NR 509 Advanced Physical Assessment Final Exam 2025 – Actual Chamberlain Exam | 100% Verified Questions and Correct Answers

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NR 509 Advanced Physical
Assessment Final Exam 2025
– Actual Chamberlain Exam |
100% Verified Questions and
Correct Answers
Question 1
A nurse practitioner is performing a cardiovascular assessment on a 65-year-old client. Which
finding during auscultation suggests aortic regurgitation?
A. High-pitched blowing murmur heard at the left sternal border
B. Low-pitched rumbling murmur heard at the apex
C. Early diastolic decrescendo murmur heard at the aortic area
D. Midsystolic ejection murmur heard at the pulmonic area

Correct Answer: C. Early diastolic decrescendo murmur heard at the aortic area
Rationale: Aortic regurgitation is characterized by an early diastolic decrescendo murmur best
heard at the aortic area (2nd right intercostal space) due to blood flowing back into the left
ventricle during diastole. This is consistent with advanced physical assessment findings for
valvular heart disease.




Question 2
During a respiratory assessment, a client exhibits diminished breath sounds in the right lower
lobe and tactile fremitus is decreased. What is the most likely diagnosis?
A. Pneumothorax
B. Pneumonia
C. Pulmonary edema
D. Chronic obstructive pulmonary disease (COPD)

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Correct Answer: A. Pneumothorax
Rationale: Diminished breath sounds and decreased tactile fremitus in a unilateral lung field
suggest pneumothorax, as air in the pleural space reduces sound transmission. Pneumonia
typically increases fremitus, and pulmonary edema or COPD affects both lungs, per advanced
physical assessment criteria.




Question 3
A nurse practitioner is assessing a client with suspected appendicitis. Which physical exam
finding is most specific?
A. Psoas sign
B. Rovsing’s sign
C. Rebound tenderness
D. Murphy’s sign

Correct Answer: B. Rovsing’s sign
Rationale: Rovsing’s sign, pain in the right lower quadrant when palpating the left lower
quadrant, is highly specific for appendicitis due to peritoneal irritation. Rebound tenderness is
sensitive but less specific, and other signs relate to different conditions, per NR 509 assessment
standards.




Question 4
When performing a cranial nerve assessment, a nurse practitioner notes that the client cannot
shrug their shoulders symmetrically. Which cranial nerve is likely affected?
A. Cranial nerve IX
B. Cranial nerve X
C. Cranial nerve XI
D. Cranial nerve XII

Correct Answer: C. Cranial nerve XI
Rationale: Cranial nerve XI (spinal accessory nerve) innervates the trapezius muscle,
responsible for shoulder shrugging. Asymmetry suggests dysfunction, consistent with advanced
neurological assessment techniques.




Question 5
A client presents with unilateral facial drooping and inability to close the left eye. Which
condition is most likely?

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A. Trigeminal neuralgia
B. Bell’s palsy
C. Stroke
D. Myasthenia gravis

Correct Answer: B. Bell’s palsy
Rationale: Bell’s palsy, a peripheral facial nerve (CN VII) paralysis, causes unilateral facial
drooping and inability to close the eye. Stroke typically involves additional neurological deficits,
and other conditions present differently, per NR 509 assessment criteria.




Question 6
During an abdominal assessment, a nurse practitioner elicits a positive Murphy’s sign. What is
the most likely diagnosis?
A. Appendicitis
B. Cholecystitis
C. Pancreatitis
D. Peptic ulcer disease

Correct Answer: B. Cholecystitis
Rationale: A positive Murphy’s sign (pain on palpation of the gallbladder during inspiration) is
highly specific for acute cholecystitis due to gallbladder inflammation. Other conditions have
different physical findings, per advanced assessment standards.




Question 7
A nurse practitioner is assessing a client’s deep tendon reflexes. Which finding indicates a
normal biceps reflex?
A. No response
B. Slight twitch of the arm
C. Exaggerated arm flexion
D. Sustained clonus

Correct Answer: B. Slight twitch of the arm
Rationale: A normal biceps reflex (C5-C6) results in a slight twitch or contraction of the biceps
muscle. Absent or exaggerated responses suggest neurological dysfunction, per NR 509
neurological assessment guidelines.




Question 8

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When assessing a client’s gait, the nurse practitioner notes a wide-based, staggering gait. Which
condition is most likely?
A. Parkinson’s disease
B. Cerebellar dysfunction
C. Peripheral neuropathy
D. Stroke

Correct Answer: B. Cerebellar dysfunction
Rationale: A wide-based, staggering gait is characteristic of cerebellar dysfunction due to
impaired coordination. Parkinson’s causes a shuffling gait, and stroke or neuropathy affects gait
differently, per advanced physical assessment criteria.




Question 9
A nurse practitioner is performing a fundoscopic exam and notes a pale optic disc. What is the
most likely cause?
A. Glaucoma
B. Optic atrophy
C. Papilledema
D. Retinal detachment

Correct Answer: B. Optic atrophy
Rationale: A pale optic disc indicates optic atrophy, often due to optic nerve damage.
Papilledema shows disc swelling, and glaucoma or retinal detachment present differently, per
NR 509 ophthalmologic assessment standards.




Question 10
During a cardiovascular exam, a nurse practitioner auscultates a loud, harsh systolic murmur at
the 2nd right intercostal space. What is the most likely diagnosis?
A. Mitral regurgitation
B. Aortic stenosis
C. Tricuspid regurgitation
D. Pulmonic stenosis

Correct Answer: B. Aortic stenosis
Rationale: A loud, harsh systolic murmur at the 2nd right intercostal space is characteristic of
aortic stenosis, caused by turbulent flow through a narrowed aortic valve. Other murmurs are
heard in different locations, per advanced cardiovascular assessment.