NR509 NGN Exam Questions (120) | Verified A+ Answers |
2025/2026 Advanced Physical Assessment
Page | 1
Question 1
A 52-year-old male presents with chronic nasal congestion and facial pressure.
What focused question should the nurse ask to assess for sinusitis?
A. “Do you experience nosebleeds at night?”
B. “Have you had any recent dental procedures?”
C. “Do you have a cough that worsens at night?”
D. “Do you feel pain when you press on your cheeks or forehead?”
Correct Answer: D
Rationale:
Sinusitis is often accompanied by tenderness over the frontal or maxillary
sinuses, particularly with palpation. Asking about facial pain is a focused and
relevant question.
Dental procedures can be a risk factor but not a diagnostic clue.
Question 2
Which physical assessment finding supports a diagnosis of allergic rhinitis?
A. Red, swollen nasal mucosa with purulent discharge
B. Pale, boggy nasal turbinates with clear drainage
C. Unilateral nasal obstruction with crusting
D. Midline nasal septum deviation
Correct Answer: B
Rationale:
Allergic rhinitis presents with pale, swollen (boggy) turbinates and clear
drainage. Red mucosa or purulent discharge suggests infection.
, Question 3
The nurse is performing a health history on a 45-year-old female with hearing
Page | 2 loss. Which question best assesses conductive hearing loss?
A. “Do you have difficulty understanding speech in noisy environments?”
B. “Have you noticed a sensation of fullness or wax in your ears?”
C. “Do you experience ringing in both ears?”
D. “Do loud sounds seem distorted?”
Correct Answer: B
Rationale:
Conductive hearing loss often feels like something is “blocking” the ear — wax,
fluid, or foreign objects. Sensory issues like speech distortion are related to
sensorineural hearing loss.
Question 4
Which of the following would be most concerning when assessing a patient's
mole using the ABCDE criteria?
A. A mole with regular borders and symmetrical shape
B. A mole measuring 3mm with uniform brown color
C. A mole that recently began to bleed and grow in size
D. A mole located on the back of the arm since childhood
Correct Answer: C
Rationale:
Any change in size, color, or bleeding (especially recent onset) is a red flag in the
ABCDE melanoma criteria (Asymmetry, Border, Color, Diameter, Evolution).
Question 5
, A 60-year-old presents with a white patch inside the oral cavity that cannot be
scraped off. What is the priority action?
A. Educate on oral hygiene
Page | 3 B. Schedule dental cleaning
C. Refer for biopsy
D. Document as candidiasis
Correct Answer: C
Rationale:
A non-removable white patch raises concern for leukoplakia, a potentially
precancerous lesion. Referral for biopsy is essential.
Question 6
A patient reports a history of smoking and now presents with hoarseness
lasting over 3 weeks. What is the nurse’s next action?
A. Assess for postnasal drip
B. Advise voice rest
C. Recommend throat lozenges
D. Refer to ENT for laryngoscopy
Correct Answer: D
Rationale:
Persistent hoarseness in a smoker is a red flag for laryngeal cancer. Prompt ENT
referral is required.
Question 7
During eye assessment, which finding is considered normal in an older adult?
A. Increased peripheral vision
B. Difficulty seeing far objects
C. Decreased accommodation
D. Rapid pupillary response to light
, Correct Answer: C
Rationale:
Presbyopia (age-related loss of lens flexibility) causes decreased
Page | 4 accommodation, affecting the ability to focus on near objects.
Question 8
A 70-year-old complains of bilateral hearing loss. What is the most
appropriate initial assessment technique?
A. Otoscopic exam
B. Whisper test
C. Rinne and Weber tuning fork tests
D. Audiometry referral
Correct Answer: B
Rationale:
The whisper test is a simple, quick screening tool used in clinical settings to assess
for hearing loss. It’s non-invasive and part of routine exams.
Question 9
Which finding during a thyroid exam is abnormal?
A. Thyroid rises symmetrically with swallowing
B. No palpable nodules
C. Palpable thrill or audible bruit
D. Smooth and rubbery texture
Correct Answer: C
Rationale:
A thrill or bruit over the thyroid gland indicates increased vascularity, possibly
due to hyperthyroidism (e.g., Graves’ disease) and should be further evaluated.
2025/2026 Advanced Physical Assessment
Page | 1
Question 1
A 52-year-old male presents with chronic nasal congestion and facial pressure.
What focused question should the nurse ask to assess for sinusitis?
A. “Do you experience nosebleeds at night?”
B. “Have you had any recent dental procedures?”
C. “Do you have a cough that worsens at night?”
D. “Do you feel pain when you press on your cheeks or forehead?”
Correct Answer: D
Rationale:
Sinusitis is often accompanied by tenderness over the frontal or maxillary
sinuses, particularly with palpation. Asking about facial pain is a focused and
relevant question.
Dental procedures can be a risk factor but not a diagnostic clue.
Question 2
Which physical assessment finding supports a diagnosis of allergic rhinitis?
A. Red, swollen nasal mucosa with purulent discharge
B. Pale, boggy nasal turbinates with clear drainage
C. Unilateral nasal obstruction with crusting
D. Midline nasal septum deviation
Correct Answer: B
Rationale:
Allergic rhinitis presents with pale, swollen (boggy) turbinates and clear
drainage. Red mucosa or purulent discharge suggests infection.
, Question 3
The nurse is performing a health history on a 45-year-old female with hearing
Page | 2 loss. Which question best assesses conductive hearing loss?
A. “Do you have difficulty understanding speech in noisy environments?”
B. “Have you noticed a sensation of fullness or wax in your ears?”
C. “Do you experience ringing in both ears?”
D. “Do loud sounds seem distorted?”
Correct Answer: B
Rationale:
Conductive hearing loss often feels like something is “blocking” the ear — wax,
fluid, or foreign objects. Sensory issues like speech distortion are related to
sensorineural hearing loss.
Question 4
Which of the following would be most concerning when assessing a patient's
mole using the ABCDE criteria?
A. A mole with regular borders and symmetrical shape
B. A mole measuring 3mm with uniform brown color
C. A mole that recently began to bleed and grow in size
D. A mole located on the back of the arm since childhood
Correct Answer: C
Rationale:
Any change in size, color, or bleeding (especially recent onset) is a red flag in the
ABCDE melanoma criteria (Asymmetry, Border, Color, Diameter, Evolution).
Question 5
, A 60-year-old presents with a white patch inside the oral cavity that cannot be
scraped off. What is the priority action?
A. Educate on oral hygiene
Page | 3 B. Schedule dental cleaning
C. Refer for biopsy
D. Document as candidiasis
Correct Answer: C
Rationale:
A non-removable white patch raises concern for leukoplakia, a potentially
precancerous lesion. Referral for biopsy is essential.
Question 6
A patient reports a history of smoking and now presents with hoarseness
lasting over 3 weeks. What is the nurse’s next action?
A. Assess for postnasal drip
B. Advise voice rest
C. Recommend throat lozenges
D. Refer to ENT for laryngoscopy
Correct Answer: D
Rationale:
Persistent hoarseness in a smoker is a red flag for laryngeal cancer. Prompt ENT
referral is required.
Question 7
During eye assessment, which finding is considered normal in an older adult?
A. Increased peripheral vision
B. Difficulty seeing far objects
C. Decreased accommodation
D. Rapid pupillary response to light
, Correct Answer: C
Rationale:
Presbyopia (age-related loss of lens flexibility) causes decreased
Page | 4 accommodation, affecting the ability to focus on near objects.
Question 8
A 70-year-old complains of bilateral hearing loss. What is the most
appropriate initial assessment technique?
A. Otoscopic exam
B. Whisper test
C. Rinne and Weber tuning fork tests
D. Audiometry referral
Correct Answer: B
Rationale:
The whisper test is a simple, quick screening tool used in clinical settings to assess
for hearing loss. It’s non-invasive and part of routine exams.
Question 9
Which finding during a thyroid exam is abnormal?
A. Thyroid rises symmetrically with swallowing
B. No palpable nodules
C. Palpable thrill or audible bruit
D. Smooth and rubbery texture
Correct Answer: C
Rationale:
A thrill or bruit over the thyroid gland indicates increased vascularity, possibly
due to hyperthyroidism (e.g., Graves’ disease) and should be further evaluated.
