NR509 MIDTERM Advanced Physical Assessment
- NR509 Examplify Online Proctored Exam
Newest 2025/2026 Complete Actual Screenshot
Exam. CHAMBERLAIN UNIVERSITY COLLEGE OF
NURSING
SECTION A: GENERAL SURVEY AND VITAL SIGNS
QUESTION 1
A 72-year-old male presents for a routine physical examination.
During the general survey, you note that he appears older than his
stated age, has a stooped posture, and walks with a shuffling gait. His
facial expression is masked and he has a resting tremor of his right
hand. Which of the following conditions is most suggested by these
findings?
A) Alzheimer's disease
B) Parkinson's disease
C) Normal age-related changes
D) Cervical spondylosis
,Correct Answer: B
Rationale: The combination of a stooped posture, shuffling gait, masked
facies, and resting tremor is classic for Parkinson's disease. This is a
neurodegenerative disorder affecting the basal ganglia. While some
age-related changes can cause decreased mobility, the specific triad of
tremor, rigidity, and bradykinesia is pathognomonic for Parkinson's
disease. Alzheimer's disease primarily presents with cognitive decline
rather than motor symptoms.
QUESTION 2
When assessing a patient's body mass index, the nurse practitioner
understands that a BMI of 32 kg/m² falls into which of the following
categories?
A) Normal weight
B) Overweight
C) Class I obesity
D) Class II obesity
Correct Answer: C
Rationale: The World Health Organization classifies obesity based on
BMI measurements. A BMI between 30.0 and 34.9 kg/m² is classified as
Class I obesity. Normal weight ranges from 18.5 to 24.9, overweight
from 25.0 to 29.9, and Class II obesity from 35.0 to 39.9. Class III obesity,
also known as morbid obesity, is defined as a BMI of 40 or greater. This
classification helps guide clinical management and risk assessment for
obesity-related comorbidities.
,QUESTION 3
A patient's blood pressure is measured as 148/92 mmHg in both arms
on two separate occasions. The patient has no symptoms and no
history of hypertension. Which of the following is the most
appropriate next step?
A) Reassure the patient and schedule a follow-up in one year
B) Diagnose hypertension and initiate pharmacologic therapy
immediately
C) Confirm the reading with ambulatory blood pressure monitoring
D) Order a complete metabolic panel and electrocardiogram
Correct Answer: C
Rationale: According to current hypertension guidelines, a diagnosis of
hypertension should be confirmed with ambulatory blood pressure
monitoring or home blood pressure monitoring before initiating
treatment. A single elevated reading in the office requires confirmation,
as white coat hypertension is a common phenomenon. While a
metabolic panel and ECG are appropriate for end-organ damage
assessment, the first step is confirming the diagnosis. Immediate
pharmacologic therapy without confirmation could lead to
overtreatment of white coat hypertension.
QUESTION 4
The nurse practitioner auscultates a patient's blood pressure and hears
a clear tapping sound that suddenly becomes muffled and then
disappears. The pressure at which the tapping sound disappears
completely is recorded as the:
, A) Systolic pressure
B) Diastolic pressure
C) Pulse pressure
D) Mean arterial pressure
Correct Answer: B
Rationale: The diastolic blood pressure is recorded as the point at which
Korotkoff sounds disappear completely, which is the fifth Korotkoff
phase. The systolic pressure is recorded as the first appearance of clear
tapping sounds. Pulse pressure is the difference between systolic and
diastolic pressures. Mean arterial pressure is calculated using a formula
involving systolic and diastolic pressures. In some patients with high
cardiac output, Korotkoff sounds may persist to zero, which requires
clinical correlation.
QUESTION 5
A 45-year-old patient presents with a fever of 102.4°F, heart rate of
112 beats per minute, respiratory rate of 24 breaths per minute, and
blood pressure of 90/60 mmHg. Which of the following best describes
this patient's condition?
A) Sepsis
B) Systemic inflammatory response syndrome
C) Septic shock
D) Bacteremia
Correct Answer: C
Rationale: The patient meets criteria for sepsis with evidence of
infection, fever, tachycardia, and tachypnea. However, the presence of
- NR509 Examplify Online Proctored Exam
Newest 2025/2026 Complete Actual Screenshot
Exam. CHAMBERLAIN UNIVERSITY COLLEGE OF
NURSING
SECTION A: GENERAL SURVEY AND VITAL SIGNS
QUESTION 1
A 72-year-old male presents for a routine physical examination.
During the general survey, you note that he appears older than his
stated age, has a stooped posture, and walks with a shuffling gait. His
facial expression is masked and he has a resting tremor of his right
hand. Which of the following conditions is most suggested by these
findings?
A) Alzheimer's disease
B) Parkinson's disease
C) Normal age-related changes
D) Cervical spondylosis
,Correct Answer: B
Rationale: The combination of a stooped posture, shuffling gait, masked
facies, and resting tremor is classic for Parkinson's disease. This is a
neurodegenerative disorder affecting the basal ganglia. While some
age-related changes can cause decreased mobility, the specific triad of
tremor, rigidity, and bradykinesia is pathognomonic for Parkinson's
disease. Alzheimer's disease primarily presents with cognitive decline
rather than motor symptoms.
QUESTION 2
When assessing a patient's body mass index, the nurse practitioner
understands that a BMI of 32 kg/m² falls into which of the following
categories?
A) Normal weight
B) Overweight
C) Class I obesity
D) Class II obesity
Correct Answer: C
Rationale: The World Health Organization classifies obesity based on
BMI measurements. A BMI between 30.0 and 34.9 kg/m² is classified as
Class I obesity. Normal weight ranges from 18.5 to 24.9, overweight
from 25.0 to 29.9, and Class II obesity from 35.0 to 39.9. Class III obesity,
also known as morbid obesity, is defined as a BMI of 40 or greater. This
classification helps guide clinical management and risk assessment for
obesity-related comorbidities.
,QUESTION 3
A patient's blood pressure is measured as 148/92 mmHg in both arms
on two separate occasions. The patient has no symptoms and no
history of hypertension. Which of the following is the most
appropriate next step?
A) Reassure the patient and schedule a follow-up in one year
B) Diagnose hypertension and initiate pharmacologic therapy
immediately
C) Confirm the reading with ambulatory blood pressure monitoring
D) Order a complete metabolic panel and electrocardiogram
Correct Answer: C
Rationale: According to current hypertension guidelines, a diagnosis of
hypertension should be confirmed with ambulatory blood pressure
monitoring or home blood pressure monitoring before initiating
treatment. A single elevated reading in the office requires confirmation,
as white coat hypertension is a common phenomenon. While a
metabolic panel and ECG are appropriate for end-organ damage
assessment, the first step is confirming the diagnosis. Immediate
pharmacologic therapy without confirmation could lead to
overtreatment of white coat hypertension.
QUESTION 4
The nurse practitioner auscultates a patient's blood pressure and hears
a clear tapping sound that suddenly becomes muffled and then
disappears. The pressure at which the tapping sound disappears
completely is recorded as the:
, A) Systolic pressure
B) Diastolic pressure
C) Pulse pressure
D) Mean arterial pressure
Correct Answer: B
Rationale: The diastolic blood pressure is recorded as the point at which
Korotkoff sounds disappear completely, which is the fifth Korotkoff
phase. The systolic pressure is recorded as the first appearance of clear
tapping sounds. Pulse pressure is the difference between systolic and
diastolic pressures. Mean arterial pressure is calculated using a formula
involving systolic and diastolic pressures. In some patients with high
cardiac output, Korotkoff sounds may persist to zero, which requires
clinical correlation.
QUESTION 5
A 45-year-old patient presents with a fever of 102.4°F, heart rate of
112 beats per minute, respiratory rate of 24 breaths per minute, and
blood pressure of 90/60 mmHg. Which of the following best describes
this patient's condition?
A) Sepsis
B) Systemic inflammatory response syndrome
C) Septic shock
D) Bacteremia
Correct Answer: C
Rationale: The patient meets criteria for sepsis with evidence of
infection, fever, tachycardia, and tachypnea. However, the presence of
