Midterm Exam: NR509 / NR 509 LATEST EXAM
2025 WITH ACTUAL QUESTIONS AND CORRECT
ANSWERS ALREADY GRADED A+
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. - ANSWER✔✔-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, - ANSWER✔✔-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 conce - ANSWER✔✔-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 em - ANSWER✔✔-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. - ANSWER✔✔-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 - ANSWER✔✔-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 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?
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 con - ANSWER✔✔-b.
Recognizing the patient's emotions by asking or confirming how she feels about
the event
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
2025 WITH ACTUAL QUESTIONS AND CORRECT
ANSWERS ALREADY GRADED A+
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. - ANSWER✔✔-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, - ANSWER✔✔-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 conce - ANSWER✔✔-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 em - ANSWER✔✔-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. - ANSWER✔✔-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 - ANSWER✔✔-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 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?
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 con - ANSWER✔✔-b.
Recognizing the patient's emotions by asking or confirming how she feels about
the event
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
