NR 509 Midterm Exam Advanced
Physical Assessment Questions and
Answers
1. 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.: b. Explain how the examination will
proceed.
2. A 34-year-old male with a history of complex social and medical
needs (in- cluding 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,: c. Following the patient's lead to understand their
thoughts, ideas, concerns, and requests
3. 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: d. Using nonverbal communication to encourage the
patient to expand their narrative
4. 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: c. Feelings, ideas, function, and
expectations
5. 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.: c. Obtain a more complete description of
problems.
6. 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?
Physical Assessment Questions and
Answers
1. 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.: b. Explain how the examination will
proceed.
2. A 34-year-old male with a history of complex social and medical
needs (in- cluding 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,: c. Following the patient's lead to understand their
thoughts, ideas, concerns, and requests
3. 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: d. Using nonverbal communication to encourage the
patient to expand their narrative
4. 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: c. Feelings, ideas, function, and
expectations
5. 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.: c. Obtain a more complete description of
problems.
6. 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?
