NUR 631 Exam 2 Advanced Health Assessment | Questions
and Answers with Rationale | New Update 2026-2027
1. Which of the following best describes the primary purpose of the health
history in advanced health assessment?
A) It provides sufficient information in about 75% of patients to establish a
diagnosis before physical examination and diagnostic tests
B) It accounts for less than 25% of diagnostic accuracy, relying primarily on
diagnostic imaging
C) It is only useful when combined with invasive laboratory tests
D) It is performed strictly after the physical examination to confirm objective
findings
Correct Answer: It provides sufficient information in about 75% of patients to
establish a diagnosis before physical examination and diagnostic tests
Rationale: The health history is a critical component of advanced health
assessment, providing sufficient information in approximately 75% of patients to
make a diagnosis before performing a physical exam and additional tests. This
underscores the importance of thorough history taking. Physical examination and
diagnostic tests complement, but do not replace, the diagnostic yield of the
history.
2. What is the primary purpose of the clinician-centered interview approach in
advanced health assessment?
A) To recognize patient expressions of personal concerns, feelings, and emotions
B) To lead the conversation to acquire symptoms, details, and specific data to
identify a disease
C) To allow the patient to control the direction of the interview
D) To focus exclusively on the patient's psychosocial history
Correct Answer: To lead the conversation to acquire symptoms, details, and
specific data to identify a disease
,Rationale: In a clinician-centered approach, the provider takes charge of the
interaction and leads the conversation to meet their own need to acquire
symptoms and disease data. A patient-centered approach recognizes patient
expressions of personal concerns, feelings, and emotions. The clinician-centered
approach is more directive and focused on data collection to identify disease.
3. According to the SPIKES protocol for disclosing serious news, what is the
specific purpose of Step 2?
A) Setting up the interview
B) Assessing the patient's perception
C) Obtaining the patient's invitation
D) Giving knowledge and information to the patient
Correct Answer: Assessing the patient's perception
Rationale: The SPIKES protocol includes six steps: Setting up the interview (Step
1), Assessing the patient's perception (Step 2), Obtaining the patient's invitation
(Step 3), Giving knowledge and information to the patient (Step 4), Addressing the
patient's emotions with empathetic responses (Step 5), and Strategy and
summary (Step 6). Step 2 involves assessing how much the patient already knows
and understands about their condition.
4. When using an interpreter to facilitate an interview, where should the
interpreter be positioned?
A) Behind the examiner so that the lips of the patient and the patient's nonverbal
cues can be seen
B) Next to the patient, so the examiner can maintain eye contact and observe the
nonverbal cues of the patient
C) Between the examiner and the patient so all parties can make the necessary
observations
D) In a corner of the room so as to provide minimal distraction to the interview
Correct Answer: Next to the patient, so the examiner can maintain eye contact
and observe the nonverbal cues of the patient
Rationale: The interpreter should be positioned next to the patient so that the
examiner can maintain direct eye contact with the patient and observe the
,patient's nonverbal cues. This positioning also allows the patient to focus on the
examiner rather than the interpreter, facilitating rapport and trust.
5. Which of the following symptom attributes was not addressed in the
description of a patient's chief complaint?
A) Location
B) Duration
C) Radiation
D) Severity
Correct Answer: Severity
Rationale: The eight attributes of a symptom include location, quality, quantity or
severity, timing, setting, aggravating or relieving factors, associated
manifestations, and the patient's perception. If the description did not include the
intensity or severity of the symptom, that attribute was not addressed. Severity is
typically assessed using a scale such as 0 to 10.
6. A 25-year-old radio announcer comes to the clinic for an annual
examination. His BMI is 26.0 kg/m². He is concerned about his weight.
Based on this information, what is appropriate counsel for the patient
during the visit?
A) Refer the patient to a nutritionist because he is anorexic.
B) Reassure the patient that he has a normal body weight.
C) Give the patient information about reduction of fat, cholesterol, and calories
because he is overweight.
D) Give the patient information about reduction of fat and cholesterol because he
is obese.
Correct Answer: Give the patient information about reduction of fat, cholesterol,
and calories because he is overweight.
Rationale: A BMI of 26.0 kg/m² falls into the overweight category (BMI 25.0–
29.9). Appropriate counseling includes information about reducing fat,
cholesterol, and calories. A BMI of 18.5–24.9 is normal, and a BMI of 30 or greater
is obese. Anorexia is characterized by a BMI below 18.5.
, 7. A 30-year-old sales clerk comes to your office wanting to lose weight; her
BMI is 30.0 kg/m². What is the most appropriate amount for a weekly
weight reduction goal?
A) 0.5 to 1 pound per week
B) 1 to 2.5 pounds per week
C) 2.5 to 3.5 pounds per week
D) 3.5 to 4.5 pounds per week
Correct Answer: 0.5 to 1 pound per week
Rationale: A safe and sustainable rate of weight loss is 0.5 to 1 pound per week.
This corresponds to a caloric deficit of approximately 250 to 500 calories per day.
More rapid weight loss is generally not recommended as it is difficult to maintain
and may pose health risks.
8. A 15-year-old high school sophomore and her mother come to your clinic
because the mother is concerned about her daughter's weight. You
measure her height and weight and obtain a BMI of 19.5 kg/m². Based on
this information, which of the following is appropriate?
A) Refer the patient to a nutritionist and a psychologist because the patient is
anorexic.
B) Reassure the mother that this is a normal body weight.
C) Give the patient information about exercise because the patient is obese.
D) Give the patient information concerning reduction of fat and cholesterol in her
diet because she is obese.
Correct Answer: Reassure the mother that this is a normal body weight.
Rationale: A BMI of 19.5 kg/m² is within the normal range (18.5–24.9) for adults
and adolescents. The nurse should reassure the mother that this is a normal body
weight. Referring to a nutritionist or psychologist would be inappropriate without
further evidence of an eating disorder.
9. What is an example of compensatory hyperplasia?
A) Cardiac hypertrophy
B) Liver regeneration
and Answers with Rationale | New Update 2026-2027
1. Which of the following best describes the primary purpose of the health
history in advanced health assessment?
A) It provides sufficient information in about 75% of patients to establish a
diagnosis before physical examination and diagnostic tests
B) It accounts for less than 25% of diagnostic accuracy, relying primarily on
diagnostic imaging
C) It is only useful when combined with invasive laboratory tests
D) It is performed strictly after the physical examination to confirm objective
findings
Correct Answer: It provides sufficient information in about 75% of patients to
establish a diagnosis before physical examination and diagnostic tests
Rationale: The health history is a critical component of advanced health
assessment, providing sufficient information in approximately 75% of patients to
make a diagnosis before performing a physical exam and additional tests. This
underscores the importance of thorough history taking. Physical examination and
diagnostic tests complement, but do not replace, the diagnostic yield of the
history.
2. What is the primary purpose of the clinician-centered interview approach in
advanced health assessment?
A) To recognize patient expressions of personal concerns, feelings, and emotions
B) To lead the conversation to acquire symptoms, details, and specific data to
identify a disease
C) To allow the patient to control the direction of the interview
D) To focus exclusively on the patient's psychosocial history
Correct Answer: To lead the conversation to acquire symptoms, details, and
specific data to identify a disease
,Rationale: In a clinician-centered approach, the provider takes charge of the
interaction and leads the conversation to meet their own need to acquire
symptoms and disease data. A patient-centered approach recognizes patient
expressions of personal concerns, feelings, and emotions. The clinician-centered
approach is more directive and focused on data collection to identify disease.
3. According to the SPIKES protocol for disclosing serious news, what is the
specific purpose of Step 2?
A) Setting up the interview
B) Assessing the patient's perception
C) Obtaining the patient's invitation
D) Giving knowledge and information to the patient
Correct Answer: Assessing the patient's perception
Rationale: The SPIKES protocol includes six steps: Setting up the interview (Step
1), Assessing the patient's perception (Step 2), Obtaining the patient's invitation
(Step 3), Giving knowledge and information to the patient (Step 4), Addressing the
patient's emotions with empathetic responses (Step 5), and Strategy and
summary (Step 6). Step 2 involves assessing how much the patient already knows
and understands about their condition.
4. When using an interpreter to facilitate an interview, where should the
interpreter be positioned?
A) Behind the examiner so that the lips of the patient and the patient's nonverbal
cues can be seen
B) Next to the patient, so the examiner can maintain eye contact and observe the
nonverbal cues of the patient
C) Between the examiner and the patient so all parties can make the necessary
observations
D) In a corner of the room so as to provide minimal distraction to the interview
Correct Answer: Next to the patient, so the examiner can maintain eye contact
and observe the nonverbal cues of the patient
Rationale: The interpreter should be positioned next to the patient so that the
examiner can maintain direct eye contact with the patient and observe the
,patient's nonverbal cues. This positioning also allows the patient to focus on the
examiner rather than the interpreter, facilitating rapport and trust.
5. Which of the following symptom attributes was not addressed in the
description of a patient's chief complaint?
A) Location
B) Duration
C) Radiation
D) Severity
Correct Answer: Severity
Rationale: The eight attributes of a symptom include location, quality, quantity or
severity, timing, setting, aggravating or relieving factors, associated
manifestations, and the patient's perception. If the description did not include the
intensity or severity of the symptom, that attribute was not addressed. Severity is
typically assessed using a scale such as 0 to 10.
6. A 25-year-old radio announcer comes to the clinic for an annual
examination. His BMI is 26.0 kg/m². He is concerned about his weight.
Based on this information, what is appropriate counsel for the patient
during the visit?
A) Refer the patient to a nutritionist because he is anorexic.
B) Reassure the patient that he has a normal body weight.
C) Give the patient information about reduction of fat, cholesterol, and calories
because he is overweight.
D) Give the patient information about reduction of fat and cholesterol because he
is obese.
Correct Answer: Give the patient information about reduction of fat, cholesterol,
and calories because he is overweight.
Rationale: A BMI of 26.0 kg/m² falls into the overweight category (BMI 25.0–
29.9). Appropriate counseling includes information about reducing fat,
cholesterol, and calories. A BMI of 18.5–24.9 is normal, and a BMI of 30 or greater
is obese. Anorexia is characterized by a BMI below 18.5.
, 7. A 30-year-old sales clerk comes to your office wanting to lose weight; her
BMI is 30.0 kg/m². What is the most appropriate amount for a weekly
weight reduction goal?
A) 0.5 to 1 pound per week
B) 1 to 2.5 pounds per week
C) 2.5 to 3.5 pounds per week
D) 3.5 to 4.5 pounds per week
Correct Answer: 0.5 to 1 pound per week
Rationale: A safe and sustainable rate of weight loss is 0.5 to 1 pound per week.
This corresponds to a caloric deficit of approximately 250 to 500 calories per day.
More rapid weight loss is generally not recommended as it is difficult to maintain
and may pose health risks.
8. A 15-year-old high school sophomore and her mother come to your clinic
because the mother is concerned about her daughter's weight. You
measure her height and weight and obtain a BMI of 19.5 kg/m². Based on
this information, which of the following is appropriate?
A) Refer the patient to a nutritionist and a psychologist because the patient is
anorexic.
B) Reassure the mother that this is a normal body weight.
C) Give the patient information about exercise because the patient is obese.
D) Give the patient information concerning reduction of fat and cholesterol in her
diet because she is obese.
Correct Answer: Reassure the mother that this is a normal body weight.
Rationale: A BMI of 19.5 kg/m² is within the normal range (18.5–24.9) for adults
and adolescents. The nurse should reassure the mother that this is a normal body
weight. Referring to a nutritionist or psychologist would be inappropriate without
further evidence of an eating disorder.
9. What is an example of compensatory hyperplasia?
A) Cardiac hypertrophy
B) Liver regeneration
