NR 509 Final Exam: (Latest 2026/2027 Update) Advanced Health Assessment
Sample Questions | Q&A | Grade A | 100% Correct (Verified Answers) –
Chamberlain University
Subject: Advanced Health Assessment – Musculoskeletal, OB/GYN, Neurologic, Geriatrics, Dermatology,
Oncology Screening
Source: NR 509 Final Exam / Chamberlain University / Clinical Practice Guidelines (2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. A 31-year-old female presents with a worsening stiff, painful neck. On inspection, the head is
laterally deviated toward the shoulder and rotated. What condition should the NP suspect?
A. Torticollis
B. Ankylosing spondylitis
C. Osteoarthritis (OA)
D. Spondylolisthesis
E. Thoracic kyphosis
Correct Answer: A. Torticollis
1. Torticollis (wry neck) presents with lateral head deviation toward the shoulder and rotation
away from the shoulder, often due to sternocleidomastoid spasm or congenital abnormality.
2. Differentiates from other causes: ankylosing spondylitis involves spine stiffness; OA is
degenerative; spondylolisthesis is vertebral slippage.
2. A 62-year-old female with rheumatoid arthritis (RA). Which assessment finding is expected?
A. Swelling of the synovial tissue in joints and tendon sheaths
B. First metatarsophalangeal joint frequently involved
C. Asymmetrical joint distribution
D. Tophi present in subcutaneous tissue
E. Stiffness follows joint activity
Correct Answer: A. Swelling of the synovial tissue in joints and tendon sheaths
1. RA is an inflammatory arthritis characterized by synovial proliferation (pannus), leading to
joint swelling, pain, and eventual deformity.
2. RA is symmetric; first MTP involvement suggests gout; tophi are gout; stiffness improves with
activity in RA (worse with rest).
,3. A 66-year-old female requests cervical cancer screening. She was screened at ages 57, 60, and 63,
all normal. Best action?
A. Deny request, inform her she is past due, schedule another visit.
B. Honor request, perform screening today.
C. Deny request, inform her three negative screenings in 10 years = no longer requires screening.
D. Deny request, inform her not due for two more years.
E. Honor request, inform her if negative she will no longer require screening.
Correct Answer: C. Deny request, inform her three negative screenings in last 10 years and no longer
requires screening
1. USPSTF and ACS recommend discontinuing cervical cancer screening at age 65 after three
negative Pap tests or two negative co-tests in prior 10 years.
2. This patient meets criteria for stopping screening; focus visit on reason for visit (hypertension
management).
4. A 45-year-old female with change in bowel patterns, history of bleeding ulcers and Crohn's,
family history of colon cancer (aunt age 49). Most concerning for colon cancer?
A. Recent onset of small-caliber stools
B. New-onset anal fissures
C. Recent history of black, tarry stools
D. Long-term history of hemorrhoids
E. Remote history of anal pruritus
Correct Answer: A. Recent onset of small-caliber stools
1. Small-caliber stools (pencil-thin) suggest a constricting lesion in the distal colon or rectum, a
red flag for colorectal cancer.
2. Family history of colon cancer in first-degree relative (aunt is not first-degree) but early age
(49) still concerning.
5. Which physical assessment finding is most suggestive of peritonitis secondary to ruptured
appendix?
A. Pain with internal rotation of right hip
B. Abdominal pain that increases with hip flexion
C. Localized pain over McBurney point
D. Pressing down onto abdomen firmly and quickly withdrawing hand produces pain
E. Voluntary contraction of abdominal wall that persists
Correct Answer: D. Pressing down onto abdomen firmly and quickly withdrawing hand produces pain
(Blumberg sign/rebound tenderness)
1. Rebound tenderness (Blumberg sign) indicates peritoneal irritation, strongly suggesting
peritonitis from appendicitis or other intra-abdominal catastrophe.
2. McBurney point tenderness suggests appendicitis but not necessarily perforation; rebound
confirms peritonitis.
, 6. A 21-year-old female's partner has condyloma acuminata. What physical assessment findings
would the NP expect?
A. Several shallow ulcers with red base
B. Translucent nodules
C. Bright red, soft lesions arising from cervical canal
D. Small red granular spots or petechiae on cervix
E. Raised friable or lobed lesions
Correct Answer: E. Raised friable or lobed lesions
1. Condyloma acuminata (genital warts) caused by HPV types 6 and 11 appear as raised, friable,
cauliflower-like or lobed lesions.
2. Shallow ulcers suggest herpes; red granular spots suggest cervicitis.
7. A 35-year-old female with migraines on OCPs now reports waking at night with headaches and
nausea. Best next step?
A. Reassure common migraine pattern
B. Evaluate for sinus infection
C. Order studies for TIAs due to OCPs
D. Take further history and perform careful neurological examination
E. Prescribe stronger migraine medication
Correct Answer: D. Take further history and perform careful neurological examination
1. New night-time headaches awakening patient from sleep are a red flag requiring thorough
neurologic assessment to rule out mass lesion, pseudotumor, or other pathology.
2. OCP use increases risk of venous sinus thrombosis; neurologic exam is critical before
prescribing.
8. Full-term infant male can pull to stand, use "mama/dada" specifically, indicates wants by
pointing. Determine developmental age.
A. 12 months
B. 4 months
C. 8 months
D. 10 months
E. 6 months
Correct Answer: A. 12 months
1. 12-month milestones: pulls to stand, says 1-2 words intentionally (mama/dada specifically),
points to indicate wants, pincer grasp.
2. 8-10 months: crawls, babbles but no specific words; 4-6 months: rolls, sits with support.
Sample Questions | Q&A | Grade A | 100% Correct (Verified Answers) –
Chamberlain University
Subject: Advanced Health Assessment – Musculoskeletal, OB/GYN, Neurologic, Geriatrics, Dermatology,
Oncology Screening
Source: NR 509 Final Exam / Chamberlain University / Clinical Practice Guidelines (2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. A 31-year-old female presents with a worsening stiff, painful neck. On inspection, the head is
laterally deviated toward the shoulder and rotated. What condition should the NP suspect?
A. Torticollis
B. Ankylosing spondylitis
C. Osteoarthritis (OA)
D. Spondylolisthesis
E. Thoracic kyphosis
Correct Answer: A. Torticollis
1. Torticollis (wry neck) presents with lateral head deviation toward the shoulder and rotation
away from the shoulder, often due to sternocleidomastoid spasm or congenital abnormality.
2. Differentiates from other causes: ankylosing spondylitis involves spine stiffness; OA is
degenerative; spondylolisthesis is vertebral slippage.
2. A 62-year-old female with rheumatoid arthritis (RA). Which assessment finding is expected?
A. Swelling of the synovial tissue in joints and tendon sheaths
B. First metatarsophalangeal joint frequently involved
C. Asymmetrical joint distribution
D. Tophi present in subcutaneous tissue
E. Stiffness follows joint activity
Correct Answer: A. Swelling of the synovial tissue in joints and tendon sheaths
1. RA is an inflammatory arthritis characterized by synovial proliferation (pannus), leading to
joint swelling, pain, and eventual deformity.
2. RA is symmetric; first MTP involvement suggests gout; tophi are gout; stiffness improves with
activity in RA (worse with rest).
,3. A 66-year-old female requests cervical cancer screening. She was screened at ages 57, 60, and 63,
all normal. Best action?
A. Deny request, inform her she is past due, schedule another visit.
B. Honor request, perform screening today.
C. Deny request, inform her three negative screenings in 10 years = no longer requires screening.
D. Deny request, inform her not due for two more years.
E. Honor request, inform her if negative she will no longer require screening.
Correct Answer: C. Deny request, inform her three negative screenings in last 10 years and no longer
requires screening
1. USPSTF and ACS recommend discontinuing cervical cancer screening at age 65 after three
negative Pap tests or two negative co-tests in prior 10 years.
2. This patient meets criteria for stopping screening; focus visit on reason for visit (hypertension
management).
4. A 45-year-old female with change in bowel patterns, history of bleeding ulcers and Crohn's,
family history of colon cancer (aunt age 49). Most concerning for colon cancer?
A. Recent onset of small-caliber stools
B. New-onset anal fissures
C. Recent history of black, tarry stools
D. Long-term history of hemorrhoids
E. Remote history of anal pruritus
Correct Answer: A. Recent onset of small-caliber stools
1. Small-caliber stools (pencil-thin) suggest a constricting lesion in the distal colon or rectum, a
red flag for colorectal cancer.
2. Family history of colon cancer in first-degree relative (aunt is not first-degree) but early age
(49) still concerning.
5. Which physical assessment finding is most suggestive of peritonitis secondary to ruptured
appendix?
A. Pain with internal rotation of right hip
B. Abdominal pain that increases with hip flexion
C. Localized pain over McBurney point
D. Pressing down onto abdomen firmly and quickly withdrawing hand produces pain
E. Voluntary contraction of abdominal wall that persists
Correct Answer: D. Pressing down onto abdomen firmly and quickly withdrawing hand produces pain
(Blumberg sign/rebound tenderness)
1. Rebound tenderness (Blumberg sign) indicates peritoneal irritation, strongly suggesting
peritonitis from appendicitis or other intra-abdominal catastrophe.
2. McBurney point tenderness suggests appendicitis but not necessarily perforation; rebound
confirms peritonitis.
, 6. A 21-year-old female's partner has condyloma acuminata. What physical assessment findings
would the NP expect?
A. Several shallow ulcers with red base
B. Translucent nodules
C. Bright red, soft lesions arising from cervical canal
D. Small red granular spots or petechiae on cervix
E. Raised friable or lobed lesions
Correct Answer: E. Raised friable or lobed lesions
1. Condyloma acuminata (genital warts) caused by HPV types 6 and 11 appear as raised, friable,
cauliflower-like or lobed lesions.
2. Shallow ulcers suggest herpes; red granular spots suggest cervicitis.
7. A 35-year-old female with migraines on OCPs now reports waking at night with headaches and
nausea. Best next step?
A. Reassure common migraine pattern
B. Evaluate for sinus infection
C. Order studies for TIAs due to OCPs
D. Take further history and perform careful neurological examination
E. Prescribe stronger migraine medication
Correct Answer: D. Take further history and perform careful neurological examination
1. New night-time headaches awakening patient from sleep are a red flag requiring thorough
neurologic assessment to rule out mass lesion, pseudotumor, or other pathology.
2. OCP use increases risk of venous sinus thrombosis; neurologic exam is critical before
prescribing.
8. Full-term infant male can pull to stand, use "mama/dada" specifically, indicates wants by
pointing. Determine developmental age.
A. 12 months
B. 4 months
C. 8 months
D. 10 months
E. 6 months
Correct Answer: A. 12 months
1. 12-month milestones: pulls to stand, says 1-2 words intentionally (mama/dada specifically),
points to indicate wants, pincer grasp.
2. 8-10 months: crawls, babbles but no specific words; 4-6 months: rolls, sits with support.
