NSG 6020 FINAL EXAM 2026 | Updated Questions and
Answers 2026/2027 | Verified Edition | South University | Pass
Guaranteed - A+ Graded
Section 1: Advanced Health History & Communication (Questions 1-25)
Q1: A 45-year-old patient presents with intermittent chest pain. To fully characterize the history
of present illness (HPI), the clinician uses the OLDCARTS mnemonic. Which of the following
corresponds to the "T" in this mnemonic?
A. Timing
B. Tolerance
C. Treatment
D. Trauma
Correct Answer: C
Rationale: The OLDCARTS mnemonic stands for Onset, Location, Duration, Character,
Aggravating/Alleviating factors, Radiation, Timing, and Severity. The "T" specifically stands for
Treatment, asking what treatments or medications the patient has tried and how they affected
the symptoms. NSG 6020 Final Exam Tip: Do not confuse OLDCARTS with PQRST
(Palliative/Provocative, Quality, Region/Radiation, Severity, Timing); knowing the exact letters in
each mnemonic is crucial for exam success.
Q2: A patient with a new diagnosis of chronic obstructive pulmonary disease (COPD) expresses
reluctance to quit smoking, stating, "I've smoked for 30 years, it's too late now." Which
motivational interviewing (MI) technique is most appropriate to address this statement?
A. Direct confrontation with statistics on lung cancer mortality
B. Developing discrepancy by exploring the patient's stated desire to see their grandchildren
grow up versus their smoking behavior
C. Providing a lecture on the pathophysiology of emphysema
D. Ignoring the statement and prescribing nicotine replacement therapy immediately
Correct Answer: B
Rationale: Developing discrepancy is a core principle of Motivational Interviewing that helps
patients recognize the gap between their current behavior (smoking) and their broader goals or
values (seeing grandchildren grow up). Confrontation and lecturing violate MI principles by
evoking resistance rather than rolling with it. NSG 6020 Final Exam Tip: Remember the OARS
,techniques (Open-ended questions, Affirmations, Reflective listening, Summaries) and the spirit
of MI (partnership, acceptance, compassion, evocation).
Q3: A nurse practitioner is assessing a patient's health literacy prior to explaining a complex
treatment plan. Which single-item screening question is most validated for rapidly identifying
inadequate health literacy?
A. "Can you read English?"
B. "How confident are you filling out medical forms by yourself?"
C. "What is your highest level of education completed?"
D. "Do you use the internet to look up your health conditions?"
Correct Answer: B
Rationale: The question "How confident are you filling out medical forms by yourself?" is a
highly validated, rapid screening tool for health literacy. Patients who answer "somewhat," "a
little," or "not at all" are at high risk for inadequate health literacy. Educational level and internet
use do not directly correlate with functional health literacy. NSG 6020 Final Exam Tip: Always
assess health literacy using validated questions rather than making assumptions based on
education or appearance.
Q4: A clinician needs to deliver bad news to a patient regarding a new diagnosis of pancreatic
cancer. According to the SPIKES protocol, what is the first step in this process?
A. Knowledge: Sharing the medical facts of the diagnosis
B. Setting: Ensuring privacy, sitting down, and arranging for support persons to be present
C. Emotions: Addressing the patient's immediate emotional reactions
D. Strategy: Discussing the treatment plan and next steps
Correct Answer: B
Rationale: The SPIKES protocol for delivering bad news stands for Setting, Perception,
Invitation, Knowledge, Emotions, and Strategy/Summary. "Setting" involves preparing the
environment (private, sitting down, minimizing interruptions, ensuring support is available)
before any information is delivered. NSG 6020 Final Exam Tip: Never skip the "Setting" and
"Perception" (finding out what the patient already knows) phases; delivering bad news without
these steps can cause severe psychological harm.
Q5: An 18-year-old female presents for a routine physical. To obtain a comprehensive sexual
history using the PARTNERS model, which question aligns with the "P" for Practices?
A. "Do you have a boyfriend, girlfriend, or both?"
B. "What types of sexual activities do you engage in (oral, vaginal, anal)?"
,C. "Do you use condoms or other forms of protection?"
D. "Have you ever been tested for HIV or other STIs?"
Correct Answer: B
Rationale: The PARTNERS model stands for Partners, Practices, Protection, Past STIs,
Reproduction, and Sexual satisfaction/Needs. "Practices" refers to the specific types of sexual
activities the patient engages in. "Partners" asks about gender and number of partners,
"Protection" asks about barrier methods, and "Past STIs" addresses testing history. NSG 6020
Final Exam Tip: Master the PARTNERS framework to ask non-judgmental, comprehensive
sexual health questions confidently.
Q6: A 65-year-old patient with a history of alcohol use disorder is brought to the clinic by his
daughter. He appears angry and shouts, "You are just trying to judge me like everyone else!"
What is the most therapeutic initial response?
A. "I am not judging you; I am just doing my job."
B. "I can see that you are upset. Let's take a step back and talk about what is worrying you the
most today."
C. "If you continue to yell, I will have to ask you to leave the clinic."
D. "Your daughter is very concerned about you, so we need to discuss your drinking."
Correct Answer: B
Rationale: When dealing with an angry patient, the initial response should acknowledge the
emotion ("I can see that you are upset"), explore the underlying concern, and de-escalate the
situation. Defensiveness, threats, or aligning with the family member over the patient will
increase anger and damage the therapeutic alliance. NSG 6020 Final Exam Tip: Use the "LEE"
approach (Listen, Empathize, Explain) for angry or hostile patient encounters to maintain safety
and build rapport.
Q7: A patient with type 2 diabetes is not taking their prescribed metformin. During the interview,
the patient states, "I just don't think I need it since I feel fine." Which stage of the
Transtheoretical Model (Stages of Change) best describes this patient?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
Correct Answer: A
Rationale: In the precontemplation stage, the patient is unaware or in denial of the need for
change and has no intention of changing their behavior within the next 6 months. Because the
, patient feels fine, they do not see the necessity of the medication. Contemplation involves
ambivalence but acknowledgment of the problem. NSG 6020 Final Exam Tip: Differentiate
precontemplation (no intent/unaware) from contemplation (ambivalent/intending to change
soon) to tailor your motivational interviewing approach.
Q8: A patient presents with a 2-week history of fatigue, weight loss, and night sweats. In the
Review of Systems (ROS), which specific category do these symptoms belong to?
A. Constitutional
B. Gastrointestinal
C. Neurologic
D. Respiratory
Correct Answer: A
Rationale: Constitutional symptoms include fever, chills, night sweats, fatigue, weight loss
(unintentional), and malaise. These are systemic symptoms that affect the whole body rather
than a specific organ system. NSG 6020 Final Exam Tip: Memorize the 14 ROS systems and
know that fever, chills, night sweats, and weight loss always fall under "Constitutional."
Q9: A patient presents with acute onset of severe epigastric pain radiating to the back after a
weekend of heavy alcohol consumption. Which component of the HPI is explicitly documented
by the phrase "after a weekend of heavy alcohol consumption"?
A. Onset
B. Aggravating factor
C. Associated signs/symptoms
D. Context
Correct Answer: B
Rationale: "After a weekend of heavy alcohol consumption" documents an aggravating factor (or
precipitating event) that worsens or triggers the condition (acute pancreatitis). Context is related
to the setting of the symptom, but in standard HPI structuring, identifying triggers like alcohol,
food, or activity is classified under aggravating/alleviating factors. NSG 6020 Final Exam Tip: Be
precise with HPI elements; alcohol as a trigger for pancreatitis or GI bleed is a classic
aggravating factor.
Q10: A 50-year-old male patient from Mexico explains that his "susto" (fright) has caused his
diabetes to become uncontrolled because his soul left his body. Which cultural competence
model is most appropriate for the clinician to use to understand this belief?
A. LEARN model
Answers 2026/2027 | Verified Edition | South University | Pass
Guaranteed - A+ Graded
Section 1: Advanced Health History & Communication (Questions 1-25)
Q1: A 45-year-old patient presents with intermittent chest pain. To fully characterize the history
of present illness (HPI), the clinician uses the OLDCARTS mnemonic. Which of the following
corresponds to the "T" in this mnemonic?
A. Timing
B. Tolerance
C. Treatment
D. Trauma
Correct Answer: C
Rationale: The OLDCARTS mnemonic stands for Onset, Location, Duration, Character,
Aggravating/Alleviating factors, Radiation, Timing, and Severity. The "T" specifically stands for
Treatment, asking what treatments or medications the patient has tried and how they affected
the symptoms. NSG 6020 Final Exam Tip: Do not confuse OLDCARTS with PQRST
(Palliative/Provocative, Quality, Region/Radiation, Severity, Timing); knowing the exact letters in
each mnemonic is crucial for exam success.
Q2: A patient with a new diagnosis of chronic obstructive pulmonary disease (COPD) expresses
reluctance to quit smoking, stating, "I've smoked for 30 years, it's too late now." Which
motivational interviewing (MI) technique is most appropriate to address this statement?
A. Direct confrontation with statistics on lung cancer mortality
B. Developing discrepancy by exploring the patient's stated desire to see their grandchildren
grow up versus their smoking behavior
C. Providing a lecture on the pathophysiology of emphysema
D. Ignoring the statement and prescribing nicotine replacement therapy immediately
Correct Answer: B
Rationale: Developing discrepancy is a core principle of Motivational Interviewing that helps
patients recognize the gap between their current behavior (smoking) and their broader goals or
values (seeing grandchildren grow up). Confrontation and lecturing violate MI principles by
evoking resistance rather than rolling with it. NSG 6020 Final Exam Tip: Remember the OARS
,techniques (Open-ended questions, Affirmations, Reflective listening, Summaries) and the spirit
of MI (partnership, acceptance, compassion, evocation).
Q3: A nurse practitioner is assessing a patient's health literacy prior to explaining a complex
treatment plan. Which single-item screening question is most validated for rapidly identifying
inadequate health literacy?
A. "Can you read English?"
B. "How confident are you filling out medical forms by yourself?"
C. "What is your highest level of education completed?"
D. "Do you use the internet to look up your health conditions?"
Correct Answer: B
Rationale: The question "How confident are you filling out medical forms by yourself?" is a
highly validated, rapid screening tool for health literacy. Patients who answer "somewhat," "a
little," or "not at all" are at high risk for inadequate health literacy. Educational level and internet
use do not directly correlate with functional health literacy. NSG 6020 Final Exam Tip: Always
assess health literacy using validated questions rather than making assumptions based on
education or appearance.
Q4: A clinician needs to deliver bad news to a patient regarding a new diagnosis of pancreatic
cancer. According to the SPIKES protocol, what is the first step in this process?
A. Knowledge: Sharing the medical facts of the diagnosis
B. Setting: Ensuring privacy, sitting down, and arranging for support persons to be present
C. Emotions: Addressing the patient's immediate emotional reactions
D. Strategy: Discussing the treatment plan and next steps
Correct Answer: B
Rationale: The SPIKES protocol for delivering bad news stands for Setting, Perception,
Invitation, Knowledge, Emotions, and Strategy/Summary. "Setting" involves preparing the
environment (private, sitting down, minimizing interruptions, ensuring support is available)
before any information is delivered. NSG 6020 Final Exam Tip: Never skip the "Setting" and
"Perception" (finding out what the patient already knows) phases; delivering bad news without
these steps can cause severe psychological harm.
Q5: An 18-year-old female presents for a routine physical. To obtain a comprehensive sexual
history using the PARTNERS model, which question aligns with the "P" for Practices?
A. "Do you have a boyfriend, girlfriend, or both?"
B. "What types of sexual activities do you engage in (oral, vaginal, anal)?"
,C. "Do you use condoms or other forms of protection?"
D. "Have you ever been tested for HIV or other STIs?"
Correct Answer: B
Rationale: The PARTNERS model stands for Partners, Practices, Protection, Past STIs,
Reproduction, and Sexual satisfaction/Needs. "Practices" refers to the specific types of sexual
activities the patient engages in. "Partners" asks about gender and number of partners,
"Protection" asks about barrier methods, and "Past STIs" addresses testing history. NSG 6020
Final Exam Tip: Master the PARTNERS framework to ask non-judgmental, comprehensive
sexual health questions confidently.
Q6: A 65-year-old patient with a history of alcohol use disorder is brought to the clinic by his
daughter. He appears angry and shouts, "You are just trying to judge me like everyone else!"
What is the most therapeutic initial response?
A. "I am not judging you; I am just doing my job."
B. "I can see that you are upset. Let's take a step back and talk about what is worrying you the
most today."
C. "If you continue to yell, I will have to ask you to leave the clinic."
D. "Your daughter is very concerned about you, so we need to discuss your drinking."
Correct Answer: B
Rationale: When dealing with an angry patient, the initial response should acknowledge the
emotion ("I can see that you are upset"), explore the underlying concern, and de-escalate the
situation. Defensiveness, threats, or aligning with the family member over the patient will
increase anger and damage the therapeutic alliance. NSG 6020 Final Exam Tip: Use the "LEE"
approach (Listen, Empathize, Explain) for angry or hostile patient encounters to maintain safety
and build rapport.
Q7: A patient with type 2 diabetes is not taking their prescribed metformin. During the interview,
the patient states, "I just don't think I need it since I feel fine." Which stage of the
Transtheoretical Model (Stages of Change) best describes this patient?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
Correct Answer: A
Rationale: In the precontemplation stage, the patient is unaware or in denial of the need for
change and has no intention of changing their behavior within the next 6 months. Because the
, patient feels fine, they do not see the necessity of the medication. Contemplation involves
ambivalence but acknowledgment of the problem. NSG 6020 Final Exam Tip: Differentiate
precontemplation (no intent/unaware) from contemplation (ambivalent/intending to change
soon) to tailor your motivational interviewing approach.
Q8: A patient presents with a 2-week history of fatigue, weight loss, and night sweats. In the
Review of Systems (ROS), which specific category do these symptoms belong to?
A. Constitutional
B. Gastrointestinal
C. Neurologic
D. Respiratory
Correct Answer: A
Rationale: Constitutional symptoms include fever, chills, night sweats, fatigue, weight loss
(unintentional), and malaise. These are systemic symptoms that affect the whole body rather
than a specific organ system. NSG 6020 Final Exam Tip: Memorize the 14 ROS systems and
know that fever, chills, night sweats, and weight loss always fall under "Constitutional."
Q9: A patient presents with acute onset of severe epigastric pain radiating to the back after a
weekend of heavy alcohol consumption. Which component of the HPI is explicitly documented
by the phrase "after a weekend of heavy alcohol consumption"?
A. Onset
B. Aggravating factor
C. Associated signs/symptoms
D. Context
Correct Answer: B
Rationale: "After a weekend of heavy alcohol consumption" documents an aggravating factor (or
precipitating event) that worsens or triggers the condition (acute pancreatitis). Context is related
to the setting of the symptom, but in standard HPI structuring, identifying triggers like alcohol,
food, or activity is classified under aggravating/alleviating factors. NSG 6020 Final Exam Tip: Be
precise with HPI elements; alcohol as a trigger for pancreatitis or GI bleed is a classic
aggravating factor.
Q10: A 50-year-old male patient from Mexico explains that his "susto" (fright) has caused his
diabetes to become uncontrolled because his soul left his body. Which cultural competence
model is most appropriate for the clinician to use to understand this belief?
A. LEARN model
