Page 1 of 47
NR509 CEA FINAL EXAM – 2026 ADVANCED PHYSICAL
ASSESSMENT COMPLETE (105) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NR509
Prepare for the NR509 CEA Final Exam – Advanced Physical Assessment with this
comprehensive practice resource designed to support your exam success. It features
exam-style questions covering advanced health assessment, patient interviewing,
physical examination techniques, diagnostic reasoning, documentation, and clinical
decision-making. Use it to reinforce essential concepts, assess your knowledge, and
build confidence before your final exam. An excellent study aid for nursing students
preparing for the NR509 Advanced Physical Assessment CEA Final Exam.
MULTIPLE CHOICE.
Question 1: A mother brings her 15-month-old toddler to the clinic for a
preventive health visit. Which of the following best describes the general
approach to the pediatric examination of a young child?
A. Perform invasive parts of the exam first to "get them over with"
B. Begin with the least invasive parts of the exam
C. Have the parent leave the room for the entire exam
D. Restrain the child for all parts of the exam
Correct answer: B. Begin with the least invasive parts of the exam
Rationale: In pediatric examinations, the general approach is to begin
with the least invasive parts of the examination to build trust and
minimize distress. This allows the clinician to observe the child's behavior
and interactions before proceeding to more invasive components .
Question 2: The parents of a 21-month-old child report that their son used to
speak nearly 50 words and use 2-word phrases, but in the last month he has
not been using as many words and tends to echo what is being said to him.
, Page 2 of 47
The clinician finds poor eye contact and limited social interactions. What is
the best response?
A. Reassure the parents that this is a normal developmental phase
B. Refer the child to a developmental and behavioral pediatrician
C. Recommend speech therapy only
D. Wait and observe for 6 more months
Correct answer: B. Refer the child to a developmental and behavioral
pediatrician
Rationale: This presentation—loss of language milestones, echolalia,
poor eye contact, and limited social interaction—raises concern for
autism spectrum disorder. Given the family history of autism in two first
cousins, immediate referral to a developmental specialist is indicated for
comprehensive evaluation .
Question 3: A clinician is meeting the mother of a 5-year-old with poorly
controlled asthma and multiple hospitalizations. Family stressors include
divorce, recent job loss, and the child living with grandparents who both
smoke. What is the best example of the role of health promotion with this
family?
A. Focus only on medication management
B. Develop a health promotion plan with more frequent visits and guidance to
address family stressors
C. Recommend the child be placed in foster care
D. Prescribe a higher dose of asthma medication
Correct answer: B. Develop a health promotion plan with more frequent
visits and guidance to address family stressors
Rationale: Health promotion involves addressing the broader
determinants of health. A plan that includes more frequent visits and
guidance to assist the family with stressors and improve the child's
asthma symptoms addresses the root causes rather than just treating
symptoms .
, Page 3 of 47
Question 4: A full-term newborn in the delivery room at 5 minutes has a heart
rate of 100, strong respiratory effort, is crying vigorously, moving actively, and
has good color except for acrocyanosis of the hands and feet. What is this
infant's APGAR score?
A. 7
B. 8
C. 9
D. 10
Correct answer: C. 9
Rationale: The APGAR score is based on five criteria: heart rate (2 points
for >100), respiratory effort (2 points for strong cry), muscle tone (2 points
for active motion), reflex irritability (2 points for vigorous cry), and color (1
point for acrocyanosis, as 2 points requires completely pink). Total = 9 .
Question 5: A newborn is floppy and limp, blue in color, with a heart rate of 60
and minimal respiratory effort. The infant has no grimace and only a very weak
cry. What is the best immediate response?
A. Continue routine monitoring
B. Begin neonatal resuscitation
C. Administer oxygen via mask
D. Call the parents into the room
Correct answer: B. Begin neonatal resuscitation
Rationale: This infant has signs of significant perinatal depression with
low APGAR scores (heart rate <100, poor respiratory effort, poor tone, and
poor color). Immediate neonatal resuscitation is required to support
oxygenation and circulation .
Question 6: An infant is born 4 weeks preterm to a mother with hypertension,
diabetes, and alcohol abuse. The infant is small for gestational age (SGA),
weighing 1,500 g. What is the most important reason for assessing both
gestational age and birth weight?
, Page 4 of 47
A. To determine the infant's blood type
B. To anticipate certain medical and developmental problems
C. To calculate the infant's APGAR score
D. To determine feeding preferences
Correct answer: B. To anticipate certain medical and developmental
problems
Rationale: Assessing both gestational age and birth weight helps
anticipate specific medical and developmental problems. SGA infants are
at risk for hypoglycemia, polycythemia, and developmental delays, while
preterm infants face additional risks related to organ immaturity .
Question 7: A clinician arrives at the hospital several hours after a full-term
infant's birth. The infant is rooming in with parents and appears to be doing
well. The nurse asks if the baby should be taken to the nursery for
examination. What is the best response?
A. "Yes, take the baby to the nursery for a complete exam"
B. "The infant should be examined in the presence of the parents so they can
be taught about what their newborn can do"
C. "The exam can wait until tomorrow"
D. "Only the parents should be present for the exam"
Correct answer: B. "The infant should be examined in the presence of the
parents so they can be taught about what their newborn can do"
Rationale: Examining the infant in the parents' presence provides an
opportunity for parent education about newborn behaviors, capabilities,
and normal findings, which promotes bonding and parental confidence .
Question 8: A full-term infant born by cesarean section with APGARs of 9 and
10 is now on day 4 of life and has developed a tremor. Which factor would
cause the most concern about the tremor?
A. The infant is hungry
B. The infant also has asymmetric limb movements
NR509 CEA FINAL EXAM – 2026 ADVANCED PHYSICAL
ASSESSMENT COMPLETE (105) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NR509
Prepare for the NR509 CEA Final Exam – Advanced Physical Assessment with this
comprehensive practice resource designed to support your exam success. It features
exam-style questions covering advanced health assessment, patient interviewing,
physical examination techniques, diagnostic reasoning, documentation, and clinical
decision-making. Use it to reinforce essential concepts, assess your knowledge, and
build confidence before your final exam. An excellent study aid for nursing students
preparing for the NR509 Advanced Physical Assessment CEA Final Exam.
MULTIPLE CHOICE.
Question 1: A mother brings her 15-month-old toddler to the clinic for a
preventive health visit. Which of the following best describes the general
approach to the pediatric examination of a young child?
A. Perform invasive parts of the exam first to "get them over with"
B. Begin with the least invasive parts of the exam
C. Have the parent leave the room for the entire exam
D. Restrain the child for all parts of the exam
Correct answer: B. Begin with the least invasive parts of the exam
Rationale: In pediatric examinations, the general approach is to begin
with the least invasive parts of the examination to build trust and
minimize distress. This allows the clinician to observe the child's behavior
and interactions before proceeding to more invasive components .
Question 2: The parents of a 21-month-old child report that their son used to
speak nearly 50 words and use 2-word phrases, but in the last month he has
not been using as many words and tends to echo what is being said to him.
, Page 2 of 47
The clinician finds poor eye contact and limited social interactions. What is
the best response?
A. Reassure the parents that this is a normal developmental phase
B. Refer the child to a developmental and behavioral pediatrician
C. Recommend speech therapy only
D. Wait and observe for 6 more months
Correct answer: B. Refer the child to a developmental and behavioral
pediatrician
Rationale: This presentation—loss of language milestones, echolalia,
poor eye contact, and limited social interaction—raises concern for
autism spectrum disorder. Given the family history of autism in two first
cousins, immediate referral to a developmental specialist is indicated for
comprehensive evaluation .
Question 3: A clinician is meeting the mother of a 5-year-old with poorly
controlled asthma and multiple hospitalizations. Family stressors include
divorce, recent job loss, and the child living with grandparents who both
smoke. What is the best example of the role of health promotion with this
family?
A. Focus only on medication management
B. Develop a health promotion plan with more frequent visits and guidance to
address family stressors
C. Recommend the child be placed in foster care
D. Prescribe a higher dose of asthma medication
Correct answer: B. Develop a health promotion plan with more frequent
visits and guidance to address family stressors
Rationale: Health promotion involves addressing the broader
determinants of health. A plan that includes more frequent visits and
guidance to assist the family with stressors and improve the child's
asthma symptoms addresses the root causes rather than just treating
symptoms .
, Page 3 of 47
Question 4: A full-term newborn in the delivery room at 5 minutes has a heart
rate of 100, strong respiratory effort, is crying vigorously, moving actively, and
has good color except for acrocyanosis of the hands and feet. What is this
infant's APGAR score?
A. 7
B. 8
C. 9
D. 10
Correct answer: C. 9
Rationale: The APGAR score is based on five criteria: heart rate (2 points
for >100), respiratory effort (2 points for strong cry), muscle tone (2 points
for active motion), reflex irritability (2 points for vigorous cry), and color (1
point for acrocyanosis, as 2 points requires completely pink). Total = 9 .
Question 5: A newborn is floppy and limp, blue in color, with a heart rate of 60
and minimal respiratory effort. The infant has no grimace and only a very weak
cry. What is the best immediate response?
A. Continue routine monitoring
B. Begin neonatal resuscitation
C. Administer oxygen via mask
D. Call the parents into the room
Correct answer: B. Begin neonatal resuscitation
Rationale: This infant has signs of significant perinatal depression with
low APGAR scores (heart rate <100, poor respiratory effort, poor tone, and
poor color). Immediate neonatal resuscitation is required to support
oxygenation and circulation .
Question 6: An infant is born 4 weeks preterm to a mother with hypertension,
diabetes, and alcohol abuse. The infant is small for gestational age (SGA),
weighing 1,500 g. What is the most important reason for assessing both
gestational age and birth weight?
, Page 4 of 47
A. To determine the infant's blood type
B. To anticipate certain medical and developmental problems
C. To calculate the infant's APGAR score
D. To determine feeding preferences
Correct answer: B. To anticipate certain medical and developmental
problems
Rationale: Assessing both gestational age and birth weight helps
anticipate specific medical and developmental problems. SGA infants are
at risk for hypoglycemia, polycythemia, and developmental delays, while
preterm infants face additional risks related to organ immaturity .
Question 7: A clinician arrives at the hospital several hours after a full-term
infant's birth. The infant is rooming in with parents and appears to be doing
well. The nurse asks if the baby should be taken to the nursery for
examination. What is the best response?
A. "Yes, take the baby to the nursery for a complete exam"
B. "The infant should be examined in the presence of the parents so they can
be taught about what their newborn can do"
C. "The exam can wait until tomorrow"
D. "Only the parents should be present for the exam"
Correct answer: B. "The infant should be examined in the presence of the
parents so they can be taught about what their newborn can do"
Rationale: Examining the infant in the parents' presence provides an
opportunity for parent education about newborn behaviors, capabilities,
and normal findings, which promotes bonding and parental confidence .
Question 8: A full-term infant born by cesarean section with APGARs of 9 and
10 is now on day 4 of life and has developed a tremor. Which factor would
cause the most concern about the tremor?
A. The infant is hungry
B. The infant also has asymmetric limb movements
