,NR 509 Midterm Exam | Advanced Physical
Assessment (2026) Q&A | Chamberlain College
1. A patient presents with a chief complaint of cough. The nurse uses the FIFE model to
explore the patient’s perspective. Which of the following questions addresses the “E”
component?
A) “How has this cough affected your daily activities?”
B) “What do you think is causing your cough?”
C) “What are you hoping we can do for you today?”
D) “How does having this cough make you feel?”
Correct Answer: C) “What are you hoping we can do for you today?”
Rationale: FIFE stands for Feelings, Ideas, Function, Expectations. “E” represents
expectations—what the patient hopes to gain from the visit. Asking about hopes targets
expectations directly. Feelings address emotional response, ideas explore beliefs about cause,
and function pertains to daily impact. Understanding expectations guides shared decision-
making.
2. During an initial encounter, the nurse wishes to establish rapport and set the stage for a
therapeutic interaction. Which action best achieves this?
A) Review the clinical record after greeting the patient.
B) Adjust the room temperature and remove physical barriers such as a computer monitor.
C) Begin immediately with closed-ended questions to save time.
D) Ask the patient to state their chief complaint before introducing oneself.
Correct Answer: B) Adjust the room temperature and remove physical barriers such as a
computer monitor.
,Rationale: Setting the stage involves ensuring a comfortable environment—private,
temperate, and free of obstacles—to promote open communication. Greeting the patient
first, clarifying the visit goals, and using open-ended questions are key. Reviewing the record
before greeting can delay rapport; closed-ended questions restrict flow.
3. Which of the following best defines the term “chief complaint” in a comprehensive health
history?
A) The patient’s primary medical diagnosis
B) The reason for the encounter expressed in the patient’s own words
C) The clinician’s impression after the history is taken
D) The longest duration symptom reported by the patient
Correct Answer: B) The reason for the encounter expressed in the patient’s own words
Rationale: The chief complaint is a concise statement in the patient’s own words describing
why they sought care. It is not a diagnosis or the clinician’s impression. Using the patient’s
language ensures accurate representation and respects the patient’s perspective. It guides
the subsequent history and physical examination.
4. A patient describes a headache that began 3 days ago, is throbbing, located in the right
temple, radiates to the neck, and is worse with bright lights. Which component of the HPI is
missing?
A) Timing
B) Severity
C) Associated factors
D) Alleviating factors
Correct Answer: D) Alleviating factors
, Rationale: Using OLD CARTS, the history includes Onset (3 days), Location (right temple),
Duration (ongoing), Character (throbbing), Aggravating factors (bright lights), and Radiation
(neck). Severity and timing partially addressed but not fully; however, what the patient does
to relieve pain (alleviating factors) is missing. Exploring what helps is essential for treatment
planning.
5. The nurse is performing a review of systems (ROS). Which statement by the patient would
be documented under the gastrointestinal system?
A) “I have occasional palpitations.”
B) “I feel short of breath when climbing stairs.”
C) “I’ve had heartburn after meals for the past week.”
D) “I wake up with stiffness in my knees.”
Correct Answer: C) “I’ve had heartburn after meals for the past week.”
Rationale: Heartburn is a gastrointestinal symptom and belongs in the GI ROS. Palpitations
and shortness of breath are cardiovascular/respiratory. Joint stiffness is musculoskeletal. A
systematic ROS ensures no symptom is overlooked. Accurate categorization aids in
differential diagnosis.
6. When performing a physical examination, the nurse uses which sequence for the
abdominal assessment?
A) Palpation, percussion, auscultation, inspection
B) Inspection, palpation, percussion, auscultation
C) Inspection, auscultation, percussion, palpation
D) Auscultation, inspection, percussion, palpation
Correct Answer: C) Inspection, auscultation, percussion, palpation
Assessment (2026) Q&A | Chamberlain College
1. A patient presents with a chief complaint of cough. The nurse uses the FIFE model to
explore the patient’s perspective. Which of the following questions addresses the “E”
component?
A) “How has this cough affected your daily activities?”
B) “What do you think is causing your cough?”
C) “What are you hoping we can do for you today?”
D) “How does having this cough make you feel?”
Correct Answer: C) “What are you hoping we can do for you today?”
Rationale: FIFE stands for Feelings, Ideas, Function, Expectations. “E” represents
expectations—what the patient hopes to gain from the visit. Asking about hopes targets
expectations directly. Feelings address emotional response, ideas explore beliefs about cause,
and function pertains to daily impact. Understanding expectations guides shared decision-
making.
2. During an initial encounter, the nurse wishes to establish rapport and set the stage for a
therapeutic interaction. Which action best achieves this?
A) Review the clinical record after greeting the patient.
B) Adjust the room temperature and remove physical barriers such as a computer monitor.
C) Begin immediately with closed-ended questions to save time.
D) Ask the patient to state their chief complaint before introducing oneself.
Correct Answer: B) Adjust the room temperature and remove physical barriers such as a
computer monitor.
,Rationale: Setting the stage involves ensuring a comfortable environment—private,
temperate, and free of obstacles—to promote open communication. Greeting the patient
first, clarifying the visit goals, and using open-ended questions are key. Reviewing the record
before greeting can delay rapport; closed-ended questions restrict flow.
3. Which of the following best defines the term “chief complaint” in a comprehensive health
history?
A) The patient’s primary medical diagnosis
B) The reason for the encounter expressed in the patient’s own words
C) The clinician’s impression after the history is taken
D) The longest duration symptom reported by the patient
Correct Answer: B) The reason for the encounter expressed in the patient’s own words
Rationale: The chief complaint is a concise statement in the patient’s own words describing
why they sought care. It is not a diagnosis or the clinician’s impression. Using the patient’s
language ensures accurate representation and respects the patient’s perspective. It guides
the subsequent history and physical examination.
4. A patient describes a headache that began 3 days ago, is throbbing, located in the right
temple, radiates to the neck, and is worse with bright lights. Which component of the HPI is
missing?
A) Timing
B) Severity
C) Associated factors
D) Alleviating factors
Correct Answer: D) Alleviating factors
, Rationale: Using OLD CARTS, the history includes Onset (3 days), Location (right temple),
Duration (ongoing), Character (throbbing), Aggravating factors (bright lights), and Radiation
(neck). Severity and timing partially addressed but not fully; however, what the patient does
to relieve pain (alleviating factors) is missing. Exploring what helps is essential for treatment
planning.
5. The nurse is performing a review of systems (ROS). Which statement by the patient would
be documented under the gastrointestinal system?
A) “I have occasional palpitations.”
B) “I feel short of breath when climbing stairs.”
C) “I’ve had heartburn after meals for the past week.”
D) “I wake up with stiffness in my knees.”
Correct Answer: C) “I’ve had heartburn after meals for the past week.”
Rationale: Heartburn is a gastrointestinal symptom and belongs in the GI ROS. Palpitations
and shortness of breath are cardiovascular/respiratory. Joint stiffness is musculoskeletal. A
systematic ROS ensures no symptom is overlooked. Accurate categorization aids in
differential diagnosis.
6. When performing a physical examination, the nurse uses which sequence for the
abdominal assessment?
A) Palpation, percussion, auscultation, inspection
B) Inspection, palpation, percussion, auscultation
C) Inspection, auscultation, percussion, palpation
D) Auscultation, inspection, percussion, palpation
Correct Answer: C) Inspection, auscultation, percussion, palpation
