NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM
NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM NEWEST 2025/2026 COMPLETE
100 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+ BRAND NEW VERSION 100%
ACCURATE ANSWERS BRAND NEW EXAM
GUARANTEED PASS
1. A 52-year-old secretary comes to your office, complaining about accidentally leaking urine
when she coughs or sneezes. She says this has been going on for about a year now. She
relates that she has not had a period for 2 years. She denies any recent illness or injuries. Her
past medical history is significant for four spontaneous vaginal deliveries. She is married and
has four children. She denies alcohol, tobacco, or drug use. During her pelvic examination you
note some atrophic vaginal tissue, but the remainder of her pelvic, abdominal, and rectal
examinations are unremarkable.
A+ TEST BANK 1
, NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM
Which type of urinary incontinence does she have?
A) Stress incontinence
B) Urge incontinence
C) Overflow incontinence
Ans: A
Chapter: 11
Page and Header: 418, The Health History
Feedback:
Stress incontinence usually occurs when the intra-abdominal pressure goes up during
coughing, sneezing, or laughing. This is usually due to a weakness of the pelvic floor, with
inadequate muscle support of the bladder. Vaginal deliveries and pelvic surgery are often
associated with these symptoms. Usually female patients are postmenopausal when stress
incontinence begins. Kegel exercises are usually recommended to strengthen the pelvic floor
muscles.
A 46-year-old former salesman presents to the ER, complaining of black stools for the past
few weeks. His past medical history is significant for cirrhosis. He has gained weight recently,
especially around his abdomen. He has smoked two packs of cigarettes a day for 30 years and
has drunk approximately 10 alcoholic beverages a day for 25 years. He has used IV heroin and
smoked crack in the past. He denies any recent use. He is currently unemployed and has
never been married. On examination you find a man appearing older than his stated age. His
skin has a yellowish tint and he is thin, with a prominent abdomen. You note multiple "spider
angiomas" at the base of his neck. Otherwise, his heart and lung examinations are normal. On
inspection he has dilated veins around his umbilicus. Increased bowel sounds are heard during
auscultation. Palpation reveals diffuse tenderness that is more severe in the epigastric area.
His liver is small and hard to palpation and he has a positive fluid wave. He is positive for
occult blood on his rectal examination.
What cause of black stools most likely describes his symptoms and signs?
A) Infectious diarrhea
B) Mallory-Weiss tear
C) Esophageal varices
A+ TEST BANK 2
, NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM
Ans: C
Chapter: 11
Page and Header: 434, Techniques of Examination
Feedback:
Varices are often found in alcoholic patients, but only when they have a diagnosis of
significant cirrhosis. This patient has symptoms of cirrhosis, including jaundice, ascites, spider
hemangiomas, and dilated veins on his abdomen (caput medusa).
3. A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states
that the stools are very loose and there is some cramping beforehand. She states this has
occurred on and off since she was in high school. She denies any nausea, vomiting, or blood in
her stool. Occasionally she has periods of constipation, but that is rare. She thinks the
diarrhea is much worse when she is nervous. Her past medical history is not significant. She is
single and a junior in college majoring in accounting. She smokes when she drinks alcohol but
denies using any illegal drugs. Both of her parents are healthy. Her entire physical examination
is unremarkable.
What is most likely the etiology of her diarrhea?
A) Secretory infections
B) Inflammatory infections
C) Irritable bowel syndrome
D) Malabsorption syndrome
Ans: C
Chapter: 11
Page and Header: 418, The Health History
Feedback:
Irritable bowel syndrome will cause loose bowel movements with cramps but no systemic
symptoms of fever, weight loss, or malaise. This syndrome is more likely in young women with
alternating symptoms of loose stools and constipation. Stress usually makes the symptoms
worse, as do certain foods.
A+ TEST BANK 3
, NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM
4. A 42-year-old florist comes to your office, complaining of chronic constipation for the last 6
months. She has had no nausea, vomiting, or diarrhea and no abdominal pain or cramping.
She denies any recent illnesses or injuries. She denies any changes to her diet or exercise
program. She is on no new medications. During the review of systems you note that she has
felt fatigued, had some weight gain, has irregular periods, and has cold intolerance. Her past
medical history is significant for one vaginal delivery and two cesarean sections. She is
married, has three children, and owns a flower shop. She denies tobacco, alcohol, or drug
use. Her mother has type 2 diabetes and her father has coronary artery disease. There is no
family history of cancers. On examination she appears her stated age. Her vital signs are
normal. Her head, eyes, ears, nose, throat, and neck examinations are normal. Her cardiac,
lung, and abdominal examinations are also unremarkable. Her rectal occult blood test is
negative. Her deep tendon reflexes are delayed in response to a blow with the hammer,
especially the Achilles tendons.
What is the best choice for the cause of her constipation?
A) Large bowel obstruction
B) Irritable bowel syndrome
C) Rectal cancer
D) Hypothyroidism
Ans: D
Chapter: 11
Page and Header: 418, The Health History
Feedback:
Many metabolic conditions can interfere with bowel motility. In this case the patient has
many symptoms of hypothyroidism, including cold intolerance, weight gain, fatigue,
constipation, and irregular menstrual cycles. On examination, thyromegaly and delayed
reflexes can help to make the diagnosis. Medication will usually correct these symptoms.
5. A 22-year-old law student comes to your office, complaining of severe abdominal pain
radiating to his back. He states it began last night after hours of heavy drinking. He has had
abdominal pain and vomiting in the past after drinking but never as bad as this. He cannot
keep any food or water down, and these symptoms have been going on for almost 12 hours.
A+ TEST BANK 4
FINAL EXAM
NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM NEWEST 2025/2026 COMPLETE
100 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+ BRAND NEW VERSION 100%
ACCURATE ANSWERS BRAND NEW EXAM
GUARANTEED PASS
1. A 52-year-old secretary comes to your office, complaining about accidentally leaking urine
when she coughs or sneezes. She says this has been going on for about a year now. She
relates that she has not had a period for 2 years. She denies any recent illness or injuries. Her
past medical history is significant for four spontaneous vaginal deliveries. She is married and
has four children. She denies alcohol, tobacco, or drug use. During her pelvic examination you
note some atrophic vaginal tissue, but the remainder of her pelvic, abdominal, and rectal
examinations are unremarkable.
A+ TEST BANK 1
, NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM
Which type of urinary incontinence does she have?
A) Stress incontinence
B) Urge incontinence
C) Overflow incontinence
Ans: A
Chapter: 11
Page and Header: 418, The Health History
Feedback:
Stress incontinence usually occurs when the intra-abdominal pressure goes up during
coughing, sneezing, or laughing. This is usually due to a weakness of the pelvic floor, with
inadequate muscle support of the bladder. Vaginal deliveries and pelvic surgery are often
associated with these symptoms. Usually female patients are postmenopausal when stress
incontinence begins. Kegel exercises are usually recommended to strengthen the pelvic floor
muscles.
A 46-year-old former salesman presents to the ER, complaining of black stools for the past
few weeks. His past medical history is significant for cirrhosis. He has gained weight recently,
especially around his abdomen. He has smoked two packs of cigarettes a day for 30 years and
has drunk approximately 10 alcoholic beverages a day for 25 years. He has used IV heroin and
smoked crack in the past. He denies any recent use. He is currently unemployed and has
never been married. On examination you find a man appearing older than his stated age. His
skin has a yellowish tint and he is thin, with a prominent abdomen. You note multiple "spider
angiomas" at the base of his neck. Otherwise, his heart and lung examinations are normal. On
inspection he has dilated veins around his umbilicus. Increased bowel sounds are heard during
auscultation. Palpation reveals diffuse tenderness that is more severe in the epigastric area.
His liver is small and hard to palpation and he has a positive fluid wave. He is positive for
occult blood on his rectal examination.
What cause of black stools most likely describes his symptoms and signs?
A) Infectious diarrhea
B) Mallory-Weiss tear
C) Esophageal varices
A+ TEST BANK 2
, NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM
Ans: C
Chapter: 11
Page and Header: 434, Techniques of Examination
Feedback:
Varices are often found in alcoholic patients, but only when they have a diagnosis of
significant cirrhosis. This patient has symptoms of cirrhosis, including jaundice, ascites, spider
hemangiomas, and dilated veins on his abdomen (caput medusa).
3. A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states
that the stools are very loose and there is some cramping beforehand. She states this has
occurred on and off since she was in high school. She denies any nausea, vomiting, or blood in
her stool. Occasionally she has periods of constipation, but that is rare. She thinks the
diarrhea is much worse when she is nervous. Her past medical history is not significant. She is
single and a junior in college majoring in accounting. She smokes when she drinks alcohol but
denies using any illegal drugs. Both of her parents are healthy. Her entire physical examination
is unremarkable.
What is most likely the etiology of her diarrhea?
A) Secretory infections
B) Inflammatory infections
C) Irritable bowel syndrome
D) Malabsorption syndrome
Ans: C
Chapter: 11
Page and Header: 418, The Health History
Feedback:
Irritable bowel syndrome will cause loose bowel movements with cramps but no systemic
symptoms of fever, weight loss, or malaise. This syndrome is more likely in young women with
alternating symptoms of loose stools and constipation. Stress usually makes the symptoms
worse, as do certain foods.
A+ TEST BANK 3
, NR 509 ADVANCED PHYSICAL ASSESSMENT
FINAL EXAM
4. A 42-year-old florist comes to your office, complaining of chronic constipation for the last 6
months. She has had no nausea, vomiting, or diarrhea and no abdominal pain or cramping.
She denies any recent illnesses or injuries. She denies any changes to her diet or exercise
program. She is on no new medications. During the review of systems you note that she has
felt fatigued, had some weight gain, has irregular periods, and has cold intolerance. Her past
medical history is significant for one vaginal delivery and two cesarean sections. She is
married, has three children, and owns a flower shop. She denies tobacco, alcohol, or drug
use. Her mother has type 2 diabetes and her father has coronary artery disease. There is no
family history of cancers. On examination she appears her stated age. Her vital signs are
normal. Her head, eyes, ears, nose, throat, and neck examinations are normal. Her cardiac,
lung, and abdominal examinations are also unremarkable. Her rectal occult blood test is
negative. Her deep tendon reflexes are delayed in response to a blow with the hammer,
especially the Achilles tendons.
What is the best choice for the cause of her constipation?
A) Large bowel obstruction
B) Irritable bowel syndrome
C) Rectal cancer
D) Hypothyroidism
Ans: D
Chapter: 11
Page and Header: 418, The Health History
Feedback:
Many metabolic conditions can interfere with bowel motility. In this case the patient has
many symptoms of hypothyroidism, including cold intolerance, weight gain, fatigue,
constipation, and irregular menstrual cycles. On examination, thyromegaly and delayed
reflexes can help to make the diagnosis. Medication will usually correct these symptoms.
5. A 22-year-old law student comes to your office, complaining of severe abdominal pain
radiating to his back. He states it began last night after hours of heavy drinking. He has had
abdominal pain and vomiting in the past after drinking but never as bad as this. He cannot
keep any food or water down, and these symptoms have been going on for almost 12 hours.
A+ TEST BANK 4
