NR509 Exam Questions With Insightful Answers
2025\2026 A+ Grade
A 23-year-old physician assistant (PA) student found that she felt nervous
when called upon to examine men in her age group. On one occasion, she
encountered a young male patient who appeared embarrassed to see her walk
into the room. What should the PA do to minimize their mutual discomfort?
a. Adjust lighting so it is tangential to the patient's body.
b. Explain how the examination will proceed.
c. Ask the patient where he comes from.
d. Explain that she is a PA student.
e. Provide ongoing interpretation of findings.
- accurate answers-b. Explain how the examination will proceed.
A 34-year-old male with a history of complex social and medical needs
(including current substance abuse) presents to a primary care teaching clinic.
The patient has experienced a number of adversarial relationships with prior
clinicians, including voluntarily leaving two practices within the previous year
and being asked to leave care at a third clinic due to misbehavior. The
attending physician desires to utilize the approaches to this patient that are
most likely lead to comprehensive care and patient compliance. Which of the
following is the most appropriate interview style for the attending physician
to use?
a. Focusing on the need for immediate diagnostic certainty over personal
connection
b. Taking charge of the interaction to meet the clinician's desire to acquire
diagnostic information
c. Following the patient's lead to understand their thoughts, ideas, concerns,
and requests
d. Deferring respect, empathy,
- accurate answers-c. Following the patient's lead to understand their
thoughts, ideas, concerns, and requests
A 17-year-old male presents to a sexually transmitted disease clinic at the
behest of his brother, who convinced the patient to attend the clinic after he
disclosed that he prefers homosexual partners but is afraid that his last
partner may have given him an infection. The patient expresses to the intake
,nurse that he is unashamed of his sexual orientation and will not stay through
the visit if he feels that he is dismissed or discriminated against because of it.
The nurse practitioner receives this communication prior to entering the
examination room and decides to employ active listening to best connect with
the patient at this critical juncture in his care with the clinic. Which of the
following is an example of an active listening technique?
a. Ignoring visual cues to focus on the patient's exact words
b. Setting aside the patient's emotional state to focus on his medical needs
c. Paring down the patient's conce
- accurate answers-d. Using nonverbal communication to encourage the
patient to expand their narrative
A 42-year-old female mathematician presents for follow-up care regarding a
new diagnosis of systemic lupus erythematosus 6 months ago after a lengthy
diagnostic process during which she was debilitated with fatigue and joint
pain. Since her diagnosis, she has been minimally compliant with medications
and has switched her rheumatology provider twice. She continues to feel ill,
and, in explanation for her lack of adherence to the prescribed treatment, she
simply says, "I don't like it." At this initial visit with her third rheumatology
provider, the clinician elects to explore the issues behind her noncompliance
before engaging in diagnostics and treatment using the FIFE model. Which of
the following best defines the elements of the FIFE model?
a. Focus, intensity, function, and evaluation
b. Facts, intensity, focus, and evidence
c. Feelings, ideas, function, and expectations
d. Feelings, impression, fantasy, and em
- accurate answers-c. Feelings, ideas, function, and expectations
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.
- accurate answers-c. Obtain a more complete description of problems.
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
- accurate answers-b. Validating and empathetic with open-ended questions
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 con
- accurate answers-b. Recognizing the patient's emotions by asking or
confirming how she feels about the event
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 diag
- accurate answers-f. Moving from open-ended to focused questions
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
- accurate answers-b. Echoing
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
2025\2026 A+ Grade
A 23-year-old physician assistant (PA) student found that she felt nervous
when called upon to examine men in her age group. On one occasion, she
encountered a young male patient who appeared embarrassed to see her walk
into the room. What should the PA do to minimize their mutual discomfort?
a. Adjust lighting so it is tangential to the patient's body.
b. Explain how the examination will proceed.
c. Ask the patient where he comes from.
d. Explain that she is a PA student.
e. Provide ongoing interpretation of findings.
- accurate answers-b. Explain how the examination will proceed.
A 34-year-old male with a history of complex social and medical needs
(including current substance abuse) presents to a primary care teaching clinic.
The patient has experienced a number of adversarial relationships with prior
clinicians, including voluntarily leaving two practices within the previous year
and being asked to leave care at a third clinic due to misbehavior. The
attending physician desires to utilize the approaches to this patient that are
most likely lead to comprehensive care and patient compliance. Which of the
following is the most appropriate interview style for the attending physician
to use?
a. Focusing on the need for immediate diagnostic certainty over personal
connection
b. Taking charge of the interaction to meet the clinician's desire to acquire
diagnostic information
c. Following the patient's lead to understand their thoughts, ideas, concerns,
and requests
d. Deferring respect, empathy,
- accurate answers-c. Following the patient's lead to understand their
thoughts, ideas, concerns, and requests
A 17-year-old male presents to a sexually transmitted disease clinic at the
behest of his brother, who convinced the patient to attend the clinic after he
disclosed that he prefers homosexual partners but is afraid that his last
partner may have given him an infection. The patient expresses to the intake
,nurse that he is unashamed of his sexual orientation and will not stay through
the visit if he feels that he is dismissed or discriminated against because of it.
The nurse practitioner receives this communication prior to entering the
examination room and decides to employ active listening to best connect with
the patient at this critical juncture in his care with the clinic. Which of the
following is an example of an active listening technique?
a. Ignoring visual cues to focus on the patient's exact words
b. Setting aside the patient's emotional state to focus on his medical needs
c. Paring down the patient's conce
- accurate answers-d. Using nonverbal communication to encourage the
patient to expand their narrative
A 42-year-old female mathematician presents for follow-up care regarding a
new diagnosis of systemic lupus erythematosus 6 months ago after a lengthy
diagnostic process during which she was debilitated with fatigue and joint
pain. Since her diagnosis, she has been minimally compliant with medications
and has switched her rheumatology provider twice. She continues to feel ill,
and, in explanation for her lack of adherence to the prescribed treatment, she
simply says, "I don't like it." At this initial visit with her third rheumatology
provider, the clinician elects to explore the issues behind her noncompliance
before engaging in diagnostics and treatment using the FIFE model. Which of
the following best defines the elements of the FIFE model?
a. Focus, intensity, function, and evaluation
b. Facts, intensity, focus, and evidence
c. Feelings, ideas, function, and expectations
d. Feelings, impression, fantasy, and em
- accurate answers-c. Feelings, ideas, function, and expectations
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.
- accurate answers-c. Obtain a more complete description of problems.
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
- accurate answers-b. Validating and empathetic with open-ended questions
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 con
- accurate answers-b. Recognizing the patient's emotions by asking or
confirming how she feels about the event
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 diag
- accurate answers-f. Moving from open-ended to focused questions
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
- accurate answers-b. Echoing
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
