NR 509 MIDTERM EXAM: ADVANCED
PHYSICAL ASSESSMENT LATEST VERSION
UPDATED AND REVISED IN 2025/2026
A 23-year-old farm worker submits urine for testing. Three test strips
from Container A show abnormally low pH levels in the urine. However,
three test strips from Container B, purchased more recently,
consistently indicate that the pH of this patient's urine is normal. Which
of the following is a true statement about the test strips? - ANSWER -
>The test strips demonstrate high intraobserver reliability
A 45-year-old forklift driver presents to the clinic at 4 o'clock in the
afternoon complaining of intense substernal chest pain and nausea. He
appears pale and sweaty. At work that day, he filled in for an absent co-
worker and was asked to perform heavy lifting not normally a part of
his job. The physician assistant (PA) questions the patient in detail
about his nausea, eating habits, and digestive history. Which of the
following steps of clinical reasoning has the PA failed to follow? -
ANSWER ->Give special considering to potential life-threatening
problems
, The positive predictive value of a test is calculated as the number of
true positives identified by the test divided by the total positives found
by the test. If a novel test for strep throat yields 150 true-positive
results and 150 false-positive results, what is the positive predictive
value of this test? - ANSWER >50%
The negative predictive value of a test is calculated as the number of
true negatives identified by the test divided by the total negatives
found by the test. If a novel test for strep throat yields 85 true-negative
results and 15 false-negative results, what is the negative predictive
value of this test? - ANSWER >85%
A 58-year-old carpenter presents for his annual physical examination.
The physician assistant notes a systolic murmur on a auscultation of the
aorta. However, she does not immediately conclude that this patient
has aortic stenosis. Which of the following is the reason that she seeks
additional information? - ANSWER ->Systolic murmurs have high
sensitivity but low specificity for aortic stenosis
A mother bring her 8-year-old daughter to the clinic because she found
a tick in the girl's hair and would like her daughter to be tested for Lyme
disease. The nurse practitioner (NP) explains that the enzyme-linked
immunosorbent assay (ELISA), an early test for Lyme disease, is
effective in finding early cases of Lyme disease but can also give
positive results in some people who do not have the disease, making
additional testing necessary.
This means that the ELISA test has which of the following? -
ANSWER ->High sensitivity, low specificity
PHYSICAL ASSESSMENT LATEST VERSION
UPDATED AND REVISED IN 2025/2026
A 23-year-old farm worker submits urine for testing. Three test strips
from Container A show abnormally low pH levels in the urine. However,
three test strips from Container B, purchased more recently,
consistently indicate that the pH of this patient's urine is normal. Which
of the following is a true statement about the test strips? - ANSWER -
>The test strips demonstrate high intraobserver reliability
A 45-year-old forklift driver presents to the clinic at 4 o'clock in the
afternoon complaining of intense substernal chest pain and nausea. He
appears pale and sweaty. At work that day, he filled in for an absent co-
worker and was asked to perform heavy lifting not normally a part of
his job. The physician assistant (PA) questions the patient in detail
about his nausea, eating habits, and digestive history. Which of the
following steps of clinical reasoning has the PA failed to follow? -
ANSWER ->Give special considering to potential life-threatening
problems
, The positive predictive value of a test is calculated as the number of
true positives identified by the test divided by the total positives found
by the test. If a novel test for strep throat yields 150 true-positive
results and 150 false-positive results, what is the positive predictive
value of this test? - ANSWER >50%
The negative predictive value of a test is calculated as the number of
true negatives identified by the test divided by the total negatives
found by the test. If a novel test for strep throat yields 85 true-negative
results and 15 false-negative results, what is the negative predictive
value of this test? - ANSWER >85%
A 58-year-old carpenter presents for his annual physical examination.
The physician assistant notes a systolic murmur on a auscultation of the
aorta. However, she does not immediately conclude that this patient
has aortic stenosis. Which of the following is the reason that she seeks
additional information? - ANSWER ->Systolic murmurs have high
sensitivity but low specificity for aortic stenosis
A mother bring her 8-year-old daughter to the clinic because she found
a tick in the girl's hair and would like her daughter to be tested for Lyme
disease. The nurse practitioner (NP) explains that the enzyme-linked
immunosorbent assay (ELISA), an early test for Lyme disease, is
effective in finding early cases of Lyme disease but can also give
positive results in some people who do not have the disease, making
additional testing necessary.
This means that the ELISA test has which of the following? -
ANSWER ->High sensitivity, low specificity
