## PART 1 of 5 — Advanced Health Assessment and
Diagnostic Reasoning, 5th Edition
**Textbook:** *Advanced Health Assessment and
Diagnostic Reasoning*, 5th Edition
**Authors:** Jacqueline Rhoads, Sandra Wiggins
Petersen
**Publisher:** Jones & Bartlett Learning
**Target Audience:** Graduate-level APRN, PA, and
medical students in the United States
**Certification Alignment:** APRN certification
examinations (ANCC, AANP), NCCPA PANCE, and
USMLE Step 2 CK
**Part Coverage:** Part 1: Strategies for Effective
Health Assessment (Chapters 1–5)
**Questions:** 1–70
---
## CHAPTER 1: INTERVIEW AND HISTORY-TAKING STRATEGIES — Questions 1–16
**1. A graduate nursing student is conducting a comprehensive health history for a new patient.
Which section of the health history is documented using the patient's own words whenever
possible?**
A. Past medical history
,B. Chief complaint
C. Family history
D. Review of systems
**Correct Answer: B**
**Rationale:** The chief complaint is the patient's reason for seeking care and should be
documented using the patient's own words (a direct quote) whenever possible, preserving the
patient's perspective [citation:2][citation:14]. Option A (past medical history) is documented in the
provider's objective terminology. Option C (family history) may be narrative or a genogram, not a
direct quote. Option D (review of systems) is a systematic checklist of symptoms. Accurate
documentation of the chief complaint in the patient's words preserves the clinical picture and
supports diagnostic reasoning.
---
**2. A clinician is evaluating a patient who reports intermittent chest pain. Using the OLD CART
mnemonic, which attribute is represented by the letter "A"?**
A. Age of onset
B. Aggravating factors
C. Associated symptoms
D. Allergy history
**Correct Answer: B**
**Rationale:** In the OLD CART mnemonic for symptom analysis, "A" stands for Aggravating
factors — what makes the symptom worse [citation:2]. Option A is not a component of OLD CART.
Option C (associated symptoms) is represented by the final "T" in some variants but is not the
primary meaning of "A." Option D (allergies) is a separate section of the health history, not part of
OLD CART. Mastery of structured symptom analysis ensures comprehensive exploration of the
patient's presenting concern.
---
,**3. A clinician is interviewing a patient who is describing a complex symptom. Which interviewing
technique involves repeating the patient's message to confirm understanding?**
A. Clarification
B. Restatement
C. Confrontation
D. Facilitation
**Correct Answer: B**
**Rationale:** Restatement involves repeating what the patient has said to confirm
understanding and encourage further elaboration [citation:14]. Option A (clarification) asks the
patient to explain or elaborate on something unclear. Option C (confrontation) addresses
discrepancies in the patient's story and should be used cautiously. Option D (facilitation) uses verbal
or nonverbal cues to encourage continued communication. Restatement is a foundational active
listening technique that validates the patient's perspective.
---
**4. Which type of health history is most appropriate for a patient presenting with an acute,
potentially life-threatening concern in the emergency department?**
A. Comprehensive history
B. Inventory history
C. Problem-focused history
D. Interim history
**Correct Answer: C**
**Rationale:** A problem-focused (focused) history is appropriate for acute, urgent, or life-
threatening situations where only information directly relevant to the immediate concern is needed
[citation:14]. Option A (comprehensive history) is used for new patients in office or hospital settings
and includes all elements. Option B (inventory history) touches major points to establish a baseline.
Option D (interim history) accounts for events since the last encounter. Selecting the appropriate
scope of history ensures efficiency without sacrificing clinical safety.
, ---
**5. During a patient interview, the clinician uses the technique of "empowering the patient." Which
action best demonstrates this technique?**
A. Providing reassurance that the problem is fully understood
B. Encouraging the patient to ask questions and express concerns about recommendations
C. Summarizing the patient's story to demonstrate active listening
D. Informing the patient when changing directions during the interview
**Correct Answer: B**
**Rationale:** Empowering the patient involves encouraging them to ask questions, express
concerns, and probe recommendations to promote adherence to advice, lifestyle changes, or
medications [citation:8]. Option A describes reassurance. Option C describes summarization. Option
D describes transitions. Empowering the patient supports shared decision-making and therapeutic
partnership.
---
**6. A clinician is taking a health history from a patient who is a poor historian due to cognitive
impairment. Which action is most appropriate?**
A. Document the history as unreliable and proceed with the physical exam
B. Obtain collateral history from a family member or caregiver
C. Skip the history and rely on laboratory data only
D. Continue questioning until the patient provides accurate information
**Correct Answer: B**
**Rationale:** When a patient cannot provide a reliable history, obtaining collateral
information from a family member, caregiver, or prior records is essential to ensure clinical accuracy
Diagnostic Reasoning, 5th Edition
**Textbook:** *Advanced Health Assessment and
Diagnostic Reasoning*, 5th Edition
**Authors:** Jacqueline Rhoads, Sandra Wiggins
Petersen
**Publisher:** Jones & Bartlett Learning
**Target Audience:** Graduate-level APRN, PA, and
medical students in the United States
**Certification Alignment:** APRN certification
examinations (ANCC, AANP), NCCPA PANCE, and
USMLE Step 2 CK
**Part Coverage:** Part 1: Strategies for Effective
Health Assessment (Chapters 1–5)
**Questions:** 1–70
---
## CHAPTER 1: INTERVIEW AND HISTORY-TAKING STRATEGIES — Questions 1–16
**1. A graduate nursing student is conducting a comprehensive health history for a new patient.
Which section of the health history is documented using the patient's own words whenever
possible?**
A. Past medical history
,B. Chief complaint
C. Family history
D. Review of systems
**Correct Answer: B**
**Rationale:** The chief complaint is the patient's reason for seeking care and should be
documented using the patient's own words (a direct quote) whenever possible, preserving the
patient's perspective [citation:2][citation:14]. Option A (past medical history) is documented in the
provider's objective terminology. Option C (family history) may be narrative or a genogram, not a
direct quote. Option D (review of systems) is a systematic checklist of symptoms. Accurate
documentation of the chief complaint in the patient's words preserves the clinical picture and
supports diagnostic reasoning.
---
**2. A clinician is evaluating a patient who reports intermittent chest pain. Using the OLD CART
mnemonic, which attribute is represented by the letter "A"?**
A. Age of onset
B. Aggravating factors
C. Associated symptoms
D. Allergy history
**Correct Answer: B**
**Rationale:** In the OLD CART mnemonic for symptom analysis, "A" stands for Aggravating
factors — what makes the symptom worse [citation:2]. Option A is not a component of OLD CART.
Option C (associated symptoms) is represented by the final "T" in some variants but is not the
primary meaning of "A." Option D (allergies) is a separate section of the health history, not part of
OLD CART. Mastery of structured symptom analysis ensures comprehensive exploration of the
patient's presenting concern.
---
,**3. A clinician is interviewing a patient who is describing a complex symptom. Which interviewing
technique involves repeating the patient's message to confirm understanding?**
A. Clarification
B. Restatement
C. Confrontation
D. Facilitation
**Correct Answer: B**
**Rationale:** Restatement involves repeating what the patient has said to confirm
understanding and encourage further elaboration [citation:14]. Option A (clarification) asks the
patient to explain or elaborate on something unclear. Option C (confrontation) addresses
discrepancies in the patient's story and should be used cautiously. Option D (facilitation) uses verbal
or nonverbal cues to encourage continued communication. Restatement is a foundational active
listening technique that validates the patient's perspective.
---
**4. Which type of health history is most appropriate for a patient presenting with an acute,
potentially life-threatening concern in the emergency department?**
A. Comprehensive history
B. Inventory history
C. Problem-focused history
D. Interim history
**Correct Answer: C**
**Rationale:** A problem-focused (focused) history is appropriate for acute, urgent, or life-
threatening situations where only information directly relevant to the immediate concern is needed
[citation:14]. Option A (comprehensive history) is used for new patients in office or hospital settings
and includes all elements. Option B (inventory history) touches major points to establish a baseline.
Option D (interim history) accounts for events since the last encounter. Selecting the appropriate
scope of history ensures efficiency without sacrificing clinical safety.
, ---
**5. During a patient interview, the clinician uses the technique of "empowering the patient." Which
action best demonstrates this technique?**
A. Providing reassurance that the problem is fully understood
B. Encouraging the patient to ask questions and express concerns about recommendations
C. Summarizing the patient's story to demonstrate active listening
D. Informing the patient when changing directions during the interview
**Correct Answer: B**
**Rationale:** Empowering the patient involves encouraging them to ask questions, express
concerns, and probe recommendations to promote adherence to advice, lifestyle changes, or
medications [citation:8]. Option A describes reassurance. Option C describes summarization. Option
D describes transitions. Empowering the patient supports shared decision-making and therapeutic
partnership.
---
**6. A clinician is taking a health history from a patient who is a poor historian due to cognitive
impairment. Which action is most appropriate?**
A. Document the history as unreliable and proceed with the physical exam
B. Obtain collateral history from a family member or caregiver
C. Skip the history and rely on laboratory data only
D. Continue questioning until the patient provides accurate information
**Correct Answer: B**
**Rationale:** When a patient cannot provide a reliable history, obtaining collateral
information from a family member, caregiver, or prior records is essential to ensure clinical accuracy
