Advanced Health Assessment for Nurse
Practitioner NP Assessment 3 Examination,
Chamberlain College of Nursing FNP Program,
2026/2027 – 155 Questions with Verified
Answers
SECTION 1: HEALTH HISTORY & COMMUNICATION (Questions 1–20)
Q1. A 45-year-old male presents with chest pain. Which question is most
appropriate to ask first?
A) "Have you ever had a heart attack before?"
B) "Can you describe the pain for me?"
C) "Does your family have a history of heart disease?"
D) "Are you feeling anxious about anything?"
Answer: B
Rationale: The first step in assessing chest pain is to obtain a detailed
description of the pain using the OLDCARTS mnemonic (Onset, Location,
Duration, Character, Aggravating factors, Relieving factors, Timing, Severity).
This guides differential diagnosis.
Q2. A nurse practitioner is conducting a health history interview. Which
technique demonstrates active listening?
A) Interrupting to ask clarifying questions immediately
B) Maintaining eye contact and nodding occasionally
C) Writing down every word the patient says
D) Glancing at the clock to monitor time
Answer: B
Rationale: Active listening involves maintaining eye contact, nodding, and
using verbal affirmations ("I see," "Go on") without interrupting. Writing
everything down (C) can be distracting; interruptions should be minimal.
Q3. A 72-year-old female reports difficulty sleeping. The NP should first ask:
A) "How much caffeine do you drink daily?"
,B) "Can you describe your typical sleep pattern?"
C) "Do you have any pain at night?"
D) "Are you worried about anything?"
Answer: B
Rationale: The NP should first obtain a description of the sleep pattern
(onset, duration, quality, nighttime awakenings, daytime sleepiness) before
exploring specific causes (caffeine, pain, anxiety).
Q4. A patient presents with abdominal pain. Which of the following is a "red
flag" symptom requiring immediate attention?
A) Dull, aching pain for 3 months
B) Pain relieved by defecation
C) Pain associated with vomiting blood (hematemesis)
D) Pain that worsens after eating
Answer: C
Rationale: Hematemesis (vomiting blood) is a red flag indicating potential
upper GI bleeding, which requires urgent evaluation. Chronic dull pain, relief
with defecation (IBS), and postprandial pain (PUD) are concerning but not
immediate emergencies.
Q5. A patient uses the term "the worst headache of my life." The NP should
first assess for:
A) Migraine with aura
B) Tension headache
C) Subarachnoid hemorrhage
D) Sinus headache
Answer: C
Rationale: "Thunderclap" or "worst headache of my life" is classic for
subarachnoid hemorrhage (ruptured aneurysm), a life-threatening
emergency requiring immediate CT head and neurosurgical consultation.
Q6. A 25-year-old female presents with fatigue. Which additional symptom
would most increase suspicion for depression?
A) Shortness of breath on exertion
B) Loss of interest in activities (anhedonia)
,C) Palpitations
D) Weight gain
Answer: B
Rationale: Anhedonia (loss of interest or pleasure in activities) is a core
symptom of major depressive disorder. The PHQ-2 screening asks about
depressed mood and anhedonia.
Q7. A patient reports "black, tarry stools" (melena). This finding suggests
bleeding from which location?
A) Lower GI tract (colon)
B) Upper GI tract (esophagus, stomach, duodenum)
C) Rectal area
D) Small intestine only
Answer: B
Rationale: Melena (black, tarry, sticky stools) indicates bleeding in the upper
GI tract (esophagus, stomach, proximal small intestine) where blood has
been digested. Bright red blood (hematochezia) suggests lower GI or rectal
bleeding.
Q8. A patient reports a 10-pound unintentional weight loss over 2 months.
The NP should first assess for:
A) Depression
B) Malignancy
C) Hyperthyroidism
D) All of the above
Answer: D
Rationale: Unintentional weight loss (>5% of body weight over 6-12 months)
has a broad differential including malignancy, depression, hyperthyroidism,
diabetes, GI disorders, and medication side effects. The NP must assess for
all.
Q9. A patient with a history of alcohol use disorder reports "my stomach
feels full quickly when I eat." This symptom (early satiety) suggests:
A) Gastritis
B) Gastroparesis
, C) Gastric outlet obstruction
D) Peptic ulcer disease
Answer: C
Rationale: Early satiety (feeling full after eating small amounts) suggests
gastric outlet obstruction (often from ulcer scarring or malignancy).
Gastroparesis (B) causes bloating and nausea but not necessarily early
satiety.
Q10. A patient reports waking up at 3 AM with shortness of breath and
needing to sit up to breathe (paroxysmal nocturnal dyspnea). This finding
suggests:
A) Asthma
B) COPD
C) Heart failure
D) Panic attack
Answer: C
Rationale: Paroxysmal nocturnal dyspnea (PND) is classic for left-sided heart
failure. When lying flat, fluid redistributes to the lungs, causing shortness of
breath that improves when sitting up (orthopnea).
Q11. A patient reports claudication (leg pain with walking that resolves with
rest). This finding suggests:
A) Peripheral neuropathy
B) Venous insufficiency
C) Peripheral arterial disease (PAD)
D) Lumbar spinal stenosis
Answer: C
Rationale: Intermittent claudication (pain with walking, relieved by rest) is
classic for peripheral arterial disease (PAD) due to inadequate blood flow to
muscles. Venous insufficiency (B) causes pain that improves with elevation.
Q12. A 68-year-old male reports difficulty starting urination, weak stream,
and feeling that his bladder is not empty. This symptom complex suggests:
A) Urinary tract infection
B) Benign prostatic hyperplasia (BPH)
Practitioner NP Assessment 3 Examination,
Chamberlain College of Nursing FNP Program,
2026/2027 – 155 Questions with Verified
Answers
SECTION 1: HEALTH HISTORY & COMMUNICATION (Questions 1–20)
Q1. A 45-year-old male presents with chest pain. Which question is most
appropriate to ask first?
A) "Have you ever had a heart attack before?"
B) "Can you describe the pain for me?"
C) "Does your family have a history of heart disease?"
D) "Are you feeling anxious about anything?"
Answer: B
Rationale: The first step in assessing chest pain is to obtain a detailed
description of the pain using the OLDCARTS mnemonic (Onset, Location,
Duration, Character, Aggravating factors, Relieving factors, Timing, Severity).
This guides differential diagnosis.
Q2. A nurse practitioner is conducting a health history interview. Which
technique demonstrates active listening?
A) Interrupting to ask clarifying questions immediately
B) Maintaining eye contact and nodding occasionally
C) Writing down every word the patient says
D) Glancing at the clock to monitor time
Answer: B
Rationale: Active listening involves maintaining eye contact, nodding, and
using verbal affirmations ("I see," "Go on") without interrupting. Writing
everything down (C) can be distracting; interruptions should be minimal.
Q3. A 72-year-old female reports difficulty sleeping. The NP should first ask:
A) "How much caffeine do you drink daily?"
,B) "Can you describe your typical sleep pattern?"
C) "Do you have any pain at night?"
D) "Are you worried about anything?"
Answer: B
Rationale: The NP should first obtain a description of the sleep pattern
(onset, duration, quality, nighttime awakenings, daytime sleepiness) before
exploring specific causes (caffeine, pain, anxiety).
Q4. A patient presents with abdominal pain. Which of the following is a "red
flag" symptom requiring immediate attention?
A) Dull, aching pain for 3 months
B) Pain relieved by defecation
C) Pain associated with vomiting blood (hematemesis)
D) Pain that worsens after eating
Answer: C
Rationale: Hematemesis (vomiting blood) is a red flag indicating potential
upper GI bleeding, which requires urgent evaluation. Chronic dull pain, relief
with defecation (IBS), and postprandial pain (PUD) are concerning but not
immediate emergencies.
Q5. A patient uses the term "the worst headache of my life." The NP should
first assess for:
A) Migraine with aura
B) Tension headache
C) Subarachnoid hemorrhage
D) Sinus headache
Answer: C
Rationale: "Thunderclap" or "worst headache of my life" is classic for
subarachnoid hemorrhage (ruptured aneurysm), a life-threatening
emergency requiring immediate CT head and neurosurgical consultation.
Q6. A 25-year-old female presents with fatigue. Which additional symptom
would most increase suspicion for depression?
A) Shortness of breath on exertion
B) Loss of interest in activities (anhedonia)
,C) Palpitations
D) Weight gain
Answer: B
Rationale: Anhedonia (loss of interest or pleasure in activities) is a core
symptom of major depressive disorder. The PHQ-2 screening asks about
depressed mood and anhedonia.
Q7. A patient reports "black, tarry stools" (melena). This finding suggests
bleeding from which location?
A) Lower GI tract (colon)
B) Upper GI tract (esophagus, stomach, duodenum)
C) Rectal area
D) Small intestine only
Answer: B
Rationale: Melena (black, tarry, sticky stools) indicates bleeding in the upper
GI tract (esophagus, stomach, proximal small intestine) where blood has
been digested. Bright red blood (hematochezia) suggests lower GI or rectal
bleeding.
Q8. A patient reports a 10-pound unintentional weight loss over 2 months.
The NP should first assess for:
A) Depression
B) Malignancy
C) Hyperthyroidism
D) All of the above
Answer: D
Rationale: Unintentional weight loss (>5% of body weight over 6-12 months)
has a broad differential including malignancy, depression, hyperthyroidism,
diabetes, GI disorders, and medication side effects. The NP must assess for
all.
Q9. A patient with a history of alcohol use disorder reports "my stomach
feels full quickly when I eat." This symptom (early satiety) suggests:
A) Gastritis
B) Gastroparesis
, C) Gastric outlet obstruction
D) Peptic ulcer disease
Answer: C
Rationale: Early satiety (feeling full after eating small amounts) suggests
gastric outlet obstruction (often from ulcer scarring or malignancy).
Gastroparesis (B) causes bloating and nausea but not necessarily early
satiety.
Q10. A patient reports waking up at 3 AM with shortness of breath and
needing to sit up to breathe (paroxysmal nocturnal dyspnea). This finding
suggests:
A) Asthma
B) COPD
C) Heart failure
D) Panic attack
Answer: C
Rationale: Paroxysmal nocturnal dyspnea (PND) is classic for left-sided heart
failure. When lying flat, fluid redistributes to the lungs, causing shortness of
breath that improves when sitting up (orthopnea).
Q11. A patient reports claudication (leg pain with walking that resolves with
rest). This finding suggests:
A) Peripheral neuropathy
B) Venous insufficiency
C) Peripheral arterial disease (PAD)
D) Lumbar spinal stenosis
Answer: C
Rationale: Intermittent claudication (pain with walking, relieved by rest) is
classic for peripheral arterial disease (PAD) due to inadequate blood flow to
muscles. Venous insufficiency (B) causes pain that improves with elevation.
Q12. A 68-year-old male reports difficulty starting urination, weak stream,
and feeling that his bladder is not empty. This symptom complex suggests:
A) Urinary tract infection
B) Benign prostatic hyperplasia (BPH)
