NR509 Week 4: Midterm Exam (Nov-2025)

A 14-year-old male presents to the clinic with his grandmother for a complaint of a sore throat. The patient denies fever or cough. After completing the history and physical examination, the NP documented the following assessment findings: Pharynx erythematous, bilateral tonsils enlarged, no exudates. What information in this scenario is subjective?

Answers: A – D

A. A 14-year-old male
B. Pharynx erythematous, bilateral tonsils enlarged, no exudates
C. There is no subjective information in this scenario
D. Denies fever or cough ✅

When assessing a patient’s symptoms, which of the following question best represents the “modifying factors” attribute?

Answers: A – D

A. “On a scale of 1–10, how would you rate your pain?”
B. “Does anything make your pain better or worse?” ✅
C. “Where did the pain start?”
D. “How long does the pain usually last?”

Which of the following is a classic feature of Broca’s aphasia?

Answers: A – D

A. Fluent but nonsensical speech with impaired comprehension
B. Repetition of words and phrases of others
C. Slow, nonfluent speech with preserved comprehension ✅
D. Tangential speech with shifting, loosely connected topics

What maneuver aids in assessing thyroid movement during inspection and palpation?

Answers: A – D

A. Having the patient close their eyes tightly
B. Asking the patient to sip and swallow water ✅
C. Asking the patient to hold their breath
D. Asking the patient to take a deep breath and cough

A 65-year-old male presents as a new patient. He wishes to discuss issues with erectile dysfunction and fatigue. As the interview continues, the NP 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 NP 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?

Answers: A – D

A. Redirect the conversation by stating that fatigue may be related to stress
B. Allow the patient to continue discussing erectile dysfunction before transitioning
C. Ask the patient to schedule another visit to discuss the chest pain in detail
D. Use a focused, directive approach to address the chest pain immediately ✅

Which of the following statements best distinguishes between subjective and objective information in clinical documentation?

Answers: A – D

A. Subjective information includes the patient’s reported symptoms and concerns, while objective information includes physical exam findings and diagnostic test results ✅
B. Subjective information consists of measurable data from the physical exam, while objective information includes patient-reported symptoms
C. Subjective information includes laboratory results and imaging findings, while objective information is limited to the physical exam
D. Subjective information is more reliable than objective information because it comes directly from the patient

A patient presents to the clinic with complaints of pain in the lower back for the past 3 months. The pain is described as a dull ache that sometimes becomes sharp with certain movements. The pain started gradually, with no obvious injury, and it is worse in the morning; especially after getting out of bed. The pain improves with stretching and rest. When the NP asks the patient to point to the pain, the patient touches the lower back and notes that it does not radiate. Based on this history, which of the following would be the best next step in the NP’s assessment?

Answers: A – D

A. Focus solely on the intensity of the pain using a pain scale
B. Immediately order imaging studies to assess for a herniated disk
C. Ask the patient to describe any associated symptoms ✅
D. Assume that the pain is due to poor posture and recommend lifestyle modifications

Which of the following best reflects the practice of cultural humility in clinical encounters?

Answers: A – D

A. Learning the health beliefs and customs of every cultural group before clinical practice
B. Engaging in self-reflection and respectful communication to build collaborative partnerships with patients ✅
C. Using your personal experience to guide the patient toward the best medical decision
D. Prioritizing biomedical knowledge over a patient’s personal beliefs when conflicts arise………………………………………………$60