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NR509 / NR 509 Final Exam (Latest
2024/2025): Advanced Physical Assessment &
Clinical Decision Making – Chamberlain |
Verified Questions & Answers | A+ Graded
Section 1: General Assessment and Clinical Decision-Making
(Questions 1-10)
1. A 35-year-old female presents with worsening migraines and nausea at night for
several weeks. She takes oral contraceptive pills (OCPs) and reports no other health
issues. What is the nurse practitioner’s best next step?
A. Prescribe a higher dose of triptans
B. Take a further history and perform a neurological exam
C. Order a CT scan immediately
D. Discontinue OCPs without further assessment
Rationale: Worsening migraines with nausea may indicate a serious condition (e.g.,
increased intracranial pressure). A detailed history and neurological exam are critical to
identify red flags before imaging or medication changes. OCPs may contribute but
require evaluation first.
2. Which approach fosters a therapeutic clinician-client relationship during a clinical
encounter?
A. Provider-centered approach only
B. Client-centered approach only
C. Shared decision-making (SDM)
D. Avoiding client input to expedite the visit
Rationale: SDM integrates client preferences with provider expertise, promoting trust
and optimal outcomes, per 2025 clinical guidelines.
3. What is the purpose of the OLD CARTS mnemonic in history-taking?
A. To assess family medical history
B. To evaluate the chief complaint’s attributes
C. To document physical exam findings
D. To guide medication reconciliation
Rationale: OLD CARTS (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Radiation, Timing, Severity) structures the history of the
chief complaint, ensuring comprehensive symptom assessment.
4. A nurse practitioner is conducting a comprehensive health assessment. Which
component is included?
A. Focused review of only the affected system
B. At least 10 systems in the review of systems
C. Limited social history
D. Physical exam without health history
, 2
Rationale: A comprehensive assessment includes an extended history, at least 10
systems in the review of systems, and a full physical exam, per NR 509 curriculum
standards.
5. Which statement by a client indicates a need for further history-taking?
A. “I feel fine and have no complaints.”
B. “I’ve had a fever and weight loss recently.”
C. “I exercise three times a week.”
D. “My last check-up was normal.”
Rationale: Fever and weight loss are red flags suggesting systemic illness (e.g.,
infection, malignancy), requiring a detailed history to identify the cause.
6. What is a pertinent negative in the context of a differential diagnosis?
A. A symptom the client confirms having
B. A symptom expected but absent
C. A physical exam finding unrelated to the complaint
D. A lab result confirming the diagnosis
Rationale: Pertinent negatives are symptoms expected for a potential diagnosis but
absent, helping to narrow the differential diagnosis.
7. During an interview, which technique best encourages a client to elaborate on their
concerns?
A. Asking rapid, focused questions
B. Interrupting to clarify details
C. Using open-ended questions with continuers
D. Summarizing without client input
Rationale: Open-ended questions with continuers (e.g., “Go on”) encourage clients to
share their story, fostering rapport and thorough data collection.
8. What is the primary goal of primary prevention during a clinical encounter?
A. Treating acute symptoms
B. Managing chronic conditions
C. Preventing disease onset
D. Rehabilitating post-injury
Rationale: Primary prevention involves interventions (e.g., vaccinations, lifestyle
counseling) to prevent disease before it occurs, per USPSTF guidelines.
9. A nurse practitioner notes a client’s preferred pronouns during the encounter. Why
is this important?
A. To expedite documentation
B. To respect client identity and build trust
C. To prioritize clinical findings over preferences
D. To avoid discussing sensitive topics
Rationale: Respecting pronouns enhances client-centered care, builds trust, and aligns
with 2025 standards for inclusive practice.
10. Which finding during a health history requires immediate further evaluation?
A. Regular exercise routine
B. Stable weight over the past year
C. Unintentional weight loss of 10% in 3 months
D. Occasional mild headaches
NR509 / NR 509 Final Exam (Latest
2024/2025): Advanced Physical Assessment &
Clinical Decision Making – Chamberlain |
Verified Questions & Answers | A+ Graded
Section 1: General Assessment and Clinical Decision-Making
(Questions 1-10)
1. A 35-year-old female presents with worsening migraines and nausea at night for
several weeks. She takes oral contraceptive pills (OCPs) and reports no other health
issues. What is the nurse practitioner’s best next step?
A. Prescribe a higher dose of triptans
B. Take a further history and perform a neurological exam
C. Order a CT scan immediately
D. Discontinue OCPs without further assessment
Rationale: Worsening migraines with nausea may indicate a serious condition (e.g.,
increased intracranial pressure). A detailed history and neurological exam are critical to
identify red flags before imaging or medication changes. OCPs may contribute but
require evaluation first.
2. Which approach fosters a therapeutic clinician-client relationship during a clinical
encounter?
A. Provider-centered approach only
B. Client-centered approach only
C. Shared decision-making (SDM)
D. Avoiding client input to expedite the visit
Rationale: SDM integrates client preferences with provider expertise, promoting trust
and optimal outcomes, per 2025 clinical guidelines.
3. What is the purpose of the OLD CARTS mnemonic in history-taking?
A. To assess family medical history
B. To evaluate the chief complaint’s attributes
C. To document physical exam findings
D. To guide medication reconciliation
Rationale: OLD CARTS (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Radiation, Timing, Severity) structures the history of the
chief complaint, ensuring comprehensive symptom assessment.
4. A nurse practitioner is conducting a comprehensive health assessment. Which
component is included?
A. Focused review of only the affected system
B. At least 10 systems in the review of systems
C. Limited social history
D. Physical exam without health history
, 2
Rationale: A comprehensive assessment includes an extended history, at least 10
systems in the review of systems, and a full physical exam, per NR 509 curriculum
standards.
5. Which statement by a client indicates a need for further history-taking?
A. “I feel fine and have no complaints.”
B. “I’ve had a fever and weight loss recently.”
C. “I exercise three times a week.”
D. “My last check-up was normal.”
Rationale: Fever and weight loss are red flags suggesting systemic illness (e.g.,
infection, malignancy), requiring a detailed history to identify the cause.
6. What is a pertinent negative in the context of a differential diagnosis?
A. A symptom the client confirms having
B. A symptom expected but absent
C. A physical exam finding unrelated to the complaint
D. A lab result confirming the diagnosis
Rationale: Pertinent negatives are symptoms expected for a potential diagnosis but
absent, helping to narrow the differential diagnosis.
7. During an interview, which technique best encourages a client to elaborate on their
concerns?
A. Asking rapid, focused questions
B. Interrupting to clarify details
C. Using open-ended questions with continuers
D. Summarizing without client input
Rationale: Open-ended questions with continuers (e.g., “Go on”) encourage clients to
share their story, fostering rapport and thorough data collection.
8. What is the primary goal of primary prevention during a clinical encounter?
A. Treating acute symptoms
B. Managing chronic conditions
C. Preventing disease onset
D. Rehabilitating post-injury
Rationale: Primary prevention involves interventions (e.g., vaccinations, lifestyle
counseling) to prevent disease before it occurs, per USPSTF guidelines.
9. A nurse practitioner notes a client’s preferred pronouns during the encounter. Why
is this important?
A. To expedite documentation
B. To respect client identity and build trust
C. To prioritize clinical findings over preferences
D. To avoid discussing sensitive topics
Rationale: Respecting pronouns enhances client-centered care, builds trust, and aligns
with 2025 standards for inclusive practice.
10. Which finding during a health history requires immediate further evaluation?
A. Regular exercise routine
B. Stable weight over the past year
C. Unintentional weight loss of 10% in 3 months
D. Occasional mild headaches
