PHYSICAL ASSESSMENT AND CLINICAL SYSTEMS REVIEW – 2025
PRACTICE 130 QUESTIONS WITH CORRECT ANSWERS FOR
ADVANCED NURSING AND MEDICAL EXAM PREP/ MOST TESTED
QUESTIONS
THIS SET OF PRACTICE QUESTIONS OFFERS CLINICAL SCENARIOS THAT ASSESS A STUDENT'S
ABILITY TO APPLY PHYSICAL EXAM TECHNIQUES AND INTERPRET FINDINGS RELATED TO THE
ABDOMEN, RESPIRATORY SYSTEM, NEUROLOGICAL FUNCTION, AND VASCULAR HEALTH.
QUESTIONS COVER KEY SIGNS SUCH AS MURPHY'S SIGN, OBTURATOR SIGN, AND
NYSTAGMUS, AS WELL AS CONDITIONS INCLUDING CHOLECYSTITIS, COPD, STROKE, AND
PERIPHERAL VASCULAR DISEASE. THIS RESOURCE IS IDEAL FOR STUDENTS IN ADVANCED
NURSING, MEDICINE, OR PHYSICIAN ASSISTANT PROGRAMS SEEKING TO MASTER PHYSICAL
DIAGNOSTIC SKILLS.
A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal pain. The pain is
associated with nausea and vomiting and occurs 1 to 2 hours after eating greasy foods. Which one of
the following physical examination descriptions would be most consistent with the diagnosis of
cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant, without rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with inspiration, to the point
of stopping inspiration, and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without rebound or guarding.
- CORRECT ANSWER-C) Abdomen is soft and tender to palpation in the right upper quadrant
with inspiration, to the point of stopping inspiration, and there is no rebound or guarding.
When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?
A) Bronchitis
B) Simple asthma
C) Cystic fibrosis
D) Heart failure - CORRECT ANSWER-A. Bronchitis
A patient with longstanding COPD was told by another practitioner that his liver was enlarged and
this needed to be assessed. Which of the following would be reasonable to do next?
A) Percuss the lower border of the liver
B) Measure the span of the liver
,C) Order a hepatitis panel
D) Obtain an ultrasound of the liver - CORRECT ANSWER-A) Percuss the lower border of the
liver
Mr. Patel is a 64-year-old man who was told by another care provider that his liver is enlarged.
Although he is a life-long smoker, he has never used drugs or alcohol and has no knowledge of liver
disease. Indeed, on examination, a liver edge is palpable 4 centimeters below the costal arch. Which
of the following would you do next?
A) Check an ultrasound of the liver
B) Obtain a hepatitis panel
C) Determine liver span by percussion
D) Adopt a "watchful waiting" approach - CORRECT ANSWER-c. Determine liver span by
percussion
You are palpating the abdomen and feel a small mass. Which of the following would you do next?
A) Ultrasound
B) Examination with the abdominal muscles tensed
C) Surgery referral
D) Determine size by percussion - CORRECT ANSWER-B) Examination with the abdominal
muscles tensed
Mr. Kruger is an 84-year-old man who presents with a smooth lower abdominal mass in the midline
which is minimally tender. There is dullness to percussion up to 6 centimeters above the symphysis
pubis. What does this most likely represent?
A) Sigmoid mass
B) Tumor in the abdominal wall
C) Hernia
D) Enlarged bladder - CORRECT ANSWER-D) Enlarged bladder
Which of the following is consistent with obturator sign?
A) Pain distant from the site used to check rebound tenderness
B) Right hypogastric pain with the right hip and knee flexed and the hip internally rotated
, C) Pain with extension of the right thigh while the patient is on her left side or while pressing her
knee against your hand with thigh flexion
D) Pain that stops inhalation in the right upper quadrant - CORRECT ANSWER-B) Right
hypogastric pain with the right hip and knee flexed and the hip internally rotated
A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has
smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned that
he may have peripheral vascular disease. Which of the following is part of common or concerning
symptoms for the peripheral vascular system?
A) Intermittent claudication
B) Chest pressure with exertion
C) Shortness of breath
D) Knee pain - CORRECT ANSWER-A) Intermittent claudication
You are a student in the vascular surgery clinic. You are asked to perform a physical examination on
a patient with known peripheral vascular disease in the legs. Which of the following aspects is
important to note when you perform your examination?
A) Size, symmetry, and skin color
B) Muscle bulk and tone
C) Nodules in joints
D) Lower extremity strength - CORRECT ANSWER-A) Size, symmetry, and skin color
Steve has had a stroke and comes to you for follow-up today. On examination you find that he has
increased muscle tone, some involuntary movements, an abnormal gait, and a slowness of response
in movements. He most likely has involvement of which of the following?
A) The corticospinal tract
B) The cerebellum
C) The cerebrum
D) The basal ganglia - CORRECT ANSWER-D. the basal ganglia
A patient with a history of seizure disorder and on several seizure medications says a friend noted
"jumping eye movements." The patient describes a sensation of movement at rest since his
medications were adjusted upward following a breakthrough seizure several weeks ago. On
examination you note that the eyes both slowly move to the right and then quickly jump to the left.
Which of the following is true?
PRACTICE 130 QUESTIONS WITH CORRECT ANSWERS FOR
ADVANCED NURSING AND MEDICAL EXAM PREP/ MOST TESTED
QUESTIONS
THIS SET OF PRACTICE QUESTIONS OFFERS CLINICAL SCENARIOS THAT ASSESS A STUDENT'S
ABILITY TO APPLY PHYSICAL EXAM TECHNIQUES AND INTERPRET FINDINGS RELATED TO THE
ABDOMEN, RESPIRATORY SYSTEM, NEUROLOGICAL FUNCTION, AND VASCULAR HEALTH.
QUESTIONS COVER KEY SIGNS SUCH AS MURPHY'S SIGN, OBTURATOR SIGN, AND
NYSTAGMUS, AS WELL AS CONDITIONS INCLUDING CHOLECYSTITIS, COPD, STROKE, AND
PERIPHERAL VASCULAR DISEASE. THIS RESOURCE IS IDEAL FOR STUDENTS IN ADVANCED
NURSING, MEDICINE, OR PHYSICIAN ASSISTANT PROGRAMS SEEKING TO MASTER PHYSICAL
DIAGNOSTIC SKILLS.
A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal pain. The pain is
associated with nausea and vomiting and occurs 1 to 2 hours after eating greasy foods. Which one of
the following physical examination descriptions would be most consistent with the diagnosis of
cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or masses.
B) Abdomen is soft and tender to palpation in the right lower quadrant, without rebound or
guarding.
C) Abdomen is soft and tender to palpation in the right upper quadrant with inspiration, to the point
of stopping inspiration, and there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric area, without rebound or guarding.
- CORRECT ANSWER-C) Abdomen is soft and tender to palpation in the right upper quadrant
with inspiration, to the point of stopping inspiration, and there is no rebound or guarding.
When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely etiology?
A) Bronchitis
B) Simple asthma
C) Cystic fibrosis
D) Heart failure - CORRECT ANSWER-A. Bronchitis
A patient with longstanding COPD was told by another practitioner that his liver was enlarged and
this needed to be assessed. Which of the following would be reasonable to do next?
A) Percuss the lower border of the liver
B) Measure the span of the liver
,C) Order a hepatitis panel
D) Obtain an ultrasound of the liver - CORRECT ANSWER-A) Percuss the lower border of the
liver
Mr. Patel is a 64-year-old man who was told by another care provider that his liver is enlarged.
Although he is a life-long smoker, he has never used drugs or alcohol and has no knowledge of liver
disease. Indeed, on examination, a liver edge is palpable 4 centimeters below the costal arch. Which
of the following would you do next?
A) Check an ultrasound of the liver
B) Obtain a hepatitis panel
C) Determine liver span by percussion
D) Adopt a "watchful waiting" approach - CORRECT ANSWER-c. Determine liver span by
percussion
You are palpating the abdomen and feel a small mass. Which of the following would you do next?
A) Ultrasound
B) Examination with the abdominal muscles tensed
C) Surgery referral
D) Determine size by percussion - CORRECT ANSWER-B) Examination with the abdominal
muscles tensed
Mr. Kruger is an 84-year-old man who presents with a smooth lower abdominal mass in the midline
which is minimally tender. There is dullness to percussion up to 6 centimeters above the symphysis
pubis. What does this most likely represent?
A) Sigmoid mass
B) Tumor in the abdominal wall
C) Hernia
D) Enlarged bladder - CORRECT ANSWER-D) Enlarged bladder
Which of the following is consistent with obturator sign?
A) Pain distant from the site used to check rebound tenderness
B) Right hypogastric pain with the right hip and knee flexed and the hip internally rotated
, C) Pain with extension of the right thigh while the patient is on her left side or while pressing her
knee against your hand with thigh flexion
D) Pain that stops inhalation in the right upper quadrant - CORRECT ANSWER-B) Right
hypogastric pain with the right hip and knee flexed and the hip internally rotated
A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has
smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned that
he may have peripheral vascular disease. Which of the following is part of common or concerning
symptoms for the peripheral vascular system?
A) Intermittent claudication
B) Chest pressure with exertion
C) Shortness of breath
D) Knee pain - CORRECT ANSWER-A) Intermittent claudication
You are a student in the vascular surgery clinic. You are asked to perform a physical examination on
a patient with known peripheral vascular disease in the legs. Which of the following aspects is
important to note when you perform your examination?
A) Size, symmetry, and skin color
B) Muscle bulk and tone
C) Nodules in joints
D) Lower extremity strength - CORRECT ANSWER-A) Size, symmetry, and skin color
Steve has had a stroke and comes to you for follow-up today. On examination you find that he has
increased muscle tone, some involuntary movements, an abnormal gait, and a slowness of response
in movements. He most likely has involvement of which of the following?
A) The corticospinal tract
B) The cerebellum
C) The cerebrum
D) The basal ganglia - CORRECT ANSWER-D. the basal ganglia
A patient with a history of seizure disorder and on several seizure medications says a friend noted
"jumping eye movements." The patient describes a sensation of movement at rest since his
medications were adjusted upward following a breakthrough seizure several weeks ago. On
examination you note that the eyes both slowly move to the right and then quickly jump to the left.
Which of the following is true?
