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NR509
NR 509/ NR509 Final Exam Study Guide Advanced Physical
Assessment (Latest ) Questions with Verified
Answers – Chamberlain
1. A client presents with right lower quadrant abdominal pain that initially began near
the umbilicus and migrated. The nurse identifies tenderness at McBurney’s point. Which
additional finding, if present, would most significantly increase the likelihood of
appendicitis?
A. Positive obturator sign
B. Positive psoas sign
C. Left lower quadrant pain
D. Epigastric tenderness
CORRECT ANSWER: B
Rationale: The presence of right lower quadrant tenderness, a positive Rovsing sign, and
a positive psoas sign together make appendicitis twice as likely. The psoas sign indicates
irritation of the psoas muscle by an inflamed appendix.
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2. When assessing for a positive Rovsing sign in a client with suspected appendicitis, the
nurse should:
A. Ask the client to raise the right thigh against resistance.
B. Press deeply in the left lower quadrant and quickly release.
C. Flex the client’s right hip and knee and internally rotate the leg.
D. Palpate the point 2 inches from the anterior superior iliac spine on a line to the
umbilicus.
CORRECT ANSWER: B
Rationale: A positive Rovsing sign is pain in the right lower quadrant when deep
pressure is applied and then released in the left lower quadrant, suggesting peritoneal
irritation from appendicitis.
3. A client suspected of having acute cholecystitis reports right upper quadrant pain. To
assess for a positive Murphy's sign, the nurse should:
A. Ask the client to take a deep breath while palpating the right upper quadrant.
B. Press deeply in the left lower quadrant and observe for right-sided pain.
C. Have the client raise the right leg against resistance.
D. Percuss the right lower anterior chest wall for dullness.
CORRECT ANSWER: A
Rationale: A positive Murphy's sign is a sharp increase in tenderness or inspiratory
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arrest when the client takes a deep breath while the examiner palpates the right upper
quadrant under the costal margin. This finding triples the likelihood of acute
cholecystitis.
4. A client with acute pancreatitis reports that pain is worse when lying supine. Which
position would likely provide the most relief?
A. Lying on the right side
B. Leaning forward with the trunk flexed
C. Lying flat with legs extended
D. Supine with the head of bed elevated
CORRECT ANSWER: B
Rationale: Pain from acute pancreatitis is often exacerbated by lying supine and relieved
by leaning forward or assuming a fetal position, which reduces pressure on the
retroperitoneal structures.
5. A client with peptic ulcer disease reports episodic epigastric burning pain. The nurse
anticipates that which intervention may provide relief for this client?
A. Drinking orange juice
B. Taking nonsteroidal anti-inflammatory drugs (NSAIDs)
C. Eating a meal
D. Lying down after eating
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CORRECT ANSWER: C
Rationale: Pain from duodenal ulcers is often relieved by food or antacids, as they help
neutralize gastric acid. Gastric ulcer pain may be less consistently relieved by food.
6. A client describes symptoms of heartburn and regurgitation, especially after eating
spicy foods or when lying down. The nurse identifies these findings as most consistent
with which condition?
A. Peptic Ulcer Disease
B. Acute Cholecystitis
C. Gastroesophageal Reflux Disease (GERD)
D. Irritable Bowel Syndrome
CORRECT ANSWER: C
Rationale: Classic symptoms of GERD include heartburn and regurgitation, which are
often triggered by meals (especially spicy or fatty foods), lying down, or bending over.
7. A client is diagnosed with diverticulitis. The nurse expects the client's pain to be
located primarily in which abdominal quadrant?
A. Right Upper Quadrant (RUQ)
B. Left Upper Quadrant (LUQ)
C. Right Lower Quadrant (RLQ)
D. Left Lower Quadrant (LLQ)
NR509
NR509
NR 509/ NR509 Final Exam Study Guide Advanced Physical
Assessment (Latest ) Questions with Verified
Answers – Chamberlain
1. A client presents with right lower quadrant abdominal pain that initially began near
the umbilicus and migrated. The nurse identifies tenderness at McBurney’s point. Which
additional finding, if present, would most significantly increase the likelihood of
appendicitis?
A. Positive obturator sign
B. Positive psoas sign
C. Left lower quadrant pain
D. Epigastric tenderness
CORRECT ANSWER: B
Rationale: The presence of right lower quadrant tenderness, a positive Rovsing sign, and
a positive psoas sign together make appendicitis twice as likely. The psoas sign indicates
irritation of the psoas muscle by an inflamed appendix.
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2. When assessing for a positive Rovsing sign in a client with suspected appendicitis, the
nurse should:
A. Ask the client to raise the right thigh against resistance.
B. Press deeply in the left lower quadrant and quickly release.
C. Flex the client’s right hip and knee and internally rotate the leg.
D. Palpate the point 2 inches from the anterior superior iliac spine on a line to the
umbilicus.
CORRECT ANSWER: B
Rationale: A positive Rovsing sign is pain in the right lower quadrant when deep
pressure is applied and then released in the left lower quadrant, suggesting peritoneal
irritation from appendicitis.
3. A client suspected of having acute cholecystitis reports right upper quadrant pain. To
assess for a positive Murphy's sign, the nurse should:
A. Ask the client to take a deep breath while palpating the right upper quadrant.
B. Press deeply in the left lower quadrant and observe for right-sided pain.
C. Have the client raise the right leg against resistance.
D. Percuss the right lower anterior chest wall for dullness.
CORRECT ANSWER: A
Rationale: A positive Murphy's sign is a sharp increase in tenderness or inspiratory
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arrest when the client takes a deep breath while the examiner palpates the right upper
quadrant under the costal margin. This finding triples the likelihood of acute
cholecystitis.
4. A client with acute pancreatitis reports that pain is worse when lying supine. Which
position would likely provide the most relief?
A. Lying on the right side
B. Leaning forward with the trunk flexed
C. Lying flat with legs extended
D. Supine with the head of bed elevated
CORRECT ANSWER: B
Rationale: Pain from acute pancreatitis is often exacerbated by lying supine and relieved
by leaning forward or assuming a fetal position, which reduces pressure on the
retroperitoneal structures.
5. A client with peptic ulcer disease reports episodic epigastric burning pain. The nurse
anticipates that which intervention may provide relief for this client?
A. Drinking orange juice
B. Taking nonsteroidal anti-inflammatory drugs (NSAIDs)
C. Eating a meal
D. Lying down after eating
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CORRECT ANSWER: C
Rationale: Pain from duodenal ulcers is often relieved by food or antacids, as they help
neutralize gastric acid. Gastric ulcer pain may be less consistently relieved by food.
6. A client describes symptoms of heartburn and regurgitation, especially after eating
spicy foods or when lying down. The nurse identifies these findings as most consistent
with which condition?
A. Peptic Ulcer Disease
B. Acute Cholecystitis
C. Gastroesophageal Reflux Disease (GERD)
D. Irritable Bowel Syndrome
CORRECT ANSWER: C
Rationale: Classic symptoms of GERD include heartburn and regurgitation, which are
often triggered by meals (especially spicy or fatty foods), lying down, or bending over.
7. A client is diagnosed with diverticulitis. The nurse expects the client's pain to be
located primarily in which abdominal quadrant?
A. Right Upper Quadrant (RUQ)
B. Left Upper Quadrant (LUQ)
C. Right Lower Quadrant (RLQ)
D. Left Lower Quadrant (LLQ)
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