tripod
position.’ What is the clinical significance of this finding?
A. It suggests the patient is experiencing respiratory distress.
B. It indicates chronic lower back pain.
C. It is a sign of severe abdominal guarding.
D. It reflects a normal relaxed posture for an adult.
E. It indicates orthostatic hypotension.
Answer: A
Rationale: The tripod position involves leaning forward with arms braced on the knees to
facilitate the use of accessory muscles for breathing. This posture is a significant objective
finding often seen in patients with COPD or acute respiratory distress. Observing this
during the general survey should prompt an immediate assessment of the patient’s
oxygenation and lung sounds.
3. When assessing the ‘P’ in the OLDCARTS acronym for a patient with a headache, which
question is most appropriate?
A. What makes the pain worse or better?
B. Where exactly is the pain located?
C. How long does the pain last?
,D. When did the pain first start?
Answer: A
Rationale: In the OLDCARTS mnemonic, ‘P’ stands for Palliating or Provoking factors.
Asking what makes the pain better or worse helps the clinician understand the aggravating
factors and potential reliefs. This information is critical for differentiating between types of
pain and guiding the diagnostic process.
4. A clinician is measuring a patient’s blood pressure and uses a cuff that is too narrow for the
patient’s arm. What is the likely result?
A. A falsely high systolic and diastolic reading
B. A falsely low systolic reading
C. An accurate reading if the cuff is wrapped tightly
D. A falsely low diastolic reading only
Answer: A
Rationale: Using a blood pressure cuff that is too small for the arm circumference requires
more pressure to compress the brachial artery. This leads to a falsely elevated blood
pressure reading for both systolic and diastolic values. Clinicians must ensure the bladder
width is approximately 40% of the arm circumference to maintain accuracy.
5. Which component of the health history is most appropriate for recording a patient’s
history of childhood illnesses and immunizations?
A. History of Present Illness
B. Past Medical History
C. Review of Systems
D. Social History
Answer: B
Rationale: Past Medical History (PMH) includes data regarding previous illnesses,
surgeries, hospitalizations, and preventative health measures like immunizations.
Recording childhood illnesses is vital for identifying long-term sequelae or immunity
status. This section provides a longitudinal view of the patient’s health status prior to the
current complaint.
6. A patient reports ‘night sweats’ during the health history. In which section of the
documentation should this be primarily recorded?
A. Physical Examination
B. Review of Systems
, C. General Survey
D. Chief Complaint
Answer: B
Rationale: Night sweats are a subjective symptom that should be recorded under the
Review of Systems (ROS), specifically in the constitutional or general section. The ROS
serves to uncover symptoms that the patient may not have associated with their chief
complaint. Accurate documentation in the ROS helps clinicians identify systemic issues
such as infection or malignancy.
7. During an interview, the clinician says, ‘I understand that losing your job has been very
stressful for you.’ Which communication technique is being used?
A. Confrontation
B. Clarification
C. Empathy
D. Summary
Answer: C
Rationale: Empathy involves recognizing and acknowledging a patient’s feelings without
necessarily experiencing them oneself. This technique builds trust and strengthens the
provider-patient relationship by showing the patient they are being heard. It encourages
the patient to continue sharing sensitive information about their social or emotional health.
8. While performing a general survey, the clinician notes the patient has a ‘flat affect.’ What
does this term describe?
A. Physical exhaustion and fatigue
B. A state of extreme agitation
C. A lack of emotional expression
D. Difficulty speaking clearly
Answer: C
Rationale: Flat affect refers to a significant reduction in the range and intensity of
emotional expression, often seen in the patient’s facial movements and tone of voice. This
observation is recorded during the general survey or psychiatric portion of the assessment.
It can be an indicator of depression, schizophrenia, or certain neurological conditions.
9. Which of the following is considered ‘Objective Data’?
A. Blood pressure reading of 142/88 mmHg.
B. Patient states they have been feeling ‘down’ lately.
Assessment (NSG500 Exam 1) [PDF] | Wilkes University
1. A 45-year-old male presents with acute chest pain. The clinician asks, ‘Can you describe the
pain for me?’ This is an example of which interviewing technique?
A. Closed-ended questioning
B. Facilitation
C. Open-ended questioning
D. Reflection
Answer: C
Rationale: Open-ended questions allow the patient to provide a narrative description of
their symptoms in their own words. This technique is essential during the initial stages of a
health history to gather comprehensive subjective data. It prevents the clinician from
leading the patient and helps uncover details that might be missed with specific ‘yes/no’
queries.
2. During a general survey, the nurse practitioner notices a patient is sitting in a ‘tripod
position.’ What is the clinical significance of this finding?
A. It suggests the patient is experiencing respiratory distress.
B. It indicates chronic lower back pain.
C. It is a sign of severe abdominal guarding.
D. It reflects a normal relaxed posture for an adult.
E. It indicates orthostatic hypotension.
Answer: A
Rationale: The tripod position involves leaning forward with arms braced on the knees to
facilitate the use of accessory muscles for breathing. This posture is a significant objective
finding often seen in patients with COPD or acute respiratory distress. Observing this
during the general survey should prompt an immediate assessment of the patient’s
oxygenation and lung sounds.
3. When assessing the ‘P’ in the OLDCARTS acronym for a patient with a headache, which
question is most appropriate?
A. What makes the pain worse or better?
B. Where exactly is the pain located?
C. How long does the pain last?
,D. When did the pain first start?
Answer: A
Rationale: In the OLDCARTS mnemonic, ‘P’ stands for Palliating or Provoking factors.
Asking what makes the pain better or worse helps the clinician understand the aggravating
factors and potential reliefs. This information is critical for differentiating between types of
pain and guiding the diagnostic process.
4. A clinician is measuring a patient’s blood pressure and uses a cuff that is too narrow for the
patient’s arm. What is the likely result?
A. A falsely high systolic and diastolic reading
B. A falsely low systolic reading
C. An accurate reading if the cuff is wrapped tightly
D. A falsely low diastolic reading only
Answer: A
Rationale: Using a blood pressure cuff that is too small for the arm circumference requires
more pressure to compress the brachial artery. This leads to a falsely elevated blood
pressure reading for both systolic and diastolic values. Clinicians must ensure the bladder
width is approximately 40% of the arm circumference to maintain accuracy.
5. Which component of the health history is most appropriate for recording a patient’s
history of childhood illnesses and immunizations?
A. History of Present Illness
B. Past Medical History
C. Review of Systems
D. Social History
Answer: B
Rationale: Past Medical History (PMH) includes data regarding previous illnesses,
surgeries, hospitalizations, and preventative health measures like immunizations.
Recording childhood illnesses is vital for identifying long-term sequelae or immunity
status. This section provides a longitudinal view of the patient’s health status prior to the
current complaint.
6. A patient reports ‘night sweats’ during the health history. In which section of the
documentation should this be primarily recorded?
A. Physical Examination
B. Review of Systems
, C. General Survey
D. Chief Complaint
Answer: B
Rationale: Night sweats are a subjective symptom that should be recorded under the
Review of Systems (ROS), specifically in the constitutional or general section. The ROS
serves to uncover symptoms that the patient may not have associated with their chief
complaint. Accurate documentation in the ROS helps clinicians identify systemic issues
such as infection or malignancy.
7. During an interview, the clinician says, ‘I understand that losing your job has been very
stressful for you.’ Which communication technique is being used?
A. Confrontation
B. Clarification
C. Empathy
D. Summary
Answer: C
Rationale: Empathy involves recognizing and acknowledging a patient’s feelings without
necessarily experiencing them oneself. This technique builds trust and strengthens the
provider-patient relationship by showing the patient they are being heard. It encourages
the patient to continue sharing sensitive information about their social or emotional health.
8. While performing a general survey, the clinician notes the patient has a ‘flat affect.’ What
does this term describe?
A. Physical exhaustion and fatigue
B. A state of extreme agitation
C. A lack of emotional expression
D. Difficulty speaking clearly
Answer: C
Rationale: Flat affect refers to a significant reduction in the range and intensity of
emotional expression, often seen in the patient’s facial movements and tone of voice. This
observation is recorded during the general survey or psychiatric portion of the assessment.
It can be an indicator of depression, schizophrenia, or certain neurological conditions.
9. Which of the following is considered ‘Objective Data’?
A. Blood pressure reading of 142/88 mmHg.
B. Patient states they have been feeling ‘down’ lately.
