lOMoARcP SD|6 463931 5
NR509 Midterm Exam
Study Guide
Advanced Physical
Assessment (Chamberlain
University)
, lOMoAR cPSD| 64639315
NR 509 Midterm Study Guide
General Study Tips and Recommendations
Topics and content on guides are intended to focus student attention when
reading/studying and some topics may be repeated in multiple chapters.
Multiple test items are derived from the same topic areas to encourage deeper
comprehension.
Students must have a broad understanding of content and not simply memorize passages
in textbooks or articles.
Information in red letters in the chapters as well as tables and appendices at the end of
the chapters may include test items.
Exam questions represent various levels of cognitive learning. You are expected to
analyze, synthesis, and evaluate patient scenarios in order to answer the questions.
Read all of the answers BEFORE reading the stem of the question. This will help you
focus on the key content and not get distracted by extraneous information.
Be familiar with “Techniques of Examination” and “Recording Your Findings” for
all body system chapters in the textbook.
Chapter 1 Approach to the Clinical Encounter
The interviewing process
Interviewing Process: Gathering Information (Study Guide)
Overview:
• Purpose: Gather and provide information to clarify health issues, reduce
uncertainty, and support coping, setting the foundation for shared decision-
making.
Initiating Information Gathering:
• Chief Complaint/Presenting Problem(s):
o Begin with open-ended questions: “What brings you in today?” or
“How can
I help?” o Ask, “Is there anything else?” to
uncover all concerns.
Inviting the Patient’s Story:
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, lOMoAR cPSD| 64639315
• Encouraging Narrative:
o Ask patients to describe their experience: “Tell me more about…” o Use
active listening (nodding, “uh-huh”) and avoid interrupting.
• Follow-up Questions:
o Dive deeper with questions like:
“How would you describe the pain?”
“What happened next?”
“What else did you notice?”
Gathering Information About the Patient’s Perspective:
• Using the FIFE Model:
o Feelings: Ask about their concerns or fears.
o Ideas: Explore their thoughts on the cause. o Function: Investigate how
the illness affects daily life. o Expectations: Clarify treatment and
clinician expectations.
Identifying and Responding to Emotional Cues:
• Emotional Distress:
o Patients may show emotional cues (e.g., anxiety, depression).
Responding with NURSE Mnemonic:
o Name: “That sounds scary.”
o Understand/Legitimize: “I understand how you feel.” o Respect: “You’ve
handled this well.” o Support: “I’ll work with you on this.” o Explore:
“How else are you feeling?”
Note-Taking During the Interview:
• Efficient Note-Taking:
o Take brief notes (words, dates) without distracting from engagement.
o Explain to the patient if note-taking feels uncomfortable.
Interviewing
techniques
Active
Listening:
o Attend to the patient's words and emotional state.
o Use verbal/nonverbal skills to encourage expansion of feelings/concerns.
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, lOMoAR cPSD| 64639315
• Guided Questioning:
o Move from open-ended to focused questions.
Example:
“Tell me about your chest discomfort.”
“What else?”
“Where did you feel it?” o Graded Response:
Ask questions requiring more than yes/no answers.
Example: "How many steps can you climb before shortness
of breath?" o Asking One Question at a Time:
Avoid overwhelming the patient with multiple questions.
o Offering Multiple Choices:
Example: "Which word best describes your pain: aching, sharp,
or burning?" o Clarifying:
Ask for clarification of terms or phrases.
Example: "What do you mean by ‘the flu’?" o Encouraging with
Continuers:
Use verbal/nonverbal cues (e.g., "Uh-huh," eye contact) to keep
the patient talking. o Echoing/Repetition:
Repeat the patient's last words to prompt further elaboration.
Example: "Spread?" "Going to die?" Empathic Responses:
o Recognize and elicit emotional content. o Nonverbal empathy: hand on
arm, tissues for crying patients.
o Example: “That sounds upsetting. I can’t imagine how hard this must be.”
Summarization: o Summarize key points during the interview to
ensure understanding. o Example: "You’ve had a cough for 3 days, yellow
phlegm, but no fever. Is that correct?" Transitions:
o Use transitional phrases ("Now, let’s move on to...") to guide the patient
through the process.
• Partnering: o Express ongoing commitment to care. Ensure the patient feels
supported.
• Validation: o Acknowledge the legitimacy of the patient's emotional experience.
o Example: "Your accident must have been terrifying.
Setting the stage for the examination o Adjust the Environment: Ensure privacy,
comfort, and minimal distractions. o Review the Clinical Record:
Familiarize yourself with the patient's history. o Set Your Agenda:
Clarify the focus of the encounter. o Greet the Patient & Establish
Rapport:
Downloaded by Skyler Sammuel's
NR509 Midterm Exam
Study Guide
Advanced Physical
Assessment (Chamberlain
University)
, lOMoAR cPSD| 64639315
NR 509 Midterm Study Guide
General Study Tips and Recommendations
Topics and content on guides are intended to focus student attention when
reading/studying and some topics may be repeated in multiple chapters.
Multiple test items are derived from the same topic areas to encourage deeper
comprehension.
Students must have a broad understanding of content and not simply memorize passages
in textbooks or articles.
Information in red letters in the chapters as well as tables and appendices at the end of
the chapters may include test items.
Exam questions represent various levels of cognitive learning. You are expected to
analyze, synthesis, and evaluate patient scenarios in order to answer the questions.
Read all of the answers BEFORE reading the stem of the question. This will help you
focus on the key content and not get distracted by extraneous information.
Be familiar with “Techniques of Examination” and “Recording Your Findings” for
all body system chapters in the textbook.
Chapter 1 Approach to the Clinical Encounter
The interviewing process
Interviewing Process: Gathering Information (Study Guide)
Overview:
• Purpose: Gather and provide information to clarify health issues, reduce
uncertainty, and support coping, setting the foundation for shared decision-
making.
Initiating Information Gathering:
• Chief Complaint/Presenting Problem(s):
o Begin with open-ended questions: “What brings you in today?” or
“How can
I help?” o Ask, “Is there anything else?” to
uncover all concerns.
Inviting the Patient’s Story:
Downloaded by Skyler Sammuel's
, lOMoAR cPSD| 64639315
• Encouraging Narrative:
o Ask patients to describe their experience: “Tell me more about…” o Use
active listening (nodding, “uh-huh”) and avoid interrupting.
• Follow-up Questions:
o Dive deeper with questions like:
“How would you describe the pain?”
“What happened next?”
“What else did you notice?”
Gathering Information About the Patient’s Perspective:
• Using the FIFE Model:
o Feelings: Ask about their concerns or fears.
o Ideas: Explore their thoughts on the cause. o Function: Investigate how
the illness affects daily life. o Expectations: Clarify treatment and
clinician expectations.
Identifying and Responding to Emotional Cues:
• Emotional Distress:
o Patients may show emotional cues (e.g., anxiety, depression).
Responding with NURSE Mnemonic:
o Name: “That sounds scary.”
o Understand/Legitimize: “I understand how you feel.” o Respect: “You’ve
handled this well.” o Support: “I’ll work with you on this.” o Explore:
“How else are you feeling?”
Note-Taking During the Interview:
• Efficient Note-Taking:
o Take brief notes (words, dates) without distracting from engagement.
o Explain to the patient if note-taking feels uncomfortable.
Interviewing
techniques
Active
Listening:
o Attend to the patient's words and emotional state.
o Use verbal/nonverbal skills to encourage expansion of feelings/concerns.
Downloaded by Skyler Sammuel's ()
, lOMoAR cPSD| 64639315
• Guided Questioning:
o Move from open-ended to focused questions.
Example:
“Tell me about your chest discomfort.”
“What else?”
“Where did you feel it?” o Graded Response:
Ask questions requiring more than yes/no answers.
Example: "How many steps can you climb before shortness
of breath?" o Asking One Question at a Time:
Avoid overwhelming the patient with multiple questions.
o Offering Multiple Choices:
Example: "Which word best describes your pain: aching, sharp,
or burning?" o Clarifying:
Ask for clarification of terms or phrases.
Example: "What do you mean by ‘the flu’?" o Encouraging with
Continuers:
Use verbal/nonverbal cues (e.g., "Uh-huh," eye contact) to keep
the patient talking. o Echoing/Repetition:
Repeat the patient's last words to prompt further elaboration.
Example: "Spread?" "Going to die?" Empathic Responses:
o Recognize and elicit emotional content. o Nonverbal empathy: hand on
arm, tissues for crying patients.
o Example: “That sounds upsetting. I can’t imagine how hard this must be.”
Summarization: o Summarize key points during the interview to
ensure understanding. o Example: "You’ve had a cough for 3 days, yellow
phlegm, but no fever. Is that correct?" Transitions:
o Use transitional phrases ("Now, let’s move on to...") to guide the patient
through the process.
• Partnering: o Express ongoing commitment to care. Ensure the patient feels
supported.
• Validation: o Acknowledge the legitimacy of the patient's emotional experience.
o Example: "Your accident must have been terrifying.
Setting the stage for the examination o Adjust the Environment: Ensure privacy,
comfort, and minimal distractions. o Review the Clinical Record:
Familiarize yourself with the patient's history. o Set Your Agenda:
Clarify the focus of the encounter. o Greet the Patient & Establish
Rapport:
Downloaded by Skyler Sammuel's
