NR-509 Advanced Physical Assessment Week 2 Quiz:
(Latest 2026/2027) HEENT, Cranial Nerves, Lymphatics,
Respiratory, and Special Senses | Q&A | Grade A | 100%
Correct Verified Answers
Subject: Advanced Physical Assessment – Pediatric Assessment (Anterior Fontanelle), Percussion
(Dullness – Increased Tissue Density), Cranial Nerve Assessment (CN V Trigeminal, CN XI Spinal
Accessory), Salivary Glands (Parotid and Submandibular), Thyroid Examination, Lymph Node
Assessment (Enlarged Nodes, Accessible Areas), Visual Acuity (Snellen Chart, 20/30 Interpretation,
Floaters), Corneal Light Reflex, Diagnostic Positions Test, Sclera Findings in African Americans, Ptosis,
Allergic Rhinitis (Pale Gray Nasal Mucosa), Sinus Palpation, Oral Assessment (Dehydration, Gingival
Line in African Americans), Tactile Fremitus (Larynx-Generated Sounds), Pregnancy-Related HEENT
Changes (Gingival Bleeding).
Source: NR-509 Week 2 Quiz 2026/2027, Bates' Guide to Physical Examination & History Taking.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
1) A mother brings her two month old daughter in for an examination says "my daughter rolled
over against the wall and now I have noticed that she has the spot soft on the top of her head,
is there something terribly wrong?" The FNP's best response would be:
Correct Answer: "That soft spot is normal and actually allows for growth of the brain during the first
year of your baby's life."
1. The anterior fontanelle is a diamond-shaped soft spot at the top of the infant's head. It normally closes
between 9-18 months (often around 12-14 months).
2. The anterior fontanelle allows for brain growth during the first year. A sunken fontanelle suggests
dehydration; a bulging fontanelle may indicate increased intracranial pressure.
3. Reassure parents that this is a normal finding unless accompanied by other concerning signs (fever,
vomiting, lethargy, bulging).
2) During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This
most likely results from:
Correct Answer: Increased density of lung tissue
1. Percussion notes: Resonance (normal lung), Hyperresonance (increased air – emphysema,
pneumothorax), Dullness (increased density – consolidation, pleural effusion, tumor, atelectasis).
2. Dullness replaces resonance when fluid or solid tissue replaces air in the lung. Examples: lobar
pneumonia (consolidation), pleural effusion (fluid), mass.
3. Dullness is also noted over the liver and heart (normal) – but over lung tissue, it indicates pathology.
, 3) The patient is unable to differentiate between sharp and dull stimulation to both sides of her
face. The FNP suspects Damage to:
Correct Answer: The trigeminal nerve
1. Cranial nerve V (Trigeminal) provides sensory innervation to the face (ophthalmic V1, maxillary V2,
mandibular V3). Sharp/dull discrimination tests the sensory component.
2. Motor component of CN V (muscles of mastication) is tested by asking patient to clench teeth (palpate
masseter and temporalis).
3. Lesion of CN V causes facial numbness, loss of corneal reflex, and weakness of mastication.
4) When examining the face, the FNP is aware that the two pairs of salivary gland's that are
accessible to examination are the _____ glands.
Correct Answer: Parotid and submandibular
1. Three major salivary glands: Parotid (largest, anterior to ear, over masseter), Submandibular (below
mandible), Sublingual (floor of mouth).
2. Parotid and submandibular are accessible to palpation. Parotid duct (Stensen's) opens opposite the
second upper molar.
3. Palpate for enlargement, tenderness, or stones. Sublingual glands are palpated bimanually in the floor
of the mouth.
5) A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her
head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by
____.
Correct Answer: XI; asking the patient to shrug her shoulders against resistance
1. Cranial nerve XI (Spinal Accessory) innervates the sternocleidomastoid (turns head to opposite side)
and trapezius (shrug shoulders).
2. To test CN XI: ask patient to shrug shoulders against resistance (trapezius) and turn head against
resistance (sternocleidomastoid).
3. Weakness suggests CN XI lesion (surgical neck dissection, trauma, polio, ALS).
6) When examining a patient's cranial nerve function, the FNP remembers that the muscles in
the neck that are innervated by CN XI are the:
Correct Answer: Sternomastoid and trapezius
1. CN XI (Spinal Accessory) provides motor innervation to sternocleidomastoid (SCM) and trapezius
muscles.
2. SCM: rotates head to opposite side and flexes neck. Trapezius: elevates shoulders (shrug) and
retracts scapula.
3. Isolated CN XI injury causes weakness in head turning and shoulder shrugging; asymmetry in neck
muscle bulk.
(Latest 2026/2027) HEENT, Cranial Nerves, Lymphatics,
Respiratory, and Special Senses | Q&A | Grade A | 100%
Correct Verified Answers
Subject: Advanced Physical Assessment – Pediatric Assessment (Anterior Fontanelle), Percussion
(Dullness – Increased Tissue Density), Cranial Nerve Assessment (CN V Trigeminal, CN XI Spinal
Accessory), Salivary Glands (Parotid and Submandibular), Thyroid Examination, Lymph Node
Assessment (Enlarged Nodes, Accessible Areas), Visual Acuity (Snellen Chart, 20/30 Interpretation,
Floaters), Corneal Light Reflex, Diagnostic Positions Test, Sclera Findings in African Americans, Ptosis,
Allergic Rhinitis (Pale Gray Nasal Mucosa), Sinus Palpation, Oral Assessment (Dehydration, Gingival
Line in African Americans), Tactile Fremitus (Larynx-Generated Sounds), Pregnancy-Related HEENT
Changes (Gingival Bleeding).
Source: NR-509 Week 2 Quiz 2026/2027, Bates' Guide to Physical Examination & History Taking.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
1) A mother brings her two month old daughter in for an examination says "my daughter rolled
over against the wall and now I have noticed that she has the spot soft on the top of her head,
is there something terribly wrong?" The FNP's best response would be:
Correct Answer: "That soft spot is normal and actually allows for growth of the brain during the first
year of your baby's life."
1. The anterior fontanelle is a diamond-shaped soft spot at the top of the infant's head. It normally closes
between 9-18 months (often around 12-14 months).
2. The anterior fontanelle allows for brain growth during the first year. A sunken fontanelle suggests
dehydration; a bulging fontanelle may indicate increased intracranial pressure.
3. Reassure parents that this is a normal finding unless accompanied by other concerning signs (fever,
vomiting, lethargy, bulging).
2) During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This
most likely results from:
Correct Answer: Increased density of lung tissue
1. Percussion notes: Resonance (normal lung), Hyperresonance (increased air – emphysema,
pneumothorax), Dullness (increased density – consolidation, pleural effusion, tumor, atelectasis).
2. Dullness replaces resonance when fluid or solid tissue replaces air in the lung. Examples: lobar
pneumonia (consolidation), pleural effusion (fluid), mass.
3. Dullness is also noted over the liver and heart (normal) – but over lung tissue, it indicates pathology.
, 3) The patient is unable to differentiate between sharp and dull stimulation to both sides of her
face. The FNP suspects Damage to:
Correct Answer: The trigeminal nerve
1. Cranial nerve V (Trigeminal) provides sensory innervation to the face (ophthalmic V1, maxillary V2,
mandibular V3). Sharp/dull discrimination tests the sensory component.
2. Motor component of CN V (muscles of mastication) is tested by asking patient to clench teeth (palpate
masseter and temporalis).
3. Lesion of CN V causes facial numbness, loss of corneal reflex, and weakness of mastication.
4) When examining the face, the FNP is aware that the two pairs of salivary gland's that are
accessible to examination are the _____ glands.
Correct Answer: Parotid and submandibular
1. Three major salivary glands: Parotid (largest, anterior to ear, over masseter), Submandibular (below
mandible), Sublingual (floor of mouth).
2. Parotid and submandibular are accessible to palpation. Parotid duct (Stensen's) opens opposite the
second upper molar.
3. Palpate for enlargement, tenderness, or stones. Sublingual glands are palpated bimanually in the floor
of the mouth.
5) A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her
head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by
____.
Correct Answer: XI; asking the patient to shrug her shoulders against resistance
1. Cranial nerve XI (Spinal Accessory) innervates the sternocleidomastoid (turns head to opposite side)
and trapezius (shrug shoulders).
2. To test CN XI: ask patient to shrug shoulders against resistance (trapezius) and turn head against
resistance (sternocleidomastoid).
3. Weakness suggests CN XI lesion (surgical neck dissection, trauma, polio, ALS).
6) When examining a patient's cranial nerve function, the FNP remembers that the muscles in
the neck that are innervated by CN XI are the:
Correct Answer: Sternomastoid and trapezius
1. CN XI (Spinal Accessory) provides motor innervation to sternocleidomastoid (SCM) and trapezius
muscles.
2. SCM: rotates head to opposite side and flexes neck. Trapezius: elevates shoulders (shrug) and
retracts scapula.
3. Isolated CN XI injury causes weakness in head turning and shoulder shrugging; asymmetry in neck
muscle bulk.
