NR 509
MIDTERM EXAM
Expected Questions with Answers
(Advanced Physical Assessment)
Chamberlain
What You Will Get:
Instant PDF download
100 multiple-choice questions
Verified answers included
Detailed rationales for review
Advanced Physical Assessment focused
Great for Midterm exam review and self-study
Please note: This is an independent study resource and is not affiliated
with or endorsed by Chamberlain University.
,.
1. 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 that led to back pain
d. Asking leading questions that focus on the presumed diagnosis of chest pain
e. Moving from open-ended to focused questions
Correct Answer: e. Moving from open-ended to focused questions
Rationale: When a potentially life-threatening symptom emerges during a patient
interview, the clinician should transition from broad, open-ended questions to more
focused inquiries that clarify the nature, severity, and urgency of the new complaint.
This ensures that critical information is gathered efficiently without completely
abandoning patient-centered communication.
2. 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
Correct Answer: b. Echoing
Rationale: Echoing is an interviewing technique in which the clinician repeats the
patient's last few words or a key phrase to encourage elaboration. By saying "Just
like?" the clinician prompted the patient to continue his narrative without directing
the content.
3. 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 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 and must be able to talk about your health."
c. "You need to see a counselor since you have not adjusted well to your new
condition."
d. "You have recovered well and should start moving on with your life."
e. "You cannot rely on your father for support forever."
Correct Answer: a. "That sounds like a frightening experience that you are recovering
well from."
Rationale: This statement validates the patient's experience, acknowledges the
emotional weight of his cancer history, and recognizes his resilience. It is
nonjudgmental and patient-centered, which helps build trust. The other options are
, either dismissive, prematurely push autonomy, or pathologize normal coping
behaviors.
4. 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.
Correct Answer: c. Obtain a more complete description of problems.
Rationale: Before ordering tests or performing procedures, the clinician must gather
a comprehensive history to understand the full scope of the patient's concerns. Sleep
disturbance, menstrual irregularities, pelvic pain, and job dissatisfaction may indicate
depression, anxiety, perimenopause, or another underlying condition. A thorough
history guides appropriate diagnostic and therapeutic decisions.
5. 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
MIDTERM EXAM
Expected Questions with Answers
(Advanced Physical Assessment)
Chamberlain
What You Will Get:
Instant PDF download
100 multiple-choice questions
Verified answers included
Detailed rationales for review
Advanced Physical Assessment focused
Great for Midterm exam review and self-study
Please note: This is an independent study resource and is not affiliated
with or endorsed by Chamberlain University.
,.
1. 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 that led to back pain
d. Asking leading questions that focus on the presumed diagnosis of chest pain
e. Moving from open-ended to focused questions
Correct Answer: e. Moving from open-ended to focused questions
Rationale: When a potentially life-threatening symptom emerges during a patient
interview, the clinician should transition from broad, open-ended questions to more
focused inquiries that clarify the nature, severity, and urgency of the new complaint.
This ensures that critical information is gathered efficiently without completely
abandoning patient-centered communication.
2. 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
Correct Answer: b. Echoing
Rationale: Echoing is an interviewing technique in which the clinician repeats the
patient's last few words or a key phrase to encourage elaboration. By saying "Just
like?" the clinician prompted the patient to continue his narrative without directing
the content.
3. 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 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 and must be able to talk about your health."
c. "You need to see a counselor since you have not adjusted well to your new
condition."
d. "You have recovered well and should start moving on with your life."
e. "You cannot rely on your father for support forever."
Correct Answer: a. "That sounds like a frightening experience that you are recovering
well from."
Rationale: This statement validates the patient's experience, acknowledges the
emotional weight of his cancer history, and recognizes his resilience. It is
nonjudgmental and patient-centered, which helps build trust. The other options are
, either dismissive, prematurely push autonomy, or pathologize normal coping
behaviors.
4. 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.
Correct Answer: c. Obtain a more complete description of problems.
Rationale: Before ordering tests or performing procedures, the clinician must gather
a comprehensive history to understand the full scope of the patient's concerns. Sleep
disturbance, menstrual irregularities, pelvic pain, and job dissatisfaction may indicate
depression, anxiety, perimenopause, or another underlying condition. A thorough
history guides appropriate diagnostic and therapeutic decisions.
5. 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
