NR 509 Midterm Study Guide
General Study Tips and Recommendations
Topics and content on guides are intended to focus student attention when reading/studying and
some topics may be repeated in multiple chapters.
Multiple test items are derived from the same topic areas to encourage deeper comprehension.
Students must have a broad understanding of content and not simply memorize passages in
textbooks or articles.
Information in red letters in the chapters as well as tables and appendices at the end of the
chapters may include test items.
Exam questions represent various levels of cognitive learning. You are expected to analyze,
synthesis, and evaluate patient scenarios in order to answer the questions.
Read all of the answers BEFORE reading the stem of the question. This will help you focus on the
key content and not get distracted by extraneous information.
Be familiar with “Techniques of Examination” and “Recording Your Findings” for all body system
chapters in the textbook.
Chapter 1 Approach to the Clinical Encounter
The interviewing process
Interviewing techniques
Setting the stage for the examination
Establishing rapport
Gender pronouns
Patient-centered medical care
The FIFE model
Chapter 2 Interviewing, Communication, and Interpersonal Skills
Fundamentals of skilled interviewing
Verbal and nonverbal communication
Challenging patient situations and behaviors
Chapter 3 Health History
Focused and comprehensive health histories
Determining the scope of the patient assessment: Comprehensive vs focused
The seven attributes of a patient’s principal symptoms: OLDCARTS
Subjective versus objective data
Modifying of the clinical interview for various clinical settings: Outpatient, inpatient, ICU,
Emergency room, Home, nursing home.
Chapter 4 Physical Examination
Determining the scope of the physical examination: Comprehensive vs Focused
Techniques of examination (Note: Be familiar with specific techniques in body system chapters)
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The head-to-toe physical assessment
Chapter 5 Clinical Reasoning, Assessment, and Plan
The clinical reasoning process
The problem list
The differential diagnosis (DDx) list
The summary statement
Assessment (medical diagnoses)
Planning (treatment and interventions)
Chapter 7 Evaluating Clinical Evidence
Using elements of the physical examination as diagnostic tests
Evaluating diagnostic tests
Critically appraising clinical evidence
Communicating clinical evidence to patients
Chapter 8 General Survey, Vital Signs, and Pain
General survey: appearance, apparent state of health, discomfort or distress, skin color, dress,
grooming and personal hygiene, facial expression, odors, posture, and gait and motor activity)
Classifying normal and abnormal blood pressures
Acute and chronic pain
Exploring weight loss (including anorexia nervosa and bulimia nervosa)
Chapter 9 Cognition, Behavior, and Mental Status
Techniques of examination
Speech patterns (including aphasia)
Assessing abstract thinking
Mental status examination
Screening for depression
Screening for substance abuse
Hallucinations and illusions
Chapter 10 Skin, Hair, and Nails
Techniques of examination
Anatomy
Skin lesion morphology
Melanoma risk factors
Health promotion and skin cancer screening
Herpes zoster
Chapter 11 Head and Neck
Techniques of examination
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