NR 509 Exam Question Bank / NR509 Exam
Question Bank (NEW- 2021/2022) : 600 Q/A&
Explanations: Chamberlain college of Nursing
Q1. A 52-year-old patient presents with fatigue and weight gain. The NP notices the patient
avoids eye contact and gives brief answers. Which interviewing technique should the NP employ
first?
A. Ask closed-ended questions to obtain specific data
B. Use open-ended questions and allow silence for reflection
C. Immediately refer to psychiatry
D. Document "poor historian" and proceed with the physical exam
Correct Answer: B
Rationale: Patients who are withdrawn or hesitant require a patient-centered approach.
Open-ended questions ("Tell me more about how you've been feeling") and allowing silence
give the patient time to formulate responses. Closed-ended questions may increase
defensiveness; immediate referral is premature. This aligns with patient-centered care principles
emphasized in NR 509.
Q2. The NP is assessing a 68-year-old patient with hearing loss. Which technique best facilitates
communication?
A. Speak loudly with exaggerated lip movements
B. Face the patient directly, speak clearly at a moderate pace, and reduce background noise
C. Write all questions on paper exclusively
D. Speak into the patient's ear at close range
Correct Answer: B
Rationale: For patients with hearing impairment, the best approach is facing them directly
(allowing lip reading), speaking clearly without shouting (which distorts sound), and minimizing
environmental noise. Exaggerated movements and shouting are demeaning and ineffective.
Q3. When obtaining a health history from a 16-year-old patient, the NP should:
,A. Interview the parent and adolescent together for all questions
B. Interview the adolescent alone for sensitive topics while ensuring confidentiality
C. Only address concerns the parent raises
D. Defer sensitive questions until the patient is 18
Correct Answer: B
Rationale: Adolescents require confidential time with the provider to discuss sensitive
issues (substance use, sexual health, mental health). The NP should explain confidentiality limits
upfront. Parents may be present for part of the visit but should be excused for sensitive
questioning.
Q4. A patient reports chest pain. Using the OLDCARTS mnemonic, which question assesses the
"R" component?
A. "Where is the pain located?"
B. "Does the pain move anywhere or radiate?"
C. "How would you describe the pain?"
D. "What makes the pain worse?"
Correct Answer: B
Rationale: OLDCARTS = Onset, Location, Duration, Characteristics, Aggravating/Alleviating
factors, Radiation, Timing, Severity. "Radiation" asks whether the pain travels (e.g., chest pain
radiating to the jaw or arm). Location is "L"; description is "C"; aggravating factors are "A."
Q5. The NP is using the FIFE model with a patient who has chronic pain. The "F" in FIFE stands
for:
A. Focus
B. Feelings
C. Function
D. Family
Correct Answer: B
Rationale: The FIFE model = Feelings, Ideas, Function, Expectations. It explores the patient's
emotional response, beliefs about the illness, impact on daily function, and expectations for
care. This patient-centered framework is frequently tested in NR 509.
,Q6. A patient with a history of alcohol use is being screened. Which questionnaire is most
appropriate?
A. PHQ-9
B. CAGE
C. GAD-7
D. MMSE
Correct Answer: B
Rationale: CAGE (Cut down, Annoyed, Guilty, Eye-opener) is a validated screening tool for
alcohol use disorder. PHQ-9 screens for depression; GAD-7 for anxiety; MMSE for cognitive
impairment.
Q7. During a health history, a patient states, "I don't know why I'm here. My wife made me
come." What is the NP's best response?
A. "You're wasting both our time if you don't want to be here."
B. "It sounds like you're feeling frustrated about being here. What concerns do you have?"
C. "Let's just do the exam and you can leave."
D. "Your wife is right to be concerned about you."
Correct Answer: B
Rationale: Acknowledging the patient's feelings without judgment demonstrates empathy
and builds rapport. This response uses therapeutic communication to explore the patient's
perspective rather than dismissing or confronting it.
Q8. Which component of the health history is documented immediately after the chief
complaint?
A. Past medical history
B. Family history
C. History of present illness
D. Review of systems
Correct Answer: C
Rationale: The HPI expands on the chief complaint using OLDCARTS. It provides the
narrative of the current illness and guides the remainder of the history and physical exam. PMH,
FH, and ROS follow the HPI.
, Q9. A 45-year-old patient reports a new mole on the back. Which question is most important to
ask first?
A. "Have you ever had a sunburn?"
B. "Has the mole changed in size, shape, or color?"
C. "Does anyone in your family have skin cancer?"
D. "What sunscreen do you use?"
Correct Answer: B
Rationale: The ABCDE criteria (Asymmetry, Border irregularity, Color variation, Diameter
>6mm, Evolution) guide melanoma assessment. "Evolution" (change) is the most concerning
feature. While sun exposure and family history are relevant, the characteristics of the lesion
itself are the priority.
Q10. The NP is performing a review of systems. Which question assesses the neurologic system?
A. "Do you have any difficulty swallowing?"
B. "Have you noticed any numbness or tingling?"
C. "Do you experience shortness of breath?"
D. "Have you had any nausea or vomiting?"
Correct Answer: B
Rationale: Numbness and tingling are neurologic symptoms. Dysphagia may be neurologic
or GI; dyspnea is respiratory; nausea is GI. The ROS systematically reviews each body system.
Q11. A patient reports a headache that awakens her from sleep. This finding is most concerning
for:
A. Tension headache
B. Migraine headache
C. Secondary headache from serious pathology
D. Sinus headache
Correct Answer: C
Rationale: Headaches that wake the patient from sleep are a red flag for serious pathology
(e.g., increased intracranial pressure, tumor, subarachnoid hemorrhage). Tension and migraine
Question Bank (NEW- 2021/2022) : 600 Q/A&
Explanations: Chamberlain college of Nursing
Q1. A 52-year-old patient presents with fatigue and weight gain. The NP notices the patient
avoids eye contact and gives brief answers. Which interviewing technique should the NP employ
first?
A. Ask closed-ended questions to obtain specific data
B. Use open-ended questions and allow silence for reflection
C. Immediately refer to psychiatry
D. Document "poor historian" and proceed with the physical exam
Correct Answer: B
Rationale: Patients who are withdrawn or hesitant require a patient-centered approach.
Open-ended questions ("Tell me more about how you've been feeling") and allowing silence
give the patient time to formulate responses. Closed-ended questions may increase
defensiveness; immediate referral is premature. This aligns with patient-centered care principles
emphasized in NR 509.
Q2. The NP is assessing a 68-year-old patient with hearing loss. Which technique best facilitates
communication?
A. Speak loudly with exaggerated lip movements
B. Face the patient directly, speak clearly at a moderate pace, and reduce background noise
C. Write all questions on paper exclusively
D. Speak into the patient's ear at close range
Correct Answer: B
Rationale: For patients with hearing impairment, the best approach is facing them directly
(allowing lip reading), speaking clearly without shouting (which distorts sound), and minimizing
environmental noise. Exaggerated movements and shouting are demeaning and ineffective.
Q3. When obtaining a health history from a 16-year-old patient, the NP should:
,A. Interview the parent and adolescent together for all questions
B. Interview the adolescent alone for sensitive topics while ensuring confidentiality
C. Only address concerns the parent raises
D. Defer sensitive questions until the patient is 18
Correct Answer: B
Rationale: Adolescents require confidential time with the provider to discuss sensitive
issues (substance use, sexual health, mental health). The NP should explain confidentiality limits
upfront. Parents may be present for part of the visit but should be excused for sensitive
questioning.
Q4. A patient reports chest pain. Using the OLDCARTS mnemonic, which question assesses the
"R" component?
A. "Where is the pain located?"
B. "Does the pain move anywhere or radiate?"
C. "How would you describe the pain?"
D. "What makes the pain worse?"
Correct Answer: B
Rationale: OLDCARTS = Onset, Location, Duration, Characteristics, Aggravating/Alleviating
factors, Radiation, Timing, Severity. "Radiation" asks whether the pain travels (e.g., chest pain
radiating to the jaw or arm). Location is "L"; description is "C"; aggravating factors are "A."
Q5. The NP is using the FIFE model with a patient who has chronic pain. The "F" in FIFE stands
for:
A. Focus
B. Feelings
C. Function
D. Family
Correct Answer: B
Rationale: The FIFE model = Feelings, Ideas, Function, Expectations. It explores the patient's
emotional response, beliefs about the illness, impact on daily function, and expectations for
care. This patient-centered framework is frequently tested in NR 509.
,Q6. A patient with a history of alcohol use is being screened. Which questionnaire is most
appropriate?
A. PHQ-9
B. CAGE
C. GAD-7
D. MMSE
Correct Answer: B
Rationale: CAGE (Cut down, Annoyed, Guilty, Eye-opener) is a validated screening tool for
alcohol use disorder. PHQ-9 screens for depression; GAD-7 for anxiety; MMSE for cognitive
impairment.
Q7. During a health history, a patient states, "I don't know why I'm here. My wife made me
come." What is the NP's best response?
A. "You're wasting both our time if you don't want to be here."
B. "It sounds like you're feeling frustrated about being here. What concerns do you have?"
C. "Let's just do the exam and you can leave."
D. "Your wife is right to be concerned about you."
Correct Answer: B
Rationale: Acknowledging the patient's feelings without judgment demonstrates empathy
and builds rapport. This response uses therapeutic communication to explore the patient's
perspective rather than dismissing or confronting it.
Q8. Which component of the health history is documented immediately after the chief
complaint?
A. Past medical history
B. Family history
C. History of present illness
D. Review of systems
Correct Answer: C
Rationale: The HPI expands on the chief complaint using OLDCARTS. It provides the
narrative of the current illness and guides the remainder of the history and physical exam. PMH,
FH, and ROS follow the HPI.
, Q9. A 45-year-old patient reports a new mole on the back. Which question is most important to
ask first?
A. "Have you ever had a sunburn?"
B. "Has the mole changed in size, shape, or color?"
C. "Does anyone in your family have skin cancer?"
D. "What sunscreen do you use?"
Correct Answer: B
Rationale: The ABCDE criteria (Asymmetry, Border irregularity, Color variation, Diameter
>6mm, Evolution) guide melanoma assessment. "Evolution" (change) is the most concerning
feature. While sun exposure and family history are relevant, the characteristics of the lesion
itself are the priority.
Q10. The NP is performing a review of systems. Which question assesses the neurologic system?
A. "Do you have any difficulty swallowing?"
B. "Have you noticed any numbness or tingling?"
C. "Do you experience shortness of breath?"
D. "Have you had any nausea or vomiting?"
Correct Answer: B
Rationale: Numbness and tingling are neurologic symptoms. Dysphagia may be neurologic
or GI; dyspnea is respiratory; nausea is GI. The ROS systematically reviews each body system.
Q11. A patient reports a headache that awakens her from sleep. This finding is most concerning
for:
A. Tension headache
B. Migraine headache
C. Secondary headache from serious pathology
D. Sinus headache
Correct Answer: C
Rationale: Headaches that wake the patient from sleep are a red flag for serious pathology
(e.g., increased intracranial pressure, tumor, subarachnoid hemorrhage). Tension and migraine
