NR 511 ADVANCED PHYSICAL
ASSESSMENT FINAL EXAM PREP
QUESTIONS AND ANSWERS
1. A 28-year-old female presents with a red, ‘bullseye’ rash on her thigh, fatigue, and joint
aches after a hiking trip in Connecticut. What is the first-line treatment for this condition?
A. Azithromycin 500mg daily for 3 days
B. Amoxicillin 500mg TID for 21 days
C. Cephalexin 500mg TID for 7 days
D. Doxycycline 100mg BID for 10-14 days
Answer: D
Conceptual Explanation: The presentation describes Erythema Migrans associated with
Lyme disease. Doxycycline is the first-line treatment for adults.
2. Which of the following physical exam findings is most suggestive of Acute Otitis Media
(AOM) rather than Otitis Media with Effusion (OME)?
A. Bulging of the tympanic membrane
B. Fluid levels behind the drum
,C. Air bubbles in the middle ear
D. Retraction of the tympanic membrane
Answer: A
Conceptual Explanation: Bulging of the tympanic membrane is a hallmark of acute
inflammation and pressure in AOM, whereas OME is characterized by fluid without signs of
acute infection.
3. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
smaller maculopapular lesions on the trunk. What is the diagnosis?
A. Tinea Corporis
B. Secondary Syphilis
C. Pityriasis Rosea
D. Guttate Psoriasis
Answer: C
Conceptual Explanation: Pityriasis Rosea typically begins with a herald patch and
progresses to a Christmas tree distribution along skin cleavage lines.
4. According to the Centor criteria, which of the following patients is MOST likely to have
Group A Beta-Hemolytic Streptococcal (GABHS) pharyngitis?
A. A 20-year-old with cough, rhinorrhea, and sore throat
B. A 10-year-old with fever, tonsillar exudates, and absent cough
, C. A 45-year-old with painful swallowing and posterior cervical lymphadenopathy
D. A 30-year-old with low-grade fever and hoarseness
Answer: B
Conceptual Explanation: Centor criteria include fever, tonsillar exudates, tender anterior
cervical lymphadenopathy, and absence of cough. Younger age also adds to the score.
5. A 65-year-old male with a history of smoking presents with a new onset of a ‘staccato’
cough and weight loss. Imaging shows a hilar mass. Which lung cancer type is most strongly
associated with smoking and central location?
A. Squamous cell carcinoma
B. Large cell carcinoma
C. Adenocarcinoma
D. Mesothelioma
Answer: A
Conceptual Explanation: Squamous cell carcinoma and small cell carcinoma are most
strongly associated with smoking and tend to be centrally located (hilar).
6. Which heart murmur is best heard at the apex of the heart with the bell of the stethoscope
in the left lateral decubitus position?
A. Aortic Stenosis
B. Aortic Regurgitation
ASSESSMENT FINAL EXAM PREP
QUESTIONS AND ANSWERS
1. A 28-year-old female presents with a red, ‘bullseye’ rash on her thigh, fatigue, and joint
aches after a hiking trip in Connecticut. What is the first-line treatment for this condition?
A. Azithromycin 500mg daily for 3 days
B. Amoxicillin 500mg TID for 21 days
C. Cephalexin 500mg TID for 7 days
D. Doxycycline 100mg BID for 10-14 days
Answer: D
Conceptual Explanation: The presentation describes Erythema Migrans associated with
Lyme disease. Doxycycline is the first-line treatment for adults.
2. Which of the following physical exam findings is most suggestive of Acute Otitis Media
(AOM) rather than Otitis Media with Effusion (OME)?
A. Bulging of the tympanic membrane
B. Fluid levels behind the drum
,C. Air bubbles in the middle ear
D. Retraction of the tympanic membrane
Answer: A
Conceptual Explanation: Bulging of the tympanic membrane is a hallmark of acute
inflammation and pressure in AOM, whereas OME is characterized by fluid without signs of
acute infection.
3. A patient presents with a ‘herald patch’ followed by a ‘Christmas tree’ distribution of
smaller maculopapular lesions on the trunk. What is the diagnosis?
A. Tinea Corporis
B. Secondary Syphilis
C. Pityriasis Rosea
D. Guttate Psoriasis
Answer: C
Conceptual Explanation: Pityriasis Rosea typically begins with a herald patch and
progresses to a Christmas tree distribution along skin cleavage lines.
4. According to the Centor criteria, which of the following patients is MOST likely to have
Group A Beta-Hemolytic Streptococcal (GABHS) pharyngitis?
A. A 20-year-old with cough, rhinorrhea, and sore throat
B. A 10-year-old with fever, tonsillar exudates, and absent cough
, C. A 45-year-old with painful swallowing and posterior cervical lymphadenopathy
D. A 30-year-old with low-grade fever and hoarseness
Answer: B
Conceptual Explanation: Centor criteria include fever, tonsillar exudates, tender anterior
cervical lymphadenopathy, and absence of cough. Younger age also adds to the score.
5. A 65-year-old male with a history of smoking presents with a new onset of a ‘staccato’
cough and weight loss. Imaging shows a hilar mass. Which lung cancer type is most strongly
associated with smoking and central location?
A. Squamous cell carcinoma
B. Large cell carcinoma
C. Adenocarcinoma
D. Mesothelioma
Answer: A
Conceptual Explanation: Squamous cell carcinoma and small cell carcinoma are most
strongly associated with smoking and tend to be centrally located (hilar).
6. Which heart murmur is best heard at the apex of the heart with the bell of the stethoscope
in the left lateral decubitus position?
A. Aortic Stenosis
B. Aortic Regurgitation
