Midterm Exam: NR 509/ NR509 Midterm Exam
Advanced Physical Assessment 100+ qns
(Latest2026) Questions with Verified Answers
A 39-year-old nurse who is a well-established patient complains of irregular menstrual periods
and pelvic pain. She says that she is having trouble sleeping and asks whether she could be
given a "sleeping pill." The patient also says she is thinking of leaving her job. What is the best
"next step" in caring for this patient?
a. Perform a pelvic examination.
b. Obtain a urine sample for testing.
c. Obtain a more complete description of problems.
d. Obtain blood for testing.
e. Ask about recent travel destinations.
Accurate answer: c.
A 34-year-old male with a history of complex social and medical needs (including current
substance abuse) presents to a primary care teaching clinic. The patient has experienced a
number of adversarial relationships with prior clinicians, including voluntarily leaving two
practices within the previous year and being asked to leave care at a third clinic due to
misbehavior. The attending physician desires to utilize the approaches to this patient that are
most likely lead to comprehensive care and patient compliance. Which of the following is the
most appropriate interview style for the attending physician to use?
a. Focusing on the need for immediate diagnostic certainty over personal connection
b. Taking charge of the interaction to meet the clinician's desire to acquire diagnostic
information
c. Following the patient's lead to understand their thoughts, ideas, concerns, and requests
,d. Deferring respect, empathy,
Accurate answer: c.
A 36-year-old female air traffic controller presents to her primary care provider for a routine
visit 3 months after losing her spouse to a lengthy battle with a neurodegenerative disease. The
patient denies any psychiatric symptoms on review of systems and, in fact, states that she has
slept better in the last month than she had in the previous years. She endorses a healthy
support system, including the extended family of her deceased spouse, with whom she is still
close. She becomes wistful and briefly tearful when speaking of the plans that they had when
they first married that were never fulfilled; she then changes the subject rapidly to whether her
Pap smear is due. Which of the following is an example of an empathetic response to this
patient?
a. Assuming that the event caused her to become depressed and expressing the same feeling on
behalf of the patient
b. Recognizing the patient's emotions by asking or con
Accurate answer: b.
A 19-year-old student of art history presents to clinic after a syncopal (fainting) episode at
school. He is notably thin; on a thorough review of his medical history, he admits that he eats
only minimally to maintain a very low body weight that he feels is ideal. He is embarrassed that
his issues were discussed by peers after this episode, especially because he believes that this is
a problem that is only faced by girls and women. Concerning the two most common eating
disorders (anorexia nervosa and bulimia nervosa), which of the following statements is true?
a. Men and women are both afflicted, but with a female:male prevalence ratio estimated at
~2:1.
b. Both of these eating disorders are associated with a body mass index (BMI) of <17.5.
c. Both of these eating disorders are associated with a real or imagined fear of appearing fat.
d. Persons with eating disorders are generally easily identified by their appeara
Accurate answer: c.
,A 23-year-old physician assistant (PA) student found that she felt nervous when called upon to
examine men in her age group. On one occasion, she encountered a young male patient who
appeared embarrassed to see her walk into the room. What should the PA do to minimize their
mutual discomfort?
a. Adjust lighting so it is tangential to the patient's body.
b. Explain how the examination will proceed.
c. Ask the patient where he comes from.
d. Explain that she is a PA student.
e. Provide ongoing interpretation of findings.
Accurate answer: b.
A 17-year-old male presents to a sexually transmitted disease clinic at the behest of his brother,
who convinced the patient to attend the clinic after he disclosed that he prefers homosexual
partners but is afraid that his last partner may have given him an infection. The patient
expresses to the intake nurse that he is unashamed of his sexual orientation and will not stay
through the visit if he feels that he is dismissed or discriminated against because of it. The nurse
practitioner receives this communication prior to entering the examination room and decides to
employ active listening to best connect with the patient at this critical juncture in his care with
the clinic. Which of the following is an example of an active listening technique?
a. Ignoring visual cues to focus on the patient's exact words
b. Setting aside the patient's emotional state to focus on his medical needs
c. Paring down the patient's conce
d. Using nonverbal communication to encourage the patient to expand their narrative
Accurate answer: d.
, A 42-year-old female mathematician presents for follow-up care regarding a new diagnosis of
systemic lupus erythematosus 6 months ago after a lengthy diagnostic process during which she
was debilitated with fatigue and joint pain. Since her diagnosis, she has been minimally
compliant with medications and has switched her rheumatology provider twice. She continues
to feel ill, and, in explanation for her lack of adherence to the prescribed treatment, she simply
says, "I don't like it." At this initial visit with her third rheumatology provider, the clinician elects
to explore the issues behind her noncompliance before engaging in diagnostics and treatment
using the FIFE model. Which of the following best defines the elements of the FIFE model?
a. Focus, intensity, function, and evaluation
b. Facts, intensity, focus, and evidence
c. Feelings, ideas, function, and expectations
d. Feelings, impression, fantasy, and em
Accurate answer: c.
A 29-year-old female professional athlete presents to a new primary care provider with chronic
menstrual complaints. She remarks to the nursing staff that, in the past, she has experienced a
dismissal of her complaints because of her high level of physical fitness and conditioning. She is
seeking a care provider who will explore the issue in more detail and work with her particular
concerns. Which of the following is the description of the patient-centered care this individual
seeks?
a. Structured and clinician-centered with open-ended questions
b. Validating and empathetic with open-ended questions
c. Dismissive and concrete with open-ended questions
d. Affirming and reassuring with close-ended questions
e. Factual and structured with active listening
Accurate answer: b.
Advanced Physical Assessment 100+ qns
(Latest2026) Questions with Verified Answers
A 39-year-old nurse who is a well-established patient complains of irregular menstrual periods
and pelvic pain. She says that she is having trouble sleeping and asks whether she could be
given a "sleeping pill." The patient also says she is thinking of leaving her job. What is the best
"next step" in caring for this patient?
a. Perform a pelvic examination.
b. Obtain a urine sample for testing.
c. Obtain a more complete description of problems.
d. Obtain blood for testing.
e. Ask about recent travel destinations.
Accurate answer: c.
A 34-year-old male with a history of complex social and medical needs (including current
substance abuse) presents to a primary care teaching clinic. The patient has experienced a
number of adversarial relationships with prior clinicians, including voluntarily leaving two
practices within the previous year and being asked to leave care at a third clinic due to
misbehavior. The attending physician desires to utilize the approaches to this patient that are
most likely lead to comprehensive care and patient compliance. Which of the following is the
most appropriate interview style for the attending physician to use?
a. Focusing on the need for immediate diagnostic certainty over personal connection
b. Taking charge of the interaction to meet the clinician's desire to acquire diagnostic
information
c. Following the patient's lead to understand their thoughts, ideas, concerns, and requests
,d. Deferring respect, empathy,
Accurate answer: c.
A 36-year-old female air traffic controller presents to her primary care provider for a routine
visit 3 months after losing her spouse to a lengthy battle with a neurodegenerative disease. The
patient denies any psychiatric symptoms on review of systems and, in fact, states that she has
slept better in the last month than she had in the previous years. She endorses a healthy
support system, including the extended family of her deceased spouse, with whom she is still
close. She becomes wistful and briefly tearful when speaking of the plans that they had when
they first married that were never fulfilled; she then changes the subject rapidly to whether her
Pap smear is due. Which of the following is an example of an empathetic response to this
patient?
a. Assuming that the event caused her to become depressed and expressing the same feeling on
behalf of the patient
b. Recognizing the patient's emotions by asking or con
Accurate answer: b.
A 19-year-old student of art history presents to clinic after a syncopal (fainting) episode at
school. He is notably thin; on a thorough review of his medical history, he admits that he eats
only minimally to maintain a very low body weight that he feels is ideal. He is embarrassed that
his issues were discussed by peers after this episode, especially because he believes that this is
a problem that is only faced by girls and women. Concerning the two most common eating
disorders (anorexia nervosa and bulimia nervosa), which of the following statements is true?
a. Men and women are both afflicted, but with a female:male prevalence ratio estimated at
~2:1.
b. Both of these eating disorders are associated with a body mass index (BMI) of <17.5.
c. Both of these eating disorders are associated with a real or imagined fear of appearing fat.
d. Persons with eating disorders are generally easily identified by their appeara
Accurate answer: c.
,A 23-year-old physician assistant (PA) student found that she felt nervous when called upon to
examine men in her age group. On one occasion, she encountered a young male patient who
appeared embarrassed to see her walk into the room. What should the PA do to minimize their
mutual discomfort?
a. Adjust lighting so it is tangential to the patient's body.
b. Explain how the examination will proceed.
c. Ask the patient where he comes from.
d. Explain that she is a PA student.
e. Provide ongoing interpretation of findings.
Accurate answer: b.
A 17-year-old male presents to a sexually transmitted disease clinic at the behest of his brother,
who convinced the patient to attend the clinic after he disclosed that he prefers homosexual
partners but is afraid that his last partner may have given him an infection. The patient
expresses to the intake nurse that he is unashamed of his sexual orientation and will not stay
through the visit if he feels that he is dismissed or discriminated against because of it. The nurse
practitioner receives this communication prior to entering the examination room and decides to
employ active listening to best connect with the patient at this critical juncture in his care with
the clinic. Which of the following is an example of an active listening technique?
a. Ignoring visual cues to focus on the patient's exact words
b. Setting aside the patient's emotional state to focus on his medical needs
c. Paring down the patient's conce
d. Using nonverbal communication to encourage the patient to expand their narrative
Accurate answer: d.
, A 42-year-old female mathematician presents for follow-up care regarding a new diagnosis of
systemic lupus erythematosus 6 months ago after a lengthy diagnostic process during which she
was debilitated with fatigue and joint pain. Since her diagnosis, she has been minimally
compliant with medications and has switched her rheumatology provider twice. She continues
to feel ill, and, in explanation for her lack of adherence to the prescribed treatment, she simply
says, "I don't like it." At this initial visit with her third rheumatology provider, the clinician elects
to explore the issues behind her noncompliance before engaging in diagnostics and treatment
using the FIFE model. Which of the following best defines the elements of the FIFE model?
a. Focus, intensity, function, and evaluation
b. Facts, intensity, focus, and evidence
c. Feelings, ideas, function, and expectations
d. Feelings, impression, fantasy, and em
Accurate answer: c.
A 29-year-old female professional athlete presents to a new primary care provider with chronic
menstrual complaints. She remarks to the nursing staff that, in the past, she has experienced a
dismissal of her complaints because of her high level of physical fitness and conditioning. She is
seeking a care provider who will explore the issue in more detail and work with her particular
concerns. Which of the following is the description of the patient-centered care this individual
seeks?
a. Structured and clinician-centered with open-ended questions
b. Validating and empathetic with open-ended questions
c. Dismissive and concrete with open-ended questions
d. Affirming and reassuring with close-ended questions
e. Factual and structured with active listening
Accurate answer: b.
