NR 509 – Midterm Exam Questions &
Correct Answers | Chamberlain
University | 2025 | Complete Exam
EXAM
**1. A 45-year-old forklift driver presents with intense substernal chest
pain, nausea, pallor, and diaphoresis after heavy lifting. The PA
questions him in detail about his nausea and eating habits. What step
of clinical reasoning did the PA fail to follow?**
a) Elicit information about the GI system
b) Localize findings anatomically
c) Match findings against conditions
d) Give special consideration to life-threatening problems
**Answer: d) Give special consideration to life-threatening problems**
**Rationale:** The patient's symptoms (chest pain, pallor, diaphoresis)
are concerning for a myocardial infarction. The clinician's first priority
should be to rule out life-threatening conditions before pursuing a
detailed history of benign issues like eating habits .
,**2. A 23-year-old PA student feels nervous examining male patients
her age. She encounters an embarrassed young male patient. What
should she do to minimize mutual discomfort?**
a) Adjust the lighting to be tangential.
b) Explain how the examination will proceed.
c) Ask the patient where he is from.
d) Explain that she is a student.
**Answer: b) Explain how the examination will proceed.**
**Rationale:** Explaining the steps of the exam sets clear expectations,
which helps reduce anxiety and embarrassment for both the patient
and the clinician by making the situation more predictable and
professional .
**3. A 34-year-old with a history of adversarial relationships with
clinicians presents. What interview style is most likely to lead to
comprehensive care and compliance?**
a) Focusing on diagnostic certainty over personal connection
b) Taking charge to meet the clinician's desire for information
c) Following the patient's lead to understand their thoughts and
concerns
d) Deferring empathy to focus on concrete details
**Answer: c) Following the patient's lead to understand their thoughts
and concerns**
**Rationale:** Patient-centered care, where the clinician follows the
patient's lead, builds trust and rapport. This is crucial for patients with a
, history of non-compliance or adversarial relationships, as it validates
their experience and engages them in their care .
**4. A 42-year-old with lupus is non-compliant, stating, "I don't like it."
The clinician uses the FIFE model. What does FIFE stand for?**
a) Focus, Intensity, Function, Evaluation
b) Facts, Intensity, Focus, Evidence
c) Feelings, Ideas, Function, Expectations
d) Feelings, Impression, Fantasy, Emotion
**Answer: c) Feelings, Ideas, Function, Expectations**
**Rationale:** FIFE is a framework for understanding the patient's
perspective: **F**eelings about the illness, **I**deas about what is
wrong, the effect on **F**unction, and **E**xpectations of what the
clinician will do .
**5. A 39-year-old nurse reports irregular menses, pelvic pain,
insomnia, and thoughts of leaving her job. What is the best next
step?**
a) Perform a pelvic examination.
b) Obtain a urine sample.
c) Obtain a more complete description of the problems.
d) Obtain blood for testing.
**Answer: c) Obtain a more complete description of the problems.**
Correct Answers | Chamberlain
University | 2025 | Complete Exam
EXAM
**1. A 45-year-old forklift driver presents with intense substernal chest
pain, nausea, pallor, and diaphoresis after heavy lifting. The PA
questions him in detail about his nausea and eating habits. What step
of clinical reasoning did the PA fail to follow?**
a) Elicit information about the GI system
b) Localize findings anatomically
c) Match findings against conditions
d) Give special consideration to life-threatening problems
**Answer: d) Give special consideration to life-threatening problems**
**Rationale:** The patient's symptoms (chest pain, pallor, diaphoresis)
are concerning for a myocardial infarction. The clinician's first priority
should be to rule out life-threatening conditions before pursuing a
detailed history of benign issues like eating habits .
,**2. A 23-year-old PA student feels nervous examining male patients
her age. She encounters an embarrassed young male patient. What
should she do to minimize mutual discomfort?**
a) Adjust the lighting to be tangential.
b) Explain how the examination will proceed.
c) Ask the patient where he is from.
d) Explain that she is a student.
**Answer: b) Explain how the examination will proceed.**
**Rationale:** Explaining the steps of the exam sets clear expectations,
which helps reduce anxiety and embarrassment for both the patient
and the clinician by making the situation more predictable and
professional .
**3. A 34-year-old with a history of adversarial relationships with
clinicians presents. What interview style is most likely to lead to
comprehensive care and compliance?**
a) Focusing on diagnostic certainty over personal connection
b) Taking charge to meet the clinician's desire for information
c) Following the patient's lead to understand their thoughts and
concerns
d) Deferring empathy to focus on concrete details
**Answer: c) Following the patient's lead to understand their thoughts
and concerns**
**Rationale:** Patient-centered care, where the clinician follows the
patient's lead, builds trust and rapport. This is crucial for patients with a
, history of non-compliance or adversarial relationships, as it validates
their experience and engages them in their care .
**4. A 42-year-old with lupus is non-compliant, stating, "I don't like it."
The clinician uses the FIFE model. What does FIFE stand for?**
a) Focus, Intensity, Function, Evaluation
b) Facts, Intensity, Focus, Evidence
c) Feelings, Ideas, Function, Expectations
d) Feelings, Impression, Fantasy, Emotion
**Answer: c) Feelings, Ideas, Function, Expectations**
**Rationale:** FIFE is a framework for understanding the patient's
perspective: **F**eelings about the illness, **I**deas about what is
wrong, the effect on **F**unction, and **E**xpectations of what the
clinician will do .
**5. A 39-year-old nurse reports irregular menses, pelvic pain,
insomnia, and thoughts of leaving her job. What is the best next
step?**
a) Perform a pelvic examination.
b) Obtain a urine sample.
c) Obtain a more complete description of the problems.
d) Obtain blood for testing.
**Answer: c) Obtain a more complete description of the problems.**
