NR509 Advanced Physical Assessment
Mid-Term week 4 Exam Actual Exam
2026/2027 – Complete Exam-Style
Questions | Detailed Rationales – Pass
Guaranteed – A+ Graded
1. 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.
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, humility, and sensitivity in favor of the
acquisition of concrete details about the patient’s condition
e. Taking a symptom-focused approach to reduce the involvement of the
patient’s emotional difficulties
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 concerns to concrete medical needs
d. Using nonverbal communication to encourage the patient to expand
their narrative
e. Considering a differential diagnosis while the patient is speaking to
maximize the patient’s time with the provider
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 emotion
e. Facts, intelligence, fortuity, and eventuality
Chapter 2
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.
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
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 confirming how she
feels about the event
c. By allowing the crying patient to look around the room for tissues to
permit her an excuse to hide her face and defer her emotions
d. Presuming that the patient’s emotions meet social expectations, such
as being depressed and even traumatized by her spouse’s death
e. Narrowing the understanding of the patient’s emotional response to
only thoughts and feelings that have been verbalized
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
Mid-Term week 4 Exam Actual Exam
2026/2027 – Complete Exam-Style
Questions | Detailed Rationales – Pass
Guaranteed – A+ Graded
1. 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.
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, humility, and sensitivity in favor of the
acquisition of concrete details about the patient’s condition
e. Taking a symptom-focused approach to reduce the involvement of the
patient’s emotional difficulties
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 concerns to concrete medical needs
d. Using nonverbal communication to encourage the patient to expand
their narrative
e. Considering a differential diagnosis while the patient is speaking to
maximize the patient’s time with the provider
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 emotion
e. Facts, intelligence, fortuity, and eventuality
Chapter 2
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.
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
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 confirming how she
feels about the event
c. By allowing the crying patient to look around the room for tissues to
permit her an excuse to hide her face and defer her emotions
d. Presuming that the patient’s emotions meet social expectations, such
as being depressed and even traumatized by her spouse’s death
e. Narrowing the understanding of the patient’s emotional response to
only thoughts and feelings that have been verbalized
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
