NR 509 Final Exam Advanced
Physical Assessment Review
2026/2027 – Questions,
Answers & Detailed Rationales
Guaranteed Pass (GRADED A+)
Question 1. During assessment of an adult patient's cranial
nerves, the examiner asks the patient to identify a familiar scent
with each nostril separately. Which cranial nerve is primarily
being assessed?
A. Cranial nerve II
B. Cranial nerve I
C. Cranial nerve V
D. Cranial nerve VII
Answer: _B. Cranial nerve I_
Rationale: Cranial nerve I, the olfactory nerve, is responsible
for the sense of smell. Testing each nostril separately helps
assess olfactory function.
Question 2. Which technique is most appropriate when
assessing tactile fremitus?
,A. Percussing the posterior chest
B. Auscultating over the trachea
C. Palpating the chest wall while the patient repeats a phrase
D. Inspecting the chest during inspiration
Answer: _C. Palpating the chest wall while the patient repeats a
phrase_
Rationale: Tactile fremitus is assessed by placing the hands or
ulnar surfaces on symmetrical areas of the chest while the
patient repeats a phrase such as “ninety-nine.” Increased or
decreased vibration can provide information about underlying
lung pathology.
Question 3. A patient has a blood pressure of 168/94 mm Hg in
the right arm and 126/78 mm Hg in the left arm. What is the
most appropriate next step?
A. Document the higher pressure as the patient's baseline
B. Repeat the measurement using appropriate technique
C. Immediately diagnose aortic dissection
D. Measure blood pressure only in the left arm thereafter
Answer: _B. Repeat the measurement using appropriate
technique_
Rationale: A substantial inter-arm blood pressure difference
should be confirmed using proper measurement technique and
repeated assessment. Persistent significant differences may
warrant further evaluation.
,Question 4. Which finding is most characteristic of a normal
adult tympanic membrane?
A. Bulging and erythematous
B. Pearly gray and translucent
C. Opaque with purulent drainage
D. Bright red with absent landmarks
Answer: _B. Pearly gray and translucent_
Rationale: A normal tympanic membrane is typically pearly
gray, translucent, and has identifiable landmarks such as the
malleus.
Question 5. When assessing the abdomen, which sequence
should generally be followed?
A. Palpation, percussion, auscultation, inspection
B. Auscultation, inspection, palpation, percussion
C. Inspection, auscultation, percussion, palpation
D. Inspection, palpation, auscultation, percussion
Answer: _C. Inspection, auscultation, percussion, palpation_
Rationale: Auscultation is performed before percussion and
palpation because manipulating the abdomen can alter bowel
sounds.
, Question 6. Which abdominal finding requires the most urgent
evaluation?
A. Tympany over the stomach
B. Mild diffuse bloating after a meal
C. Rigid abdomen with severe pain
D. Active bowel sounds
Answer: _C. Rigid abdomen with severe pain_
Rationale: Rigidity accompanied by severe abdominal pain may
indicate peritoneal irritation or another acute abdominal
process and requires prompt evaluation.
Question 7. The examiner asks a patient to smile, raise the
eyebrows, and close the eyes tightly. Which cranial nerve is
primarily assessed?
A. CN V
B. CN VII
C. CN IX
D. CN XII
Answer: _B. CN VII_
Rationale: The facial nerve (CN VII) controls muscles of facial
expression. Testing smiling, eyebrow movement, and eye closure
evaluates facial nerve function.
Physical Assessment Review
2026/2027 – Questions,
Answers & Detailed Rationales
Guaranteed Pass (GRADED A+)
Question 1. During assessment of an adult patient's cranial
nerves, the examiner asks the patient to identify a familiar scent
with each nostril separately. Which cranial nerve is primarily
being assessed?
A. Cranial nerve II
B. Cranial nerve I
C. Cranial nerve V
D. Cranial nerve VII
Answer: _B. Cranial nerve I_
Rationale: Cranial nerve I, the olfactory nerve, is responsible
for the sense of smell. Testing each nostril separately helps
assess olfactory function.
Question 2. Which technique is most appropriate when
assessing tactile fremitus?
,A. Percussing the posterior chest
B. Auscultating over the trachea
C. Palpating the chest wall while the patient repeats a phrase
D. Inspecting the chest during inspiration
Answer: _C. Palpating the chest wall while the patient repeats a
phrase_
Rationale: Tactile fremitus is assessed by placing the hands or
ulnar surfaces on symmetrical areas of the chest while the
patient repeats a phrase such as “ninety-nine.” Increased or
decreased vibration can provide information about underlying
lung pathology.
Question 3. A patient has a blood pressure of 168/94 mm Hg in
the right arm and 126/78 mm Hg in the left arm. What is the
most appropriate next step?
A. Document the higher pressure as the patient's baseline
B. Repeat the measurement using appropriate technique
C. Immediately diagnose aortic dissection
D. Measure blood pressure only in the left arm thereafter
Answer: _B. Repeat the measurement using appropriate
technique_
Rationale: A substantial inter-arm blood pressure difference
should be confirmed using proper measurement technique and
repeated assessment. Persistent significant differences may
warrant further evaluation.
,Question 4. Which finding is most characteristic of a normal
adult tympanic membrane?
A. Bulging and erythematous
B. Pearly gray and translucent
C. Opaque with purulent drainage
D. Bright red with absent landmarks
Answer: _B. Pearly gray and translucent_
Rationale: A normal tympanic membrane is typically pearly
gray, translucent, and has identifiable landmarks such as the
malleus.
Question 5. When assessing the abdomen, which sequence
should generally be followed?
A. Palpation, percussion, auscultation, inspection
B. Auscultation, inspection, palpation, percussion
C. Inspection, auscultation, percussion, palpation
D. Inspection, palpation, auscultation, percussion
Answer: _C. Inspection, auscultation, percussion, palpation_
Rationale: Auscultation is performed before percussion and
palpation because manipulating the abdomen can alter bowel
sounds.
, Question 6. Which abdominal finding requires the most urgent
evaluation?
A. Tympany over the stomach
B. Mild diffuse bloating after a meal
C. Rigid abdomen with severe pain
D. Active bowel sounds
Answer: _C. Rigid abdomen with severe pain_
Rationale: Rigidity accompanied by severe abdominal pain may
indicate peritoneal irritation or another acute abdominal
process and requires prompt evaluation.
Question 7. The examiner asks a patient to smile, raise the
eyebrows, and close the eyes tightly. Which cranial nerve is
primarily assessed?
A. CN V
B. CN VII
C. CN IX
D. CN XII
Answer: _B. CN VII_
Rationale: The facial nerve (CN VII) controls muscles of facial
expression. Testing smiling, eyebrow movement, and eye closure
evaluates facial nerve function.
