NR 509 – Midterm Exam Questions and Correct
Answers | Chamberlain University | 2025 |
Complete Exam
1. A 68-year-old patient with hearing loss answers questions inappropriately and frequently
asks for repetition. Which action by the nurse is most appropriate?
A. Speak in a louder voice using a high-pitched tone
B. Face the patient directly, speak clearly at a moderate pace, and minimize background noise
C. Document the patient as confused and continue the interview
D. Refer the patient immediately for audiology testing before continuing
Correct Answer: B
Rationale: Presbycusis (age-related hearing loss) typically involves high-frequency loss.
Speaking clearly at a moderate pace, facing the patient so they can read lips, and reducing
background noise are appropriate strategies. Shouting in a high-pitched voice is
counterproductive because high-frequency sounds are lost first. Confusion and hearing loss are
different issues — do not mislabel. Referral may be appropriate later, but you must first
complete the interview using effective communication techniques.
2. Which component of the OLDCARTS mnemonic assesses the "T" element?
A. The quality of the pain
B. How long the symptom has been present and whether it changes over time
C. What makes the symptom better or worse
D. The patient's rating on a 0–10 scale
Correct Answer: B
Rationale: OLDCARTS stands for Onset, Location, Duration, Character,
Aggravating/Alleviating factors, Radiation, Timing, and Severity. "T" = Timing, which includes
when the symptom began, how long it lasts, and its pattern over time. "T" is sometimes also
taught as "Timing/duration." Quality is "C" (Character), aggravating/alleviating is "A," and
severity is "S."
,3. A nurse is interviewing a 45-year-old patient who becomes tearful when discussing a recent
divorce. Which response is most therapeutic?
A. "Don't worry, things will get better."
B. "I can see this is difficult. Take your time — we can pause whenever you need."
C. "Let's move on to your physical symptoms; we can discuss this another time."
D. "Have you considered seeing a therapist?"
Correct Answer: B
Rationale: This response uses active listening, acknowledges the patient's emotion
(empathy), and gives the patient control. Option A offers false reassurance. Option C dismisses
the patient's emotional state and may shut down communication. Option D, while possibly a
future referral, deflects from the immediate therapeutic moment.
4. Which of the following are components of the FIFE model for understanding the patient's
perspective? (Select All That Apply)
A. Feelings
B. Ideas
C. Family history
D. Function
E. Expectations
Correct Answers: A, B, D, E
Rationale: FIFE = Feelings, Ideas, Function, Expectations. It is a patient-centered framework
used to explore the patient's experience of illness. Family history is part of the standard health
history but is not a component of the FIFE mnemonic.
5. A 30-year-old patient reports drinking "a few beers" most weekends. Which screening tool
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 brief screening tool
for alcohol misuse. PHQ-9 screens for depression, GAD-7 for anxiety, and MMSE for cognitive
impairment.
6. During the health history, a patient says, "My mother had a heart attack at 50, and my
father has high blood pressure." This information belongs in which section?
A. Chief complaint
B. Past medical history
C. Family history
D. Social history
Correct Answer: C
Rationale: Family history documents the health status and causes of death of first-degree
relatives (parents, siblings, children). This provides risk information for the patient. The chief
complaint is the reason for the visit; past medical history is the patient's own history; social
history covers lifestyle and environmental factors.
7. Which technique is most effective when interviewing a 16-year-old patient about sensitive
topics such as substance use and sexual activity?
A. Interview the patient with the parent present to ensure accuracy
B. Use a direct, authoritative tone to discourage dishonesty
C. Interview the patient alone and assure confidentiality within legal limits
D. Skip sensitive questions to avoid discomfort
Correct Answer: C
Rationale: Adolescents should be interviewed privately, and confidentiality should be
explained within legal boundaries (e.g., mandatory reporting for abuse, imminent danger).
Interviewing with a parent present reduces honesty. An authoritative tone damages rapport.
Skipping sensitive questions misses critical health data.
8. Which of the following are examples of subjective data? (Select All That Apply)
A. Patient's report of nausea
B. Blood pressure of 148/92 mm Hg
, C. Patient's description of "burning" chest pain
D. Observation of a limping gait
E. Patient's report of dizziness
Correct Answers: A, C, E
Rationale: Subjective data are what the patient reports — symptoms, feelings, and
perceptions. Objective data are observable and measurable findings such as vital signs, gait, and
physical exam findings. Nausea, burning chest pain, and dizziness are subjective; blood pressure
and limp are objective.
9. A nurse suspects a patient is minimizing their alcohol intake. Which statement is most
appropriate?
A. "You're not being honest with me, are you?"
B. "I need you to tell me the truth about your drinking."
C. "Many people your age have a drink now and then. How much do you typically drink in a
week?"
D. "If you don't tell me the truth, I can't help you."
Correct Answer: C
Rationale: This uses a nonjudgmental, normalizing approach that reduces the patient's
defensiveness and encourages honest disclosure. Options A, B, and D are confrontational and
damage the therapeutic relationship.
10. Which of the following best describes the purpose of the "review of systems"?
A. To document the patient's chief complaint in detail
B. To systematically screen for symptoms across all body systems
C. To record the patient's family health risks
D. To assess the patient's mental status
Correct Answer: B
Rationale: The review of systems (ROS) is a systematic head-to-toe screening of symptoms
by body system. It is not the detailed exploration of the chief complaint (that is the HPI), nor the
family history or a mental status exam.
Answers | Chamberlain University | 2025 |
Complete Exam
1. A 68-year-old patient with hearing loss answers questions inappropriately and frequently
asks for repetition. Which action by the nurse is most appropriate?
A. Speak in a louder voice using a high-pitched tone
B. Face the patient directly, speak clearly at a moderate pace, and minimize background noise
C. Document the patient as confused and continue the interview
D. Refer the patient immediately for audiology testing before continuing
Correct Answer: B
Rationale: Presbycusis (age-related hearing loss) typically involves high-frequency loss.
Speaking clearly at a moderate pace, facing the patient so they can read lips, and reducing
background noise are appropriate strategies. Shouting in a high-pitched voice is
counterproductive because high-frequency sounds are lost first. Confusion and hearing loss are
different issues — do not mislabel. Referral may be appropriate later, but you must first
complete the interview using effective communication techniques.
2. Which component of the OLDCARTS mnemonic assesses the "T" element?
A. The quality of the pain
B. How long the symptom has been present and whether it changes over time
C. What makes the symptom better or worse
D. The patient's rating on a 0–10 scale
Correct Answer: B
Rationale: OLDCARTS stands for Onset, Location, Duration, Character,
Aggravating/Alleviating factors, Radiation, Timing, and Severity. "T" = Timing, which includes
when the symptom began, how long it lasts, and its pattern over time. "T" is sometimes also
taught as "Timing/duration." Quality is "C" (Character), aggravating/alleviating is "A," and
severity is "S."
,3. A nurse is interviewing a 45-year-old patient who becomes tearful when discussing a recent
divorce. Which response is most therapeutic?
A. "Don't worry, things will get better."
B. "I can see this is difficult. Take your time — we can pause whenever you need."
C. "Let's move on to your physical symptoms; we can discuss this another time."
D. "Have you considered seeing a therapist?"
Correct Answer: B
Rationale: This response uses active listening, acknowledges the patient's emotion
(empathy), and gives the patient control. Option A offers false reassurance. Option C dismisses
the patient's emotional state and may shut down communication. Option D, while possibly a
future referral, deflects from the immediate therapeutic moment.
4. Which of the following are components of the FIFE model for understanding the patient's
perspective? (Select All That Apply)
A. Feelings
B. Ideas
C. Family history
D. Function
E. Expectations
Correct Answers: A, B, D, E
Rationale: FIFE = Feelings, Ideas, Function, Expectations. It is a patient-centered framework
used to explore the patient's experience of illness. Family history is part of the standard health
history but is not a component of the FIFE mnemonic.
5. A 30-year-old patient reports drinking "a few beers" most weekends. Which screening tool
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 brief screening tool
for alcohol misuse. PHQ-9 screens for depression, GAD-7 for anxiety, and MMSE for cognitive
impairment.
6. During the health history, a patient says, "My mother had a heart attack at 50, and my
father has high blood pressure." This information belongs in which section?
A. Chief complaint
B. Past medical history
C. Family history
D. Social history
Correct Answer: C
Rationale: Family history documents the health status and causes of death of first-degree
relatives (parents, siblings, children). This provides risk information for the patient. The chief
complaint is the reason for the visit; past medical history is the patient's own history; social
history covers lifestyle and environmental factors.
7. Which technique is most effective when interviewing a 16-year-old patient about sensitive
topics such as substance use and sexual activity?
A. Interview the patient with the parent present to ensure accuracy
B. Use a direct, authoritative tone to discourage dishonesty
C. Interview the patient alone and assure confidentiality within legal limits
D. Skip sensitive questions to avoid discomfort
Correct Answer: C
Rationale: Adolescents should be interviewed privately, and confidentiality should be
explained within legal boundaries (e.g., mandatory reporting for abuse, imminent danger).
Interviewing with a parent present reduces honesty. An authoritative tone damages rapport.
Skipping sensitive questions misses critical health data.
8. Which of the following are examples of subjective data? (Select All That Apply)
A. Patient's report of nausea
B. Blood pressure of 148/92 mm Hg
, C. Patient's description of "burning" chest pain
D. Observation of a limping gait
E. Patient's report of dizziness
Correct Answers: A, C, E
Rationale: Subjective data are what the patient reports — symptoms, feelings, and
perceptions. Objective data are observable and measurable findings such as vital signs, gait, and
physical exam findings. Nausea, burning chest pain, and dizziness are subjective; blood pressure
and limp are objective.
9. A nurse suspects a patient is minimizing their alcohol intake. Which statement is most
appropriate?
A. "You're not being honest with me, are you?"
B. "I need you to tell me the truth about your drinking."
C. "Many people your age have a drink now and then. How much do you typically drink in a
week?"
D. "If you don't tell me the truth, I can't help you."
Correct Answer: C
Rationale: This uses a nonjudgmental, normalizing approach that reduces the patient's
defensiveness and encourages honest disclosure. Options A, B, and D are confrontational and
damage the therapeutic relationship.
10. Which of the following best describes the purpose of the "review of systems"?
A. To document the patient's chief complaint in detail
B. To systematically screen for symptoms across all body systems
C. To record the patient's family health risks
D. To assess the patient's mental status
Correct Answer: B
Rationale: The review of systems (ROS) is a systematic head-to-toe screening of symptoms
by body system. It is not the detailed exploration of the chief complaint (that is the HPI), nor the
family history or a mental status exam.
