Final Exam: NR509 / NR-509 (Latest
) Advanced Physical
Assessment | Questions and Verified
Answers | 100% Correct | Grade A -
Chamberlain
Question:
A 25-year-old male presents to the clinic with a complaint of severe rectal pain
during defecation. The pain is so severe he waits several days before having a
bowel movement. He has a history of ulcerative colitis (UC). He also reports
being in an active sexual new relationship with a male partner. After
conducting a history and physical exam, the NP documents the following
anorectal findings: Perirectal area inflamed; no ulcerations, open sores,
fissures, or verruca. Scant, whiteyellow, mucoid, rectal discharge noted.
Unable to examine external sphincter, rectal vault, or prostate because of
spasm of the external sphincter and marked inflammation and tenderness of
anal canal. Which of the following is the most accurate interpretation of these
findings?
Answer:
These findings suggest infectious proctitis
,Question:
A 54-year-old female with a history of migraines since childhood presents to
the clinic with chronic intermittent, progressive pulsatile headaches which
are similar in nature to prior attacks and precipitated by current life stressors.
The headaches are accompanied by nausea and vomiting. She denies
constitutional symptoms. On examination, she has elevated blood pressure
but otherwise a normal cardiovascular, neurologic, and fundoscopic
examination. Based on the history and physical examination findings, which
diagnoses are appropriate for the differential diagnosis (DDx) list? Select all
that apply.
Answer:
Migraine
Tension
Question:
A 50-year-old female presents to the clinic for evaluation of neck stiffness and
aching pain. She was a restrained driver in a low-speed, rear-end, motor
vehicle collision 1 day ago. The pain started several hours after the accident.
On physical examination, you note muscle spasms over the paraspinous
muscles on the left side of the neck, as well as pain reported during active
range of motion of the cervical spine. No neurological deficits are noted.
Which of the following is the most accurate interpretation of these findings?
Answer:
These findings suggest cervical strain
,Question:
Which muscle(s) are being assessed during active rotation of the neck?
Answer:
Sternocleidomastoid
Question:
A 34-year-old female presents to the office with left elbow pain following
rigorous training for a tennis match. Tenderness is noted with palpation in
the area on the image marked by the red circle. What correlative diagnosis
does this assessment finding indicate? ADA Description: Left elbow with
emphasis on the small, tuberculated eminence, curved a little forward, about
1 cm from the joint.
Answer:
lateral epicondylitis
Question:
An NP student conducted a clinical breast examination on a 27-year-old
female with a history of fibroadenomas. The NP palpated a rubbery, mobile,
nontender mass in the right breast. The mass was located 3 cm proximal to
and 3 cm to the left of the nipple. Which of the following would be the most
appropriate way to document the physical assessment findings?
Answer:
rubbery, mobile, nontender mass located in the right breast, in the 10:30
position from the nipple
, Question:
A 35-year-old male presents to the clinic for a routine physical examination.
His only complaint is a feeling of heaviness in his scrotum. He denies injury or
trauma. After conducting a history and physical, the NP documents the
following genitourinary (GU) findings: Uncircumcised penis; prepuce easily
retractable. No penile discharge or lesions. No scrotal swelling or
discoloration. Testes descended bilaterally; right testicle smooth; 1 × 1 cm
firm, fixed, nontender, nodule on the left lateral testicle. Epididymis
nontender. No inguinal or femoral hernias. Negative CVA tenderness. Which
of the following is the most accurate interpretation of these findings?
Answer:
These findings suggest testicular cancer
Question:
A 26-year-old female presents to the Emergency Department with intense
abdominal pain for 6 hours, light-headedness, and a fainting episode that
finally prompted her to seek medical attention. She has a history of gallstones
and is concerned that she is having another gallbladder attack. She denies
nausea and vomiting, and her last normal bowel movement was this morning.
She reports that her LMP was 10 weeks ago. Vital signs: pulse 118; blood
pressure, 86/68; respiratory rate, 20/min; oxygen saturation, 99%; and
temperature, 37.3ºC orally. A β-human chorionic gonadotropin (β-hCG) blood
test is pending. The NP performs an abdominal exam prior to her pelvic exam
and, on palpation of her abdomen, finds involuntary rigidity and rebound
tenderness. Which of the following is the most likely etiology for these
assessment findings?
Answer:
Ruptured ectopic pregnancy
) Advanced Physical
Assessment | Questions and Verified
Answers | 100% Correct | Grade A -
Chamberlain
Question:
A 25-year-old male presents to the clinic with a complaint of severe rectal pain
during defecation. The pain is so severe he waits several days before having a
bowel movement. He has a history of ulcerative colitis (UC). He also reports
being in an active sexual new relationship with a male partner. After
conducting a history and physical exam, the NP documents the following
anorectal findings: Perirectal area inflamed; no ulcerations, open sores,
fissures, or verruca. Scant, whiteyellow, mucoid, rectal discharge noted.
Unable to examine external sphincter, rectal vault, or prostate because of
spasm of the external sphincter and marked inflammation and tenderness of
anal canal. Which of the following is the most accurate interpretation of these
findings?
Answer:
These findings suggest infectious proctitis
,Question:
A 54-year-old female with a history of migraines since childhood presents to
the clinic with chronic intermittent, progressive pulsatile headaches which
are similar in nature to prior attacks and precipitated by current life stressors.
The headaches are accompanied by nausea and vomiting. She denies
constitutional symptoms. On examination, she has elevated blood pressure
but otherwise a normal cardiovascular, neurologic, and fundoscopic
examination. Based on the history and physical examination findings, which
diagnoses are appropriate for the differential diagnosis (DDx) list? Select all
that apply.
Answer:
Migraine
Tension
Question:
A 50-year-old female presents to the clinic for evaluation of neck stiffness and
aching pain. She was a restrained driver in a low-speed, rear-end, motor
vehicle collision 1 day ago. The pain started several hours after the accident.
On physical examination, you note muscle spasms over the paraspinous
muscles on the left side of the neck, as well as pain reported during active
range of motion of the cervical spine. No neurological deficits are noted.
Which of the following is the most accurate interpretation of these findings?
Answer:
These findings suggest cervical strain
,Question:
Which muscle(s) are being assessed during active rotation of the neck?
Answer:
Sternocleidomastoid
Question:
A 34-year-old female presents to the office with left elbow pain following
rigorous training for a tennis match. Tenderness is noted with palpation in
the area on the image marked by the red circle. What correlative diagnosis
does this assessment finding indicate? ADA Description: Left elbow with
emphasis on the small, tuberculated eminence, curved a little forward, about
1 cm from the joint.
Answer:
lateral epicondylitis
Question:
An NP student conducted a clinical breast examination on a 27-year-old
female with a history of fibroadenomas. The NP palpated a rubbery, mobile,
nontender mass in the right breast. The mass was located 3 cm proximal to
and 3 cm to the left of the nipple. Which of the following would be the most
appropriate way to document the physical assessment findings?
Answer:
rubbery, mobile, nontender mass located in the right breast, in the 10:30
position from the nipple
, Question:
A 35-year-old male presents to the clinic for a routine physical examination.
His only complaint is a feeling of heaviness in his scrotum. He denies injury or
trauma. After conducting a history and physical, the NP documents the
following genitourinary (GU) findings: Uncircumcised penis; prepuce easily
retractable. No penile discharge or lesions. No scrotal swelling or
discoloration. Testes descended bilaterally; right testicle smooth; 1 × 1 cm
firm, fixed, nontender, nodule on the left lateral testicle. Epididymis
nontender. No inguinal or femoral hernias. Negative CVA tenderness. Which
of the following is the most accurate interpretation of these findings?
Answer:
These findings suggest testicular cancer
Question:
A 26-year-old female presents to the Emergency Department with intense
abdominal pain for 6 hours, light-headedness, and a fainting episode that
finally prompted her to seek medical attention. She has a history of gallstones
and is concerned that she is having another gallbladder attack. She denies
nausea and vomiting, and her last normal bowel movement was this morning.
She reports that her LMP was 10 weeks ago. Vital signs: pulse 118; blood
pressure, 86/68; respiratory rate, 20/min; oxygen saturation, 99%; and
temperature, 37.3ºC orally. A β-human chorionic gonadotropin (β-hCG) blood
test is pending. The NP performs an abdominal exam prior to her pelvic exam
and, on palpation of her abdomen, finds involuntary rigidity and rebound
tenderness. Which of the following is the most likely etiology for these
assessment findings?
Answer:
Ruptured ectopic pregnancy
