Page 1 of 84
NSG 5340 ADVANCED HEALTH ASSESSMENT FINAL EXAM
WITH VERIFIED ANSWERS DETAILED RATIONALES
GRADED A+
NSG 5340 Advanced Health Assessment Final Exam
Section 1: Foundations of Health Assessment & Interviewing (Questions 1–40)
1. During a comprehensive health history interview, the MSN-prepared nurse must ask about
sensitive topics. Which guideline should be followed when broaching sensitive topics?
A. Be direct and confrontational
B. Do not be judgmental
C. Ask about sensitive topics first
D. Avoid eye contact
Rationale: B. When asking about sensitive topics during a comprehensive health history, the
nurse should be nonjudgmental, maintain a professional demeanor, and create a safe
environment for the patient to share information.
2. Which situation calls for a comprehensive health assessment versus a focused assessment?
A. A patient returning for a follow-up visit for hypertension
B. A new patient office visit
C. A patient with an acute ankle injury
D. A patient requesting a medication refill
Rationale: B. A comprehensive health assessment is warranted for new patient office visits,
1|Page
,Page 2 of 84
annual physicals, and initial encounters. Focused assessments are appropriate for established
patients with specific concerns or follow-up visits.
3. What is the first step in performing a comprehensive health history?
A. Review of systems
B. Identifying data
C. Past medical history
D. Family history
Rationale: B. The first step in a comprehensive health history is collecting identifying data,
which includes the patient's name, age, gender, marital status, occupation, and source of
history.
4. During a comprehensive adult health history, which components are part of the past
history portion of the interview? (Select all that apply)
A. Adult illnesses
B. Childhood illnesses
C. Health maintenance
D. Chief complaint
E. Review of systems
Rationale: A, B, C. The past history portion includes adult illnesses, childhood illnesses, and
health maintenance. The chief complaint and review of systems are separate components.
5. When interviewing an older adult patient, which consideration is important to keep in
mind?
A. Older adults always overreport symptoms
B. Older adults may underreport symptomatology
C. Older adults have better recall of recent events
D. Older adults are not reliable historians
Rationale: B. Older adults may underreport symptoms due to fear of institutionalization,
concerns about cost, or beliefs that symptoms are a normal part of aging. The nurse should
probe carefully and validate findings.
2|Page
,Page 3 of 84
6. Which health interview question is the most open-ended?
A. "Does your cough bring up mucous?"
B. "How would you describe your back pain?"
C. "When did the pain begin?"
D. "Is the pain sharp or dull?"
Rationale: B. Open-ended questions like "How would you describe your back pain?"
encourage the patient to provide narrative information in their own words. Closed-ended
questions elicit brief, specific responses.
7. A patient is having difficulty describing the characteristics of their symptoms. What is the
best approach for the nurse to take?
A. Repeat the question louder
B. Offer the patient multiple-choice answers
C. Document that the patient is unable to provide history
D. Skip this part of the interview
Rationale: B. When a patient has difficulty describing symptoms, offering multiple-choice
options can help them articulate their experience without leading them to a specific
diagnosis.
8. The MSN-prepared nurse is unfamiliar with the patient's chronic illness. What is the nurse's
best response?
A. "I know exactly what you're going through."
B. "Tell me more about how this condition affects your daily life."
C. "That condition is not really my area of expertise."
D. "You should see a specialist for that."
Rationale: B. The nurse should use therapeutic communication to explore the patient's
experience rather than pretending to understand or dismissing the patient's concern.
9. During a patient-centered interview, which stage involves inviting the patient's story?
A. Stage 1
B. Stage 2
3|Page
, Page 4 of 84
C. Stage 3
D. Stage 4
Rationale: C. In the patient-centered interviewing model, Stage 3 involves inviting the
patient's story and exploring their perspective.
10. A 62-year-old male presents to the clinic for an initial visit. Which component of the
health history should the APN elicit FIRST according to the patient-centered interviewing
model?
A. Review of systems using a head-to-toe approach
B. Chief complaint in the patient's own words
C. Past medical history including hospitalizations and surgeries
D. Family history with a three-generation pedigree
Rationale: B. In patient-centered interviewing, the chief complaint (CC), recorded in the
patient's own words and often quoted, is always elicited first after establishing rapport. The
CC frames the entire encounter and directs the subsequent History of Present Illness (HPI).
11. A 45-year-old female reports chest pain for the past three days. The APN uses the
OLDCARTS mnemonic to structure the HPI. Which element of OLDCARTS addresses the
patient's report that the pain 'feels like an elephant sitting on my chest'?
A. O- Onset
B. L- Location
C. C- Character
D. R- Radiation
Rationale: C. The 'C' in OLDCARTS represents Character, which captures the descriptive quality
of the symptom in the patient's own words (e.g., 'crushing,' 'burning,' 'elephant on chest').
Onset refers to when the symptom began, Location identifies where it is.
12. Which of the following is considered subjective data?
A. Blood pressure of 148/88 mmHg
B. Temperature of 38.2°C
C. Patient reports experiencing chest pressure
4|Page
NSG 5340 ADVANCED HEALTH ASSESSMENT FINAL EXAM
WITH VERIFIED ANSWERS DETAILED RATIONALES
GRADED A+
NSG 5340 Advanced Health Assessment Final Exam
Section 1: Foundations of Health Assessment & Interviewing (Questions 1–40)
1. During a comprehensive health history interview, the MSN-prepared nurse must ask about
sensitive topics. Which guideline should be followed when broaching sensitive topics?
A. Be direct and confrontational
B. Do not be judgmental
C. Ask about sensitive topics first
D. Avoid eye contact
Rationale: B. When asking about sensitive topics during a comprehensive health history, the
nurse should be nonjudgmental, maintain a professional demeanor, and create a safe
environment for the patient to share information.
2. Which situation calls for a comprehensive health assessment versus a focused assessment?
A. A patient returning for a follow-up visit for hypertension
B. A new patient office visit
C. A patient with an acute ankle injury
D. A patient requesting a medication refill
Rationale: B. A comprehensive health assessment is warranted for new patient office visits,
1|Page
,Page 2 of 84
annual physicals, and initial encounters. Focused assessments are appropriate for established
patients with specific concerns or follow-up visits.
3. What is the first step in performing a comprehensive health history?
A. Review of systems
B. Identifying data
C. Past medical history
D. Family history
Rationale: B. The first step in a comprehensive health history is collecting identifying data,
which includes the patient's name, age, gender, marital status, occupation, and source of
history.
4. During a comprehensive adult health history, which components are part of the past
history portion of the interview? (Select all that apply)
A. Adult illnesses
B. Childhood illnesses
C. Health maintenance
D. Chief complaint
E. Review of systems
Rationale: A, B, C. The past history portion includes adult illnesses, childhood illnesses, and
health maintenance. The chief complaint and review of systems are separate components.
5. When interviewing an older adult patient, which consideration is important to keep in
mind?
A. Older adults always overreport symptoms
B. Older adults may underreport symptomatology
C. Older adults have better recall of recent events
D. Older adults are not reliable historians
Rationale: B. Older adults may underreport symptoms due to fear of institutionalization,
concerns about cost, or beliefs that symptoms are a normal part of aging. The nurse should
probe carefully and validate findings.
2|Page
,Page 3 of 84
6. Which health interview question is the most open-ended?
A. "Does your cough bring up mucous?"
B. "How would you describe your back pain?"
C. "When did the pain begin?"
D. "Is the pain sharp or dull?"
Rationale: B. Open-ended questions like "How would you describe your back pain?"
encourage the patient to provide narrative information in their own words. Closed-ended
questions elicit brief, specific responses.
7. A patient is having difficulty describing the characteristics of their symptoms. What is the
best approach for the nurse to take?
A. Repeat the question louder
B. Offer the patient multiple-choice answers
C. Document that the patient is unable to provide history
D. Skip this part of the interview
Rationale: B. When a patient has difficulty describing symptoms, offering multiple-choice
options can help them articulate their experience without leading them to a specific
diagnosis.
8. The MSN-prepared nurse is unfamiliar with the patient's chronic illness. What is the nurse's
best response?
A. "I know exactly what you're going through."
B. "Tell me more about how this condition affects your daily life."
C. "That condition is not really my area of expertise."
D. "You should see a specialist for that."
Rationale: B. The nurse should use therapeutic communication to explore the patient's
experience rather than pretending to understand or dismissing the patient's concern.
9. During a patient-centered interview, which stage involves inviting the patient's story?
A. Stage 1
B. Stage 2
3|Page
, Page 4 of 84
C. Stage 3
D. Stage 4
Rationale: C. In the patient-centered interviewing model, Stage 3 involves inviting the
patient's story and exploring their perspective.
10. A 62-year-old male presents to the clinic for an initial visit. Which component of the
health history should the APN elicit FIRST according to the patient-centered interviewing
model?
A. Review of systems using a head-to-toe approach
B. Chief complaint in the patient's own words
C. Past medical history including hospitalizations and surgeries
D. Family history with a three-generation pedigree
Rationale: B. In patient-centered interviewing, the chief complaint (CC), recorded in the
patient's own words and often quoted, is always elicited first after establishing rapport. The
CC frames the entire encounter and directs the subsequent History of Present Illness (HPI).
11. A 45-year-old female reports chest pain for the past three days. The APN uses the
OLDCARTS mnemonic to structure the HPI. Which element of OLDCARTS addresses the
patient's report that the pain 'feels like an elephant sitting on my chest'?
A. O- Onset
B. L- Location
C. C- Character
D. R- Radiation
Rationale: C. The 'C' in OLDCARTS represents Character, which captures the descriptive quality
of the symptom in the patient's own words (e.g., 'crushing,' 'burning,' 'elephant on chest').
Onset refers to when the symptom began, Location identifies where it is.
12. Which of the following is considered subjective data?
A. Blood pressure of 148/88 mmHg
B. Temperature of 38.2°C
C. Patient reports experiencing chest pressure
4|Page
