NR509 Advanced Physical
Assessment Exam Questions.
Latest Updated 2025/2026 Guide
with 100% Verified Answers.
What are the symptoms of the 26-year-old public servant presenting to the Emergency
Department? - ansIntense abdominal pain, light-headedness, and a fainting episode.
What is the family medical history concern for the 26-year-old patient? - ansStrong family
history of gallstones.
What is the significance of the positive β-hCG in the 26-year-old patient? - ansIt indicates a
possible pregnancy.
What vital sign abnormalities were noted in the 26-year-old patient? - ansPulse of 118, blood
pressure of 86/68.
What abdominal exam findings were noted in the 26-year-old patient? - ansInvoluntary
rigidity and rebound tenderness.
What is the most likely diagnosis for the 26-year-old patient? - ansRuptured tubal pregnancy.
What lab findings were noted for the 63-year-old janitor during his well visit? - ansModerate
elevations of liver enzymes and mildly elevated total bilirubin.
What finding would be most consistent with hepatomegaly in the 63-year-old janitor? -
ansLiver palpable 3 cm below the right costal margin, midclavicular line on expiration.
What is considered a normal liver span measurement at the midclavicular line? - ans6-12 cm.
What is the significance of dullness to percussion over the liver span? - ansIt indicates the
size and condition of the liver.
What is the primary concern for the underweight 63-year-old administrative clerk? -
ansProminent abdominal aorta concerning for an abdominal aortic aneurysm (AAA).
What is the most significant risk factor for an abdominal aortic aneurysm (AAA) in the
underweight clerk? - ansHistory of smoking.
What vital signs were recorded for the underweight administrative clerk? - ansPulse of 86,
blood pressure of 148/92.
What is the BMI of the underweight administrative clerk? - ans17.6.
What is the age of the first cousin who died from a ruptured aneurysm? - ans68 years.
What are the normal ranges for liver span measurements at the midsternal line? - ans4-8 cm.
What is the clinical significance of a liver span greater than 12 cm at the midclavicular line? -
ansIt supports the diagnosis of hepatomegaly.
What is the expected liver position during inspiration? - ansThe liver is pushed down into the
abdominal cavity.
What is the expected liver position during expiration? - ansThe liver is normally palpable at
the right costal margin.
What is the relationship between obstructive lung disease and liver position? - ansAir
trapping may displace the liver downwards into the abdominal cavity.
What is the significance of a patient's family history in assessing risk for AAA? - ansFamily
history of ruptured aneurysms increases risk.
What is the clinical relevance of a patient's smoking history in relation to AAA? -
ansSmoking is a significant risk factor for developing an abdominal aortic aneurysm.
What are the potential symptoms of an abdominal aortic aneurysm? - ansRecurrent epigastric
abdominal discomfort.
,NR509 Advanced Physical
Assessment Exam Questions.
Latest Updated 2025/2026 Guide
with 100% Verified Answers.
What is the importance of performing an abdominal exam in patients with concerning
symptoms? - ansTo assess for abnormalities such as hepatomegaly or AAA.
What is the most significant risk factor for an abdominal aortic aneurysm (AAA) in the
provided notes? - ansHistory of smoking.
Which gender is considered a risk factor for AAA? - ansMale gender.
What is the relevance of family history in relation to AAA risk? - ansFamily history of
ruptured aneurysm is vague and could refer to cerebral aneurysm.
What is the USPSTF recommendation for routine colon cancer screening in a 76-year-old
man? - ansDo not screen routinely.
What is the life expectancy necessary for colon cancer screening to be potentially beneficial
according to USPSTF? - ansA life expectancy greater than 7 years.
What should be discussed with patients aged 76-85 regarding colon cancer screening? -
ansIndividualized risks and benefits.
What screening method may continue until age 80-85 if benefits outweigh risks? - ansAnnual
FOBT screening.
What findings on a colonoscopy would indicate no need for a repeat colonoscopy? -
ansAbsence of any cancerous or precancerous findings.
What is the most likely physiological mechanism for constipation in the 31-year-old
accountant? - ansFunctional change in bowel movement.
What are the three patterns of irritable bowel syndrome (IBS)? - ansDiarrhea predominant,
constipation predominant, or mixed.
What is characteristic of fecal impaction? - ansA large, firm fecal mass in the rectum.
What dietary characteristic is associated with decreased fecal bulk? - ansA diet low in fiber.
What condition is spasm of the external sphincter associated with? - ansPainful anal lesions.
What conditions are associated with impairment of autonomic innervations? - ansMultiple
sclerosis, spinal cord injuries, and Hirschsprung disease.
What symptom did the accountant experience that is associated with constipation? -
ansRecurrent crampy abdominal pain.
What did the accountant resort to for relief from constipation? - ansOver-the-counter
laxatives.
What is a common characteristic of IBS related to bowel movements? - ansFunctional
changes in bowel movement.
What was found during the colonoscopy of the 76-year-old man? - ansInternal hemorrhoids
and sigmoid diverticuli.
What is the significance of a positive FOBT in the context of colon cancer screening? - ansIt
indicates the need for further investigation, such as a colonoscopy.
What is the age limit for routine colon cancer screening according to the USPSTF? - ansAge
75 years.
What is the recommended frequency for sigmoidoscopy and FOBT in the notes? -
ansSigmoidoscopy every 5 years with FOBT every 3 years.
What is the typical resolution pattern for the accountant's constipation symptoms? -
ansSymptoms typically gradually resolve with bowel movements.
, NR509 Advanced Physical
Assessment Exam Questions.
Latest Updated 2025/2026 Guide
with 100% Verified Answers.
What is the common stool characteristic reported by the accountant? - ansInfrequent, small
hard stool.
What congenital condition is associated with the 23-year-old woman's chronic sinusitis and
bronchiectasis? - ansKartagener syndrome.
What is the significance of situs inversus in the context of the abdominal exam findings? -
ansIn situs inversus, the stomach and gastric air bubble are on the right, and liver dullness is
on the left.
What physical exam finding indicates peritonitis in the 28-year-old lawyer suspected of
having appendicitis? - ansRebound tenderness, where pressing down firmly and slowly and
then quickly withdrawing the hand produces pain.
What does involuntary contraction of the abdominal wall indicate during an exam? - ansIt
indicates rigidity, which is different from voluntary contraction.
How does abdominal pain change with hip flexion in patients with peritonitis? - ansPatients
with peritonitis tend to keep their hips flexed to reduce stretch and irritation of the parietal
peritoneum.
What is McBurney's point and its relevance in appendicitis? - ansMcBurney's point is located
2 inches from the anterior superior iliac spine on a line drawn from the umbilicus and is
associated with localized pain in appendicitis.
What is the most likely diagnosis for the 58-year-old man with chronic diarrhea and weight
loss? - ansChronic pancreatitis.
What mechanism leads to diarrhea in chronic pancreatitis? - ansFibrosis of the pancreas leads
to decreased pancreatic function and enzyme insufficiency.
What is the role of H. Pylori infection in gastrointestinal conditions? - ansH. Pylori infection
may cause peptic ulcer disease and dyspepsia, but is not usually associated with diarrhea.
What condition is characterized by inflammation of the colonic diverticulum? -
ansDiverticulitis, which typically causes left-lower-quadrant pain, fever, and sometimes
diarrhea.
What is mesenteric ischemia and its associated symptoms? - ansMesenteric ischemia is
characterized by reduced blood supply to the bowel, causing diffuse abdominal pain,
vomiting, diarrhea, or constipation.
What are the common symptoms of chronic pancreatitis? - ansIncreasing weakness, recurrent
epigastric pain radiating to the back, chronic diarrhea, and weight loss.
What does a protuberant abdomen with scattered areas of tympany and dullness indicate? -
ansIt may suggest fluid accumulation or other abdominal abnormalities, but is not the best fit
for the case presented.
What does dullness to percussion in the left lower anterior chest wall suggest? - ansIt may
indicate pleural effusion or other lung-related issues, not directly related to the abdominal
findings.
What does a change in percussion from tympany to dullness in the lower left anterior chest
wall on inspiration indicate? - ansIt suggests possible pleural effusion or lung pathology.
What is the significance of guarding during a physical exam? - ansGuarding indicates
abdominal pain and may suggest peritoneal irritation.
Assessment Exam Questions.
Latest Updated 2025/2026 Guide
with 100% Verified Answers.
What are the symptoms of the 26-year-old public servant presenting to the Emergency
Department? - ansIntense abdominal pain, light-headedness, and a fainting episode.
What is the family medical history concern for the 26-year-old patient? - ansStrong family
history of gallstones.
What is the significance of the positive β-hCG in the 26-year-old patient? - ansIt indicates a
possible pregnancy.
What vital sign abnormalities were noted in the 26-year-old patient? - ansPulse of 118, blood
pressure of 86/68.
What abdominal exam findings were noted in the 26-year-old patient? - ansInvoluntary
rigidity and rebound tenderness.
What is the most likely diagnosis for the 26-year-old patient? - ansRuptured tubal pregnancy.
What lab findings were noted for the 63-year-old janitor during his well visit? - ansModerate
elevations of liver enzymes and mildly elevated total bilirubin.
What finding would be most consistent with hepatomegaly in the 63-year-old janitor? -
ansLiver palpable 3 cm below the right costal margin, midclavicular line on expiration.
What is considered a normal liver span measurement at the midclavicular line? - ans6-12 cm.
What is the significance of dullness to percussion over the liver span? - ansIt indicates the
size and condition of the liver.
What is the primary concern for the underweight 63-year-old administrative clerk? -
ansProminent abdominal aorta concerning for an abdominal aortic aneurysm (AAA).
What is the most significant risk factor for an abdominal aortic aneurysm (AAA) in the
underweight clerk? - ansHistory of smoking.
What vital signs were recorded for the underweight administrative clerk? - ansPulse of 86,
blood pressure of 148/92.
What is the BMI of the underweight administrative clerk? - ans17.6.
What is the age of the first cousin who died from a ruptured aneurysm? - ans68 years.
What are the normal ranges for liver span measurements at the midsternal line? - ans4-8 cm.
What is the clinical significance of a liver span greater than 12 cm at the midclavicular line? -
ansIt supports the diagnosis of hepatomegaly.
What is the expected liver position during inspiration? - ansThe liver is pushed down into the
abdominal cavity.
What is the expected liver position during expiration? - ansThe liver is normally palpable at
the right costal margin.
What is the relationship between obstructive lung disease and liver position? - ansAir
trapping may displace the liver downwards into the abdominal cavity.
What is the significance of a patient's family history in assessing risk for AAA? - ansFamily
history of ruptured aneurysms increases risk.
What is the clinical relevance of a patient's smoking history in relation to AAA? -
ansSmoking is a significant risk factor for developing an abdominal aortic aneurysm.
What are the potential symptoms of an abdominal aortic aneurysm? - ansRecurrent epigastric
abdominal discomfort.
,NR509 Advanced Physical
Assessment Exam Questions.
Latest Updated 2025/2026 Guide
with 100% Verified Answers.
What is the importance of performing an abdominal exam in patients with concerning
symptoms? - ansTo assess for abnormalities such as hepatomegaly or AAA.
What is the most significant risk factor for an abdominal aortic aneurysm (AAA) in the
provided notes? - ansHistory of smoking.
Which gender is considered a risk factor for AAA? - ansMale gender.
What is the relevance of family history in relation to AAA risk? - ansFamily history of
ruptured aneurysm is vague and could refer to cerebral aneurysm.
What is the USPSTF recommendation for routine colon cancer screening in a 76-year-old
man? - ansDo not screen routinely.
What is the life expectancy necessary for colon cancer screening to be potentially beneficial
according to USPSTF? - ansA life expectancy greater than 7 years.
What should be discussed with patients aged 76-85 regarding colon cancer screening? -
ansIndividualized risks and benefits.
What screening method may continue until age 80-85 if benefits outweigh risks? - ansAnnual
FOBT screening.
What findings on a colonoscopy would indicate no need for a repeat colonoscopy? -
ansAbsence of any cancerous or precancerous findings.
What is the most likely physiological mechanism for constipation in the 31-year-old
accountant? - ansFunctional change in bowel movement.
What are the three patterns of irritable bowel syndrome (IBS)? - ansDiarrhea predominant,
constipation predominant, or mixed.
What is characteristic of fecal impaction? - ansA large, firm fecal mass in the rectum.
What dietary characteristic is associated with decreased fecal bulk? - ansA diet low in fiber.
What condition is spasm of the external sphincter associated with? - ansPainful anal lesions.
What conditions are associated with impairment of autonomic innervations? - ansMultiple
sclerosis, spinal cord injuries, and Hirschsprung disease.
What symptom did the accountant experience that is associated with constipation? -
ansRecurrent crampy abdominal pain.
What did the accountant resort to for relief from constipation? - ansOver-the-counter
laxatives.
What is a common characteristic of IBS related to bowel movements? - ansFunctional
changes in bowel movement.
What was found during the colonoscopy of the 76-year-old man? - ansInternal hemorrhoids
and sigmoid diverticuli.
What is the significance of a positive FOBT in the context of colon cancer screening? - ansIt
indicates the need for further investigation, such as a colonoscopy.
What is the age limit for routine colon cancer screening according to the USPSTF? - ansAge
75 years.
What is the recommended frequency for sigmoidoscopy and FOBT in the notes? -
ansSigmoidoscopy every 5 years with FOBT every 3 years.
What is the typical resolution pattern for the accountant's constipation symptoms? -
ansSymptoms typically gradually resolve with bowel movements.
, NR509 Advanced Physical
Assessment Exam Questions.
Latest Updated 2025/2026 Guide
with 100% Verified Answers.
What is the common stool characteristic reported by the accountant? - ansInfrequent, small
hard stool.
What congenital condition is associated with the 23-year-old woman's chronic sinusitis and
bronchiectasis? - ansKartagener syndrome.
What is the significance of situs inversus in the context of the abdominal exam findings? -
ansIn situs inversus, the stomach and gastric air bubble are on the right, and liver dullness is
on the left.
What physical exam finding indicates peritonitis in the 28-year-old lawyer suspected of
having appendicitis? - ansRebound tenderness, where pressing down firmly and slowly and
then quickly withdrawing the hand produces pain.
What does involuntary contraction of the abdominal wall indicate during an exam? - ansIt
indicates rigidity, which is different from voluntary contraction.
How does abdominal pain change with hip flexion in patients with peritonitis? - ansPatients
with peritonitis tend to keep their hips flexed to reduce stretch and irritation of the parietal
peritoneum.
What is McBurney's point and its relevance in appendicitis? - ansMcBurney's point is located
2 inches from the anterior superior iliac spine on a line drawn from the umbilicus and is
associated with localized pain in appendicitis.
What is the most likely diagnosis for the 58-year-old man with chronic diarrhea and weight
loss? - ansChronic pancreatitis.
What mechanism leads to diarrhea in chronic pancreatitis? - ansFibrosis of the pancreas leads
to decreased pancreatic function and enzyme insufficiency.
What is the role of H. Pylori infection in gastrointestinal conditions? - ansH. Pylori infection
may cause peptic ulcer disease and dyspepsia, but is not usually associated with diarrhea.
What condition is characterized by inflammation of the colonic diverticulum? -
ansDiverticulitis, which typically causes left-lower-quadrant pain, fever, and sometimes
diarrhea.
What is mesenteric ischemia and its associated symptoms? - ansMesenteric ischemia is
characterized by reduced blood supply to the bowel, causing diffuse abdominal pain,
vomiting, diarrhea, or constipation.
What are the common symptoms of chronic pancreatitis? - ansIncreasing weakness, recurrent
epigastric pain radiating to the back, chronic diarrhea, and weight loss.
What does a protuberant abdomen with scattered areas of tympany and dullness indicate? -
ansIt may suggest fluid accumulation or other abdominal abnormalities, but is not the best fit
for the case presented.
What does dullness to percussion in the left lower anterior chest wall suggest? - ansIt may
indicate pleural effusion or other lung-related issues, not directly related to the abdominal
findings.
What does a change in percussion from tympany to dullness in the lower left anterior chest
wall on inspiration indicate? - ansIt suggests possible pleural effusion or lung pathology.
What is the significance of guarding during a physical exam? - ansGuarding indicates
abdominal pain and may suggest peritoneal irritation.
