NR 509 APEA 3P EXAM WEEK 4 2024 UPDATE QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES ALREADY GRADED A+

NR 509 APEA 3P EXAM WEEK 4 2024 UPDATE
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES ALREADY GRADED A+
A 59-year-old unemployed man complains of almost always feeling tired and hungry, despite getting
sufficient rest and having a good appetite and access to sufficient food. The patient is obese and, despite
the warm weather outside, wearing thermal socks with his sandals. He says this is because his feet are
always cold and "feel funny." With which body system should the clinician begin the examination?
 b. Head and neck
 Rationale: The physical examination should proceed "head to toe" to optimize patient
comfort; minimize the number of changes in patient position; and, because it is always done
in the same way, to ensure that nothing is missed. Even though symptoms are reported in the
lower extremities, the examination will attend to this region at the appropriate time. The
same argument applies to the posterior thorax, abdomen, and nervous system.
A 65-year-old retired pilot visits the clinic because of recurrent headache. The patient reports dizziness
of recent onset (previous 2 weeks) and occasional numbness on the left side. Which of the following
systems or regions should be examined in the clinician's focused assessment?
 Nervous
 Rationale: The nervous system examination covers mental status, cranial nerves, motor and
sensory systems, and reflexes. The presence of headache, dizziness, and numbness suggest
nervous system involvement. Symptoms of cardiovascular involvement include palpitations,
chest pain, edema, or heart murmurs, none of which are noted in the case description.
Musculoskeletal problems are usually associated with muscle or joint pain or stiffness. The
respiratory system should be examined when patients have a cough, difficulty breathing, or
hemoptysis. The gastrointestinal system should be examined when patients complain of
heartburn, irregular or bloody stools, or food intolerance (among other symptoms).
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?
 d. Cut over eye from shaving
 Rationale: Subjective information is any information that the patient reports but that is not
directly observable or measurable. In this case, the cut is observable but the manner in which
the cut was sustained is not. Shaving injuries are not usually seen above an eye, so this part of
the patient's report could be explored further. Temperature, blood pressure, and height are
incorrect because these were measured by the clinician. Employment at the United Nations is
incorrect because, although this was not measured by the clinician, it is a fact that can be
verified objectively.
A 32-year-old office worker reports excessive stress at work and pain in