NSG 464 - Physical Assessment for Advanced Practice Midterm Questions and Answers
Already Passed Latest Update 2025-2026
A 19 y/o college student, Todd, is brought to your clinic by his mother. She is concerned that
there is something seriously wrong with him. She states for the past 6 months his behavior has
become peculiar and he has flunked out of college. Todd denies any recent illness or injuries.
His past medical history is remarkable only for a broken foot. His parents are both healthy. He
has a paternal uncle who had similar symptoms in college. The patient admits to smoking
cigarettes and drinking alcohol. He also admits to marijuana use but none in the last week. He
denies using any other substances. He denies any feelings of depression or anxiety. While
speaking with Todd and his mother you do a complete physical examination, which is
essentially normal. When you question him on how he is feeling, he says that he is very worried
that Microsoft has stolen his software for creating a better browser. He tells you he has seen a -
Answers D. Schizophrenia
Rationale: Schizophrenia generally occurs in the late teens to early 20s. It often is seen in other
family members, as in this case. Symptoms must be present for at least 6 months and must
have at least two features of 1. delusions (e.g. Microsoft is after his programs); 2. hallucinations
(e.g. technicians sending telepathic signals); 3. disorganized speech, 4. disorganized behavior,
and 5. negative symptoms such as flat affect
For which of the following patients would a comprehensive health history be appropriate?
A. A new patient with the chief complaint of "I sprained my ankle"
B. An established patient with the chief complaint of "I have an upper respiratory infection"
C. A new patient with chief complaint of "I am here to establish care"
D. A new patient with the chief complaint of "I cut my hand" - Answers C. A new patient with
chief complaint of "I am here to establish care"
rationale: this patient is here to establish care, and because she is new to you, a comprehensive
health history is appropriate
The components of the health history include all of the following except which one?
A. Review of systems
B. Thorax and Lungs
C. Present Illness
,D. Personal and social items - Answers B. Thorax and Lungs
rationale: the thorax and lungs are part of the physical examination, not part of the health
history. The other answers are all part of a complete health history
Is the following information subjective or objective? Mr. M has shortness of breath that has
persisted for the past 10 days, it is worse with activity, and relieved by rest.
A. Subjective
B. Objective - Answers A. Subjective
Rationale: This is information given by the patient about the circumstances of his chief
complaint. It doesn't represent an objective observation by the examiner
Is the following information subjective or objective? Mr. M has a respiratory rate of 32 and a
pulse rate of 120.
A. Subjective
B. Objective - Answers B. Objective
Rationale: This is a measurement obtained by the examiner, so it is considered objective data.
The patient is unlikely to be able to give this information to the examiner
The following information is recorded in the health history: "The patient had had abdominal pain
for 1 week. The pain lasts for 30 minutes at a time, it comes and goes. The severity is 7 to 9 on
a scale of 1-10. It is accompanied by nausea and vomiting. It is located in the mid-epigastric
area". Which of these categories does it belong to?
A. Chief complaint
B. Present Illness
C. Personal and social history
D. Review of systems - Answers B. Present Illness
Rationale: This info describes the problem of abdominal pain, which is the present illness. The
interviewer has obtained the location, timing, severity, and associated manifestations of the
,pain, the setting in which it occurred, and the factors that aggravate and relieve the pain. You
will notice that it does include portions of the pertinent review of systems, but because it related
directly to the chief complaint, it is included in the history of present illness.
The following information is recorded in the health history: "The patient completed 8th grade.
He currently lives with his wife and two children. He works on old cars on the weekend. He
works in a glass factory during the week. Which category does it belong to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems - Answers C. Personal and social history
Rationale: Personal and social history information includes educational level, family of origin,
current household status, personal interest, employment, religious beliefs, military history, and
lifestyle (including diet and exercise habits; use of alcohol, tobacco, and drugs; sexual
preferences and history). All of this information is documented in this example
The following information is recorded in the health history: "I feel really tired". Which category
does this belong to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems - Answers A. Chief complaint
Rationale: The chief complaint is an attempt to quote the patient's own words, as long as they
are suitable to print. It is brief, like a headline, and further details should be sought in the present
illness section. The above information is a chief complaint
The following information is recorded in the health history: "Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea". Which category does this belong
to?
A. Chief complaint
B. Present illness
, C. Personal and social history
D. Review of Systems - Answers D. Review of systems
Rationale: Review of systems documents the presence or absence of common symptoms
related to each major body system. The absence of cardiac symptoms is listed in the above
example
The following information is best placed in which category? "The patient has had 3 Cesarean
sections".
A. Adult illnesses
B. Surgeries
C. Obstetrics/Gynecologic
D. Psychiatric - Answers B. Surgeries
Rationale: A cesarean section is a surgical procedure. Approximate dates or the age of the
patient at the time of the surgery should be recorded
The following information is best placed in which category? "The patient had a stent placed in
the left anterior descending (LAD) artery in 1999"
A. Adult illnesses
B. Surgeries
C. Obstetrics/Gynecologic
D. Psychiatric - Answers A. Adult illnesses
Rationale: The adult illnesses category is reserved for chronic illnesses, significant
hospitalizations, significant injuries, and significant procedures. A stent is a major procedure,
but does not involve a surgeon
The following information is best placed in which category? "The patient was treated for an
asthma exacerbation in the hospital last year, the patient has never been intubated".
A. Adult illnesses
B. Surgeries
Already Passed Latest Update 2025-2026
A 19 y/o college student, Todd, is brought to your clinic by his mother. She is concerned that
there is something seriously wrong with him. She states for the past 6 months his behavior has
become peculiar and he has flunked out of college. Todd denies any recent illness or injuries.
His past medical history is remarkable only for a broken foot. His parents are both healthy. He
has a paternal uncle who had similar symptoms in college. The patient admits to smoking
cigarettes and drinking alcohol. He also admits to marijuana use but none in the last week. He
denies using any other substances. He denies any feelings of depression or anxiety. While
speaking with Todd and his mother you do a complete physical examination, which is
essentially normal. When you question him on how he is feeling, he says that he is very worried
that Microsoft has stolen his software for creating a better browser. He tells you he has seen a -
Answers D. Schizophrenia
Rationale: Schizophrenia generally occurs in the late teens to early 20s. It often is seen in other
family members, as in this case. Symptoms must be present for at least 6 months and must
have at least two features of 1. delusions (e.g. Microsoft is after his programs); 2. hallucinations
(e.g. technicians sending telepathic signals); 3. disorganized speech, 4. disorganized behavior,
and 5. negative symptoms such as flat affect
For which of the following patients would a comprehensive health history be appropriate?
A. A new patient with the chief complaint of "I sprained my ankle"
B. An established patient with the chief complaint of "I have an upper respiratory infection"
C. A new patient with chief complaint of "I am here to establish care"
D. A new patient with the chief complaint of "I cut my hand" - Answers C. A new patient with
chief complaint of "I am here to establish care"
rationale: this patient is here to establish care, and because she is new to you, a comprehensive
health history is appropriate
The components of the health history include all of the following except which one?
A. Review of systems
B. Thorax and Lungs
C. Present Illness
,D. Personal and social items - Answers B. Thorax and Lungs
rationale: the thorax and lungs are part of the physical examination, not part of the health
history. The other answers are all part of a complete health history
Is the following information subjective or objective? Mr. M has shortness of breath that has
persisted for the past 10 days, it is worse with activity, and relieved by rest.
A. Subjective
B. Objective - Answers A. Subjective
Rationale: This is information given by the patient about the circumstances of his chief
complaint. It doesn't represent an objective observation by the examiner
Is the following information subjective or objective? Mr. M has a respiratory rate of 32 and a
pulse rate of 120.
A. Subjective
B. Objective - Answers B. Objective
Rationale: This is a measurement obtained by the examiner, so it is considered objective data.
The patient is unlikely to be able to give this information to the examiner
The following information is recorded in the health history: "The patient had had abdominal pain
for 1 week. The pain lasts for 30 minutes at a time, it comes and goes. The severity is 7 to 9 on
a scale of 1-10. It is accompanied by nausea and vomiting. It is located in the mid-epigastric
area". Which of these categories does it belong to?
A. Chief complaint
B. Present Illness
C. Personal and social history
D. Review of systems - Answers B. Present Illness
Rationale: This info describes the problem of abdominal pain, which is the present illness. The
interviewer has obtained the location, timing, severity, and associated manifestations of the
,pain, the setting in which it occurred, and the factors that aggravate and relieve the pain. You
will notice that it does include portions of the pertinent review of systems, but because it related
directly to the chief complaint, it is included in the history of present illness.
The following information is recorded in the health history: "The patient completed 8th grade.
He currently lives with his wife and two children. He works on old cars on the weekend. He
works in a glass factory during the week. Which category does it belong to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems - Answers C. Personal and social history
Rationale: Personal and social history information includes educational level, family of origin,
current household status, personal interest, employment, religious beliefs, military history, and
lifestyle (including diet and exercise habits; use of alcohol, tobacco, and drugs; sexual
preferences and history). All of this information is documented in this example
The following information is recorded in the health history: "I feel really tired". Which category
does this belong to?
A. Chief complaint
B. Present illness
C. Personal and social history
D. Review of systems - Answers A. Chief complaint
Rationale: The chief complaint is an attempt to quote the patient's own words, as long as they
are suitable to print. It is brief, like a headline, and further details should be sought in the present
illness section. The above information is a chief complaint
The following information is recorded in the health history: "Patient denies chest pain,
palpitations, orthopnea, and paroxysmal nocturnal dyspnea". Which category does this belong
to?
A. Chief complaint
B. Present illness
, C. Personal and social history
D. Review of Systems - Answers D. Review of systems
Rationale: Review of systems documents the presence or absence of common symptoms
related to each major body system. The absence of cardiac symptoms is listed in the above
example
The following information is best placed in which category? "The patient has had 3 Cesarean
sections".
A. Adult illnesses
B. Surgeries
C. Obstetrics/Gynecologic
D. Psychiatric - Answers B. Surgeries
Rationale: A cesarean section is a surgical procedure. Approximate dates or the age of the
patient at the time of the surgery should be recorded
The following information is best placed in which category? "The patient had a stent placed in
the left anterior descending (LAD) artery in 1999"
A. Adult illnesses
B. Surgeries
C. Obstetrics/Gynecologic
D. Psychiatric - Answers A. Adult illnesses
Rationale: The adult illnesses category is reserved for chronic illnesses, significant
hospitalizations, significant injuries, and significant procedures. A stent is a major procedure,
but does not involve a surgeon
The following information is best placed in which category? "The patient was treated for an
asthma exacerbation in the hospital last year, the patient has never been intubated".
A. Adult illnesses
B. Surgeries
