NR509 ADVANCED PHYSICAL
ASSESSMENT FINAL EXAM REVIEW 300
PRACTICE QUESTIONS WITH VERIFIED &
ANSWERS | ALREADY GRADED A+ | MOST
RECENT | GUARANTEED PASS
Section 1: General Assessment & Clinical Reasoning
1. A client presents with right lower quadrant (RLQ) pain. Which finding is most
specific for acute appendicitis?
A. Diffuse abdominal tenderness
B. Hyperactive bowel sounds
C. McBurney point tenderness
D. Abdominal distention
Answer: C. McBurney point tenderness
2. A nurse palpates the left lower quadrant (LLQ) and the client reports pain in
the RLQ. This is documented as:
A. Psoas sign
B. Obturator sign
C. Rovsing sign
D. Murphy sign
Answer: C. Rovsing sign
3. A client with RLQ pain reports increased pain when extending the right hip.
The nurse documents this as a positive:
A. Obturator sign
B. Rovsing sign
C. Psoas sign
D. Blumberg sign
Answer: C. Psoas sign
4. Which maneuver is performed to assess for Murphy's sign?
A. Palpate the LLQ and quickly release pressure.
B. Hook fingers under the right costal margin and ask the client to inhale deeply.
C. Ask the client to flex the right hip and knee and internally rotate the hip.
,D. Percuss the right lower chest for dullness.
Answer: B. Hook fingers under the right costal margin and ask the client to
inhale deeply.
5. A client with acute pancreatitis would likely report pain is relieved by which
position?
A. Lying supine
B. Lying on the right side
C. Leaning forward or sitting up
D. Lying in the Trendelenburg position
Answer: C. Leaning forward or sitting up
6. Which of the following is considered a "red flag" symptom in a patient
presenting with a headache?
A. Photophobia
B. Nausea with vomiting
C. Thunderclap onset
D. Unilateral location
Answer: C. Thunderclap onset
7. The "review of systems" (ROS) differs from the HPI because the ROS:
A. Is a complete inventory of body systems for positive and negative responses.
B. Focuses solely on the chief complaint.
C. Is only completed by the patient on a form.
D. Is a legal document that cannot be modified.
Answer: A. Is a complete inventory of body systems for positive and negative
responses.
8. The FIFE model in clinical interviewing includes:
A. Focus, Intensity, Function, Evaluation
B. Facts, Impression, Findings, Evidence
C. Feelings, Ideas, Function, Expectations
D. Fear, Insight, Feelings, Education
Answer: C. Feelings, Ideas, Function, Expectations
9. A patient reports using "herbal supplements" for sleep. This information
should be documented under:
A. Past medical history
B. Family history
C. Social history
D. Medications
Answer: D. Medications
10. The "BATHE" mnemonic is used to:
A. Screen for depression
,B. Assess a patient's psychosocial context
C. Evaluate a patient's functional status
D. Identify substance use disorders
Answer: B. Assess a patient's psychosocial context
11. A patient presents for evaluation of a sharp, aching chest pain which
increases with breathing. Which anatomic area would you localize the symptom
to?
A. Reproductive
B. Urinary
C. Endocrine
D. Musculoskeletal
Answer: D. Musculoskeletal
Section 2: HEENT & Neurological Assessment
12. A 45-year-old patient has a right pupil that is constricted and does not react
to light, and a right eyelid that is drooping. What condition should be
suspected?
A. Horner's syndrome
B. Third nerve palsy
C. Marcus Gunn pupil
D. Adie's tonic pupil
Answer: A. Horner's syndrome
13. Which cranial nerve is assessed by testing the gag reflex?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
Answer: B. CN X (Vagus)
14. On inspection, a patient's head is laterally deviated toward the shoulder and
rotated. This finding is consistent with:
A. Ankylosing spondylitis
B. Osteoarthritis (OA)
C. Torticollis
D. Spondylolisthesis
Answer: C. Torticollis
15. Which of the following is the most appropriate technique for assessing for
the presence of a pleural effusion?
A. Auscultation for bronchial breath sounds.
B. Percussion for dullness over the affected area.
, C. Palpation for tactile fremitus.
D. Inspection for asymmetrical chest expansion.
Answer: B. Percussion for dullness over the affected area.
Section 3: Cardiovascular & Respiratory
16. Which description best matches the characteristics of a vesicular breath
sound?
A. Inspiration is longer than expiration, with a soft, low-pitched quality.
B. Expiration is longer than inspiration, with a high-pitched, blowing quality.
C. Inspiration and expiration are equal in duration, with a medium-pitched quality.
D. A harsh, grating sound heard during both inspiration and expiration.
Answer: A. Inspiration is longer than expiration, with a soft, low-pitched
quality.
17. A patient with a history of COPD presents with increased shortness of
breath and a barrel chest. This finding is best explained by:
A. Flattening of the diaphragm due to hyperinflation.
B. Pleural effusion causing lung compression.
C. Kyphoscoliosis altering chest wall structure.
D. Pneumothorax causing lung collapse.
Answer: A. Flattening of the diaphragm due to hyperinflation.
18. Which physical examination finding is most specific for an abdominal aortic
aneurysm (AAA)?
A. A palpable, pulsatile, non-tender mass in the epigastric region.
B. A bruit audible over the abdominal aorta.
C. Pulsatile mass in the periumbilical area that is expansile.
D. Auscultation of a venous hum over the umbilicus.
Answer: C. Pulsatile mass in the periumbilical area that is expansile.
19. Which physical examination maneuver is most appropriate to confirm a
bruit in a patient with suspected renal artery stenosis?
A. Auscultation with the bell of the stethoscope over the costovertebral angles.
B. Palpation of the abdomen for a pulsatile mass.
C. Auscultation with the diaphragm of the stethoscope over the abdominal aorta.
D. Percussion of the abdomen to assess for ascites.
Answer: A. Auscultation with the bell of the stethoscope over the
costovertebral angles.
Section 4: Musculoskeletal & Abdominal
20. Which muscle is the primary knee extensor?
A. Biceps femoris
ASSESSMENT FINAL EXAM REVIEW 300
PRACTICE QUESTIONS WITH VERIFIED &
ANSWERS | ALREADY GRADED A+ | MOST
RECENT | GUARANTEED PASS
Section 1: General Assessment & Clinical Reasoning
1. A client presents with right lower quadrant (RLQ) pain. Which finding is most
specific for acute appendicitis?
A. Diffuse abdominal tenderness
B. Hyperactive bowel sounds
C. McBurney point tenderness
D. Abdominal distention
Answer: C. McBurney point tenderness
2. A nurse palpates the left lower quadrant (LLQ) and the client reports pain in
the RLQ. This is documented as:
A. Psoas sign
B. Obturator sign
C. Rovsing sign
D. Murphy sign
Answer: C. Rovsing sign
3. A client with RLQ pain reports increased pain when extending the right hip.
The nurse documents this as a positive:
A. Obturator sign
B. Rovsing sign
C. Psoas sign
D. Blumberg sign
Answer: C. Psoas sign
4. Which maneuver is performed to assess for Murphy's sign?
A. Palpate the LLQ and quickly release pressure.
B. Hook fingers under the right costal margin and ask the client to inhale deeply.
C. Ask the client to flex the right hip and knee and internally rotate the hip.
,D. Percuss the right lower chest for dullness.
Answer: B. Hook fingers under the right costal margin and ask the client to
inhale deeply.
5. A client with acute pancreatitis would likely report pain is relieved by which
position?
A. Lying supine
B. Lying on the right side
C. Leaning forward or sitting up
D. Lying in the Trendelenburg position
Answer: C. Leaning forward or sitting up
6. Which of the following is considered a "red flag" symptom in a patient
presenting with a headache?
A. Photophobia
B. Nausea with vomiting
C. Thunderclap onset
D. Unilateral location
Answer: C. Thunderclap onset
7. The "review of systems" (ROS) differs from the HPI because the ROS:
A. Is a complete inventory of body systems for positive and negative responses.
B. Focuses solely on the chief complaint.
C. Is only completed by the patient on a form.
D. Is a legal document that cannot be modified.
Answer: A. Is a complete inventory of body systems for positive and negative
responses.
8. The FIFE model in clinical interviewing includes:
A. Focus, Intensity, Function, Evaluation
B. Facts, Impression, Findings, Evidence
C. Feelings, Ideas, Function, Expectations
D. Fear, Insight, Feelings, Education
Answer: C. Feelings, Ideas, Function, Expectations
9. A patient reports using "herbal supplements" for sleep. This information
should be documented under:
A. Past medical history
B. Family history
C. Social history
D. Medications
Answer: D. Medications
10. The "BATHE" mnemonic is used to:
A. Screen for depression
,B. Assess a patient's psychosocial context
C. Evaluate a patient's functional status
D. Identify substance use disorders
Answer: B. Assess a patient's psychosocial context
11. A patient presents for evaluation of a sharp, aching chest pain which
increases with breathing. Which anatomic area would you localize the symptom
to?
A. Reproductive
B. Urinary
C. Endocrine
D. Musculoskeletal
Answer: D. Musculoskeletal
Section 2: HEENT & Neurological Assessment
12. A 45-year-old patient has a right pupil that is constricted and does not react
to light, and a right eyelid that is drooping. What condition should be
suspected?
A. Horner's syndrome
B. Third nerve palsy
C. Marcus Gunn pupil
D. Adie's tonic pupil
Answer: A. Horner's syndrome
13. Which cranial nerve is assessed by testing the gag reflex?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
Answer: B. CN X (Vagus)
14. On inspection, a patient's head is laterally deviated toward the shoulder and
rotated. This finding is consistent with:
A. Ankylosing spondylitis
B. Osteoarthritis (OA)
C. Torticollis
D. Spondylolisthesis
Answer: C. Torticollis
15. Which of the following is the most appropriate technique for assessing for
the presence of a pleural effusion?
A. Auscultation for bronchial breath sounds.
B. Percussion for dullness over the affected area.
, C. Palpation for tactile fremitus.
D. Inspection for asymmetrical chest expansion.
Answer: B. Percussion for dullness over the affected area.
Section 3: Cardiovascular & Respiratory
16. Which description best matches the characteristics of a vesicular breath
sound?
A. Inspiration is longer than expiration, with a soft, low-pitched quality.
B. Expiration is longer than inspiration, with a high-pitched, blowing quality.
C. Inspiration and expiration are equal in duration, with a medium-pitched quality.
D. A harsh, grating sound heard during both inspiration and expiration.
Answer: A. Inspiration is longer than expiration, with a soft, low-pitched
quality.
17. A patient with a history of COPD presents with increased shortness of
breath and a barrel chest. This finding is best explained by:
A. Flattening of the diaphragm due to hyperinflation.
B. Pleural effusion causing lung compression.
C. Kyphoscoliosis altering chest wall structure.
D. Pneumothorax causing lung collapse.
Answer: A. Flattening of the diaphragm due to hyperinflation.
18. Which physical examination finding is most specific for an abdominal aortic
aneurysm (AAA)?
A. A palpable, pulsatile, non-tender mass in the epigastric region.
B. A bruit audible over the abdominal aorta.
C. Pulsatile mass in the periumbilical area that is expansile.
D. Auscultation of a venous hum over the umbilicus.
Answer: C. Pulsatile mass in the periumbilical area that is expansile.
19. Which physical examination maneuver is most appropriate to confirm a
bruit in a patient with suspected renal artery stenosis?
A. Auscultation with the bell of the stethoscope over the costovertebral angles.
B. Palpation of the abdomen for a pulsatile mass.
C. Auscultation with the diaphragm of the stethoscope over the abdominal aorta.
D. Percussion of the abdomen to assess for ascites.
Answer: A. Auscultation with the bell of the stethoscope over the
costovertebral angles.
Section 4: Musculoskeletal & Abdominal
20. Which muscle is the primary knee extensor?
A. Biceps femoris
