NR 509 WEEK 4 CONCEPT REVIEW GUIDE
2026 NORMAL AND ABNORMAL PHYSICAL
EXAM INTERPRETATION
◉ 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 19-year-old student of art history presents to clinic after a
syncopal (fainting) episode at school. He is notably thin; on a
,thorough review of his medical history, he admits that he eats only
minimally to maintain a very low body weight that he feels is ideal.
He is embarrassed that his issues were discussed by peers after this
episode, especially because he believes that this is a problem that is
only faced by girls and women. Concerning the two most common
eating disorders (anorexia nervosa and bulimia nervosa), which of
the following statements is true?
a. Men and women are both afflicted, but with a female:male
prevalence ratio estimated at ~2:1.
b. Both of these eating disorders are associated with a body mass
index (BMI) of <17.5.
c. Both of these eating disorders are associated with a real or
imagined fear of appearing fat.
d. Persons with eating disorders are generally easily identified by
their appeara.
Answer: c. Both of these eating disorders are associated with a real
or imagined fear of appearing fat.
◉ 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 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
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?
2026 NORMAL AND ABNORMAL PHYSICAL
EXAM INTERPRETATION
◉ 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 19-year-old student of art history presents to clinic after a
syncopal (fainting) episode at school. He is notably thin; on a
,thorough review of his medical history, he admits that he eats only
minimally to maintain a very low body weight that he feels is ideal.
He is embarrassed that his issues were discussed by peers after this
episode, especially because he believes that this is a problem that is
only faced by girls and women. Concerning the two most common
eating disorders (anorexia nervosa and bulimia nervosa), which of
the following statements is true?
a. Men and women are both afflicted, but with a female:male
prevalence ratio estimated at ~2:1.
b. Both of these eating disorders are associated with a body mass
index (BMI) of <17.5.
c. Both of these eating disorders are associated with a real or
imagined fear of appearing fat.
d. Persons with eating disorders are generally easily identified by
their appeara.
Answer: c. Both of these eating disorders are associated with a real
or imagined fear of appearing fat.
◉ 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 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
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?
