NR 507 MIDTERM EXAM 2026/2027 SUMMER-FALL
QUESTIONS AND CORRECT ANSWERS GRADED A+
CHAMBERLAIN
Your newly established patient states in the past year, they have progressively
developed a noticeable bump on their neck and when asked about symptoms, they
report feeling very anxious, have developed a tremor, and are commonly feeling
palpitations in their chest.On examination, you identify an enlarged thyroid gland
suspicious for a goiter. Of the following diagnoses, which is most likely for the
patient to develop based on these findings above?
thyrotoxicosis
Your patient has a diagnosis of Addison's disease. Which of the following might
you expect to find during examination?
low body temperature
Your patient with a diagnosis of autoimmune hepatitis is beingseen in your clinic
for routine liver serology and follow-up examination. Which of the following
correctly identifies the normal liver span when percussing the liver of a
HEALTHY adult?
6-12 cm in the right midclavicular line.
,The 19 year old male patient presents with acute symptomsof abdominal pain and a
history of intermittent heartburn and spicy foodintolerance, as well as anxiety due
to his college athletic performance. You have a concern the patient may have a
perforated gastric ulcer and is experiencing peritonitis. Which of the following
exam findings is NOT supportive of this diagnosis?
Absence of pain with withdrawal of palpation.
Your new patient intake history of an elderly man includes a history of Ehlers-
Danlos with complications of retinal detachment treated with gas pneumopexy. In
discussing this history, you recall the transparent mass of gelatinous material
where the gas pneumopexy is performed can be found in which chamber(s) of the
eye?
Anterior only
While assessing the patient, you covered their right eye while you covered your
left eye, then brought a set number of fingers or wiggling fingers into each
quadrant of the patient's visual field while you had them identify when they saw
your fingers/movement. A normal exam would be documented as which of the
following?
Normal Confrontation
A patient of Mediterranean descent who presents with microcytic anemia with
normal red cell distribution width should be evaluated using gel electrophoresis to
confirm which of the following types of anemia?
Thalassemia
,The 43 year old male patient with macrocytic anemia should be evaluated for
which of the following lab levels to help narrow down the etiology?
Vitamin B12
While examining a 53 year old female patient, you auscultate abnormal breath
sounds over all fields, and now assess transmission of voice sounds by having the
patient say "ee" while auscultating the chest with the diaphragm of your
stethoscope. Normally, you should auscultate a muffled "e" sound, however, you
hear hear a nasally "a" sound. Which one of the following will you document is
present?Positive stereognosis.Positive for egophony.Negative for
bronchophony.Negative for egophony
Positive for egophony
While assessing the 19 year old patient for a new onset cough, the nurse
practitioner may inspect, auscultate, palpate, and/or percuss.How does performing
percussion of the thorax assist the provider during the physical examination?To
assist with the confirmation of cardiac origin of angina.To assess for deep-seated
lesion and tumors.To assess for any pain or discomfort prior to palpitation of the
chest wall.To identify if underlying tissue are air-filled, fluid-filled or consolidated
To identify if underlying tissue are air-filled, fluid-filled or consolidated
During a post-hospital discharge visit, you notice your 71 year old female patient
has been diagnosed with a "new murmur" found by the hospitalist during their
recent hospitalization for CHF exacerbation. In evaluating the patient, during
which phase of the cardiac cycle would you anticipate auscultation of a S3 or S4
heart sound?
Diastole
, The point of maximum impulse (PMI) is most often palpable in healthy adults
when positioned in the supine or left lateral decubitus position. Which one of the
following locations is most commonly described as the PMI in a healthy adult?
left 5th ICS, MCL
The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess
for a pulse deficit by auscultating the patient's heart while watching the EKG
rhythm. Where would the S1 heart sound correlate with the electrocardiographic
waves?
Peak of the R wave
Michael, a 72 year old male patient who previously presented with stable cardiac-
type chest pain has underwent a stress test. He presents today to review the stress
test results, which show EKG findings of ST segment depression during the exam
in leads V3 and V4 as well as some concurrent chest discomfort. Based on these
findings, which of the following are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction
Check for thyroid dysfunction
Your 42 year old male patient has been referred to your clinic for establishing care
and on his intake survey, you note he has documented diagnosis of interstitial lung
QUESTIONS AND CORRECT ANSWERS GRADED A+
CHAMBERLAIN
Your newly established patient states in the past year, they have progressively
developed a noticeable bump on their neck and when asked about symptoms, they
report feeling very anxious, have developed a tremor, and are commonly feeling
palpitations in their chest.On examination, you identify an enlarged thyroid gland
suspicious for a goiter. Of the following diagnoses, which is most likely for the
patient to develop based on these findings above?
thyrotoxicosis
Your patient has a diagnosis of Addison's disease. Which of the following might
you expect to find during examination?
low body temperature
Your patient with a diagnosis of autoimmune hepatitis is beingseen in your clinic
for routine liver serology and follow-up examination. Which of the following
correctly identifies the normal liver span when percussing the liver of a
HEALTHY adult?
6-12 cm in the right midclavicular line.
,The 19 year old male patient presents with acute symptomsof abdominal pain and a
history of intermittent heartburn and spicy foodintolerance, as well as anxiety due
to his college athletic performance. You have a concern the patient may have a
perforated gastric ulcer and is experiencing peritonitis. Which of the following
exam findings is NOT supportive of this diagnosis?
Absence of pain with withdrawal of palpation.
Your new patient intake history of an elderly man includes a history of Ehlers-
Danlos with complications of retinal detachment treated with gas pneumopexy. In
discussing this history, you recall the transparent mass of gelatinous material
where the gas pneumopexy is performed can be found in which chamber(s) of the
eye?
Anterior only
While assessing the patient, you covered their right eye while you covered your
left eye, then brought a set number of fingers or wiggling fingers into each
quadrant of the patient's visual field while you had them identify when they saw
your fingers/movement. A normal exam would be documented as which of the
following?
Normal Confrontation
A patient of Mediterranean descent who presents with microcytic anemia with
normal red cell distribution width should be evaluated using gel electrophoresis to
confirm which of the following types of anemia?
Thalassemia
,The 43 year old male patient with macrocytic anemia should be evaluated for
which of the following lab levels to help narrow down the etiology?
Vitamin B12
While examining a 53 year old female patient, you auscultate abnormal breath
sounds over all fields, and now assess transmission of voice sounds by having the
patient say "ee" while auscultating the chest with the diaphragm of your
stethoscope. Normally, you should auscultate a muffled "e" sound, however, you
hear hear a nasally "a" sound. Which one of the following will you document is
present?Positive stereognosis.Positive for egophony.Negative for
bronchophony.Negative for egophony
Positive for egophony
While assessing the 19 year old patient for a new onset cough, the nurse
practitioner may inspect, auscultate, palpate, and/or percuss.How does performing
percussion of the thorax assist the provider during the physical examination?To
assist with the confirmation of cardiac origin of angina.To assess for deep-seated
lesion and tumors.To assess for any pain or discomfort prior to palpitation of the
chest wall.To identify if underlying tissue are air-filled, fluid-filled or consolidated
To identify if underlying tissue are air-filled, fluid-filled or consolidated
During a post-hospital discharge visit, you notice your 71 year old female patient
has been diagnosed with a "new murmur" found by the hospitalist during their
recent hospitalization for CHF exacerbation. In evaluating the patient, during
which phase of the cardiac cycle would you anticipate auscultation of a S3 or S4
heart sound?
Diastole
, The point of maximum impulse (PMI) is most often palpable in healthy adults
when positioned in the supine or left lateral decubitus position. Which one of the
following locations is most commonly described as the PMI in a healthy adult?
left 5th ICS, MCL
The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess
for a pulse deficit by auscultating the patient's heart while watching the EKG
rhythm. Where would the S1 heart sound correlate with the electrocardiographic
waves?
Peak of the R wave
Michael, a 72 year old male patient who previously presented with stable cardiac-
type chest pain has underwent a stress test. He presents today to review the stress
test results, which show EKG findings of ST segment depression during the exam
in leads V3 and V4 as well as some concurrent chest discomfort. Based on these
findings, which of the following are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction
Check for thyroid dysfunction
Your 42 year old male patient has been referred to your clinic for establishing care
and on his intake survey, you note he has documented diagnosis of interstitial lung
