NR 509
FINAL EXAM
Expected Questions with Answers
(Advanced Physical Assessment)
Chamberlain
What You Will Get:
Instant PDF download
100 multiple-choice questions
Verified answers included
Detailed rationales for review
Advanced Physical Assessment focused
Great for Final exam review and self-study
Please note: This is an independent study resource and is not affiliated
with or endorsed by Chamberlain University.
,1. A 37-year-old nurse comes for evaluation of colicky right upper quadrant
abdominal pain. The pain is associated with nausea and vomiting and occurs
1 to 2 hours after eating greasy foods. Which one of the following physical
examination descriptions would be most consistent with the diagnosis of
cholecystitis?
A. Rebound tenderness and guarding in the right lower quadrant
B. Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or
guarding
C. Painless jaundice with palpable gallbladder
D. Diffuse abdominal rigidity and absent bowel sounds
Correct Answer: B. Abdomen is soft and tender to palpation in the right upper
quadrant with inspiration, to the point of stopping inspiration, and there is no
rebound or guarding
Rationale: This describes Murphy’s sign, characteristic of acute cholecystitis. Post-
prandial RUQ pain after fatty meals aligns with biliary colic. The absence of
rebound/guarding helps distinguish uncomplicated cholecystitis from peritonitis.
2. A 15-year-old high school sophomore and her mother come to your clinic
because the mother is concerned about her daughter's weight. You measure
her daughter's height and weight and obtain a BMI of 19.5 kg/m². Based on
this information, which of the following is appropriate?
A. Recommend a high-protein weight-gain diet
B. Reassure the mother that this is a normal body weight
C. Refer to an eating disorder specialist
D. Initiate a 1,200-calorie restrictive diet
,Correct Answer: B. Reassure the mother that this is a normal body weight
Rationale: A BMI between the 5th and 85th percentile (or approximately 18.5–
24.9 kg/m² for adults) is considered normal. For a 15-year-old, a BMI of 19.5 falls
within the healthy range, and reassurance is the appropriate intervention.
3. A 30-year-old sales clerk comes to your office wanting to lose weight; her
BMI is 30.0 kg/m². What is the most appropriate amount for a weekly weight
reduction goal?
A. 2–3 lb per week
B. 0.5–1 lb per week
C. 5–7 lb per week
D. 10 lb per month
Correct Answer: B. 0.5–1 lb per week
Rationale: A safe, sustainable weight loss goal for obesity (BMI ≥30) is 0.5–1 lb
(0.25–0.5 kg) per week, achieved through a caloric deficit of approximately 500
kcal/day. Rapid weight loss increases risk of gallstones and muscle catabolism.
4. A 67-year-old retired janitor comes to the clinic with his wife. She brought
him in because she is concerned about his weight loss. He has a history of
smoking 3 packs of cigarettes a day for 30 years, for a total of 90 pack-years.
He has noticed a daily cough for the past several years, which he states is
productive of sputum. He came into the clinic approximately 1 year ago, and
at that time his weight was 140 pounds. Today, his weight is 110 pounds.
Which one of the following questions would be the most important to ask if
you suspect that he has lung cancer?
A. Have you tried to lose weight?
B. Have you had recent travel abroad?
C. Do you have a family history of asthma?
D. Have you started any new exercise programs?
, Correct Answer: A. Have you tried to lose weight?
Rationale: Unintentional weight loss in a patient with a 90 pack-year smoking
history and chronic cough is a red flag for malignancy. Determining whether
weight loss was intentional or unintentional is critical to assessing for cancer-
related cachexia.
5. A patient presents for evaluation of a sharp, aching chest pain which
increases with breathing. To which anatomic area would you localize the
symptom?
A. Cardiac
B. Pulmonary
C. Musculoskeletal
D. Gastrointestinal
Correct Answer: C. Musculoskeletal
Rationale: Pain that worsens with inspiration or movement is classic for pleuritic
or chest-wall (musculoskeletal) origins. Cardiac pain is typically pressure-like and
not pleuritic, while GI pain is unrelated to respiration.
6. A patient comes to the emergency room for evaluation of shortness of
breath. To which anatomic region would you assign the symptom?
A. Musculoskeletal
B. Cardiac
C. Neurologic
D. Endocrine
Correct Answer: B. Cardiac
FINAL EXAM
Expected Questions with Answers
(Advanced Physical Assessment)
Chamberlain
What You Will Get:
Instant PDF download
100 multiple-choice questions
Verified answers included
Detailed rationales for review
Advanced Physical Assessment focused
Great for Final exam review and self-study
Please note: This is an independent study resource and is not affiliated
with or endorsed by Chamberlain University.
,1. A 37-year-old nurse comes for evaluation of colicky right upper quadrant
abdominal pain. The pain is associated with nausea and vomiting and occurs
1 to 2 hours after eating greasy foods. Which one of the following physical
examination descriptions would be most consistent with the diagnosis of
cholecystitis?
A. Rebound tenderness and guarding in the right lower quadrant
B. Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or
guarding
C. Painless jaundice with palpable gallbladder
D. Diffuse abdominal rigidity and absent bowel sounds
Correct Answer: B. Abdomen is soft and tender to palpation in the right upper
quadrant with inspiration, to the point of stopping inspiration, and there is no
rebound or guarding
Rationale: This describes Murphy’s sign, characteristic of acute cholecystitis. Post-
prandial RUQ pain after fatty meals aligns with biliary colic. The absence of
rebound/guarding helps distinguish uncomplicated cholecystitis from peritonitis.
2. A 15-year-old high school sophomore and her mother come to your clinic
because the mother is concerned about her daughter's weight. You measure
her daughter's height and weight and obtain a BMI of 19.5 kg/m². Based on
this information, which of the following is appropriate?
A. Recommend a high-protein weight-gain diet
B. Reassure the mother that this is a normal body weight
C. Refer to an eating disorder specialist
D. Initiate a 1,200-calorie restrictive diet
,Correct Answer: B. Reassure the mother that this is a normal body weight
Rationale: A BMI between the 5th and 85th percentile (or approximately 18.5–
24.9 kg/m² for adults) is considered normal. For a 15-year-old, a BMI of 19.5 falls
within the healthy range, and reassurance is the appropriate intervention.
3. A 30-year-old sales clerk comes to your office wanting to lose weight; her
BMI is 30.0 kg/m². What is the most appropriate amount for a weekly weight
reduction goal?
A. 2–3 lb per week
B. 0.5–1 lb per week
C. 5–7 lb per week
D. 10 lb per month
Correct Answer: B. 0.5–1 lb per week
Rationale: A safe, sustainable weight loss goal for obesity (BMI ≥30) is 0.5–1 lb
(0.25–0.5 kg) per week, achieved through a caloric deficit of approximately 500
kcal/day. Rapid weight loss increases risk of gallstones and muscle catabolism.
4. A 67-year-old retired janitor comes to the clinic with his wife. She brought
him in because she is concerned about his weight loss. He has a history of
smoking 3 packs of cigarettes a day for 30 years, for a total of 90 pack-years.
He has noticed a daily cough for the past several years, which he states is
productive of sputum. He came into the clinic approximately 1 year ago, and
at that time his weight was 140 pounds. Today, his weight is 110 pounds.
Which one of the following questions would be the most important to ask if
you suspect that he has lung cancer?
A. Have you tried to lose weight?
B. Have you had recent travel abroad?
C. Do you have a family history of asthma?
D. Have you started any new exercise programs?
, Correct Answer: A. Have you tried to lose weight?
Rationale: Unintentional weight loss in a patient with a 90 pack-year smoking
history and chronic cough is a red flag for malignancy. Determining whether
weight loss was intentional or unintentional is critical to assessing for cancer-
related cachexia.
5. A patient presents for evaluation of a sharp, aching chest pain which
increases with breathing. To which anatomic area would you localize the
symptom?
A. Cardiac
B. Pulmonary
C. Musculoskeletal
D. Gastrointestinal
Correct Answer: C. Musculoskeletal
Rationale: Pain that worsens with inspiration or movement is classic for pleuritic
or chest-wall (musculoskeletal) origins. Cardiac pain is typically pressure-like and
not pleuritic, while GI pain is unrelated to respiration.
6. A patient comes to the emergency room for evaluation of shortness of
breath. To which anatomic region would you assign the symptom?
A. Musculoskeletal
B. Cardiac
C. Neurologic
D. Endocrine
Correct Answer: B. Cardiac
