NURS 500 EXAM ONE QUESTIONS AND ANSWERS | NURS 500
EXAM ONE STUDY GUIDE & PRACTICE TEST 2026/2027
What are the two types of visits we conduct as FNPs? When would you conduct each? What are the
components of each? - ANS ✔✔Comprehensive: all the elements of the health history and complete PE
Focused: returning for routine care or with specific "urgent" concerns (e.g. sore throat, knee pain)
What is the difference between subjective and objective data? What are some examples of each? - ANS
✔✔Subjective: what the patient tells you (e.g. symptoms, history, from cc to ROS)
Objective: what you detect during the exam, labs, test data, all PE findings or signs
What is the HPI? How would the FNP obtain one? - ANS ✔✔Complete, clear, and chronological
description of the problems prompting the patient's visit (OLDCART)
What does OLDCART stand for? How is onset in OLDCART different from the onset in the seven attributes
of a symptom? - ANS ✔✔Onset, location, duration, characteristics, aggravating/relieving, timing
(frequency)
What are the seven attributes of a symptom? How do you define each? What is the difference between
onset and timing? - ANS ✔✔Location, quality, quantity/severity, timing (onset, duration, frequency), the
setting in which it occurs, factors that have aggravated/relieved the symptom, associated manifestations
What is a differential diagnosis and how is one formulated? - ANS ✔✔List of potential causes for the
patient's problems
Identify abnormal findings, localize findings anatomically, cluster clinical findings, search for the probable
cause, cluster clinical data
What is a leading question? Should these be used when obtaining a history from a patient? - ANS
✔✔Already contain an answer or suggested response - DONT USE
How should the FNP quantify tobacco use? - ANS ✔✔Pack years - a person who has smoked 1.5 packs a
day for 12 years has an 18 pack/year history
How would you approach the silent patient? What should you consider as part of your DDx for the silent
patient? Why are periods of silence important? - ANS ✔✔If already tried guided questioning, try asking
more direct questions about symptoms (for patients with depression or dementia)
Important because may be collecting thoughts, trying to remember details, offended by previous
questions asked, etc.
How would you approach the confusing patient? What should you consider as part of your DDx for the
confusing patient? - ANS ✔✔If patient presents with an array of symptoms ("a positive ROS") - focus on
,context of symptom, emphasize patient's perspective, guide the interview into a psychosocial
assessment
Consider mental status change, delirium in acutely ill or intoxicated patients, dementia in elderly --> shift
to MSE and focus on LOC, orientation, memory, capacity to understand
How would you approach the talkative patient? What are some strategies that you can use during a visit
with a talkative patient? - ANS ✔✔Give them free reign for the first 5-10 minutes while listening closely,
set limits, brief summary can help change subject
Avoid showing impatience, explain possible need for second visit and set time limit
How would you approach the patient with a language barrier? What would you look for in the ideal
interpreter? - ANS ✔✔Ideal interpreter - "cultural navigator" who is neutral and trained in both
languages/cultures
Guidelines for working with an interpreter: introductions, note goals, transparency, ethics, respect
beliefs, patient focus, retain control, explain, thanks
How would you approach the patient with a low literacy or low health literacy? What are some strategies
that you can use during a visit with this patient? - ANS ✔✔Ask about years completed in school or check
how well the patient reads written instructions (hand a patient a book upside down)
Identify reasons - language barrier, learning disorder, poor vision, level of education
How would you approach the patient with hearing loss? What are some strategies that you can use
during a visit with this patient? - ANS ✔✔Determine the patient's preferred method of communication,
if they belong to the hearing or deaf culture, when the hearing loss occurred relative to the development
of speech and language, kind of schools the patient attended
Write out instructions for them to take home
How should you approach the history of the patient with an altered mental status or delirium? - ANS
✔✔Obtain historical information from other sources (family members or caregivers)
Cannot disclose patient information unless informant is the healthcare proxy, has durable power of
attorney, or permission from the patient
Determine if patient has "decision making capacity" (if no healthcare proxy, may default to spouse or
family member)
What are some questions you should ask the depressed patient? - ANS ✔✔"Over the past 2 weeks, have
you felt down, depressed, or hopeless?", "Over the past 2 weeks, have you felt little interest or pleasure
in doing things?", "Have you ever thought about hurting yourself or ending your life?"
What are some strategies you can use and questions that you might ask when taking a sexual history? -
ANS ✔✔Ask questions during OB/Gyn section of PMH for women, in health maintenance, or personal
and social history (in sexual practices of ROS during comprehensive exam)
, Start with an orienting sentence, use specific language
What are some questions that you might ask when taking a mental health history? - ANS ✔✔Ask open-
ended questions initially ("Have you ever had any problem with emotional or mental illnesses?") then
move to more specific questions
Have you ever taken medication for a mental health condition? Have you ever been hospitalized for an
emotional or mental health problem? What about members of your family?
When considering alcohol and illicit drug use, what are some screening strategies that the FNP might
use? What questions should the FNP ask? - ANS ✔✔Conversations follow naturally after asking about
caffeine and cigarettes
Alcohol - "Tell me about your use of alcohol", "Have you ever had a drinking problem?", "When was your
last drink?"
Use CAGE questions - cutting down, annoyance when criticized, guilty feelings, eye openers --> two
affirmatives suggest alcohol misuse --> ask about blackouts, seizures, accidents/injuries, job problems,
conflict in personal relationships
Illicit drugs - "How many times in the past year have you used an illegal drug or used a prescription med
for non-clinical reasons?"
Modify CAGE questions by adding "or drugs" to each question
Who should be screened for intimate partner violence (IPV)? What is the best approach to IPV
screening? - ANS ✔✔Women of reproductive age
Begin with normalizing statement ("Because abuse is common in many women's lives, I've begun to ask
about it routinely")
What is a health care proxy and who should have one? - ANS ✔✔Act as the patient's health decision
maker when they are incapable
Any adult, especially the elderly or chronically ill
What is the difference between weakness and fatigue? When is fatigue and expected finding? - ANS
✔✔Fatigue: nonspecific symptom with many causes, sense of weariness or loss of energy --> ask about
life circumstances (normal response to hard work, stress, grief)
Weakness: demonstrable loss of muscle power
How do we define weight loss? Overweight? Obesity? What are some etiologies that we would consider?
- ANS ✔✔Overweight: BMI >25-29
Obese: BMI >30
Weight loss: loss of >5% over a 6 month period
EXAM ONE STUDY GUIDE & PRACTICE TEST 2026/2027
What are the two types of visits we conduct as FNPs? When would you conduct each? What are the
components of each? - ANS ✔✔Comprehensive: all the elements of the health history and complete PE
Focused: returning for routine care or with specific "urgent" concerns (e.g. sore throat, knee pain)
What is the difference between subjective and objective data? What are some examples of each? - ANS
✔✔Subjective: what the patient tells you (e.g. symptoms, history, from cc to ROS)
Objective: what you detect during the exam, labs, test data, all PE findings or signs
What is the HPI? How would the FNP obtain one? - ANS ✔✔Complete, clear, and chronological
description of the problems prompting the patient's visit (OLDCART)
What does OLDCART stand for? How is onset in OLDCART different from the onset in the seven attributes
of a symptom? - ANS ✔✔Onset, location, duration, characteristics, aggravating/relieving, timing
(frequency)
What are the seven attributes of a symptom? How do you define each? What is the difference between
onset and timing? - ANS ✔✔Location, quality, quantity/severity, timing (onset, duration, frequency), the
setting in which it occurs, factors that have aggravated/relieved the symptom, associated manifestations
What is a differential diagnosis and how is one formulated? - ANS ✔✔List of potential causes for the
patient's problems
Identify abnormal findings, localize findings anatomically, cluster clinical findings, search for the probable
cause, cluster clinical data
What is a leading question? Should these be used when obtaining a history from a patient? - ANS
✔✔Already contain an answer or suggested response - DONT USE
How should the FNP quantify tobacco use? - ANS ✔✔Pack years - a person who has smoked 1.5 packs a
day for 12 years has an 18 pack/year history
How would you approach the silent patient? What should you consider as part of your DDx for the silent
patient? Why are periods of silence important? - ANS ✔✔If already tried guided questioning, try asking
more direct questions about symptoms (for patients with depression or dementia)
Important because may be collecting thoughts, trying to remember details, offended by previous
questions asked, etc.
How would you approach the confusing patient? What should you consider as part of your DDx for the
confusing patient? - ANS ✔✔If patient presents with an array of symptoms ("a positive ROS") - focus on
,context of symptom, emphasize patient's perspective, guide the interview into a psychosocial
assessment
Consider mental status change, delirium in acutely ill or intoxicated patients, dementia in elderly --> shift
to MSE and focus on LOC, orientation, memory, capacity to understand
How would you approach the talkative patient? What are some strategies that you can use during a visit
with a talkative patient? - ANS ✔✔Give them free reign for the first 5-10 minutes while listening closely,
set limits, brief summary can help change subject
Avoid showing impatience, explain possible need for second visit and set time limit
How would you approach the patient with a language barrier? What would you look for in the ideal
interpreter? - ANS ✔✔Ideal interpreter - "cultural navigator" who is neutral and trained in both
languages/cultures
Guidelines for working with an interpreter: introductions, note goals, transparency, ethics, respect
beliefs, patient focus, retain control, explain, thanks
How would you approach the patient with a low literacy or low health literacy? What are some strategies
that you can use during a visit with this patient? - ANS ✔✔Ask about years completed in school or check
how well the patient reads written instructions (hand a patient a book upside down)
Identify reasons - language barrier, learning disorder, poor vision, level of education
How would you approach the patient with hearing loss? What are some strategies that you can use
during a visit with this patient? - ANS ✔✔Determine the patient's preferred method of communication,
if they belong to the hearing or deaf culture, when the hearing loss occurred relative to the development
of speech and language, kind of schools the patient attended
Write out instructions for them to take home
How should you approach the history of the patient with an altered mental status or delirium? - ANS
✔✔Obtain historical information from other sources (family members or caregivers)
Cannot disclose patient information unless informant is the healthcare proxy, has durable power of
attorney, or permission from the patient
Determine if patient has "decision making capacity" (if no healthcare proxy, may default to spouse or
family member)
What are some questions you should ask the depressed patient? - ANS ✔✔"Over the past 2 weeks, have
you felt down, depressed, or hopeless?", "Over the past 2 weeks, have you felt little interest or pleasure
in doing things?", "Have you ever thought about hurting yourself or ending your life?"
What are some strategies you can use and questions that you might ask when taking a sexual history? -
ANS ✔✔Ask questions during OB/Gyn section of PMH for women, in health maintenance, or personal
and social history (in sexual practices of ROS during comprehensive exam)
, Start with an orienting sentence, use specific language
What are some questions that you might ask when taking a mental health history? - ANS ✔✔Ask open-
ended questions initially ("Have you ever had any problem with emotional or mental illnesses?") then
move to more specific questions
Have you ever taken medication for a mental health condition? Have you ever been hospitalized for an
emotional or mental health problem? What about members of your family?
When considering alcohol and illicit drug use, what are some screening strategies that the FNP might
use? What questions should the FNP ask? - ANS ✔✔Conversations follow naturally after asking about
caffeine and cigarettes
Alcohol - "Tell me about your use of alcohol", "Have you ever had a drinking problem?", "When was your
last drink?"
Use CAGE questions - cutting down, annoyance when criticized, guilty feelings, eye openers --> two
affirmatives suggest alcohol misuse --> ask about blackouts, seizures, accidents/injuries, job problems,
conflict in personal relationships
Illicit drugs - "How many times in the past year have you used an illegal drug or used a prescription med
for non-clinical reasons?"
Modify CAGE questions by adding "or drugs" to each question
Who should be screened for intimate partner violence (IPV)? What is the best approach to IPV
screening? - ANS ✔✔Women of reproductive age
Begin with normalizing statement ("Because abuse is common in many women's lives, I've begun to ask
about it routinely")
What is a health care proxy and who should have one? - ANS ✔✔Act as the patient's health decision
maker when they are incapable
Any adult, especially the elderly or chronically ill
What is the difference between weakness and fatigue? When is fatigue and expected finding? - ANS
✔✔Fatigue: nonspecific symptom with many causes, sense of weariness or loss of energy --> ask about
life circumstances (normal response to hard work, stress, grief)
Weakness: demonstrable loss of muscle power
How do we define weight loss? Overweight? Obesity? What are some etiologies that we would consider?
- ANS ✔✔Overweight: BMI >25-29
Obese: BMI >30
Weight loss: loss of >5% over a 6 month period
