NR 509 / NR509 Advanced Physical Assessment Final
Practice Exam Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section 1: Health History & Interviewing Techniques (Questions 1–10)
Q1. A 55-year-old male presents with chest pain that is described as a "heavy
pressure" radiating to the left arm. What is the most appropriate next question to
ask?
● A. "Does the pain worsen with deep breathing?"
● B. "When did the pain start, and what were you doing?"
● C. "Do you have a history of heartburn?"
● D. "Is the pain worse when you lie flat?"
● Correct Answer: B
● Rationale: Determining the onset and context of chest pain helps differentiate
cardiac from other causes.
Q2. In a cardiac assessment, the S1 heart sound corresponds to which cardiac
event?
● A. Closure of the aortic and pulmonic valves
● B. Closure of the mitral and tricuspid valves
● C. Opening of the aortic and pulmonic valves
● D. Opening of the mitral and tricuspid valves
● Correct Answer: B
● Rationale: S1 ("lub") is the closure of the atrioventricular (mitral and tricuspid)
valves.
Q3. A patient's lung sounds reveal crackles that are heard at the end of inspiration.
This finding is most consistent with:
, ● A. Asthma
● B. Emphysema
● C. Pulmonary edema
● D. Pleural effusion
● Correct Answer: C
● Rationale: Fine end-inspiratory crackles are characteristic of pulmonary
edema and interstitial fluid.
Q4. A patient with a history of stroke has difficulty swallowing and coughing during
meals. This finding is known as:
● A. Aphagia
● B. Dysphagia
● C. Dysarthria
● D. Aspiration
● Correct Answer: B
● Rationale: Dysphagia is difficulty swallowing, which increases aspiration risk.
Q5. A patient has decreased vibration sense in the lower extremities, absent ankle
reflexes, and positive Romberg sign. This is most consistent with:
● A. Peripheral neuropathy
● B. Cerebellar dysfunction
● C. Upper motor neuron lesion
● D. Subacute combined degeneration
● Correct Answer: A
● Rationale: Peripheral neuropathy presents with distal sensory loss, absent
reflexes, and impaired proprioception.
Q6. The normal adult resting respiratory rate is:
● A. 8–12 breaths per minute
● B. 12–20 breaths per minute
● C. 20–24 breaths per minute
● D. 24–30 breaths per minute
● Correct Answer: B
● Rationale: Normal respiratory rate for adults is 12–20 breaths per minute.
Q7. A patient presents with a palpable thrill over the carotid artery. This finding is
most consistent with:
, ● A. Carotid stenosis
● B. Aortic stenosis
● C. Hyperthyroidism
● D. Normal finding
● Correct Answer: A
● Rationale: A carotid thrill indicates turbulent blood flow, often from stenosis.
Q8. Which cranial nerve is assessed by having the patient shrug their shoulders
against resistance?
● A. CN IX (Glossopharyngeal)
● B. CN X (Vagus)
● C. CN XI (Spinal Accessory)
● D. CN XII (Hypoglossal)
● Correct Answer: C
● Rationale: Cranial nerve XI innervates the trapezius and sternocleidomastoid
muscles.
Q9. A patient's abdominal exam reveals a pulsatile mass in the epigastric area. This
finding is concerning for:
● A. Abdominal aortic aneurysm
● B. Hepatomegaly
● C. Splenomegaly
● D. Gastric outlet obstruction
● Correct Answer: A
● Rationale: A pulsatile epigastric mass suggests abdominal aortic aneurysm.
Q10. In assessing a patient for peripheral arterial disease, which finding is most
concerning?
● A. Dependent rubor
● B. Hair loss on toes
● C. Thickened toenails
● D. Skin pallor on elevation
● Correct Answer: D
● Rationale: Pallor on elevation indicates severe arterial insufficiency.
Section 2: General Survey & Vital Signs (Questions 11–18)
Practice Exam Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section 1: Health History & Interviewing Techniques (Questions 1–10)
Q1. A 55-year-old male presents with chest pain that is described as a "heavy
pressure" radiating to the left arm. What is the most appropriate next question to
ask?
● A. "Does the pain worsen with deep breathing?"
● B. "When did the pain start, and what were you doing?"
● C. "Do you have a history of heartburn?"
● D. "Is the pain worse when you lie flat?"
● Correct Answer: B
● Rationale: Determining the onset and context of chest pain helps differentiate
cardiac from other causes.
Q2. In a cardiac assessment, the S1 heart sound corresponds to which cardiac
event?
● A. Closure of the aortic and pulmonic valves
● B. Closure of the mitral and tricuspid valves
● C. Opening of the aortic and pulmonic valves
● D. Opening of the mitral and tricuspid valves
● Correct Answer: B
● Rationale: S1 ("lub") is the closure of the atrioventricular (mitral and tricuspid)
valves.
Q3. A patient's lung sounds reveal crackles that are heard at the end of inspiration.
This finding is most consistent with:
, ● A. Asthma
● B. Emphysema
● C. Pulmonary edema
● D. Pleural effusion
● Correct Answer: C
● Rationale: Fine end-inspiratory crackles are characteristic of pulmonary
edema and interstitial fluid.
Q4. A patient with a history of stroke has difficulty swallowing and coughing during
meals. This finding is known as:
● A. Aphagia
● B. Dysphagia
● C. Dysarthria
● D. Aspiration
● Correct Answer: B
● Rationale: Dysphagia is difficulty swallowing, which increases aspiration risk.
Q5. A patient has decreased vibration sense in the lower extremities, absent ankle
reflexes, and positive Romberg sign. This is most consistent with:
● A. Peripheral neuropathy
● B. Cerebellar dysfunction
● C. Upper motor neuron lesion
● D. Subacute combined degeneration
● Correct Answer: A
● Rationale: Peripheral neuropathy presents with distal sensory loss, absent
reflexes, and impaired proprioception.
Q6. The normal adult resting respiratory rate is:
● A. 8–12 breaths per minute
● B. 12–20 breaths per minute
● C. 20–24 breaths per minute
● D. 24–30 breaths per minute
● Correct Answer: B
● Rationale: Normal respiratory rate for adults is 12–20 breaths per minute.
Q7. A patient presents with a palpable thrill over the carotid artery. This finding is
most consistent with:
, ● A. Carotid stenosis
● B. Aortic stenosis
● C. Hyperthyroidism
● D. Normal finding
● Correct Answer: A
● Rationale: A carotid thrill indicates turbulent blood flow, often from stenosis.
Q8. Which cranial nerve is assessed by having the patient shrug their shoulders
against resistance?
● A. CN IX (Glossopharyngeal)
● B. CN X (Vagus)
● C. CN XI (Spinal Accessory)
● D. CN XII (Hypoglossal)
● Correct Answer: C
● Rationale: Cranial nerve XI innervates the trapezius and sternocleidomastoid
muscles.
Q9. A patient's abdominal exam reveals a pulsatile mass in the epigastric area. This
finding is concerning for:
● A. Abdominal aortic aneurysm
● B. Hepatomegaly
● C. Splenomegaly
● D. Gastric outlet obstruction
● Correct Answer: A
● Rationale: A pulsatile epigastric mass suggests abdominal aortic aneurysm.
Q10. In assessing a patient for peripheral arterial disease, which finding is most
concerning?
● A. Dependent rubor
● B. Hair loss on toes
● C. Thickened toenails
● D. Skin pallor on elevation
● Correct Answer: D
● Rationale: Pallor on elevation indicates severe arterial insufficiency.
Section 2: General Survey & Vital Signs (Questions 11–18)
