,Maryville NURS 612 Exam 1 | Advanced Health Assessment
(2026) Q&A
1. A 72-year-old patient reports frequent urinary incontinence. When taking the
health history, what is the most appropriate initial response?
A) "That's normal at your age—don't worry."
B) Ask the patient to keep a bladder diary for one week.
C) Explain that surgery is usually required for incontinence.
D) Ask, "Please tell me more about the problem."
Correct Answer: D) Ask, "Please tell me more about the problem."
Rationale: Open-ended questions encourage the patient to describe the symptom in
their own words, preserving the narrative thread. This approach builds rapport and
gathers richer clinical information than closed-ended or dismissive statements.
Asking the patient to elaborate on the problem is the first step in a comprehensive
assessment.
2. A patient reports, "My chest hurts when I walk fast." Using the mnemonic OLD-
CART, the examiner asks about the Location of the pain. What is the correct
question?
A) "What does the pain feel like?"
B) "Can you point to where the pain is?"
C) "Does anything make the pain better?"
D) "How long does the pain last?"
Correct Answer: B) "Can you point to where the pain is?"
,Rationale: OLD-CART stands for Onset, Location, Duration, Character, Aggravating
factors, Relieving factors, and Temporal pattern (or Timing). Asking the patient to
point to the pain specifically addresses the "Location" component of the mnemonic.
3. A 45-year-old patient states she has "always been healthy" but now feels tired.
What should the advanced practice nurse do FIRST?
A) Order a complete blood count and ferritin level.
B) Tell the patient to rest more and return in one month.
C) Ask, "When did you first notice the fatigue?" followed by "What makes it worse or
better?"
D) Refer the patient to a sleep specialist.
Correct Answer: C) Ask, "When did you first notice the fatigue?" followed by "What
makes it worse or better?"
Rationale: Fatigue is a common but nonspecific symptom. The clinician should first
characterize the symptom fully by exploring its onset, duration, and associated
factors before ordering tests or making referrals. This approach ensures a thorough
and accurate assessment.
4. Which interviewing technique is most likely to increase the accuracy of the
patient's history?
A) Using leading questions to confirm suspicions
B) Interrupting the patient to keep the interview on track
C) Asking the patient to describe events in chronological order
D) Relying exclusively on a computer-based questionnaire
Correct Answer: C) Asking the patient to describe events in chronological order
, Rationale: A chronological narrative helps the patient recall details and helps the
clinician understand the sequence and potential relationships among symptoms. It
reduces the chance of missing key information, leading to a more accurate history.
5. A patient becomes tearful while discussing a recent cancer diagnosis. What is the
most appropriate response?
A) "Don't cry—everything will be fine."
B) "I understand this is difficult. Take your time."
C) "We need to stay focused on the medical facts."
D) "Let's move on to the next question."
Correct Answer: B) "I understand this is difficult. Take your time."
Rationale: Acknowledging the patient's emotional response is crucial for building
rapport and trust. Allowing the patient time to process their feelings and providing
empathetic support is more therapeutic than dismissing the emotion or rushing the
interview. This approach demonstrates respect for the patient's experience and
fosters open communication.
6. When performing a cardiovascular assessment, where is the best location to
auscultate the aortic valve?
A) Second intercostal space, right sternal border
B) Second intercostal space, left sternal border
C) Fifth intercostal space, midclavicular line
D) Fourth intercostal space, left sternal border
Correct Answer: A) Second intercostal space, right sternal border
(2026) Q&A
1. A 72-year-old patient reports frequent urinary incontinence. When taking the
health history, what is the most appropriate initial response?
A) "That's normal at your age—don't worry."
B) Ask the patient to keep a bladder diary for one week.
C) Explain that surgery is usually required for incontinence.
D) Ask, "Please tell me more about the problem."
Correct Answer: D) Ask, "Please tell me more about the problem."
Rationale: Open-ended questions encourage the patient to describe the symptom in
their own words, preserving the narrative thread. This approach builds rapport and
gathers richer clinical information than closed-ended or dismissive statements.
Asking the patient to elaborate on the problem is the first step in a comprehensive
assessment.
2. A patient reports, "My chest hurts when I walk fast." Using the mnemonic OLD-
CART, the examiner asks about the Location of the pain. What is the correct
question?
A) "What does the pain feel like?"
B) "Can you point to where the pain is?"
C) "Does anything make the pain better?"
D) "How long does the pain last?"
Correct Answer: B) "Can you point to where the pain is?"
,Rationale: OLD-CART stands for Onset, Location, Duration, Character, Aggravating
factors, Relieving factors, and Temporal pattern (or Timing). Asking the patient to
point to the pain specifically addresses the "Location" component of the mnemonic.
3. A 45-year-old patient states she has "always been healthy" but now feels tired.
What should the advanced practice nurse do FIRST?
A) Order a complete blood count and ferritin level.
B) Tell the patient to rest more and return in one month.
C) Ask, "When did you first notice the fatigue?" followed by "What makes it worse or
better?"
D) Refer the patient to a sleep specialist.
Correct Answer: C) Ask, "When did you first notice the fatigue?" followed by "What
makes it worse or better?"
Rationale: Fatigue is a common but nonspecific symptom. The clinician should first
characterize the symptom fully by exploring its onset, duration, and associated
factors before ordering tests or making referrals. This approach ensures a thorough
and accurate assessment.
4. Which interviewing technique is most likely to increase the accuracy of the
patient's history?
A) Using leading questions to confirm suspicions
B) Interrupting the patient to keep the interview on track
C) Asking the patient to describe events in chronological order
D) Relying exclusively on a computer-based questionnaire
Correct Answer: C) Asking the patient to describe events in chronological order
, Rationale: A chronological narrative helps the patient recall details and helps the
clinician understand the sequence and potential relationships among symptoms. It
reduces the chance of missing key information, leading to a more accurate history.
5. A patient becomes tearful while discussing a recent cancer diagnosis. What is the
most appropriate response?
A) "Don't cry—everything will be fine."
B) "I understand this is difficult. Take your time."
C) "We need to stay focused on the medical facts."
D) "Let's move on to the next question."
Correct Answer: B) "I understand this is difficult. Take your time."
Rationale: Acknowledging the patient's emotional response is crucial for building
rapport and trust. Allowing the patient time to process their feelings and providing
empathetic support is more therapeutic than dismissing the emotion or rushing the
interview. This approach demonstrates respect for the patient's experience and
fosters open communication.
6. When performing a cardiovascular assessment, where is the best location to
auscultate the aortic valve?
A) Second intercostal space, right sternal border
B) Second intercostal space, left sternal border
C) Fifth intercostal space, midclavicular line
D) Fourth intercostal space, left sternal border
Correct Answer: A) Second intercostal space, right sternal border
