NR 509 Advanced Physical
Assessment Final Exam Questions
and Answers Latest
2026/2027(100% Guaranteed
success)
Course
NR 509
1. Which question is most appropriate when beginning the history of present illness?
A. “You don't smoke, correct?”
B. “Can you tell me more about what brought you in today?”
C. “Is your pain caused by arthritis?”
D. “You have had this problem before, haven't you?”
Answer: B. “Can you tell me more about what brought you in today?”
Rationale: An open-ended question encourages the patient to describe the chief concern in
their own words without prematurely directing the history toward a particular diagnosis.
2. Which component of the history describes the patient's current symptoms in detail?
A. Family history
B. Social history
C. History of present illness
D. Past surgical history
Answer: C. History of present illness
Rationale: The HPI expands the chief complaint by describing onset, location, duration,
characteristics, aggravating/relieving factors, associated symptoms, and other relevant details.
3. When assessing pain, which mnemonic is commonly useful for obtaining a structured
history?
A. FAST
B. OLD CARTS
C. ABCDE only
D. SAMPLE only
,Answer: B. OLD CARTS
Rationale: OLD CARTS can organize information about onset, location, duration, characteristics,
aggravating/alleviating factors, radiation, timing, and severity.
4. A patient reports chest discomfort that began while walking uphill and resolves after
resting. Which feature is most concerning for myocardial ischemia?
A. Pain reproducible with light palpation
B. Exertional onset with relief at rest
C. Pain occurring only after eating spicy food
D. Pain lasting one second when turning the head
Answer: B. Exertional onset with relief at rest
Rationale: Exertional chest pressure or discomfort relieved by rest is a classic pattern of
myocardial ischemia and requires appropriate cardiovascular evaluation.
5. Which finding is most concerning when assessing a patient's general appearance?
A. Relaxed posture
B. Appropriate eye contact
C. Severe respiratory distress
D. Clean clothing
Answer: C. Severe respiratory distress
Rationale: Respiratory distress is an immediate potential threat to life and requires prompt
assessment of airway, breathing, oxygenation, and circulation.
6. What is the correct sequence for examining the abdomen?
A. Palpation, percussion, auscultation, inspection
B. Inspection, auscultation, percussion, palpation
C. Auscultation, palpation, inspection, percussion
D. Percussion, inspection, palpation, auscultation
Answer: B. Inspection, auscultation, percussion, palpation
Rationale: Auscultation is performed before percussion and palpation because manipulating the
abdomen can alter bowel sounds.
7. A patient has right upper quadrant abdominal pain after fatty meals. Which organ should
receive particular attention?
,A. Gallbladder
B. Bladder
C. Spleen
D. Thyroid
Answer: A. Gallbladder
Rationale: Right upper quadrant pain associated with fatty meals can occur with gallbladder
disease, particularly biliary colic or cholecystitis.
8. Which abdominal finding is most concerning?
A. Mild tympany
B. Soft abdomen
C. Rigid abdomen with severe tenderness
D. Active bowel sounds
Answer: C. Rigid abdomen with severe tenderness
Rationale: Rigidity and severe tenderness may indicate peritoneal irritation, such as perforation
or peritonitis, and require urgent evaluation.
9. Which heart sound is normally associated with closure of the mitral and tricuspid valves?
A. S1
B. S2
C. S3
D. S4
Answer: A. S1
Rationale: S1 results primarily from closure of the atrioventricular valves at the beginning of
ventricular systole.
10. Which heart sound is produced primarily by closure of the aortic and pulmonic valves?
A. S1
B. S2
C. S3
D. S4
Answer: B. S2
Rationale: S2 occurs at the end of ventricular systole when the semilunar valves close.
, 11. An S3 gallop in an older adult with dyspnea and peripheral edema should raise concern
for:
A. Heart failure
B. Otitis media
C. Migraine
D. Peripheral neuropathy
Answer: A. Heart failure
Rationale: An S3 in an older adult, particularly when accompanied by dyspnea and fluid-
retention findings, may indicate ventricular volume overload and heart failure.
12. What is the most appropriate technique for assessing jugular venous pressure?
A. Examine the neck with the patient completely upright
B. Assess the neck veins with the patient appropriately positioned, commonly around 30–45
degrees
C. Palpate the carotid artery and call it JVP
D. Have the patient stand during examination
Answer: B. Assess the neck veins with the patient appropriately positioned, commonly
around 30–45 degrees
Rationale: Proper positioning allows visualization of venous pulsations and estimation of jugular
venous pressure.
13. Which finding suggests peripheral arterial disease?
A. Warm feet with strong pulses
B. Dependent rubor and diminished peripheral pulses
C. Bilateral pitting edema only
D. Bounding pedal pulses
Answer: B. Dependent rubor and diminished peripheral pulses
Rationale: Arterial insufficiency can produce diminished pulses, cool extremities, pallor with
elevation, and dependent rubor.
14. Which finding is most consistent with chronic venous insufficiency?
A. Dependent edema
B. Absent venous pressure
C. Severe pallor with elevation only
D. Bounding arterial pulses as the defining feature
Assessment Final Exam Questions
and Answers Latest
2026/2027(100% Guaranteed
success)
Course
NR 509
1. Which question is most appropriate when beginning the history of present illness?
A. “You don't smoke, correct?”
B. “Can you tell me more about what brought you in today?”
C. “Is your pain caused by arthritis?”
D. “You have had this problem before, haven't you?”
Answer: B. “Can you tell me more about what brought you in today?”
Rationale: An open-ended question encourages the patient to describe the chief concern in
their own words without prematurely directing the history toward a particular diagnosis.
2. Which component of the history describes the patient's current symptoms in detail?
A. Family history
B. Social history
C. History of present illness
D. Past surgical history
Answer: C. History of present illness
Rationale: The HPI expands the chief complaint by describing onset, location, duration,
characteristics, aggravating/relieving factors, associated symptoms, and other relevant details.
3. When assessing pain, which mnemonic is commonly useful for obtaining a structured
history?
A. FAST
B. OLD CARTS
C. ABCDE only
D. SAMPLE only
,Answer: B. OLD CARTS
Rationale: OLD CARTS can organize information about onset, location, duration, characteristics,
aggravating/alleviating factors, radiation, timing, and severity.
4. A patient reports chest discomfort that began while walking uphill and resolves after
resting. Which feature is most concerning for myocardial ischemia?
A. Pain reproducible with light palpation
B. Exertional onset with relief at rest
C. Pain occurring only after eating spicy food
D. Pain lasting one second when turning the head
Answer: B. Exertional onset with relief at rest
Rationale: Exertional chest pressure or discomfort relieved by rest is a classic pattern of
myocardial ischemia and requires appropriate cardiovascular evaluation.
5. Which finding is most concerning when assessing a patient's general appearance?
A. Relaxed posture
B. Appropriate eye contact
C. Severe respiratory distress
D. Clean clothing
Answer: C. Severe respiratory distress
Rationale: Respiratory distress is an immediate potential threat to life and requires prompt
assessment of airway, breathing, oxygenation, and circulation.
6. What is the correct sequence for examining the abdomen?
A. Palpation, percussion, auscultation, inspection
B. Inspection, auscultation, percussion, palpation
C. Auscultation, palpation, inspection, percussion
D. Percussion, inspection, palpation, auscultation
Answer: B. Inspection, auscultation, percussion, palpation
Rationale: Auscultation is performed before percussion and palpation because manipulating the
abdomen can alter bowel sounds.
7. A patient has right upper quadrant abdominal pain after fatty meals. Which organ should
receive particular attention?
,A. Gallbladder
B. Bladder
C. Spleen
D. Thyroid
Answer: A. Gallbladder
Rationale: Right upper quadrant pain associated with fatty meals can occur with gallbladder
disease, particularly biliary colic or cholecystitis.
8. Which abdominal finding is most concerning?
A. Mild tympany
B. Soft abdomen
C. Rigid abdomen with severe tenderness
D. Active bowel sounds
Answer: C. Rigid abdomen with severe tenderness
Rationale: Rigidity and severe tenderness may indicate peritoneal irritation, such as perforation
or peritonitis, and require urgent evaluation.
9. Which heart sound is normally associated with closure of the mitral and tricuspid valves?
A. S1
B. S2
C. S3
D. S4
Answer: A. S1
Rationale: S1 results primarily from closure of the atrioventricular valves at the beginning of
ventricular systole.
10. Which heart sound is produced primarily by closure of the aortic and pulmonic valves?
A. S1
B. S2
C. S3
D. S4
Answer: B. S2
Rationale: S2 occurs at the end of ventricular systole when the semilunar valves close.
, 11. An S3 gallop in an older adult with dyspnea and peripheral edema should raise concern
for:
A. Heart failure
B. Otitis media
C. Migraine
D. Peripheral neuropathy
Answer: A. Heart failure
Rationale: An S3 in an older adult, particularly when accompanied by dyspnea and fluid-
retention findings, may indicate ventricular volume overload and heart failure.
12. What is the most appropriate technique for assessing jugular venous pressure?
A. Examine the neck with the patient completely upright
B. Assess the neck veins with the patient appropriately positioned, commonly around 30–45
degrees
C. Palpate the carotid artery and call it JVP
D. Have the patient stand during examination
Answer: B. Assess the neck veins with the patient appropriately positioned, commonly
around 30–45 degrees
Rationale: Proper positioning allows visualization of venous pulsations and estimation of jugular
venous pressure.
13. Which finding suggests peripheral arterial disease?
A. Warm feet with strong pulses
B. Dependent rubor and diminished peripheral pulses
C. Bilateral pitting edema only
D. Bounding pedal pulses
Answer: B. Dependent rubor and diminished peripheral pulses
Rationale: Arterial insufficiency can produce diminished pulses, cool extremities, pallor with
elevation, and dependent rubor.
14. Which finding is most consistent with chronic venous insufficiency?
A. Dependent edema
B. Absent venous pressure
C. Severe pallor with elevation only
D. Bounding arterial pulses as the defining feature
