NR 509 WEEK 7 QUIZ / NR509 WEEK 7 QUIZ
: CHAMBERLAIN COLLEGE OF NURSING |
ANSWERS
SECTION I: Health History & Communication (Questions 1–25)
Question 1 (MC)
A 58-year-old patient presents with chest discomfort. Using the OLDCARTS mnemonic, which
component is assessed by asking, "Does the pain radiate to your arm, jaw, or back?"
A. Onset
B. Location
C. Associated symptoms
D. Timing
Correct Answer: C. Associated symptoms
Rationale: Radiation of pain is classified as an associated symptom (A in OLDCARTS). Onset
asks when it started, Location asks where it is, and Timing asks how long it lasts and how often it
occurs. Associated symptoms include radiation, nausea, diaphoresis, and other accompanying
features that help characterize the symptom cluster.
Question 2 (MC)
A 68-year-old male presents with a 2-week history of progressive shortness of breath. Which of
the following is the MOST appropriate open-ended question to begin the history of present
illness?
A. "Did this start suddenly or gradually?"
B. "Tell me more about the shortness of breath you've been experiencing."
C. "Have you had any chest pain with the shortness of breath?"
D. "Rate your shortness of breath on a scale of 1 to 10."
Correct Answer: B. "Tell me more about the shortness of breath you've been
experiencing."
, Rationale: Open-ended questions allow the patient to narrate their experience in their own
words and provide rich, detailed information. This approach is fundamental to patient-centered
interviewing and builds rapport. Options A and D are closed-ended, while C is a leading question
that may bias the patient's response.
Question 3 (MC)
When documenting a patient's chief complaint, which of the following is the BEST practice?
A. Use the patient's own words in quotation marks
B. Paraphrase the patient's symptoms in medical terminology
C. List all possible differential diagnoses
D. Document the clinician's impression of the problem
Correct Answer: A. Use the patient's own words in quotation marks
Rationale: The chief complaint should be documented in the patient's own words to
preserve accuracy and patient perspective. This is a standard component of medical
documentation and helps maintain the patient-centered focus of the history. Using medical
terminology or clinician interpretation introduces bias.
Question 4 (SATA)
A nurse practitioner is creating a genogram to assess a client's family history. Which of the
following are purposes of a genogram? Select all that apply.
A. Identify genetic and familial health risks
B. Identify the client's social support
C. Identify patterns of inheritance for heritable conditions
D. Document the client's lifestyle habits
E. Identify the client's current medications
Correct Answers: A, C
Rationale: A genogram is a visual representation of a client's family history, used to identify
genetic and familial health risks (e.g., heart disease, cancer, diabetes) and patterns of
inheritance. Social support is assessed through the social history, not a genogram. Lifestyle
habits and current medications are separate components of the health history.
,Question 5 (MC)
A 34-year-old male with a history of substance abuse presents to a primary care clinic. He has
experienced adversarial relationships with prior clinicians. Which interview style is MOST
appropriate to promote comprehensive care and patient compliance?
A. Focusing on diagnostic certainty over personal connection
B. Taking charge to meet the clinician's desire for diagnostic information
C. Following the patient's lead to understand their thoughts, ideas, concerns, and requests
D. Deferring respect and empathy to focus on concrete medical needs
Correct Answer: C. Following the patient's lead to understand their thoughts, ideas,
concerns, and requests
Rationale: Patient-centered interviewing that follows the patient's lead builds trust and
therapeutic alliance, especially in patients with prior negative healthcare experiences. This
approach improves adherence and outcomes. Options A, B, and D are paternalistic and may
further alienate the patient.
Question 6 (MC)
A 55-year-old patient reports a family history of breast cancer. Which of the following family
history details is MOST important to document?
A. The age of onset in affected relatives
B. The number of affected relatives
C. The side of the family (maternal vs. paternal)
D. All of the above
Correct Answer: D. All of the above
Rationale: Comprehensive family history documentation includes age of onset, number of
affected relatives, and side of the family, as all these factors influence genetic risk assessment.
Early onset and multiple affected relatives increase suspicion for hereditary syndromes.
Question 7 (MC)
When assessing health literacy, which technique is most effective for ensuring patient
understanding?
, A. Asking "Do you understand?"
B. Using the teach-back method
C. Providing written materials only
D. Speaking more loudly
Correct Answer: B. Using the teach-back method
Rationale: The teach-back method asks patients to explain information in their own words,
which is the most reliable way to confirm comprehension. Asking "do you understand?" often
yields false positives. Written materials alone do not confirm understanding.
Question 8 (MC)
A patient reports drinking alcohol "socially." To obtain objective data about alcohol use, the
nurse practitioner should use which screening tool?
A. CAGE questionnaire
B. PHQ-9
C. GAD-7
D. SLUMS
Correct Answer: A. CAGE questionnaire
Rationale: The CAGE questionnaire (Cut down, Annoyed, Guilty, Eye-opener) is a validated
screening tool for alcohol use disorders. PHQ-9 screens for depression, GAD-7 for anxiety, and
SLUMS for cognitive impairment.
Question 9 (MC)
A patient recently immigrated from Vietnam and speaks limited English. Using the LEARN model
for cultural assessment, what is the first step the nurse practitioner should take?
A. Negotiate a treatment plan
B. Listen to the patient's perception of the illness
C. Recommend a treatment immediately
D. Ask the patient to learn English
Correct Answer: B. Listen to the patient's perception of the illness
: CHAMBERLAIN COLLEGE OF NURSING |
ANSWERS
SECTION I: Health History & Communication (Questions 1–25)
Question 1 (MC)
A 58-year-old patient presents with chest discomfort. Using the OLDCARTS mnemonic, which
component is assessed by asking, "Does the pain radiate to your arm, jaw, or back?"
A. Onset
B. Location
C. Associated symptoms
D. Timing
Correct Answer: C. Associated symptoms
Rationale: Radiation of pain is classified as an associated symptom (A in OLDCARTS). Onset
asks when it started, Location asks where it is, and Timing asks how long it lasts and how often it
occurs. Associated symptoms include radiation, nausea, diaphoresis, and other accompanying
features that help characterize the symptom cluster.
Question 2 (MC)
A 68-year-old male presents with a 2-week history of progressive shortness of breath. Which of
the following is the MOST appropriate open-ended question to begin the history of present
illness?
A. "Did this start suddenly or gradually?"
B. "Tell me more about the shortness of breath you've been experiencing."
C. "Have you had any chest pain with the shortness of breath?"
D. "Rate your shortness of breath on a scale of 1 to 10."
Correct Answer: B. "Tell me more about the shortness of breath you've been
experiencing."
, Rationale: Open-ended questions allow the patient to narrate their experience in their own
words and provide rich, detailed information. This approach is fundamental to patient-centered
interviewing and builds rapport. Options A and D are closed-ended, while C is a leading question
that may bias the patient's response.
Question 3 (MC)
When documenting a patient's chief complaint, which of the following is the BEST practice?
A. Use the patient's own words in quotation marks
B. Paraphrase the patient's symptoms in medical terminology
C. List all possible differential diagnoses
D. Document the clinician's impression of the problem
Correct Answer: A. Use the patient's own words in quotation marks
Rationale: The chief complaint should be documented in the patient's own words to
preserve accuracy and patient perspective. This is a standard component of medical
documentation and helps maintain the patient-centered focus of the history. Using medical
terminology or clinician interpretation introduces bias.
Question 4 (SATA)
A nurse practitioner is creating a genogram to assess a client's family history. Which of the
following are purposes of a genogram? Select all that apply.
A. Identify genetic and familial health risks
B. Identify the client's social support
C. Identify patterns of inheritance for heritable conditions
D. Document the client's lifestyle habits
E. Identify the client's current medications
Correct Answers: A, C
Rationale: A genogram is a visual representation of a client's family history, used to identify
genetic and familial health risks (e.g., heart disease, cancer, diabetes) and patterns of
inheritance. Social support is assessed through the social history, not a genogram. Lifestyle
habits and current medications are separate components of the health history.
,Question 5 (MC)
A 34-year-old male with a history of substance abuse presents to a primary care clinic. He has
experienced adversarial relationships with prior clinicians. Which interview style is MOST
appropriate to promote comprehensive care and patient compliance?
A. Focusing on diagnostic certainty over personal connection
B. Taking charge to meet the clinician's desire for diagnostic information
C. Following the patient's lead to understand their thoughts, ideas, concerns, and requests
D. Deferring respect and empathy to focus on concrete medical needs
Correct Answer: C. Following the patient's lead to understand their thoughts, ideas,
concerns, and requests
Rationale: Patient-centered interviewing that follows the patient's lead builds trust and
therapeutic alliance, especially in patients with prior negative healthcare experiences. This
approach improves adherence and outcomes. Options A, B, and D are paternalistic and may
further alienate the patient.
Question 6 (MC)
A 55-year-old patient reports a family history of breast cancer. Which of the following family
history details is MOST important to document?
A. The age of onset in affected relatives
B. The number of affected relatives
C. The side of the family (maternal vs. paternal)
D. All of the above
Correct Answer: D. All of the above
Rationale: Comprehensive family history documentation includes age of onset, number of
affected relatives, and side of the family, as all these factors influence genetic risk assessment.
Early onset and multiple affected relatives increase suspicion for hereditary syndromes.
Question 7 (MC)
When assessing health literacy, which technique is most effective for ensuring patient
understanding?
, A. Asking "Do you understand?"
B. Using the teach-back method
C. Providing written materials only
D. Speaking more loudly
Correct Answer: B. Using the teach-back method
Rationale: The teach-back method asks patients to explain information in their own words,
which is the most reliable way to confirm comprehension. Asking "do you understand?" often
yields false positives. Written materials alone do not confirm understanding.
Question 8 (MC)
A patient reports drinking alcohol "socially." To obtain objective data about alcohol use, the
nurse practitioner should use which screening tool?
A. CAGE questionnaire
B. PHQ-9
C. GAD-7
D. SLUMS
Correct Answer: A. CAGE questionnaire
Rationale: The CAGE questionnaire (Cut down, Annoyed, Guilty, Eye-opener) is a validated
screening tool for alcohol use disorders. PHQ-9 screens for depression, GAD-7 for anxiety, and
SLUMS for cognitive impairment.
Question 9 (MC)
A patient recently immigrated from Vietnam and speaks limited English. Using the LEARN model
for cultural assessment, what is the first step the nurse practitioner should take?
A. Negotiate a treatment plan
B. Listen to the patient's perception of the illness
C. Recommend a treatment immediately
D. Ask the patient to learn English
Correct Answer: B. Listen to the patient's perception of the illness
