NR509ADVANCED PHYSICAL ASSESSMENT
NR509ADVANCED PHYSICAL ASSESSMENT
MIDTERM EXAM TESTBANK| 200Qs&As WITH
RATIONALES|GRADED A+
A 22-year-old advertising copywriter presents for evaluation of joint pain. The
pain is new,located in the wrists and fingers bilaterally, with some subjective
fever. The patient denies a rash; she also denies recent travel or camping
activities. She has a family history significant for rheumatoid arthritis. Based
on this information, which of the following pathologic processes would be the
most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic
B) Inflammatory
Rationale: The description is most consistent with an inflammatory process,
although all the other etiologies should be considered. Lyme disease is an
infection which commonly causes arthritis, hemophilia is a hematologic
condition which can cause bleeding in the joints, and trauma can obviously
cause joint pain.
A 47-year-old contractor presents for evaluation of neck pain, which has been
intermittent for several years. He normally takes over-the-counter medications
to ease the pain, but this time they haven't worked as well and he still has
discomfort. He recently wallpapered the entire second floor in his house,
which caused him great discomfort. The pain resolved with rest. He denies
,NR509ADVANCED PHYSICAL ASSESSMENT
fever, chills, rash, upper respiratory symptoms, trauma, or injury to the neck.
Based on this description, what is the most likely pathologic process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic
C) Degenerative
The description is most consistent with degenerative arthritis in the neck. The
patient has had intermittent symptoms and the questions asked to elicit
pertinent negative and positive findings are negative for infectious, traumatic,
or neoplastic disease.
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-
week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain;
and nonproductive cough. Which is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular
C) Allergic
,NR509ADVANCED PHYSICAL ASSESSMENT
This description is most consistent with allergic rhinitis.
A 19-year old-college student presents to the emergency room with fever,
headache, and neck pain/stiffness. She is concerned about the possibility of
meningococcal meningitis.Several of her dorm mates have been vaccinated,
but she hasn't been. Which of the following physical examination descriptions
is most consistent with meningitis?
A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple
with full range of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck tender to palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck supple with full range of motion
C) Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck tender topalpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and
lack of range of motion are consistent with neck stiffness, which in this
scenario is likely to be caused by meningeal inflammation. Kernig's and
Brudzinski's signs are also helpful in testing for meningeal irritation on exam.
, NR509ADVANCED PHYSICAL ASSESSMENT
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) Abdomen is soft, nontender, and nondistended, without
hepatosplenomegaly or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant,
without rebound or guarding.
C) 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.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or guarding.
C) 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.
In cholecystitis, the pain, which originates from the gallbladder, is located in
the right upper quadrant. Severity of pain with inspiration that is sufficient to
stop further inhalation is also known as Murphy's sign, which, if present, is
further indicative of inflammation of the gallbladder.
A 55-year-old data entry operator comes to the clinic to establish care. She has
the following symptoms: headache, neck pain, sinus congestion, sore throat,
ringing in ears, sharp brief chest pains at rest, burning abdominal pain with
NR509ADVANCED PHYSICAL ASSESSMENT
MIDTERM EXAM TESTBANK| 200Qs&As WITH
RATIONALES|GRADED A+
A 22-year-old advertising copywriter presents for evaluation of joint pain. The
pain is new,located in the wrists and fingers bilaterally, with some subjective
fever. The patient denies a rash; she also denies recent travel or camping
activities. She has a family history significant for rheumatoid arthritis. Based
on this information, which of the following pathologic processes would be the
most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic
B) Inflammatory
Rationale: The description is most consistent with an inflammatory process,
although all the other etiologies should be considered. Lyme disease is an
infection which commonly causes arthritis, hemophilia is a hematologic
condition which can cause bleeding in the joints, and trauma can obviously
cause joint pain.
A 47-year-old contractor presents for evaluation of neck pain, which has been
intermittent for several years. He normally takes over-the-counter medications
to ease the pain, but this time they haven't worked as well and he still has
discomfort. He recently wallpapered the entire second floor in his house,
which caused him great discomfort. The pain resolved with rest. He denies
,NR509ADVANCED PHYSICAL ASSESSMENT
fever, chills, rash, upper respiratory symptoms, trauma, or injury to the neck.
Based on this description, what is the most likely pathologic process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic
C) Degenerative
The description is most consistent with degenerative arthritis in the neck. The
patient has had intermittent symptoms and the questions asked to elicit
pertinent negative and positive findings are negative for infectious, traumatic,
or neoplastic disease.
A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-
week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain;
and nonproductive cough. Which is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular
C) Allergic
,NR509ADVANCED PHYSICAL ASSESSMENT
This description is most consistent with allergic rhinitis.
A 19-year old-college student presents to the emergency room with fever,
headache, and neck pain/stiffness. She is concerned about the possibility of
meningococcal meningitis.Several of her dorm mates have been vaccinated,
but she hasn't been. Which of the following physical examination descriptions
is most consistent with meningitis?
A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple
with full range of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck tender to palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck supple with full range of motion
C) Head is normocephalic and atraumatic, fundi with blurred disc margins,
neck tender topalpation, unable to perform range of motion
Blurred disc margins are consistent with papilledema, and neck tenderness and
lack of range of motion are consistent with neck stiffness, which in this
scenario is likely to be caused by meningeal inflammation. Kernig's and
Brudzinski's signs are also helpful in testing for meningeal irritation on exam.
, NR509ADVANCED PHYSICAL ASSESSMENT
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) Abdomen is soft, nontender, and nondistended, without
hepatosplenomegaly or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant,
without rebound or guarding.
C) 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.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or guarding.
C) 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.
In cholecystitis, the pain, which originates from the gallbladder, is located in
the right upper quadrant. Severity of pain with inspiration that is sufficient to
stop further inhalation is also known as Murphy's sign, which, if present, is
further indicative of inflammation of the gallbladder.
A 55-year-old data entry operator comes to the clinic to establish care. She has
the following symptoms: headache, neck pain, sinus congestion, sore throat,
ringing in ears, sharp brief chest pains at rest, burning abdominal pain with
