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. 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
thinking he would benefit from physical therapy, three times a week, for an hour per
session. 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.
Correct Answer: C) Discuss the plan with Mr. Larson.
Rationale: You should discuss your proposed plan with the patient before implementing
it. In this case, you and Mr. Larson will need to weigh the benefit of physical therapy
against the ability to provide for his family. You may need to consider other ways of
helping the patient, perhaps through prescribed back exercises he can do at home. It is a
common mistake to implement a plan without coming to an agreement with the patient
first.
2. You are seeing an elderly man with multiple complaints. He has chronic arthritis,
pain from an old war injury, and headaches. Today he complains of these pains, as well
as dull chest pain under his sternum. What would the order of priority be for your
problem list?
A) Arthritis, war injury pain, headaches, chest pain
B) War injury pain, arthritis, headaches, chest pain
C) Headaches, arthritis, war injury pain, chest pain
D) Chest pain, headaches, arthritis, war injury pain
Correct Answer: D) Chest pain, headaches, arthritis, war injury pain
Rationale: The problem list should have the most active and serious problem first. This
new complaint of chest pain is almost certainly a higher priority than his other, more
chronic problems.
3. You are excited about a positive test finding you have just noticed on physical
examination of your patient. You go on to do more examination, laboratory work, and
,diagnostic tests, only to find that there is no sign of the disease you thought would
correlate with the finding. This same experience happens several times. What should
you conclude?
A) Consider not doing this test routinely.
B) Use this test when you have a higher suspicion for a certain correlating condition.
C) Continue using the test, perhaps doing less laboratory work and diagnostics.
D) Omit this test from future examinations.
Correct Answer: C) Continue using the test, perhaps doing less laboratory work and
diagnostics.
Rationale: This is an example of a specific test that lacks sensitivity. With this scenario,
when you finally find a positive, you might be very certain that a given condition is
present. We generally develop our examinations to fit our clinical experiences. Sensitive
tests are performed routinely on the screening examination, while specific tests are
usually saved for the detailed or "branched" examinations. Branched examinations are
further maneuvers we can perform to investigate positive findings on our screening
examinations. Save this type of maneuver to confirm your hypothesis.
4. A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine
Correct Answer: A) Musculoskeletal
Rationale: Chest pain may be due to a musculoskeletal condition, such as
costochondritis or intercostal muscle cramp. This would be worsened by motion of the
chest wall. Pleuritic chest pain is also a sharp chest pain which increases with a deep
breath. This type of pain can occur with inflammation of the pleura from pneumonia or
other conditions and pulmonary embolus.
, 5. A 62-year-old teacher presents to the clinic for evaluation of the following
symptoms: fever, headache, sinus congestion, sore throat, green nasal discharge, and
cough. This cluster of symptoms is best explained by:
A) One disease process
B) More than one disease process
Correct Answer: A) One disease process
Rationale: 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 patient is
much less than the possibility of having one problem which accounts for all of them.
6. 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.
Correct Answer: D) You have created a hypothesis.
Rationale: 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
one idea too early.
7. Ms. Washington is a 67-year-old who had a heart attack last month. Now she
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
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. 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
thinking he would benefit from physical therapy, three times a week, for an hour per
session. 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.
Correct Answer: C) Discuss the plan with Mr. Larson.
Rationale: You should discuss your proposed plan with the patient before implementing
it. In this case, you and Mr. Larson will need to weigh the benefit of physical therapy
against the ability to provide for his family. You may need to consider other ways of
helping the patient, perhaps through prescribed back exercises he can do at home. It is a
common mistake to implement a plan without coming to an agreement with the patient
first.
2. You are seeing an elderly man with multiple complaints. He has chronic arthritis,
pain from an old war injury, and headaches. Today he complains of these pains, as well
as dull chest pain under his sternum. What would the order of priority be for your
problem list?
A) Arthritis, war injury pain, headaches, chest pain
B) War injury pain, arthritis, headaches, chest pain
C) Headaches, arthritis, war injury pain, chest pain
D) Chest pain, headaches, arthritis, war injury pain
Correct Answer: D) Chest pain, headaches, arthritis, war injury pain
Rationale: The problem list should have the most active and serious problem first. This
new complaint of chest pain is almost certainly a higher priority than his other, more
chronic problems.
3. You are excited about a positive test finding you have just noticed on physical
examination of your patient. You go on to do more examination, laboratory work, and
,diagnostic tests, only to find that there is no sign of the disease you thought would
correlate with the finding. This same experience happens several times. What should
you conclude?
A) Consider not doing this test routinely.
B) Use this test when you have a higher suspicion for a certain correlating condition.
C) Continue using the test, perhaps doing less laboratory work and diagnostics.
D) Omit this test from future examinations.
Correct Answer: C) Continue using the test, perhaps doing less laboratory work and
diagnostics.
Rationale: This is an example of a specific test that lacks sensitivity. With this scenario,
when you finally find a positive, you might be very certain that a given condition is
present. We generally develop our examinations to fit our clinical experiences. Sensitive
tests are performed routinely on the screening examination, while specific tests are
usually saved for the detailed or "branched" examinations. Branched examinations are
further maneuvers we can perform to investigate positive findings on our screening
examinations. Save this type of maneuver to confirm your hypothesis.
4. A patient presents for evaluation of a sharp, aching chest pain which increases with
breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine
Correct Answer: A) Musculoskeletal
Rationale: Chest pain may be due to a musculoskeletal condition, such as
costochondritis or intercostal muscle cramp. This would be worsened by motion of the
chest wall. Pleuritic chest pain is also a sharp chest pain which increases with a deep
breath. This type of pain can occur with inflammation of the pleura from pneumonia or
other conditions and pulmonary embolus.
, 5. A 62-year-old teacher presents to the clinic for evaluation of the following
symptoms: fever, headache, sinus congestion, sore throat, green nasal discharge, and
cough. This cluster of symptoms is best explained by:
A) One disease process
B) More than one disease process
Correct Answer: A) One disease process
Rationale: 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 patient is
much less than the possibility of having one problem which accounts for all of them.
6. 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.
Correct Answer: D) You have created a hypothesis.
Rationale: 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
one idea too early.
7. Ms. Washington is a 67-year-old who had a heart attack last month. Now she
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
