Midterm Exam: NR 509/ NR509 Midterm Exam
Advanced Physical Assessment (Latest 2025/ 2026)
Questions with Verified Answers Chamberlain
Introduction
This document provides 80 non-repeating multiple-choice questions for the NR 509 Midterm
Exam on Advanced Physical Assessment, aligned with the 2025/2026 curriculum at
Chamberlain University. Designed for advanced practice nursing students, each question
includes four answer options, a verified correct answer, and a detailed clinical rationale
based on evidence-based practice. Topics cover comprehensive physical assessment tech-
niques, health history, system-specific examinations, and clinical decision-making across
the lifespan. Formatted for professional PDF output, this resource supports thorough
exam preparation.
Multiple-Choice Questions
Question 1: Which technique is used to assess for tactile fremitus during a lung examination?
a. Percussion
b. Palpation
c. Auscultation
d. Inspection
Answer: b
Rationale: Tactile fremitus is assessed by palpation, feeling vibrations on the chest
wall as the patient speaks (e.g., saying "ninety-nine"). Increased fremitus suggests
consolidation, while decreased fremitus may indicate pleural effusion.
Question 2: What is the most appropriate initial question to ask when taking a health history?
a. "Do you have any allergies?"
b. "What brings you here today?"
c. "When was your last physical exam?"
d. "What medications do you take?"
Answer: b
Rationale: Starting with an open-ended question like "What brings you here to-
day?" allows the patient to describe their chief complaint, guiding the history-taking
process effectively.
Question 3: Which cranial nerve is assessed by testing the gag reflex?
a. Cranial nerve VII
b. Cranial nerve IX
c. Cranial nerve X
1
, d. Both b and c
Answer: d
Rationale: The gag reflex is mediated by cranial nerve IX (glossopharyngeal,
sensory) and cranial nerve X (vagus, motor). Testing it evaluates their function in
the pharynx.
Question 4: A patient reports chest pain that worsens with inspiration. This suggests:
a. Angina pectoris
b. Pleuritic pain
c. Myocardial infarction
d. Esophageal reflux
Answer: b
Rationale: Pleuritic pain, associated with pleural inflammation (e.g., pleurisy or
pulmonary embolism), worsens with inspiration due to pleural movement. Angina
and myocardial infarction are cardiac, and esophageal reflux is gastrointestinal.
Question 5: Which finding during a thyroid exam suggests a possible goiter?
a. Visible neck swelling
b. Normal thyroid size
c. Soft, non-tender gland
d. Bruit on auscultation
Answer: a
Rationale: A goiter is an enlarged thyroid gland, often presenting as visible neck
swelling. A bruit may indicate hyperthyroidism, but swelling is the primary sign.
Question 6: What is the normal range for respiratory rate in adults at rest?
a. 812 breaths/min
b. 1220 breaths/min
c. 2030 breaths/min
d. 3040 breaths/min
Answer: b
Rationale: The normal adult respiratory rate at rest is 1220 breaths per minute.
Rates outside this range may indicate respiratory or systemic issues.
Question 7: Which heart sound is heard at the beginning of systole?
a. S1
b. S2
c. S3
d. S4
2
, Answer: a
Rationale: S1, caused by the closure of mitral and tricuspid valves, marks the
start of systole. S2 occurs at the end of systole, and S3/S4 are associated with
ventricular filling.
Question 8: During an abdominal exam, what does a positive Murphys sign indicate?
a. Appendicitis
b. Cholecystitis
c. Pancreatitis
d. Peptic ulcer disease
Answer: b
Rationale: A positive Murphys sign (pain on inspiration during palpation under
the right costal margin) suggests acute cholecystitis due to gallbladder inflamma-
tion.
Question 9: Which pulse is palpated to assess peripheral arterial disease in the lower extremities?
a. Radial pulse
b. Brachial pulse
c. Posterior tibial pulse
d. Carotid pulse
Answer: c
Rationale: The posterior tibial pulse, located behind the medial malleolus, is
assessed to evaluate lower extremity perfusion. Diminished pulses may indicate
peripheral arterial disease.
Question 10: What is the expected finding when percussing a healthy lung field?
a. Dullness
b. Resonance
c. Hyperresonance
d. Tympany
Answer: b
Rationale: Healthy lung fields produce resonance on percussion due to air-filled
alveoli. Dullness suggests consolidation, hyperresonance indicates pneumothorax,
and tympany is typical of the abdomen.
Question 11: Which eye structure is examined using an ophthalmoscope?
a. Cornea
b. Retina
c. Lens
d. Iris
3
Advanced Physical Assessment (Latest 2025/ 2026)
Questions with Verified Answers Chamberlain
Introduction
This document provides 80 non-repeating multiple-choice questions for the NR 509 Midterm
Exam on Advanced Physical Assessment, aligned with the 2025/2026 curriculum at
Chamberlain University. Designed for advanced practice nursing students, each question
includes four answer options, a verified correct answer, and a detailed clinical rationale
based on evidence-based practice. Topics cover comprehensive physical assessment tech-
niques, health history, system-specific examinations, and clinical decision-making across
the lifespan. Formatted for professional PDF output, this resource supports thorough
exam preparation.
Multiple-Choice Questions
Question 1: Which technique is used to assess for tactile fremitus during a lung examination?
a. Percussion
b. Palpation
c. Auscultation
d. Inspection
Answer: b
Rationale: Tactile fremitus is assessed by palpation, feeling vibrations on the chest
wall as the patient speaks (e.g., saying "ninety-nine"). Increased fremitus suggests
consolidation, while decreased fremitus may indicate pleural effusion.
Question 2: What is the most appropriate initial question to ask when taking a health history?
a. "Do you have any allergies?"
b. "What brings you here today?"
c. "When was your last physical exam?"
d. "What medications do you take?"
Answer: b
Rationale: Starting with an open-ended question like "What brings you here to-
day?" allows the patient to describe their chief complaint, guiding the history-taking
process effectively.
Question 3: Which cranial nerve is assessed by testing the gag reflex?
a. Cranial nerve VII
b. Cranial nerve IX
c. Cranial nerve X
1
, d. Both b and c
Answer: d
Rationale: The gag reflex is mediated by cranial nerve IX (glossopharyngeal,
sensory) and cranial nerve X (vagus, motor). Testing it evaluates their function in
the pharynx.
Question 4: A patient reports chest pain that worsens with inspiration. This suggests:
a. Angina pectoris
b. Pleuritic pain
c. Myocardial infarction
d. Esophageal reflux
Answer: b
Rationale: Pleuritic pain, associated with pleural inflammation (e.g., pleurisy or
pulmonary embolism), worsens with inspiration due to pleural movement. Angina
and myocardial infarction are cardiac, and esophageal reflux is gastrointestinal.
Question 5: Which finding during a thyroid exam suggests a possible goiter?
a. Visible neck swelling
b. Normal thyroid size
c. Soft, non-tender gland
d. Bruit on auscultation
Answer: a
Rationale: A goiter is an enlarged thyroid gland, often presenting as visible neck
swelling. A bruit may indicate hyperthyroidism, but swelling is the primary sign.
Question 6: What is the normal range for respiratory rate in adults at rest?
a. 812 breaths/min
b. 1220 breaths/min
c. 2030 breaths/min
d. 3040 breaths/min
Answer: b
Rationale: The normal adult respiratory rate at rest is 1220 breaths per minute.
Rates outside this range may indicate respiratory or systemic issues.
Question 7: Which heart sound is heard at the beginning of systole?
a. S1
b. S2
c. S3
d. S4
2
, Answer: a
Rationale: S1, caused by the closure of mitral and tricuspid valves, marks the
start of systole. S2 occurs at the end of systole, and S3/S4 are associated with
ventricular filling.
Question 8: During an abdominal exam, what does a positive Murphys sign indicate?
a. Appendicitis
b. Cholecystitis
c. Pancreatitis
d. Peptic ulcer disease
Answer: b
Rationale: A positive Murphys sign (pain on inspiration during palpation under
the right costal margin) suggests acute cholecystitis due to gallbladder inflamma-
tion.
Question 9: Which pulse is palpated to assess peripheral arterial disease in the lower extremities?
a. Radial pulse
b. Brachial pulse
c. Posterior tibial pulse
d. Carotid pulse
Answer: c
Rationale: The posterior tibial pulse, located behind the medial malleolus, is
assessed to evaluate lower extremity perfusion. Diminished pulses may indicate
peripheral arterial disease.
Question 10: What is the expected finding when percussing a healthy lung field?
a. Dullness
b. Resonance
c. Hyperresonance
d. Tympany
Answer: b
Rationale: Healthy lung fields produce resonance on percussion due to air-filled
alveoli. Dullness suggests consolidation, hyperresonance indicates pneumothorax,
and tympany is typical of the abdomen.
Question 11: Which eye structure is examined using an ophthalmoscope?
a. Cornea
b. Retina
c. Lens
d. Iris
3
