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NUR 643E ADVANCED HEALTH ASSESSMENT
FINAL EXAM QUESTIONS AND ANSWERS UPDATED
(2024/2025) (VERIFIED ANSWERS)
You are seeing an elderly man with multiple complaints. He has chronic
arthritis, pain from an old war injury, and headaches. Today he complains
of these pains, as well as dull chest pain under his sternum. What would the
order of priority be for your problem list?
A) Arthritis, war injury pain, headaches, chest pain
B) War injury pain, arthritis, headaches, chest pain
C) Headaches, arthritis, war injury pain, chest pain
D) Chest pain, headaches, arthritis, war injury pain - ANS ✓D) CP, HA,
arthritis, war injury pain
You are excited about a positive test finding you have just noticed on
physical examination of your patient. You go on to do more examination,
laboratory work, and diagnostic tests, only to find that there is no sign of
the disease you thought would correlate with the finding. This same
experience happens several times. What should you conclude?
A) Consider not doing this test routinely.
B) Use this test when you have a higher suspicion for a certain correlating
condition.
C) Continue using the test, perhaps doing less laboratory work and
diagnostics.
D) Omit this test from future examinations. - ANS ✓C) continue using the test,
perhaps doing less laboratory work and diagnostics
You are growing fatigued of performing a maneuver on examination
because you have never found a positive and are usually pressed for time.
How should you next approach this maneuver?
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A) Use this test when you have a higher suspicion for a certain correlating
condition.
B) Omit this test from future examinations.
C) Continue doing the test, but rely more heavily on laboratory work and
diagnostics.
D) Continue performing it on all future examinations. - ANS ✓A) use this test
when you have a higher suspicion for a certain correlating condition
You have recently returned from a medical missions trip to sub-Saharan
Africa, where you learned a great deal about malaria. You decide to use
some of the same questions and maneuvers in your "routine" when
examining patients in the midwestern United States. You are disappointed
to find that despite getting some positive answers and findings, on further
workup, none of your patients has malaria except one, who recently
emigrated from Ghana. How should you next approach these questions and
maneuvers?
A) Continue asking these questions in a more selective way.
B) Stop asking these questions, because they are low yield.
C) Question the validity of the questions.
D) Ask these questions of all your patients. - ANS ✓A) continue asking these
questions in a more selective way
You are running late after your quarterly quality improvement meeting at
the hospital and have just gotten paged from the nurses' station because a
family member of one of your patients wants to talk with you about that
patient's care. You have clinic this afternoon and are double-booked for the
first appointment time; three other patients also have arrived and are
sitting in the waiting room. Which of the following demeanors is a behavior
consistent with skilled interviewing when you walk into the examination
room to speak with your first clinic patient?
A) Irritability
B) Impatience
C) Boredom
D) Calm - ANS ✓D) calm
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Suzanne, a 25 year old, comes to your clinic to establish care. You are the
student preparing to go into the examination room to interview her. Which
of the following is the most logical sequence for the patient-provider
interview?
A) Establish the agenda, negotiate a plan, establish rapport, and invite the
patient's story.
B) Invite the patient's story, negotiate a plan, establish the agenda, and
establish rapport.
C) Greet the patient, establish rapport, invite the patient's story, establish
the agenda, expand and clarify the patient's story, and negotiate a plan.
D) Negotiate a plan, establish an agenda, invite the patient's story, and
establish rapport. - ANS ✓C) greet the patient, establish rapport, invite the
patients story, establish agenda, expand and clarify the story, negotiate the plan
Alexandra is a 28-year-old editor who presents to the clinic with abdominal
pain. The pain is a dull ache, located in the right upper quadrant, that she
rates as a 3 at the least and an 8 at the worst. The pain started a few weeks
ago, it lasts for 2 to 3 hours at a time, it comes and goes, and it seems to be
worse a couple of hours after eating. She has noticed that it starts after
eating greasy foods, so she has cut down on these as much as she can.
Initially it occurred once a week, but now it is occurring every other day.
Nothing makes it better. From this description, which of the seven
attributes of a symptom has been omitted?
A) Setting in which the symptom occurs
B) Associated manifestations
C) Quality
D) Timing - ANS ✓B) associated manifestations
is pain accompanied by N/V?
Jason is a 41-year-old electrician who presents to the clinic for evaluation
of shortness of breath. The shortness of breath occurs with exertion and
improves with rest. It has been going on for several months and initially
occurred only a couple of times a day with strenuous exertion; however, it
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has started to occur with minimal exertion and is happening more than a
dozen times per day. The shortness of breath lasts for less than 5 minutes
at a time. He has no cough, chest pressure, chest pain, swelling in his feet,
palpitations, orthopnea, or paroxysmal nocturnal dyspnea.
Which of the following symptom attributes was not addressed in this
description?
A) Severity
B) Setting in which the symptom occurs
C) Timing
D) Associated manifestations - ANS ✓A) severity
should've asked pain on 0-10 scale
You are interviewing an elderly woman in the ambulatory setting and
trying to get more information about her urinary symptoms. Which of the
following techniques is not a component of adaptive questioning?
A) Directed questioning: starting with the general and proceeding to the
specific in a manner that does not make the patient give a yes/no answer
B) Reassuring the patient that the urinary symptoms are benign and that
she doesn't need to worry about it being a sign of cancer
C) Offering the patient multiple choices in order to clarify the character of
the urinary symptoms that she is experiencing
D) Asking her to tell you exactly what she means when she states that she
has a urinary tract infection - ANS ✓B) reassuring the patient that the urinary
symptoms are benign and that she doesn't need to worry about it being a sign of
cancer
Mr. W. is a 51-year-old auto mechanic who comes to the emergency room
wanting to be checked out for the symptom of chest pain. As you listen to
him describe his symptom in more detail, you say "Go on," and later, "Mm-
hmmm." This is an example of which of the following skilled interviewing
techniques?
A) Echoing
B) Nonverbal communication
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