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NR509 Physical Assessment Notes | Advanced Health Assessment Study Guide

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Master advanced physical assessment for the NR509 course with these comprehensive notes. Covers system-by-system examination techniques, documentation, differential diagnosis, and clinical reasoning for nurse practitioners and advanced practice nursing students.

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Physical Assessment Notes - NR509 / NR 509 (Latest

2025) : Advanced Physical Assessment - Chamberlain

The nurse practitioner (NP) is completing a comprehensive

assessment of Anita, a new client in a primary care facility.

Which assessment finding(s) reported by Anita are related to

social determinants of health? Select all that apply.

.....ANSWER.....occasionally running out of food, being

discriminated against in the workplace, has a great amount of

smog in their community, having difficulty making the rent

payment

Focused assessment: .....ANSWER.....- addresses focused concerns

or symptoms

-used for established clients during routine or urgent care visits

- health history and physical exams are focused on the problem

,Page 2 of 59


-Includes: brief history of present illness, only the system related

to the problem in the ROS

comprehensive assessment: .....ANSWER.....- used for new clients

-provides personalized information about the client

-strengthens the clinician-client relationship

-provides a baseline for future assessments

-provides an opportunity for health promotion education and

counseling

includes: extended history of the present illness, at least two area

of PMhx, family hx, social hx, at least 10 ROS

subjective data .....ANSWER.....Subjective data includes symptoms

that the client describes such as a sore throat, headache, or pain.

It also includes the client's feelings, perceptions, and concerns

objective data .....ANSWER.....Objective data includes the

physical examination findings or signs observed. Information

,Page 3 of 59


obtained from the client during any part of the health history is

considered subjective data. All physical examinations, laboratory

information, and test data are considered objective data

initial encounter .....ANSWER.....-review the clinical record

-ensure the client is comfortable

-clarify the goals/agenda for the encounter

-establish rapport

-identify client's preferred title, name, and gender pronouns

-use "people first" language (i.e. hearing loss, wheelchair)

-identify the c/o

-open-ended approach for client's story

-gather information about the client's perspective of the illness

using the FIFE (feelings, ideas, function, expectations)

-conduct health history interview

, Page 4 of 59


-gather information about PMHx, meds, allergies, family,

personal and social, ROS

"How would you describe your sexual identity?"

"How would you describe your gender identity?"

"What is the sex on your original birth certificate?"

.....ANSWER.....

Basic Interviewing Skills .....ANSWER.....-active listening-closely

attending to what the pt is communicating, connect to pt's

emotional state, use verbal and nonverbal skills

-empathy- the capacity to identify with the pt and feel the pt's

pain as your own

-guided questioning- allows for interviewer to facilitate full

communications

-validating- affirm legitimacy of pt's emotional experience

-empowerment; encourage pt to ask questions
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