NR509 2024-2025 update/NR509 / NR 509 Midterm Exam (Latest ):
Advanced Physical Assessment - Chamberlain/GET IT 100% ACCURATE!
/GRADED A+
1. 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,: c. Following the patient's lead to understand their thoughts, ideas, concerns, and
requests
2. 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 tearfu
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: b. Recognizing the patient's emotions by asking or confirming
how she feels about the event
3. 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 ap-peara: c. Both of these eating disorders are
associated with a real or imagined fear of appearing fat.
4. 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?
,NR509 2024-2025 update/NR509 / NR 509 Midterm Exam (Latest ):
Advanced Physical Assessment - Chamberlain/GET IT 100% ACCURATE!
/GRADED A+
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.: b. Explain how the examination will proceed.
5. 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
6. 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: c. Feelings, ideas, function, and expectations
7. 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.
, NR509 2024-2025 update/NR509 / NR 509 Midterm Exam (Latest ):
Advanced Physical Assessment - Chamberlain/GET IT 100% ACCURATE!
/GRADED A+
d. Obtain blood for testing.
e. Ask about recent travel destinations.: c. Obtain a more complete description of problems.
8. 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: b. Validating and empathetic with open-ended questions
9. 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. Providing serial reassurances such as, "Don't worry, you're going to be fine."
b. Asking a series of negative questions such as, "You don't have any swelling in your feet, do you?"
c. Nonverbally cuing the patient to focus on his narrative regarding a motor vehicle accident
d. (MVA) that led to back pain
e. Asking leading questions that focus on the presumed diag: f. Moving from open-ended to focused questions
10. A 59-year-old patient presents to his primary care provider with a history of several episodes of sharp epigastric pain. His
father died of pancreatic cancer at age 52 years, and the patient recalls to the clinician that, "His pain was just like mine is now ..."
The patient then pauses several seconds. The clinician replies, "Just like?" after which the patient restarts his narrative. Which of
the following is an example of the interviewing techniques employed by the clinician?
a. Clarifying
b. Echoing
c. Encouraging with continuers d. Eliciting a graded response
e. Asking a leading question: b. Echoing
Advanced Physical Assessment - Chamberlain/GET IT 100% ACCURATE!
/GRADED A+
1. 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,: c. Following the patient's lead to understand their thoughts, ideas, concerns, and
requests
2. 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 tearfu
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: b. Recognizing the patient's emotions by asking or confirming
how she feels about the event
3. 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 ap-peara: c. Both of these eating disorders are
associated with a real or imagined fear of appearing fat.
4. 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?
,NR509 2024-2025 update/NR509 / NR 509 Midterm Exam (Latest ):
Advanced Physical Assessment - Chamberlain/GET IT 100% ACCURATE!
/GRADED A+
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.: b. Explain how the examination will proceed.
5. 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
6. 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: c. Feelings, ideas, function, and expectations
7. 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.
, NR509 2024-2025 update/NR509 / NR 509 Midterm Exam (Latest ):
Advanced Physical Assessment - Chamberlain/GET IT 100% ACCURATE!
/GRADED A+
d. Obtain blood for testing.
e. Ask about recent travel destinations.: c. Obtain a more complete description of problems.
8. 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: b. Validating and empathetic with open-ended questions
9. 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. Providing serial reassurances such as, "Don't worry, you're going to be fine."
b. Asking a series of negative questions such as, "You don't have any swelling in your feet, do you?"
c. Nonverbally cuing the patient to focus on his narrative regarding a motor vehicle accident
d. (MVA) that led to back pain
e. Asking leading questions that focus on the presumed diag: f. Moving from open-ended to focused questions
10. A 59-year-old patient presents to his primary care provider with a history of several episodes of sharp epigastric pain. His
father died of pancreatic cancer at age 52 years, and the patient recalls to the clinician that, "His pain was just like mine is now ..."
The patient then pauses several seconds. The clinician replies, "Just like?" after which the patient restarts his narrative. Which of
the following is an example of the interviewing techniques employed by the clinician?
a. Clarifying
b. Echoing
c. Encouraging with continuers d. Eliciting a graded response
e. Asking a leading question: b. Echoing
