NR 509 2026 UPDATE/ MIDTERM EXAM:
AVANCED PHYSICS ASSESSMENT/ 100%
GRADED A+
A first-semester physician assistant student reports to his supervisor that he has trouble
determining the diastolic blood pressure. On manual blood pressure, which of the following
provides the best estimate of the true diastolic blood pressure?
a. The point at which Korotkoff sounds first muffle after systolic blood pressure is discerned.
b. The average between the highest and lowest points of the auscultatory gap.
c. The recommencement of Korotkoff sounds following the lower point of the auscultatory gap.
d. The disappearance of Korotkoff sounds following initial muffling.
e. The average reading between the onset of the auscultatory gap and the resumption of
Korotkoff sounds. - ANSWER✔️d. The disappearance of Korotkoff sounds following initial
muffling.
A 72-year-old retiree presents to the cardiology clinic with palpitations after several months of
symptoms. An electrocardiogram (ECG) shows a tachyarrhythmia, which the cardiologist
diagnoses as atrial fibrillation. In measuring the blood pressure of a patient with chronic atrial
fibrillation, which of the following statements is true?
,a. The precise blood pressure is measured by taking the average of three pressures in both arms
over a span of 20 minutes.
b. Single automated measurement in the office setting provides a reliable value for the true blood
pressure.
c. Ambulatory monitoring over 2-24 hours is recommended because this rhythm produces
variable and inconsistent
blood pressures.
d. Measuring blood pressure in patients with atrial fibrillation is no different than measuring
blood pressure in patients with normal cardiac rhythms.
e. Because atrial fibrillation is an uncommon arrhythmia, blood pressure manag - ANSWER✔️c.
Ambulatory monitoring over 2-24 hours is recommended because this rhythm produces variable
and inconsistent
blood pressures.
A 42-year-old architect presents with widespread pain complaints, including headaches almost
daily, pain at the site of an old motor vehicle accident injury, and generalized achiness and
hypersensitivity throughout the body. He recounts that his first episodes of ongoing pain
occurred in his early 20s, and he has been to many practitioners over several years seeking a firm
diagnosis and adequate treatment of his complaints. Which of the following statements is true
regarding chronic pain?
a. Following assessment and evaluation, ~80% of patients with non-cancer-related pain report
control of their symptoms.
b. Chronic pain is defined as pain not due to cancer or a recognized medical condition that
persists for >3-6 months.
c. Chronic pain is defined as focused pain lasting >8 months following acute injury or illness.d.
In primary care practices, non-cancer-related chronic pain is seen in <10% of patients.
e. Pain th - ANSWER✔️b. Chronic pain is defined as pain not due to cancer or a recognized
medical condition that persists for >3-6 months.
Disparities in pain treatment have been well described in numerous studies comparing Caucasian
patients to those of African American and Hispanic origin. Which of the following statements is
true concerning this issue?
a. Racial and ethnic biases are only relevant in geographic areas that have a history of racial and
ethnic discrimination.
b. Racial and ethnic biases never involve two persons of the same race or ethnic group.
c. Language barriers do not contribute to the problem of racial and ethnic biases.
d. Biases of the treating clinician are associated with overtreatment of pain in minority patients
and non-English speakers.
e. Biases of the treating clinician are associated with under-treatment of pain in minority patients
and non-English
speakers. - ANSWER✔️e. Biases of the treating clinician are associated with under-treatment of
pain in minority patients and non-English
speakers.
, Which of the following statements is true concerning mental health disorders in primary care?
a. The prevalence for mental disorders is estimated to be ~10%, of which only 25% are not
diagnosed.
b. Anxiety disorders are the most prevalent of all diagnoses in this setting.
c. Somatic symptom disorder (DSM-5) is distinctly uncommon in this setting and constitutes less
than 5% of these disorders.
d. Mood disorders make up ~25% of all diagnoses.
e. Alcohol and substance abuse are not considered mental health disorders.d. Mood disorders
make up ~25% of all diagnoses. - ANSWER✔️d. Mood disorders make up ~25% of all
diagnoses.
Which of the following complaints/findings is considered to be a patient identifier for mental
health screening?
a. High use of health services due to chronic unstable medical diagnoses
b. Symptoms lasting for >2 weeks
c. Acute pain syndromes of 10 days' duration that require opiates for relief
d. Substance abuse
e. A patient with type I diabetes and neuropathic pain - ANSWER✔️d. Substance abuse
The focused cardiovascular assessment includes - ANSWER✔️Inspection, palpation, and
auscultation of the chest, neck, and extremities. Percussion is used to determine the borders of
the heart.
A 38-year-old accountant presents to the office with a series of generalized complaints. He
relates that he feels a loss of pleasure in daily activities, has difficulty sleeping, and is
experiencing problems making decisions. Which of the following best explains the patient's
presentation?
a. Substance abuse with anhedonia
b. Bipolar disorder in the early pre-excitatory phase
c. Histrionic personality
d. Depression
e. Antisocial personality - ANSWER✔️d. Depression
Concerning hallucinations, an abnormal perception experienced by a patient, which of the
following statements is true about this abnormality?
a. They include false perceptions associated with dreaming and occurring with falling asleep and
awakening.
b. Objective testing can be performed by a trained neuropsychologist to ascertain the correct
diagnosis associated with this complaint.
c. Although alcoholism may be associated with abnormalities of perception, it is not considered a
cause of hallucinations as this finding is due to its direct toxic effects.
AVANCED PHYSICS ASSESSMENT/ 100%
GRADED A+
A first-semester physician assistant student reports to his supervisor that he has trouble
determining the diastolic blood pressure. On manual blood pressure, which of the following
provides the best estimate of the true diastolic blood pressure?
a. The point at which Korotkoff sounds first muffle after systolic blood pressure is discerned.
b. The average between the highest and lowest points of the auscultatory gap.
c. The recommencement of Korotkoff sounds following the lower point of the auscultatory gap.
d. The disappearance of Korotkoff sounds following initial muffling.
e. The average reading between the onset of the auscultatory gap and the resumption of
Korotkoff sounds. - ANSWER✔️d. The disappearance of Korotkoff sounds following initial
muffling.
A 72-year-old retiree presents to the cardiology clinic with palpitations after several months of
symptoms. An electrocardiogram (ECG) shows a tachyarrhythmia, which the cardiologist
diagnoses as atrial fibrillation. In measuring the blood pressure of a patient with chronic atrial
fibrillation, which of the following statements is true?
,a. The precise blood pressure is measured by taking the average of three pressures in both arms
over a span of 20 minutes.
b. Single automated measurement in the office setting provides a reliable value for the true blood
pressure.
c. Ambulatory monitoring over 2-24 hours is recommended because this rhythm produces
variable and inconsistent
blood pressures.
d. Measuring blood pressure in patients with atrial fibrillation is no different than measuring
blood pressure in patients with normal cardiac rhythms.
e. Because atrial fibrillation is an uncommon arrhythmia, blood pressure manag - ANSWER✔️c.
Ambulatory monitoring over 2-24 hours is recommended because this rhythm produces variable
and inconsistent
blood pressures.
A 42-year-old architect presents with widespread pain complaints, including headaches almost
daily, pain at the site of an old motor vehicle accident injury, and generalized achiness and
hypersensitivity throughout the body. He recounts that his first episodes of ongoing pain
occurred in his early 20s, and he has been to many practitioners over several years seeking a firm
diagnosis and adequate treatment of his complaints. Which of the following statements is true
regarding chronic pain?
a. Following assessment and evaluation, ~80% of patients with non-cancer-related pain report
control of their symptoms.
b. Chronic pain is defined as pain not due to cancer or a recognized medical condition that
persists for >3-6 months.
c. Chronic pain is defined as focused pain lasting >8 months following acute injury or illness.d.
In primary care practices, non-cancer-related chronic pain is seen in <10% of patients.
e. Pain th - ANSWER✔️b. Chronic pain is defined as pain not due to cancer or a recognized
medical condition that persists for >3-6 months.
Disparities in pain treatment have been well described in numerous studies comparing Caucasian
patients to those of African American and Hispanic origin. Which of the following statements is
true concerning this issue?
a. Racial and ethnic biases are only relevant in geographic areas that have a history of racial and
ethnic discrimination.
b. Racial and ethnic biases never involve two persons of the same race or ethnic group.
c. Language barriers do not contribute to the problem of racial and ethnic biases.
d. Biases of the treating clinician are associated with overtreatment of pain in minority patients
and non-English speakers.
e. Biases of the treating clinician are associated with under-treatment of pain in minority patients
and non-English
speakers. - ANSWER✔️e. Biases of the treating clinician are associated with under-treatment of
pain in minority patients and non-English
speakers.
, Which of the following statements is true concerning mental health disorders in primary care?
a. The prevalence for mental disorders is estimated to be ~10%, of which only 25% are not
diagnosed.
b. Anxiety disorders are the most prevalent of all diagnoses in this setting.
c. Somatic symptom disorder (DSM-5) is distinctly uncommon in this setting and constitutes less
than 5% of these disorders.
d. Mood disorders make up ~25% of all diagnoses.
e. Alcohol and substance abuse are not considered mental health disorders.d. Mood disorders
make up ~25% of all diagnoses. - ANSWER✔️d. Mood disorders make up ~25% of all
diagnoses.
Which of the following complaints/findings is considered to be a patient identifier for mental
health screening?
a. High use of health services due to chronic unstable medical diagnoses
b. Symptoms lasting for >2 weeks
c. Acute pain syndromes of 10 days' duration that require opiates for relief
d. Substance abuse
e. A patient with type I diabetes and neuropathic pain - ANSWER✔️d. Substance abuse
The focused cardiovascular assessment includes - ANSWER✔️Inspection, palpation, and
auscultation of the chest, neck, and extremities. Percussion is used to determine the borders of
the heart.
A 38-year-old accountant presents to the office with a series of generalized complaints. He
relates that he feels a loss of pleasure in daily activities, has difficulty sleeping, and is
experiencing problems making decisions. Which of the following best explains the patient's
presentation?
a. Substance abuse with anhedonia
b. Bipolar disorder in the early pre-excitatory phase
c. Histrionic personality
d. Depression
e. Antisocial personality - ANSWER✔️d. Depression
Concerning hallucinations, an abnormal perception experienced by a patient, which of the
following statements is true about this abnormality?
a. They include false perceptions associated with dreaming and occurring with falling asleep and
awakening.
b. Objective testing can be performed by a trained neuropsychologist to ascertain the correct
diagnosis associated with this complaint.
c. Although alcoholism may be associated with abnormalities of perception, it is not considered a
cause of hallucinations as this finding is due to its direct toxic effects.
