NR 509
FINAL EXAM
Expected Questions with Answers
(Advanced Physical Assessment)
Chamberlain
What You Will Get:
Instant PDF download
100 multiple-choice questions
Verified answers included
Detailed rationales for review
Advanced Physical Assessment focused
Great for Final exam review and self-study
Please note: This is an independent study resource and is not affiliated
with or endorsed by Chamberlain University.
,1. You are beginning the examination of the skin on a 25-year-old teacher.
You have previously elicited that she came to the office for evaluation of
fatigue, weight gain, and hair loss. You strongly suspect that she has
hypothyroidism. What is the expected moisture and texture of the skin of a
patient with hypothyroidism?
A) Moist and smooth
B) Moist and rough
C) Dry and smooth
D) Dry and rough
Correct Answer: D) Dry and rough
Rationale: Hypothyroidism reduces metabolic rate, cutaneous blood flow, and
sweating, resulting in skin that is dry, rough, cool, and pale. Myxedema (non-pitting
edema) may also be present. Moist skin suggests hyperthyroidism or normal
thermoregulation.
2. Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic
lupus erythematosus). She has noticed a raised, dark red rash on her legs.
When you press on the rash, it doesn't blanch. What would you tell her
regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any concern.
Correct Answer: A) It is likely to be related to her lupus.
Rationale: A non-blanching, raised, dark red rash is consistent with palpable
purpura, which in a patient with SLE strongly suggests cutaneous vasculitis or
immune-complex–mediated inflammation related to her underlying autoimmune
disease. SLE commonly manifests with malar rashes, discoid lesions, and vasculitic
purpura.
,3. A 68-year-old mechanic presents to the emergency room for shortness of
breath. You are concerned about a cardiac cause and measure his jugular
venous pressure (JVP). It is elevated. Which one of the following conditions is
a potential cause of elevated JVP?
A) Left-sided heart failure
B) Mitral stenosis
C) Constrictive pericarditis
D) Aortic aneurysm
Correct Answer: C) Constrictive pericarditis
Rationale: Elevated JVP reflects increased right atrial pressure and right-sided
heart failure. Constrictive pericarditis restricts diastolic filling, leading to elevated
right-sided pressures and jugular venous distension. Left-sided heart failure and
mitral stenosis primarily elevate pulmonary pressures before affecting the right
side. An aortic aneurysm does not typically cause JVP elevation unless it leads to
heart failure.
4. Which of the following lymph node groups is most commonly involved in
breast cancer?
A) Lateral
B) Subscapular
C) Pectoral
D) Central
Correct Answer: D) Central
Rationale: The central axillary lymph nodes are the most common initial site of
breast cancer metastasis because they receive lymphatic drainage from the
pectoral, lateral, and subscapular groups. On clinical examination, a firm, fixed, or
matted central axillary node warrants further oncologic workup.
, 5. A young man feels something in his scrotum and comes to you for
clarification. On your examination, you note what feels like a "bag of worms"
in the left scrotum, superior to the testicles. Which of the following is most
likely?
A) Hydrocele of the spermatic cord
B) Varicocele
C) Testicular carcinoma
D) A normal vas deferens
Correct Answer: B) Varicocele
Rationale: A varicocele is classically described as a "bag of worms" palpated
superior to the testicle, most commonly on the left side due to the vertical
insertion of the left gonadal vein into the left renal vein. It should decompress
when the patient lies supine. If it remains firm in the supine position or occurs
only on the right side, further imaging is warranted to rule out retroperitoneal
pathology. Varicoceles can contribute to infertility by elevating scrotal temperature
and impairing spermatogenesis.
6. Which of the following changes are expected in vision as part of the
normal aging process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision
Correct Answer: D) Blurring of near vision
Rationale: Presbyopia is the expected, physiologic loss of lens elasticity that
occurs with aging. It results in decreased accommodation and difficulty focusing on
near objects. Cataracts, glaucoma, and macular degeneration are pathologic
FINAL EXAM
Expected Questions with Answers
(Advanced Physical Assessment)
Chamberlain
What You Will Get:
Instant PDF download
100 multiple-choice questions
Verified answers included
Detailed rationales for review
Advanced Physical Assessment focused
Great for Final exam review and self-study
Please note: This is an independent study resource and is not affiliated
with or endorsed by Chamberlain University.
,1. You are beginning the examination of the skin on a 25-year-old teacher.
You have previously elicited that she came to the office for evaluation of
fatigue, weight gain, and hair loss. You strongly suspect that she has
hypothyroidism. What is the expected moisture and texture of the skin of a
patient with hypothyroidism?
A) Moist and smooth
B) Moist and rough
C) Dry and smooth
D) Dry and rough
Correct Answer: D) Dry and rough
Rationale: Hypothyroidism reduces metabolic rate, cutaneous blood flow, and
sweating, resulting in skin that is dry, rough, cool, and pale. Myxedema (non-pitting
edema) may also be present. Moist skin suggests hyperthyroidism or normal
thermoregulation.
2. Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic
lupus erythematosus). She has noticed a raised, dark red rash on her legs.
When you press on the rash, it doesn't blanch. What would you tell her
regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any concern.
Correct Answer: A) It is likely to be related to her lupus.
Rationale: A non-blanching, raised, dark red rash is consistent with palpable
purpura, which in a patient with SLE strongly suggests cutaneous vasculitis or
immune-complex–mediated inflammation related to her underlying autoimmune
disease. SLE commonly manifests with malar rashes, discoid lesions, and vasculitic
purpura.
,3. A 68-year-old mechanic presents to the emergency room for shortness of
breath. You are concerned about a cardiac cause and measure his jugular
venous pressure (JVP). It is elevated. Which one of the following conditions is
a potential cause of elevated JVP?
A) Left-sided heart failure
B) Mitral stenosis
C) Constrictive pericarditis
D) Aortic aneurysm
Correct Answer: C) Constrictive pericarditis
Rationale: Elevated JVP reflects increased right atrial pressure and right-sided
heart failure. Constrictive pericarditis restricts diastolic filling, leading to elevated
right-sided pressures and jugular venous distension. Left-sided heart failure and
mitral stenosis primarily elevate pulmonary pressures before affecting the right
side. An aortic aneurysm does not typically cause JVP elevation unless it leads to
heart failure.
4. Which of the following lymph node groups is most commonly involved in
breast cancer?
A) Lateral
B) Subscapular
C) Pectoral
D) Central
Correct Answer: D) Central
Rationale: The central axillary lymph nodes are the most common initial site of
breast cancer metastasis because they receive lymphatic drainage from the
pectoral, lateral, and subscapular groups. On clinical examination, a firm, fixed, or
matted central axillary node warrants further oncologic workup.
, 5. A young man feels something in his scrotum and comes to you for
clarification. On your examination, you note what feels like a "bag of worms"
in the left scrotum, superior to the testicles. Which of the following is most
likely?
A) Hydrocele of the spermatic cord
B) Varicocele
C) Testicular carcinoma
D) A normal vas deferens
Correct Answer: B) Varicocele
Rationale: A varicocele is classically described as a "bag of worms" palpated
superior to the testicle, most commonly on the left side due to the vertical
insertion of the left gonadal vein into the left renal vein. It should decompress
when the patient lies supine. If it remains firm in the supine position or occurs
only on the right side, further imaging is warranted to rule out retroperitoneal
pathology. Varicoceles can contribute to infertility by elevating scrotal temperature
and impairing spermatogenesis.
6. Which of the following changes are expected in vision as part of the
normal aging process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision
Correct Answer: D) Blurring of near vision
Rationale: Presbyopia is the expected, physiologic loss of lens elasticity that
occurs with aging. It results in decreased accommodation and difficulty focusing on
near objects. Cataracts, glaucoma, and macular degeneration are pathologic
