NURS 6512 ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC
REASONING MIDTERM PRACTICE EXAMINATION – 100 CASE-
BASED MULTIPLE-CHOICE QUESTIONS
TEST BANK - QUESTIONS 1-100
1. During
Duringaacomprehensive
comprehensivehealth
healthhistory,
history,a a47-year-old
47-year-oldpatient
patient reports
reports intermittent
intermittent chest
chest
discomfort. The
discomfort. The nurse
nurse practitioner
practitionerasks,
asks,"When
"Whendid didyou
youfirst
firstnotice
noticethe
thediscomfort,
discomfort,and
and what
what weredoing
were you you doing
when when it began?"
it began?" WhichNeed the finalelement
OLDCARTS exam guide or assessed
is being a study guide
most for the
directly?
3 Ps? Check qn 2. Which OLDCARTS element is being assessed most directly?
A. Onset
B. Duration
C. Location
D. Severity
2.
2. A A 62-year-old
62-year-old patient
patient presents
presents with
with newnew
lowlow back
back painpain after
after lifting
lifting a box.
a box. The The clinician
clinician asks,
asks, "What makes the pain worse, and is there anything you do that makes
"What makes the pain worse, and is there anything you do that makes it better?" Which it better?"
PQRST
Find a Pdf and ebook at hhwmunyes . gumroad . com. For paperback, see qn 3. Which
component
PQRST is the clinician
component is theassessing?
clinician assessing?
A. Provocation/palliation
B. Severity
C. Quality
D. Region/radiation
3. A A 38-year-old
38-year-old patientstates,
patient states,
"I"I have
have had
had a dry
a dry cough
cough forfor three
three weeks
weeks and
and it isitworse
is worse at
at night."
night." Get my portable paperback on armazon. Since I can't post the details here, raechout
Which portion
hhwmunyes at of
gmthis
ail statement is subjective
dot com. Which portion data?
of this statement is subjective data?
A. A dry cough that is worse at night
B. An oxygen saturation of 94%
C. A respiratory rate of 22/min
D. Scattered expiratory wheezes
4. At the start of a visit, a 55-year-old patient says, "I just haven't felt right for the past month."
Which response by the nurse practitioner best facilitates an accurate initial history?
A. "Tell
me more about what not feeling right has been like for you."
B. "You mean you have been tired, correct?"
C. "Why did you wait a month before coming in?"
D. "Have you had chest pain, shortness of breath, or fever?"
Page
1
,5. A 71-year-old patient who speaks limited English arrives with an adult daughter who offers to
interpret. The visit includes medication review and discussion of a new breast mass. What is the
most appropriate communication strategy?
A. Use a qualified medical interpreter and address the patient directly
B. Conduct the examination first and obtain the history later
C. Ask only yes/no questions to reduce translation errors
D. Use the daughter because family members usually know the patient best
6. A 66-year-old patient is learning how to use a new inhaler. After demonstrating the technique,
the nurse practitioner says, "To make sure I explained it clearly, please show me how you will
use it at home." Which communication method is being used?
A. Reflection
B. Teach-back
C. Confrontation
D. Summarization
7. During alcohol screening, a 44-year-old patient answers "yes" when asked, "Have you ever felt
you should cut down on your drinking?" Which screening instrument contains this question?
A. CRAFFT
B. PHQ-2
C. GAD-7
D. CAGE
8. A 16-year-old presents for a sports physical. After establishing confidentiality, the nurse
practitioner asks whether the teen has ever ridden in a car driven by someone who had been
using alcohol or drugs. Which tool is being applied?
A. AUDIT-C
B. OLDCARTS
C. CRAFFT
D. CAGE
9. A 34-year-old patient arrives with a partner who answers most questions and refuses to leave
the room. The patient has bruising in different stages of healing. What should the nurse
practitioner do next?
A. Document only the visible bruises because asking may increase risk
B. Ask the partner whether the patient is being abused
C. Arrange a private opportunity to speak with the patient and use direct, nonjudgmental
screening
D. Avoid screening unless the patient independently reports abuse
Page
2
,10. A 29-year-old patient appears anxious while discussing recreational drug use. Which
question is most likely to obtain accurate information?
A. "Manypeople use substances for different reasons. What substances, including
cannabis or other drugs, have you used in the past year?"
B. "You don't use illegal drugs, do you?"
C. "Are you an addict?"
D. "Why would you use drugs if you know they are harmful?"
11. A 58-year-old patient describes shoulder pain as "about a seven out of ten when I reach
overhead and a two when I rest." Which symptom dimension has the patient quantified?
A. Radiation
B. Quality
C. Severity
D. Timing
12. A 50-year-old patient reports headaches. The clinician asks the patient to describe the first
episode, what happened next, and how the pattern has changed over the past six months. What
diagnostic purpose does this questioning serve?
A. It replaces the need for a review of systems
B. It establishes symptom chronology
C. It assesses functional status only
D. It determines family history
13. An 82-year-old patient gives inconsistent medication information, and the accompanying
caregiver reports recent memory problems. How should the nurse practitioner document the
history source?
A. Document only the caregiver's account
B. Identify the patient as the primary source and the caregiver as an additional
source, noting apparent reliability
C. Record the history as unreliable and omit all patient statements
D. Do not mention the source because it is implied
14. A 76-year-old patient with hearing impairment repeatedly asks the clinician to repeat
questions. Which approach best improves communication?
A. Exaggerate lip movements and use medical terminology
B. Ask the family to answer all questions instead
C. Speak loudly from behind the patient
D. Face the patient, reduce background noise, and speak clearly at a normal pace
Page
3
, 15. During a history, a patient from a cultural background unfamiliar to the clinician attributes
recurrent headaches to an imbalance caused by certain foods. What is the best initial response?
A. Avoid discussing the belief because it is not evidence-based
B. Ask the patient to describe the belief, treatments used, and what outcomes are
expected
C. Correct the belief and explain the biomedical cause
D. Assume the patient will refuse conventional treatment
16. A patient screened privately for intimate partner violence becomes tearful and says, "Yes,
my partner sometimes hits me, but I am not ready to leave." Which response is most
appropriate?
A. "Thankyou for telling me. I am concerned about your safety, and we can
discuss options and resources at your pace."
B. "Iwill call your partner so we can discuss this together."
C. "Why have you stayed in the relationship?"
D. "You need to leave immediately or the abuse will continue."
17. A 63-year-old patient looks confused when the clinician says, "Your dyspnea may be related
to orthopnea." Which communication change is most appropriate?
A. Use plain language such as "shortness of breath" and "trouble breathing when lying
flat"
B. Repeat the same terms more slowly
C. Provide the terms in writing without explanation
D. Ask the patient to search the terms after the visit
18. A 41-year-old patient reports intermittent right-sided facial pain. The clinician asks, "Does
the pain stay in that area, or does it travel anywhere else?" Which OLDCARTS feature is being
assessed?
A. Character
B. Location/radiation
C. Severity
D. Aggravating factors
19. A 15-year-old is being screened with CRAFFT. Before asking about substance use,
which statement is most appropriate?
A. "You can skip the questions because your parent is present."
B. "Everything you tell me is confidential under every circumstance."
C. "I usually speak with teens privately. What you tell me is confidential except when
I am concerned about serious safety risks or when the law requires disclosure."
D. "I will share all of your answers with your parent after the visit."
Page
4
REASONING MIDTERM PRACTICE EXAMINATION – 100 CASE-
BASED MULTIPLE-CHOICE QUESTIONS
TEST BANK - QUESTIONS 1-100
1. During
Duringaacomprehensive
comprehensivehealth
healthhistory,
history,a a47-year-old
47-year-oldpatient
patient reports
reports intermittent
intermittent chest
chest
discomfort. The
discomfort. The nurse
nurse practitioner
practitionerasks,
asks,"When
"Whendid didyou
youfirst
firstnotice
noticethe
thediscomfort,
discomfort,and
and what
what weredoing
were you you doing
when when it began?"
it began?" WhichNeed the finalelement
OLDCARTS exam guide or assessed
is being a study guide
most for the
directly?
3 Ps? Check qn 2. Which OLDCARTS element is being assessed most directly?
A. Onset
B. Duration
C. Location
D. Severity
2.
2. A A 62-year-old
62-year-old patient
patient presents
presents with
with newnew
lowlow back
back painpain after
after lifting
lifting a box.
a box. The The clinician
clinician asks,
asks, "What makes the pain worse, and is there anything you do that makes
"What makes the pain worse, and is there anything you do that makes it better?" Which it better?"
PQRST
Find a Pdf and ebook at hhwmunyes . gumroad . com. For paperback, see qn 3. Which
component
PQRST is the clinician
component is theassessing?
clinician assessing?
A. Provocation/palliation
B. Severity
C. Quality
D. Region/radiation
3. A A 38-year-old
38-year-old patientstates,
patient states,
"I"I have
have had
had a dry
a dry cough
cough forfor three
three weeks
weeks and
and it isitworse
is worse at
at night."
night." Get my portable paperback on armazon. Since I can't post the details here, raechout
Which portion
hhwmunyes at of
gmthis
ail statement is subjective
dot com. Which portion data?
of this statement is subjective data?
A. A dry cough that is worse at night
B. An oxygen saturation of 94%
C. A respiratory rate of 22/min
D. Scattered expiratory wheezes
4. At the start of a visit, a 55-year-old patient says, "I just haven't felt right for the past month."
Which response by the nurse practitioner best facilitates an accurate initial history?
A. "Tell
me more about what not feeling right has been like for you."
B. "You mean you have been tired, correct?"
C. "Why did you wait a month before coming in?"
D. "Have you had chest pain, shortness of breath, or fever?"
Page
1
,5. A 71-year-old patient who speaks limited English arrives with an adult daughter who offers to
interpret. The visit includes medication review and discussion of a new breast mass. What is the
most appropriate communication strategy?
A. Use a qualified medical interpreter and address the patient directly
B. Conduct the examination first and obtain the history later
C. Ask only yes/no questions to reduce translation errors
D. Use the daughter because family members usually know the patient best
6. A 66-year-old patient is learning how to use a new inhaler. After demonstrating the technique,
the nurse practitioner says, "To make sure I explained it clearly, please show me how you will
use it at home." Which communication method is being used?
A. Reflection
B. Teach-back
C. Confrontation
D. Summarization
7. During alcohol screening, a 44-year-old patient answers "yes" when asked, "Have you ever felt
you should cut down on your drinking?" Which screening instrument contains this question?
A. CRAFFT
B. PHQ-2
C. GAD-7
D. CAGE
8. A 16-year-old presents for a sports physical. After establishing confidentiality, the nurse
practitioner asks whether the teen has ever ridden in a car driven by someone who had been
using alcohol or drugs. Which tool is being applied?
A. AUDIT-C
B. OLDCARTS
C. CRAFFT
D. CAGE
9. A 34-year-old patient arrives with a partner who answers most questions and refuses to leave
the room. The patient has bruising in different stages of healing. What should the nurse
practitioner do next?
A. Document only the visible bruises because asking may increase risk
B. Ask the partner whether the patient is being abused
C. Arrange a private opportunity to speak with the patient and use direct, nonjudgmental
screening
D. Avoid screening unless the patient independently reports abuse
Page
2
,10. A 29-year-old patient appears anxious while discussing recreational drug use. Which
question is most likely to obtain accurate information?
A. "Manypeople use substances for different reasons. What substances, including
cannabis or other drugs, have you used in the past year?"
B. "You don't use illegal drugs, do you?"
C. "Are you an addict?"
D. "Why would you use drugs if you know they are harmful?"
11. A 58-year-old patient describes shoulder pain as "about a seven out of ten when I reach
overhead and a two when I rest." Which symptom dimension has the patient quantified?
A. Radiation
B. Quality
C. Severity
D. Timing
12. A 50-year-old patient reports headaches. The clinician asks the patient to describe the first
episode, what happened next, and how the pattern has changed over the past six months. What
diagnostic purpose does this questioning serve?
A. It replaces the need for a review of systems
B. It establishes symptom chronology
C. It assesses functional status only
D. It determines family history
13. An 82-year-old patient gives inconsistent medication information, and the accompanying
caregiver reports recent memory problems. How should the nurse practitioner document the
history source?
A. Document only the caregiver's account
B. Identify the patient as the primary source and the caregiver as an additional
source, noting apparent reliability
C. Record the history as unreliable and omit all patient statements
D. Do not mention the source because it is implied
14. A 76-year-old patient with hearing impairment repeatedly asks the clinician to repeat
questions. Which approach best improves communication?
A. Exaggerate lip movements and use medical terminology
B. Ask the family to answer all questions instead
C. Speak loudly from behind the patient
D. Face the patient, reduce background noise, and speak clearly at a normal pace
Page
3
, 15. During a history, a patient from a cultural background unfamiliar to the clinician attributes
recurrent headaches to an imbalance caused by certain foods. What is the best initial response?
A. Avoid discussing the belief because it is not evidence-based
B. Ask the patient to describe the belief, treatments used, and what outcomes are
expected
C. Correct the belief and explain the biomedical cause
D. Assume the patient will refuse conventional treatment
16. A patient screened privately for intimate partner violence becomes tearful and says, "Yes,
my partner sometimes hits me, but I am not ready to leave." Which response is most
appropriate?
A. "Thankyou for telling me. I am concerned about your safety, and we can
discuss options and resources at your pace."
B. "Iwill call your partner so we can discuss this together."
C. "Why have you stayed in the relationship?"
D. "You need to leave immediately or the abuse will continue."
17. A 63-year-old patient looks confused when the clinician says, "Your dyspnea may be related
to orthopnea." Which communication change is most appropriate?
A. Use plain language such as "shortness of breath" and "trouble breathing when lying
flat"
B. Repeat the same terms more slowly
C. Provide the terms in writing without explanation
D. Ask the patient to search the terms after the visit
18. A 41-year-old patient reports intermittent right-sided facial pain. The clinician asks, "Does
the pain stay in that area, or does it travel anywhere else?" Which OLDCARTS feature is being
assessed?
A. Character
B. Location/radiation
C. Severity
D. Aggravating factors
19. A 15-year-old is being screened with CRAFFT. Before asking about substance use,
which statement is most appropriate?
A. "You can skip the questions because your parent is present."
B. "Everything you tell me is confidential under every circumstance."
C. "I usually speak with teens privately. What you tell me is confidential except when
I am concerned about serious safety risks or when the law requires disclosure."
D. "I will share all of your answers with your parent after the visit."
Page
4
