NR509 Study Guide Questions with 100% Correct
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.
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, humility, and sensitivity in favor of the acquisition of
concrete details about the patient's condition
e. Taking a symptom-focused approach to reduce the involvement of the patient's
emotional difficulties
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 concerns to concrete medical needs
d. Using nonverbal communication to encourage the patient to expand their narrative
e. Considering a differential diagnosis while the patient is speaking to maximize the
patient's time with the provider
,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 emotion e. Facts, intelligence, fortuity, and
eventuality
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.
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
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
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.
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, humility, and sensitivity in favor of the acquisition of
concrete details about the patient's condition
e. Taking a symptom-focused approach to reduce the involvement of the patient's
emotional difficulties
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 concerns to concrete medical needs
d. Using nonverbal communication to encourage the patient to expand their narrative
e. Considering a differential diagnosis while the patient is speaking to maximize the
patient's time with the provider
,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 emotion e. Facts, intelligence, fortuity, and
eventuality
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.
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
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
