ASSESSMENT & CLINICAL REASONING
MASTERY | Complete Nursing Assessment
Framework | 600+ Cases & Diagnostic Thinking
Exercises | 2026/2027
Chamberlain University, College of Nursing | 2026/2027 Academic Year
Exam Instructions: This exam consists of 50 questions based on the 2026/2027 NR 302
curriculum. It evaluates your knowledge of foundational health assessment techniques,
normal versus abnormal findings, and initial clinical reasoning. Select the nurse's most
appropriate action or interpretation. Time: 80 minutes.
1. A 34-year-old woman arrives for a routine physical. The nurse begins the health
history. Which action should the nurse take first?
A) Ask the patient to list current medications.
B) Introduce self and explain the purpose and process of the interview.
C) Immediately start with demographic verification.
D) Request the patient complete a paper checklist while the nurse reviews the
chart.
Rationale: B is correct. The 2026 ANA Health Assessment Standard emphasizes
establishing rapport and trust before data collection. Introducing self and clarifying
purpose reduces anxiety and sets a collaborative tone. Option A skips rapport-building.
Option C is clerical and impersonal. Option D delegates history-taking prematurely and
may overlook verbal cues.
, 2. A 55-year-old man says, “I’ve been having chest discomfort.” Which response
best elicits additional data using COLDSPA?
A) “What medications are you taking?”
B) “Point to where it hurts.”
C) “Describe the discomfort and anything that makes it better or worse.”
[CORRECT]
D) “Have you seen a doctor for this?”
Rationale: C is correct. COLDSPA (Character, Onset, Location, Duration, Severity, Pattern,
Associated factors) guides symptom analysis. Asking for description and alleviating
factors addresses Character and Pattern. Option A jumps to medications. Option B
covers only Location. Option D focuses on past care, not current symptom details.
3. A 27-year-old recent immigrant from Guatemala is accompanied by her bilingual
sister. Which communication strategy is most appropriate?
A) Conduct the interview in English with occasional Spanish greetings.
B) Ask the sister to translate medical questions.
C) Use a qualified medical interpreter and maintain eye contact with the patient.
D) Speak slowly and loudly in English.
Rationale: C is correct. The 2026 Joint Commission CLAS standards require qualified
interpreters to ensure accuracy and confidentiality. Eye contact respects patient dignity.
Option A risks miscommunication. Option B breaches confidentiality. Option D is
ineffective and culturally insensitive.
4. A 40-year-old woman becomes tearful when discussing recent divorce. Which
therapeutic response is best?
A) “Don’t worry, you’ll meet someone new.”
B) “Let’s move on to your medical history.”
C) Silent presence with gentle eye contact [CORRECT]
D) “I know exactly how you feel.”
Rationale: C is correct. Silent presence conveys acceptance and allows emotional
expression without interruption (2026 APA supportive communication guidelines).
Option A offers premature reassurance. Option B avoids emotion. Option D assumes
shared experience.