Midterm Exam: NR509/ NR 509 (2023/ 2024 Latest Update) Advanced Physical Assessment Exam| 100% Correct Questions and Verified Answers| Grade A - Chamberlain

Q: 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

Answer:

f. Moving from open-ended to focused questions

Q: 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

Answer:

b. Echoing

Midterm Exam: NR509/ NR 509 (2023/ 2024

Latest Update) Advanced Physical

Assessment Exam| 100% Correct Questions

and Verified Answers| Grade A -

Chamberlain

Q: 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 of the following statements is most likely to

be helpful in cementing the patient's trust in the new provider

a. "That sounds like a frightening experience that you are recovering well from."

b. "You are becoming an adult

Answer:

a. "That sounds like a frightening experience that you are recovering well from."

Q: A 29-year-old electrician complains of persistent cough and wheezing, particularly when he

exercises. He says he smokes "occasionally" but rarely so much that he needs to purchase

cigarettes: "Mostly, I bum them," he says, chuckling. Upon hearing this information, what is the

best next step on the part of the clinician?

a. Determine the patient's exercise regimen.

b. Determine the number of pack-years the patient smokes.

c. Conduct a mental status examination.

d. Explain the relationship between smoking and cancer.

e. Determine the patient's immunization history.

Answer:

b. Determine the number of pack-years the patient smokes.

Q: A 47-year-old fitness trainer visits the physician assistant (PA) because of skin dryness,

night sweats, and irregular menstrual periods. It is the PA's first contact with this patient. The

patient notes that "My sex life has really gone downhill lately" and says that she is considering

divorcing her husband of 20 years, stating that "He's not a bad guy. I just think that I can do

better." In which of the following ways should the clinician proceed?

a. Obtain a menstrual history for the previous 6 months.

b. Help the patient review the pros and cons of divorce.

c. Inform the patient that menopause is a normal part of aging.

d. Conduct a breast examination.

e. Determine the patient's out-of-country travel history.

Answer:

a. Obtain a menstrual history for the previous 6 months.

Q: One important examination technique involves using the third fingers of each hand to

determine the health of internal organs. What is the name of this technique?

a. Auscultation

b. Percussion

c. Inspection

d. Palpation

e. Listening

Answer:

b. Percussion

Q: The CAGE questionnaire is a short screening examination administered in the office to

evaluate for which of the following?

a. Alcohol misuse

b. Risk for illicit substance abuse

c. Likelihood that the patient complaints are "psychosomatic"

d. Major depressive disorder

e. Bipolar disorder

Answer:

a. Alcohol misuse

Q: A 53-year-old caterer comes to the clinic for a routine examination. She has type 2 diabetes

mellitus, which is well controlled on medication. Her history from her last visit reveals that she

smoked one pack of cigarettes a day at that time. The 5 As Model is a useful approach to take

with trying to help patients to quit smoking. What is the 5 As Model?

a. Admonish, action, available, assess, alleviating factors

b. Agitate, assist, alleviating factors, able, action

c. Affable, associated manifestations, ask, admonish, available

d. Ask, advise, assess, assist, arrange

e. Arrange, aggravating factors, action, attitude, able

Answer:

d. Ask, advise, assess, assist, arrange

Q: A 21-year-old college student experiences tachycardia following a night of heavy drinking.

She is advised to undergo a stress electrocardiogram (ECG). As she exercises, the recently

calibrated pulse oximeter records a heart rate ranging from 25 beats per minute (bpm) at rest to

50 bpm while jogging. The test is stopped and re-started twice, and each time the pulse oximeter

yields a resting heart rate of 25 and a jogging heart rate of 50. Which aspect of this instrument

does the ECG technician question?

a. Prevalence

b. Validity

c. Sensitivity

d. Specificity

e. Predictive value

Answer:

b. Validity

Q: A 51-year-old moderately overweight college professor visits the clinic with a complaint of

chest pain after tennis matches. He jokes that his tennis partner "is in a lot better shape than I

am" but says that he is trying to keep up. Later in the day, a 28-year-old female student at the

same college reports that "my chest often feels hot and tight." She also feels stressed on the

evening before mid-term exams. The clinician recommends an immediate evaluation for

coronary artery disease (CAD) for the professor, but not for the student. Why?

a. Positive predictive value of an observation is higher in a group with a higher prevalence of

disease.

b. Positive predictive value of an observation is lower in a group with a higher prevalence of

disease.