NR509 / NR 509 Midterm Exam
Advanced Physical Assessment
Questions and Answers (Verified Answers)
1. 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.
ANS: b. Explain how the examination will proceed.
2. A 34-year-old male with a history of complex social and medical needs
(including current substance abuse) presents to a primary care teaching
1/
,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, 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 their thoughts, ideas,
concerns, and requests
3. 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
2/
,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
3/
, 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 to encourage the patient to
expand their narrative
4. 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
4/
Advanced Physical Assessment
Questions and Answers (Verified Answers)
1. 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.
ANS: b. Explain how the examination will proceed.
2. A 34-year-old male with a history of complex social and medical needs
(including current substance abuse) presents to a primary care teaching
1/
,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, 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 their thoughts, ideas,
concerns, and requests
3. 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
2/
,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
3/
, 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 to encourage the patient to
expand their narrative
4. 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
4/
