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."

Honestly.

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

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.

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.

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 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.

“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.”

replying on a scale helps them :)

4/10 today

"Alive and conscious enough. How about you?"

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

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.

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.

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

“Oh I’m doing ok, how are you?

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?").

I'm fond of the reply:

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

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

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

"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"

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.

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

(Or whatever the problem is.)

The same way I answer everyone else:

"Fine, relatively."

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?”

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.

As you can see

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

As good as it gets, is my default response.

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