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Midterm Exam: NR 509/ NR509 Advanced Physical Assessment Midterm Exam Questions with Verified Answers (Latest 2025/ 2026)- Chamberlain
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Midterm Exam: NR 509/ NR509 Advanced Physical Assessment Midterm Exam Questions with Verified Answers (Latest 2025/ 2026)- Chamberlain 1. NR509 midterm exam study guide with verified answers. 2. Advanced physical assessment practice questions for NR509. 3. Chamberlain NR509 midterm exam pr...

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  • January 7, 2025
  • 65
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • midterm exam nr 509
  • nr509
  • midterm exam
  • nr509 advanced physical assessment
  • nr509 advanced physical assessment midterm exam
  • advanced physical assessment
  • chamberlain university nr509 midterm

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NR 509 / NR509 Advanced Physical Assessment
Midterm Exam
Questions with Verified Answers - Chamberlain



Consist of 100 multiple choices Questions with Answers



1. 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 sleep-
ing 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
ANS: c. Obtain a more complete descriptionof problems.
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,2. 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
ANS: b. Validating and empathetic withopen-ended questions


3. 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 never fulfilled; she
then changes the subject rapidly to whether her Pap smear is due. Which of
the following is an example of an empathetic response to this patient?
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,a. Assuming that the event caused her to become depressed and expressing
the same feeling on behalf of the patient
b. Recognizing the patient's emotions by asking or confirming how she feels
about the event
c. By allowing the crying patient to look around the room for tissues to permit
her an excuse to hide her face and defer her emotions
d. Presuming that the patient's emotions meet social expectations, such as
being depressed and even trau
ANS: b. Recognizing the patient's emotions by askingor confirming how she feels
about the event


4. A 63-year-old male presents to establish care at a new primary care clinic
to discuss issues with pain and fatigue. The clinician conducting the visit
begins with general historical questions but quickly becomes suspicious that

the patient is suffering from decompensated heart failure. When the patient
mentions that he has had vague chest pain since last night, the clinician feels
that the focus must be redirected to this potentially emergent condition. Which
of the following interview techniques is the most appropriate to effectively
manage this visit?


a. Providing serial reassurances such as, "Don't worry, you're going to be
fine."
b. Asking a series of negative questions such as, "You don't have any swelling
in your feet, do you?"
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c. Nonverbally cuing the patient to focus on his narrative regarding a motor
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,vehicle accident
d. (MVA) that led to back pain
e. Asking leading questions that focus on the presumed diagnosis of chest
pain
f. Moving from open-ended to focused questions: f. Moving from open-ended to
focused questions


5. A 59-year-old patient presents to his primary care provider with a history of
several episodes of sharp epigastric pain. His father died of pancreatic cancer
at age 52 years, and the patient recalls to the clinician that, "His pain was just
like mine is now ..." The patient then pauses several seconds. The clinician
replies, "Just like?" after which the patient restarts his narrative. Which of
the following is an example of the interviewing techniques employed by the
clinician?


a. Clarifying
b. Echoing
c. Encouraging with continuers
d. d. Eliciting a graded response
e. Asking a leading question
ANS: b. Echoing


6. A 14-year-old male presents to a new primary care provider after his family
relocates to a state. The patient underwent treatment for sarcoma when he
was age 11 years, including an above-the-knee amputation. He has learned to
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successfully navigate with a prosthetic leg and even engage in competitive
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,athletics at school. He does not like to speak of his experience with cancer
and often makes up humorous stories to tell new acquaintances about his
amputation (such as, "I got bit by a squirrel and they had to amputate.").
Although he is very well engaged in most of the visit with the new clinician,
when the topic of cancer arises, he demurs to his father, who accompanies
him to this appointment. Which of the following statements is most likely to

be helpful in cementing the patient's trust in the new provider

a. "That sounds like a frightening experience that you are recovering well
from."
b. "You are becoming an adult and must be able to talk about your health."
c. "You need to see a counselor since you have not adjusted well to your new
condition."
d. "You have recovered well and should start moving on with your life."
e. "You cannot rely on your father for support forever."
ANS: a. "That sounds like afrightening experience that you are recovering well
from."


7. A 29-year-old electrician complains of persistent cough and wheezing,
particularly when he exercises. He says he smokes "occasionally" but rarely
so much that he needs to purchase cigarettes: "Mostly, I bum them," he says,
chuckling. Upon hearing this information, what is the best next step on the
part of the clinician?


a. Determine the patient's exercise regimen.
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b. Determine the number of pack-years the patient smokes.
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,c. Conduct a mental status examination.
d. Explain the relationship between smoking and cancer.
e. Determine the patient's immunization history.
ANS: b. Determine the number ofpack-years the patient smokes.


8. A 47-year-old fitness trainer visits the physician assistant (PA) because of
skin dryness, night sweats, and irregular menstrual periods. It is the PA's first
contact with this patient. The patient notes that "My sex life has really gone
downhill lately" and says that she is considering divorcing her husband of
20 years, stating that "He's not a bad guy. I just think that I can do better." In
which of the following ways should the clinician proceed?


a. Obtain a menstrual history for the previous 6 months.
b. Help the patient review the pros and cons of divorce.
c. Inform the patient that menopause is a normal part of aging.
d. Conduct a breast examination.
e. Determine the patient's out-of-country travel history.
ANS: a. Obtain a menstrualhistory for the previous 6 months.


9. One important examination technique involves using the third fingers of
each hand to determine the health of internal organs. What is the name of this
technique?

a. Auscultation
b. Percussion
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c. Inspection
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,d. Palpation
e. Listening
ANS: b. Percussion


10. A 23-year-old physician assistant (PA) student found that she felt
nervouswhen called upon to examine men in her age group. On one
occasion, she encountered a young male patient who appeared embarrassed
to see her walkinto 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.




ANS: b. Explain how the examinationwill proceed.


11. 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
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most likely lead to comprehensive care and patient compliance. Which of the
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,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 acquisi-
tion of concrete details about the patient's condition
e. Taking a symptom-focused approach to reduce the involvement of the
patient's emotional difficulties




ANS: c. Following the patient's lead to understand theirthoughts, ideas, concerns,
and requests


12. A 17-year-old male presents to a sexually transmitted disease clinic at
thebehest 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
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, 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 maxi-
mize the patient's time with the provider




ANS: d. Using nonverbal communication toencourage the patient to expand their
narrative


13. A 42-year-old female mathematician presents for follow-up care
regarding anew diagnosis of systemic lupus erythematosus 6 months ago
after a lengthydiagnostic process during which she was debilitated with
fatigue and joint pain. Since her diagnosis, she has been minimally compliant
with medicationsand has switched her rheumatology provider twice. She
continues to feel ill, and, in explanation for her lack of adherence to the
prescribed treatment, shesimply says, "I don't like it." At this initial visit with
her third rheumatology provider, the clinician elects to explore the issues
behind her noncompliancebefore engaging in diagnostics and treatment
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using the FIFE model. Which ofthe following best defines the elements of the
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