NR509 MIDTERM EXAM QUESTIONS
AND ANSWERS 100% PASS 2026/2027
Is the clinical encounter clinician-centered to patient-centered - ANS both; needs to be a
balance of the clinician meeting their needs of the interaction and the patient feeling heard and
create personal dimension
patient-centered approach - ANS Interviewing technique empowering the patient to provide
a candid and complete medical history
recognizes importance of patient concerns, feelings and emotions and understands the patients
personal contact of the symptoms/disease
FIFE model - ANS mnemonic for patients perspective on the illness
Feelings (fears and concerns about the problem)
Ideas (about nature and cause of problem)
Functioning (effect of illness on function)
Expectations
general structure of patient encounter (5 steps) - ANS initiate the encounter
gather information
@2026 ALLRIGHTS RESERVED 1
,perform the physical examination
explaining and planning
closing the encounter
2 frameworks that continue throughout whole clinical encounter - ANS relationship building
structuring the interview
what happens while initiating the encounter - ANS greet the patient and set the
stage/preparation
what does it mean to set the stage - ANS prepare for the interview
check your appearance
make sure patient is comfortable and environment is conducive to private info being shared
what happens during the gathering information stage - ANS initiate information gathering
history of present illness
past medical history
social history
explore patients perspective of disease and relevant background information
what happens during explaining and planning - ANS provide correct amount and type of
information
negotiate plan of action
shared decision making
@2026 ALLRIGHTS RESERVED 2
,when asking patient about there pronouns it may be helpful to.... - ANS share your own
pronouns
"in an effort to promote an inclusive and respectful environment, we use pronouns that are
right for us. The pronouns I prefer are......how about you what pronouns do you prefer?
the initial moments of your encounter lay the foundation for.... - ANS your ongoing
relationship
how to establish rapport - ANS introduce yourself, explain your role and how you will be a
part of their care
3 dimensions of cultural humility - ANS 1) Self-awareness
2) Respectful communication
3) Collaborative partnerships
active listening - ANS Closely listening to what the patient is communicating, connecting on
an emotional state to the patient.
use both verbal and nonverbal skills to encourage pt to expand on their feelings/concerns
Empathetic responses - ANS capacity to identify with a patient and feel patients pain as your
own and respond in a supportive manner
"That must have been difficult for you."
"I understand, you're worried."
Non-verbal: offering a tissue to a crying patient; reaching out and gently touching a patient's
hand.
@2026 ALLRIGHTS RESERVED 3
, Therapeutic use of self: "I've had surgery before, so I can relate to what you're going through."
guided questioning - ANS Helps to continue the patients story, shows sustained interest and
allows clinician to adapt questioning based on patient i.e.:
-moving from open ended to focused questions
-using questions that elicit a graded response
-asking a series of questions, ONE at a time
-clarifying what the patient means
-encouraging with continuers
-using echoing
guided questioning aka - ANS adaptive questioning
nonverbal communication - ANS communication using body movements, gestures, and facial
expressions rather than speech
validation - ANS affirm validity of patients emotional experience
"Your accident must have been terrifying. Car accidents are always unsettling because they
remind us how vulnerable we are. Perhaps that explains why you still feel upset,"
reassurance - ANS first step is to identify and acknowledge the patients feelings
Helps pt feel that the problems have been fully understood and are being addressed
@2026 ALLRIGHTS RESERVED 4
AND ANSWERS 100% PASS 2026/2027
Is the clinical encounter clinician-centered to patient-centered - ANS both; needs to be a
balance of the clinician meeting their needs of the interaction and the patient feeling heard and
create personal dimension
patient-centered approach - ANS Interviewing technique empowering the patient to provide
a candid and complete medical history
recognizes importance of patient concerns, feelings and emotions and understands the patients
personal contact of the symptoms/disease
FIFE model - ANS mnemonic for patients perspective on the illness
Feelings (fears and concerns about the problem)
Ideas (about nature and cause of problem)
Functioning (effect of illness on function)
Expectations
general structure of patient encounter (5 steps) - ANS initiate the encounter
gather information
@2026 ALLRIGHTS RESERVED 1
,perform the physical examination
explaining and planning
closing the encounter
2 frameworks that continue throughout whole clinical encounter - ANS relationship building
structuring the interview
what happens while initiating the encounter - ANS greet the patient and set the
stage/preparation
what does it mean to set the stage - ANS prepare for the interview
check your appearance
make sure patient is comfortable and environment is conducive to private info being shared
what happens during the gathering information stage - ANS initiate information gathering
history of present illness
past medical history
social history
explore patients perspective of disease and relevant background information
what happens during explaining and planning - ANS provide correct amount and type of
information
negotiate plan of action
shared decision making
@2026 ALLRIGHTS RESERVED 2
,when asking patient about there pronouns it may be helpful to.... - ANS share your own
pronouns
"in an effort to promote an inclusive and respectful environment, we use pronouns that are
right for us. The pronouns I prefer are......how about you what pronouns do you prefer?
the initial moments of your encounter lay the foundation for.... - ANS your ongoing
relationship
how to establish rapport - ANS introduce yourself, explain your role and how you will be a
part of their care
3 dimensions of cultural humility - ANS 1) Self-awareness
2) Respectful communication
3) Collaborative partnerships
active listening - ANS Closely listening to what the patient is communicating, connecting on
an emotional state to the patient.
use both verbal and nonverbal skills to encourage pt to expand on their feelings/concerns
Empathetic responses - ANS capacity to identify with a patient and feel patients pain as your
own and respond in a supportive manner
"That must have been difficult for you."
"I understand, you're worried."
Non-verbal: offering a tissue to a crying patient; reaching out and gently touching a patient's
hand.
@2026 ALLRIGHTS RESERVED 3
, Therapeutic use of self: "I've had surgery before, so I can relate to what you're going through."
guided questioning - ANS Helps to continue the patients story, shows sustained interest and
allows clinician to adapt questioning based on patient i.e.:
-moving from open ended to focused questions
-using questions that elicit a graded response
-asking a series of questions, ONE at a time
-clarifying what the patient means
-encouraging with continuers
-using echoing
guided questioning aka - ANS adaptive questioning
nonverbal communication - ANS communication using body movements, gestures, and facial
expressions rather than speech
validation - ANS affirm validity of patients emotional experience
"Your accident must have been terrifying. Car accidents are always unsettling because they
remind us how vulnerable we are. Perhaps that explains why you still feel upset,"
reassurance - ANS first step is to identify and acknowledge the patients feelings
Helps pt feel that the problems have been fully understood and are being addressed
@2026 ALLRIGHTS RESERVED 4
