NR509 Midterm – Comprehensive Nursing Review and Study
Guide|Questions and Correct Answers Latest 2025-2026
Update|Graded A+
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. - Answer-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
pg. 1
,d. Deferring respect, empathy,
- Answer-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
- Answer-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
pg. 2
,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
- Answer-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.
- Answer-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
pg. 3
, c. Dismissive and concrete with open-ended questions
d. Affirming and reassuring with close-ended questions
e. Factual and structured with active listening
- Answer-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
- Answer-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."
pg. 4
Guide|Questions and Correct Answers Latest 2025-2026
Update|Graded A+
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. - Answer-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
pg. 1
,d. Deferring respect, empathy,
- Answer-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
- Answer-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
pg. 2
,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
- Answer-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.
- Answer-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
pg. 3
, c. Dismissive and concrete with open-ended questions
d. Affirming and reassuring with close-ended questions
e. Factual and structured with active listening
- Answer-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
- Answer-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."
pg. 4
