NR-509 Advanced Physical Assessment
Final Exam
The NP is conducting a physical assessment on a woman in her 26th week of
pregnancy. Which of the examination finding is worrisome for a potential,
emergent condition?
Correct Answer:
facial edema
An 11-month-old infant male is accompanied to the clinic by his father. The
father is concerned about the skin rash on this son's arms represented in
this image. Family history is significant for a 4-year-old sibling with atopic
dermatitis and asthma. Which of the following is the best documentation of
the integument findings?
Correct Answer:
Erythematous, patches and plaques involving the extensor surfaces of the
bilateral antecubital fossa. Mild, secondary excoriations present with serous
exudate. No streaking. Scant purulent drainage
The NP assesses for the Moro Reflex as part of an infant routine physical
examination. The NP should suspect a neurologic disease if the reflex has
not disappeared by what specific timeframe?
Correct Answer:
16 weeks (4 months)
,A mother brings her 15-day-old female infant to the outpatient clinic for
evaluation of a rash that appeared suddenly after visiting family in Florida. It
is August and the house did not have air conditioning. The infant is afebrile,
eating and drinking well, and does not appear to be in distress. The physical
assessment findings are represented in this image. Based on the history and
examination findings, what is the likely etiology? ADA Description: Infant
with a red, facial rash.
Correct Answer:
miliaria rubra
A 2-month-old female is accompanied by her parents for her first visit to the
practice. When reviewing the hospital medical records of her birth, the NP
notes documentation regarding significantly edematous hands and feet
present at birth. Upon physical examination of the infant, the NP finds skin
folds that run along the sides of the neck down to the shoulders. Which of
the following should be assessed and monitored by the NP and parents
related to these findings? Select all that apply
Correct Answer:
The infant's growth chart with concern for height and length.
The infant's ability to properly latch during breastfeeding.
The infant's fluid gain or loss.
The NP is observing a female pediatric patient during a routine physical. She
can jump in place and balance on one foot. She speaks in full sentences and
her mother states that she can feed herself. Based on your observations and
the history, determine her developmental age
4 years
The NP is observing
Correct Answer:
3 years
,The NP is observing a full-term infant male. He can pull to a stand, use
"mama" and "dada" specifically, and indicates his wants by vocalization and
pointing. Based on your observations, determine his developmental age.
Correct Answer:
8 months
A 48-year-old female presents to the clinic with complaints of heavy vaginal
discharge and severe itching for 1 week. On visualization of the vulva, a
thick, white, curdy discharge is seen at the introitus. On speculum
examination, there is a copious amount of this discharge. The pH of the
discharge is 4.1 and the KOH whiff test is negative, with no unusual smell.
Wet prep shows budding hyphae. Which of the following is the most accurate
interpretation of these findings?
Correct Answer:
These findings suggest candida vaginitis
A 42-year-old female presents to the office for her annual well-woman
examination. She has a history of fibrocystic breast changes since her mid-
20s, so she did not report any new issues except that her right breast feels
"heavier" than usual. After a careful history and physical examination, the
NP documents the following breast findings: Breasts pendulous with diffuse
fibrocystic changes. Single firm 1 × 1 cm mass, mobile, and nontender, with
overlying peau d'orange appearance in the right breast, upper outer
quadrant at 11 o'clock, 2 cm from the nipple. Which of the following is the
most accurate interpretation of these findings?
Correct Answer:
cancer
, A 35-year-old male presents to the clinic for a routine physical examination.
His only complaint is a feeling of heaviness in his scrotum. He denies injury
or trauma. After conducting a history and physical, the NP documents the
following genitourinary (GU) findings: Uncircumcised penis; prepuce easily
retractable. No penile discharge or lesions. No scrotal swelling or
discoloration. Testes descended bilaterally; right testicle smooth; 1 × 1 cm
firm, fixed, nontender, nodule on the left lateral testicle. Epididymis
nontender. No inguinal or femoral hernias. Negative CVA tenderness. Which
of the following is the most accurate interpretation of these findings?
Correct Answer:
testicular cancer
A 34-year-old female presents to the office with left elbow pain following
rigorous training for a tennis match. Tenderness is noted with palpation in
the area on the image marked by the red circle. What correlative diagnosis
does this assessment finding indicate? ADA Description: Left elbow with
emphasis on the small, tuberculated eminence, curved a little forward, about
1 cm from the joint.
Correct Answer:
lateral epicondylitis
A 24-year-old male presents to the office for evaluation of a lump under his
left nipple. He reports no other symptoms, denies trauma or injury, and
reports no known family history of a first-degree relative with breast cancer.
On examination, the NP notes a firm, 2-cm mass under his areola. What is
the most likely etiology for these findings?
Correct Answer:
breast tissue
Final Exam
The NP is conducting a physical assessment on a woman in her 26th week of
pregnancy. Which of the examination finding is worrisome for a potential,
emergent condition?
Correct Answer:
facial edema
An 11-month-old infant male is accompanied to the clinic by his father. The
father is concerned about the skin rash on this son's arms represented in
this image. Family history is significant for a 4-year-old sibling with atopic
dermatitis and asthma. Which of the following is the best documentation of
the integument findings?
Correct Answer:
Erythematous, patches and plaques involving the extensor surfaces of the
bilateral antecubital fossa. Mild, secondary excoriations present with serous
exudate. No streaking. Scant purulent drainage
The NP assesses for the Moro Reflex as part of an infant routine physical
examination. The NP should suspect a neurologic disease if the reflex has
not disappeared by what specific timeframe?
Correct Answer:
16 weeks (4 months)
,A mother brings her 15-day-old female infant to the outpatient clinic for
evaluation of a rash that appeared suddenly after visiting family in Florida. It
is August and the house did not have air conditioning. The infant is afebrile,
eating and drinking well, and does not appear to be in distress. The physical
assessment findings are represented in this image. Based on the history and
examination findings, what is the likely etiology? ADA Description: Infant
with a red, facial rash.
Correct Answer:
miliaria rubra
A 2-month-old female is accompanied by her parents for her first visit to the
practice. When reviewing the hospital medical records of her birth, the NP
notes documentation regarding significantly edematous hands and feet
present at birth. Upon physical examination of the infant, the NP finds skin
folds that run along the sides of the neck down to the shoulders. Which of
the following should be assessed and monitored by the NP and parents
related to these findings? Select all that apply
Correct Answer:
The infant's growth chart with concern for height and length.
The infant's ability to properly latch during breastfeeding.
The infant's fluid gain or loss.
The NP is observing a female pediatric patient during a routine physical. She
can jump in place and balance on one foot. She speaks in full sentences and
her mother states that she can feed herself. Based on your observations and
the history, determine her developmental age
4 years
The NP is observing
Correct Answer:
3 years
,The NP is observing a full-term infant male. He can pull to a stand, use
"mama" and "dada" specifically, and indicates his wants by vocalization and
pointing. Based on your observations, determine his developmental age.
Correct Answer:
8 months
A 48-year-old female presents to the clinic with complaints of heavy vaginal
discharge and severe itching for 1 week. On visualization of the vulva, a
thick, white, curdy discharge is seen at the introitus. On speculum
examination, there is a copious amount of this discharge. The pH of the
discharge is 4.1 and the KOH whiff test is negative, with no unusual smell.
Wet prep shows budding hyphae. Which of the following is the most accurate
interpretation of these findings?
Correct Answer:
These findings suggest candida vaginitis
A 42-year-old female presents to the office for her annual well-woman
examination. She has a history of fibrocystic breast changes since her mid-
20s, so she did not report any new issues except that her right breast feels
"heavier" than usual. After a careful history and physical examination, the
NP documents the following breast findings: Breasts pendulous with diffuse
fibrocystic changes. Single firm 1 × 1 cm mass, mobile, and nontender, with
overlying peau d'orange appearance in the right breast, upper outer
quadrant at 11 o'clock, 2 cm from the nipple. Which of the following is the
most accurate interpretation of these findings?
Correct Answer:
cancer
, A 35-year-old male presents to the clinic for a routine physical examination.
His only complaint is a feeling of heaviness in his scrotum. He denies injury
or trauma. After conducting a history and physical, the NP documents the
following genitourinary (GU) findings: Uncircumcised penis; prepuce easily
retractable. No penile discharge or lesions. No scrotal swelling or
discoloration. Testes descended bilaterally; right testicle smooth; 1 × 1 cm
firm, fixed, nontender, nodule on the left lateral testicle. Epididymis
nontender. No inguinal or femoral hernias. Negative CVA tenderness. Which
of the following is the most accurate interpretation of these findings?
Correct Answer:
testicular cancer
A 34-year-old female presents to the office with left elbow pain following
rigorous training for a tennis match. Tenderness is noted with palpation in
the area on the image marked by the red circle. What correlative diagnosis
does this assessment finding indicate? ADA Description: Left elbow with
emphasis on the small, tuberculated eminence, curved a little forward, about
1 cm from the joint.
Correct Answer:
lateral epicondylitis
A 24-year-old male presents to the office for evaluation of a lump under his
left nipple. He reports no other symptoms, denies trauma or injury, and
reports no known family history of a first-degree relative with breast cancer.
On examination, the NP notes a firm, 2-cm mass under his areola. What is
the most likely etiology for these findings?
Correct Answer:
breast tissue
