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Midterm Exam: NR 509/ NR509 Midterm Exam Advanced Physical
Assessment (Latest 2026/ 2027) Questions with Verified Answers -
Chamberlain
Favoured stuvia
THIS DOCUMENT CONTAINS :
NR 509/ NR509 Midterm Exam
NR509 Midterm Exam Advanced Physical Assessment
Latest 2026/ 2027
Questions with Verified Answers - Chamberlain
,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. –
Answer-c. Obtain a more complete description of problems.
Explanation:
This patient is presenting with multiple, loosely connected complaints—irregular menses, pelvic pain,
insomnia, and thoughts about leaving her job. That pattern raises the possibility of psychosocial stress,
mood disturbance, or a broader underlying issue (e.g., anxiety, depression, perimenopause, or stress-
related somatic symptoms), not just a single gynecologic problem.
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 –
Answer-b. Validating and empathetic with open-ended questions
Explanation:
This patient clearly states that her concerns were previously dismissed because she is a professional
athlete. She is now seeking a provider who will take her symptoms seriously, explore them fully, and
partner with her in care. That is the core of patient-centered care.
A 63-year-old male presents to establish care at a new primary care clinic to discuss issues with pain and
fatigue. The clinician conducting the visit begins with general historical questions but quickly becomes
suspicious that the patient is suffering from decompensated heart failure. When the patient mentions
that he has had vague chest pain since last night, the clinician feels that the focus must be redirected to
this potentially emergent condition. Which of the following interview techniques is the most
appropriate to effectively manage this visit?
a. Providing0serial0reassurances0such0as,0"Don't0worry,0you're0going0to0be0fine."
b. Asking0a0series0of0negative0questions0such0as,0"You0don't0have0any0swelling0in0your0feet,0do0you?"
c. Nonverbally0cuing0the0patient0to0focus0on0his0narrative0regarding0a0motor0vehicle0accident
d. (MVA)0that0led0to0back0pain
e. Asking0leading0questions0that0focus0on0the0presumed0diag0–
Answer-f.0Moving0from0open-
ended0to0focused0questions0Explanation:
In0a0patient0interview,0the0clinician0typically0begins0with0open-
ended0questions0to0allow0the0patient0to0describe0their0concerns0in0their0own0words.0This0helps0buil
d0rapport0and0ensures0that0important
information0isn’t0missed.
However,0if0the0clinician0suspects0a0potentially0serious0or0emergent0condition0(like0decompensated0h
eart0failure0or0acute0chest0pain),0it0is0appropriate0to0narrow0the0interview0to0focused,0specific0quest
ions0that0target0the0urgent0problem.
, A059-year-
old0patient0presents0to0his0primary0care0provider0with0a0history0of0several0episodes0of0sharp0epigas
tric0pain.0His0father0died0of0pancreatic0cancer0at0age0520years,0and0the0patient0recalls0to0the0clinici
an0that,0"His0pain0was0just0like0mine0is0now0..."0The0patient0then0pauses0several0seconds.0The0clini
cian0replies,0"Just0like?"0after0which0the0patient0restarts0his0narrative.0Which0of0the0following0is0an0
example0of0the0interviewing0techniques0employed0by0the0clinician?
a. Clarifying
b. Echoing
c. Encouraging0with0continuers0d.0Eliciting0a0graded0response
e.0Asking0a0leading0question0–
Answer-
b.0Echoing0Explan
ation:
Echoing0is0an0interview0technique0in0which0the0clinician0repeats0a0key0word0or0phrase0from0the0pat
ient’s0statement0to0prompt0further0elaboration.0It0is0often0done0without0adding0new0content,0simpl
y0to0encourage0the0patient0to0continue0and0clarify0their0story.
A014-year-
old0male0presents0to0a0new0primary0care0provider0after0his0family0relocates0to0a0state.0The0patient0
underwent0treatment0for0sarcoma0when0he0was0age0110years,0including0an0above-the-
knee0amputation.0He0has0learned0to0successfully0navigate0with0a0prosthetic0leg0and0even0engage0in0
competitive0athletics0at0school.0He0does0not0like0to0speak0of0his0experience0with0cancer0and0often0
makes0up0humorous0stories0to0tell0new0acquaintances0about0his0amputation0(such0as,0"I0got0bit0by0a
0squirrel0and0they0had0to0amputate.").0Although0he0is0very0well0engaged0in0most0of0the0visit0with0t
he0new0clinician,0when0the0topic0of0cancer0arises,0he0demurs0to0his0father,0who0accompanies0him0t
o0this0appointment.
Which0of0the0following0statements0is0most0likely0to0be0helpful0in0cementing0the0patient's0trust0in0th
e0new0provider
a. "That0sounds0like0a0frightening0experience0that0you0are0recovering0well0from."
b. "You0are0becoming0an0adult0–
Answer-a.0"That0sounds0like0a0frightening0experience0that0you0are0recovering0well0from."
Explanation:
This0adolescent0patient0has0a0history0of0serious0illness0and0amputation,0and0he0demonstrates0copi
Midterm Exam: NR 509/ NR509 Midterm Exam Advanced Physical
Assessment (Latest 2026/ 2027) Questions with Verified Answers -
Chamberlain
Favoured stuvia
THIS DOCUMENT CONTAINS :
NR 509/ NR509 Midterm Exam
NR509 Midterm Exam Advanced Physical Assessment
Latest 2026/ 2027
Questions with Verified Answers - Chamberlain
,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. –
Answer-c. Obtain a more complete description of problems.
Explanation:
This patient is presenting with multiple, loosely connected complaints—irregular menses, pelvic pain,
insomnia, and thoughts about leaving her job. That pattern raises the possibility of psychosocial stress,
mood disturbance, or a broader underlying issue (e.g., anxiety, depression, perimenopause, or stress-
related somatic symptoms), not just a single gynecologic problem.
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 –
Answer-b. Validating and empathetic with open-ended questions
Explanation:
This patient clearly states that her concerns were previously dismissed because she is a professional
athlete. She is now seeking a provider who will take her symptoms seriously, explore them fully, and
partner with her in care. That is the core of patient-centered care.
A 63-year-old male presents to establish care at a new primary care clinic to discuss issues with pain and
fatigue. The clinician conducting the visit begins with general historical questions but quickly becomes
suspicious that the patient is suffering from decompensated heart failure. When the patient mentions
that he has had vague chest pain since last night, the clinician feels that the focus must be redirected to
this potentially emergent condition. Which of the following interview techniques is the most
appropriate to effectively manage this visit?
a. Providing0serial0reassurances0such0as,0"Don't0worry,0you're0going0to0be0fine."
b. Asking0a0series0of0negative0questions0such0as,0"You0don't0have0any0swelling0in0your0feet,0do0you?"
c. Nonverbally0cuing0the0patient0to0focus0on0his0narrative0regarding0a0motor0vehicle0accident
d. (MVA)0that0led0to0back0pain
e. Asking0leading0questions0that0focus0on0the0presumed0diag0–
Answer-f.0Moving0from0open-
ended0to0focused0questions0Explanation:
In0a0patient0interview,0the0clinician0typically0begins0with0open-
ended0questions0to0allow0the0patient0to0describe0their0concerns0in0their0own0words.0This0helps0buil
d0rapport0and0ensures0that0important
information0isn’t0missed.
However,0if0the0clinician0suspects0a0potentially0serious0or0emergent0condition0(like0decompensated0h
eart0failure0or0acute0chest0pain),0it0is0appropriate0to0narrow0the0interview0to0focused,0specific0quest
ions0that0target0the0urgent0problem.
, A059-year-
old0patient0presents0to0his0primary0care0provider0with0a0history0of0several0episodes0of0sharp0epigas
tric0pain.0His0father0died0of0pancreatic0cancer0at0age0520years,0and0the0patient0recalls0to0the0clinici
an0that,0"His0pain0was0just0like0mine0is0now0..."0The0patient0then0pauses0several0seconds.0The0clini
cian0replies,0"Just0like?"0after0which0the0patient0restarts0his0narrative.0Which0of0the0following0is0an0
example0of0the0interviewing0techniques0employed0by0the0clinician?
a. Clarifying
b. Echoing
c. Encouraging0with0continuers0d.0Eliciting0a0graded0response
e.0Asking0a0leading0question0–
Answer-
b.0Echoing0Explan
ation:
Echoing0is0an0interview0technique0in0which0the0clinician0repeats0a0key0word0or0phrase0from0the0pat
ient’s0statement0to0prompt0further0elaboration.0It0is0often0done0without0adding0new0content,0simpl
y0to0encourage0the0patient0to0continue0and0clarify0their0story.
A014-year-
old0male0presents0to0a0new0primary0care0provider0after0his0family0relocates0to0a0state.0The0patient0
underwent0treatment0for0sarcoma0when0he0was0age0110years,0including0an0above-the-
knee0amputation.0He0has0learned0to0successfully0navigate0with0a0prosthetic0leg0and0even0engage0in0
competitive0athletics0at0school.0He0does0not0like0to0speak0of0his0experience0with0cancer0and0often0
makes0up0humorous0stories0to0tell0new0acquaintances0about0his0amputation0(such0as,0"I0got0bit0by0a
0squirrel0and0they0had0to0amputate.").0Although0he0is0very0well0engaged0in0most0of0the0visit0with0t
he0new0clinician,0when0the0topic0of0cancer0arises,0he0demurs0to0his0father,0who0accompanies0him0t
o0this0appointment.
Which0of0the0following0statements0is0most0likely0to0be0helpful0in0cementing0the0patient's0trust0in0th
e0new0provider
a. "That0sounds0like0a0frightening0experience0that0you0are0recovering0well0from."
b. "You0are0becoming0an0adult0–
Answer-a.0"That0sounds0like0a0frightening0experience0that0you0are0recovering0well0from."
Explanation:
This0adolescent0patient0has0a0history0of0serious0illness0and0amputation,0and0he0demonstrates0copi
