NR 509 FINAL EXAM / NR509 FINAL EXAM(50 Questions
with Correct Answers, Latest 2020): Chamberlain
Collage of Nursing: Already Graded A, Best for
Preparation
Section 1: Health History, Interviewing & Clinical Reasoning
1. Which component of the health history describes the patient's primary reason for seeking
care?
A. Past medical history
B. Review of systems
C. Chief complaint
D. Family history
Correct Answer: C. Chief complaint
Rationale: The chief complaint documents the patient's primary reason for the visit, ideally
in the patient's own words. Past medical history includes previous illnesses and surgeries.
Review of systems is a systematic head-to-toe symptom inventory. Family history identifies
inherited disease risks.
2. When documenting a chief complaint, the clinician should generally:
A. Translate it immediately into a medical diagnosis
B. Use only medical terminology
C. Record the patient's reason for the visit using the patient's own words when appropriate
D. Document only abnormal physical findings
Correct Answer: C. Record the patient's reason for the visit using the patient's own words
when appropriate
Rationale: The chief complaint should be recorded in the patient's own words to preserve
the authenticity of their concern. Translating to medical terminology immediately (A) may
distort meaning. Using only medical jargon (B) defeats the purpose of capturing the patient's
perspective. Physical findings belong in objective examination documentation (D).
,3. In OLDCARTS, the "O" primarily refers to:
A. Outcome
B. Objective findings
C. Onset
D. Observation
Correct Answer: C. Onset
Rationale: OLDCARTS stands for Onset, Location, Duration, Character, Aggravating factors,
Radiation, Timing, and Severity. Onset refers to when the symptom began. Outcome and
Objective findings are not components of this mnemonic.
4. Which communication technique encourages a patient to provide additional information?
A. Changing the subject
B. Asking only yes/no questions
C. Using open-ended questions
D. Interrupting frequently
Correct Answer: C. Using open-ended questions
Rationale: Open-ended questions invite the patient to describe their experience in their
own words and facilitate comprehensive data collection. Closed-ended questions elicit brief,
specific responses and may miss important context. Interrupting or changing the subject
disrupts the patient's narrative.
5. A patient becomes silent after discussing a recent diagnosis. The clinician should initially:
A. Immediately change the subject
B. Tell the patient not to worry
C. Allow an appropriate period of silence
D. End the interview
Correct Answer: C. Allow an appropriate period of silence
Rationale: Silence can be therapeutic, giving the patient time to process emotions and
formulate thoughts. Changing the subject or minimizing concerns may block communication.
Ending the interview prematurely is not patient-centered.
,6. Which response demonstrates therapeutic communication?
A. "You should not feel that way."
B. "I know exactly how you feel."
C. "Tell me more about what concerns you most."
D. "Everything will definitely be fine."
Correct Answer: C. "Tell me more about what concerns you most."
Rationale: This open-ended, patient-centered response invites further elaboration without
judgment or false reassurance. Minimizing feelings (A), claiming to know exactly how the
patient feels (B), and offering false reassurance (D) all impede therapeutic communication.
7. Which question best assesses tobacco exposure?
A. "Do you exercise?"
B. "Do you currently smoke or use other tobacco products?"
C. "Do you drink alcohol?"
D. "Are you sexually active?"
Correct Answer: B. "Do you currently smoke or use other tobacco products?"
Rationale: This question directly assesses tobacco use, a major modifiable risk factor for
cardiovascular and pulmonary disease. Follow-up should quantify pack-years for cumulative
exposure assessment.
8. Which finding belongs in the past medical history?
A. Current abdominal pain
B. Previous hospitalization for pneumonia
C. Current heart rate
D. Current respiratory pattern
Correct Answer: B. Previous hospitalization for pneumonia
Rationale: Past medical history includes previous illnesses, hospitalizations, surgeries, and
chronic conditions. Current symptoms (A) and vital signs (C, D) are part of the present illness or
objective examination.
, 9. Medication reconciliation should include:
A. Prescription drugs only
B. Herbal products only
C. Prescription medications, OTC medications, supplements, and relevant substances
D. Medications prescribed by the current clinician only
Correct Answer: C. Prescription medications, OTC medications, supplements, and relevant
substances
Rationale: Comprehensive medication reconciliation captures all substances that may affect
the patient's health, including prescriptions, over-the-counter medications, herbal products,
vitamins, and supplements. Incomplete reconciliation risks drug interactions and adverse
effects.
10. A family history is particularly useful for identifying:
A. Current vital signs
B. Inherited and familial disease risks
C. Current pain severity
D. Physical examination technique
Correct Answer: B. Inherited and familial disease risks
Rationale: Family history identifies patterns of disease within families that may indicate
genetic predisposition or shared environmental factors. Conditions such as premature
cardiovascular disease, diabetes, and certain cancers have hereditary components.
11. A 45-year-old male presents with a persistent headache. The patient states: "My head has
been throbbing constantly for the past three days." In which section of the health history
should this statement be documented?
A. History of Present Illness (HPI)
B. Chief Complaint (CC)
C. Review of Systems (ROS)
D. Past Medical History (PMH)
Correct Answer: B. Chief Complaint (CC)
with Correct Answers, Latest 2020): Chamberlain
Collage of Nursing: Already Graded A, Best for
Preparation
Section 1: Health History, Interviewing & Clinical Reasoning
1. Which component of the health history describes the patient's primary reason for seeking
care?
A. Past medical history
B. Review of systems
C. Chief complaint
D. Family history
Correct Answer: C. Chief complaint
Rationale: The chief complaint documents the patient's primary reason for the visit, ideally
in the patient's own words. Past medical history includes previous illnesses and surgeries.
Review of systems is a systematic head-to-toe symptom inventory. Family history identifies
inherited disease risks.
2. When documenting a chief complaint, the clinician should generally:
A. Translate it immediately into a medical diagnosis
B. Use only medical terminology
C. Record the patient's reason for the visit using the patient's own words when appropriate
D. Document only abnormal physical findings
Correct Answer: C. Record the patient's reason for the visit using the patient's own words
when appropriate
Rationale: The chief complaint should be recorded in the patient's own words to preserve
the authenticity of their concern. Translating to medical terminology immediately (A) may
distort meaning. Using only medical jargon (B) defeats the purpose of capturing the patient's
perspective. Physical findings belong in objective examination documentation (D).
,3. In OLDCARTS, the "O" primarily refers to:
A. Outcome
B. Objective findings
C. Onset
D. Observation
Correct Answer: C. Onset
Rationale: OLDCARTS stands for Onset, Location, Duration, Character, Aggravating factors,
Radiation, Timing, and Severity. Onset refers to when the symptom began. Outcome and
Objective findings are not components of this mnemonic.
4. Which communication technique encourages a patient to provide additional information?
A. Changing the subject
B. Asking only yes/no questions
C. Using open-ended questions
D. Interrupting frequently
Correct Answer: C. Using open-ended questions
Rationale: Open-ended questions invite the patient to describe their experience in their
own words and facilitate comprehensive data collection. Closed-ended questions elicit brief,
specific responses and may miss important context. Interrupting or changing the subject
disrupts the patient's narrative.
5. A patient becomes silent after discussing a recent diagnosis. The clinician should initially:
A. Immediately change the subject
B. Tell the patient not to worry
C. Allow an appropriate period of silence
D. End the interview
Correct Answer: C. Allow an appropriate period of silence
Rationale: Silence can be therapeutic, giving the patient time to process emotions and
formulate thoughts. Changing the subject or minimizing concerns may block communication.
Ending the interview prematurely is not patient-centered.
,6. Which response demonstrates therapeutic communication?
A. "You should not feel that way."
B. "I know exactly how you feel."
C. "Tell me more about what concerns you most."
D. "Everything will definitely be fine."
Correct Answer: C. "Tell me more about what concerns you most."
Rationale: This open-ended, patient-centered response invites further elaboration without
judgment or false reassurance. Minimizing feelings (A), claiming to know exactly how the
patient feels (B), and offering false reassurance (D) all impede therapeutic communication.
7. Which question best assesses tobacco exposure?
A. "Do you exercise?"
B. "Do you currently smoke or use other tobacco products?"
C. "Do you drink alcohol?"
D. "Are you sexually active?"
Correct Answer: B. "Do you currently smoke or use other tobacco products?"
Rationale: This question directly assesses tobacco use, a major modifiable risk factor for
cardiovascular and pulmonary disease. Follow-up should quantify pack-years for cumulative
exposure assessment.
8. Which finding belongs in the past medical history?
A. Current abdominal pain
B. Previous hospitalization for pneumonia
C. Current heart rate
D. Current respiratory pattern
Correct Answer: B. Previous hospitalization for pneumonia
Rationale: Past medical history includes previous illnesses, hospitalizations, surgeries, and
chronic conditions. Current symptoms (A) and vital signs (C, D) are part of the present illness or
objective examination.
, 9. Medication reconciliation should include:
A. Prescription drugs only
B. Herbal products only
C. Prescription medications, OTC medications, supplements, and relevant substances
D. Medications prescribed by the current clinician only
Correct Answer: C. Prescription medications, OTC medications, supplements, and relevant
substances
Rationale: Comprehensive medication reconciliation captures all substances that may affect
the patient's health, including prescriptions, over-the-counter medications, herbal products,
vitamins, and supplements. Incomplete reconciliation risks drug interactions and adverse
effects.
10. A family history is particularly useful for identifying:
A. Current vital signs
B. Inherited and familial disease risks
C. Current pain severity
D. Physical examination technique
Correct Answer: B. Inherited and familial disease risks
Rationale: Family history identifies patterns of disease within families that may indicate
genetic predisposition or shared environmental factors. Conditions such as premature
cardiovascular disease, diabetes, and certain cancers have hereditary components.
11. A 45-year-old male presents with a persistent headache. The patient states: "My head has
been throbbing constantly for the past three days." In which section of the health history
should this statement be documented?
A. History of Present Illness (HPI)
B. Chief Complaint (CC)
C. Review of Systems (ROS)
D. Past Medical History (PMH)
Correct Answer: B. Chief Complaint (CC)
