AND CORRECT ANSWERS WITH RATIONALE LATEST 2026
A+ GRADE
This comprehensive collection provides 300 unique, multiple-choice questions
designed to thoroughly prepare you for the NURS 5220 Advanced Health
Assessment exam. Each question reflects the depth and rigor required in
advanced practice, covering high-yield topics including history-taking
techniques, symptom analysis, differential diagnosis, physical examination
maneuvers, and clinical reasoning across all body systems. Every entry
includes the correct answer and a detailed, educational rationale that explains
the underlying pathophysiological and clinical reasoning principles. This
resource is structured to help you identify knowledge gaps, build confidence,
and master the critical thinking skills needed to succeed on the NURS 5220
Advanced Health Assessment exam.
1. A patient tells you, "I don't know why I'm here. My wife made me come." What
is the best initial response?
A) "You should listen to your wife."
B) "Tell me more about that."
C) "Let's focus on your blood pressure."
D) "Why do you think she made you come?"
Answer: B
Rationale: This open-ended response respects the patient's perspective and
encourages dialogue without being confrontational. It allows the patient to express
their feelings and concerns freely .
2. Which question is most appropriate to assess a patient's functional health?
A) "Do you have any heart disease?"
B) "How many pills do you take daily?"
C) "Are you able to prepare your own meals?"
D) "When was your last physical exam?"
Answer: C
Rationale: Functional assessment evaluates activities of daily living (ADLs), such
as the ability to prepare meals, bathe, dress, and manage household tasks. This
helps determine a patient's level of independence and need for support .
,3. A patient reports chest pain. Which attribute is most important to clarify first?
A) Family history of heart disease
B) Quality of the pain (sharp, pressure, burning)
C) Insurance status
D) Last meal
Answer: B
Rationale: Pain quality helps differentiate cardiac, gastrointestinal,
musculoskeletal, or anxiety-related causes. Clarifying the character of the pain is
essential for developing an accurate differential diagnosis .
4. Using the mnemonic OLDCARTS, the "T" stands for:
A) Treatment
B) Timing
C) Tenderness
D) Type
Answer: B
Rationale: In the OLDCARTS mnemonic, T stands for Timing, which includes
onset, duration, and frequency of the symptom. This is a key component of
symptom analysis .
5. A patient avoids eye contact and answers in monosyllables. The best action is:
A) Document resistance to the interview
B) Assume cognitive impairment
C) Use open-ended questions and explore possible discomfort
D) End the interview and reschedule
Answer: C
Rationale: Poor eye contact or sparse answers can be due to anxiety, depression,
pain, or cultural differences. The clinician should use open-ended questions and
explore potential discomfort rather than making assumptions .
6. A patient with abdominal pain says the pain started in the periumbilical area and
then moved to the right lower quadrant. This pattern is classic for:
A) Acute cholecystitis
B) Acute appendicitis
C) Diverticulitis
D) Pancreatitis
Answer: B
Rationale: Appendicitis classically presents with visceral pain (periumbilical) that
migrates to parietal pain (right lower quadrant) as inflammation spreads to the
,peritoneum. Cholecystitis typically causes right upper quadrant pain, diverticulitis
causes left lower quadrant pain, and pancreatitis causes epigastric pain radiating to
the back .
7. The "review of systems" (ROS) is best described as:
A) A chronological account of the present illness
B) A systematic inventory of symptoms by organ system
C) The patient's past medical and surgical history
D) The family history of diseases
Answer: B
Rationale: ROS is a comprehensive, head-to-toe inventory of symptoms in each
organ system to identify potential problems not mentioned in the HPI. It is a key
component of the comprehensive health history .
8. A patient answers "no" to every question during the review of systems. This is
most likely due to:
A) The patient is healthy with no symptoms
B) The patient is tired or rushing through the interview
C) The patient does not understand the questions
D) All of the above
Answer: D
Rationale: A "negative" ROS can be legitimate but may also indicate fatigue, poor
understanding, or rushing. Clinicians should periodically validate understanding by
asking, "Are you understanding my questions?" .
9. When taking a family history, which condition has the strongest genetic
component requiring specific documentation?
A) Migraine headaches
B) Breast cancer (first-degree relatives)
C) Osteoarthritis
D) Kidney stones
Answer: B
Rationale: Family history of breast cancer, especially in first-degree relatives
(mother, sister, daughter), significantly increases risk. Genetic syndromes like
BRCA1/2 guide screening recommendations .
10. A patient reports a past medical history of "rheumatic fever as a child." This
history is most relevant for which current condition?
A) Asthma
B) Valvular heart disease (especially mitral stenosis)
, C) Rheumatoid arthritis
D) Chronic kidney disease
Answer: B
Rationale: Rheumatic fever causes valvular damage, with mitral stenosis being the
most common complication, followed by aortic regurgitation. Patients require
monitoring for heart failure and arrhythmias .
11. The "CAGE" questionnaire is a screening tool for:
A) Depression
B) Anxiety
C) Alcohol use disorder
D) Dementia
Answer: C
Rationale: CAGE (Cut down, Annoyed, Guilty, Eye-opener) is a brief screening
tool for alcohol use disorder. Two or more positive answers suggest the need for
further assessment .
12. A patient reports using "herbal supplements" but cannot name them. The best
response is:
A) "Herbal supplements don't matter – only prescription medications."
B) "Please bring in all bottles from home so we can review them."
C) "You should stop all supplements immediately."
D) "Herbal products are never dangerous."
Answer: B
Rationale: Many herbal supplements interact with prescription drugs (e.g., St.
John's wort with antidepressants, ginkgo with anticoagulants). Asking the patient
to bring in bottles ensures accurate documentation .
13. A 16-year-old is brought in by a parent for "fatigue." The parent stays in the
room and answers all questions for the adolescent. The best action is to:
A) Continue with the parent as the primary historian
B) Ask the parent to step out briefly to interview the adolescent alone
C) Ignore the parent and ask the adolescent directly
D) End the interview and reschedule
Answer: B
Rationale: Adolescents should be interviewed alone at least partially to discuss
sensitive issues (depression, substance use, sexual activity, abuse). Confidentiality
limits should be explained .