1|Page
2025/2026 NUR 509 FINAL EXAM/NUR 509 EXAM
BANK CURRENTLY COMPLETE TESTING
QUESTIONS AND DETAILED CORRECT ANSWERS
(VERIFIED) FOR GUARANTEED PASS TOP-RATED
A+.
NUR 509
Ace your NUR 509 final exam with this comprehensive review guide,
designed to solidify your advanced practice nursing knowledge for
accurate diagnosis and patient management. This resource efficiently
consolidates complex concepts into a high-yield format, featuring
realistic practice questions and evidence-based rationales. Maximize
your study efficiency and approach your culminating exam with the
confidence to excel and advance in your nursing career.
An overweight 26-year-old public servant presents to the
Emergency Department with 12 hours of intense abdominal
pain, light-headedness, and a fainting episode that finally
prompted her to seek medical attention. She has a strong
family history of gallstones and is concerned about this
possibility. She has not had any vomiting or diarrhea. She
had a normal bowel movement this morning. Her β-human
chorionic gonadotropin (β-hCG) is positive at triage. She
reports that her last period was 10 weeks ago. Her vital signs
at triage are pulse, 118; blood pressure, 86/68; respiratory
rate, 20/min; oxygen saturation, 99%; and temperature,
37.3ºC orally. The clinician performs an abdominal exam
prior to her pelvic exam and, on palpation of her abdomen,
finds involuntary rigidity and rebound tenderness. What is
,2|Page
the most likely diagnosis? ...... ANSWER .......
Ruptured tubal (or ectopic) pregnancy
RATIONALE: bc the constellation of abdominal pain,
syncope, tachycardia, hypotension, positive β-hCG, and
findings suggestive of peritoneal inflammation/irritation
strongly suggest a ruptured ectopic pregnancy with
significant intra-abdominal bleeding leading to peritoneal
signs.
A 63-year-old janitor with a history of adenomatous colonic
polyps presents for a well visit. Basic labs are performed to
screen for diabetes mellitus and dyslipidemia. Electrolytes
and liver enzymes were also measured. His labs are all
normal expect for moderate elevations of aspartate
aminotransferase, alanine aminotransferase, γ-glutamyl
transferase, and alkaline phosphatase as well as a mildly
elevated total bilirubin. He presents for a follow-up
appointment and the clinician performs an abdominal exam
to assess his liver. Which of the following findings would be
most consistent with hepatomegaly? ...... ANSWER .......
Liver palpable 3 cm below the right costal margin, mid
clavicular line, on expiration
RATIONALE: bc the liver being palpable 3 cm below the
right costal margin, midclavicular line, would be considered
,3|Page
normal on inspiration when the liver is pushed down into the
abdominal cavity on inspiration, but is abnormal on
expiration.
A 63-year-old underweight administrative clerk with a 50-
pack-year smoking history presents with a several month
history of recurrent epigastric abdominal discomfort. She
feels fairly well otherwise and denies any nausea, vomiting,
diarrhea, or constipation. She reports that a first cousin died
from a ruptured aneurysm at age 68 years. Her vital signs are
pulse, 86; blood pressure, 148/92; respiratory rate, 16;
oxygen saturation, 95%; and temperature, 36.2ºC. Her body
mass index is 17.6. On exam, her abdominal aorta is
prominent, which is concerning for an abdominal aortic
aneurysm (AAA). Which of the following is her most
significant risk factor for an AAA? ...... ANSWER .......
History of smoking
A 76-year-old retired man with a history of prostate cancer
and hypertension has been screened annually for colon
cancer using high sensitivity fecal occult blood testing
(FOBT). He presents for follow-up of his hypertension,
during which the clinician scans his chart to ensure he is up
to date with his preventive health care. He has a positive
FOBT on one occasion at age 66 years and subsequently
went for a colonoscopy. Internal hemorrhoids and sigmoid
diverticuli were found on colonoscopy. He has no first-degree
, 4|Page
relatives with a history of colorectal cancer or adenomatous
polyps. What are the U.S. Preventive Services Task Force
(USPSTF) screening recommendations for this patient?
...... ANSWER ....... Do not screen routinely
An otherwise healthy 31-year-old accountant presents to an
outpatient clinic with a 3-year history of recurrent crampy
abdominal pain that lasts for about 1-2 weeks each episode
and is associated with onset of constipation. She describes
infrequent, small hard stool that she finds very difficult to
pass. She has tried to increase dietary fiber and water intake,
but usually this is not sufficient and she resorts to over-the-
counter laxatives, which she finds upset her stomach but do
resolve the constipation. Symptoms typically gradually
resolve with bowel movements. Which of the following is the
most likely physiological mechanism for her constipation?
...... ANSWER ....... Functional change in bowel
movement
RATIONALE: bc this is a characteristic of IBS
A 23-year-old woman comes to the respirology clinic for
follow-up of her chronic sinusitis and bronchiectasis that is
associated with a rare congenital condition called Kartagener
syndrome. The preceptor notes that she has situs inversus
and asks for a physical exam. Which of the following
2025/2026 NUR 509 FINAL EXAM/NUR 509 EXAM
BANK CURRENTLY COMPLETE TESTING
QUESTIONS AND DETAILED CORRECT ANSWERS
(VERIFIED) FOR GUARANTEED PASS TOP-RATED
A+.
NUR 509
Ace your NUR 509 final exam with this comprehensive review guide,
designed to solidify your advanced practice nursing knowledge for
accurate diagnosis and patient management. This resource efficiently
consolidates complex concepts into a high-yield format, featuring
realistic practice questions and evidence-based rationales. Maximize
your study efficiency and approach your culminating exam with the
confidence to excel and advance in your nursing career.
An overweight 26-year-old public servant presents to the
Emergency Department with 12 hours of intense abdominal
pain, light-headedness, and a fainting episode that finally
prompted her to seek medical attention. She has a strong
family history of gallstones and is concerned about this
possibility. She has not had any vomiting or diarrhea. She
had a normal bowel movement this morning. Her β-human
chorionic gonadotropin (β-hCG) is positive at triage. She
reports that her last period was 10 weeks ago. Her vital signs
at triage are pulse, 118; blood pressure, 86/68; respiratory
rate, 20/min; oxygen saturation, 99%; and temperature,
37.3ºC orally. The clinician performs an abdominal exam
prior to her pelvic exam and, on palpation of her abdomen,
finds involuntary rigidity and rebound tenderness. What is
,2|Page
the most likely diagnosis? ...... ANSWER .......
Ruptured tubal (or ectopic) pregnancy
RATIONALE: bc the constellation of abdominal pain,
syncope, tachycardia, hypotension, positive β-hCG, and
findings suggestive of peritoneal inflammation/irritation
strongly suggest a ruptured ectopic pregnancy with
significant intra-abdominal bleeding leading to peritoneal
signs.
A 63-year-old janitor with a history of adenomatous colonic
polyps presents for a well visit. Basic labs are performed to
screen for diabetes mellitus and dyslipidemia. Electrolytes
and liver enzymes were also measured. His labs are all
normal expect for moderate elevations of aspartate
aminotransferase, alanine aminotransferase, γ-glutamyl
transferase, and alkaline phosphatase as well as a mildly
elevated total bilirubin. He presents for a follow-up
appointment and the clinician performs an abdominal exam
to assess his liver. Which of the following findings would be
most consistent with hepatomegaly? ...... ANSWER .......
Liver palpable 3 cm below the right costal margin, mid
clavicular line, on expiration
RATIONALE: bc the liver being palpable 3 cm below the
right costal margin, midclavicular line, would be considered
,3|Page
normal on inspiration when the liver is pushed down into the
abdominal cavity on inspiration, but is abnormal on
expiration.
A 63-year-old underweight administrative clerk with a 50-
pack-year smoking history presents with a several month
history of recurrent epigastric abdominal discomfort. She
feels fairly well otherwise and denies any nausea, vomiting,
diarrhea, or constipation. She reports that a first cousin died
from a ruptured aneurysm at age 68 years. Her vital signs are
pulse, 86; blood pressure, 148/92; respiratory rate, 16;
oxygen saturation, 95%; and temperature, 36.2ºC. Her body
mass index is 17.6. On exam, her abdominal aorta is
prominent, which is concerning for an abdominal aortic
aneurysm (AAA). Which of the following is her most
significant risk factor for an AAA? ...... ANSWER .......
History of smoking
A 76-year-old retired man with a history of prostate cancer
and hypertension has been screened annually for colon
cancer using high sensitivity fecal occult blood testing
(FOBT). He presents for follow-up of his hypertension,
during which the clinician scans his chart to ensure he is up
to date with his preventive health care. He has a positive
FOBT on one occasion at age 66 years and subsequently
went for a colonoscopy. Internal hemorrhoids and sigmoid
diverticuli were found on colonoscopy. He has no first-degree
, 4|Page
relatives with a history of colorectal cancer or adenomatous
polyps. What are the U.S. Preventive Services Task Force
(USPSTF) screening recommendations for this patient?
...... ANSWER ....... Do not screen routinely
An otherwise healthy 31-year-old accountant presents to an
outpatient clinic with a 3-year history of recurrent crampy
abdominal pain that lasts for about 1-2 weeks each episode
and is associated with onset of constipation. She describes
infrequent, small hard stool that she finds very difficult to
pass. She has tried to increase dietary fiber and water intake,
but usually this is not sufficient and she resorts to over-the-
counter laxatives, which she finds upset her stomach but do
resolve the constipation. Symptoms typically gradually
resolve with bowel movements. Which of the following is the
most likely physiological mechanism for her constipation?
...... ANSWER ....... Functional change in bowel
movement
RATIONALE: bc this is a characteristic of IBS
A 23-year-old woman comes to the respirology clinic for
follow-up of her chronic sinusitis and bronchiectasis that is
associated with a rare congenital condition called Kartagener
syndrome. The preceptor notes that she has situs inversus
and asks for a physical exam. Which of the following
