NR509 ADVANCED PHYSICAL ASSESSMENT FINAL PRACTICE EXAM CHAMBERLAIN COLLEGE OF NURSING QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES GRADED A+ LATEST

NR509 ADVANCED PHYSICAL ASSESSMENT FINAL PRACTICE EXAM
CHAMBERLAIN COLLEGE OF NURSING QUESTIONS AND VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
Course
NR 509
Question 1
During palpation of the thyroid gland, the examiner asks the patient to swallow water. What is
the primary reason for this maneuver?
A. To evaluate carotid artery patency
B. To identify thyroid movement during swallowing
C. To assess tracheal deviation
D. To evaluate vocal cord function
Answer: B
Rationale:
The thyroid gland normally moves upward during swallowing because it is attached to the
trachea and larynx. Failure to move may indicate fixation from malignancy or fibrosis.



Question 2
A patient presents with unilateral facial drooping involving the forehead, inability to close one
eye, and drooping of the mouth. Which diagnosis is most likely?
A. Stroke involving the cerebral cortex
B. Bell's palsy (CN VII lesion)
C. Trigeminal neuralgia
D. Myasthenia gravis
Answer: B
Rationale:
Bell's palsy affects the entire ipsilateral face, including the forehead. Central strokes typically
spare the forehead because of bilateral cortical innervation.



Question 3
A positive Murphy's sign most strongly suggests:

,A. Appendicitis
B. Cholecystitis
C. Splenomegaly
D. Pancreatitis
Answer: B
Rationale:
Murphy's sign is inspiratory arrest caused by pain during palpation of the right upper quadrant
over the gallbladder and is highly suggestive of acute cholecystitis.



Question 4
When performing an abdominal examination, which sequence is correct?
A. Inspection, percussion, palpation, auscultation
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, palpation, percussion
D. Inspection, palpation, percussion, auscultation
Answer: B
Rationale:
Palpation and percussion may alter bowel sounds; therefore, auscultation is performed
immediately after inspection.



Question 5
A patient reports severe tearing chest pain radiating to the back. Which condition should be
considered first?
A. Stable angina
B. Gastroesophageal reflux disease
C. Aortic dissection
D. Costochondritis
Answer: C

,Rationale:
Sudden tearing chest pain radiating to the back is classic for an aortic dissection and requires
emergency evaluation.



Question 6
The Romberg test primarily evaluates:
A. Cerebellar function only
B. Vestibular function and proprioception
C. Motor strength
D. Cranial nerve II
Answer: B
Rationale:
The Romberg test assesses proprioception and vestibular integrity by comparing balance with
eyes open versus closed.



Question 7
A patient demonstrates a resting tremor that improves with purposeful movement. This finding is
most consistent with:
A. Essential tremor
B. Parkinson disease
C. Multiple sclerosis
D. Cerebellar lesion
Answer: B
Rationale:
Parkinson disease classically presents with a resting "pill-rolling" tremor that diminishes during
voluntary movement.



Question 8
Which heart sound is considered normal in many children and young adults but may indicate
heart failure in older adults?

, A. S1
B. S2
C. S3
D. Opening snap
Answer: C
Rationale:
An S3 is physiologic in youth but often indicates volume overload or left ventricular dysfunction
in adults over 40 years.



Question 9
A patient has diminished sensation over the lateral forearm. Which cervical nerve root is most
likely affected?
A. C4
B. C5
C. C6
D. C8
Answer: C
Rationale:
The C6 dermatome includes the lateral forearm and thumb.



Question 10
Which physical finding is most concerning for bacterial meningitis?
A. Positive Kernig sign
B. Positive Tinel sign
C. Positive McMurray test
D. Positive Phalen test
Answer: A
Rationale:
Kernig's sign reflects meningeal irritation and is associated with meningitis.