NURN 155 - FINAL EXAM QUESTIONS
AND ANSWERS WITH COMPLETE
SOLUTIONS (GRADED A+)
1. Clinical Interview & Holistic Health Assessment
A. The Assessment Phase: Interviewing, Background History, & Physical
Examination
The Clinical Interview
Initial Point of Contact: Conducted during the very first physical
interaction with the patient.
Professional Scope: Must be executed directly by a Registered Nurse (RN);
this cognitive task cannot be delegated to assistive personnel.
Preventative Focus: Incorporates age-specific screening standards and age-
appropriate clinical guidelines.
Clinical Objective: Formulates an accurate baseline picture of the patient’s
active health status, historical medical track, and lifestyle risks.
Comprehensive Health History Components
Biographic Data: Baseline demographics including full name, age, gender
identity, birth date, occupation, and primary language spoken.
The Historian (Data Sources):
o Primary Source: The patient themselves (the most reliable source if
cognitively intact).
o Secondary Sources: Immediate family members, close friends,
medical transport records, letters of referral, or past electronic medical
records.
Reason for Seeking Care: The patient's subjective description of their
current situation—conventionally termed the Chief Complaint (CC).
History of Present Illness (HPI): A detailed, chronological expansion of
the primary complaint.
The PQRSTU Pain & Symptom Assessment Tool
,To elicit precise details regarding the History of Present Illness, clinicians use the
PQRSTU framework:
Assessment
Letter Clinical Focus & Example Questions
Parameter
What causes or worsens the symptom?
Provoking /
P What makes it feel better (e.g., ice, rest,
Palliating Factors
heat)?
How does the sensation feel to the patient
Q Quality / Quantity (e.g., sharp, dull ache, burning,
throbbing)?
Where exactly is the pain located? Does
R Region / Radiation the sensation travel or radiate to another
body part?
On a quantified scale from 0 to 10, how
S Severity Scale
intense is the pain or symptom currently?
What was the exact time of onset? Is the
T Timing symptom constant, intermittent, or
cyclical?
What does the patient believe is
U Understanding happening? How does this impact their
daily life?
Past Medical History (PMH): A documentation of all previous health
encounters, including childhood illnesses, surgical procedures, chronic
disease diagnoses, immunizations, known allergies, and current medications.
Family Medical History: A systemic map (frequently drawn as a
genogram) tracking hereditary illnesses, genetic predispositions, and causes
, of death across immediate blood relatives to pinpoint long-term familial
health risks.
ROS - The nurse evaluates each body system's past and present state of health.
- Medication Reconciliation.
- ADL - The patient's ability to provide self care-bathing, toileting, walking, etc.
Physical Assessment -ANSWER ✔✔objective data: Observations or
measurements of the patient's health status.
Example- Checking Vital signs, nurse observing patient's behavior.
c. Health History-sources -ANSWER ✔✔Primary or Secondary Source:
•Patient.
•Family member.
•Observer.
•Caretaker.
•Health care team
•Electronic Medical Record (EMR).
•Other records- Immunization, educational, military, employment.
•Nurses Experience
d. Interview- Technique, sources, -ANSWER ✔✔Interview techniques:
§ Observation.
§ Open-ended Questions.
§ Closed-ended Questions.
, § Non-verbal skills - body language. I.e., posture, gesture, facial expression, eye
contact, foot tapping, touch etc.
d. Communication technique -ANSWER ✔✔• Sending - verbal and non-verbal
communication.
• Receiving - the receiver uses his or her own interpretations of your own words.
• Internal Factors- Respect, Empathy, Listening, Self-awareness
• External Factors- Privacy, No Interruptions, Environment
• Dress - the client must remain in street clothes when conducting the interview.
The interviewer's appearance should be appropriate to the setting.
• Note-taking - keep note-taking to a minimum.
e. Data collection- Subjective and Objective data, Open ended, closed ended -
ANSWER ✔✔• Subjective data - what the person says about himself or herself.
• Objective data - what the interviewer obtains through physical examination.
• Open-ended - allow clients to discuss their concerns freely.
• Closed-ended - can be answered with "Yes" or "No," or they have a limited set of
possible answers.
2. General and Environmental survey, PA technique, documentation -ANSWER
✔✔
a. SWIPE -ANSWER ✔✔Safety/Survey, Wash your hands, Identify yourself &
client, Provide for privacy, and Explain.
b. General survey- Physical Appearance, Body structure, Mobility, and Behavior -
ANSWER ✔✔
AND ANSWERS WITH COMPLETE
SOLUTIONS (GRADED A+)
1. Clinical Interview & Holistic Health Assessment
A. The Assessment Phase: Interviewing, Background History, & Physical
Examination
The Clinical Interview
Initial Point of Contact: Conducted during the very first physical
interaction with the patient.
Professional Scope: Must be executed directly by a Registered Nurse (RN);
this cognitive task cannot be delegated to assistive personnel.
Preventative Focus: Incorporates age-specific screening standards and age-
appropriate clinical guidelines.
Clinical Objective: Formulates an accurate baseline picture of the patient’s
active health status, historical medical track, and lifestyle risks.
Comprehensive Health History Components
Biographic Data: Baseline demographics including full name, age, gender
identity, birth date, occupation, and primary language spoken.
The Historian (Data Sources):
o Primary Source: The patient themselves (the most reliable source if
cognitively intact).
o Secondary Sources: Immediate family members, close friends,
medical transport records, letters of referral, or past electronic medical
records.
Reason for Seeking Care: The patient's subjective description of their
current situation—conventionally termed the Chief Complaint (CC).
History of Present Illness (HPI): A detailed, chronological expansion of
the primary complaint.
The PQRSTU Pain & Symptom Assessment Tool
,To elicit precise details regarding the History of Present Illness, clinicians use the
PQRSTU framework:
Assessment
Letter Clinical Focus & Example Questions
Parameter
What causes or worsens the symptom?
Provoking /
P What makes it feel better (e.g., ice, rest,
Palliating Factors
heat)?
How does the sensation feel to the patient
Q Quality / Quantity (e.g., sharp, dull ache, burning,
throbbing)?
Where exactly is the pain located? Does
R Region / Radiation the sensation travel or radiate to another
body part?
On a quantified scale from 0 to 10, how
S Severity Scale
intense is the pain or symptom currently?
What was the exact time of onset? Is the
T Timing symptom constant, intermittent, or
cyclical?
What does the patient believe is
U Understanding happening? How does this impact their
daily life?
Past Medical History (PMH): A documentation of all previous health
encounters, including childhood illnesses, surgical procedures, chronic
disease diagnoses, immunizations, known allergies, and current medications.
Family Medical History: A systemic map (frequently drawn as a
genogram) tracking hereditary illnesses, genetic predispositions, and causes
, of death across immediate blood relatives to pinpoint long-term familial
health risks.
ROS - The nurse evaluates each body system's past and present state of health.
- Medication Reconciliation.
- ADL - The patient's ability to provide self care-bathing, toileting, walking, etc.
Physical Assessment -ANSWER ✔✔objective data: Observations or
measurements of the patient's health status.
Example- Checking Vital signs, nurse observing patient's behavior.
c. Health History-sources -ANSWER ✔✔Primary or Secondary Source:
•Patient.
•Family member.
•Observer.
•Caretaker.
•Health care team
•Electronic Medical Record (EMR).
•Other records- Immunization, educational, military, employment.
•Nurses Experience
d. Interview- Technique, sources, -ANSWER ✔✔Interview techniques:
§ Observation.
§ Open-ended Questions.
§ Closed-ended Questions.
, § Non-verbal skills - body language. I.e., posture, gesture, facial expression, eye
contact, foot tapping, touch etc.
d. Communication technique -ANSWER ✔✔• Sending - verbal and non-verbal
communication.
• Receiving - the receiver uses his or her own interpretations of your own words.
• Internal Factors- Respect, Empathy, Listening, Self-awareness
• External Factors- Privacy, No Interruptions, Environment
• Dress - the client must remain in street clothes when conducting the interview.
The interviewer's appearance should be appropriate to the setting.
• Note-taking - keep note-taking to a minimum.
e. Data collection- Subjective and Objective data, Open ended, closed ended -
ANSWER ✔✔• Subjective data - what the person says about himself or herself.
• Objective data - what the interviewer obtains through physical examination.
• Open-ended - allow clients to discuss their concerns freely.
• Closed-ended - can be answered with "Yes" or "No," or they have a limited set of
possible answers.
2. General and Environmental survey, PA technique, documentation -ANSWER
✔✔
a. SWIPE -ANSWER ✔✔Safety/Survey, Wash your hands, Identify yourself &
client, Provide for privacy, and Explain.
b. General survey- Physical Appearance, Body structure, Mobility, and Behavior -
ANSWER ✔✔
