✅ NR 509 Final Actual Exam – ORIGINAL
Practice Questions And correct Answers
Includes answers + brief rationales
1. A 55-year-old male presents with intermittent chest
tightness that occurs during exertion and resolves with
rest. What is the MOST likely cause?
A. Gastroesophageal reflux
B. Stable angina
C. Costochondritis
D. Anxiety-related dyspnea
Correct Answer: B
Rationale: Classic exertional chest pressure relieved by rest strongly indicates stable angina.
2. During an abdominal exam, you hear a high-pitched
“tinkling” sound with rushing noises. What does this
suggest?
A. Normal bowel sounds
B. Early appendicitis
C. Small-bowel obstruction
D. Peritonitis
Correct Answer: C
Rationale: High-pitched, hyperactive bowel sounds indicate obstruction.
,3. A patient presents with a unilateral painless breast
mass that is hard and non-mobile. What is the most
concerning diagnosis?
A. Lipoma
B. Fibroadenoma
C. Breast carcinoma
D. Cyst
Correct Answer: C
Rationale: Hard, fixed, painless masses raise suspicion for malignancy.
4. What lung sound is characterized by continuous,
high-pitched, musical sounds heard mainly during
expiration?
A. Crackles
B. Rhonchi
C. Wheezes
D. Pleural rub
Correct Answer: C
Rationale: Wheezes = narrowed airways.
5. Which cranial nerve is tested by assessing facial
symmetry and movement?
A. CN VII
B. CN V
C. CN IX
D. CN XII
Correct Answer: A
Rationale: CN VII controls facial muscles.
, 6. A positive McMurray test suggests injury to which
structure?
A. ACL
B. PCL
C. Meniscus
D. Collateral ligaments
Correct Answer: C
Rationale: McMurray detects medial/lateral meniscal tears.
7. A 72-year-old woman reports sudden severe headache
“like a thunderclap.” What should you suspect first?
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Cluster headache
Correct Answer: C
Rationale: Sudden “worst headache of life” → SAH.
8. Which heart sound is associated with heart failure and
volume overload?
A. S1
B. S2
C. S3
D. S4
Correct Answer: C
Rationale: S3 occurs with rapid ventricular filling → HF.
9. A patient has right lower quadrant rebound tenderness
and guarding. What does this most likely indicate?
Practice Questions And correct Answers
Includes answers + brief rationales
1. A 55-year-old male presents with intermittent chest
tightness that occurs during exertion and resolves with
rest. What is the MOST likely cause?
A. Gastroesophageal reflux
B. Stable angina
C. Costochondritis
D. Anxiety-related dyspnea
Correct Answer: B
Rationale: Classic exertional chest pressure relieved by rest strongly indicates stable angina.
2. During an abdominal exam, you hear a high-pitched
“tinkling” sound with rushing noises. What does this
suggest?
A. Normal bowel sounds
B. Early appendicitis
C. Small-bowel obstruction
D. Peritonitis
Correct Answer: C
Rationale: High-pitched, hyperactive bowel sounds indicate obstruction.
,3. A patient presents with a unilateral painless breast
mass that is hard and non-mobile. What is the most
concerning diagnosis?
A. Lipoma
B. Fibroadenoma
C. Breast carcinoma
D. Cyst
Correct Answer: C
Rationale: Hard, fixed, painless masses raise suspicion for malignancy.
4. What lung sound is characterized by continuous,
high-pitched, musical sounds heard mainly during
expiration?
A. Crackles
B. Rhonchi
C. Wheezes
D. Pleural rub
Correct Answer: C
Rationale: Wheezes = narrowed airways.
5. Which cranial nerve is tested by assessing facial
symmetry and movement?
A. CN VII
B. CN V
C. CN IX
D. CN XII
Correct Answer: A
Rationale: CN VII controls facial muscles.
, 6. A positive McMurray test suggests injury to which
structure?
A. ACL
B. PCL
C. Meniscus
D. Collateral ligaments
Correct Answer: C
Rationale: McMurray detects medial/lateral meniscal tears.
7. A 72-year-old woman reports sudden severe headache
“like a thunderclap.” What should you suspect first?
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Cluster headache
Correct Answer: C
Rationale: Sudden “worst headache of life” → SAH.
8. Which heart sound is associated with heart failure and
volume overload?
A. S1
B. S2
C. S3
D. S4
Correct Answer: C
Rationale: S3 occurs with rapid ventricular filling → HF.
9. A patient has right lower quadrant rebound tenderness
and guarding. What does this most likely indicate?
