Advanced Physical Assessment Exam 1 – Study Guide, Practice
Questions & Revision Notes
For which of the following patients would a comprehensive health history be appropriate? - ANS
✔✔A new patient with the chief complaint of "I am here to establish care"
Patient is new
The components of health history include of the following except which? - ANS ✔✔Thorax and
lungs
This is part of physical examination
Is the following information subjective or objective? Mrs. M has SOB that has persisted for the
past 10 days, it is worse with activity & relieved by rest. - ANS ✔✔Subjective
Information given by pt about circumstances of chief complaint, does not represent objective
observation
Is the following information subjective or objective? Mrs. M has a RR of 32 and PR 120 - ANS
✔✔Objective
The following information is recorded in the healthy history, pt has had abdominal pain for 1
week, pain lasts for 30 mins at a time, comes & goes, 7-9/10 pain, accompanied by NV, located
mid-epigastric. Which of these categories does it belong to? - ANS ✔✔Present Illness
,The following information is recorded in the health history, "the patient completed 8th grade,
currently lives with his wife & 2 children, works on old cars on weekend, works in glass factory
during the week." Which category? - ANS ✔✔Personal and social history
The following information is recorded in the health history, "I feel really tired", what category? -
ANS ✔✔Chief complaint
The following information is recorded in health history, "patient denies CP, palpitations,
orthopnea, paroxysmal nocturnal dyspnea", which category? - ANS ✔✔Review of systems
The following information is best placed in which category? "The pt has had 3 c-sections" - ANS
✔✔Surgeries
the following information is best placed in which category? "the pt had stent placed in left
anterior descending artery in 1999" - ANS ✔✔adult illnesses
the following information is best placed in which category? "the patient was treated for an
asthma exacerbation in the hospital last year, the pt has never been intubated" - ANS ✔✔adult
illnesses
You are running late after your quarterly quality improvement meeting at the hospital and
have just gotten paged from the nurses' station because a family member of one of your
patients
wants to talk with you about that patient's care. You have clinic this afternoon and are
double-booked for the first appointment time; three other patients also have arrived and are
sitting in the waiting room. Which of the following demeanors is a behavior consistent with
skilled interviewing when you walk into the examination room to speak with your first clinic
patient? - ANS ✔✔Calm
,Suzanne, a 25 year old, comes to your clinic to establish care. You are the student preparing
to go into the examination room to interview her. Which of the following is the most logical
sequence for the patient-provider interview? - ANS ✔✔Greet the patient, establish rapport,
invite the patient's story, establish the agenda, expand
and clarify the patient's story, and negotiate a plan.
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The pain is
a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an 8 at the
worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and goes,
and
it seems to be worse a couple of hours after eating. She has noticed that it starts after eating
greasy foods, so she has cut down on these as much as she can. Initially it occurred once a
week,
but now it is occurring every other day. Nothing makes it better. From this description, which of
the seven attributes of a symptom has been omitted? - ANS ✔✔associated manifestations
Jason is a 41-year-old electrician who presents to the clinic for evaluation of shortness of
breath. The shortness of breath occurs with exertion and improves with rest. It has been going
on
for several months and initially occurred only a couple of times a day with strenuous exertion;
however, it has started to occur with minimal exertion and is happening more than a dozen
times
per day. The shortness of breath lasts for less than 5 minutes at a time. He has no cough, chest
pressure, chest pain, swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal
dyspnea. - ANS ✔✔Severity
You are interviewing an elderly woman in the ambulatory setting and trying to get more
information about her urinary symptoms. Which of the following techniques is not a component
, of adaptive questioning? - ANS ✔✔Reassuring the patient that the urinary symptoms are
benign and that she doesn't need to
worry about it being a sign of cancer
Mr. W. is a 51-year-old auto mechanic who comes to the emergency room wanting to be
checked out for the symptom of chest pain. As you listen to him describe his symptom in more
detail, you say "Go on," and later, "Mm-hmmm." This is an example of which of the following
skilled interviewing techniques? - ANS ✔✔Facilitation
Mrs. R. is a 92-year-old retired teacher who comes to your clinic accompanied by her
daughter. You ask Mrs. R. why she came to your clinic today. She looks at her daughter and
doesn't say anything in response to your question. This is an example of which type of
challenging patient? - ANS ✔✔Silent patient
Mrs. T. comes for her regular visit to the clinic. She is on your schedule because her regular
provider is on vacation and she wanted to be seen. You have heard about her many times from
your colleague and are aware that she is a very talkative person. Which of the following is a
helpful technique to improve the quality of the interview for both the provider and the patient?
- ANS ✔✔Briefly summarize what you heard from the patient in the first 5 minutes and then try
to
have her focus on one aspect of what she told you.
Mrs. H. comes to your clinic, wanting antibiotics for a sinus infection. When you enter the
room, she appears to be very angry. She has a raised tone of voice and states that she has been
waiting for the past hour and has to get back to work. She states that she is unimpressed by the
reception staff, the nurse, and the clinic in general and wants to know why the office wouldn't
call in an antibiotic for her. Which of the following techniques is not useful in helping to calm
Questions & Revision Notes
For which of the following patients would a comprehensive health history be appropriate? - ANS
✔✔A new patient with the chief complaint of "I am here to establish care"
Patient is new
The components of health history include of the following except which? - ANS ✔✔Thorax and
lungs
This is part of physical examination
Is the following information subjective or objective? Mrs. M has SOB that has persisted for the
past 10 days, it is worse with activity & relieved by rest. - ANS ✔✔Subjective
Information given by pt about circumstances of chief complaint, does not represent objective
observation
Is the following information subjective or objective? Mrs. M has a RR of 32 and PR 120 - ANS
✔✔Objective
The following information is recorded in the healthy history, pt has had abdominal pain for 1
week, pain lasts for 30 mins at a time, comes & goes, 7-9/10 pain, accompanied by NV, located
mid-epigastric. Which of these categories does it belong to? - ANS ✔✔Present Illness
,The following information is recorded in the health history, "the patient completed 8th grade,
currently lives with his wife & 2 children, works on old cars on weekend, works in glass factory
during the week." Which category? - ANS ✔✔Personal and social history
The following information is recorded in the health history, "I feel really tired", what category? -
ANS ✔✔Chief complaint
The following information is recorded in health history, "patient denies CP, palpitations,
orthopnea, paroxysmal nocturnal dyspnea", which category? - ANS ✔✔Review of systems
The following information is best placed in which category? "The pt has had 3 c-sections" - ANS
✔✔Surgeries
the following information is best placed in which category? "the pt had stent placed in left
anterior descending artery in 1999" - ANS ✔✔adult illnesses
the following information is best placed in which category? "the patient was treated for an
asthma exacerbation in the hospital last year, the pt has never been intubated" - ANS ✔✔adult
illnesses
You are running late after your quarterly quality improvement meeting at the hospital and
have just gotten paged from the nurses' station because a family member of one of your
patients
wants to talk with you about that patient's care. You have clinic this afternoon and are
double-booked for the first appointment time; three other patients also have arrived and are
sitting in the waiting room. Which of the following demeanors is a behavior consistent with
skilled interviewing when you walk into the examination room to speak with your first clinic
patient? - ANS ✔✔Calm
,Suzanne, a 25 year old, comes to your clinic to establish care. You are the student preparing
to go into the examination room to interview her. Which of the following is the most logical
sequence for the patient-provider interview? - ANS ✔✔Greet the patient, establish rapport,
invite the patient's story, establish the agenda, expand
and clarify the patient's story, and negotiate a plan.
Alexandra is a 28-year-old editor who presents to the clinic with abdominal pain. The pain is
a dull ache, located in the right upper quadrant, that she rates as a 3 at the least and an 8 at the
worst. The pain started a few weeks ago, it lasts for 2 to 3 hours at a time, it comes and goes,
and
it seems to be worse a couple of hours after eating. She has noticed that it starts after eating
greasy foods, so she has cut down on these as much as she can. Initially it occurred once a
week,
but now it is occurring every other day. Nothing makes it better. From this description, which of
the seven attributes of a symptom has been omitted? - ANS ✔✔associated manifestations
Jason is a 41-year-old electrician who presents to the clinic for evaluation of shortness of
breath. The shortness of breath occurs with exertion and improves with rest. It has been going
on
for several months and initially occurred only a couple of times a day with strenuous exertion;
however, it has started to occur with minimal exertion and is happening more than a dozen
times
per day. The shortness of breath lasts for less than 5 minutes at a time. He has no cough, chest
pressure, chest pain, swelling in his feet, palpitations, orthopnea, or paroxysmal nocturnal
dyspnea. - ANS ✔✔Severity
You are interviewing an elderly woman in the ambulatory setting and trying to get more
information about her urinary symptoms. Which of the following techniques is not a component
, of adaptive questioning? - ANS ✔✔Reassuring the patient that the urinary symptoms are
benign and that she doesn't need to
worry about it being a sign of cancer
Mr. W. is a 51-year-old auto mechanic who comes to the emergency room wanting to be
checked out for the symptom of chest pain. As you listen to him describe his symptom in more
detail, you say "Go on," and later, "Mm-hmmm." This is an example of which of the following
skilled interviewing techniques? - ANS ✔✔Facilitation
Mrs. R. is a 92-year-old retired teacher who comes to your clinic accompanied by her
daughter. You ask Mrs. R. why she came to your clinic today. She looks at her daughter and
doesn't say anything in response to your question. This is an example of which type of
challenging patient? - ANS ✔✔Silent patient
Mrs. T. comes for her regular visit to the clinic. She is on your schedule because her regular
provider is on vacation and she wanted to be seen. You have heard about her many times from
your colleague and are aware that she is a very talkative person. Which of the following is a
helpful technique to improve the quality of the interview for both the provider and the patient?
- ANS ✔✔Briefly summarize what you heard from the patient in the first 5 minutes and then try
to
have her focus on one aspect of what she told you.
Mrs. H. comes to your clinic, wanting antibiotics for a sinus infection. When you enter the
room, she appears to be very angry. She has a raised tone of voice and states that she has been
waiting for the past hour and has to get back to work. She states that she is unimpressed by the
reception staff, the nurse, and the clinic in general and wants to know why the office wouldn't
call in an antibiotic for her. Which of the following techniques is not useful in helping to calm
