• NURS 190 PA 09/16/2026
Midterm
NURS 190 PA Midterm Exam 1 | Questions and
Answers – spring 2026| 100% Correct – WCU
2026–2027 | Review & Next Gen Practice
Questions with Answers, Detailed Rationales
Mr. W. is a 51-year-old auto mechanic who comes to the emergency room wanting to be checked out for the
symptom of chest pain. As you listen to him describe his symptom in more detail, you say "Go on," and later,
"Mm-hmmm." This is an example of which of the following skilled interviewing techniques?
A) Echoing
B) Nonverbal communication
C) Facilitation
D) Empathic response
P 1
, • NURS 190 PA 09/16/2026
Midterm
C) Facilitation
Chapter: 03
Feedback: This is an example of facilitation. Facilitation can be posture, actions, or words that encourage the
patient to say more.
Mrs. R. is a 92-year-old retired teacher who comes to your clinic accompanied by her daughter. You ask Mrs. R.
why she came to your clinic today. She looks at her daughter and doesn't say anything in response to your
question. This is an example of which type of challenging patient?
A) Talkative patient
B) Angry patient
C) Silent patient
D) Hearing-impaired patient
C) Silent patient
Chapter: 03
Feedback: This is one example of a silent patient. There are many possibilities for this patient's silence:
depression, dementia, the manner in which you asked the question, and so on.
Mrs. T. comes for her regular visit to the clinic. She is on your schedule because her regular provider is on
vacation and she wanted to be seen. You have heard about her many times from your colleague and are aware
that she is a very talkative person. Which of the following is a helpful technique to improve the quality of the
interview for both the provider and the patient?
A) Allow the patient to speak uninterrupted for the duration of the appointment.
B) Briefly summarize what you heard from the patient in the first 5 minutes and then try to have her focus on
one aspect of what she told you.
C) Set the time limit at the beginning of the interview and stick with it, no matter what occurs in the course of
the interview.
D) Allow your impatience to show so that the patient picks up on your nonverbal cue that the appointment
needs to end.
B) Briefly summarize what you heard from the patient in the first 5 minutes and then try to have her focus on
one aspect of what she told you.
Chapter: 03
Feedback: You can also say, "I want to make sure I take good care of this problem because it is very important.
We may need to talk about the others at the next appointment. Is that okay with you?" This is a technique that
can help you to change the subject but, at the same time, validate the patient's concerns; it also can provide
more structure to the interview.
Mrs. H. comes to your clinic, wanting antibiotics for a sinus infection. When you enter the room, she appears to
be very angry. She has a raised tone of voice and states that she has been waiting for the past hour and has to
get back to work. She states that she is unimpressed by the reception staff, the nurse, and the clinic in general
P 2
, • NURS 190 PA 09/16/2026
Midterm
and wants to know why the office wouldn't call in an antibiotic for her. Which of the following techniques is not
useful in helping to calm this patient?
A) Avoiding admission that you had a part in provoking her anger because you were late
B) Accepting angry feelings from the patient and trying not to get angry in return
C) Staying calm
D) Keeping your posture relaxed
A) Avoiding admission that you had a part in provoking her anger because you were late
Chapter: 03
Feedback: In this scenario, the provider was 1 hour late in seeing the patient. The provider should acknowledge
that he was late and apologize for this, no matter the reason for being late. It often helps to acknowledge that a
patient's anger with you is understandable and that you might be angry in a similar situation.
A 23-year-old graduate student comes to your clinic for evaluation of a urethral discharge. As the provider, you
need to get a sexual history. Which one of the following questions is inappropriate for eliciting the information?
A) Are you sexually active?
B) When was the last time you had intimate physical contact with someone, and did that contact include sexual
intercourse?
C) Do you have sex with men, women, or both?
D) How many sexual partners have you had in the last 6 months?
A) Are you sexually active?
Chapter: 03
Feedback: This is inappropriate because it is too vague. Given the complaint, you should probably assume that
he is sexually active. Sometimes patients may respond to this question with the phrase "No, I just lie there." A
specific sexual history will help you to assess this patient's risk for other sexually transmitted infections.
Mr. Q. is a 45-year-old salesman who comes to your office for evaluation of fatigue. He has come to the office
many times in the past with a variety of injuries, and you suspect that he has a problem with alcohol. Which one
of the following questions will be most helpful in diagnosing this problem?
A) You are an alcoholic, aren't you?
B) When was your last drink?
C) Do you drink 2 to 3 beers every weekend?
D) Do you drink alcohol when you are supposed to be working?
B) When was your last drink?
Chapter: 03
Feedback: This is a good opening question that is general and neutral in tone; depending on the timing, you will
be able to ask for more specific information related to the patient's last drink. The others will tend to stifle the
P 3
, • NURS 190 PA 09/16/2026
Midterm
conversation because they are closed-ended questions. Answer D implies negative behavior and may also keep
the person from sharing freely with you.
On a very busy day in the office, Mrs. Donelan, who is 81 years old, comes for her usual visit for her blood
pressure. She is on a low-dose diuretic chronically and denies any side effects. Her blood pressure is 118/78 today,
which is well-controlled. As you are writing her script, she mentions that it is hard not having her husband Bill
around anymore. What would you do next?
A) Hand her the script and make sure she has a 3-month follow-up appointment.
B) Make sure she understands the script.
C) Ask why Bill is not there.
D) Explain that you will have more time at the next visit to discuss this.
C) Ask why Bill is not there.
Chapter: 03
Feedback: Sometimes, the pts greatest need is for support & empathy. It would be inappropriate to ignore this
comment today. She may have relied heavily on Bill for care and may be in danger. She may be depressed and
even suicidal, but you will not know unless you discuss this with her. Most importantly, you should empathize
with her by saying something like "It must be very difficult not to have him at home" and allow a pause for her to
answer. You may also ask "What did you rely on him to do for you?" Only a life-threatening crisis with another pt
should take you out of her room at this point, & you may need to adjust your office schedule to allow adequate
time for her today.
A patient is describing a very personal part of her history very quickly and in great detail. How should you react?
A) Write down as much as you can, as quickly as possible.
B) Ask her to repeat key phrases or to pause at regular intervals, so you can get almost every word.
C) Tell her that she can go over the notes later to make sure they are accurate.
D) Push away from the keyboard or put down your pen and listen.
D) Push away from the keyboard or put down your pen and listen.
Chapter: 03
Feedback: This is a common event in clinical practice. It is much more important to listen actively with good eye
contact at this time than to document the story verbatim. You want to minimize interruption (e.g., answer B). It
is usually not appropriate to ask a patient to go over the written notes, but it would be a good idea to repeat the
main ideas back to her. You should be certain she has completed her story before doing this. By putting down
your pen or pushing away from the keyboard, you let the pt know her story is the most important thing to you at
this moment.
You arrive at the bedside of an elderly woman who has had a stroke, affecting her entire right side. She cannot
speak (aphasia). You are supposed to examine her. You notice that the last examiner left her socks at the
bottom of the bed, and although sensitive areas are covered by a sheet, the blanket is heaped by her feet at the
bottom of the bed. What would you do next?
P 4
Midterm
NURS 190 PA Midterm Exam 1 | Questions and
Answers – spring 2026| 100% Correct – WCU
2026–2027 | Review & Next Gen Practice
Questions with Answers, Detailed Rationales
Mr. W. is a 51-year-old auto mechanic who comes to the emergency room wanting to be checked out for the
symptom of chest pain. As you listen to him describe his symptom in more detail, you say "Go on," and later,
"Mm-hmmm." This is an example of which of the following skilled interviewing techniques?
A) Echoing
B) Nonverbal communication
C) Facilitation
D) Empathic response
P 1
, • NURS 190 PA 09/16/2026
Midterm
C) Facilitation
Chapter: 03
Feedback: This is an example of facilitation. Facilitation can be posture, actions, or words that encourage the
patient to say more.
Mrs. R. is a 92-year-old retired teacher who comes to your clinic accompanied by her daughter. You ask Mrs. R.
why she came to your clinic today. She looks at her daughter and doesn't say anything in response to your
question. This is an example of which type of challenging patient?
A) Talkative patient
B) Angry patient
C) Silent patient
D) Hearing-impaired patient
C) Silent patient
Chapter: 03
Feedback: This is one example of a silent patient. There are many possibilities for this patient's silence:
depression, dementia, the manner in which you asked the question, and so on.
Mrs. T. comes for her regular visit to the clinic. She is on your schedule because her regular provider is on
vacation and she wanted to be seen. You have heard about her many times from your colleague and are aware
that she is a very talkative person. Which of the following is a helpful technique to improve the quality of the
interview for both the provider and the patient?
A) Allow the patient to speak uninterrupted for the duration of the appointment.
B) Briefly summarize what you heard from the patient in the first 5 minutes and then try to have her focus on
one aspect of what she told you.
C) Set the time limit at the beginning of the interview and stick with it, no matter what occurs in the course of
the interview.
D) Allow your impatience to show so that the patient picks up on your nonverbal cue that the appointment
needs to end.
B) Briefly summarize what you heard from the patient in the first 5 minutes and then try to have her focus on
one aspect of what she told you.
Chapter: 03
Feedback: You can also say, "I want to make sure I take good care of this problem because it is very important.
We may need to talk about the others at the next appointment. Is that okay with you?" This is a technique that
can help you to change the subject but, at the same time, validate the patient's concerns; it also can provide
more structure to the interview.
Mrs. H. comes to your clinic, wanting antibiotics for a sinus infection. When you enter the room, she appears to
be very angry. She has a raised tone of voice and states that she has been waiting for the past hour and has to
get back to work. She states that she is unimpressed by the reception staff, the nurse, and the clinic in general
P 2
, • NURS 190 PA 09/16/2026
Midterm
and wants to know why the office wouldn't call in an antibiotic for her. Which of the following techniques is not
useful in helping to calm this patient?
A) Avoiding admission that you had a part in provoking her anger because you were late
B) Accepting angry feelings from the patient and trying not to get angry in return
C) Staying calm
D) Keeping your posture relaxed
A) Avoiding admission that you had a part in provoking her anger because you were late
Chapter: 03
Feedback: In this scenario, the provider was 1 hour late in seeing the patient. The provider should acknowledge
that he was late and apologize for this, no matter the reason for being late. It often helps to acknowledge that a
patient's anger with you is understandable and that you might be angry in a similar situation.
A 23-year-old graduate student comes to your clinic for evaluation of a urethral discharge. As the provider, you
need to get a sexual history. Which one of the following questions is inappropriate for eliciting the information?
A) Are you sexually active?
B) When was the last time you had intimate physical contact with someone, and did that contact include sexual
intercourse?
C) Do you have sex with men, women, or both?
D) How many sexual partners have you had in the last 6 months?
A) Are you sexually active?
Chapter: 03
Feedback: This is inappropriate because it is too vague. Given the complaint, you should probably assume that
he is sexually active. Sometimes patients may respond to this question with the phrase "No, I just lie there." A
specific sexual history will help you to assess this patient's risk for other sexually transmitted infections.
Mr. Q. is a 45-year-old salesman who comes to your office for evaluation of fatigue. He has come to the office
many times in the past with a variety of injuries, and you suspect that he has a problem with alcohol. Which one
of the following questions will be most helpful in diagnosing this problem?
A) You are an alcoholic, aren't you?
B) When was your last drink?
C) Do you drink 2 to 3 beers every weekend?
D) Do you drink alcohol when you are supposed to be working?
B) When was your last drink?
Chapter: 03
Feedback: This is a good opening question that is general and neutral in tone; depending on the timing, you will
be able to ask for more specific information related to the patient's last drink. The others will tend to stifle the
P 3
, • NURS 190 PA 09/16/2026
Midterm
conversation because they are closed-ended questions. Answer D implies negative behavior and may also keep
the person from sharing freely with you.
On a very busy day in the office, Mrs. Donelan, who is 81 years old, comes for her usual visit for her blood
pressure. She is on a low-dose diuretic chronically and denies any side effects. Her blood pressure is 118/78 today,
which is well-controlled. As you are writing her script, she mentions that it is hard not having her husband Bill
around anymore. What would you do next?
A) Hand her the script and make sure she has a 3-month follow-up appointment.
B) Make sure she understands the script.
C) Ask why Bill is not there.
D) Explain that you will have more time at the next visit to discuss this.
C) Ask why Bill is not there.
Chapter: 03
Feedback: Sometimes, the pts greatest need is for support & empathy. It would be inappropriate to ignore this
comment today. She may have relied heavily on Bill for care and may be in danger. She may be depressed and
even suicidal, but you will not know unless you discuss this with her. Most importantly, you should empathize
with her by saying something like "It must be very difficult not to have him at home" and allow a pause for her to
answer. You may also ask "What did you rely on him to do for you?" Only a life-threatening crisis with another pt
should take you out of her room at this point, & you may need to adjust your office schedule to allow adequate
time for her today.
A patient is describing a very personal part of her history very quickly and in great detail. How should you react?
A) Write down as much as you can, as quickly as possible.
B) Ask her to repeat key phrases or to pause at regular intervals, so you can get almost every word.
C) Tell her that she can go over the notes later to make sure they are accurate.
D) Push away from the keyboard or put down your pen and listen.
D) Push away from the keyboard or put down your pen and listen.
Chapter: 03
Feedback: This is a common event in clinical practice. It is much more important to listen actively with good eye
contact at this time than to document the story verbatim. You want to minimize interruption (e.g., answer B). It
is usually not appropriate to ask a patient to go over the written notes, but it would be a good idea to repeat the
main ideas back to her. You should be certain she has completed her story before doing this. By putting down
your pen or pushing away from the keyboard, you let the pt know her story is the most important thing to you at
this moment.
You arrive at the bedside of an elderly woman who has had a stroke, affecting her entire right side. She cannot
speak (aphasia). You are supposed to examine her. You notice that the last examiner left her socks at the
bottom of the bed, and although sensitive areas are covered by a sheet, the blanket is heaped by her feet at the
bottom of the bed. What would you do next?
P 4
