NU 325 Exam 2 (PDF) | (Updated) Health Assessment
Exam-Style Questions — 190 Questions
Section 1: Health History and Interview Techniques (Questions 1-17)
1 During a health history interview, a patient provides a vague description of chest discomfort. Which
interviewing technique is most effective for eliciting a clear, detailed description of the symptom?
A) Use closed-ended questions to narrow down possibilities quickly.
B) Employ the mnemonic PQRSTU to systematically explore the symptom.
C) Paraphrase the patient's statement to confirm understanding.
D) Ask leading questions to guide the patient toward cardiac symptoms.
Answer: B
Rationale: The PQRSTU mnemonic (Provocative/Palliative, Quality, Region/Radiation, Severity, Timing,
Understanding) is a structured approach to elicit comprehensive symptom details. Closed-ended questions may
miss nuances, paraphrasing confirms but doesn't explore, and leading questions introduce bias.
2 A patient being interviewed for a health history suddenly becomes tearful when discussing a recent loss. Which
response by the nurse best demonstrates therapeutic communication?
A) Offer a tissue and say, 'I can see this is difficult. Would you like to take a break?'
B) Acknowledge the emotion and say, 'Tell me more about what happened.'
C) Redirect the interview to less sensitive topics to reduce distress.
D) Provide reassurance by saying, 'Everything will be okay in time.'
Answer: A
Rationale: Option A validates the patient's emotion, offers support, and respects autonomy by allowing a pause.
Option B may push too quickly into details. Redirecting avoids the issue, and false reassurance dismisses the
patient's feelings.
3 When interviewing a patient from a culture that values family decision-making, which approach is most
appropriate for obtaining a health history?
A) Insist on speaking only with the patient to maintain confidentiality.
B) Ask the patient if they prefer to have family members present during the interview.
C) Interview the family separately to gather collateral information.
D) Use a medical interpreter to ensure accurate communication.
Answer: B
Rationale: Respecting cultural preferences involves asking the patient about their wishes regarding family
involvement. Option A may violate cultural norms, option C may bypass the patient's autonomy, and option D
addresses language but not decision-making preferences.
4 A patient reports 'feeling tired all the time' but provides no other details. Which open-ended question is most
likely to elicit additional information about the fatigue?
A) Do you have trouble sleeping at night?
B) Can you describe what you mean by 'tired'?
C) Is the fatigue related to stress or depression?
D) How long have you been feeling this way?
Answer: B
,Rationale: Option B uses an open-ended request for description, allowing the patient to define fatigue in their own
words. Option A is closed, option C is leading, and option D is closed-ended (though it asks duration, it doesn't
explore quality).
5 During a health history, a patient gives inconsistent answers about alcohol use. Which technique is most
appropriate to clarify the discrepancy?
A) Confront the patient directly about the inconsistency.
B) Use the CAGE questionnaire to screen for alcohol problems.
C) Revisit the question later with different phrasing.
D) Document the inconsistency and move on to avoid confrontation.
Answer: C
Rationale: Revisiting the question later with different phrasing reduces defensiveness and may yield more accurate
information. Direct confrontation (A) can damage rapport; using CAGE (B) assumes a problem; ignoring (D)
misses important data.
6 A patient with limited English proficiency presents for a health history. A family member offers to interpret.
What is the nurse's best action?
A) Proceed with the family member as interpreter to build trust.
B) Use a professional medical interpreter to ensure accuracy and confidentiality.
C) Speak slowly and use simple English to communicate directly.
D) Use written translated materials and have the patient read them.
Answer: B
Rationale: Professional interpreters maintain accuracy, confidentiality, and avoid bias or omission. Family members
may filter information or feel uncomfortable with sensitive topics. Options C and D risk misunderstandings.
7 When taking a sexual history, which question demonstrates a nonjudgmental and inclusive approach?
A) Are you sexually active with men, women, or both?
B) Do you have sex with men, women, or both?
C) What is the sex of your partner(s)?
D) Tell me about your sexual activity and partners.
Answer: D
Rationale: Option D is the most open-ended and does not assume categories or labels. Options A, B, and C use
potentially limiting terminology and may inadvertently exclude individuals who do not identify with those labels.
8 A patient reports intermittent headaches. Which component of the health history is most critical to assess first to
identify potential red flags?
A) Family history of migraines.
B) Onset, duration, and associated symptoms like fever or neck stiffness.
C) Medication history including over-the-counter analgesics.
D) Impact on daily activities and quality of life.
Answer: B
Rationale: Assessing onset, duration, and associated symptoms (e.g., fever, neck stiffness) helps identify
life-threatening conditions like meningitis or subarachnoid hemorrhage. Other options are important but secondary
to immediate red flag identification.
9 A patient is reluctant to discuss their smoking history. Which motivational interviewing technique is most
appropriate?
,A) Advise the patient to quit smoking for health reasons.
B) Ask permission to discuss smoking and explore their thoughts.
C) Use scare tactics to emphasize the dangers of smoking.
D) Skip the smoking history to maintain rapport.
Answer: B
Rationale: Asking permission respects autonomy and reduces resistance, a core principle of motivational
interviewing. Advising (A) may elicit defensiveness; scare tactics (C) can backfire; skipping (D) misses a key
health risk.
10 During a health history, a patient states, 'I don't believe in taking medications.' How should the nurse respond to
explore this belief?
A) Explain the importance of medications in treating illness.
B) Say, 'Tell me more about your thoughts on medications.'
C) Ask, 'Have you ever had a bad experience with medications?'
D) Document the statement and move to the next topic.
Answer: B
Rationale: Option B is an open-ended exploration that invites the patient to share their perspective without
judgment. Option A dismisses the belief, option C is leading and assumes a negative experience, and option D
avoids important health beliefs.
11 During a health history interview, a patient provides a detailed narrative of their symptoms but avoids eye
contact and frequently changes the subject when asked about medication adherence. Which interviewing
technique is most appropriate to explore this discrepancy without causing defensiveness?
A) Confrontation: directly state the observed inconsistency and ask for an explanation.
B) Facilitation: use open-ended prompts to encourage continuation of the narrative.
C) Empathic response: acknowledge the patient's feelings and reflect the observed behavior.
D) Interpretation: infer the underlying reason for the avoidance and present it to the patient.
Answer: C
Rationale: An empathic response acknowledges the patient's emotional state while gently noting the behavioral
shift, which maintains rapport and encourages honest disclosure. Confrontation may be perceived as accusatory,
facilitation ignores the discrepancy, and interpretation risks imposing the clinician's assumptions.
12 A clinician is conducting a health history for a patient who reports chronic fatigue. The patient states the fatigue
began six months ago after a viral illness. Which follow-up question best assesses the impact on functional
status and guides further investigation?
A) Have you experienced any fever, weight loss, or night sweats?
B) Can you describe a typical day and how the fatigue affects your activities?
C) Do you have any family history of autoimmune disorders?
D) What medications are you currently taking?
Answer: B
Rationale: Assessing functional status through a description of daily activities helps quantify the severity and impact
of fatigue, which is crucial for differential diagnosis and management. Options A, C, and D address specific
etiologies but do not directly evaluate functional limitation.
13 When using the BATHE technique during a health history interview, which component involves asking the
patient how the situation affects their daily functioning?
A) Background
, B) Affect
C) Trouble
D) Handling
Answer: D
Rationale: The 'Handling' component of BATHE specifically assesses the patient's ability to cope and the impact on
daily life. 'Background' explores context, 'Affect' identifies emotional response, and 'Trouble' asks what is most
distressing.
14 A patient with limited English proficiency uses a family member as an interpreter during the health history.
Which action by the clinician best ensures accurate and ethical data collection?
A) Proceed with the family interpreter to maintain patient comfort.
B) Request a certified medical interpreter via phone or video service.
C) Use simple English words and speak slowly to the patient directly.
D) Ask the family interpreter to translate verbatim without summarization.
Answer: B
Rationale: Certified medical interpreters are trained to ensure accuracy, confidentiality, and cultural sensitivity,
reducing the risk of misinterpretation or omission. Family members may filter information or introduce bias.
Speaking slowly in English does not overcome language barriers, and verbatim translation may not be feasible.
15 During a health history, a patient with chronic pain describes their pain as 'unbearable' and rates it 10/10, yet
they are smiling and watching television. Which interviewing approach is most appropriate to reconcile this
incongruence?
A) Validate the pain rating and explore the context of the pain experience.
B) Confront the patient about the inconsistency between behavior and report.
C) Document the pain as 10/10 without further questioning.
D) Assume the pain is exaggerated and re-assess later.
Answer: A
Rationale: Validating the patient's reported pain and exploring context (e.g., distraction, coping strategies)
acknowledges their experience while gathering more data. Confrontation may damage trust, and assuming
exaggeration is biased. Simply documenting without exploration misses important clinical information.
16 A clinician is taking a sexual health history. Which question is most appropriate to assess risk for sexually
transmitted infections in a nonjudgmental manner?
A) Do you have sex with men, women, or both?
B) Are you sexually active?
C) Have you ever had an STI?
D) How many partners have you had in the past year?
Answer: A
Rationale: Asking about the gender of partners is an open, nonjudgmental way to assess sexual orientation and risk,
and it is recommended by CDC guidelines. 'Are you sexually active?' is vague; 'Have you ever had an STI?' may be
perceived as accusatory; and asking number of partners can be intrusive without context.
17 A patient reports intermittent chest pain that occurs only during emotional stress. Which component of the
health history is most critical to explore to differentiate cardiac from noncardiac causes?
A) Family history of heart disease
B) Quality and radiation of the pain
C) Medication list including over-the-counter drugs
Exam-Style Questions — 190 Questions
Section 1: Health History and Interview Techniques (Questions 1-17)
1 During a health history interview, a patient provides a vague description of chest discomfort. Which
interviewing technique is most effective for eliciting a clear, detailed description of the symptom?
A) Use closed-ended questions to narrow down possibilities quickly.
B) Employ the mnemonic PQRSTU to systematically explore the symptom.
C) Paraphrase the patient's statement to confirm understanding.
D) Ask leading questions to guide the patient toward cardiac symptoms.
Answer: B
Rationale: The PQRSTU mnemonic (Provocative/Palliative, Quality, Region/Radiation, Severity, Timing,
Understanding) is a structured approach to elicit comprehensive symptom details. Closed-ended questions may
miss nuances, paraphrasing confirms but doesn't explore, and leading questions introduce bias.
2 A patient being interviewed for a health history suddenly becomes tearful when discussing a recent loss. Which
response by the nurse best demonstrates therapeutic communication?
A) Offer a tissue and say, 'I can see this is difficult. Would you like to take a break?'
B) Acknowledge the emotion and say, 'Tell me more about what happened.'
C) Redirect the interview to less sensitive topics to reduce distress.
D) Provide reassurance by saying, 'Everything will be okay in time.'
Answer: A
Rationale: Option A validates the patient's emotion, offers support, and respects autonomy by allowing a pause.
Option B may push too quickly into details. Redirecting avoids the issue, and false reassurance dismisses the
patient's feelings.
3 When interviewing a patient from a culture that values family decision-making, which approach is most
appropriate for obtaining a health history?
A) Insist on speaking only with the patient to maintain confidentiality.
B) Ask the patient if they prefer to have family members present during the interview.
C) Interview the family separately to gather collateral information.
D) Use a medical interpreter to ensure accurate communication.
Answer: B
Rationale: Respecting cultural preferences involves asking the patient about their wishes regarding family
involvement. Option A may violate cultural norms, option C may bypass the patient's autonomy, and option D
addresses language but not decision-making preferences.
4 A patient reports 'feeling tired all the time' but provides no other details. Which open-ended question is most
likely to elicit additional information about the fatigue?
A) Do you have trouble sleeping at night?
B) Can you describe what you mean by 'tired'?
C) Is the fatigue related to stress or depression?
D) How long have you been feeling this way?
Answer: B
,Rationale: Option B uses an open-ended request for description, allowing the patient to define fatigue in their own
words. Option A is closed, option C is leading, and option D is closed-ended (though it asks duration, it doesn't
explore quality).
5 During a health history, a patient gives inconsistent answers about alcohol use. Which technique is most
appropriate to clarify the discrepancy?
A) Confront the patient directly about the inconsistency.
B) Use the CAGE questionnaire to screen for alcohol problems.
C) Revisit the question later with different phrasing.
D) Document the inconsistency and move on to avoid confrontation.
Answer: C
Rationale: Revisiting the question later with different phrasing reduces defensiveness and may yield more accurate
information. Direct confrontation (A) can damage rapport; using CAGE (B) assumes a problem; ignoring (D)
misses important data.
6 A patient with limited English proficiency presents for a health history. A family member offers to interpret.
What is the nurse's best action?
A) Proceed with the family member as interpreter to build trust.
B) Use a professional medical interpreter to ensure accuracy and confidentiality.
C) Speak slowly and use simple English to communicate directly.
D) Use written translated materials and have the patient read them.
Answer: B
Rationale: Professional interpreters maintain accuracy, confidentiality, and avoid bias or omission. Family members
may filter information or feel uncomfortable with sensitive topics. Options C and D risk misunderstandings.
7 When taking a sexual history, which question demonstrates a nonjudgmental and inclusive approach?
A) Are you sexually active with men, women, or both?
B) Do you have sex with men, women, or both?
C) What is the sex of your partner(s)?
D) Tell me about your sexual activity and partners.
Answer: D
Rationale: Option D is the most open-ended and does not assume categories or labels. Options A, B, and C use
potentially limiting terminology and may inadvertently exclude individuals who do not identify with those labels.
8 A patient reports intermittent headaches. Which component of the health history is most critical to assess first to
identify potential red flags?
A) Family history of migraines.
B) Onset, duration, and associated symptoms like fever or neck stiffness.
C) Medication history including over-the-counter analgesics.
D) Impact on daily activities and quality of life.
Answer: B
Rationale: Assessing onset, duration, and associated symptoms (e.g., fever, neck stiffness) helps identify
life-threatening conditions like meningitis or subarachnoid hemorrhage. Other options are important but secondary
to immediate red flag identification.
9 A patient is reluctant to discuss their smoking history. Which motivational interviewing technique is most
appropriate?
,A) Advise the patient to quit smoking for health reasons.
B) Ask permission to discuss smoking and explore their thoughts.
C) Use scare tactics to emphasize the dangers of smoking.
D) Skip the smoking history to maintain rapport.
Answer: B
Rationale: Asking permission respects autonomy and reduces resistance, a core principle of motivational
interviewing. Advising (A) may elicit defensiveness; scare tactics (C) can backfire; skipping (D) misses a key
health risk.
10 During a health history, a patient states, 'I don't believe in taking medications.' How should the nurse respond to
explore this belief?
A) Explain the importance of medications in treating illness.
B) Say, 'Tell me more about your thoughts on medications.'
C) Ask, 'Have you ever had a bad experience with medications?'
D) Document the statement and move to the next topic.
Answer: B
Rationale: Option B is an open-ended exploration that invites the patient to share their perspective without
judgment. Option A dismisses the belief, option C is leading and assumes a negative experience, and option D
avoids important health beliefs.
11 During a health history interview, a patient provides a detailed narrative of their symptoms but avoids eye
contact and frequently changes the subject when asked about medication adherence. Which interviewing
technique is most appropriate to explore this discrepancy without causing defensiveness?
A) Confrontation: directly state the observed inconsistency and ask for an explanation.
B) Facilitation: use open-ended prompts to encourage continuation of the narrative.
C) Empathic response: acknowledge the patient's feelings and reflect the observed behavior.
D) Interpretation: infer the underlying reason for the avoidance and present it to the patient.
Answer: C
Rationale: An empathic response acknowledges the patient's emotional state while gently noting the behavioral
shift, which maintains rapport and encourages honest disclosure. Confrontation may be perceived as accusatory,
facilitation ignores the discrepancy, and interpretation risks imposing the clinician's assumptions.
12 A clinician is conducting a health history for a patient who reports chronic fatigue. The patient states the fatigue
began six months ago after a viral illness. Which follow-up question best assesses the impact on functional
status and guides further investigation?
A) Have you experienced any fever, weight loss, or night sweats?
B) Can you describe a typical day and how the fatigue affects your activities?
C) Do you have any family history of autoimmune disorders?
D) What medications are you currently taking?
Answer: B
Rationale: Assessing functional status through a description of daily activities helps quantify the severity and impact
of fatigue, which is crucial for differential diagnosis and management. Options A, C, and D address specific
etiologies but do not directly evaluate functional limitation.
13 When using the BATHE technique during a health history interview, which component involves asking the
patient how the situation affects their daily functioning?
A) Background
, B) Affect
C) Trouble
D) Handling
Answer: D
Rationale: The 'Handling' component of BATHE specifically assesses the patient's ability to cope and the impact on
daily life. 'Background' explores context, 'Affect' identifies emotional response, and 'Trouble' asks what is most
distressing.
14 A patient with limited English proficiency uses a family member as an interpreter during the health history.
Which action by the clinician best ensures accurate and ethical data collection?
A) Proceed with the family interpreter to maintain patient comfort.
B) Request a certified medical interpreter via phone or video service.
C) Use simple English words and speak slowly to the patient directly.
D) Ask the family interpreter to translate verbatim without summarization.
Answer: B
Rationale: Certified medical interpreters are trained to ensure accuracy, confidentiality, and cultural sensitivity,
reducing the risk of misinterpretation or omission. Family members may filter information or introduce bias.
Speaking slowly in English does not overcome language barriers, and verbatim translation may not be feasible.
15 During a health history, a patient with chronic pain describes their pain as 'unbearable' and rates it 10/10, yet
they are smiling and watching television. Which interviewing approach is most appropriate to reconcile this
incongruence?
A) Validate the pain rating and explore the context of the pain experience.
B) Confront the patient about the inconsistency between behavior and report.
C) Document the pain as 10/10 without further questioning.
D) Assume the pain is exaggerated and re-assess later.
Answer: A
Rationale: Validating the patient's reported pain and exploring context (e.g., distraction, coping strategies)
acknowledges their experience while gathering more data. Confrontation may damage trust, and assuming
exaggeration is biased. Simply documenting without exploration misses important clinical information.
16 A clinician is taking a sexual health history. Which question is most appropriate to assess risk for sexually
transmitted infections in a nonjudgmental manner?
A) Do you have sex with men, women, or both?
B) Are you sexually active?
C) Have you ever had an STI?
D) How many partners have you had in the past year?
Answer: A
Rationale: Asking about the gender of partners is an open, nonjudgmental way to assess sexual orientation and risk,
and it is recommended by CDC guidelines. 'Are you sexually active?' is vague; 'Have you ever had an STI?' may be
perceived as accusatory; and asking number of partners can be intrusive without context.
17 A patient reports intermittent chest pain that occurs only during emotional stress. Which component of the
health history is most critical to explore to differentiate cardiac from noncardiac causes?
A) Family history of heart disease
B) Quality and radiation of the pain
C) Medication list including over-the-counter drugs
