MIDTERM EXAM: NR509 / NR-509 (LATEST
2026/2027) ADVANCED PHYSICAL
ASSESSMENT | QUESTIONS AND ANSWERS
| 100% CORRECT | GRADE A -
CHAMBERLAIN
AT CHAMBERLAIN COLLEGE OF NURSING
Midterm Exam: NR509 / NR-509 – Advanced Physical Assessment
Questions and Answers | 100% Correct | Grade A - Chamberlain
Question 1: What sound are we listening for when auscultating carotid arteries?
Answer: When auscultating the carotid arteries, we are listening for bruits, which are
turbulent blood flow sounds often caused by arterial narrowing or atherosclerosis.
Bruits can indicate an increased risk of cerebrovascular events like stroke. Carotids
should be palpated and auscultated one at a time to prevent compromising blood flow
to the brain.
Question 2: What are the risk factors for cardiovascular disease (CVD)?
Answer: Risk factors for CVD include family history of heart disease, cigarette
smoking, an unhealthy diet, physical inactivity, obesity, hypertension, dyslipidemias
(abnormal cholesterol levels), diabetes mellitus, and atrial fibrillation. These factors
contribute to atherosclerosis and increase the likelihood of events like myocardial
infarction and stroke. Recognizing and addressing these risks is essential in preventive
care.
Question 3: In respiratory terminology, what do “infra,” “inter,” and “supra” mean?
Answer: The prefixes relate to anatomical locations: infra means below, inter means
between, and supra means above. For example, supraclavicular refers to above the
,clavicle, intercostal refers to between the ribs, and inframammary refers to below the
breast. These terms help precisely describe locations during assessment or
documentation.
Question 4: What are the common signs and symptoms (s/s) of COPD?
Answer: COPD often presents with a chronic cough with excessive sputum
production, wheezing, dyspnea, and poor exercise tolerance. On auscultation, hyper-
resonance may be present due to air trapping in the lungs. Over time, patients may
show accessory muscle use, barrel-shaped chest, and signs of right-sided heart strain
in advanced disease.
Question 5: What are the basic ways to measure the severity of COPD?
Answer: COPD severity is commonly measured by the degree of dyspnea and by
spirometry results. Spirometry evaluates airflow obstruction by measuring forced
expiratory volume in 1 second (FEV1) and the FEV1/FVC ratio. Clinical assessment also
considers exercise tolerance and frequency of exacerbations.
Question 6: What is the most common cause of an acute cough?
Answer: The most common cause of an acute cough is viral upper respiratory
infections (URIs), such as the common cold or influenza. These infections typically
resolve within 2–3 weeks and are often self-limiting. Persistent or worsening cough
may indicate bacterial infection, asthma, or other underlying conditions.
Question 7: What does a clenched fist over the sternum (Levine sign) suggest?
Answer: The Levine sign suggests angina pectoris, which is chest pain due to
myocardial ischemia. Patients instinctively clutch the chest in a fist when experiencing
this type of discomfort. Recognition of this sign is crucial for timely assessment and
management of potential cardiac events.
Question 8: What are the signs and symptoms of respiratory distress?
, Answer: Signs of respiratory distress include tachypnea (respiratory rate ≥25/min),
cyanosis or pallor, stridor, diaphoresis, and contraction of accessory muscles in the
neck, intercostal spaces, or abdomen. Early recognition is critical for prompt
intervention to prevent hypoxemia and respiratory failure.
Question 9: During inspection of the chest, what should you look for?
Answer: During chest inspection, observe for symmetry of chest expansion, use of
accessory muscles, retractions, and overall respiratory effort. Abnormal findings may
indicate underlying respiratory compromise, obstruction, or neuromuscular weakness.
Inspection is the first step in a comprehensive respiratory assessment.
Question 10: During percussion of the chest over the lungs, what sounds indicate
fluid or air trapping?
Answer: Dullness on percussion suggests fluid in the lungs, as seen with pleural
effusion or pneumonia. Hyper-resonance indicates air trapping, commonly observed in
asthma or COPD. Percussion helps identify underlying lung pathology and guides
further diagnostic testing.
Question 11: What are vesicular breath sounds?
Answer: Vesicular breath sounds are soft, low-pitched sounds heard over most of the
lungs, with inspiration longer than expiration. They are normal sounds indicating
unobstructed airflow through the alveoli. Distinguishing vesicular sounds from
bronchial or adventitious sounds is essential for accurate respiratory assessment.
Question 12: What is the significance of jugular venous distension (JVD) during
cardiovascular assessment?
Answer: JVD indicates increased central venous pressure, often associated with right-
sided heart failure, fluid overload, or pulmonary hypertension. Assess the patient at a
30–45° incline and observe the height of venous pulsations. Documenting JVD helps
evaluate the severity of cardiac dysfunction.
2026/2027) ADVANCED PHYSICAL
ASSESSMENT | QUESTIONS AND ANSWERS
| 100% CORRECT | GRADE A -
CHAMBERLAIN
AT CHAMBERLAIN COLLEGE OF NURSING
Midterm Exam: NR509 / NR-509 – Advanced Physical Assessment
Questions and Answers | 100% Correct | Grade A - Chamberlain
Question 1: What sound are we listening for when auscultating carotid arteries?
Answer: When auscultating the carotid arteries, we are listening for bruits, which are
turbulent blood flow sounds often caused by arterial narrowing or atherosclerosis.
Bruits can indicate an increased risk of cerebrovascular events like stroke. Carotids
should be palpated and auscultated one at a time to prevent compromising blood flow
to the brain.
Question 2: What are the risk factors for cardiovascular disease (CVD)?
Answer: Risk factors for CVD include family history of heart disease, cigarette
smoking, an unhealthy diet, physical inactivity, obesity, hypertension, dyslipidemias
(abnormal cholesterol levels), diabetes mellitus, and atrial fibrillation. These factors
contribute to atherosclerosis and increase the likelihood of events like myocardial
infarction and stroke. Recognizing and addressing these risks is essential in preventive
care.
Question 3: In respiratory terminology, what do “infra,” “inter,” and “supra” mean?
Answer: The prefixes relate to anatomical locations: infra means below, inter means
between, and supra means above. For example, supraclavicular refers to above the
,clavicle, intercostal refers to between the ribs, and inframammary refers to below the
breast. These terms help precisely describe locations during assessment or
documentation.
Question 4: What are the common signs and symptoms (s/s) of COPD?
Answer: COPD often presents with a chronic cough with excessive sputum
production, wheezing, dyspnea, and poor exercise tolerance. On auscultation, hyper-
resonance may be present due to air trapping in the lungs. Over time, patients may
show accessory muscle use, barrel-shaped chest, and signs of right-sided heart strain
in advanced disease.
Question 5: What are the basic ways to measure the severity of COPD?
Answer: COPD severity is commonly measured by the degree of dyspnea and by
spirometry results. Spirometry evaluates airflow obstruction by measuring forced
expiratory volume in 1 second (FEV1) and the FEV1/FVC ratio. Clinical assessment also
considers exercise tolerance and frequency of exacerbations.
Question 6: What is the most common cause of an acute cough?
Answer: The most common cause of an acute cough is viral upper respiratory
infections (URIs), such as the common cold or influenza. These infections typically
resolve within 2–3 weeks and are often self-limiting. Persistent or worsening cough
may indicate bacterial infection, asthma, or other underlying conditions.
Question 7: What does a clenched fist over the sternum (Levine sign) suggest?
Answer: The Levine sign suggests angina pectoris, which is chest pain due to
myocardial ischemia. Patients instinctively clutch the chest in a fist when experiencing
this type of discomfort. Recognition of this sign is crucial for timely assessment and
management of potential cardiac events.
Question 8: What are the signs and symptoms of respiratory distress?
, Answer: Signs of respiratory distress include tachypnea (respiratory rate ≥25/min),
cyanosis or pallor, stridor, diaphoresis, and contraction of accessory muscles in the
neck, intercostal spaces, or abdomen. Early recognition is critical for prompt
intervention to prevent hypoxemia and respiratory failure.
Question 9: During inspection of the chest, what should you look for?
Answer: During chest inspection, observe for symmetry of chest expansion, use of
accessory muscles, retractions, and overall respiratory effort. Abnormal findings may
indicate underlying respiratory compromise, obstruction, or neuromuscular weakness.
Inspection is the first step in a comprehensive respiratory assessment.
Question 10: During percussion of the chest over the lungs, what sounds indicate
fluid or air trapping?
Answer: Dullness on percussion suggests fluid in the lungs, as seen with pleural
effusion or pneumonia. Hyper-resonance indicates air trapping, commonly observed in
asthma or COPD. Percussion helps identify underlying lung pathology and guides
further diagnostic testing.
Question 11: What are vesicular breath sounds?
Answer: Vesicular breath sounds are soft, low-pitched sounds heard over most of the
lungs, with inspiration longer than expiration. They are normal sounds indicating
unobstructed airflow through the alveoli. Distinguishing vesicular sounds from
bronchial or adventitious sounds is essential for accurate respiratory assessment.
Question 12: What is the significance of jugular venous distension (JVD) during
cardiovascular assessment?
Answer: JVD indicates increased central venous pressure, often associated with right-
sided heart failure, fluid overload, or pulmonary hypertension. Assess the patient at a
30–45° incline and observe the height of venous pulsations. Documenting JVD helps
evaluate the severity of cardiac dysfunction.
