NR509 FINAL EXAM 2026-2027
ADVANCED PHYSICAL ASSESSMENT
COMPREHENSIVE EXAM PREP Q&A |
CHAMBERLAIN UNIVERSITY
1. A 35-year-old female with a history of migraines presents
with worsening headache symptoms over the past three
weeks. She notes waking up in the middle of the night with
severe headaches accompanied by nausea. Her only current
medication is an oral contraceptive pill. What is the most
appropriate next step for the nurse practitioner? A.
Immediately order an MRI of the brain with and without
contrast.
B. Prescribe a triptan for acute migraine management and follow
up in two weeks.
C. Take a further focused history and perform a thorough
neurological examination.
D. Advise the patient to discontinue her oral contraceptive pills
immediately.
• Correct Answer: C
• Rationale: Red flag headache symptoms (waking up at
night, nausea, changing pattern) necessitate a
comprehensive clinical history and detailed neurological
evaluation before jumping to imaging or altering treatment
plans.
,2. During a routine well-child assessment of a 9-year-old
female, the nurse practitioner notes asymmetric projection
of the right areola and nipple, forming a secondary mound
above the level of the breast tissue. The left breast shows no
secondary mound. Which Tanner Stage of breast
development is represented by this finding? A. Tanner Stage
II
B. Tanner Stage III
C. Tanner Stage IV
D. Tanner Stage V
• Correct Answer: C
• Rationale: Tanner Stage IV is characterized by the
projection of the areola and nipple to form a secondary
mound above the level of the rest of the breast tissue.
3. A nurse practitioner is leading a community health
program aimed at administering the HPV vaccine to
adolescents. Under which category of prevention does this
clinical intervention fall? A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention
, • Correct Answer: A
• Rationale: Primary prevention consists of measures and
interventions, such as immunizations, designed to prevent
the onset of a specific disease before it occurs.
4. According to the United States Preventive Services Task
Force (USPSTF) guidelines for average-risk women, what is
the recommended screening schedule for breast cancer? A.
Annual mammography beginning at age 40 until age 70.
B. Biennial mammography for women aged 50 to 74 years.
C. Screening every 3 years starting at age 45, stopping at age 65.
D. Annual clinical breast exams only for women aged 40 to 49.
• Correct Answer: B
• Rationale: The USPSTF recommends biennial (every 2
years) screening mammography for average-risk women
aged 50 to 74 years, with insufficient evidence regarding
screening in women 75 and older.
5. According to Eighth Joint National Committee (JNC8)
guidelines, what is the primary target blood pressure for an
adult aged 62 with no diabetes or chronic kidney disease? A.
< 120/80 mmHg
B. < 130/80 mmHg
C. < 140/90 mmHg
, D. < 150/90 mmHg
• Correct Answer: D
• Rationale: JNC8 recommends a target blood pressure of <
150/90 mmHg for general adults aged 60 and older, noting
that if current well-tolerated therapy lowers SBP below 140
mmHg without adverse effects, treatment does not need
adjustment.
6. A nurse practitioner needs to perform a physical
assessment on a 2-year-old child. Which examination
strategy is most effective for reducing anxiety and
facilitating cooperation? A. Conduct the exam in a separate
quiet room away from the parents.
B. Perform the most invasive procedures, like the otoscopic
exam, first.
C. Have the parent facilitate the examination while holding the
child on their lap.
D. Insist that the child stand independently on the examination
table.
• Correct Answer: C
• Rationale: In young children aged 1 to 4 years, parent
participation—such as holding the child on their lap during
the exam—minimizes distress and enhances patient
cooperation.
ADVANCED PHYSICAL ASSESSMENT
COMPREHENSIVE EXAM PREP Q&A |
CHAMBERLAIN UNIVERSITY
1. A 35-year-old female with a history of migraines presents
with worsening headache symptoms over the past three
weeks. She notes waking up in the middle of the night with
severe headaches accompanied by nausea. Her only current
medication is an oral contraceptive pill. What is the most
appropriate next step for the nurse practitioner? A.
Immediately order an MRI of the brain with and without
contrast.
B. Prescribe a triptan for acute migraine management and follow
up in two weeks.
C. Take a further focused history and perform a thorough
neurological examination.
D. Advise the patient to discontinue her oral contraceptive pills
immediately.
• Correct Answer: C
• Rationale: Red flag headache symptoms (waking up at
night, nausea, changing pattern) necessitate a
comprehensive clinical history and detailed neurological
evaluation before jumping to imaging or altering treatment
plans.
,2. During a routine well-child assessment of a 9-year-old
female, the nurse practitioner notes asymmetric projection
of the right areola and nipple, forming a secondary mound
above the level of the breast tissue. The left breast shows no
secondary mound. Which Tanner Stage of breast
development is represented by this finding? A. Tanner Stage
II
B. Tanner Stage III
C. Tanner Stage IV
D. Tanner Stage V
• Correct Answer: C
• Rationale: Tanner Stage IV is characterized by the
projection of the areola and nipple to form a secondary
mound above the level of the rest of the breast tissue.
3. A nurse practitioner is leading a community health
program aimed at administering the HPV vaccine to
adolescents. Under which category of prevention does this
clinical intervention fall? A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention
, • Correct Answer: A
• Rationale: Primary prevention consists of measures and
interventions, such as immunizations, designed to prevent
the onset of a specific disease before it occurs.
4. According to the United States Preventive Services Task
Force (USPSTF) guidelines for average-risk women, what is
the recommended screening schedule for breast cancer? A.
Annual mammography beginning at age 40 until age 70.
B. Biennial mammography for women aged 50 to 74 years.
C. Screening every 3 years starting at age 45, stopping at age 65.
D. Annual clinical breast exams only for women aged 40 to 49.
• Correct Answer: B
• Rationale: The USPSTF recommends biennial (every 2
years) screening mammography for average-risk women
aged 50 to 74 years, with insufficient evidence regarding
screening in women 75 and older.
5. According to Eighth Joint National Committee (JNC8)
guidelines, what is the primary target blood pressure for an
adult aged 62 with no diabetes or chronic kidney disease? A.
< 120/80 mmHg
B. < 130/80 mmHg
C. < 140/90 mmHg
, D. < 150/90 mmHg
• Correct Answer: D
• Rationale: JNC8 recommends a target blood pressure of <
150/90 mmHg for general adults aged 60 and older, noting
that if current well-tolerated therapy lowers SBP below 140
mmHg without adverse effects, treatment does not need
adjustment.
6. A nurse practitioner needs to perform a physical
assessment on a 2-year-old child. Which examination
strategy is most effective for reducing anxiety and
facilitating cooperation? A. Conduct the exam in a separate
quiet room away from the parents.
B. Perform the most invasive procedures, like the otoscopic
exam, first.
C. Have the parent facilitate the examination while holding the
child on their lap.
D. Insist that the child stand independently on the examination
table.
• Correct Answer: C
• Rationale: In young children aged 1 to 4 years, parent
participation—such as holding the child on their lap during
the exam—minimizes distress and enhances patient
cooperation.
