NR509 ADVANCED PHYSICAL
ASSESSMENT EXAM 2 -
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS 2026/2027 UPDATE ||
100% GUARANTEED PASS
1. A 65-year-old patient presents with a history of hypertension and complains of sudden
onset shortness of breath. On auscultation, you hear a high-pitched, blowing diastolic
murmur at the left sternal border. Which valvular abnormality is most likely?
A. Mitral Stenosis
B. Aortic Regurgitation
C. Tricuspid Regurgitation
D. Aortic Stenosis
Answer: B
Conceptual Explanation: Aortic regurgitation typically presents as a high-pitched,
blowing decrescendo diastolic murmur heard best at the left sternal border.
2. During a cardiac examination, the clinician notes a split S2 that disappears during
expiration and becomes audible during inspiration. How should this finding be documented?
A. Fixed splitting of S2
,B. Physiological splitting of S2
C. Paradoxical splitting of S2
D. Pathological S3 gallop
Answer: B
Conceptual Explanation: Physiological splitting of S2 is a normal finding caused by the
delayed closure of the pulmonic valve due to increased venous return during inspiration.
3. Which of the following physical exam findings is most suggestive of right-sided heart
failure?
A. Jugular Venous Distention (JVD)
B. Pulmonary crackles
C. S3 gallop at the apex
D. Paroxysmal nocturnal dyspnea
Answer: A
Conceptual Explanation: JVD is a classic sign of increased central venous pressure, often
resulting from right-sided heart failure.
4. When assessing for a pleural effusion, which percussion note is expected over the affected
area?
A. Resonance
B. Hyperresonance
, C. Tympany
D. Dullness
Answer: D
Conceptual Explanation: Fluid in the pleural space (effusion) replaces air-filled lung
tissue, leading to a dull percussion note.
5. A patient presents with acute abdominal pain. Upon palpation of the left lower quadrant,
the patient experiences pain in the right lower quadrant. This sign is known as:
A. Murphy’s sign
B. Rovsing’s sign
C. Psoas sign
D. McBurney’s sign
Answer: B
Conceptual Explanation: Rovsing’s sign is indirect tenderness in the right lower quadrant
elicited by palpation of the left lower quadrant, indicative of peritoneal
irritation/appendicitis.
6. Which heart sound is associated with the ‘atrial kick’ and is frequently heard in patients
with stiffened left ventricles due to hypertension?
A. S1
B. S2
ASSESSMENT EXAM 2 -
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS 2026/2027 UPDATE ||
100% GUARANTEED PASS
1. A 65-year-old patient presents with a history of hypertension and complains of sudden
onset shortness of breath. On auscultation, you hear a high-pitched, blowing diastolic
murmur at the left sternal border. Which valvular abnormality is most likely?
A. Mitral Stenosis
B. Aortic Regurgitation
C. Tricuspid Regurgitation
D. Aortic Stenosis
Answer: B
Conceptual Explanation: Aortic regurgitation typically presents as a high-pitched,
blowing decrescendo diastolic murmur heard best at the left sternal border.
2. During a cardiac examination, the clinician notes a split S2 that disappears during
expiration and becomes audible during inspiration. How should this finding be documented?
A. Fixed splitting of S2
,B. Physiological splitting of S2
C. Paradoxical splitting of S2
D. Pathological S3 gallop
Answer: B
Conceptual Explanation: Physiological splitting of S2 is a normal finding caused by the
delayed closure of the pulmonic valve due to increased venous return during inspiration.
3. Which of the following physical exam findings is most suggestive of right-sided heart
failure?
A. Jugular Venous Distention (JVD)
B. Pulmonary crackles
C. S3 gallop at the apex
D. Paroxysmal nocturnal dyspnea
Answer: A
Conceptual Explanation: JVD is a classic sign of increased central venous pressure, often
resulting from right-sided heart failure.
4. When assessing for a pleural effusion, which percussion note is expected over the affected
area?
A. Resonance
B. Hyperresonance
, C. Tympany
D. Dullness
Answer: D
Conceptual Explanation: Fluid in the pleural space (effusion) replaces air-filled lung
tissue, leading to a dull percussion note.
5. A patient presents with acute abdominal pain. Upon palpation of the left lower quadrant,
the patient experiences pain in the right lower quadrant. This sign is known as:
A. Murphy’s sign
B. Rovsing’s sign
C. Psoas sign
D. McBurney’s sign
Answer: B
Conceptual Explanation: Rovsing’s sign is indirect tenderness in the right lower quadrant
elicited by palpation of the left lower quadrant, indicative of peritoneal
irritation/appendicitis.
6. Which heart sound is associated with the ‘atrial kick’ and is frequently heard in patients
with stiffened left ventricles due to hypertension?
A. S1
B. S2
