NR 509 / NR509 Advanced Physical Assessment
Midterm Exam
Questions with Verified Answers - Chamberlain
Consist of 100 multiple choices Questions with Answers
1. 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 sleep-
ing 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
ANS: c. Obtain a more complete descriptionof problems.
,2. 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
ANS: b. Validating and empathetic withopen-ended questions
3. A 36-year-old female air traffic controller presents to her primary care
provider for a routine visit 3 months after losing her spouse to a lengthy
battle with a neurodegenerative disease. The patient denies any psychiatric
symptoms on review of systems and, in fact, states that she has slept better
in the last month than she had in the previous years. She endorses a healthy
support system, including the extended family of her deceased spouse, with
whom she is still close. She becomes wistful and briefly tearful when speaking
of the plans that they had when they first married that were never fulfilled; she
then changes the subject rapidly to whether her Pap smear is due. Which of
the following is an example of an empathetic response to this patient?
,a. Assuming that the event caused her to become depressed and expressing
the same feeling on behalf of the patient
b. Recognizing the patient's emotions by asking or confirming how she feels
about the event
c. By allowing the crying patient to look around the room for tissues to permit
her an excuse to hide her face and defer her emotions
d. Presuming that the patient's emotions meet social expectations, such as
being depressed and even trau
ANS: b. Recognizing the patient's emotions by askingor confirming how she feels
about the event
4. 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
d. (MVA) that led to back pain
e. Asking leading questions that focus on the presumed diagnosis of chest
pain
f. Moving from open-ended to focused questions: f. Moving from open-ended to
focused questions
5. 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. d. Eliciting a graded response
e. Asking a leading question
ANS: b. Echoing
6. 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
Midterm Exam
Questions with Verified Answers - Chamberlain
Consist of 100 multiple choices Questions with Answers
1. 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 sleep-
ing 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
ANS: c. Obtain a more complete descriptionof problems.
,2. 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
ANS: b. Validating and empathetic withopen-ended questions
3. A 36-year-old female air traffic controller presents to her primary care
provider for a routine visit 3 months after losing her spouse to a lengthy
battle with a neurodegenerative disease. The patient denies any psychiatric
symptoms on review of systems and, in fact, states that she has slept better
in the last month than she had in the previous years. She endorses a healthy
support system, including the extended family of her deceased spouse, with
whom she is still close. She becomes wistful and briefly tearful when speaking
of the plans that they had when they first married that were never fulfilled; she
then changes the subject rapidly to whether her Pap smear is due. Which of
the following is an example of an empathetic response to this patient?
,a. Assuming that the event caused her to become depressed and expressing
the same feeling on behalf of the patient
b. Recognizing the patient's emotions by asking or confirming how she feels
about the event
c. By allowing the crying patient to look around the room for tissues to permit
her an excuse to hide her face and defer her emotions
d. Presuming that the patient's emotions meet social expectations, such as
being depressed and even trau
ANS: b. Recognizing the patient's emotions by askingor confirming how she feels
about the event
4. 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
d. (MVA) that led to back pain
e. Asking leading questions that focus on the presumed diagnosis of chest
pain
f. Moving from open-ended to focused questions: f. Moving from open-ended to
focused questions
5. 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. d. Eliciting a graded response
e. Asking a leading question
ANS: b. Echoing
6. 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
