NU 325 Exam 3 (PDF) | (Updated) Health Assessment
Exam-Style Questions — 200 Questions
Section 1: Health History and Interview Techniques (Questions 1-17)
1 A patient uses a metaphor to describe their pain: 'It feels like a knife twisting inside.' Which interview technique
is most appropriate to clarify this description without leading the patient?
A) Reflection: 'You say it feels like a knife twisting inside.'
B) Facilitation: 'Go on, tell me more about that sensation.'
C) Clarification: 'Can you describe what you mean by a knife twisting?'
D) Confrontation: 'That sounds like severe pain; is it a 10 out of 10?'
Answer: C
Rationale: Clarification is used when the patient's statement is vague or metaphorical, asking for elaboration without
imposing the clinician's interpretation. Reflection repeats the patient's words, which may not clarify. Facilitation
encourages continuation but doesn't specify clarification. Confrontation introduces a numeric scale, which may lead
the patient.
2 During an interview, a patient repeatedly looks away and crosses their arms when discussing a particular
symptom. Which approach best addresses the potential emotional distress without causing discomfort?
A) Directly ask: 'Why do you look away when I ask about that symptom?'
B) Pause and use silence to allow the patient to gather thoughts.
C) Change the subject to a less sensitive topic and revisit later.
D) Empathize: 'I notice you seem uncomfortable; we can discuss this later if you prefer.'
Answer: D
Rationale: Empathy and offering control to the patient respects their emotional state and builds trust. Direct
confrontation (A) may increase anxiety. Silence (B) might be misinterpreted as judgment. Changing the subject (C)
may avoid the issue entirely, missing important data.
3 A patient reports 'I've been feeling tired all the time, but I don't know why.' Which response demonstrates the
use of open-ended questioning to explore the symptom further?
A) Do you have trouble sleeping at night?
B) How has this tiredness affected your daily activities?
C) Is the tiredness related to stress or depression?
D) When did the tiredness first begin?
Answer: B
Rationale: Open-ended questions allow the patient to describe the impact in their own words, providing richer data.
'How' and 'what' prompts encourage narrative. Options A, C, and D are closed-ended or leading, limiting the
patient's response.
4 A patient from a culture where direct eye contact is considered disrespectful avoids eye contact during the
interview. The nurse's best action is to:
A) Politely ask the patient to maintain eye contact for effective communication.
B) Continue the interview without commenting on the behavior.
C) Explain that in this setting, eye contact is a sign of honesty.
D) Document the behavior as a potential sign of anxiety or deception.
,Answer: B
Rationale: Cultural competence requires adapting to the patient's norms without imposing one's own. Asking to
change (A) or explaining (C) may disrespect cultural values. Documenting as abnormal (D) is ethnocentric and
inaccurate.
5 Which statement best reflects the principle of 'patient-centered interviewing' in health history collection?
A) The clinician directs the interview based on the patient's chief complaint and medical history.
B) The interview focuses on the patient's illness experience, including their ideas, concerns, and expectations.
C) The clinician uses a standardized checklist to ensure all relevant topics are covered efficiently.
D) The interview prioritizes the clinician's agenda of gathering data for diagnosis and treatment.
Answer: B
Rationale: Patient-centered interviewing emphasizes understanding the patient's perspective, including their ideas
about cause, concerns, and expectations. Option A is clinician-directed, C is checklist-based, and D is
clinician-centered, all of which may miss the patient's unique context.
6 A patient provides a detailed narrative about their symptoms but frequently goes off-topic. Which technique is
most effective in redirecting the interview without disrupting rapport?
A) Interrupt politely and say, 'Let's focus on the main problem.'
B) Use a transition statement: 'Thank you for sharing that. Now, to help me understand better, tell me about
when the pain started.'
C) Allow the patient to continue uninterrupted until they finish.
D) Ask closed-ended questions to regain control of the interview.
Answer: B
Rationale: Transition statements acknowledge the patient's contribution while guiding back to relevant topics,
preserving rapport. Interrupting (A) may seem dismissive; allowing unlimited digression (C) wastes time;
closed-ended questions (D) may limit information.
7 A patient reports 'I have a history of high blood pressure, but I'm not sure about the numbers.' Which response
demonstrates the use of probing to obtain more precise data?
A) Do you remember the approximate values or the medication you take?
B) You should try to find your records for accuracy.
C) It's important to know your numbers; can you check and let me know?
D) Who manages your blood pressure, and when was it last checked?
Answer: A
Rationale: Probing involves asking for specific details or alternatives to recall, such as approximate values or
medication names. Option D asks about management but not numbers. Options B and C defer the question,
potentially losing the opportunity for immediate data.
8 During an interview, the patient says, 'I don't think the medication is working.' The nurse responds, 'You feel the
medication is not effective.' This is an example of:
A) Empathy
B) Summarization
C) Restatement
D) Interpretation
Answer: C
Rationale: Restatement repeats the patient's statement in similar words to confirm understanding. Empathy involves
recognizing feelings. Summarization condenses multiple statements. Interpretation adds meaning, which can be
,biased.
9 Which of the following best describes the purpose of the 'review of systems' in a health history interview?
A) To confirm the diagnosis based on the patient's chief complaint.
B) To systematically evaluate each body system for symptoms not yet mentioned.
C) To assess the patient's overall functional status and quality of life.
D) To gather detailed information about the patient's past medical history.
Answer: B
Rationale: The review of systems is a systematic inventory of body systems to uncover symptoms the patient may
have omitted. It is not for diagnosis (A) or functional status (C) or past medical history (D), though it complements
those areas.
10 A patient becomes tearful when discussing a recent loss. The nurse's most therapeutic response is:
A) Offer a tissue and say, 'I can see this is difficult for you.'
B) Change the subject to reduce emotional distress.
C) Say, 'It's okay, let's move on to something else.'
D) Ask, 'Why are you crying?' to explore the emotion.
Answer: A
Rationale: Acknowledging the emotion with empathy and offering a tissue validates the patient's feelings without
pushing. Changing the subject (B, C) dismisses the emotion. Asking 'why' (D) may feel interrogative and increase
distress.
11 A patient presents with a complex medical history involving multiple chronic conditions. During the health
history interview, the patient provides inconsistent responses regarding medication adherence. Which
interviewing technique is most appropriate to clarify discrepancies without compromising trust?
A) Confront the patient directly with the inconsistencies and demand clarification
B) Use a series of closed-ended questions to pin down exact medication timing
C) Employ a facilitative statement such as, 'Tell me more about how you take your medications each day'
D) Review the electronic health record aloud and ask the patient to correct any errors
Answer: C
Rationale: Facilitative statements (e.g., 'tell me more') encourage elaboration without judgment, preserving rapport
while gathering accurate data. Direct confrontation (A) damages trust; closed-ended questions (B) limit depth;
reading the record aloud (D) may seem accusatory and lead to defensive responses.
12 During a health history interview, a patient uses a culturally specific term to describe a symptom. The nurse is
unfamiliar with the term. Which action best demonstrates cultural humility and accurate data collection?
A) Ask the patient to use standard medical terminology to ensure clarity
B) Acknowledge the term and ask the patient to explain what it means in their own words
C) Document the term verbatim and research its meaning after the interview
D) Use a medical interpreter to translate the term into English
Answer: B
Rationale: Asking the patient to explain the term validates their cultural perspective while obtaining precise
meaning. Requiring standard terminology (A) dismisses cultural context; researching later (C) risks
misunderstanding; using an interpreter (D) may be unnecessary if the patient speaks English and the term is
cultural, not linguistic.
, 13 Which of the following best describes the purpose of the 'review of systems' (ROS) in the context of a
comprehensive health history interview?
A) To confirm the diagnosis suggested by the chief complaint
B) To systematically identify subjective symptoms across all body systems, including those not mentioned in the
chief complaint
C) To prioritize the patient's concerns based on severity
D) To document objective physical findings from the examination
Answer: B
Rationale: The ROS is a systematic inventory of subjective symptoms from each body system, aiming to detect
symptoms the patient may have forgotten or not linked to the chief complaint. It does not confirm diagnoses (A),
prioritize concerns (C), or record objective findings (D).
14 A patient reports a history of 'anxiety attacks.' When exploring this symptom, which question is most effective
for eliciting the chronology and pattern of the episodes?
A) Do your anxiety attacks occur more often in the morning or evening?
B) Can you describe what happens from the moment you start to feel anxious until it resolves?
C) How many anxiety attacks have you had in the past week?
D) What triggers your anxiety attacks?
Answer: B
Rationale: Asking for a sequential description from onset to resolution captures chronology and pattern
comprehensively. Option A focuses only on time of day; C quantifies frequency but not pattern; D addresses
triggers but not the full temporal sequence.
15 When interviewing a patient who is visibly distressed and crying, which approach best balances empathy with
the need to complete the health history?
A) Continue with the interview as planned to avoid delaying care
B) Pause the interview, offer a tissue, and say, 'I can see this is difficult. Would you like to take a moment?'
C) Switch to closed-ended questions to reduce emotional burden
D) Provide reassurance by saying, 'Don't worry, everything will be fine'
Answer: B
Rationale: Acknowledging the patient's emotion and offering control respects their distress while maintaining
therapeutic rapport. Continuing as planned (A) dismisses feelings; closed-ended questions (C) may seem
impersonal; false reassurance (D) invalidates the patient's experience.
16 A patient provides a lengthy, tangential response to an open-ended question about their chief complaint. Which
interviewing technique is most appropriate to refocus the interview while preserving the therapeutic
relationship?
A) Interrupt and redirect with a direct, closed-ended question
B) Use a summarizing statement to capture key points and then guide back to the topic
C) Allow the patient to continue until they naturally return to the topic
D) Note the tangential behavior in the chart and proceed with the physical exam
Answer: B
Rationale: Summarizing shows active listening and respect, then a gentle redirect maintains focus without
abruptness. Interrupting (A) can damage rapport; allowing continuation (C) wastes time; proceeding to exam (D)
abandons the history.
Exam-Style Questions — 200 Questions
Section 1: Health History and Interview Techniques (Questions 1-17)
1 A patient uses a metaphor to describe their pain: 'It feels like a knife twisting inside.' Which interview technique
is most appropriate to clarify this description without leading the patient?
A) Reflection: 'You say it feels like a knife twisting inside.'
B) Facilitation: 'Go on, tell me more about that sensation.'
C) Clarification: 'Can you describe what you mean by a knife twisting?'
D) Confrontation: 'That sounds like severe pain; is it a 10 out of 10?'
Answer: C
Rationale: Clarification is used when the patient's statement is vague or metaphorical, asking for elaboration without
imposing the clinician's interpretation. Reflection repeats the patient's words, which may not clarify. Facilitation
encourages continuation but doesn't specify clarification. Confrontation introduces a numeric scale, which may lead
the patient.
2 During an interview, a patient repeatedly looks away and crosses their arms when discussing a particular
symptom. Which approach best addresses the potential emotional distress without causing discomfort?
A) Directly ask: 'Why do you look away when I ask about that symptom?'
B) Pause and use silence to allow the patient to gather thoughts.
C) Change the subject to a less sensitive topic and revisit later.
D) Empathize: 'I notice you seem uncomfortable; we can discuss this later if you prefer.'
Answer: D
Rationale: Empathy and offering control to the patient respects their emotional state and builds trust. Direct
confrontation (A) may increase anxiety. Silence (B) might be misinterpreted as judgment. Changing the subject (C)
may avoid the issue entirely, missing important data.
3 A patient reports 'I've been feeling tired all the time, but I don't know why.' Which response demonstrates the
use of open-ended questioning to explore the symptom further?
A) Do you have trouble sleeping at night?
B) How has this tiredness affected your daily activities?
C) Is the tiredness related to stress or depression?
D) When did the tiredness first begin?
Answer: B
Rationale: Open-ended questions allow the patient to describe the impact in their own words, providing richer data.
'How' and 'what' prompts encourage narrative. Options A, C, and D are closed-ended or leading, limiting the
patient's response.
4 A patient from a culture where direct eye contact is considered disrespectful avoids eye contact during the
interview. The nurse's best action is to:
A) Politely ask the patient to maintain eye contact for effective communication.
B) Continue the interview without commenting on the behavior.
C) Explain that in this setting, eye contact is a sign of honesty.
D) Document the behavior as a potential sign of anxiety or deception.
,Answer: B
Rationale: Cultural competence requires adapting to the patient's norms without imposing one's own. Asking to
change (A) or explaining (C) may disrespect cultural values. Documenting as abnormal (D) is ethnocentric and
inaccurate.
5 Which statement best reflects the principle of 'patient-centered interviewing' in health history collection?
A) The clinician directs the interview based on the patient's chief complaint and medical history.
B) The interview focuses on the patient's illness experience, including their ideas, concerns, and expectations.
C) The clinician uses a standardized checklist to ensure all relevant topics are covered efficiently.
D) The interview prioritizes the clinician's agenda of gathering data for diagnosis and treatment.
Answer: B
Rationale: Patient-centered interviewing emphasizes understanding the patient's perspective, including their ideas
about cause, concerns, and expectations. Option A is clinician-directed, C is checklist-based, and D is
clinician-centered, all of which may miss the patient's unique context.
6 A patient provides a detailed narrative about their symptoms but frequently goes off-topic. Which technique is
most effective in redirecting the interview without disrupting rapport?
A) Interrupt politely and say, 'Let's focus on the main problem.'
B) Use a transition statement: 'Thank you for sharing that. Now, to help me understand better, tell me about
when the pain started.'
C) Allow the patient to continue uninterrupted until they finish.
D) Ask closed-ended questions to regain control of the interview.
Answer: B
Rationale: Transition statements acknowledge the patient's contribution while guiding back to relevant topics,
preserving rapport. Interrupting (A) may seem dismissive; allowing unlimited digression (C) wastes time;
closed-ended questions (D) may limit information.
7 A patient reports 'I have a history of high blood pressure, but I'm not sure about the numbers.' Which response
demonstrates the use of probing to obtain more precise data?
A) Do you remember the approximate values or the medication you take?
B) You should try to find your records for accuracy.
C) It's important to know your numbers; can you check and let me know?
D) Who manages your blood pressure, and when was it last checked?
Answer: A
Rationale: Probing involves asking for specific details or alternatives to recall, such as approximate values or
medication names. Option D asks about management but not numbers. Options B and C defer the question,
potentially losing the opportunity for immediate data.
8 During an interview, the patient says, 'I don't think the medication is working.' The nurse responds, 'You feel the
medication is not effective.' This is an example of:
A) Empathy
B) Summarization
C) Restatement
D) Interpretation
Answer: C
Rationale: Restatement repeats the patient's statement in similar words to confirm understanding. Empathy involves
recognizing feelings. Summarization condenses multiple statements. Interpretation adds meaning, which can be
,biased.
9 Which of the following best describes the purpose of the 'review of systems' in a health history interview?
A) To confirm the diagnosis based on the patient's chief complaint.
B) To systematically evaluate each body system for symptoms not yet mentioned.
C) To assess the patient's overall functional status and quality of life.
D) To gather detailed information about the patient's past medical history.
Answer: B
Rationale: The review of systems is a systematic inventory of body systems to uncover symptoms the patient may
have omitted. It is not for diagnosis (A) or functional status (C) or past medical history (D), though it complements
those areas.
10 A patient becomes tearful when discussing a recent loss. The nurse's most therapeutic response is:
A) Offer a tissue and say, 'I can see this is difficult for you.'
B) Change the subject to reduce emotional distress.
C) Say, 'It's okay, let's move on to something else.'
D) Ask, 'Why are you crying?' to explore the emotion.
Answer: A
Rationale: Acknowledging the emotion with empathy and offering a tissue validates the patient's feelings without
pushing. Changing the subject (B, C) dismisses the emotion. Asking 'why' (D) may feel interrogative and increase
distress.
11 A patient presents with a complex medical history involving multiple chronic conditions. During the health
history interview, the patient provides inconsistent responses regarding medication adherence. Which
interviewing technique is most appropriate to clarify discrepancies without compromising trust?
A) Confront the patient directly with the inconsistencies and demand clarification
B) Use a series of closed-ended questions to pin down exact medication timing
C) Employ a facilitative statement such as, 'Tell me more about how you take your medications each day'
D) Review the electronic health record aloud and ask the patient to correct any errors
Answer: C
Rationale: Facilitative statements (e.g., 'tell me more') encourage elaboration without judgment, preserving rapport
while gathering accurate data. Direct confrontation (A) damages trust; closed-ended questions (B) limit depth;
reading the record aloud (D) may seem accusatory and lead to defensive responses.
12 During a health history interview, a patient uses a culturally specific term to describe a symptom. The nurse is
unfamiliar with the term. Which action best demonstrates cultural humility and accurate data collection?
A) Ask the patient to use standard medical terminology to ensure clarity
B) Acknowledge the term and ask the patient to explain what it means in their own words
C) Document the term verbatim and research its meaning after the interview
D) Use a medical interpreter to translate the term into English
Answer: B
Rationale: Asking the patient to explain the term validates their cultural perspective while obtaining precise
meaning. Requiring standard terminology (A) dismisses cultural context; researching later (C) risks
misunderstanding; using an interpreter (D) may be unnecessary if the patient speaks English and the term is
cultural, not linguistic.
, 13 Which of the following best describes the purpose of the 'review of systems' (ROS) in the context of a
comprehensive health history interview?
A) To confirm the diagnosis suggested by the chief complaint
B) To systematically identify subjective symptoms across all body systems, including those not mentioned in the
chief complaint
C) To prioritize the patient's concerns based on severity
D) To document objective physical findings from the examination
Answer: B
Rationale: The ROS is a systematic inventory of subjective symptoms from each body system, aiming to detect
symptoms the patient may have forgotten or not linked to the chief complaint. It does not confirm diagnoses (A),
prioritize concerns (C), or record objective findings (D).
14 A patient reports a history of 'anxiety attacks.' When exploring this symptom, which question is most effective
for eliciting the chronology and pattern of the episodes?
A) Do your anxiety attacks occur more often in the morning or evening?
B) Can you describe what happens from the moment you start to feel anxious until it resolves?
C) How many anxiety attacks have you had in the past week?
D) What triggers your anxiety attacks?
Answer: B
Rationale: Asking for a sequential description from onset to resolution captures chronology and pattern
comprehensively. Option A focuses only on time of day; C quantifies frequency but not pattern; D addresses
triggers but not the full temporal sequence.
15 When interviewing a patient who is visibly distressed and crying, which approach best balances empathy with
the need to complete the health history?
A) Continue with the interview as planned to avoid delaying care
B) Pause the interview, offer a tissue, and say, 'I can see this is difficult. Would you like to take a moment?'
C) Switch to closed-ended questions to reduce emotional burden
D) Provide reassurance by saying, 'Don't worry, everything will be fine'
Answer: B
Rationale: Acknowledging the patient's emotion and offering control respects their distress while maintaining
therapeutic rapport. Continuing as planned (A) dismisses feelings; closed-ended questions (C) may seem
impersonal; false reassurance (D) invalidates the patient's experience.
16 A patient provides a lengthy, tangential response to an open-ended question about their chief complaint. Which
interviewing technique is most appropriate to refocus the interview while preserving the therapeutic
relationship?
A) Interrupt and redirect with a direct, closed-ended question
B) Use a summarizing statement to capture key points and then guide back to the topic
C) Allow the patient to continue until they naturally return to the topic
D) Note the tangential behavior in the chart and proceed with the physical exam
Answer: B
Rationale: Summarizing shows active listening and respect, then a gentle redirect maintains focus without
abruptness. Interrupting (A) can damage rapport; allowing continuation (C) wastes time; proceeding to exam (D)
abandons the history.
