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NR 509 Advanced Physical Assessment Final
Exam | Latest 2026 Update | Questions &
Answers PDF
1. A 35yearold female with a history of migraines presents to the clinic
with worsening symptoms for the past few weeks. She reports waking
up at night with headaches and nausea. Her only medication history is
oral contraceptive pills (OCPs). Otherwise, she states she is healthy.
Which of the following actions if taken by the NP is the best next step?
A) Order an immediate CT scan of the head
B) Discontinue the oral contraceptive pills
C) Prescribe a triptan medication for acute relief
D) Take a further history and perform a very careful neurological exam
E) Refer to neurology for specialist consultation
Correct Answer: D. A thorough history and neurological examination
are essential before making any diagnostic or therapeutic decisions, as
the combination of OCP use and newonset nocturnal headaches with
nausea raises concern for increased intracranial pressure or other serious
pathology.
@SMARTDOCTOR007 1
,2
2. A grandmother is accompanying her 9yearold granddaughter during a
routine physical examination. She asks you privately if her
granddaughter has started puberty yet. During the examination, the NP
notes asymmetric projection of the areola and nipple of the right chest to
form a secondary mound above the level of the breast. The left breast is
underdeveloped. These assessment findings are consistent with which
Tanner Stage of development?
A) I
B) II
C) III
D) IV
E) V
Correct Answer: D. Tanner Stage IV is characterized by projection of
the areola and nipple to form a secondary mound above the breast level,
with asymmetric development being common during this stage of
pubertal progression.
3. Primary prevention is defined as which of the following?
A) Early detection of disease through screening tests
B) Interventions designed to prevent disease before it occurs
C) Treatment to prevent complications of an existing disease
D) Rehabilitation after disease has caused impairment
E) Monitoring for recurrence of disease after treatment
@SMARTDOCTOR007 2
,3
Correct Answer: B. Primary prevention involves measures taken to
prevent the onset of disease or injury before it occurs, such as
immunizations, lifestyle modifications, and health education.
4. Based on the U.S. Preventive Services Task Force (USPSTF)
recommendations, which of the following statements is true about
screening for breast cancer in averagerisk women?
A) Mammography is recommended annually for all women starting at
age 40
B) Mammography is recommended every 2 years for women aged 5074
with insufficient evidence for screening women over the age of 75
C) Clinical breast examination should be performed at every annual visit
for women over 40
D) Breast selfexamination is recommended monthly for all women over
40
E) Mammography should be discontinued after age 65
Correct Answer: B. The USPSTF recommends biennial screening
mammography for women aged 5074 years and states that the evidence
is insufficient to assess benefits and harms for women aged 75 and older.
@SMARTDOCTOR007 3
, 4
5. Which of the following statements is true regarding recommendations
by the eighth Joint National Committee (JNC8) for adults aged 60 and
older? Select all that apply.
A) Target blood pressure should be less than 130/80 mmHg for all adults
over 60
B) Target blood pressure should be ≤150/90 mmHg but if treatment
results in SBP <140 and is well tolerated, treatment does not need to be
adjusted
C) In those aged 80 or older, blood pressure targets of 140 to <150/70 to
80 appear optimal
D) All patients over 60 should be treated with at least two
antihypertensive medications
E) Blood pressure targets should be stricter for African American
patients over 60
Correct Answer: B, C. JNC8 recommends a target BP <150/90 for
adults ≥60, noting that if treatment achieves SBP <140 and is well
tolerated, no adjustment is needed. For those ≥80, targets of
140<150/7080 appear optimal for reducing cardiovascular events.
6. Which of the following is a useful strategy when examining young
children between the ages of 1 and 4?
A) Perform the examination from across the room to avoid frightening
the child
@SMARTDOCTOR007 4
NR 509 Advanced Physical Assessment Final
Exam | Latest 2026 Update | Questions &
Answers PDF
1. A 35yearold female with a history of migraines presents to the clinic
with worsening symptoms for the past few weeks. She reports waking
up at night with headaches and nausea. Her only medication history is
oral contraceptive pills (OCPs). Otherwise, she states she is healthy.
Which of the following actions if taken by the NP is the best next step?
A) Order an immediate CT scan of the head
B) Discontinue the oral contraceptive pills
C) Prescribe a triptan medication for acute relief
D) Take a further history and perform a very careful neurological exam
E) Refer to neurology for specialist consultation
Correct Answer: D. A thorough history and neurological examination
are essential before making any diagnostic or therapeutic decisions, as
the combination of OCP use and newonset nocturnal headaches with
nausea raises concern for increased intracranial pressure or other serious
pathology.
@SMARTDOCTOR007 1
,2
2. A grandmother is accompanying her 9yearold granddaughter during a
routine physical examination. She asks you privately if her
granddaughter has started puberty yet. During the examination, the NP
notes asymmetric projection of the areola and nipple of the right chest to
form a secondary mound above the level of the breast. The left breast is
underdeveloped. These assessment findings are consistent with which
Tanner Stage of development?
A) I
B) II
C) III
D) IV
E) V
Correct Answer: D. Tanner Stage IV is characterized by projection of
the areola and nipple to form a secondary mound above the breast level,
with asymmetric development being common during this stage of
pubertal progression.
3. Primary prevention is defined as which of the following?
A) Early detection of disease through screening tests
B) Interventions designed to prevent disease before it occurs
C) Treatment to prevent complications of an existing disease
D) Rehabilitation after disease has caused impairment
E) Monitoring for recurrence of disease after treatment
@SMARTDOCTOR007 2
,3
Correct Answer: B. Primary prevention involves measures taken to
prevent the onset of disease or injury before it occurs, such as
immunizations, lifestyle modifications, and health education.
4. Based on the U.S. Preventive Services Task Force (USPSTF)
recommendations, which of the following statements is true about
screening for breast cancer in averagerisk women?
A) Mammography is recommended annually for all women starting at
age 40
B) Mammography is recommended every 2 years for women aged 5074
with insufficient evidence for screening women over the age of 75
C) Clinical breast examination should be performed at every annual visit
for women over 40
D) Breast selfexamination is recommended monthly for all women over
40
E) Mammography should be discontinued after age 65
Correct Answer: B. The USPSTF recommends biennial screening
mammography for women aged 5074 years and states that the evidence
is insufficient to assess benefits and harms for women aged 75 and older.
@SMARTDOCTOR007 3
, 4
5. Which of the following statements is true regarding recommendations
by the eighth Joint National Committee (JNC8) for adults aged 60 and
older? Select all that apply.
A) Target blood pressure should be less than 130/80 mmHg for all adults
over 60
B) Target blood pressure should be ≤150/90 mmHg but if treatment
results in SBP <140 and is well tolerated, treatment does not need to be
adjusted
C) In those aged 80 or older, blood pressure targets of 140 to <150/70 to
80 appear optimal
D) All patients over 60 should be treated with at least two
antihypertensive medications
E) Blood pressure targets should be stricter for African American
patients over 60
Correct Answer: B, C. JNC8 recommends a target BP <150/90 for
adults ≥60, noting that if treatment achieves SBP <140 and is well
tolerated, no adjustment is needed. For those ≥80, targets of
140<150/7080 appear optimal for reducing cardiovascular events.
6. Which of the following is a useful strategy when examining young
children between the ages of 1 and 4?
A) Perform the examination from across the room to avoid frightening
the child
@SMARTDOCTOR007 4
