NU 325 Exam 4 (PDF) | (Updated) Health Assessment
Exam-Style Questions — 200 Questions
Section 1: Health History and Interview Techniques (Questions 1-20)
1 A clinician is conducting a health history interview with a patient who exhibits a flat affect, avoids eye contact,
and provides monosyllabic responses. Which interviewing strategy is most likely to enhance data collection
while maintaining therapeutic rapport?
A) Use closed-ended questions to obtain factual information quickly
B) Reflect the patient's affect and use open-ended prompts with pauses
C) Transition to a written questionnaire to reduce perceived pressure
D) Confront the patient about their lack of engagement to establish honesty
Answer: B
Rationale: Reflecting affect validates the patient's emotional state and open-ended prompts with pauses create space
for the patient to elaborate at their own pace, which can build trust and yield richer data. Closed-ended questions
(A) may feel interrogative, written questionnaires (C) bypass verbal interaction and may miss non-verbal cues, and
confrontation (D) can damage rapport.
2 During a health history interview, a patient reports a history of chronic pain but becomes vague when asked
about medication use. Which approach best balances thorough assessment with patient autonomy?
A) Reassure the patient that all information is confidential and continue probing
B) Ask specifically about over-the-counter and prescription medications using a nonjudgmental tone
C) Document the patient's reluctance and skip medication questions to preserve trust
D) Administer a standardized pain assessment questionnaire to replace verbal inquiry
Answer: B
Rationale: Asking specifically about both OTC and prescription medications in a nonjudgmental manner reduces
ambiguity and may decrease defensiveness, facilitating accurate reporting. Reassurance (A) may not address the
patient's underlying concerns, skipping questions (C) compromises completeness, and replacing with a
questionnaire (D) loses the opportunity to explore context through dialogue.
3 A nurse is interviewing a patient who recently immigrated and uses a family member as an interpreter. Which
action best ensures the accuracy and ethical integrity of the health history?
A) Rely on the family interpreter as they know the patient best
B) Request a professional medical interpreter and explain the need for confidentiality
C) Use simple English phrases and avoid complex medical terminology
D) Ask the family interpreter to read the patient's previous medical records aloud
Answer: B
Rationale: Professional medical interpreters are trained to maintain confidentiality, accuracy, and neutrality,
reducing risks of misinterpretation or omission. Family interpreters may filter information or introduce bias (A).
Using simple English (C) may not suffice if the patient has limited English proficiency, and asking to read records
(D) is not part of the interview process and may violate privacy.
4 In a health history interview, a patient discloses a history of childhood trauma when asked about mental health.
Which response by the clinician is most appropriate?
A) Acknowledge the disclosure, thank the patient, and proceed to the next topic to avoid distress
,B) Acknowledge the disclosure, ask if the patient feels safe discussing further, and offer resources
C) Document the disclosure and refer to a mental health specialist without further discussion
D) Reassure the patient that the trauma is in the past and focus on current symptoms
Answer: B
Rationale: Acknowledging the disclosure validates the patient's courage, asking permission respects autonomy, and
offering resources provides support. Proceeding immediately (A) may dismiss the patient's experience, referring
without discussion (C) may feel abandoning, and reassurance (D) may minimize the impact of trauma.
5 A clinician is taking a health history from a patient who uses a wheelchair and has a speech impediment. Which
approach best facilitates effective communication?
A) Position yourself at eye level and allow extra time for responses
B) Speak loudly and slowly to compensate for the speech impediment
C) Direct questions to the accompanying caregiver to ensure accuracy
D) Use a communication board with pictures and symbols for all questions
Answer: A
Rationale: Positioning at eye level promotes respect and reduces power differentials, and allowing extra time
reduces pressure. Speaking loudly (B) is unnecessary and may be perceived as patronizing, directing questions to a
caregiver (C) undermines patient autonomy, and using a communication board (D) is only appropriate if the patient
needs it and should not be assumed.
6 During a health history interview, a patient states, 'I don't believe in taking medications; they're all poison.'
Which response best aligns with motivational interviewing principles?
A) Educate the patient about the benefits of modern medicine
B) Explore the patient's beliefs and experiences that led to this view
C) Acknowledge the statement and move to the next topic
D) Respectfully disagree and provide evidence of medication efficacy
Answer: B
Rationale: Motivational interviewing emphasizes exploring the patient's perspective without judgment to understand
underlying concerns, which can build rapport and open the door to behavior change. Educating (A) or disagreeing
(D) may create resistance, and moving on (C) misses an opportunity to address medication adherence.
7 A patient reports a family history of breast cancer but becomes tearful when discussing it. Which action by the
nurse is most appropriate?
A) Offer a tissue and continue the interview to maintain efficiency
B) Pause, offer support, and ask if the patient would like to continue or take a break
C) Reassure the patient that modern screening can detect cancer early
D) Document the family history and refer to a genetic counselor
Answer: B
Rationale: Pausing and offering support demonstrates empathy and respect for the patient's emotional state. Asking
about continuation empowers the patient. Offering a tissue and continuing (A) may seem dismissive, reassurance
(C) may not address the emotional impact, and referral (D) is premature without exploring the patient's concerns.
8 A clinician is interviewing a patient who provides contradictory information about their alcohol use: first
denying any use, then later reporting 'a few drinks daily.' Which technique is most effective in clarifying the
discrepancy?
A) Confront the patient with the inconsistency and request honesty
B) Ask a neutral, open-ended question like 'Tell me more about your alcohol use'
,C) Document the initial denial and disregard the later report as unreliable
D) Use a validated screening tool like the AUDIT to replace verbal questioning
Answer: B
Rationale: An open-ended question invites the patient to elaborate without accusation, potentially resolving the
discrepancy through narrative. Confrontation (A) may elicit shame or defensiveness, disregarding the later report
(C) risks losing accurate information, and using a screening tool (D) does not address the inconsistency in the
interview context.
9 A nurse is taking a health history from a patient who is a survivor of intimate partner violence. Which question
is most appropriate to assess safety?
A) Do you feel safe in your current relationship?
B) Is your partner violent with you?
C) Are you afraid of your partner?
D) Does your partner hit you?
Answer: C
Rationale: Asking about fear is a validated, sensitive way to screen for intimate partner violence without requiring
the patient to label the partner as violent, which can be dangerous or emotionally difficult. Direct questions about
violence (B, D) may be too confronting, and 'feeling safe' (A) may be interpreted broadly.
10 A clinician is conducting a health history interview via telehealth. The patient's camera is off, and audio is
intermittent. Which action best balances data collection with technical limitations?
A) Ask the patient to turn on the camera for non-verbal cues
B) Proceed with the interview using verbal communication only
C) Reschedule the interview for an in-person visit
D) Use the chat function to type questions and receive typed responses
Answer: B
Rationale: Proceeding verbally is practical and respects the patient's choice to keep the camera off; intermittent
audio can be managed by repeating or rephrasing. Insisting on camera (A) may not be feasible or comfortable,
rescheduling (C) delays care, and chat (D) may be inefficient for complex history taking.
11 A patient reports intermittent chest pain that occurs only during emotional stress. The clinician suspects a
psychogenic component. Which interviewing technique is most appropriate to explore the link between
emotions and symptoms without introducing bias?
A) Ask 'Does the pain happen when you are upset?'
B) Ask 'Tell me what you are feeling when the pain starts.'
C) Ask 'Do you think stress causes your pain?'
D) Ask 'Are you anxious or depressed?'
Answer: B
Rationale: Open-ended questions that invite the patient's narrative (option B) reduce bias and allow the patient to
describe associations without leading. Options A, C, and D are leading or closed-ended, potentially suggesting a
cause and limiting the patient's response.
12 During a health history interview, a patient provides vague answers and avoids eye contact. The clinician
suspects the patient may be withholding information. Which approach is most likely to encourage disclosure
while maintaining rapport?
A) Directly ask 'Is there something you are not telling me?'
B) Use silence and maintain steady eye contact to prompt the patient.
, C) Reflect the patient's behavior: 'I notice you seem uncomfortable. Can you help me understand what might be
bothering you?'
D) Reassure the patient that all information is confidential and proceed with the next question.
Answer: C
Rationale: Reflective statements that acknowledge observed behavior without judgment (option C) validate the
patient's feelings and invite explanation. Direct confrontation (A) can increase defensiveness. Silence with eye
contact (B) may be perceived as pressure. Simply reassuring confidentiality (D) does not address the immediate
resistance.
13 A clinician is taking a health history from a patient who is a recent immigrant with limited English proficiency.
A family member offers to interpret. Which action best balances ethical obligations and effective
communication?
A) Accept the family member as interpreter to build trust.
B) Use the family member but verify key points with the patient.
C) Decline the family member and arrange for a professional medical interpreter.
D) Use the family member only for non-sensitive information.
Answer: C
Rationale: Professional medical interpreters are preferred to ensure accuracy, confidentiality, and reduce bias.
Family members may filter information, omit details, or introduce their own perspectives. Option C adheres to
standards for linguistic access and ethical care.
14 When documenting a patient's history of present illness (HPI), which element is most critical to include to
ensure the narrative supports clinical reasoning?
A) The patient's exact words in quotation marks
B) A chronological sequence of events with associated symptoms
C) The clinician's interpretation of the symptom's etiology
D) The patient's vital signs at the time of interview
Answer: B
Rationale: A chronological sequence (option B) provides a clear timeline that aids differential diagnosis. While
patient quotes can be useful, they are not essential. Interpretations (C) belong in the assessment, not HPI. Vital
signs (D) are part of the physical exam.
15 A patient with chronic pain states, 'The pain is always there, but sometimes it's worse.' Which question is most
effective to characterize the variability of the pain?
A) 'On a scale of 0 to 10, what is your pain level right now?'
B) 'Can you describe a typical day with your pain, from morning to night?'
C) 'Does the pain wake you up at night?'
D) 'What makes the pain better or worse?'
Answer: B
Rationale: Asking for a typical day (option B) elicits a narrative that reveals patterns and triggers without leading.
Option A gives only a single point in time. Options C and D are more focused but may miss the broader context of
variability.
16 During a review of systems, a patient denies any cardiovascular symptoms. Later, the patient casually mentions
occasional palpitations. Which response demonstrates appropriate interviewing technique?
A) Ignore the comment because the patient already denied symptoms.
B) Ask 'Why didn't you mention this earlier?'
Exam-Style Questions — 200 Questions
Section 1: Health History and Interview Techniques (Questions 1-20)
1 A clinician is conducting a health history interview with a patient who exhibits a flat affect, avoids eye contact,
and provides monosyllabic responses. Which interviewing strategy is most likely to enhance data collection
while maintaining therapeutic rapport?
A) Use closed-ended questions to obtain factual information quickly
B) Reflect the patient's affect and use open-ended prompts with pauses
C) Transition to a written questionnaire to reduce perceived pressure
D) Confront the patient about their lack of engagement to establish honesty
Answer: B
Rationale: Reflecting affect validates the patient's emotional state and open-ended prompts with pauses create space
for the patient to elaborate at their own pace, which can build trust and yield richer data. Closed-ended questions
(A) may feel interrogative, written questionnaires (C) bypass verbal interaction and may miss non-verbal cues, and
confrontation (D) can damage rapport.
2 During a health history interview, a patient reports a history of chronic pain but becomes vague when asked
about medication use. Which approach best balances thorough assessment with patient autonomy?
A) Reassure the patient that all information is confidential and continue probing
B) Ask specifically about over-the-counter and prescription medications using a nonjudgmental tone
C) Document the patient's reluctance and skip medication questions to preserve trust
D) Administer a standardized pain assessment questionnaire to replace verbal inquiry
Answer: B
Rationale: Asking specifically about both OTC and prescription medications in a nonjudgmental manner reduces
ambiguity and may decrease defensiveness, facilitating accurate reporting. Reassurance (A) may not address the
patient's underlying concerns, skipping questions (C) compromises completeness, and replacing with a
questionnaire (D) loses the opportunity to explore context through dialogue.
3 A nurse is interviewing a patient who recently immigrated and uses a family member as an interpreter. Which
action best ensures the accuracy and ethical integrity of the health history?
A) Rely on the family interpreter as they know the patient best
B) Request a professional medical interpreter and explain the need for confidentiality
C) Use simple English phrases and avoid complex medical terminology
D) Ask the family interpreter to read the patient's previous medical records aloud
Answer: B
Rationale: Professional medical interpreters are trained to maintain confidentiality, accuracy, and neutrality,
reducing risks of misinterpretation or omission. Family interpreters may filter information or introduce bias (A).
Using simple English (C) may not suffice if the patient has limited English proficiency, and asking to read records
(D) is not part of the interview process and may violate privacy.
4 In a health history interview, a patient discloses a history of childhood trauma when asked about mental health.
Which response by the clinician is most appropriate?
A) Acknowledge the disclosure, thank the patient, and proceed to the next topic to avoid distress
,B) Acknowledge the disclosure, ask if the patient feels safe discussing further, and offer resources
C) Document the disclosure and refer to a mental health specialist without further discussion
D) Reassure the patient that the trauma is in the past and focus on current symptoms
Answer: B
Rationale: Acknowledging the disclosure validates the patient's courage, asking permission respects autonomy, and
offering resources provides support. Proceeding immediately (A) may dismiss the patient's experience, referring
without discussion (C) may feel abandoning, and reassurance (D) may minimize the impact of trauma.
5 A clinician is taking a health history from a patient who uses a wheelchair and has a speech impediment. Which
approach best facilitates effective communication?
A) Position yourself at eye level and allow extra time for responses
B) Speak loudly and slowly to compensate for the speech impediment
C) Direct questions to the accompanying caregiver to ensure accuracy
D) Use a communication board with pictures and symbols for all questions
Answer: A
Rationale: Positioning at eye level promotes respect and reduces power differentials, and allowing extra time
reduces pressure. Speaking loudly (B) is unnecessary and may be perceived as patronizing, directing questions to a
caregiver (C) undermines patient autonomy, and using a communication board (D) is only appropriate if the patient
needs it and should not be assumed.
6 During a health history interview, a patient states, 'I don't believe in taking medications; they're all poison.'
Which response best aligns with motivational interviewing principles?
A) Educate the patient about the benefits of modern medicine
B) Explore the patient's beliefs and experiences that led to this view
C) Acknowledge the statement and move to the next topic
D) Respectfully disagree and provide evidence of medication efficacy
Answer: B
Rationale: Motivational interviewing emphasizes exploring the patient's perspective without judgment to understand
underlying concerns, which can build rapport and open the door to behavior change. Educating (A) or disagreeing
(D) may create resistance, and moving on (C) misses an opportunity to address medication adherence.
7 A patient reports a family history of breast cancer but becomes tearful when discussing it. Which action by the
nurse is most appropriate?
A) Offer a tissue and continue the interview to maintain efficiency
B) Pause, offer support, and ask if the patient would like to continue or take a break
C) Reassure the patient that modern screening can detect cancer early
D) Document the family history and refer to a genetic counselor
Answer: B
Rationale: Pausing and offering support demonstrates empathy and respect for the patient's emotional state. Asking
about continuation empowers the patient. Offering a tissue and continuing (A) may seem dismissive, reassurance
(C) may not address the emotional impact, and referral (D) is premature without exploring the patient's concerns.
8 A clinician is interviewing a patient who provides contradictory information about their alcohol use: first
denying any use, then later reporting 'a few drinks daily.' Which technique is most effective in clarifying the
discrepancy?
A) Confront the patient with the inconsistency and request honesty
B) Ask a neutral, open-ended question like 'Tell me more about your alcohol use'
,C) Document the initial denial and disregard the later report as unreliable
D) Use a validated screening tool like the AUDIT to replace verbal questioning
Answer: B
Rationale: An open-ended question invites the patient to elaborate without accusation, potentially resolving the
discrepancy through narrative. Confrontation (A) may elicit shame or defensiveness, disregarding the later report
(C) risks losing accurate information, and using a screening tool (D) does not address the inconsistency in the
interview context.
9 A nurse is taking a health history from a patient who is a survivor of intimate partner violence. Which question
is most appropriate to assess safety?
A) Do you feel safe in your current relationship?
B) Is your partner violent with you?
C) Are you afraid of your partner?
D) Does your partner hit you?
Answer: C
Rationale: Asking about fear is a validated, sensitive way to screen for intimate partner violence without requiring
the patient to label the partner as violent, which can be dangerous or emotionally difficult. Direct questions about
violence (B, D) may be too confronting, and 'feeling safe' (A) may be interpreted broadly.
10 A clinician is conducting a health history interview via telehealth. The patient's camera is off, and audio is
intermittent. Which action best balances data collection with technical limitations?
A) Ask the patient to turn on the camera for non-verbal cues
B) Proceed with the interview using verbal communication only
C) Reschedule the interview for an in-person visit
D) Use the chat function to type questions and receive typed responses
Answer: B
Rationale: Proceeding verbally is practical and respects the patient's choice to keep the camera off; intermittent
audio can be managed by repeating or rephrasing. Insisting on camera (A) may not be feasible or comfortable,
rescheduling (C) delays care, and chat (D) may be inefficient for complex history taking.
11 A patient reports intermittent chest pain that occurs only during emotional stress. The clinician suspects a
psychogenic component. Which interviewing technique is most appropriate to explore the link between
emotions and symptoms without introducing bias?
A) Ask 'Does the pain happen when you are upset?'
B) Ask 'Tell me what you are feeling when the pain starts.'
C) Ask 'Do you think stress causes your pain?'
D) Ask 'Are you anxious or depressed?'
Answer: B
Rationale: Open-ended questions that invite the patient's narrative (option B) reduce bias and allow the patient to
describe associations without leading. Options A, C, and D are leading or closed-ended, potentially suggesting a
cause and limiting the patient's response.
12 During a health history interview, a patient provides vague answers and avoids eye contact. The clinician
suspects the patient may be withholding information. Which approach is most likely to encourage disclosure
while maintaining rapport?
A) Directly ask 'Is there something you are not telling me?'
B) Use silence and maintain steady eye contact to prompt the patient.
, C) Reflect the patient's behavior: 'I notice you seem uncomfortable. Can you help me understand what might be
bothering you?'
D) Reassure the patient that all information is confidential and proceed with the next question.
Answer: C
Rationale: Reflective statements that acknowledge observed behavior without judgment (option C) validate the
patient's feelings and invite explanation. Direct confrontation (A) can increase defensiveness. Silence with eye
contact (B) may be perceived as pressure. Simply reassuring confidentiality (D) does not address the immediate
resistance.
13 A clinician is taking a health history from a patient who is a recent immigrant with limited English proficiency.
A family member offers to interpret. Which action best balances ethical obligations and effective
communication?
A) Accept the family member as interpreter to build trust.
B) Use the family member but verify key points with the patient.
C) Decline the family member and arrange for a professional medical interpreter.
D) Use the family member only for non-sensitive information.
Answer: C
Rationale: Professional medical interpreters are preferred to ensure accuracy, confidentiality, and reduce bias.
Family members may filter information, omit details, or introduce their own perspectives. Option C adheres to
standards for linguistic access and ethical care.
14 When documenting a patient's history of present illness (HPI), which element is most critical to include to
ensure the narrative supports clinical reasoning?
A) The patient's exact words in quotation marks
B) A chronological sequence of events with associated symptoms
C) The clinician's interpretation of the symptom's etiology
D) The patient's vital signs at the time of interview
Answer: B
Rationale: A chronological sequence (option B) provides a clear timeline that aids differential diagnosis. While
patient quotes can be useful, they are not essential. Interpretations (C) belong in the assessment, not HPI. Vital
signs (D) are part of the physical exam.
15 A patient with chronic pain states, 'The pain is always there, but sometimes it's worse.' Which question is most
effective to characterize the variability of the pain?
A) 'On a scale of 0 to 10, what is your pain level right now?'
B) 'Can you describe a typical day with your pain, from morning to night?'
C) 'Does the pain wake you up at night?'
D) 'What makes the pain better or worse?'
Answer: B
Rationale: Asking for a typical day (option B) elicits a narrative that reveals patterns and triggers without leading.
Option A gives only a single point in time. Options C and D are more focused but may miss the broader context of
variability.
16 During a review of systems, a patient denies any cardiovascular symptoms. Later, the patient casually mentions
occasional palpitations. Which response demonstrates appropriate interviewing technique?
A) Ignore the comment because the patient already denied symptoms.
B) Ask 'Why didn't you mention this earlier?'
