NR509 WEEK 8 FINAL EXAM DUE 22ND JUNE 2026 – 3
COMPLETE ACTUAL EXAM QUESTIONS | ADVANCED
PHYSICAL ASSESSMENT | CHAMBERLAIN
UNIVERSITYIntroduction
This comprehensive examination assesses the advanced physical assessment
and clinical reasoning skills required of the family nurse practitioner. It
evaluates history-taking, interviewing techniques, systematic physical
examination, specialized maneuvers, differential diagnosis, and documentation
across the lifespan. Questions are structured in multiple-choice and scenario-
based formats to emphasize real-world application and decision-making. A
strong emphasis is placed on patient-centered care, cultural sensitivity, and the
synthesis of subjective and objective data to formulate accurate diagnoses and
management plans. Candidates must demonstrate the ability to apply
evidence-based assessment principles to diverse clinical presentations.
VERSION 1: QUESTIONS 1–100
1. A 58-year-old male presents with crushing substernal chest pain
radiating to the left arm. The nurse practitioner observes the following
ECG finding. What is the most likely diagnosis?
[Diagram: ECG showing ST-segment elevation in leads V1–V4]
A. Stable angina
B. Anterior wall myocardial infarction
,C. Pericarditis
D. Pulmonary embolism
B
RATIONALE: ST-segment elevation in leads V1–V4 indicates an anterior
wall myocardial infarction due to occlusion of the left anterior descending
artery.
2. A 45-year-old female presents with sudden-onset shortness of breath
and pleuritic chest pain. The nurse practitioner observes the following
chest X-ray finding. What is the most likely diagnosis?
[Diagram: Chest X-ray showing a wedge-shaped opacity in the right lower
lobe with blunting of the costophrenic angle]
A. Community-acquired pneumonia
B. Pulmonary embolism with infarction
C. Pneumothorax
D. Pleural effusion
B
RATIONALE: A wedge-shaped opacity (Hampton's hump) with blunting
of the costophrenic angle is classic for pulmonary embolism with infarction.
3. A 62-year-old male with a history of hypertension presents with a
sudden severe headache. The nurse practitioner observes the following
,fundoscopic finding. What is the most likely diagnosis?
[Diagram: Fundoscopic image showing papilledema with blurred optic disc
margins and flame hemorrhages]
A. Migraine headache
B. Hypertensive emergency with papilledema
C. Cluster headache
D. Temporal arteritis
B
RATIONALE: Papilledema with blurred optic disc margins and flame
hemorrhages indicates hypertensive emergency with end-organ damage.
4. A 35-year-old female presents with fatigue, weight gain, and cold
intolerance. The nurse practitioner observes the following thyroid
ultrasound finding. What is the most likely diagnosis?
[Diagram: Thyroid ultrasound showing an enlarged, heterogeneous gland
with decreased echogenicity]
, A. Graves' disease
B. Hashimoto's thyroiditis
C. Thyroid nodule
D. Thyroid cancer
B
RATIONALE: An enlarged, heterogeneous thyroid gland with decreased
echogenicity on ultrasound is characteristic of Hashimoto's thyroiditis.
5. A 70-year-old male presents with progressive difficulty walking and
urinary incontinence. The nurse practitioner observes the following
MRI finding. What is the most likely diagnosis?
[Diagram: Brain MRI showing enlarged lateral ventricles with normal cortical
sulci]
A. Alzheimer's disease
B. Normal pressure hydrocephalus
C. Parkinson's disease
D. Vascular dementia
B
RATIONALE: Enlarged lateral ventricles with normal cortical sulci,
combined with the triad of gait disturbance, urinary incontinence, and
cognitive decline, is classic for normal pressure hydrocephalus.
COMPLETE ACTUAL EXAM QUESTIONS | ADVANCED
PHYSICAL ASSESSMENT | CHAMBERLAIN
UNIVERSITYIntroduction
This comprehensive examination assesses the advanced physical assessment
and clinical reasoning skills required of the family nurse practitioner. It
evaluates history-taking, interviewing techniques, systematic physical
examination, specialized maneuvers, differential diagnosis, and documentation
across the lifespan. Questions are structured in multiple-choice and scenario-
based formats to emphasize real-world application and decision-making. A
strong emphasis is placed on patient-centered care, cultural sensitivity, and the
synthesis of subjective and objective data to formulate accurate diagnoses and
management plans. Candidates must demonstrate the ability to apply
evidence-based assessment principles to diverse clinical presentations.
VERSION 1: QUESTIONS 1–100
1. A 58-year-old male presents with crushing substernal chest pain
radiating to the left arm. The nurse practitioner observes the following
ECG finding. What is the most likely diagnosis?
[Diagram: ECG showing ST-segment elevation in leads V1–V4]
A. Stable angina
B. Anterior wall myocardial infarction
,C. Pericarditis
D. Pulmonary embolism
B
RATIONALE: ST-segment elevation in leads V1–V4 indicates an anterior
wall myocardial infarction due to occlusion of the left anterior descending
artery.
2. A 45-year-old female presents with sudden-onset shortness of breath
and pleuritic chest pain. The nurse practitioner observes the following
chest X-ray finding. What is the most likely diagnosis?
[Diagram: Chest X-ray showing a wedge-shaped opacity in the right lower
lobe with blunting of the costophrenic angle]
A. Community-acquired pneumonia
B. Pulmonary embolism with infarction
C. Pneumothorax
D. Pleural effusion
B
RATIONALE: A wedge-shaped opacity (Hampton's hump) with blunting
of the costophrenic angle is classic for pulmonary embolism with infarction.
3. A 62-year-old male with a history of hypertension presents with a
sudden severe headache. The nurse practitioner observes the following
,fundoscopic finding. What is the most likely diagnosis?
[Diagram: Fundoscopic image showing papilledema with blurred optic disc
margins and flame hemorrhages]
A. Migraine headache
B. Hypertensive emergency with papilledema
C. Cluster headache
D. Temporal arteritis
B
RATIONALE: Papilledema with blurred optic disc margins and flame
hemorrhages indicates hypertensive emergency with end-organ damage.
4. A 35-year-old female presents with fatigue, weight gain, and cold
intolerance. The nurse practitioner observes the following thyroid
ultrasound finding. What is the most likely diagnosis?
[Diagram: Thyroid ultrasound showing an enlarged, heterogeneous gland
with decreased echogenicity]
, A. Graves' disease
B. Hashimoto's thyroiditis
C. Thyroid nodule
D. Thyroid cancer
B
RATIONALE: An enlarged, heterogeneous thyroid gland with decreased
echogenicity on ultrasound is characteristic of Hashimoto's thyroiditis.
5. A 70-year-old male presents with progressive difficulty walking and
urinary incontinence. The nurse practitioner observes the following
MRI finding. What is the most likely diagnosis?
[Diagram: Brain MRI showing enlarged lateral ventricles with normal cortical
sulci]
A. Alzheimer's disease
B. Normal pressure hydrocephalus
C. Parkinson's disease
D. Vascular dementia
B
RATIONALE: Enlarged lateral ventricles with normal cortical sulci,
combined with the triad of gait disturbance, urinary incontinence, and
cognitive decline, is classic for normal pressure hydrocephalus.
