NR509 / NR 509 Midterm Exam: Advanced
Physical Assessment Questions and Answers
() (Verified Answers)
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
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 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
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
Physical Assessment Questions and Answers
() (Verified Answers)
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
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 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
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
