NR509 Midterm Exam Study
Guide 113021
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 o Stage 1: Initiating the
Encounter
This is the stage of relationship building with
your patient.
Fostering the patient–clinician relationship is
critical because without a good relationship
none of the other goals of the clinical
encounter can be pursued in an optimal
manner.
, lOMoAR cPSD| 64639315
Respect trust, and rapport are necessary
components of a therapeutic relationship that
is just beginning.
Set the Stage.
• Prepare for the interview.
• Check your appearance.
• Make sure the patient is comfortable and the
environment is conducive to the very personal
information soon to be shared.
• You will find that each interview has its own rhythm
and sequence.
• Master the steps described.
• Finally, the interview has important societal
dimensions.
• Reflect on any biases you have that color your
reactions to the patient and the therapeutic alliance
you need to create.
Adjust the Environment.
• Make the interview setting as private and
comfortable as possible.
• You may have to talk with the patient in
surroundings like a two-bedded hospital room or
the corridor of a busy emergency department.
, lOMoAR cPSD| 64639315
• Making the environment as confidential as possible
improves communication.
• If there are privacy curtains, try to pull them shut.
• Suggest moving to an empty room instead of
talking in a waiting area.
• If possible, adjust the room temperature for the
patient’s comfort.
• As the clinician, it is part of your role to make the
patient more comfortable.
• These efforts are always worth the time.
o Stage 2: Gathering Information
This stage has two functions: gathering and providing
information.
Clinicians gather information from their patients about
symptoms, experience and expectations for establishing
a diagnosis and treatment plan.
Patients, on the other hand, need information that
clarifies their health problems, reduces possible
uncertainties, and supports their coping efforts.
This stage is also the basis for shared decision making
later in the clinical encounter.
o Once you have established rapport, you are ready to pursue
the patient’s reason for seeking care, traditionally called the
chief complaint or chief concern.
Guide 113021
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 o Stage 1: Initiating the
Encounter
This is the stage of relationship building with
your patient.
Fostering the patient–clinician relationship is
critical because without a good relationship
none of the other goals of the clinical
encounter can be pursued in an optimal
manner.
, lOMoAR cPSD| 64639315
Respect trust, and rapport are necessary
components of a therapeutic relationship that
is just beginning.
Set the Stage.
• Prepare for the interview.
• Check your appearance.
• Make sure the patient is comfortable and the
environment is conducive to the very personal
information soon to be shared.
• You will find that each interview has its own rhythm
and sequence.
• Master the steps described.
• Finally, the interview has important societal
dimensions.
• Reflect on any biases you have that color your
reactions to the patient and the therapeutic alliance
you need to create.
Adjust the Environment.
• Make the interview setting as private and
comfortable as possible.
• You may have to talk with the patient in
surroundings like a two-bedded hospital room or
the corridor of a busy emergency department.
, lOMoAR cPSD| 64639315
• Making the environment as confidential as possible
improves communication.
• If there are privacy curtains, try to pull them shut.
• Suggest moving to an empty room instead of
talking in a waiting area.
• If possible, adjust the room temperature for the
patient’s comfort.
• As the clinician, it is part of your role to make the
patient more comfortable.
• These efforts are always worth the time.
o Stage 2: Gathering Information
This stage has two functions: gathering and providing
information.
Clinicians gather information from their patients about
symptoms, experience and expectations for establishing
a diagnosis and treatment plan.
Patients, on the other hand, need information that
clarifies their health problems, reduces possible
uncertainties, and supports their coping efforts.
This stage is also the basis for shared decision making
later in the clinical encounter.
o Once you have established rapport, you are ready to pursue
the patient’s reason for seeking care, traditionally called the
chief complaint or chief concern.
