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ADVANCED HEALTH ASSESSMENT AND DIFFERENTIAL
DIAGNOSIS – MYRICK & KAROSAS (1ST EDITION) EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
ADVANCED HEALTH ASSESSMENT AND DIFFERENTIAL DIAGNOSIS – MYRICK &
KAROSAS (1ST EDITION) – 250 EXAM-STYLE QUESTIONS
SECTION 1: HEALTH HISTORY, PATIENT INTERVIEW & MOTIVATIONAL
INTERVIEWING
Questions 1-40
1. The nurse is preparing to conduct a health history. Which statement best
describes the purpose of a health history?
A) To provide an opportunity for interaction between the patient and the nurse
B) To provide a form for obtaining the patient's biographic information
C) To document the normal and abnormal findings of a physical assessment
D) To provide a database of subjective information about the patient's past and current
health
Correct Answer: D
Rationale: The purpose of the health history is to collect subjective data—what the
person says about themselves . This subjective data forms the foundation for clinical
reasoning and diagnosis, providing a comprehensive understanding of the patient's
health status that cannot be obtained from a physical exam alone. Options A, B, and C
describe secondary benefits or components of the assessment process rather than the
primary purpose .
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2. When the nurse is evaluating the reliability of a patient's responses, which
statement would be correct?
A) The patient has a history of drug abuse and therefore is not reliable
B) The patient provided consistent information and therefore is reliable
C) The patient smiled throughout the interview and therefore is assumed reliable
D) The patient would not answer questions concerning stress and therefore is not
reliable
Correct Answer: B
Rationale: A reliable person consistently gives the same answers, even when questions
are rephrased or repeated later in the interview . Consistency in responses across the
interview indicates reliability, while inconsistent responses, guarded answers, or refusal
to answer questions may suggest the patient is a poor historian .
3. A 59-year-old patient tells the nurse that he has ulcerative colitis and has been
having black stools for the last 24 hours. How should the nurse best document his
reason for seeking care?
A) "J.M. is a 59-year-old man seeking treatment for ulcerative colitis."
B) "J.M. came into the clinic complaining of having black stools for the past 24 hours."
C) "J.M. is a 59-year-old man who states that he has ulcerative colitis and wants it
checked."
D) "J.M. is a 59-year-old man who states that he has been having black stools for the
past 24 hours."
Correct Answer: D
Rationale: The reason for seeking care is a brief, spontaneous statement in the
person's own words that describes the reason for the visit. It states one (or possibly two)
signs or symptoms and their duration, enclosed in quotation marks to indicate the
person's exact words . The presence of black stools is the immediate concern and
should be documented verbatim as the chief complaint .
4. A patient tells the nurse that she has had abdominal pain for the past week.
What is the nurse's best response to clarify the location of the pain?
A) "Can you point to where it hurts?"
B) "We'll talk more about that later in the interview."
C) "What have you had to eat in the last 24 hours?"
D) "Have you ever had any surgeries on your abdomen?"
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Correct Answer: A
Rationale: A final summary of any symptom should include, among seven other critical
characteristics, the specific location. Asking the patient to point to the location
provides precise, objective information that helps narrow the differential diagnosis . The
other options, while potentially relevant later, do not prioritize immediate clarification of
the symptom's location .
5. The nurse is using the PQRSTU mnemonic to assess a patient's symptom. The "P"
in PQRSTU stands for:
A) Pain
B) Palliative factors
C) Provocative or palliative factors
D) Past medical history
Correct Answer: C
Rationale: The "P" in the PQRSTU mnemonic stands for Provocative or Palliative
factors . This encompasses what makes the symptom worse (provocative) and what
makes it better (palliative). Understanding these factors is essential for differential
diagnosis—for example, chest pain worsened by exertion suggests cardiac origin, while
pain worsened by palpation suggests musculoskeletal origin .
6. A patient describes her pain as "a dull ache that radiates down my left arm."
Which dimension of the symptom history is being addressed?
A) Severity
B) Quality
C) Timing
D) Location with radiation
Correct Answer: D
Rationale: Location includes both the primary site of the symptom and any radiation to
other areas . Radiation of pain (e.g., down the left arm) is a key feature of certain
conditions, particularly cardiac ischemia, and must be documented as part of the
location characteristic . Severity is quantified using a standardized pain rating scale;
quality describes the nature of the pain (sharp, dull, burning); timing addresses onset,
duration, and frequency.
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7. The nurse asks the patient, "What makes your chest pain worse?" This question
is addressing which characteristic of a symptom?
A) Location
B) Quality
C) Aggravating factors
D) Associated manifestations
Correct Answer: C
Rationale: Aggravating factors are conditions or actions that worsen the symptom . This
information helps differentiate between possible etiologies—for example, chest pain
worsened by exertion suggests cardiac origin, while pain worsened by palpation
suggests musculoskeletal origin . The other options assess location, quality, and
associated manifestations, respectively.
8. A patient rates their pain as 8 out of 10. This assessment addresses which
dimension of the symptom?
A) Quality
B) Timing
C) Severity
D) Associated manifestations
Correct Answer: C
Rationale: Severity is quantified using a standardized pain rating scale (e.g., 0-10) . This
provides a measurable, reproducible assessment that can be tracked over time to
evaluate treatment effectiveness . The other options assess timing, aggravating factors,
and quality, respectively.
9. The nurse is obtaining a history from a 30-year-old male patient and is concerned
about health promotion activities. Which question would be appropriate to assess
health promotion activities for this patient?
A) "Do you perform testicular self-examinations?"
B) "Have you ever noticed any pain in your testicles?"
C) "Have you had any problems with passing urine?"
D) "Do you have any history of sexually transmitted diseases?"
Correct Answer: A
ADVANCED HEALTH ASSESSMENT AND DIFFERENTIAL
DIAGNOSIS – MYRICK & KAROSAS (1ST EDITION) EXAM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
ADVANCED HEALTH ASSESSMENT AND DIFFERENTIAL DIAGNOSIS – MYRICK &
KAROSAS (1ST EDITION) – 250 EXAM-STYLE QUESTIONS
SECTION 1: HEALTH HISTORY, PATIENT INTERVIEW & MOTIVATIONAL
INTERVIEWING
Questions 1-40
1. The nurse is preparing to conduct a health history. Which statement best
describes the purpose of a health history?
A) To provide an opportunity for interaction between the patient and the nurse
B) To provide a form for obtaining the patient's biographic information
C) To document the normal and abnormal findings of a physical assessment
D) To provide a database of subjective information about the patient's past and current
health
Correct Answer: D
Rationale: The purpose of the health history is to collect subjective data—what the
person says about themselves . This subjective data forms the foundation for clinical
reasoning and diagnosis, providing a comprehensive understanding of the patient's
health status that cannot be obtained from a physical exam alone. Options A, B, and C
describe secondary benefits or components of the assessment process rather than the
primary purpose .
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2. When the nurse is evaluating the reliability of a patient's responses, which
statement would be correct?
A) The patient has a history of drug abuse and therefore is not reliable
B) The patient provided consistent information and therefore is reliable
C) The patient smiled throughout the interview and therefore is assumed reliable
D) The patient would not answer questions concerning stress and therefore is not
reliable
Correct Answer: B
Rationale: A reliable person consistently gives the same answers, even when questions
are rephrased or repeated later in the interview . Consistency in responses across the
interview indicates reliability, while inconsistent responses, guarded answers, or refusal
to answer questions may suggest the patient is a poor historian .
3. A 59-year-old patient tells the nurse that he has ulcerative colitis and has been
having black stools for the last 24 hours. How should the nurse best document his
reason for seeking care?
A) "J.M. is a 59-year-old man seeking treatment for ulcerative colitis."
B) "J.M. came into the clinic complaining of having black stools for the past 24 hours."
C) "J.M. is a 59-year-old man who states that he has ulcerative colitis and wants it
checked."
D) "J.M. is a 59-year-old man who states that he has been having black stools for the
past 24 hours."
Correct Answer: D
Rationale: The reason for seeking care is a brief, spontaneous statement in the
person's own words that describes the reason for the visit. It states one (or possibly two)
signs or symptoms and their duration, enclosed in quotation marks to indicate the
person's exact words . The presence of black stools is the immediate concern and
should be documented verbatim as the chief complaint .
4. A patient tells the nurse that she has had abdominal pain for the past week.
What is the nurse's best response to clarify the location of the pain?
A) "Can you point to where it hurts?"
B) "We'll talk more about that later in the interview."
C) "What have you had to eat in the last 24 hours?"
D) "Have you ever had any surgeries on your abdomen?"
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Correct Answer: A
Rationale: A final summary of any symptom should include, among seven other critical
characteristics, the specific location. Asking the patient to point to the location
provides precise, objective information that helps narrow the differential diagnosis . The
other options, while potentially relevant later, do not prioritize immediate clarification of
the symptom's location .
5. The nurse is using the PQRSTU mnemonic to assess a patient's symptom. The "P"
in PQRSTU stands for:
A) Pain
B) Palliative factors
C) Provocative or palliative factors
D) Past medical history
Correct Answer: C
Rationale: The "P" in the PQRSTU mnemonic stands for Provocative or Palliative
factors . This encompasses what makes the symptom worse (provocative) and what
makes it better (palliative). Understanding these factors is essential for differential
diagnosis—for example, chest pain worsened by exertion suggests cardiac origin, while
pain worsened by palpation suggests musculoskeletal origin .
6. A patient describes her pain as "a dull ache that radiates down my left arm."
Which dimension of the symptom history is being addressed?
A) Severity
B) Quality
C) Timing
D) Location with radiation
Correct Answer: D
Rationale: Location includes both the primary site of the symptom and any radiation to
other areas . Radiation of pain (e.g., down the left arm) is a key feature of certain
conditions, particularly cardiac ischemia, and must be documented as part of the
location characteristic . Severity is quantified using a standardized pain rating scale;
quality describes the nature of the pain (sharp, dull, burning); timing addresses onset,
duration, and frequency.
, Page 4 of 78
7. The nurse asks the patient, "What makes your chest pain worse?" This question
is addressing which characteristic of a symptom?
A) Location
B) Quality
C) Aggravating factors
D) Associated manifestations
Correct Answer: C
Rationale: Aggravating factors are conditions or actions that worsen the symptom . This
information helps differentiate between possible etiologies—for example, chest pain
worsened by exertion suggests cardiac origin, while pain worsened by palpation
suggests musculoskeletal origin . The other options assess location, quality, and
associated manifestations, respectively.
8. A patient rates their pain as 8 out of 10. This assessment addresses which
dimension of the symptom?
A) Quality
B) Timing
C) Severity
D) Associated manifestations
Correct Answer: C
Rationale: Severity is quantified using a standardized pain rating scale (e.g., 0-10) . This
provides a measurable, reproducible assessment that can be tracked over time to
evaluate treatment effectiveness . The other options assess timing, aggravating factors,
and quality, respectively.
9. The nurse is obtaining a history from a 30-year-old male patient and is concerned
about health promotion activities. Which question would be appropriate to assess
health promotion activities for this patient?
A) "Do you perform testicular self-examinations?"
B) "Have you ever noticed any pain in your testicles?"
C) "Have you had any problems with passing urine?"
D) "Do you have any history of sexually transmitted diseases?"
Correct Answer: A
