NR 509/ NR509 Advanced Physical Assessment Midterm Exam Questions with Verified Answers (Latest 2025/ 2026)
Exam Format ✔️Non-Cumulative
Number of Questions ✔️100
Time Allotted ✔️120 minutes
Testing Timeframe ✔️The midterm exam will be available starting on Wednesday of Week 4 at 12:01 am MT until Saturday of Week 4 at 11:59
pm MT.
Illness ✔️Patient's lived experience.
Disease ✔️Clinician's biomedical explanation.
Goal of the Encounter ✔️Therapeutic partnership with mutual respect, empathy, and clarity.
FIFE ✔️Feelings, Ideas, Function, Expectations.
NURSE ✔️Name, Understand, Respect, Support, Explore.
Teach-Back ✔️Patient repeats plan to confirm understanding.
Shared Decision-Making ✔️Options → Explore preferences → Decide together.
5Rs of Cultural Humility ✔️Reflection, Respect, Regard, Relevance, Resiliency.
Core Values of Ethics ✔️Beneficence, Nonmaleficence, Autonomy, Justice.
Decisional Capacity ✔️Understand, Appreciate, Reason, Communicate choice (different from legal competence).
Active Listening ✔️Full attention to patient's words + cues.
Guided Questioning ✔️Open → focused → closed; continuers ("go on"), echoing, clarifying vague terms.
Empathy ✔️Reflect back feelings.
Validation ✔️Legitimize concerns.
Patient Education ✔️Use plain language; 1-3 key points.
Ask Me Three ✔️What is my problem? What do I need to do? Why is it important?
SBAR ✔️Situation, Background, Assessment, Recommendation (team communication).
INTERPRET ✔️Introduce, Note goals, Transparency, Ethics, Respect, Patient focus, Retain control, Explain, Thank (working with interpreters).
SPIKES ✔️Setting, Perception, Invitation, Knowledge, Emotions, Strategy/Summary (delivering serious news).
OARS ✔️Open-ended questions, Affirmations, Reflections, Summaries (motivational interviewing).
Informed Consent - 5 Elements ✔️Nature of procedure, Risks and benefits, Alternatives, Risks and benefits of alternatives, Patient understanding
(requires decisional capacity).
Angry ✔️stay calm, validate, ensure safety.
Confused/cognitively impaired ✔️clarify, involve caregiver.
Emotional/tearful ✔️allow expression, respond with empathy.
Low literacy ✔️use plain language + teach-back.
Discriminatory or flirtatious ✔️set professional boundaries.
, Risk in EHR and Communication ✔️loss of eye contact, fragmented rapport.
Strategies for EHR and Communication ✔️review before, face patient, share screen, narrate typing, pause during sensitive topics.
FIFE - Patient's Perspective ✔️Feelings → "How has this made you feel?" "What worries you most?"
NURSE - Responding to Emotions ✔️Name → "It sounds like this has been very stressful for you."
Teach-Back - Confirming Understanding ✔️"I want to make sure I explained things clearly. Can you tell me in your own words how you'll take
this medication?"
Shared Decision-Making (3-Talk Model) ✔️Team Talk → "There are a few different ways we could approach this, and I'd like us to decide
together."
SBAR - Interprofessional Communication ✔️Situation: "This is Ms. Jones, she came in today with chest pain."
INTERPRET - Using an Interpreter ✔️Introduce → "This is [interpreter's name]; they'll help us communicate today."
SPIKES - Delivering Serious News ✔️Setting → "I'd like to talk in private. Would you like a family member here with you?"
Open-ended question ✔️A question that cannot be answered with a simple 'yes' or 'no', such as 'What concerns you about your smoking?'
Affirmation ✔️Acknowledging a patient's efforts, e.g., 'It sounds like you've already taken steps by cutting down.'
Reflection ✔️Mirroring a patient's feelings, e.g., 'You feel torn—you want to quit, but you're afraid of failing.'
Summary ✔️Recapping what a patient has said, e.g., 'So far, you've said your main reasons to quit are for your kids and your health. Did I get
that right?'
Health history ✔️Includes identifying data, chief complaint, HPI, past medical history, family history, personal and social history, and review of
systems.
Focused history ✔️Emphasizes problem-oriented details.
Comprehensive history ✔️Covers full health context.
Techniques of Examination ✔️Includes inspection, palpation, percussion, and auscultation.
Comprehensive exam ✔️A full head-to-toe examination.
Focused exam ✔️A symptom/problem-specific examination.
General survey ✔️Observing overall health, body habitus, posture, gait, dress, grooming, and affect.
Vital signs ✔️Key measurements include temperature, pulse, respiratory rate, blood pressure, and pain.
Abnormal findings ✔️Includes fever/hypothermia, tachy/bradycardia, tachypnea/bradypnea, hypertension/hypotension.
Health promotion ✔️Involves screening, counseling, and immunizations.
Differential Diagnosis ✔️Uses patient history, physical exam, and evidence-based guidelines to generate possible causes.
Problem list ✔️Documents active issues, past resolved problems, and risk factors to prioritize care planning.
Behavior and Mental Health Assessment ✔️Includes affect, mood, speech, thought processes, thought content, insight, and judgment.
Mental status exam ✔️Evaluates appearance & behavior, speech & language, mood & affect, thought processes & content, and cognition.
Skin, Hair, and Nails ✔️Inspect for color, lesions, rashes, scars, turgor, and hydration.
Common abnormalities ✔️Includes cyanosis, jaundice, pallor, clubbing, alopecia, and nail pitting.
Head, Eyes, Ears, Nose, and Throat (HEENT) ✔️A comprehensive examination area that includes specific findings for eyes and ears.
Papilledema ✔️Characterized by blurred disc margins, no venous pulsation, and increased intracranial pressure (↑ ICP).
Exam Format ✔️Non-Cumulative
Number of Questions ✔️100
Time Allotted ✔️120 minutes
Testing Timeframe ✔️The midterm exam will be available starting on Wednesday of Week 4 at 12:01 am MT until Saturday of Week 4 at 11:59
pm MT.
Illness ✔️Patient's lived experience.
Disease ✔️Clinician's biomedical explanation.
Goal of the Encounter ✔️Therapeutic partnership with mutual respect, empathy, and clarity.
FIFE ✔️Feelings, Ideas, Function, Expectations.
NURSE ✔️Name, Understand, Respect, Support, Explore.
Teach-Back ✔️Patient repeats plan to confirm understanding.
Shared Decision-Making ✔️Options → Explore preferences → Decide together.
5Rs of Cultural Humility ✔️Reflection, Respect, Regard, Relevance, Resiliency.
Core Values of Ethics ✔️Beneficence, Nonmaleficence, Autonomy, Justice.
Decisional Capacity ✔️Understand, Appreciate, Reason, Communicate choice (different from legal competence).
Active Listening ✔️Full attention to patient's words + cues.
Guided Questioning ✔️Open → focused → closed; continuers ("go on"), echoing, clarifying vague terms.
Empathy ✔️Reflect back feelings.
Validation ✔️Legitimize concerns.
Patient Education ✔️Use plain language; 1-3 key points.
Ask Me Three ✔️What is my problem? What do I need to do? Why is it important?
SBAR ✔️Situation, Background, Assessment, Recommendation (team communication).
INTERPRET ✔️Introduce, Note goals, Transparency, Ethics, Respect, Patient focus, Retain control, Explain, Thank (working with interpreters).
SPIKES ✔️Setting, Perception, Invitation, Knowledge, Emotions, Strategy/Summary (delivering serious news).
OARS ✔️Open-ended questions, Affirmations, Reflections, Summaries (motivational interviewing).
Informed Consent - 5 Elements ✔️Nature of procedure, Risks and benefits, Alternatives, Risks and benefits of alternatives, Patient understanding
(requires decisional capacity).
Angry ✔️stay calm, validate, ensure safety.
Confused/cognitively impaired ✔️clarify, involve caregiver.
Emotional/tearful ✔️allow expression, respond with empathy.
Low literacy ✔️use plain language + teach-back.
Discriminatory or flirtatious ✔️set professional boundaries.
, Risk in EHR and Communication ✔️loss of eye contact, fragmented rapport.
Strategies for EHR and Communication ✔️review before, face patient, share screen, narrate typing, pause during sensitive topics.
FIFE - Patient's Perspective ✔️Feelings → "How has this made you feel?" "What worries you most?"
NURSE - Responding to Emotions ✔️Name → "It sounds like this has been very stressful for you."
Teach-Back - Confirming Understanding ✔️"I want to make sure I explained things clearly. Can you tell me in your own words how you'll take
this medication?"
Shared Decision-Making (3-Talk Model) ✔️Team Talk → "There are a few different ways we could approach this, and I'd like us to decide
together."
SBAR - Interprofessional Communication ✔️Situation: "This is Ms. Jones, she came in today with chest pain."
INTERPRET - Using an Interpreter ✔️Introduce → "This is [interpreter's name]; they'll help us communicate today."
SPIKES - Delivering Serious News ✔️Setting → "I'd like to talk in private. Would you like a family member here with you?"
Open-ended question ✔️A question that cannot be answered with a simple 'yes' or 'no', such as 'What concerns you about your smoking?'
Affirmation ✔️Acknowledging a patient's efforts, e.g., 'It sounds like you've already taken steps by cutting down.'
Reflection ✔️Mirroring a patient's feelings, e.g., 'You feel torn—you want to quit, but you're afraid of failing.'
Summary ✔️Recapping what a patient has said, e.g., 'So far, you've said your main reasons to quit are for your kids and your health. Did I get
that right?'
Health history ✔️Includes identifying data, chief complaint, HPI, past medical history, family history, personal and social history, and review of
systems.
Focused history ✔️Emphasizes problem-oriented details.
Comprehensive history ✔️Covers full health context.
Techniques of Examination ✔️Includes inspection, palpation, percussion, and auscultation.
Comprehensive exam ✔️A full head-to-toe examination.
Focused exam ✔️A symptom/problem-specific examination.
General survey ✔️Observing overall health, body habitus, posture, gait, dress, grooming, and affect.
Vital signs ✔️Key measurements include temperature, pulse, respiratory rate, blood pressure, and pain.
Abnormal findings ✔️Includes fever/hypothermia, tachy/bradycardia, tachypnea/bradypnea, hypertension/hypotension.
Health promotion ✔️Involves screening, counseling, and immunizations.
Differential Diagnosis ✔️Uses patient history, physical exam, and evidence-based guidelines to generate possible causes.
Problem list ✔️Documents active issues, past resolved problems, and risk factors to prioritize care planning.
Behavior and Mental Health Assessment ✔️Includes affect, mood, speech, thought processes, thought content, insight, and judgment.
Mental status exam ✔️Evaluates appearance & behavior, speech & language, mood & affect, thought processes & content, and cognition.
Skin, Hair, and Nails ✔️Inspect for color, lesions, rashes, scars, turgor, and hydration.
Common abnormalities ✔️Includes cyanosis, jaundice, pallor, clubbing, alopecia, and nail pitting.
Head, Eyes, Ears, Nose, and Throat (HEENT) ✔️A comprehensive examination area that includes specific findings for eyes and ears.
Papilledema ✔️Characterized by blurred disc margins, no venous pulsation, and increased intracranial pressure (↑ ICP).
