NR509 Bates Interactive Chapters 1-17
UPDATED ACTUAL Exam Questions and
CORRECT Answers
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? - CORRECT ANSWER✔✔- Explain how the examination will
proceed.
A 34-year-old male with a history of complex social and medical needs (including current
substance abuse) presents to a primary care teaching 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? - CORRECT
ANSWER✔✔- Following the patient's lead to understand their thoughts, ideas, concerns,
and requests
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 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 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? - CORRECT ANSWER✔✔- Using nonverbal communication to encourage the
patient to expand their narrative
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
,elements of the FIFE model? - CORRECT ANSWER✔✔- Feelings, ideas, function, and
expectations
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 sleeping 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? - CORRECT ANSWER✔✔- Obtain a more
complete description of problems
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? - CORRECT ANSWER✔✔- 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? - CORRECT ANSWER✔✔- 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?
- CORRECT ANSWER✔✔- 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? - CORRECT ANSWER✔✔- 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 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 -
CORRECT ANSWER✔✔- "That sounds like a frightening experience that you are
recovering well from."
A 54-year-old diplomat working at the United Nations reports occasional chest pain and a
sense of tightness in his chest when particularly stressed over work deadlines. The patient is 6
feet 4 inches tall. He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut
over one eye that he says is "from shaving." Which of the following represents subjective
information about this patient? - CORRECT ANSWER✔✔- Cut over eye from shaving
A 32-year-old office worker reports excessive stress at work and pain in the right lower
quadrant. She states that last night she vomited twice. Her blood pressure is 120/75, heart rate
93 bpm. The patient looks pale and is sweating lightly. Which of the following is an objective
finding? - CORRECT ANSWER✔✔- Accelerated heart rate
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? - CORRECT ANSWER✔✔- Determine the
number of pack-years the patient smokes.
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? -
CORRECT ANSWER✔✔- Obtain a menstrual history for the previous 6 months.
UPDATED ACTUAL Exam Questions and
CORRECT Answers
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? - CORRECT ANSWER✔✔- Explain how the examination will
proceed.
A 34-year-old male with a history of complex social and medical needs (including current
substance abuse) presents to a primary care teaching 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? - CORRECT
ANSWER✔✔- Following the patient's lead to understand their thoughts, ideas, concerns,
and requests
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 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 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? - CORRECT ANSWER✔✔- Using nonverbal communication to encourage the
patient to expand their narrative
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
,elements of the FIFE model? - CORRECT ANSWER✔✔- Feelings, ideas, function, and
expectations
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 sleeping 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? - CORRECT ANSWER✔✔- Obtain a more
complete description of problems
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? - CORRECT ANSWER✔✔- 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? - CORRECT ANSWER✔✔- 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?
- CORRECT ANSWER✔✔- 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? - CORRECT ANSWER✔✔- 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 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 -
CORRECT ANSWER✔✔- "That sounds like a frightening experience that you are
recovering well from."
A 54-year-old diplomat working at the United Nations reports occasional chest pain and a
sense of tightness in his chest when particularly stressed over work deadlines. The patient is 6
feet 4 inches tall. He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut
over one eye that he says is "from shaving." Which of the following represents subjective
information about this patient? - CORRECT ANSWER✔✔- Cut over eye from shaving
A 32-year-old office worker reports excessive stress at work and pain in the right lower
quadrant. She states that last night she vomited twice. Her blood pressure is 120/75, heart rate
93 bpm. The patient looks pale and is sweating lightly. Which of the following is an objective
finding? - CORRECT ANSWER✔✔- Accelerated heart rate
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? - CORRECT ANSWER✔✔- Determine the
number of pack-years the patient smokes.
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? -
CORRECT ANSWER✔✔- Obtain a menstrual history for the previous 6 months.
