NR-509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM / ACTUAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH RATIONALES |
CHAMBERLAIN UNIVERSITY
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A nurse practitioner is conducting an initial evaluation of a 52-year-old patient
who has recently transferred to the practice. The patient reports occasional
headaches but has not identified a specific concern requiring urgent attention. The
medical record contains limited information about previous illnesses, medications,
family history, and preventive screenings. Which assessment approach is most
appropriate?
A. Perform a focused neurological examination and defer all other assessments
until the headaches resolve.
B. Complete a comprehensive health history and physical examination to establish
baseline findings and identify additional health needs.
C. Document the headache characteristics and refer the patient for diagnostic
imaging before obtaining a complete history.
D. Perform only the review of systems because objective examination findings are
unnecessary during an initial visit.
Answer: B
,Rationale: A comprehensive assessment is appropriate for a new patient because it
establishes baseline health information, identifies existing and potential problems,
and supports preventive care planning. It includes a detailed health history, review
of systems, and a comprehensive physical examination. A focused assessment is
more appropriate when evaluating a specific acute or established problem.
Diagnostic testing should be guided by the findings and clinical indications rather
than automatically ordered before completing the initial evaluation.
Question 2
During a routine follow-up visit, a patient reports, “My right knee has been
swelling for three days, and it hurts most when I climb stairs.” The practitioner
observes visible swelling and measures reduced knee flexion. Which
documentation correctly distinguishes subjective from objective information?
A. Subjective: reduced knee flexion; objective: pain when climbing stairs.
B. Subjective: visible swelling; objective: the patient's report of discomfort.
C. Subjective: the patient's description of pain; objective: observed swelling and
measured limitation of flexion.
D. Subjective: the patient's age and vital signs; objective: the reported duration of
symptoms.
Answer: C
Rationale: Subjective data consist of information reported by the patient,
including symptoms, pain characteristics, and the history of the present illness.
Objective data consist of measurable or observable findings, such as swelling, vital
signs, range of motion, and examination results. Correctly separating these
categories supports accurate clinical documentation and helps distinguish reported
symptoms from verified examination findings.
,Question 3
A 46-year-old patient presents with severe right upper-quadrant abdominal pain
that began after a fatty meal. The pain radiates toward the right shoulder and is
accompanied by nausea. During palpation beneath the right costal margin, the
practitioner notes that the patient abruptly stops inhaling because of increased pain.
Which finding has been elicited?
A. Rovsing's sign
B. Murphy's sign
C. McBurney's point tenderness
D. Obturator sign
Answer: B
Rationale: Murphy's sign is positive when palpation of the right upper quadrant
beneath the costal margin causes marked tenderness and an abrupt interruption of
inspiration. In the appropriate clinical context, this finding supports suspected
acute cholecystitis. Biliary disease may cause pain radiating to the right shoulder or
scapular region. Rovsing's sign and McBurney's point tenderness are associated
with appendiceal inflammation, while the obturator sign is used to assess irritation
involving the obturator muscle or nearby pelvic structures.
Question 4
Before examining a patient with abdominal discomfort, a practitioner reviews the
correct sequence for the physical examination. Which sequence should be followed
to minimize the possibility of altering bowel sounds before auscultation?
A. Inspection, palpation, percussion, auscultation
B. Auscultation, inspection, palpation, percussion
C. Inspection, percussion, auscultation, palpation
D. Inspection, auscultation, percussion, palpation
Answer: D
, Rationale: The correct sequence for abdominal examination is inspection,
auscultation, percussion, and palpation. Auscultation precedes percussion and
palpation because physical manipulation can potentially alter bowel sounds.
Inspection allows the practitioner to assess contour, symmetry, distention, visible
pulsations, and skin changes before proceeding to the other examination
techniques.
Question 5
A 23-year-old patient is evaluated for worsening abdominal pain. The discomfort
began near the umbilicus and has migrated to the right lower quadrant. The patient
also reports anorexia and nausea. During examination, pressure applied to the left
lower quadrant produces pain in the right lower quadrant. Which finding is
documented?
A. Positive psoas sign
B. Positive Murphy's sign
C. Positive Rovsing's sign
D. Positive fluid wave
Answer: C
Rationale: Rovsing's sign is present when palpation of the left lower quadrant
produces pain in the right lower quadrant. In a patient with migrating abdominal
pain, anorexia, and nausea, this finding raises concern for appendicitis. The psoas
sign involves increased right lower-quadrant pain with a maneuver that stretches or
contracts the psoas muscle. Murphy's sign suggests gallbladder inflammation,
while a fluid wave is used to assess for ascites.
FINAL EXAM / ACTUAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH RATIONALES |
CHAMBERLAIN UNIVERSITY
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A nurse practitioner is conducting an initial evaluation of a 52-year-old patient
who has recently transferred to the practice. The patient reports occasional
headaches but has not identified a specific concern requiring urgent attention. The
medical record contains limited information about previous illnesses, medications,
family history, and preventive screenings. Which assessment approach is most
appropriate?
A. Perform a focused neurological examination and defer all other assessments
until the headaches resolve.
B. Complete a comprehensive health history and physical examination to establish
baseline findings and identify additional health needs.
C. Document the headache characteristics and refer the patient for diagnostic
imaging before obtaining a complete history.
D. Perform only the review of systems because objective examination findings are
unnecessary during an initial visit.
Answer: B
,Rationale: A comprehensive assessment is appropriate for a new patient because it
establishes baseline health information, identifies existing and potential problems,
and supports preventive care planning. It includes a detailed health history, review
of systems, and a comprehensive physical examination. A focused assessment is
more appropriate when evaluating a specific acute or established problem.
Diagnostic testing should be guided by the findings and clinical indications rather
than automatically ordered before completing the initial evaluation.
Question 2
During a routine follow-up visit, a patient reports, “My right knee has been
swelling for three days, and it hurts most when I climb stairs.” The practitioner
observes visible swelling and measures reduced knee flexion. Which
documentation correctly distinguishes subjective from objective information?
A. Subjective: reduced knee flexion; objective: pain when climbing stairs.
B. Subjective: visible swelling; objective: the patient's report of discomfort.
C. Subjective: the patient's description of pain; objective: observed swelling and
measured limitation of flexion.
D. Subjective: the patient's age and vital signs; objective: the reported duration of
symptoms.
Answer: C
Rationale: Subjective data consist of information reported by the patient,
including symptoms, pain characteristics, and the history of the present illness.
Objective data consist of measurable or observable findings, such as swelling, vital
signs, range of motion, and examination results. Correctly separating these
categories supports accurate clinical documentation and helps distinguish reported
symptoms from verified examination findings.
,Question 3
A 46-year-old patient presents with severe right upper-quadrant abdominal pain
that began after a fatty meal. The pain radiates toward the right shoulder and is
accompanied by nausea. During palpation beneath the right costal margin, the
practitioner notes that the patient abruptly stops inhaling because of increased pain.
Which finding has been elicited?
A. Rovsing's sign
B. Murphy's sign
C. McBurney's point tenderness
D. Obturator sign
Answer: B
Rationale: Murphy's sign is positive when palpation of the right upper quadrant
beneath the costal margin causes marked tenderness and an abrupt interruption of
inspiration. In the appropriate clinical context, this finding supports suspected
acute cholecystitis. Biliary disease may cause pain radiating to the right shoulder or
scapular region. Rovsing's sign and McBurney's point tenderness are associated
with appendiceal inflammation, while the obturator sign is used to assess irritation
involving the obturator muscle or nearby pelvic structures.
Question 4
Before examining a patient with abdominal discomfort, a practitioner reviews the
correct sequence for the physical examination. Which sequence should be followed
to minimize the possibility of altering bowel sounds before auscultation?
A. Inspection, palpation, percussion, auscultation
B. Auscultation, inspection, palpation, percussion
C. Inspection, percussion, auscultation, palpation
D. Inspection, auscultation, percussion, palpation
Answer: D
, Rationale: The correct sequence for abdominal examination is inspection,
auscultation, percussion, and palpation. Auscultation precedes percussion and
palpation because physical manipulation can potentially alter bowel sounds.
Inspection allows the practitioner to assess contour, symmetry, distention, visible
pulsations, and skin changes before proceeding to the other examination
techniques.
Question 5
A 23-year-old patient is evaluated for worsening abdominal pain. The discomfort
began near the umbilicus and has migrated to the right lower quadrant. The patient
also reports anorexia and nausea. During examination, pressure applied to the left
lower quadrant produces pain in the right lower quadrant. Which finding is
documented?
A. Positive psoas sign
B. Positive Murphy's sign
C. Positive Rovsing's sign
D. Positive fluid wave
Answer: C
Rationale: Rovsing's sign is present when palpation of the left lower quadrant
produces pain in the right lower quadrant. In a patient with migrating abdominal
pain, anorexia, and nausea, this finding raises concern for appendicitis. The psoas
sign involves increased right lower-quadrant pain with a maneuver that stretches or
contracts the psoas muscle. Murphy's sign suggests gallbladder inflammation,
while a fluid wave is used to assess for ascites.
