NR509 ADVANCED PHYSICAL ASSESSMENT
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A 42-year-old architect presents with widespread pain complaints, including
headaches almost daily, pain at the site of an old motor vehicle accident injury,
and generalized achiness and hypersensitivity throughout the body. He recounts
that his first episodes of ongoing pain occurred in his early 20s, and he has been
to many practitioners over several years seeking a firm diagnosis and adequate
treatment of his complaints. Which of the following statements is true regarding
chronic pain?
a. Following assessment and evaluation, ~80% of patients with non-cancer-related
pain report control of their symptoms.
b. Chronic pain is defined as pain not due to cancer or a recognized medical
condition that persists for >3-6 months.
c. Chronic pain is defined as focused pain lasting >8 months following acute injury
or illness.d. In primary care practices, non-cancer-related chronic pain is seen in
<10% of patients.
,e. Pain th
b. Chronic pain is defined as pain not due to cancer or a recognized medical
condition that persists for >3-6 months.
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 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?"
c. Nonverbally cuing the patient to focus on his narrative regarding a motor
vehicle accident
d. (MVA) that led to back pain
e. Asking leading questions that focus on the presumed diag
f. Moving from open-ended to focused questions
, 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. Eliciting a graded response
e. Asking a leading question
b. Echoing
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
successfully navigate with a prosthetic leg and even engage in competitive
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
Actual Exam Questions and Correct Detailed
Answers Already Graded A+ Brand New 2025
Guaranteed Pass
A 42-year-old architect presents with widespread pain complaints, including
headaches almost daily, pain at the site of an old motor vehicle accident injury,
and generalized achiness and hypersensitivity throughout the body. He recounts
that his first episodes of ongoing pain occurred in his early 20s, and he has been
to many practitioners over several years seeking a firm diagnosis and adequate
treatment of his complaints. Which of the following statements is true regarding
chronic pain?
a. Following assessment and evaluation, ~80% of patients with non-cancer-related
pain report control of their symptoms.
b. Chronic pain is defined as pain not due to cancer or a recognized medical
condition that persists for >3-6 months.
c. Chronic pain is defined as focused pain lasting >8 months following acute injury
or illness.d. In primary care practices, non-cancer-related chronic pain is seen in
<10% of patients.
,e. Pain th
b. Chronic pain is defined as pain not due to cancer or a recognized medical
condition that persists for >3-6 months.
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 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?"
c. Nonverbally cuing the patient to focus on his narrative regarding a motor
vehicle accident
d. (MVA) that led to back pain
e. Asking leading questions that focus on the presumed diag
f. Moving from open-ended to focused questions
, 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. Eliciting a graded response
e. Asking a leading question
b. Echoing
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
successfully navigate with a prosthetic leg and even engage in competitive
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
