Be honest about what's wrong, that's why you're there. But in a polite way. "Well, my day started off well but then I broke my arm so I'm worse now."

It’s their job to know how you are truly doing and what you’re there to be treated for, no decent nurse would be offended if you got right to the point. “Hi, I’ve been having lower abdominal pain for a couple days, if it weren’t for that, I’d be doing good.” If the straight forward approach seems weird, you can follow it up with other pleasantries. Source: I’m a nurse.

Can't you just tell the nurse if you don't feel okay? How is that not being polite?

Honestly.

They're partly gauging your delivery and seeing where your mental state is at. So, being coherent if possible is probably ideal. Beyond that it's a matter of taste I imagine.

I'm honest. If I'm there for an annual exam and have no complaints I just say I'm fine. If I'm there for an issue I say "not great". If I'm there for a follow up of an issue and it's gotten better I say "better than last time", or if it's not gotten better or gotten worse I say "not as good as I'd hoped for". These leave it open for the nurse to leave the answer as-is and continue with their checklist or follow up and ask about the symptoms.

We ask open ended questions just to assess your general response. If we want other information, we'll ask more focused questions. There isn't a right answer and we get paid by the hour so you're not wasting our time.

“I’m about to find out!”

It's an open question, there is no correct answer, they are seeking to elicit information

"Well I'm at a hospital so you can imagine things aren't going quite as well as I want."

"I've been better" simple and to the point.

You too!

“Well, I’m here.”

The nurse is asking you to summarize your chief complaint (the reason why you came to the doctor).

I update them on my condition. Given the context, they're likely asking whether anything is going on with me that I believe they ought to know about.

I usually answer with essentially some form of phatic expression and segue into why I'm there. "Fine thanks, just been having this persistent cough for a bit that I can't seem to shake." Honestly, the phatic expression is likely enough, but you know the next question is going to be why are you here. This kind of opens that door and gets the exchange moving forward in my opinion.

"Alive and conscious enough. How about you?"

replying on a scale helps them :)

4/10 today

“Oh I’m doing ok, how are you?

Usually “oh you know. Monday’s” if it’s a Monday, “x days better than Monday.”

Unless she’s specifically asking in a professional capacity

Yeah, it's one of those weird questions that you don't know if it's social ("eh, fine") or clinical ("well, my lower back's been hurting ever since I turned 30, but that's not why I'm here. I'm here because tripped, fell face-into-arm, and bit myself and the internet tells me I need a tetanus shot, but now I'm worried you'll put me down for 'self-harm' and have me involuntarily committed and oh no did I say that out loud?").

At first I respond automatically with a "I'm fine" then I realize my mistake and say what's actually wrong.

Someone might be going in for an annual checkup, so you can’t just assume that something is wrong.

I'm fond of the reply:

"I'm upright, breathing, and able to take nutrients; I'm doing well"

"Well if I were doing perfect I wouldn't be here"

'Can't be that good if I'm here."

Or, "better now that you're here"

"Eh, pretty well except for the bloodsucking squid-fungus hybrid hanging off my navel."

(Or whatever the problem is.)

I usually just take that question to be them wanting to know if there is anything specific I want to tell them about that they might want to look into. My response is usually a lighthearted "well, I've been better but also been worse!" Or something along those lines.

As you can see

The same way I answer everyone else:

"Fine, relatively."

I do my socializing in the hallway on the way to the examination room for the appointment. We get down to why I'm there once I'm in the examination room.

Don’t sweat it: it’s just a social greeting. The bigger question is “How can we help you today?” or “What brings you in to see us?”

As good as it gets, is my default response.

Just basic, simple talk with nurse. No details because you'll need to repeat it all for the doc anyway.

Can't you be polite and truthful at the same time?

I always just say "I'd be better if you were checking my prostate" but I always get kicked out right after! I can never quite put my finger in why though...

:P