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NR509
NR 509/ NR509 Midterm Exam Study Guide Advanced Physical
Assessment (Latest ) Questions with Verified
Answers - Chamberlain
1. A teenage girl presents to the clinic with left wrist pain after falling on her hand
during a basketball game. Which complaint by the patient would most lead the nurse
practitioner to suspect a fracture?
A. A dull, constant ache at the site.
B. Sharp pain that increases with movement.
C. Tingling and numbness in the fingers.
D. Pain that is worse at night.
CORRECT ANSWER: B
Rationale: A key indicator of a potential fracture is sharp, localized pain that is
exacerbated by movement or attempted use of the injured area, as this stresses the
fracture site.
2. A patient newly diagnosed with osteoporosis asks, "What exactly is osteoporosis?"
What is the nurse practitioner's best response?
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A. "It is a degeneration of the cartilage in your joints."
B. "It is an autoimmune inflammation of the synovial membranes."
C. "It is a loss of bone density, making bones more fragile."
D. "It is a congenital softening of the bones."
CORRECT ANSWER: C
Rationale: Osteoporosis is defined by a reduction in bone mass and deterioration of
bone microarchitecture, leading to decreased bone density and increased fracture risk.
3. A patient reports, "I hear a crunching sound when I kneel," and describes significant
morning joint stiffness and pain. The nurse practitioner should assess for signs of which
problem?
A. Crepitation
B. Subluxation
C. Effusion
D. Contracture
CORRECT ANSWER: A
Rationale: Crepitation (crepitus) is the grating sound or sensation produced by friction
between bone and cartilage or fractured bone pieces. This, combined with morning
stiffness, is often associated with osteoarthritis.
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4. When obtaining a history from a patient with a seizure disorder, the nurse
practitioner wants to assess for the presence of an aura. Which question is best?
A. "How do you feel after a seizure ends?"
B. "Do you have any warning signs before your seizure starts?"
C. "Can you describe the seizure activity itself?"
D. "Do you lose consciousness during the event?"
CORRECT ANSWER: B
Rationale: An aura is a sensory warning symptom that occurs prior to a seizure. Directly
asking about warning signs is the most effective way to elicit this specific history.
5. The nurse practitioner is teaching a class on osteoporosis prevention to
postmenopausal women. Which statement by a participant indicates a need for further
instruction?
A. "I will ensure adequate intake of calcium and vitamin D."
B. "I plan to quit smoking."
C. "I will start swimming to increase my weight-bearing exercise."
D. "I will limit my alcohol consumption."
CORRECT ANSWER: C
Rationale: While excellent for cardiovascular health, swimming is not a weight-bearing
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exercise. Weight-bearing exercises (e.g., walking, jogging) are crucial for osteoporosis
prevention as they force the body to work against gravity, stimulating bone formation.
6. During a neurological assessment on a 41-year-old patient with diabetes, the nurse
practitioner finds the patient cannot feel vibration on the great toes or ankles bilaterally
but can feel it on both patellae. What does this finding suggest?
A. A lesion in the cerebral cortex.
B. Peripheral neuropathy.
C. A problem with the dorsal columns of the spinal cord.
D. Normal age-related sensory changes.
CORRECT ANSWER: B
Rationale: This pattern of a distal sensory deficit (starting at the toes/ankles) with
preserved proximal sensation is classic for "stocking-glove" distribution peripheral
neuropathy, a common complication of diabetes.
7. An 80-year-old patient states during a check-up, "I can't walk as much as I used to
because I get so short of breath." The nurse practitioner notes a history of heart failure.
Which finding on physical exam would be most consistent with left-sided heart failure?
A. Bilateral pitting edema in the lower extremities.
B. Hepatomegaly and ascites.
NR509
NR509
NR 509/ NR509 Midterm Exam Study Guide Advanced Physical
Assessment (Latest ) Questions with Verified
Answers - Chamberlain
1. A teenage girl presents to the clinic with left wrist pain after falling on her hand
during a basketball game. Which complaint by the patient would most lead the nurse
practitioner to suspect a fracture?
A. A dull, constant ache at the site.
B. Sharp pain that increases with movement.
C. Tingling and numbness in the fingers.
D. Pain that is worse at night.
CORRECT ANSWER: B
Rationale: A key indicator of a potential fracture is sharp, localized pain that is
exacerbated by movement or attempted use of the injured area, as this stresses the
fracture site.
2. A patient newly diagnosed with osteoporosis asks, "What exactly is osteoporosis?"
What is the nurse practitioner's best response?
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A. "It is a degeneration of the cartilage in your joints."
B. "It is an autoimmune inflammation of the synovial membranes."
C. "It is a loss of bone density, making bones more fragile."
D. "It is a congenital softening of the bones."
CORRECT ANSWER: C
Rationale: Osteoporosis is defined by a reduction in bone mass and deterioration of
bone microarchitecture, leading to decreased bone density and increased fracture risk.
3. A patient reports, "I hear a crunching sound when I kneel," and describes significant
morning joint stiffness and pain. The nurse practitioner should assess for signs of which
problem?
A. Crepitation
B. Subluxation
C. Effusion
D. Contracture
CORRECT ANSWER: A
Rationale: Crepitation (crepitus) is the grating sound or sensation produced by friction
between bone and cartilage or fractured bone pieces. This, combined with morning
stiffness, is often associated with osteoarthritis.
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4. When obtaining a history from a patient with a seizure disorder, the nurse
practitioner wants to assess for the presence of an aura. Which question is best?
A. "How do you feel after a seizure ends?"
B. "Do you have any warning signs before your seizure starts?"
C. "Can you describe the seizure activity itself?"
D. "Do you lose consciousness during the event?"
CORRECT ANSWER: B
Rationale: An aura is a sensory warning symptom that occurs prior to a seizure. Directly
asking about warning signs is the most effective way to elicit this specific history.
5. The nurse practitioner is teaching a class on osteoporosis prevention to
postmenopausal women. Which statement by a participant indicates a need for further
instruction?
A. "I will ensure adequate intake of calcium and vitamin D."
B. "I plan to quit smoking."
C. "I will start swimming to increase my weight-bearing exercise."
D. "I will limit my alcohol consumption."
CORRECT ANSWER: C
Rationale: While excellent for cardiovascular health, swimming is not a weight-bearing
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exercise. Weight-bearing exercises (e.g., walking, jogging) are crucial for osteoporosis
prevention as they force the body to work against gravity, stimulating bone formation.
6. During a neurological assessment on a 41-year-old patient with diabetes, the nurse
practitioner finds the patient cannot feel vibration on the great toes or ankles bilaterally
but can feel it on both patellae. What does this finding suggest?
A. A lesion in the cerebral cortex.
B. Peripheral neuropathy.
C. A problem with the dorsal columns of the spinal cord.
D. Normal age-related sensory changes.
CORRECT ANSWER: B
Rationale: This pattern of a distal sensory deficit (starting at the toes/ankles) with
preserved proximal sensation is classic for "stocking-glove" distribution peripheral
neuropathy, a common complication of diabetes.
7. An 80-year-old patient states during a check-up, "I can't walk as much as I used to
because I get so short of breath." The nurse practitioner notes a history of heart failure.
Which finding on physical exam would be most consistent with left-sided heart failure?
A. Bilateral pitting edema in the lower extremities.
B. Hepatomegaly and ascites.
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