NURS 5220: Advanced Health
Assessment Quiz 1 :Cultural Competency,
SOAP Notes, and Diagnostic Reasoning
in Healthcare Examination 2026–2027 |
Comprehensive -Question Practice Test
with Answers & Rationales| Free Pdf
Access
1. A 68-year-old Hispanic patient tells you, "I don't want a flu shot because
my curandero says it will give me a bad fever." The nurse practitioner's best
response is:
A) "I respect your provider, but the CDC strongly recommends this for your age."
B) "Tell me more about your concerns so we can discuss what is best for you."
C) "I will make a note in your chart that you are refusing evidence-based care."
D) "Fever is a normal immune response and not harmful to you."
Correct Answer: B
This is correct because it demonstrates cultural humility by inviting the patient to
elaborate on their health belief system. This opens a dialogue for shared decision-making,
respects patient autonomy, and allows the NP to address specific fears without being
dismissive of the curandero's influence.
,2. During a cultural assessment, the NP uses the RESPECT model. After establishing
rapport and showing empathy, which action best demonstrates the "Support"
component of this model?
A) Using the teach-back method to confirm the patient understands the treatment plan.
B) Asking the patient if they would like a family member involved in the discussion.
C) Admitting to the patient that you are unfamiliar with their specific cultural dietary
practices.
D) Explaining the mechanism of the prescribed medication in basic terms.
Correct Answer: B
This is correct because the "Support" component of RESPECT specifically involves helping
the patient overcome barriers, involving their support system (such as family), and
reassuring the patient that you will work alongside them through their challenges.
3. A 45-year-old male presents with acute right lower quadrant abdominal pain.
Which of the following is a pertinent negative when trying to rule out
appendicitis?
A) Fever of 100.8°F
B) Rebound tenderness at McBurney's point
C) Pain that started in the periumbilical area
D) Absence of anorexia or nausea
Correct Answer: D
This is correct because anorexia, nausea, and vomiting are classic associated symptoms
(pertinent positives) of appendicitis. Their absence is a pertinent negative, meaning it helps
rule out appendicitis and makes the diagnosis less likely.
,4. A patient with a history of alcohol use disorder presents with fatigue and
jaundice. You suspect cirrhosis. In your Assessment section, you write: "Elevated
liver enzymes, jaundice, and caput medusae. Rule out cirrhosis versus hepatitis."
Which part of the SOAP note has been written incorrectly here?
A) The provider included pathognomonic findings.
B) The provider included subjective data in the Assessment section.
C) The provider included physical exam findings in the Assessment section.
D) The provider failed to list at least three differentials.
Correct Answer: C
This is correct because the Assessment section should contain your synthesized thinking
(diagnoses and differentials). Physical exam findings (caput medusae, jaundice) and lab
values (elevated liver enzymes) belong strictly in the Objective section, not the
Assessment.
5. In the SOAP format, a patient's history of a childhood illness (e.g., varicella) and
their current immunization status should be documented under which section?
A) Subjective - Past Medical History (PMH)
B) Subjective - Review of Systems (ROS)
C) Objective - Physical Exam
D) Assessment - Differential Diagnoses
Correct Answer: A
This is correct because Past Medical History (PMH) includes childhood illnesses, chronic
diseases, surgeries, hospitalizations, and immunizations. The Review of Systems is strictly a
head-to-toe inquiry of current symptoms, not historical data.
, 6. A 16-year-old female is brought in by her mother for a sports physical. The NP
wants to screen for substance use. Which screening tool is specifically validated
and designed for this adolescent population?
A) CAGE
B) FICA
C) CRAFFT
D) HITS
Correct Answer: C
This is correct because the CRAFFT screening tool is specifically validated for adolescents
(ages 12-21) to assess for substance use. CAGE is for adults, FICA assesses spirituality, and
HITS screens for domestic violence.
7. You are precepting a new NP student. The student asks, "What is the best
clinical strategy to reduce unconscious bias and healthcare disparities in my
practice?" You tell them to:
A) Memorize the cultural health beliefs of the top 5 ethnic groups in your state.
B) Use the same standardized patient education handouts for every diagnosis.
C) Consistently use the "teach-back" method and humanize each patient interaction.
D) Ask every patient to fill out a detailed demographic questionnaire at check-in.
Correct Answer: C
This is correct because using the teach-back method ensures understanding regardless of
health literacy level, and consciously humanizing each patient interaction reduces implicit
bias. Standardized handouts are not always culturally tailored, and memorizing beliefs
leads to stereotyping rather than individualizing care.
Assessment Quiz 1 :Cultural Competency,
SOAP Notes, and Diagnostic Reasoning
in Healthcare Examination 2026–2027 |
Comprehensive -Question Practice Test
with Answers & Rationales| Free Pdf
Access
1. A 68-year-old Hispanic patient tells you, "I don't want a flu shot because
my curandero says it will give me a bad fever." The nurse practitioner's best
response is:
A) "I respect your provider, but the CDC strongly recommends this for your age."
B) "Tell me more about your concerns so we can discuss what is best for you."
C) "I will make a note in your chart that you are refusing evidence-based care."
D) "Fever is a normal immune response and not harmful to you."
Correct Answer: B
This is correct because it demonstrates cultural humility by inviting the patient to
elaborate on their health belief system. This opens a dialogue for shared decision-making,
respects patient autonomy, and allows the NP to address specific fears without being
dismissive of the curandero's influence.
,2. During a cultural assessment, the NP uses the RESPECT model. After establishing
rapport and showing empathy, which action best demonstrates the "Support"
component of this model?
A) Using the teach-back method to confirm the patient understands the treatment plan.
B) Asking the patient if they would like a family member involved in the discussion.
C) Admitting to the patient that you are unfamiliar with their specific cultural dietary
practices.
D) Explaining the mechanism of the prescribed medication in basic terms.
Correct Answer: B
This is correct because the "Support" component of RESPECT specifically involves helping
the patient overcome barriers, involving their support system (such as family), and
reassuring the patient that you will work alongside them through their challenges.
3. A 45-year-old male presents with acute right lower quadrant abdominal pain.
Which of the following is a pertinent negative when trying to rule out
appendicitis?
A) Fever of 100.8°F
B) Rebound tenderness at McBurney's point
C) Pain that started in the periumbilical area
D) Absence of anorexia or nausea
Correct Answer: D
This is correct because anorexia, nausea, and vomiting are classic associated symptoms
(pertinent positives) of appendicitis. Their absence is a pertinent negative, meaning it helps
rule out appendicitis and makes the diagnosis less likely.
,4. A patient with a history of alcohol use disorder presents with fatigue and
jaundice. You suspect cirrhosis. In your Assessment section, you write: "Elevated
liver enzymes, jaundice, and caput medusae. Rule out cirrhosis versus hepatitis."
Which part of the SOAP note has been written incorrectly here?
A) The provider included pathognomonic findings.
B) The provider included subjective data in the Assessment section.
C) The provider included physical exam findings in the Assessment section.
D) The provider failed to list at least three differentials.
Correct Answer: C
This is correct because the Assessment section should contain your synthesized thinking
(diagnoses and differentials). Physical exam findings (caput medusae, jaundice) and lab
values (elevated liver enzymes) belong strictly in the Objective section, not the
Assessment.
5. In the SOAP format, a patient's history of a childhood illness (e.g., varicella) and
their current immunization status should be documented under which section?
A) Subjective - Past Medical History (PMH)
B) Subjective - Review of Systems (ROS)
C) Objective - Physical Exam
D) Assessment - Differential Diagnoses
Correct Answer: A
This is correct because Past Medical History (PMH) includes childhood illnesses, chronic
diseases, surgeries, hospitalizations, and immunizations. The Review of Systems is strictly a
head-to-toe inquiry of current symptoms, not historical data.
, 6. A 16-year-old female is brought in by her mother for a sports physical. The NP
wants to screen for substance use. Which screening tool is specifically validated
and designed for this adolescent population?
A) CAGE
B) FICA
C) CRAFFT
D) HITS
Correct Answer: C
This is correct because the CRAFFT screening tool is specifically validated for adolescents
(ages 12-21) to assess for substance use. CAGE is for adults, FICA assesses spirituality, and
HITS screens for domestic violence.
7. You are precepting a new NP student. The student asks, "What is the best
clinical strategy to reduce unconscious bias and healthcare disparities in my
practice?" You tell them to:
A) Memorize the cultural health beliefs of the top 5 ethnic groups in your state.
B) Use the same standardized patient education handouts for every diagnosis.
C) Consistently use the "teach-back" method and humanize each patient interaction.
D) Ask every patient to fill out a detailed demographic questionnaire at check-in.
Correct Answer: C
This is correct because using the teach-back method ensures understanding regardless of
health literacy level, and consciously humanizing each patient interaction reduces implicit
bias. Standardized handouts are not always culturally tailored, and memorizing beliefs
leads to stereotyping rather than individualizing care.
