NR 509 WEEK 4 MIDTERM ADVANCED PHYSICAL ASSESSMENT 2025/2026
EXAMINATIONS Chamberlain University | Master of Science in Nursing | Family Nurse
Practitioner Track
SECTION I: HEALTH HISTORY AND INTERVIEWING TECHNIQUES
1. A 72-year-old male presents for a routine physical examination. He reports feeling
"a bit tired lately." Which technique represents the cardinal principle of advanced
physical assessment when initiating the patient encounter?
A. Immediately focus on the cardiovascular system due to his age
B. Perform a comprehensive physical exam before taking the history
C. Establish a therapeutic relationship by asking open-ended questions about his
fatigue and overall health
D. Obtain vital signs and defer the interview until after the examination
Rationale: The cardinal principle of advanced assessment is establishing a therapeutic
relationship through open-ended questions that fully explore patient concerns. This builds
trust and yields comprehensive data, while the history should guide the exam—not the
other way around.
2. A 45-year-old female patient states, "I guess some families are just better off
without certain members." What is the most appropriate initial response?
A. "That sounds like a terrible thing to say."
B. "You don't really mean that, do you?"
C. "Tell me more about what you're feeling right now."
D. "Let's focus on your physical symptoms instead."
,Rationale: This response uses therapeutic communication to explore the patient's
emotional state without judgment. The statement may indicate depression or suicidal
ideation, requiring gentle exploration using open-ended techniques.
3. After completing an initial assessment, the nurse charts that respirations are
eupneic and pulse is 58 beats per minute. These types of data are:
A. Objective
B. Reflective
C. Subjective
D. Introspective
Rationale: Objective data is observable and measurable—what the health professional
observes or detects through examination. Vital signs are classic objective data.
4. A patient tells the nurse he is very nervous, nauseated, and feels hot. This
information represents:
A. Objective data
B. Reflective data
C. Subjective data
D. Introspective data
Rationale: Subjective data is what the patient tells you—their sensations, feelings, and
perceptions that cannot be directly observed or verified by others.
5. The mnemonic "OPQRST" is used to analyze a symptom. What does the "P"
specifically assess?
A. The primary location of the pain
B. The pathophysiology of the condition
C. Palliating and provocative factors
D. The patient's perception of severity
,Rationale: OPQRST stands for Onset, Palliating/Provocative factors, Quality,
Region/Radiation, Severity, Timing. The "P" asks what makes the symptom better or worse.
6. To accurately assess a patient's adherence to antihypertensive medication, which
questioning technique is most effective?
A. "You haven't missed any doses, have you?"
B. "Do you take your medication as prescribed?"
C. "Many patients find it hard to take pills every day. How often do you take yours?"
D. "Why aren't you taking your medication?"
Rationale: A normalizing statement reduces patient defensiveness and encourages honest
disclosure about medication adherence.
7. The patient's record, laboratory studies, objective data, and subjective data
combine to form the:
A. Database
B. Admitting data
C. Financial statement
D. Discharge summary
Rationale: The database is the compilation of all health-related information—subjective
data, objective data, patient record, and lab studies—used to identify patient problems.
8. Which of the following is an example of objective data?
A. Patient reports of nausea
B. Patient's description of chest pain
C. 2.5 cm scar on the right lower forearm
D. Patient's statement of feeling dizzy
, Rationale: Objective data are observable and measurable findings obtained through
inspection, palpation, percussion, and auscultation. A scar measurement is a physical
finding that can be verified by the examiner.
9. The nurse is reviewing information about Evidence-Based Practice (EBP). Which
statement best reflects EBP?
A. EBP is simply the use of best practice techniques for the treatment of patients
B. EBP is the traditional practice passed down through generations
C. EBP emphasizes the use of best evidence with the clinician's experience
D. EBP relies solely on patient preferences
Rationale: Evidence-Based Practice integrates the best available research evidence with
the clinician's clinical expertise and the patient's unique values and circumstances.
10. Which critical thinking skill helps see relationships among the data?
A. Validation
B. Clustering related cues
C. Identifying gaps in data
D. Distinguishing relevant from irrelevant
Rationale: Clustering related cues involves grouping together pieces of data that are
related, which helps the clinician see patterns and relationships.
SECTION II: PHYSICAL EXAMINATION TECHNIQUES
11. When listening to a patient's breath sounds, the nurse is unsure of a sound. The
next action should be to:
A. Immediately notify the patient's physician
B. Document the sound exactly as heard
C. Validate the data by asking a coworker to listen
D. Assess again in 20 minutes
EXAMINATIONS Chamberlain University | Master of Science in Nursing | Family Nurse
Practitioner Track
SECTION I: HEALTH HISTORY AND INTERVIEWING TECHNIQUES
1. A 72-year-old male presents for a routine physical examination. He reports feeling
"a bit tired lately." Which technique represents the cardinal principle of advanced
physical assessment when initiating the patient encounter?
A. Immediately focus on the cardiovascular system due to his age
B. Perform a comprehensive physical exam before taking the history
C. Establish a therapeutic relationship by asking open-ended questions about his
fatigue and overall health
D. Obtain vital signs and defer the interview until after the examination
Rationale: The cardinal principle of advanced assessment is establishing a therapeutic
relationship through open-ended questions that fully explore patient concerns. This builds
trust and yields comprehensive data, while the history should guide the exam—not the
other way around.
2. A 45-year-old female patient states, "I guess some families are just better off
without certain members." What is the most appropriate initial response?
A. "That sounds like a terrible thing to say."
B. "You don't really mean that, do you?"
C. "Tell me more about what you're feeling right now."
D. "Let's focus on your physical symptoms instead."
,Rationale: This response uses therapeutic communication to explore the patient's
emotional state without judgment. The statement may indicate depression or suicidal
ideation, requiring gentle exploration using open-ended techniques.
3. After completing an initial assessment, the nurse charts that respirations are
eupneic and pulse is 58 beats per minute. These types of data are:
A. Objective
B. Reflective
C. Subjective
D. Introspective
Rationale: Objective data is observable and measurable—what the health professional
observes or detects through examination. Vital signs are classic objective data.
4. A patient tells the nurse he is very nervous, nauseated, and feels hot. This
information represents:
A. Objective data
B. Reflective data
C. Subjective data
D. Introspective data
Rationale: Subjective data is what the patient tells you—their sensations, feelings, and
perceptions that cannot be directly observed or verified by others.
5. The mnemonic "OPQRST" is used to analyze a symptom. What does the "P"
specifically assess?
A. The primary location of the pain
B. The pathophysiology of the condition
C. Palliating and provocative factors
D. The patient's perception of severity
,Rationale: OPQRST stands for Onset, Palliating/Provocative factors, Quality,
Region/Radiation, Severity, Timing. The "P" asks what makes the symptom better or worse.
6. To accurately assess a patient's adherence to antihypertensive medication, which
questioning technique is most effective?
A. "You haven't missed any doses, have you?"
B. "Do you take your medication as prescribed?"
C. "Many patients find it hard to take pills every day. How often do you take yours?"
D. "Why aren't you taking your medication?"
Rationale: A normalizing statement reduces patient defensiveness and encourages honest
disclosure about medication adherence.
7. The patient's record, laboratory studies, objective data, and subjective data
combine to form the:
A. Database
B. Admitting data
C. Financial statement
D. Discharge summary
Rationale: The database is the compilation of all health-related information—subjective
data, objective data, patient record, and lab studies—used to identify patient problems.
8. Which of the following is an example of objective data?
A. Patient reports of nausea
B. Patient's description of chest pain
C. 2.5 cm scar on the right lower forearm
D. Patient's statement of feeling dizzy
, Rationale: Objective data are observable and measurable findings obtained through
inspection, palpation, percussion, and auscultation. A scar measurement is a physical
finding that can be verified by the examiner.
9. The nurse is reviewing information about Evidence-Based Practice (EBP). Which
statement best reflects EBP?
A. EBP is simply the use of best practice techniques for the treatment of patients
B. EBP is the traditional practice passed down through generations
C. EBP emphasizes the use of best evidence with the clinician's experience
D. EBP relies solely on patient preferences
Rationale: Evidence-Based Practice integrates the best available research evidence with
the clinician's clinical expertise and the patient's unique values and circumstances.
10. Which critical thinking skill helps see relationships among the data?
A. Validation
B. Clustering related cues
C. Identifying gaps in data
D. Distinguishing relevant from irrelevant
Rationale: Clustering related cues involves grouping together pieces of data that are
related, which helps the clinician see patterns and relationships.
SECTION II: PHYSICAL EXAMINATION TECHNIQUES
11. When listening to a patient's breath sounds, the nurse is unsure of a sound. The
next action should be to:
A. Immediately notify the patient's physician
B. Document the sound exactly as heard
C. Validate the data by asking a coworker to listen
D. Assess again in 20 minutes
