,NR509 Exam 2 | Advanced Physical Assessment
(2026) Actual Q&A PDF | Chamberlain
1. A nurse practitioner is performing a comprehensive physical assessment. Which technique is always
used first?
A) Palpation
B) Auscultation
C) Percussion
D) Inspection
Correct Answer: Inspection
Rationale: Inspection is the first technique used in every physical assessment. It provides visual
information about the patient's general appearance, symmetry, and any visible abnormalities before
any physical contact occurs.
2. During a cardiac auscultation, the nurse practitioner uses the bell of the stethoscope. The bell is
best suited to detect which type of sound?
A) High-pitched murmurs
B) Low-pitched sounds
C) Bowel sounds
D) Lung crackles
Correct Answer: Low-pitched sounds
Rationale: The bell is designed to detect low-frequency sounds such as S3 and S4 gallops, as well as
the diastolic murmur of mitral stenosis. The diaphragm is used for high-pitched sounds.
3. A patient with chronic obstructive pulmonary disease (COPD) demonstrates hyperresonance on
chest percussion. This finding is most indicative of:
A) Pleural effusion
,B) Consolidation
C) Air trapping
D) Normal lung tissue
Correct Answer: Air trapping
Rationale: Hyperresonance reflects increased air within the lungs, a hallmark of emphysema and air
trapping in COPD. Pleural effusion and consolidation produce dullness.
4. A patient presents with sudden onset of ptosis, a dilated pupil, and the affected eye is deviated
downward and outward. Which cranial nerve is most likely involved?
A) Optic (II)
B) Oculomotor (III)
C) Trochlear (IV)
D) Abducens (VI)
Correct Answer: Oculomotor (III)
Rationale: CN III palsy causes ptosis (levator palpebrae weakness), pupil dilation (parasympathetic
fiber loss), and an eye that is "down and out" (unopposed CN IV and VI). This is a classic presentation.
5. The nurse practitioner flexes the patient's neck and observes involuntary flexion of the hips and
knees. This positive Brudzinski sign indicates:
A) Cervical radiculopathy
B) Meningeal irritation
C) Lumbar disc herniation
D) Parkinson's disease
Correct Answer: Meningeal irritation
, Rationale: Brudzinski's sign, along with Kernig's sign, is a classic indicator of meningeal inflammation,
such as in meningitis. It is not associated with the other conditions.
6. A pregnant patient at 28 weeks gestation has a new, grade 2 systolic murmur at the left sternal
border. The nurse practitioner should:
A) Refer immediately to cardiology
B) Recognize this as a common physiologic finding due to increased blood flow
C) Order an echocardiogram
D) Diagnose mitral valve prolapse
Correct Answer: Recognize this as a common physiologic finding due to increased blood flow
Rationale: Pregnancy increases blood volume and cardiac output, often causing flow murmurs that
are benign. These resolve postpartum and do not require intervention unless other symptoms are
present.
7. A patient reports numbness and tingling in the thumb, index finger, and middle finger. The nurse
practitioner should suspect compression of which nerve?
A) Ulnar nerve
B) Radial nerve
C) Median nerve
D) Axillary nerve
Correct Answer: Median nerve
Rationale: The median nerve provides sensation to the palmar aspect of the thumb, index, middle,
and radial half of the ring finger. This pattern is characteristic of carpal tunnel syndrome.
8. During a general survey, the nurse practitioner notes a patient is wearing soiled clothing, has
unkempt hair, and has a strong body odor. This finding is most concerning for:
A) A cultural preference
(2026) Actual Q&A PDF | Chamberlain
1. A nurse practitioner is performing a comprehensive physical assessment. Which technique is always
used first?
A) Palpation
B) Auscultation
C) Percussion
D) Inspection
Correct Answer: Inspection
Rationale: Inspection is the first technique used in every physical assessment. It provides visual
information about the patient's general appearance, symmetry, and any visible abnormalities before
any physical contact occurs.
2. During a cardiac auscultation, the nurse practitioner uses the bell of the stethoscope. The bell is
best suited to detect which type of sound?
A) High-pitched murmurs
B) Low-pitched sounds
C) Bowel sounds
D) Lung crackles
Correct Answer: Low-pitched sounds
Rationale: The bell is designed to detect low-frequency sounds such as S3 and S4 gallops, as well as
the diastolic murmur of mitral stenosis. The diaphragm is used for high-pitched sounds.
3. A patient with chronic obstructive pulmonary disease (COPD) demonstrates hyperresonance on
chest percussion. This finding is most indicative of:
A) Pleural effusion
,B) Consolidation
C) Air trapping
D) Normal lung tissue
Correct Answer: Air trapping
Rationale: Hyperresonance reflects increased air within the lungs, a hallmark of emphysema and air
trapping in COPD. Pleural effusion and consolidation produce dullness.
4. A patient presents with sudden onset of ptosis, a dilated pupil, and the affected eye is deviated
downward and outward. Which cranial nerve is most likely involved?
A) Optic (II)
B) Oculomotor (III)
C) Trochlear (IV)
D) Abducens (VI)
Correct Answer: Oculomotor (III)
Rationale: CN III palsy causes ptosis (levator palpebrae weakness), pupil dilation (parasympathetic
fiber loss), and an eye that is "down and out" (unopposed CN IV and VI). This is a classic presentation.
5. The nurse practitioner flexes the patient's neck and observes involuntary flexion of the hips and
knees. This positive Brudzinski sign indicates:
A) Cervical radiculopathy
B) Meningeal irritation
C) Lumbar disc herniation
D) Parkinson's disease
Correct Answer: Meningeal irritation
, Rationale: Brudzinski's sign, along with Kernig's sign, is a classic indicator of meningeal inflammation,
such as in meningitis. It is not associated with the other conditions.
6. A pregnant patient at 28 weeks gestation has a new, grade 2 systolic murmur at the left sternal
border. The nurse practitioner should:
A) Refer immediately to cardiology
B) Recognize this as a common physiologic finding due to increased blood flow
C) Order an echocardiogram
D) Diagnose mitral valve prolapse
Correct Answer: Recognize this as a common physiologic finding due to increased blood flow
Rationale: Pregnancy increases blood volume and cardiac output, often causing flow murmurs that
are benign. These resolve postpartum and do not require intervention unless other symptoms are
present.
7. A patient reports numbness and tingling in the thumb, index finger, and middle finger. The nurse
practitioner should suspect compression of which nerve?
A) Ulnar nerve
B) Radial nerve
C) Median nerve
D) Axillary nerve
Correct Answer: Median nerve
Rationale: The median nerve provides sensation to the palmar aspect of the thumb, index, middle,
and radial half of the ring finger. This pattern is characteristic of carpal tunnel syndrome.
8. During a general survey, the nurse practitioner notes a patient is wearing soiled clothing, has
unkempt hair, and has a strong body odor. This finding is most concerning for:
A) A cultural preference
