NR 509 Exam Question Bank (750 Q and A) / NR509
Exam Question Bank (NEW, 2021) : Chamberlain
College of Nursing (750 Questions with Answers
and Explanations, Answers)
1. A 58-year-old patient presents with chest discomfort. The nurse practitioner asks, “Can you
tell me more about what brought you in today?” Which interviewing technique is being used?
A. Closed-ended questioning
B. Open-ended questioning
C. Confrontation
D. Interpretation
Answer: B) Open-ended questioning
Rationale: Open-ended questions invite patients to describe their concerns in their own
words without restricting the response. Closed-ended questions yield yes/no or limited
answers, while confrontation and interpretation are advanced techniques used later in the
interview to address discrepancies or offer alternative explanations.
2. During a health history, the patient describes abdominal pain. The nurse practitioner asks,
“What does the pain feel like—sharp, dull, burning, or cramping?” Which component of the
HPI is being assessed?
A. Severity
B. Quality
C. Timing
D. Radiation
Answer: B) Quality
Rationale: Quality describes the character or nature of the symptom (sharp, dull, burning,
cramping). Severity is typically rated on a 0–10 scale, timing refers to onset and duration, and
radiation describes where the symptom spreads.
,3. A patient states, “I stopped taking my blood pressure medication because I felt fine.” The
nurse practitioner responds, “It sounds like you were concerned about taking a medication
when you didn’t have symptoms. Can you tell me more about that?” Which technique is
demonstrated?
A. Summarization
B. Empathic response and focused clarification
C. Transition statement
D. Confrontation
Answer: B) Empathic response and focused clarification
Rationale: This response validates the patient’s perspective (empathy) and asks for further
elaboration (focused clarification). Summarization recaps multiple points, transition statements
shift topics, and confrontation directly addresses discrepancies in a more challenging manner.
4. A 45-year-old patient reports drinking alcohol. Which screening tool is the most widely
validated brief instrument for identifying alcohol use disorders in primary care?
A. CAGE questionnaire
B. AUDIT-C
C. GAD-7
D. PHQ-9
Answer: B) AUDIT-C
Rationale: The AUDIT-C (Alcohol Use Disorders Identification Test–Consumption) is a 3-item
validated screening tool for alcohol use disorders in primary care. The CAGE is older and less
sensitive for detecting risky drinking. GAD-7 and PHQ-9 screen for anxiety and depression, not
substance use.
5. A patient who smokes one pack of cigarettes daily has done so for 20 years. What is the
correct pack-years calculation?
A. 10 pack-years
B. 20 pack-years
C. 40 pack-years
D. 2 pack-years
Answer: B) 20 pack-years
,Rationale: Pack-years are calculated by multiplying the number of packs smoked per day by
the number of years smoked (1 pack/day × 20 years = 20 pack-years). This quantifies tobacco
exposure and lung cancer risk.
6. During a family history assessment, the patient reports that her mother developed breast
cancer at age 42 and her maternal aunt had ovarian cancer at age 45. Which genetic risk
should the nurse practitioner discuss?
A. Lynch syndrome
B. BRCA1/BRCA2 mutation risk
C. Familial hypercholesterolemia
D. Huntington disease
Answer: B) BRCA1/BRCA2 mutation risk
Rationale: Early-onset breast cancer (under 50) and ovarian cancer in first-degree relatives
are hallmark features of BRCA1/BRCA2 hereditary breast and ovarian cancer syndrome. Lynch
syndrome is associated with colorectal and endometrial cancers.
7. A patient reports taking lisinopril, metformin, and a daily multivitamin. The nurse
practitioner asks about the dose, route, frequency, reason for use, and duration for each.
Which process is being performed?
A. Medication reconciliation
B. Medication administration
C. Prescription writing
D. Medication disposal
Answer: A) Medication reconciliation
Rationale: Medication reconciliation involves creating an accurate list of all medications
(prescription, OTC, supplements), including dose, route, frequency, indication, and duration, and
comparing it to the current medical record to identify discrepancies.
8. Which of the following represents the “OLDCARTS” mnemonic element of “Quality”?
A. “The pain started 3 days ago.”
B. “The pain is a sharp, stabbing sensation.”
, C. “The pain worsens when I lie down.”
D. “The pain is an 8 out of 10.”
Answer: B) “The pain is a sharp, stabbing sensation.”
Rationale: “Quality” refers to the descriptive nature of the symptom (sharp, dull, crushing,
burning). The other options represent Onset (A), Aggravating factors (C), and Severity (D).
9. A 34-year-old female reports chronic fatigue. During the review of systems (ROS), she notes
she has cold intolerance and dry skin. This information is most pertinent to which body
system?
A. Hematologic
B. Musculoskeletal
C. Endocrine
D. Neurologic
Answer: C) Endocrine
Rationale: Cold intolerance and dry skin are classic signs of hypothyroidism, which falls
under the endocrine system. These symptoms warrant further thyroid-focused assessment.
10. Which of the following is an example of a “pertinent negative” in a patient presenting
with acute abdominal pain?
A. The patient has a history of cholecystectomy.
B. The patient reports nausea and vomiting.
C. The patient denies rebound tenderness or guarding.
D. The patient’s pain is localized to the right lower quadrant.
Answer: C) The patient denies rebound tenderness or guarding.
Rationale: A pertinent negative is a clinically significant finding that is absent, helping to
rule out specific pathologies (e.g., peritonitis). The absence of rebound tenderness helps rule
out peritoneal inflammation, which is critical in acute abdominal pain evaluation.
11. A 70-year-old male is asked to recall three words after 5 minutes during a mental status
exam. He can only recall one. This primarily assesses:
Exam Question Bank (NEW, 2021) : Chamberlain
College of Nursing (750 Questions with Answers
and Explanations, Answers)
1. A 58-year-old patient presents with chest discomfort. The nurse practitioner asks, “Can you
tell me more about what brought you in today?” Which interviewing technique is being used?
A. Closed-ended questioning
B. Open-ended questioning
C. Confrontation
D. Interpretation
Answer: B) Open-ended questioning
Rationale: Open-ended questions invite patients to describe their concerns in their own
words without restricting the response. Closed-ended questions yield yes/no or limited
answers, while confrontation and interpretation are advanced techniques used later in the
interview to address discrepancies or offer alternative explanations.
2. During a health history, the patient describes abdominal pain. The nurse practitioner asks,
“What does the pain feel like—sharp, dull, burning, or cramping?” Which component of the
HPI is being assessed?
A. Severity
B. Quality
C. Timing
D. Radiation
Answer: B) Quality
Rationale: Quality describes the character or nature of the symptom (sharp, dull, burning,
cramping). Severity is typically rated on a 0–10 scale, timing refers to onset and duration, and
radiation describes where the symptom spreads.
,3. A patient states, “I stopped taking my blood pressure medication because I felt fine.” The
nurse practitioner responds, “It sounds like you were concerned about taking a medication
when you didn’t have symptoms. Can you tell me more about that?” Which technique is
demonstrated?
A. Summarization
B. Empathic response and focused clarification
C. Transition statement
D. Confrontation
Answer: B) Empathic response and focused clarification
Rationale: This response validates the patient’s perspective (empathy) and asks for further
elaboration (focused clarification). Summarization recaps multiple points, transition statements
shift topics, and confrontation directly addresses discrepancies in a more challenging manner.
4. A 45-year-old patient reports drinking alcohol. Which screening tool is the most widely
validated brief instrument for identifying alcohol use disorders in primary care?
A. CAGE questionnaire
B. AUDIT-C
C. GAD-7
D. PHQ-9
Answer: B) AUDIT-C
Rationale: The AUDIT-C (Alcohol Use Disorders Identification Test–Consumption) is a 3-item
validated screening tool for alcohol use disorders in primary care. The CAGE is older and less
sensitive for detecting risky drinking. GAD-7 and PHQ-9 screen for anxiety and depression, not
substance use.
5. A patient who smokes one pack of cigarettes daily has done so for 20 years. What is the
correct pack-years calculation?
A. 10 pack-years
B. 20 pack-years
C. 40 pack-years
D. 2 pack-years
Answer: B) 20 pack-years
,Rationale: Pack-years are calculated by multiplying the number of packs smoked per day by
the number of years smoked (1 pack/day × 20 years = 20 pack-years). This quantifies tobacco
exposure and lung cancer risk.
6. During a family history assessment, the patient reports that her mother developed breast
cancer at age 42 and her maternal aunt had ovarian cancer at age 45. Which genetic risk
should the nurse practitioner discuss?
A. Lynch syndrome
B. BRCA1/BRCA2 mutation risk
C. Familial hypercholesterolemia
D. Huntington disease
Answer: B) BRCA1/BRCA2 mutation risk
Rationale: Early-onset breast cancer (under 50) and ovarian cancer in first-degree relatives
are hallmark features of BRCA1/BRCA2 hereditary breast and ovarian cancer syndrome. Lynch
syndrome is associated with colorectal and endometrial cancers.
7. A patient reports taking lisinopril, metformin, and a daily multivitamin. The nurse
practitioner asks about the dose, route, frequency, reason for use, and duration for each.
Which process is being performed?
A. Medication reconciliation
B. Medication administration
C. Prescription writing
D. Medication disposal
Answer: A) Medication reconciliation
Rationale: Medication reconciliation involves creating an accurate list of all medications
(prescription, OTC, supplements), including dose, route, frequency, indication, and duration, and
comparing it to the current medical record to identify discrepancies.
8. Which of the following represents the “OLDCARTS” mnemonic element of “Quality”?
A. “The pain started 3 days ago.”
B. “The pain is a sharp, stabbing sensation.”
, C. “The pain worsens when I lie down.”
D. “The pain is an 8 out of 10.”
Answer: B) “The pain is a sharp, stabbing sensation.”
Rationale: “Quality” refers to the descriptive nature of the symptom (sharp, dull, crushing,
burning). The other options represent Onset (A), Aggravating factors (C), and Severity (D).
9. A 34-year-old female reports chronic fatigue. During the review of systems (ROS), she notes
she has cold intolerance and dry skin. This information is most pertinent to which body
system?
A. Hematologic
B. Musculoskeletal
C. Endocrine
D. Neurologic
Answer: C) Endocrine
Rationale: Cold intolerance and dry skin are classic signs of hypothyroidism, which falls
under the endocrine system. These symptoms warrant further thyroid-focused assessment.
10. Which of the following is an example of a “pertinent negative” in a patient presenting
with acute abdominal pain?
A. The patient has a history of cholecystectomy.
B. The patient reports nausea and vomiting.
C. The patient denies rebound tenderness or guarding.
D. The patient’s pain is localized to the right lower quadrant.
Answer: C) The patient denies rebound tenderness or guarding.
Rationale: A pertinent negative is a clinically significant finding that is absent, helping to
rule out specific pathologies (e.g., peritonitis). The absence of rebound tenderness helps rule
out peritoneal inflammation, which is critical in acute abdominal pain evaluation.
11. A 70-year-old male is asked to recall three words after 5 minutes during a mental status
exam. He can only recall one. This primarily assesses:
