NR509 ADVANCED PHYSICAL ASSESSMENT FINAL
EXAM STUDY GUIDE 2025/2026 COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS ||
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What is the best next maneuver to visualize the cervix if it is not
easily seen? ......ANSWER........Withdraw the speculum slightly
and reposition it on a different slope.
Why is replacing the speculum with a larger one incorrect in this
case? ......ANSWER........In this patient, a larger speculum would
not be helpful as she is thin.
Why is withdrawing the speculum for a bimanual exam not the
next maneuver? ......ANSWER........It is not the immediate next
maneuver after failing to visualize the cervix.
,age 2 of 123
What is incorrect about replacing the speculum with a plastic
one with a better light source? ......ANSWER........It is not the next
maneuver to visualize the cervix.
What is the clinician's approach if the cervix is not visualized
after one attempt? ......ANSWER........The clinician would not stop
trying to visualize the cervix.
What are some possible conditions that could be causing the
discharge? ......ANSWER........Bacterial vaginosis, Trichomonas, a
yeast infection, or another sexually transmitted infection.
What are the symptoms of the 26-year-old public servant
presenting to the Emergency Department?
......ANSWER........Intense abdominal pain, light-headedness, and
a fainting episode.
,age 3 of 123
What is the family medical history concern for the 26-year-old
patient? ......ANSWER........Strong family history of gallstones.
What is the significance of the positive β-hCG in the 26-year-
old patient? ......ANSWER........It indicates a possible pregnancy.
What vital sign abnormalities were noted in the 26-year-old
patient? ......ANSWER........Pulse of 118, blood pressure of
86/68.
What abdominal exam findings were noted in the 26-year-old
patient? ......ANSWER........Involuntary rigidity and rebound
tenderness.
What is the most likely diagnosis for the 26-year-old patient?
......ANSWER........Ruptured tubal pregnancy.
, age 4 of 123
What lab findings were noted for the 63-year-old janitor during
his well visit? ......ANSWER........Moderate elevations of liver
enzymes and mildly elevated total bilirubin.
What finding would be most consistent with hepatomegaly in the
63-year-old janitor? ......ANSWER........Liver palpable 3 cm
below the right costal margin, midclavicular line on expiration.
What is considered a normal liver span measurement at the
midclavicular line? ......ANSWER........6-12 cm.
What is the significance of dullness to percussion over the liver
span? ......ANSWER........It indicates the size and condition of the
liver.
What is the primary concern for the underweight 63-year-old
administrative clerk? ......ANSWER........Prominent abdominal
aorta concerning for an abdominal aortic aneurysm (AAA).