NSG 464 Physical Assessment for Advanced Practice FINAL EXAM STUDY GUIDE 2026/2027 ACCURATE QUESTIONS WITH CORRECT DETAILED ANSWERS || 100% GUARANTEED PASS NEWEST VERSION

NSG 464 Physical Assessment for Advanced Practice FINAL EXAM STUDY GUIDE 2026/2027 ACCURATE QUESTIONS WITH CORRECT DETAILED ANSWERS || 100% GUARANTEED PASS NEWEST VERSION 1. The nurse identifies that the patient with the greatest risk for a urinary tract infection is: a. 37-year-old man with renal colic associated with kidney stones. b. 26-year-old pregnant woman who has a history of urinary tract infections. c. 69-year-old man who has urinary retention caused by benign prostatic hyperplasia. d. 72-year-old woman hospitalized with a stroke who has a urinary catheter because of urinary incontinence. - ANSWER d. 72-year old woman hospitalized with a stroke who has a urinary catheter because of urinary incontinence. 2. When caring for a patient with a biliary obstruction, the nurse will anticipate administering which vitamin supplements (select all that apply)? a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K e. Vitamin B - ANSWER a. Vitamin A b. Vitamin D c. Vitamin E d. Vitamin K 3. Which area of the arm drains to the epitrochlear nodes? A. Ulnar surface of the forearm and hand, little and ring fingers, and ulnar middle finger B. Radial surface of the forearm and hand, thumb, and index fingers, and radial middle finger C. Ulnar surface of the forearm and hand, second, third, and fourth fingers D. Radial surface of the forearm and hand; second, third, and fourth fingers - ANSWER A. Ulnar surface of the forearm and hand, little and ring fingers, and ulnar middle finger Rationale: The epitrochlear node receives lymphatic drainage from the ulnar surface of the forearm and hand, little and ring fingers, and ulnar middle finger. More importantly, it is generally a sign of generalized lymphadenopathy as seen in syphilis and HIV infection 4. Mr. Edwards complains of cramps and difficulties with walking. The cramps occur in his calves consistently after walking about 100 yards. After a period of rest, he can start to walk again, but after 100 yards these same symptoms recur. Which of the following would suggest spinal stenosis as a cause of this pain? A. Coldness and pallor of the legs B. Relief of the pain with bending at the waist C. Color changes of the skin D. Swelling with tenderness of the skin - ANSWER B. Relief of the pain with bending at the waist Rationale: While these symptoms are classic for claudication, they may also be accounted for by spinal stenosis. Relief with bending at the waist would be consistent with this etiology. Some will state that they must lean over the shopping cart while shopping to avoid these symptoms. Bending stretches the spinal cord and presumably decreases compression. The other symptoms would lead one to suspect a vascular etiology 5. Which of the following pairs of ischemic symptoms versus vascular supply is correct? A. Lower calf/superficial femoral B. Erectile dysfunction/iliac or pudendal C. Buttock/common femoral D. Upper calf/tibial or peroneal - ANSWER B. Erectile dysfunction/iliac or pudendal Rationale: The ischemia from the iliac or pudendal arteries results in erectile dysfunction. The lower calf is supplied by the popliteal artery, the buttock is supplied by the common femoral artery, and the upper calf is supplied by the superficial femoral artery 6. The ankle-brachial index (ABI) is calculated by dividing the systolic BP at the dorsalis pedis by the systolic BP at the brachial artery. Which of the following values would be consistent with mild peripheral arterial disease? A. 1.1 B. 0.85 C. 0.65 D. 0.35 - ANSWER B. 0.85 Rationale: The mild disease is represented by an ABI of 0.71 to 0.9. Any value above 0.9 is normal. Moderate disease is defined as between 0.7 and 0.41, and severe disease is defined as 0.4 or less. Patients in the "severe" category have a 20% to 25% annual risk of death. 7. Asymmetric BPs are seen in which of the following conditions? A. Coronary artery disease B. Congenital narrowing of the aorta C. Diffuse atherosclerosis D. Vasculitis, as seen in systemic lupus erythematosus - ANSWER B. Congenital narrowing of the aorta Rationale: A difference of as little at 10 mmHg in the SBP may be significant. Coarctation and dissecting aortic aneurysm are causes of asymmetric blood pressures. Coarctation represents a congenital narrowing of the aorta. While some forms of vasculitis can affect large vessels where we measure the blood pressure, lupus is generally a small-vessel vasculitis. Usually, neither diffuse atherosclerosis nor coronary artery disease is responsible for a focal difference in blood pressure 8. Levels of Alertness - ANSWER - Alert - Lethargy - Obtunded - Stupor - Coma 9. Grading Muscle Strength - ANSWER 1-5 Scale 5: normal 3: only move against gravity 10. RAMs - ANSWER - turn hand rapidly over and back on thigh - tap index finger on distal thumb - tap ball of foot rapidly on hand 11. Assess gait as the patient: - ANSWER - walks across room - walks heel-to-toe - walks on toes then heels - hops in place 12. Romberg test - ANSWER - pt stands with feet together and eyes open, then for 30-60 seconds with eyes closed - positive: loss of balance with eyes closed 13. Pronator drift - ANSWER - pt stands for 20-30 seconds with both arms straight forward, palms up; tap arms briskly downward - positive: pronation and downward drift of arm 14. First sense to go in peripheral neuropathy? - ANSWER Vibration 15. Stereognosis - ANSWER ability to recognize objects by feeling their form, size, and weight while the eyes are closed