NR 509 / NR509 Advanced Physical Assessment
Midterm Exam Study Guide
Questions with Verified Answers - Chamberlain
Consist of 250+ multiple choices Questions with Answers
1. A 62-year-old teacher presents to the clinic for evaluation of the following
symptoms: fever, headache, sinus congestion, sore throat, green nasal dis- charge,
and cough. This cluster of symptoms is best explained by:
A) One disease process
B) More than one disease process
ANS: A) One disease process
This cluster of symptoms is most consistent with sinusitis. The chance that all of these
symptoms are caused by multiple synchronous conditions in the same patientis much
less than the possibility of having one problem which accounts for all of them.
,2. Steve has just seen a 5-year-old girl who wheezes when exposed to cats.The
patient's family history is positive for asthma. You think the child most likely has
asthma. What have you just accomplished?
A) You have tested your hypothesis.
B) You have developed a plan.
C) You have established a working diagnosis.
D) You have created a hypothesis.
ANS: D) You have created a hypothesis.
As you go through a history and examination, you will start to generate ideas to
explain the patient's symptoms. It is best to keep an open mind and make as many
hypotheses
as you can, to avoid missing a possibility. A common mistake is to latch onto oneidea
too early.
3. Ms. Washington is a 67-year-old who had a heart attack last month. Nowshe
complains of shortness of breath and not being able to sleep in a flat position
(orthopnea). On examination you note increased jugular venous pressure, an S3
gallop, crackles low in the lung fields, and swollen ankles (edema). This is an
example of a:
,A) Pathophysiologic*problem
B) Psychopathologic*problem
ANS:*A)*Pathophysiologic*problem
This*is*an*example*of*a*pathophysiologic*problem*because*Ms.*Washington's*sympto
ms*are*consistent*with*a*pathophysiologic*process.*The*heart*attack*reduced*the*ability*
of*her*heart*to*handle*her*volume*status*and*subsequently*produced*the*many*featur
es*of*congestive*heart*failure.
4. On*the*way*to*see*your*next*patient,*you*glance*at*the*calendar*and*make*a*ment
al*note*to
buy*a*Mother's*Day*card.*Your*patient*is*Ms.*Hernandez,*a*76-year-
old*widow*who*lost*her
husband*in*May,*two*years*ago.*She*comes*in*today*with*a*headaches,*abdom-
inal*pain,*and
*
general*malaise.*This*happened*once*before,*about*a*year*ago,*according*to*your*de
tailed*office
notes.*You*have*done*a*thorough*evaluation*but*are*unable*to*arrive*at*a*consistent*
picture*to
tie*these*symptoms*together.*This*is*an*example*of*a:
A) Pathophysiologic*problem
B) Psychopathologic*problem
ANS:*B)*Psychopathologic*problem
3*/*104
, It*is*not*uncommon*for*patients*to*experience*psychopathologic*symptoms*around*th
e*anniversary*of*a*traumatic*event.*The*time*of*year*and*the*lack*of*an*obvious*conne
ction
between*Ms.*Hernandez's*symptoms*would*make*you*consider*this*as*a*possibility.*Yo
u*will*note*that*although*this*might*have*been*an*early*consideration*in*your*hypothe
sis*generation,*it*is
key*to*convince*yourself*that*there*is*not*a*physiologic*explanation*for*these*symp-
toms,*by
*
performing*a*careful*history*and*examination.
5. Mr.*Larson*is*a*42-year-old*widowed*father*of*two*children,*ages*4*and*11.
He*works*in*a
sales*office*to*support*his*family.*Recently*he*has*injured*his*back*and*you*are*thin
king*he
would*benefit*from*physical*therapy,*three*times*a*week,*for*an*hour*per*sessio
n.*What*would
be*your*next*step?
A) Write*the*physical*therapy*prescription.
B) Have*your*office*staff*explain*directions*to*the*physical*therapy*center.
C) Discuss*the*plan*with*Mr.*Larson.
D) Tell*Mr.*Larson*that*he*will*be*going*to*physical*therapy*three*times*a*week.
ANS:*C)*Discuss*the*plan*with*Mr.*Larson.
4*/*104
Midterm Exam Study Guide
Questions with Verified Answers - Chamberlain
Consist of 250+ multiple choices Questions with Answers
1. A 62-year-old teacher presents to the clinic for evaluation of the following
symptoms: fever, headache, sinus congestion, sore throat, green nasal dis- charge,
and cough. This cluster of symptoms is best explained by:
A) One disease process
B) More than one disease process
ANS: A) One disease process
This cluster of symptoms is most consistent with sinusitis. The chance that all of these
symptoms are caused by multiple synchronous conditions in the same patientis much
less than the possibility of having one problem which accounts for all of them.
,2. Steve has just seen a 5-year-old girl who wheezes when exposed to cats.The
patient's family history is positive for asthma. You think the child most likely has
asthma. What have you just accomplished?
A) You have tested your hypothesis.
B) You have developed a plan.
C) You have established a working diagnosis.
D) You have created a hypothesis.
ANS: D) You have created a hypothesis.
As you go through a history and examination, you will start to generate ideas to
explain the patient's symptoms. It is best to keep an open mind and make as many
hypotheses
as you can, to avoid missing a possibility. A common mistake is to latch onto oneidea
too early.
3. Ms. Washington is a 67-year-old who had a heart attack last month. Nowshe
complains of shortness of breath and not being able to sleep in a flat position
(orthopnea). On examination you note increased jugular venous pressure, an S3
gallop, crackles low in the lung fields, and swollen ankles (edema). This is an
example of a:
,A) Pathophysiologic*problem
B) Psychopathologic*problem
ANS:*A)*Pathophysiologic*problem
This*is*an*example*of*a*pathophysiologic*problem*because*Ms.*Washington's*sympto
ms*are*consistent*with*a*pathophysiologic*process.*The*heart*attack*reduced*the*ability*
of*her*heart*to*handle*her*volume*status*and*subsequently*produced*the*many*featur
es*of*congestive*heart*failure.
4. On*the*way*to*see*your*next*patient,*you*glance*at*the*calendar*and*make*a*ment
al*note*to
buy*a*Mother's*Day*card.*Your*patient*is*Ms.*Hernandez,*a*76-year-
old*widow*who*lost*her
husband*in*May,*two*years*ago.*She*comes*in*today*with*a*headaches,*abdom-
inal*pain,*and
*
general*malaise.*This*happened*once*before,*about*a*year*ago,*according*to*your*de
tailed*office
notes.*You*have*done*a*thorough*evaluation*but*are*unable*to*arrive*at*a*consistent*
picture*to
tie*these*symptoms*together.*This*is*an*example*of*a:
A) Pathophysiologic*problem
B) Psychopathologic*problem
ANS:*B)*Psychopathologic*problem
3*/*104
, It*is*not*uncommon*for*patients*to*experience*psychopathologic*symptoms*around*th
e*anniversary*of*a*traumatic*event.*The*time*of*year*and*the*lack*of*an*obvious*conne
ction
between*Ms.*Hernandez's*symptoms*would*make*you*consider*this*as*a*possibility.*Yo
u*will*note*that*although*this*might*have*been*an*early*consideration*in*your*hypothe
sis*generation,*it*is
key*to*convince*yourself*that*there*is*not*a*physiologic*explanation*for*these*symp-
toms,*by
*
performing*a*careful*history*and*examination.
5. Mr.*Larson*is*a*42-year-old*widowed*father*of*two*children,*ages*4*and*11.
He*works*in*a
sales*office*to*support*his*family.*Recently*he*has*injured*his*back*and*you*are*thin
king*he
would*benefit*from*physical*therapy,*three*times*a*week,*for*an*hour*per*sessio
n.*What*would
be*your*next*step?
A) Write*the*physical*therapy*prescription.
B) Have*your*office*staff*explain*directions*to*the*physical*therapy*center.
C) Discuss*the*plan*with*Mr.*Larson.
D) Tell*Mr.*Larson*that*he*will*be*going*to*physical*therapy*three*times*a*week.
ANS:*C)*Discuss*the*plan*with*Mr.*Larson.
4*/*104
