NR 509 Final Exam Advanced Physical
Assessment Examination Questions and
Answers
1. A 37-year-old nurse comes for evaluation of colicky right upper
quadrant abdominal pain. The pain is associated with nausea and
vomiting and occurs 1 to 2 hours after eating greasy foods. Which
one of the following physical examination descriptions would be
most consistent with the diagnosis of chole- cystitis?
A) Abdomen is soft, nontender, and nondistended,
without hepatosplenomegaly or masses.
B)Abdomen is soft and tender to palpation in the right lower
quadrant, without rebound or guarding.
C) Abdomen is soft and tender to palpation in the right upper
quadrant with inspiration, to the point of stopping inspiration,
and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area,
without rebound or guarding.: C) Abdomen is soft and tender to palpation in the right
upper quadrant with inspiration, to the point of stopping inspiration, and there is no rebound or
guarding.
2. When crackles, wheezes, or rhonchi clear with a cough, which of
,the following is a likely etiology?
A) Bronchitis
B) Simple asthma
C) Cystic fibrosis
D) Heart failure: A. Bronchitis
3. A patient with longstanding COPD was told by another
practitioner that his liver was enlarged and this needed to be
assessed. Which of the following would be reasonable to do
next?
A) Percuss the lower border of the liver
B) Measure the span of the liver
C) Order a hepatitis panel
D) Obtain an ultrasound of the liver: A) Percuss the lower border of the liver
4. Mr. Patel is a 64-year-old man who was told by another care
provider that his liver is enlarged. Although he is a life-long smoker,
he has never used drugs or alcohol and has no knowledge of liver
disease. Indeed, on examination, a liver edge is palpable 4
centimeters below the costal arch. Which of the following would you
do next?
A) Check an ultrasound of the liver
,B) Obtain a hepatitis panel
C) Determine liver span by percussion
D) Adopt a "watchful waiting" approach: c. Determine liver span by percussion
5. You are palpating the abdomen and feel a small mass. Which of
the following would you do next?
A) Ultrasound
B) Examination with the abdominal muscles tensed
C) Surgery referral
D) Determine size by percussion: B) Examination with the abdominal muscles tensed
6. Mr. Kruger is an 84-year-old man who presents with a
smooth lower ab- dominal mass in the midline which is minimally
tender. There is dullness to percussion up to 6 centimeters above
the symphysis pubis. What does this most likely represent?
A) Sigmoid mass
B) Tumor in the abdominal wall
C) Hernia
D) Enlarged bladder: D) Enlarged bladder
7. Which of the following is consistent with obturator sign?
, A) Pain distant from the site used to check rebound tenderness
B) Right hypogastric pain with the right hip and knee flexed
and the hip internally rotated
C) Pain with extension of the right thigh while the patient is on her
left side or
while pressing her knee against your hand with thigh flexion
D) Pain that stops inhalation in the right upper quadrant: B) Right
hypogastric pain with the right hip and knee flexed and the hip internally rotated
8. A 57-year-old maintenance worker comes to your office for
evaluation of pain in his legs. He has smoked two packs per day
since the age of 16, but he is otherwise healthy. You are concerned
that he may have peripheral vascular disease. Which of the
following is part of common or concerning symptoms for the
peripheral vascular system?
A) Intermittent claudication
B) Chest pressure with exertion
C) Shortness of breath
D) Knee pain: A) Intermittent claudication
9. You are a student in the vascular surgery clinic. You are asked to
perform a physical examination on a patient with known peripheral
vascular disease in the legs. Which of the following aspects is
Assessment Examination Questions and
Answers
1. A 37-year-old nurse comes for evaluation of colicky right upper
quadrant abdominal pain. The pain is associated with nausea and
vomiting and occurs 1 to 2 hours after eating greasy foods. Which
one of the following physical examination descriptions would be
most consistent with the diagnosis of chole- cystitis?
A) Abdomen is soft, nontender, and nondistended,
without hepatosplenomegaly or masses.
B)Abdomen is soft and tender to palpation in the right lower
quadrant, without rebound or guarding.
C) Abdomen is soft and tender to palpation in the right upper
quadrant with inspiration, to the point of stopping inspiration,
and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area,
without rebound or guarding.: C) Abdomen is soft and tender to palpation in the right
upper quadrant with inspiration, to the point of stopping inspiration, and there is no rebound or
guarding.
2. When crackles, wheezes, or rhonchi clear with a cough, which of
,the following is a likely etiology?
A) Bronchitis
B) Simple asthma
C) Cystic fibrosis
D) Heart failure: A. Bronchitis
3. A patient with longstanding COPD was told by another
practitioner that his liver was enlarged and this needed to be
assessed. Which of the following would be reasonable to do
next?
A) Percuss the lower border of the liver
B) Measure the span of the liver
C) Order a hepatitis panel
D) Obtain an ultrasound of the liver: A) Percuss the lower border of the liver
4. Mr. Patel is a 64-year-old man who was told by another care
provider that his liver is enlarged. Although he is a life-long smoker,
he has never used drugs or alcohol and has no knowledge of liver
disease. Indeed, on examination, a liver edge is palpable 4
centimeters below the costal arch. Which of the following would you
do next?
A) Check an ultrasound of the liver
,B) Obtain a hepatitis panel
C) Determine liver span by percussion
D) Adopt a "watchful waiting" approach: c. Determine liver span by percussion
5. You are palpating the abdomen and feel a small mass. Which of
the following would you do next?
A) Ultrasound
B) Examination with the abdominal muscles tensed
C) Surgery referral
D) Determine size by percussion: B) Examination with the abdominal muscles tensed
6. Mr. Kruger is an 84-year-old man who presents with a
smooth lower ab- dominal mass in the midline which is minimally
tender. There is dullness to percussion up to 6 centimeters above
the symphysis pubis. What does this most likely represent?
A) Sigmoid mass
B) Tumor in the abdominal wall
C) Hernia
D) Enlarged bladder: D) Enlarged bladder
7. Which of the following is consistent with obturator sign?
, A) Pain distant from the site used to check rebound tenderness
B) Right hypogastric pain with the right hip and knee flexed
and the hip internally rotated
C) Pain with extension of the right thigh while the patient is on her
left side or
while pressing her knee against your hand with thigh flexion
D) Pain that stops inhalation in the right upper quadrant: B) Right
hypogastric pain with the right hip and knee flexed and the hip internally rotated
8. A 57-year-old maintenance worker comes to your office for
evaluation of pain in his legs. He has smoked two packs per day
since the age of 16, but he is otherwise healthy. You are concerned
that he may have peripheral vascular disease. Which of the
following is part of common or concerning symptoms for the
peripheral vascular system?
A) Intermittent claudication
B) Chest pressure with exertion
C) Shortness of breath
D) Knee pain: A) Intermittent claudication
9. You are a student in the vascular surgery clinic. You are asked to
perform a physical examination on a patient with known peripheral
vascular disease in the legs. Which of the following aspects is
