NU 664 FINAL EXAM
Advanced Health Assessment & Diagnostic Reasoning
2025 Practice Edition
100 Multiple-Choice Questions with Answers and Rationales
Original graduate-level practice assessment
Page 1 of 36
,Table of Contents
Section 1: Advanced Health History & Interviewing Techniques (Questions 1–15)
........................................ 3
Section 2: Physical Examination Techniques & System-Based Assessment (Questions 16–30)
........................................ 8
Section 3: Differential Diagnosis & Clinical Reasoning (Questions 31–45)
........................................ 13
Section 4: Diagnostic Testing & Laboratory Interpretation (Questions 46–60)
........................................ 18
Section 5: Assessment of Special Populations & Lifespan Considerations (Questions 61–75)
........................................ 23
Section 6: Documentation, Coding & Advanced Practice Competencies (Questions 76–90)
........................................ 28
Section 7: Complex Case Analysis & Clinical Decision Making (Questions 91–100)
........................................ 33
Page 2 of 36
,Section 1: Advanced Health History & Interviewing Techniques
(Questions 1–15)
Q1: A 52-year-old says, ‘I get winded sometimes.’ Which follow-up best begins a focused
characterization of this symptom?
A. ‘Do you have asthma?’
B. ‘Tell me what you mean by winded and what happens when it occurs.’ [CORRECT]
C. ‘You should stop exercising until we know more.’
D. ‘Is the shortness of breath severe?’
Correct Answer: B
Rationale: An open-ended invitation clarifies the patient's meaning before the clinician narrows the
history; leading questions or premature advice can bias the account.
Q2: Which component of OLDCARTS specifically establishes the timing pattern of a
symptom?
A. Onset
B. Character
C. Radiation
D. Timing [CORRECT]
Correct Answer: D
Rationale: Timing asks about frequency, duration, and pattern. Onset concerns when the
symptom began, character describes its quality, and radiation identifies spread.
Q3: A patient is hesitant while describing intimate partner violence. Which response is
most therapeutic?
A. ‘Why have you stayed in the relationship?’
B. ‘I ask all patients these questions privately; you may share only what feels safe.’ [CORRECT]
C. ‘You need to leave today.’
D. ‘Your partner seems unlikely to hurt you.’
Correct Answer: B
Rationale: Normalize private, nonjudgmental inquiry and support patient control. Blame,
assumptions, and prescriptive advice may increase danger or inhibit disclosure.
Page 3 of 36
, Q4: A patient with limited English proficiency arrives with an adult child who offers to
interpret. What should the APRN do for a sensitive health history?
A. Use the child because the patient trusts them
B. Use a qualified medical interpreter and speak directly to the patient [CORRECT]
C. Proceed in English and use gestures
D. Ask the child to summarize only the chief complaint
Correct Answer: B
Rationale: A qualified interpreter improves accuracy, confidentiality, and informed participation;
clinicians should address the patient rather than the interpreter.
Q5: During a medication reconciliation, a patient reports taking ‘a natural sleep product’
but cannot recall its name. What is the best next step?
A. Record no medications because the product is not prescription
B. Ask the patient to bring the container or provide a photo and document use meanwhile
[CORRECT]
C. Assume it is melatonin
D. Tell the patient to discontinue all supplements
Correct Answer: B
Rationale: Nonprescription products, supplements, and substances can affect safety and
interactions; identify the product rather than guessing or dismissing it.
Q6: Which question best assesses a patient's understanding and priorities using a
patient-centered approach?
A. ‘You understand the treatment plan, correct?’
B. ‘What concerns you most, and what were you hoping we could address today?’ [CORRECT]
C. ‘Why did you wait so long to come in?’
D. ‘Would you agree this is probably stress?’
Correct Answer: B
Rationale: Eliciting the patient's agenda and concerns supports shared decision-making. The
other questions are leading, judgmental, or prematurely interpretive.
Page 4 of 36
Advanced Health Assessment & Diagnostic Reasoning
2025 Practice Edition
100 Multiple-Choice Questions with Answers and Rationales
Original graduate-level practice assessment
Page 1 of 36
,Table of Contents
Section 1: Advanced Health History & Interviewing Techniques (Questions 1–15)
........................................ 3
Section 2: Physical Examination Techniques & System-Based Assessment (Questions 16–30)
........................................ 8
Section 3: Differential Diagnosis & Clinical Reasoning (Questions 31–45)
........................................ 13
Section 4: Diagnostic Testing & Laboratory Interpretation (Questions 46–60)
........................................ 18
Section 5: Assessment of Special Populations & Lifespan Considerations (Questions 61–75)
........................................ 23
Section 6: Documentation, Coding & Advanced Practice Competencies (Questions 76–90)
........................................ 28
Section 7: Complex Case Analysis & Clinical Decision Making (Questions 91–100)
........................................ 33
Page 2 of 36
,Section 1: Advanced Health History & Interviewing Techniques
(Questions 1–15)
Q1: A 52-year-old says, ‘I get winded sometimes.’ Which follow-up best begins a focused
characterization of this symptom?
A. ‘Do you have asthma?’
B. ‘Tell me what you mean by winded and what happens when it occurs.’ [CORRECT]
C. ‘You should stop exercising until we know more.’
D. ‘Is the shortness of breath severe?’
Correct Answer: B
Rationale: An open-ended invitation clarifies the patient's meaning before the clinician narrows the
history; leading questions or premature advice can bias the account.
Q2: Which component of OLDCARTS specifically establishes the timing pattern of a
symptom?
A. Onset
B. Character
C. Radiation
D. Timing [CORRECT]
Correct Answer: D
Rationale: Timing asks about frequency, duration, and pattern. Onset concerns when the
symptom began, character describes its quality, and radiation identifies spread.
Q3: A patient is hesitant while describing intimate partner violence. Which response is
most therapeutic?
A. ‘Why have you stayed in the relationship?’
B. ‘I ask all patients these questions privately; you may share only what feels safe.’ [CORRECT]
C. ‘You need to leave today.’
D. ‘Your partner seems unlikely to hurt you.’
Correct Answer: B
Rationale: Normalize private, nonjudgmental inquiry and support patient control. Blame,
assumptions, and prescriptive advice may increase danger or inhibit disclosure.
Page 3 of 36
, Q4: A patient with limited English proficiency arrives with an adult child who offers to
interpret. What should the APRN do for a sensitive health history?
A. Use the child because the patient trusts them
B. Use a qualified medical interpreter and speak directly to the patient [CORRECT]
C. Proceed in English and use gestures
D. Ask the child to summarize only the chief complaint
Correct Answer: B
Rationale: A qualified interpreter improves accuracy, confidentiality, and informed participation;
clinicians should address the patient rather than the interpreter.
Q5: During a medication reconciliation, a patient reports taking ‘a natural sleep product’
but cannot recall its name. What is the best next step?
A. Record no medications because the product is not prescription
B. Ask the patient to bring the container or provide a photo and document use meanwhile
[CORRECT]
C. Assume it is melatonin
D. Tell the patient to discontinue all supplements
Correct Answer: B
Rationale: Nonprescription products, supplements, and substances can affect safety and
interactions; identify the product rather than guessing or dismissing it.
Q6: Which question best assesses a patient's understanding and priorities using a
patient-centered approach?
A. ‘You understand the treatment plan, correct?’
B. ‘What concerns you most, and what were you hoping we could address today?’ [CORRECT]
C. ‘Why did you wait so long to come in?’
D. ‘Would you agree this is probably stress?’
Correct Answer: B
Rationale: Eliciting the patient's agenda and concerns supports shared decision-making. The
other questions are leading, judgmental, or prematurely interpretive.
Page 4 of 36
