NURS 612 Final Exam Advanced Health Assessment
(Maryville University) Questions and Answers| Updated| Pass
Guaranteed
1. The chief complaint should be documented using:
A. The patient's own words, in quotation marks when possible
B. The provider's presumptive diagnosis
C. A list of all past medical conditions
D. Only the physical exam findings
Answer: A. The patient's own words, in quotation marks when
possible
Rationale: The chief complaint is the reason for the visit stated in the
patient's words (e.g., "My chest feels tight"). Diagnoses belong in the
assessment.
2. In the OLDCARTS mnemonic for symptom analysis, the letters
stand for:
A. Onset, Laterality, Diagnosis, Cause, Allergies, Risk, Treatment,
Symptoms
B. Onset, Location, Duration, Character, Aggravating/Alleviating factors,
Radiation, Timing, Severity
C. Observation, Labs, Diagnostics, Care, Assessment, Referral, Teaching,
Support
D. Onset, Location, Drugs, Character, Allergies, Review, Time, Stress
Answer: B. Onset, Location, Duration, Character,
Aggravating/Alleviating factors, Radiation, Timing, Severity
Rationale: OLDCARTS organizes the history of present illness so that
each symptom is characterized completely.
NURS 612 Final Exam– Page 1
,3. Which statement is classified as objective data?
A. The patient states, "I have a headache."
B. The patient reports nausea
C. Blood pressure 148/92 mmHg
D. The patient feels dizzy when standing
Answer: C. Blood pressure 148/92 mmHg
Rationale: Objective data are measurable or observable findings by the
examiner. Symptoms reported by the patient are subjective.
4. Which is an example of an open-ended question?
A. "Does the pain radiate to your arm?"
B. "Is the pain sharp?"
C. "Did the pain start yesterday?"
D. "Tell me about the pain you've been having."
Answer: D. "Tell me about the pain you've been having."
Rationale: Open-ended questions invite narrative responses and uncover
information the examiner may not think to ask. Closed questions are used
to clarify details.
5. The primary purpose of the review of systems (ROS) is to:
A. Identify symptoms the patient did not mention in the history of present
illness
B. Confirm the diagnosis
C. Record vital signs
D. Replace the physical examination
Answer: A. Identify symptoms the patient did not mention in the
history of present illness
Rationale: ROS is a head-to-toe symptom inventory that uncovers
additional or related problems and guides the focused physical exam.
NURS 612 Final Exam– Page 2
,6. In a SOAP note, the Assessment section contains:
A. Patient quotes
B. The diagnoses or differential diagnoses based on subjective and
objective data
C. Vital signs
D. Prescriptions only
Answer: B. The diagnoses or differential diagnoses based on
subjective and objective data
Rationale: Assessment is the clinical interpretation (problem list,
diagnoses and differential). Plan contains diagnostics, treatment, education,
and follow-up.
7. When a patient has limited English proficiency, the best practice is
to use:
A. The patient's minor child
B. A bilingual staff member without training
C. A qualified professional medical interpreter
D. Gestures only
Answer: C. A qualified professional medical interpreter
Rationale: Qualified interpreters improve accuracy and protect
confidentiality. Family members, especially children, should not be used
except in emergencies.
8. Which technique best confirms patient understanding of
instructions?
A. Giving written handouts only
B. Asking, "Do you understand?"
C. Speaking louder
D. Teach-back method
Answer: D. Teach-back method
Rationale: Asking patients to restate instructions in their own words
verifies understanding and addresses low health literacy.
NURS 612 Final Exam– Page 3
, 9. The HEADSSS assessment is used to obtain a psychosocial history
from:
A. Adolescents
B. Older adults
C. Newborns
D. Pregnant women only
Answer: A. Adolescents
Rationale: HEADSSS (Home, Education/Employment, Activities, Drugs,
Sexuality, Suicide/depression, Safety) is a structured adolescent interview.
Confidentiality and its limits should be explained first.
10. A visit for a sore throat, with a history and exam focused on the
ears, nose and throat, is classified as a(n):
A. Comprehensive assessment
B. Problem-focused (episodic) assessment
C. Emergency assessment only
D. Follow-up screening only
Answer: B. Problem-focused (episodic) assessment
Rationale: An episodic or problem-focused assessment addresses a
specific complaint. A comprehensive assessment includes the complete
history and all systems.
11. Which documentation practice is correct when an error is found in
the medical record?
A. Use correction fluid
B. Delete the entry
C. Draw a single line through the error, date, sign and enter the correction
(or use a labeled addendum in the EHR)
D. Alter the record without a note
Answer: C. Draw a single line through the error, date, sign and enter
the correction (or use a labeled addendum in the EHR)
Rationale: Medical records are legal documents. Errors must be corrected
transparently with the original entry still legible. Late entries must be clearly
labeled.
NURS 612 Final Exam– Page 4
(Maryville University) Questions and Answers| Updated| Pass
Guaranteed
1. The chief complaint should be documented using:
A. The patient's own words, in quotation marks when possible
B. The provider's presumptive diagnosis
C. A list of all past medical conditions
D. Only the physical exam findings
Answer: A. The patient's own words, in quotation marks when
possible
Rationale: The chief complaint is the reason for the visit stated in the
patient's words (e.g., "My chest feels tight"). Diagnoses belong in the
assessment.
2. In the OLDCARTS mnemonic for symptom analysis, the letters
stand for:
A. Onset, Laterality, Diagnosis, Cause, Allergies, Risk, Treatment,
Symptoms
B. Onset, Location, Duration, Character, Aggravating/Alleviating factors,
Radiation, Timing, Severity
C. Observation, Labs, Diagnostics, Care, Assessment, Referral, Teaching,
Support
D. Onset, Location, Drugs, Character, Allergies, Review, Time, Stress
Answer: B. Onset, Location, Duration, Character,
Aggravating/Alleviating factors, Radiation, Timing, Severity
Rationale: OLDCARTS organizes the history of present illness so that
each symptom is characterized completely.
NURS 612 Final Exam– Page 1
,3. Which statement is classified as objective data?
A. The patient states, "I have a headache."
B. The patient reports nausea
C. Blood pressure 148/92 mmHg
D. The patient feels dizzy when standing
Answer: C. Blood pressure 148/92 mmHg
Rationale: Objective data are measurable or observable findings by the
examiner. Symptoms reported by the patient are subjective.
4. Which is an example of an open-ended question?
A. "Does the pain radiate to your arm?"
B. "Is the pain sharp?"
C. "Did the pain start yesterday?"
D. "Tell me about the pain you've been having."
Answer: D. "Tell me about the pain you've been having."
Rationale: Open-ended questions invite narrative responses and uncover
information the examiner may not think to ask. Closed questions are used
to clarify details.
5. The primary purpose of the review of systems (ROS) is to:
A. Identify symptoms the patient did not mention in the history of present
illness
B. Confirm the diagnosis
C. Record vital signs
D. Replace the physical examination
Answer: A. Identify symptoms the patient did not mention in the
history of present illness
Rationale: ROS is a head-to-toe symptom inventory that uncovers
additional or related problems and guides the focused physical exam.
NURS 612 Final Exam– Page 2
,6. In a SOAP note, the Assessment section contains:
A. Patient quotes
B. The diagnoses or differential diagnoses based on subjective and
objective data
C. Vital signs
D. Prescriptions only
Answer: B. The diagnoses or differential diagnoses based on
subjective and objective data
Rationale: Assessment is the clinical interpretation (problem list,
diagnoses and differential). Plan contains diagnostics, treatment, education,
and follow-up.
7. When a patient has limited English proficiency, the best practice is
to use:
A. The patient's minor child
B. A bilingual staff member without training
C. A qualified professional medical interpreter
D. Gestures only
Answer: C. A qualified professional medical interpreter
Rationale: Qualified interpreters improve accuracy and protect
confidentiality. Family members, especially children, should not be used
except in emergencies.
8. Which technique best confirms patient understanding of
instructions?
A. Giving written handouts only
B. Asking, "Do you understand?"
C. Speaking louder
D. Teach-back method
Answer: D. Teach-back method
Rationale: Asking patients to restate instructions in their own words
verifies understanding and addresses low health literacy.
NURS 612 Final Exam– Page 3
, 9. The HEADSSS assessment is used to obtain a psychosocial history
from:
A. Adolescents
B. Older adults
C. Newborns
D. Pregnant women only
Answer: A. Adolescents
Rationale: HEADSSS (Home, Education/Employment, Activities, Drugs,
Sexuality, Suicide/depression, Safety) is a structured adolescent interview.
Confidentiality and its limits should be explained first.
10. A visit for a sore throat, with a history and exam focused on the
ears, nose and throat, is classified as a(n):
A. Comprehensive assessment
B. Problem-focused (episodic) assessment
C. Emergency assessment only
D. Follow-up screening only
Answer: B. Problem-focused (episodic) assessment
Rationale: An episodic or problem-focused assessment addresses a
specific complaint. A comprehensive assessment includes the complete
history and all systems.
11. Which documentation practice is correct when an error is found in
the medical record?
A. Use correction fluid
B. Delete the entry
C. Draw a single line through the error, date, sign and enter the correction
(or use a labeled addendum in the EHR)
D. Alter the record without a note
Answer: C. Draw a single line through the error, date, sign and enter
the correction (or use a labeled addendum in the EHR)
Rationale: Medical records are legal documents. Errors must be corrected
transparently with the original entry still legible. Late entries must be clearly
labeled.
NURS 612 Final Exam– Page 4
