1|Page
NR 509 MIDTERM EXAM STUDY
GUIDE 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS
ALREADY A GRADED |NEW AND
REVISED
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 - ANSWER- b. Echoing
A 14-year-old male presents to a new primary care provider after his
family relocates to a state. The patient underwent treatment for sarcoma
when he was age 11 years, including an above-the-knee amputation. He
has learned to successfully navigate with a prosthetic leg and even
engage in competitive athletics at school. He does not like to speak of
his experience with cancer and often makes up humorous stories to tell
new acquaintances about his amputation (such as, "I got bit by a squirrel
,2|Page
and they had to amputate."). Although he is very well engaged in most
of the visit with the new clinician, when the topic of cancer arises, he
demurs to his father, who accompanies him to this appointment. Which
of the following statements is most likely to be helpful in cementing the
patient's trust in the new provider
a. "That sounds like a frightening experience that you are recovering
well from."
b. "You are becoming an adult - ANSWER- a. "That sounds like a
frightening experience that you are recovering well from."
A 29-year-old electrician complains of persistent cough and wheezing,
particularly when he exercises. He says he smokes "occasionally" but
rarely so much that he needs to purchase cigarettes: "Mostly, I bum
them," he says, chuckling. Upon hearing this information, what is the
best next step on the part of the clinician?
a. Determine the patient's exercise regimen.
b. Determine the number of pack-years the patient smokes.
c. Conduct a mental status examination.
d. Explain the relationship between smoking and cancer.
e. Determine the patient's immunization history. - ANSWER- b.
Determine the number of pack-years the patient smokes.
A 47-year-old fitness trainer visits the physician assistant (PA) because
of skin dryness, night sweats, and irregular menstrual periods. It is the
PA's first contact with this patient. The patient notes that "My sex life
,3|Page
has really gone downhill lately" and says that she is considering
divorcing her husband of 20 years, stating that "He's not a bad guy. I just
think that I can do better." In which of the following ways should the
clinician proceed?
a. Obtain a menstrual history for the previous 6 months.
b. Help the patient review the pros and cons of divorce.
c. Inform the patient that menopause is a normal part of aging.
d. Conduct a breast examination.
e. Determine the patient's out-of-country travel history. - ANSWER- a.
Obtain a menstrual history for the previous 6 months.
One important examination technique involves using the third fingers of
each hand to determine the health of internal organs. What is the name
of this technique?
a. Auscultation
b. Percussion
c. Inspection
d. Palpation
e. Listening - ANSWER- b. Percussion
The CAGE questionnaire is a short screening examination administered
in the office to evaluate for which of the following?
, 4|Page
a. Alcohol misuse
b. Risk for illicit substance abuse
c. Likelihood that the patient complaints are "psychosomatic"
d. Major depressive disorder
e. Bipolar disorder - ANSWER- a. Alcohol misuse
A 53-year-old caterer comes to the clinic for a routine examination. She
has type 2 diabetes mellitus, which is well controlled on medication. Her
history from her last visit reveals that she smoked one pack of cigarettes
a day at that time. The 5 As Model is a useful approach to take with
trying to help patients to quit smoking. What is the 5 As Model?
a. Admonish, action, available, assess, alleviating factors
b. Agitate, assist, alleviating factors, able, action
c. Affable, associated manifestations, ask, admonish, available
d. Ask, advise, assess, assist, arrange
e. Arrange, aggravating factors, action, attitude, able - ANSWER- d.
Ask, advise, assess, assist, arrange
A 21-year-old college student experiences tachycardia following a night
of heavy drinking. She is advised to undergo a stress electrocardiogram
(ECG). As she exercises, the recently calibrated pulse oximeter records a
heart rate ranging from 25 beats per minute (bpm) at rest to 50 bpm
while jogging. The test is stopped and re-started twice, and each time the
pulse oximeter yields a resting heart rate of 25 and a jogging heart rate
of 50. Which aspect of this instrument does the ECG technician
question?
NR 509 MIDTERM EXAM STUDY
GUIDE 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS
ALREADY A GRADED |NEW AND
REVISED
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 - ANSWER- b. Echoing
A 14-year-old male presents to a new primary care provider after his
family relocates to a state. The patient underwent treatment for sarcoma
when he was age 11 years, including an above-the-knee amputation. He
has learned to successfully navigate with a prosthetic leg and even
engage in competitive athletics at school. He does not like to speak of
his experience with cancer and often makes up humorous stories to tell
new acquaintances about his amputation (such as, "I got bit by a squirrel
,2|Page
and they had to amputate."). Although he is very well engaged in most
of the visit with the new clinician, when the topic of cancer arises, he
demurs to his father, who accompanies him to this appointment. Which
of the following statements is most likely to be helpful in cementing the
patient's trust in the new provider
a. "That sounds like a frightening experience that you are recovering
well from."
b. "You are becoming an adult - ANSWER- a. "That sounds like a
frightening experience that you are recovering well from."
A 29-year-old electrician complains of persistent cough and wheezing,
particularly when he exercises. He says he smokes "occasionally" but
rarely so much that he needs to purchase cigarettes: "Mostly, I bum
them," he says, chuckling. Upon hearing this information, what is the
best next step on the part of the clinician?
a. Determine the patient's exercise regimen.
b. Determine the number of pack-years the patient smokes.
c. Conduct a mental status examination.
d. Explain the relationship between smoking and cancer.
e. Determine the patient's immunization history. - ANSWER- b.
Determine the number of pack-years the patient smokes.
A 47-year-old fitness trainer visits the physician assistant (PA) because
of skin dryness, night sweats, and irregular menstrual periods. It is the
PA's first contact with this patient. The patient notes that "My sex life
,3|Page
has really gone downhill lately" and says that she is considering
divorcing her husband of 20 years, stating that "He's not a bad guy. I just
think that I can do better." In which of the following ways should the
clinician proceed?
a. Obtain a menstrual history for the previous 6 months.
b. Help the patient review the pros and cons of divorce.
c. Inform the patient that menopause is a normal part of aging.
d. Conduct a breast examination.
e. Determine the patient's out-of-country travel history. - ANSWER- a.
Obtain a menstrual history for the previous 6 months.
One important examination technique involves using the third fingers of
each hand to determine the health of internal organs. What is the name
of this technique?
a. Auscultation
b. Percussion
c. Inspection
d. Palpation
e. Listening - ANSWER- b. Percussion
The CAGE questionnaire is a short screening examination administered
in the office to evaluate for which of the following?
, 4|Page
a. Alcohol misuse
b. Risk for illicit substance abuse
c. Likelihood that the patient complaints are "psychosomatic"
d. Major depressive disorder
e. Bipolar disorder - ANSWER- a. Alcohol misuse
A 53-year-old caterer comes to the clinic for a routine examination. She
has type 2 diabetes mellitus, which is well controlled on medication. Her
history from her last visit reveals that she smoked one pack of cigarettes
a day at that time. The 5 As Model is a useful approach to take with
trying to help patients to quit smoking. What is the 5 As Model?
a. Admonish, action, available, assess, alleviating factors
b. Agitate, assist, alleviating factors, able, action
c. Affable, associated manifestations, ask, admonish, available
d. Ask, advise, assess, assist, arrange
e. Arrange, aggravating factors, action, attitude, able - ANSWER- d.
Ask, advise, assess, assist, arrange
A 21-year-old college student experiences tachycardia following a night
of heavy drinking. She is advised to undergo a stress electrocardiogram
(ECG). As she exercises, the recently calibrated pulse oximeter records a
heart rate ranging from 25 beats per minute (bpm) at rest to 50 bpm
while jogging. The test is stopped and re-started twice, and each time the
pulse oximeter yields a resting heart rate of 25 and a jogging heart rate
of 50. Which aspect of this instrument does the ECG technician
question?
