NUR 6111 ADVANCED PHYSICAL
ASSESSMENT ULTIMATE 200 QUESTION
EXAM PREP PACK WITH RATIONALES
NUR 6111 Exam 1 Practice Questions
1. A 75-year-old male presents with a painful, unilateral vesicular
rash that follows a dermatomal pattern on his right thorax. He
reports the pain started several days before the rash appeared.
What is the most likely diagnosis?
a. Allergic contact dermatitis
b. Herpes Zoster (Shingles)
c. Atopic dermatitis
d. Tinea corporis
Rationale: Herpes Zoster typically presents as a painful,
unilateral vesicular eruption within a single dermatome, often
preceded by a prodromal period of pain or paresthesia.
2. A patient presents with a slow-growing, pearly nodule on the upper
lip that has visible telangiectasia and rolled edges. The nurse
practitioner suspects:
a. Squamous cell carcinoma
b. Basal cell carcinoma
c. Malignant melanoma
d. Seborrheic keratosis
Rationale: Basal cell carcinoma is characterized by slow growth
and rarely metastasizes; classic features include a pearly
appearance, telangiectasia, and rolled borders.
3. Which of the following is considered the most common pathogen
causing community-acquired skin infections like folliculitis and
cellulitis?
a. Streptococcus pyogenes
b. Pseudomonas aeruginosa
c. Staphylococcus aureus
d. Escherichia coli
Rationale: Staphylococcus aureus is the primary pathogen
, responsible for the majority of bacterial skin and soft tissue
infections in the outpatient setting.
4. A 25-year-old hiker presents with a warm, red, and tender area on
his right arm following a minor scratch. There is no ulceration or
drainage. According to current guidelines, what is the appropriate
initial treatment?
a. Oral Cephalexin (Keflex) 500mg BID for 5 days
b. Topical corticosteroid cream
c. Intravenous Vancomycin
d. Observation without treatment
Rationale: For non-purulent cellulitis likely caused by typical skin
flora (Staph or Strep), oral Cephalexin is a recommended first-
line therapy.
5. A patient presents with red, scaly lesions on the scalp where the
hair appears brittle and lusterless. The NP plans to use a Wood’s
lamp for evaluation. What is the most likely recommended
management?
a. Topical antibacterial ointment
b. 1% or 2.5% Selenium sulfide shampoo
c. Oral corticosteroids
d. Immediate surgical excision
Rationale: Scalp lesions with brittle hair (often Tinea Capitis)
may be managed with antifungal shampoos like Selenium sulfide;
a negative culture is typically required for follow-up.
6. In distinguishing atopic dermatitis from other skin conditions,
which history finding is a key diagnostic indicator?
a. Personal or family history of asthma or allergic rhinitis
b. History of recent travel to tropical areas
c. Recent use of new laundry detergent
d. Exposure to poisonous plants while gardening
Rationale: The "atopic triad" includes atopic dermatitis, asthma,
and allergic rhinitis; a history of these conditions strongly
supports a diagnosis of atopic dermatitis.
7. A 78-year-old male presents with multiple tan-to-brown, "stuck-
on" appearing plaques on his back. These lesions are asymptomatic
and have a warty texture. The diagnosis is likely:
a. Actinic keratosis
b. Seborrheic keratosis
, c. Malignant melanoma
d. Squamous cell carcinoma
Rationale: Seborrheic keratoses are benign, common in older
adults, and classically described as having a "stuck-on" or
waxy/warty appearance.
8. When performing a physical assessment, in which order should the
nurse practitioner typically assess the abdomen?
a. Inspection, Palpation, Percussion, Auscultation
b. Inspection, Auscultation, Percussion, Palpation
c. Auscultation, Inspection, Palpation, Percussion
d. Percussion, Auscultation, Inspection, Palpation
Rationale: For the abdominal exam, auscultation follows
inspection but precedes percussion and palpation to avoid
altering bowel sounds through physical manipulation.
9. A patient presents with a rough, scaly patch on the ear that is
tender to the touch and has been present for months despite using
moisturizer. This lesion is most likely:
a. Actinic Keratosis
b. Seborrheic Keratosis
c. Psoriasis
d. Contact dermatitis
Rationale: Actinic keratosis is a common precancerous lesion
resulting from chronic sun exposure and can progress to
squamous cell carcinoma if left untreated.
10. Sudden onset loss of peripheral vision in an adult patient is
most indicative of:
a. Macular degeneration
b. Acute closed-angle glaucoma
c. Chronic glaucoma
d. Normal aging process
Rationale: Acute closed-angle glaucoma is a medical emergency
often characterized by sudden vision loss and increased
intraocular pressure, whereas macular degeneration affects
central vision.
11. A 45-year-old female presents with a chief complaint of "the room
spinning" whenever she turns her head quickly to the left. The episodes
last less than a minute. She denies hearing loss or tinnitus. What is the
, most likely diagnosis?
a. Ménière’s disease
b. Benign Paroxysmal Positional Vertigo (BPPV)
c. Acoustic neuroma
d. Labyrinthitis
Rationale: BPPV is characterized by brief episodes of vertigo triggered
by specific changes in head position, without the auditory symptoms
associated with Ménière’s.
12. During a physical exam, the NP notes a blowing, holosystolic
murmur heard best at the apex, radiating to the left axilla. This finding is
most consistent with:
a. Aortic stenosis
b. Mitral regurgitation
c. Mitral stenosis
d. Tricuspid regurgitation
Rationale: Mitral regurgitation is a holosystolic murmur heard at the
apex that typically radiates to the axilla.
13. A 68-year-old patient reports a gradual loss of central vision, while
peripheral vision remains intact. This clinical presentation is classic for:
a. Open-angle glaucoma
b. Cataracts
c. Age-related macular degeneration (AMD)
d. Retinal detachment
Rationale: AMD primarily affects the macula, leading to a loss of
central vision; glaucoma typically affects peripheral vision first.
14. When assessing a patient with suspected bacterial pneumonia, the
NP expects to find which of the following on physical examination of the
chest?
a. Hyperresonance on percussion
b. Increased tactile fremitus over the affected area
c. Decreased tactile fremitus over the affected area
d. Vesicular breath sounds throughout
Rationale: Consolidation (as seen in pneumonia) increases the
transmission of vibrations, resulting in increased tactile fremitus and
dullness to percussion.
15. A patient presents with a "curtain-like" shadow appearing across
their field of vision and sudden "floaters." This should be treated as:
a. An expected sign of aging
ASSESSMENT ULTIMATE 200 QUESTION
EXAM PREP PACK WITH RATIONALES
NUR 6111 Exam 1 Practice Questions
1. A 75-year-old male presents with a painful, unilateral vesicular
rash that follows a dermatomal pattern on his right thorax. He
reports the pain started several days before the rash appeared.
What is the most likely diagnosis?
a. Allergic contact dermatitis
b. Herpes Zoster (Shingles)
c. Atopic dermatitis
d. Tinea corporis
Rationale: Herpes Zoster typically presents as a painful,
unilateral vesicular eruption within a single dermatome, often
preceded by a prodromal period of pain or paresthesia.
2. A patient presents with a slow-growing, pearly nodule on the upper
lip that has visible telangiectasia and rolled edges. The nurse
practitioner suspects:
a. Squamous cell carcinoma
b. Basal cell carcinoma
c. Malignant melanoma
d. Seborrheic keratosis
Rationale: Basal cell carcinoma is characterized by slow growth
and rarely metastasizes; classic features include a pearly
appearance, telangiectasia, and rolled borders.
3. Which of the following is considered the most common pathogen
causing community-acquired skin infections like folliculitis and
cellulitis?
a. Streptococcus pyogenes
b. Pseudomonas aeruginosa
c. Staphylococcus aureus
d. Escherichia coli
Rationale: Staphylococcus aureus is the primary pathogen
, responsible for the majority of bacterial skin and soft tissue
infections in the outpatient setting.
4. A 25-year-old hiker presents with a warm, red, and tender area on
his right arm following a minor scratch. There is no ulceration or
drainage. According to current guidelines, what is the appropriate
initial treatment?
a. Oral Cephalexin (Keflex) 500mg BID for 5 days
b. Topical corticosteroid cream
c. Intravenous Vancomycin
d. Observation without treatment
Rationale: For non-purulent cellulitis likely caused by typical skin
flora (Staph or Strep), oral Cephalexin is a recommended first-
line therapy.
5. A patient presents with red, scaly lesions on the scalp where the
hair appears brittle and lusterless. The NP plans to use a Wood’s
lamp for evaluation. What is the most likely recommended
management?
a. Topical antibacterial ointment
b. 1% or 2.5% Selenium sulfide shampoo
c. Oral corticosteroids
d. Immediate surgical excision
Rationale: Scalp lesions with brittle hair (often Tinea Capitis)
may be managed with antifungal shampoos like Selenium sulfide;
a negative culture is typically required for follow-up.
6. In distinguishing atopic dermatitis from other skin conditions,
which history finding is a key diagnostic indicator?
a. Personal or family history of asthma or allergic rhinitis
b. History of recent travel to tropical areas
c. Recent use of new laundry detergent
d. Exposure to poisonous plants while gardening
Rationale: The "atopic triad" includes atopic dermatitis, asthma,
and allergic rhinitis; a history of these conditions strongly
supports a diagnosis of atopic dermatitis.
7. A 78-year-old male presents with multiple tan-to-brown, "stuck-
on" appearing plaques on his back. These lesions are asymptomatic
and have a warty texture. The diagnosis is likely:
a. Actinic keratosis
b. Seborrheic keratosis
, c. Malignant melanoma
d. Squamous cell carcinoma
Rationale: Seborrheic keratoses are benign, common in older
adults, and classically described as having a "stuck-on" or
waxy/warty appearance.
8. When performing a physical assessment, in which order should the
nurse practitioner typically assess the abdomen?
a. Inspection, Palpation, Percussion, Auscultation
b. Inspection, Auscultation, Percussion, Palpation
c. Auscultation, Inspection, Palpation, Percussion
d. Percussion, Auscultation, Inspection, Palpation
Rationale: For the abdominal exam, auscultation follows
inspection but precedes percussion and palpation to avoid
altering bowel sounds through physical manipulation.
9. A patient presents with a rough, scaly patch on the ear that is
tender to the touch and has been present for months despite using
moisturizer. This lesion is most likely:
a. Actinic Keratosis
b. Seborrheic Keratosis
c. Psoriasis
d. Contact dermatitis
Rationale: Actinic keratosis is a common precancerous lesion
resulting from chronic sun exposure and can progress to
squamous cell carcinoma if left untreated.
10. Sudden onset loss of peripheral vision in an adult patient is
most indicative of:
a. Macular degeneration
b. Acute closed-angle glaucoma
c. Chronic glaucoma
d. Normal aging process
Rationale: Acute closed-angle glaucoma is a medical emergency
often characterized by sudden vision loss and increased
intraocular pressure, whereas macular degeneration affects
central vision.
11. A 45-year-old female presents with a chief complaint of "the room
spinning" whenever she turns her head quickly to the left. The episodes
last less than a minute. She denies hearing loss or tinnitus. What is the
, most likely diagnosis?
a. Ménière’s disease
b. Benign Paroxysmal Positional Vertigo (BPPV)
c. Acoustic neuroma
d. Labyrinthitis
Rationale: BPPV is characterized by brief episodes of vertigo triggered
by specific changes in head position, without the auditory symptoms
associated with Ménière’s.
12. During a physical exam, the NP notes a blowing, holosystolic
murmur heard best at the apex, radiating to the left axilla. This finding is
most consistent with:
a. Aortic stenosis
b. Mitral regurgitation
c. Mitral stenosis
d. Tricuspid regurgitation
Rationale: Mitral regurgitation is a holosystolic murmur heard at the
apex that typically radiates to the axilla.
13. A 68-year-old patient reports a gradual loss of central vision, while
peripheral vision remains intact. This clinical presentation is classic for:
a. Open-angle glaucoma
b. Cataracts
c. Age-related macular degeneration (AMD)
d. Retinal detachment
Rationale: AMD primarily affects the macula, leading to a loss of
central vision; glaucoma typically affects peripheral vision first.
14. When assessing a patient with suspected bacterial pneumonia, the
NP expects to find which of the following on physical examination of the
chest?
a. Hyperresonance on percussion
b. Increased tactile fremitus over the affected area
c. Decreased tactile fremitus over the affected area
d. Vesicular breath sounds throughout
Rationale: Consolidation (as seen in pneumonia) increases the
transmission of vibrations, resulting in increased tactile fremitus and
dullness to percussion.
15. A patient presents with a "curtain-like" shadow appearing across
their field of vision and sudden "floaters." This should be treated as:
a. An expected sign of aging
