Midterm Exam - Midterm Exam Questions with Verified Answers - ...

NR 509 / NR509 Advanced Physical Assessment Midterm Exam Questions with Verified Answers - Chamberlain

Consist of 100 multiple choices Questions with Answers

• 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 sleep- ing 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?

• Perform a pelvic examination.
• Obtain a urine sample for testing.
• Obtain a more complete description of problems.
• Obtain blood for testing.

• Ask about recent travel destinations

ANS: c. Obtain a more complete description of problems.

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• 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?

• Structured and clinician-centered with open-ended questions
• Validating and empathetic with open-ended questions
• Dismissive and concrete with open-ended questions
• Affirming and reassuring with close-ended questions
• Factual and structured with active listening

ANS: 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?Joshua 2 / 9

• Assuming that the event caused her to become depressed and expressing

the same feeling on behalf of the patient

• Recognizing the patient's emotions by asking or confirming how she feels

about the event

• By allowing the crying patient to look around the room for tissues to permit

her an excuse to hide her face and defer her emotions

• Presuming that the patient's emotions meet social expectations, such as

being depressed and even trau ANS: 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 of the following interview techniques is the most appropriate to effectively manage this visit?

• Providing serial reassurances such as, "Don't worry, you're going to be

fine."

• Asking a series of negative questions such as, "You don't have any swelling

in your feet, do you?"

• Nonverbally cuing the patient to focus on his narrative regarding a motor Joshua 3 / 9

vehicle accident

• (MVA) that led to back pain
• Asking leading questions that focus on the presumed diagnosis of chest

pain

f. Moving from open-ended to focused questions: f. Moving from open-ended to

focused questions

• 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?

• Clarifying
• Echoing
• Encouraging with continuers
• d. Eliciting a graded response
• Asking a leading question

ANS: b. Echoing

• 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 Joshua 4 / 9