NR509 MIDTERM Advanced Physical
Assessment 2025/2026 Complete
Actual Screenshot Exam.
CHAMBERLAIN UNIVERSITY COLLEGE
OF NURSING
1. During an initial encounter, a patient gives brief answers, avoids eye
contact, and repeatedly looks toward the door. Which action by the
advanced practice nurse is most appropriate?
a. Continue rapidly asking focused questions to complete the history.
b. Acknowledge the patient’s apparent discomfort and ask how the interview can
feel safer.
,c. Interpret the behavior as evidence of substance use.
d. Ask the accompanying family member to answer instead.
ANS: B
EXPERT RATIONALE: Effective interviewing requires attention to verbal and
nonverbal communication. Avoiding eye contact and repeatedly looking toward
the door may indicate anxiety, fear, discomfort, pain, cultural communication
differences, or concern about privacy. The nurse should not assume a diagnosis
from behavior alone. Option B is correct because acknowledging the observation
and inviting the patient to identify concerns promotes trust and patient-centered
communication. Option A may increase anxiety and reduce disclosure. Option C is
an unsupported assumption. Option D removes the patient’s voice unless the
patient is unable to provide the history or specifically requests assistance.
2. A patient states, “I have been tired lately.” Which follow-up question best
clarifies the symptom?
a. “Are you depressed?”
b. “What do you mean by tired?”
c. “Have you been sleeping poorly?”
d. “Do you have anemia?”
ANS: B
EXPERT RATIONALE: The first step is to clarify what the patient means by “tired.”
Fatigue, sleepiness, weakness, exercise intolerance, and lack of motivation are
different symptoms with different differentials. Option B is correct because it uses
an open-ended clarification before narrowing the assessment. Option A
prematurely labels the symptom. Option C addresses only one possible cause and
may miss the patient’s actual meaning. Option D introduces a diagnosis without
sufficient information.
, 3. A patient reports intermittent abdominal pain. Which history-taking
approach best follows the OLDCARTS framework?
a. Ask only about the pain intensity.
b. Determine onset, location, duration, characteristics, aggravating and relieving
factors, radiation, timing, and associated symptoms.
c. Focus on the patient’s family history before characterizing the pain.
d. Ask whether the patient has taken medication and end the interview.
ANS: B
EXPERT RATIONALE: OLDCARTS organizes symptom assessment by onset, location,
duration, characteristics, aggravating and relieving factors, radiation, timing, and
associated symptoms. Option B is correct because it produces a complete
symptom analysis that supports clinical reasoning. Option A is incomplete. Option
C may eventually be relevant but does not replace characterization of the
presenting symptom. Option D does not establish severity, pattern, or potential
causes.
4. A patient reports chest discomfort but says, “It is probably nothing.” Which
response best demonstrates therapeutic interviewing?
a. “You are probably right.”
b. “Tell me more about what you are feeling and what concerns you most.”
c. “Chest pain is usually caused by anxiety.”
d. “You should have come in sooner.”
ANS: B
EXPERT RATIONALE: The nurse should explore the symptom and the patient’s
perspective without minimizing or prematurely assigning a cause. Option B is
correct because it uses an open-ended question and invites the patient’s
concerns. Option A may falsely reassure. Option C prematurely attributes
symptoms to anxiety. Option D is judgmental and may reduce future disclosure.
, 5. A patient becomes tearful while discussing a recent diagnosis. Which
response is most therapeutic?
a. “Do not cry; everything will be fine.”
b. “I can see this is difficult. Take your time.”
c. “You need to stay calm so we can finish.”
d. “Many patients have problems worse than this.”
ANS: B
EXPERT RATIONALE: Therapeutic communication includes empathy, validation,
and allowing the patient time to process information. Option B is correct because
it acknowledges the emotion without minimizing it or making unrealistic
promises. Option A provides false reassurance. Option C is controlling and
invalidating. Option D minimizes the patient’s experience and may damage
rapport.
6. A patient provides inconsistent information about medication use. Which
response is best?
a. “You are not being honest with me.”
b. “Help me understand how you take each medication during a typical day.”
c. “I will document that you are noncompliant.”
d. “Your family member should manage your medications.”
ANS: B
EXPERT RATIONALE: Medication discrepancies may result from misunderstanding,
cost, side effects, complex schedules, memory problems, or health literacy rather
than intentional dishonesty. Option B is correct because it uses a nonjudgmental,
behavior-focused question. Option A creates defensiveness. Option C labels the
patient without understanding the cause. Option D removes autonomy without
establishing a need for assistance.
Assessment 2025/2026 Complete
Actual Screenshot Exam.
CHAMBERLAIN UNIVERSITY COLLEGE
OF NURSING
1. During an initial encounter, a patient gives brief answers, avoids eye
contact, and repeatedly looks toward the door. Which action by the
advanced practice nurse is most appropriate?
a. Continue rapidly asking focused questions to complete the history.
b. Acknowledge the patient’s apparent discomfort and ask how the interview can
feel safer.
,c. Interpret the behavior as evidence of substance use.
d. Ask the accompanying family member to answer instead.
ANS: B
EXPERT RATIONALE: Effective interviewing requires attention to verbal and
nonverbal communication. Avoiding eye contact and repeatedly looking toward
the door may indicate anxiety, fear, discomfort, pain, cultural communication
differences, or concern about privacy. The nurse should not assume a diagnosis
from behavior alone. Option B is correct because acknowledging the observation
and inviting the patient to identify concerns promotes trust and patient-centered
communication. Option A may increase anxiety and reduce disclosure. Option C is
an unsupported assumption. Option D removes the patient’s voice unless the
patient is unable to provide the history or specifically requests assistance.
2. A patient states, “I have been tired lately.” Which follow-up question best
clarifies the symptom?
a. “Are you depressed?”
b. “What do you mean by tired?”
c. “Have you been sleeping poorly?”
d. “Do you have anemia?”
ANS: B
EXPERT RATIONALE: The first step is to clarify what the patient means by “tired.”
Fatigue, sleepiness, weakness, exercise intolerance, and lack of motivation are
different symptoms with different differentials. Option B is correct because it uses
an open-ended clarification before narrowing the assessment. Option A
prematurely labels the symptom. Option C addresses only one possible cause and
may miss the patient’s actual meaning. Option D introduces a diagnosis without
sufficient information.
, 3. A patient reports intermittent abdominal pain. Which history-taking
approach best follows the OLDCARTS framework?
a. Ask only about the pain intensity.
b. Determine onset, location, duration, characteristics, aggravating and relieving
factors, radiation, timing, and associated symptoms.
c. Focus on the patient’s family history before characterizing the pain.
d. Ask whether the patient has taken medication and end the interview.
ANS: B
EXPERT RATIONALE: OLDCARTS organizes symptom assessment by onset, location,
duration, characteristics, aggravating and relieving factors, radiation, timing, and
associated symptoms. Option B is correct because it produces a complete
symptom analysis that supports clinical reasoning. Option A is incomplete. Option
C may eventually be relevant but does not replace characterization of the
presenting symptom. Option D does not establish severity, pattern, or potential
causes.
4. A patient reports chest discomfort but says, “It is probably nothing.” Which
response best demonstrates therapeutic interviewing?
a. “You are probably right.”
b. “Tell me more about what you are feeling and what concerns you most.”
c. “Chest pain is usually caused by anxiety.”
d. “You should have come in sooner.”
ANS: B
EXPERT RATIONALE: The nurse should explore the symptom and the patient’s
perspective without minimizing or prematurely assigning a cause. Option B is
correct because it uses an open-ended question and invites the patient’s
concerns. Option A may falsely reassure. Option C prematurely attributes
symptoms to anxiety. Option D is judgmental and may reduce future disclosure.
, 5. A patient becomes tearful while discussing a recent diagnosis. Which
response is most therapeutic?
a. “Do not cry; everything will be fine.”
b. “I can see this is difficult. Take your time.”
c. “You need to stay calm so we can finish.”
d. “Many patients have problems worse than this.”
ANS: B
EXPERT RATIONALE: Therapeutic communication includes empathy, validation,
and allowing the patient time to process information. Option B is correct because
it acknowledges the emotion without minimizing it or making unrealistic
promises. Option A provides false reassurance. Option C is controlling and
invalidating. Option D minimizes the patient’s experience and may damage
rapport.
6. A patient provides inconsistent information about medication use. Which
response is best?
a. “You are not being honest with me.”
b. “Help me understand how you take each medication during a typical day.”
c. “I will document that you are noncompliant.”
d. “Your family member should manage your medications.”
ANS: B
EXPERT RATIONALE: Medication discrepancies may result from misunderstanding,
cost, side effects, complex schedules, memory problems, or health literacy rather
than intentional dishonesty. Option B is correct because it uses a nonjudgmental,
behavior-focused question. Option A creates defensiveness. Option C labels the
patient without understanding the cause. Option D removes autonomy without
establishing a need for assistance.
