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CHAMBERLAIN NR 509 ADVANCED PHYSICAL ASSESSMENT]
ACTUAL QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
*Core Domains:
• Comprehensive Health History and Interviewing
• General Survey and Vital Signs
• Skin, Hair, and Nail Assessment
• Head, Eyes, Ears, Nose, and Throat (HEENT)
• Neck, Thyroid, and Lymphatics
• Respiratory and Cardiovascular Assessment
• Abdominal, Genitourinary, and Rectal Assessment
• Musculoskeletal and Neurological Assessment
• Pediatric, Geriatric, and Pregnant Patient Variations
• Clinical Reasoning, Documentation, and Health Promotion*
Introduction:
This comprehensive advanced physical assessment examination evaluates the
graduate nursing student’s ability to perform systematic, evidence-based health
assessments across the lifespan. The exam assesses history-taking skills,
inspection, palpation, percussion, and auscultation techniques, interpretation of
normal and abnormal findings, and integration of physical assessment data into
clinical reasoning. Multiple-choice and scenario-based questions mirror real
patient encounters, requiring prioritization, accurate documentation, and
culturally sensitive communication. Successful performance confirms readiness to
conduct advanced health assessments and to differentiate common, benign, and
urgent findings in primary care and acute settings.
pg. 1
,2
SECTION ONE: QUESTIONS 1–100
1. A 58-year-old man reports worsening shortness of breath when lying flat.
Which term should the nurse document?
A. Dyspnea on exertion
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Platypnea
B. Orthopnea
RATIONALE: Orthopnea is dyspnea that occurs when the client is lying
flat and improves when sitting up, often due to left-sided heart failure.
Paroxysmal nocturnal dyspnea wakes the client from sleep; dyspnea on
exertion occurs with activity; platypnea is dyspnea relieved by lying down.
2. During a general survey, the nurse observes a client with a barrel-shaped
chest, using pursed-lip breathing, and sitting in a tripod position. These
findings are most consistent with:
A. Acute appendicitis
B. Chronic obstructive pulmonary disease
C. Myocardial infarction
D. Anxiety attack only
B. Chronic obstructive pulmonary disease
RATIONALE: Barrel chest from hyperinflation, pursed-lip breathing, and
tripod positioning to recruit accessory muscles are classic signs of chronic
obstructive pulmonary disease, reflecting increased work of breathing and
air trapping.
3. Which is the correct sequence for abdominal assessment?
A. Palpation, auscultation, inspection, percussion
B. Inspection, auscultation, percussion, palpation
C. Auscultation, palpation, inspection, percussion
D. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation
RATIONALE: Abdominal assessment follows inspection, auscultation,
pg. 2
,3
percussion, then palpation. Auscultation precedes palpation and percussion
because these maneuvers can alter bowel sounds.
4. The nurse asks a client to say “ninety-nine” while auscultating the chest and
notes increased clarity and loudness of the voice through the stethoscope.
This finding is called:
A. Bronchophony
B. Egophony
C. Whispered pectoriloquy
D. Fremitus
A. Bronchophony
RATIONALE: Bronchophony is increased clarity and loudness of spoken
voice over consolidated lung tissue. Egophony is a change of “E” to “A”;
whispered pectoriloquy is whispered words heard clearly. These are signs
of consolidation.
5. A client has a painless, erythematous, vesicular rash in a unilateral
dermatomal distribution on the trunk. The nurse should suspect:
A. Herpes simplex
B. Cellulitis
C. Herpes zoster (shingles)
D. Contact dermatitis
C. Herpes zoster (shingles)
RATIONALE: Herpes zoster (shingles) presents as a painful or burning,
vesicular rash along a dermatome, not crossing the midline. It is caused by
reactivation of varicella-zoster virus. Herpes simplex is usually oral or
genital; cellulitis is diffuse; contact dermatitis is not dermatomal.
6. Which lymph node group is most accessible for palpation just anterior to
the ear?
A. Posterior auricular
B. Preauricular
C. Submental
D. Supraclavicular
B. Preauricular
RATIONALE: Preauricular lymph nodes are located just in front of the
pg. 3
, 4
ear. Posterior auricular are behind the ear; submental are under the chin;
supraclavicular are above the clavicle and may indicate malignancy if
enlarged.
7. The nurse palpates a client’s radial pulse and notes it is absent on the left
but present on the right. Which assessment should be performed first?
A. Check the left pedal pulse only
B. Measure blood pressure in both arms
C. Auscultate the carotid arteries only
D. Document and discharge
B. Measure blood pressure in both arms
RATIONALE: A decreased or absent radial pulse on one side may
indicate arterial occlusion, dissection, or coarctation. Measuring blood
pressure in both arms is essential to identify a significant discrepancy,
which can be a sign of vascular pathology.
8. Which is the correct technique to assess a client’s pupillary light reflex?
A. Shine a light directly into one eye and observe constriction of both pupils
B. Ask the client to focus on a distant object and then on your finger
C. Cover one eye and observe movement of the uncovered eye
D. Use an ophthalmoscope to view the red reflex only
A. Shine a light directly into one eye and observe constriction of both
pupils
RATIONALE: The pupillary light reflex tests the direct and consensual
response: when light is shined in one eye, both ipsilateral (direct) and
contralateral (consensual) pupils should constrict.
9. A client reports hearing a “whooshing” sound in one ear that is
synchronous with the pulse. The nurse should suspect:
A. Tinnitus
B. Bruit or vascular anomaly
C. Meniere disease
D. Otitis media
B. Bruit or vascular anomaly
RATIONALE: Pulsatile tinnitus—a rhythmic whooshing matching the
heartbeat—may indicate a vascular cause such as carotid stenosis,
pg. 4
CHAMBERLAIN NR 509 ADVANCED PHYSICAL ASSESSMENT]
ACTUAL QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
*Core Domains:
• Comprehensive Health History and Interviewing
• General Survey and Vital Signs
• Skin, Hair, and Nail Assessment
• Head, Eyes, Ears, Nose, and Throat (HEENT)
• Neck, Thyroid, and Lymphatics
• Respiratory and Cardiovascular Assessment
• Abdominal, Genitourinary, and Rectal Assessment
• Musculoskeletal and Neurological Assessment
• Pediatric, Geriatric, and Pregnant Patient Variations
• Clinical Reasoning, Documentation, and Health Promotion*
Introduction:
This comprehensive advanced physical assessment examination evaluates the
graduate nursing student’s ability to perform systematic, evidence-based health
assessments across the lifespan. The exam assesses history-taking skills,
inspection, palpation, percussion, and auscultation techniques, interpretation of
normal and abnormal findings, and integration of physical assessment data into
clinical reasoning. Multiple-choice and scenario-based questions mirror real
patient encounters, requiring prioritization, accurate documentation, and
culturally sensitive communication. Successful performance confirms readiness to
conduct advanced health assessments and to differentiate common, benign, and
urgent findings in primary care and acute settings.
pg. 1
,2
SECTION ONE: QUESTIONS 1–100
1. A 58-year-old man reports worsening shortness of breath when lying flat.
Which term should the nurse document?
A. Dyspnea on exertion
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Platypnea
B. Orthopnea
RATIONALE: Orthopnea is dyspnea that occurs when the client is lying
flat and improves when sitting up, often due to left-sided heart failure.
Paroxysmal nocturnal dyspnea wakes the client from sleep; dyspnea on
exertion occurs with activity; platypnea is dyspnea relieved by lying down.
2. During a general survey, the nurse observes a client with a barrel-shaped
chest, using pursed-lip breathing, and sitting in a tripod position. These
findings are most consistent with:
A. Acute appendicitis
B. Chronic obstructive pulmonary disease
C. Myocardial infarction
D. Anxiety attack only
B. Chronic obstructive pulmonary disease
RATIONALE: Barrel chest from hyperinflation, pursed-lip breathing, and
tripod positioning to recruit accessory muscles are classic signs of chronic
obstructive pulmonary disease, reflecting increased work of breathing and
air trapping.
3. Which is the correct sequence for abdominal assessment?
A. Palpation, auscultation, inspection, percussion
B. Inspection, auscultation, percussion, palpation
C. Auscultation, palpation, inspection, percussion
D. Inspection, palpation, percussion, auscultation
B. Inspection, auscultation, percussion, palpation
RATIONALE: Abdominal assessment follows inspection, auscultation,
pg. 2
,3
percussion, then palpation. Auscultation precedes palpation and percussion
because these maneuvers can alter bowel sounds.
4. The nurse asks a client to say “ninety-nine” while auscultating the chest and
notes increased clarity and loudness of the voice through the stethoscope.
This finding is called:
A. Bronchophony
B. Egophony
C. Whispered pectoriloquy
D. Fremitus
A. Bronchophony
RATIONALE: Bronchophony is increased clarity and loudness of spoken
voice over consolidated lung tissue. Egophony is a change of “E” to “A”;
whispered pectoriloquy is whispered words heard clearly. These are signs
of consolidation.
5. A client has a painless, erythematous, vesicular rash in a unilateral
dermatomal distribution on the trunk. The nurse should suspect:
A. Herpes simplex
B. Cellulitis
C. Herpes zoster (shingles)
D. Contact dermatitis
C. Herpes zoster (shingles)
RATIONALE: Herpes zoster (shingles) presents as a painful or burning,
vesicular rash along a dermatome, not crossing the midline. It is caused by
reactivation of varicella-zoster virus. Herpes simplex is usually oral or
genital; cellulitis is diffuse; contact dermatitis is not dermatomal.
6. Which lymph node group is most accessible for palpation just anterior to
the ear?
A. Posterior auricular
B. Preauricular
C. Submental
D. Supraclavicular
B. Preauricular
RATIONALE: Preauricular lymph nodes are located just in front of the
pg. 3
, 4
ear. Posterior auricular are behind the ear; submental are under the chin;
supraclavicular are above the clavicle and may indicate malignancy if
enlarged.
7. The nurse palpates a client’s radial pulse and notes it is absent on the left
but present on the right. Which assessment should be performed first?
A. Check the left pedal pulse only
B. Measure blood pressure in both arms
C. Auscultate the carotid arteries only
D. Document and discharge
B. Measure blood pressure in both arms
RATIONALE: A decreased or absent radial pulse on one side may
indicate arterial occlusion, dissection, or coarctation. Measuring blood
pressure in both arms is essential to identify a significant discrepancy,
which can be a sign of vascular pathology.
8. Which is the correct technique to assess a client’s pupillary light reflex?
A. Shine a light directly into one eye and observe constriction of both pupils
B. Ask the client to focus on a distant object and then on your finger
C. Cover one eye and observe movement of the uncovered eye
D. Use an ophthalmoscope to view the red reflex only
A. Shine a light directly into one eye and observe constriction of both
pupils
RATIONALE: The pupillary light reflex tests the direct and consensual
response: when light is shined in one eye, both ipsilateral (direct) and
contralateral (consensual) pupils should constrict.
9. A client reports hearing a “whooshing” sound in one ear that is
synchronous with the pulse. The nurse should suspect:
A. Tinnitus
B. Bruit or vascular anomaly
C. Meniere disease
D. Otitis media
B. Bruit or vascular anomaly
RATIONALE: Pulsatile tinnitus—a rhythmic whooshing matching the
heartbeat—may indicate a vascular cause such as carotid stenosis,
pg. 4
