NR509 Final TD: (Latest 2026/2027 Update) Advanced Physical Assessment |
Q&A | Grade A | 100% Correct (Verified Answers) – Chamberlain University
Subject: Advanced Physical Assessment – NR509 Final TD
Source: Chamberlain University College of Nursing – 2026/2027 Curriculum
Format: Q&A Guide with Rationale • Advanced Health Assessment • NP Board Prep
1: A young man feels something in his scrotum and comes to you for clarification. On your
examination, you note what feels like a "bag of worms" in the left scrotum, superior to the testicles.
Which of the following is most likely?
A. Hydrocele of the spermatic cord
B. Varicocele
C. Testicular carcinoma
D. A normal vas deferens
Correct Answer: B. Varicocele
1. The "bag of worms" sensation is classic for varicocele, which represents varicosities within the
spermatic cord, often on the left side.
2. Varicoceles are common in normal men, typically resolve in the supine position, and can
contribute to infertility due to increased scrotal temperature.
3. A hydrocele would be a painless mass on the spermatic cord, while testicular carcinoma
typically presents as a firm, irregular, painless mass.
2: Which of the following changes are expected in vision as part of the normal aging process?
A. Cataracts
B. Glaucoma
C. Macular degeneration
D. Blurring of near vision
Correct Answer: D. Blurring of near vision
1. The lens loses its elasticity over time as part of the normal aging process, resulting in
presbyopia and blurring of near vision.
2. This condition typically becomes noticeable around age 40-45 and progresses with age.
3. Cataracts, glaucoma, and macular degeneration are pathologic conditions, not normal age-
related changes.
,3: A 68-year-old mechanic presents to the emergency room for shortness of breath. You are
concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated.
Which one of the following conditions is a potential cause of elevated JVP?
A. Left-sided heart failure
B. Mitral stenosis
C. Constrictive pericarditis
D. Aortic aneurysm
Correct Answer: C. Constrictive pericarditis
1. Constrictive pericarditis impairs diastolic filling of the ventricles, leading to elevated right
atrial pressure and elevated JVP.
2. Other causes of elevated JVP include heart failure, tricuspid stenosis, chronic pulmonary
hypertension, superior vena cava obstruction, and cardiac tamponade.
3. Left-sided heart failure alone does not typically elevate JVP unless right-sided failure also
develops.
4: Which of the following lymph node groups is most commonly involved in breast cancer?
A. Lateral
B. Subscapular
C. Pectoral
D. Central
Correct Answer: D. Central
1. The central axillary lymph nodes are most commonly involved in breast cancer metastasis
because they receive drainage from the other axillary node groups.
2. Breast cancer typically spreads first to the axillary lymph nodes before systemic dissemination.
3. The pectoral (anterior) nodes receive primary drainage from the breast, but the central nodes
are most frequently palpably enlarged due to confluence of lymphatic channels.
5: You are beginning the examination of the skin on a 25-year-old teacher. You have previously
elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly
suspect that she has hypothyroidism. What is the expected moisture and texture of the skin of a
patient with hypothyroidism?
A. Moist and smooth
B. Moist and rough
C. Dry and smooth
D. Dry and rough
Correct Answer: D. Dry and rough
1. Hypothyroidism causes decreased metabolic rate, leading to reduced sweat and sebum
production, resulting in dry, rough, and often scaly skin.
2. Other skin findings include cool extremities, coarse hair, and non-pitting edema (myxedema).
3. Hyperthyroidism typically presents with moist, smooth, warm skin due to increased metabolic
activity and sweating.
, 6: Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus
erythematosus). She has noticed a raised, dark red rash on her legs. When you press on the rash, it
doesn't blanch. What would you tell her regarding her rash?
A. It is likely to be related to her lupus.
B. It is likely to be related to an exposure to a chemical.
C. It is likely to be related to an allergic reaction.
D. It should not cause any problems.
Correct Answer: A. It is likely to be related to her lupus.
1. Non-blanching, raised, dark red rashes in SLE may represent vasculitis or cutaneous
manifestations of lupus activity.
2. Lupus can cause palpable purpura, livedo reticularis, and other skin lesions related to immune
complex deposition.
3. Chemical exposure or allergic reactions typically cause blanching erythema or urticaria, not
non-blanching rashes.
7: You are palpating the abdomen and feel a small mass. Which of the following would you do next?
A. Ultrasound
B. Examination with the abdominal muscles tensed
C. Surgery referral
D. Determine size by percussion
Correct Answer: B. Examination with the abdominal muscles tensed
1. Asking the patient to raise the head and shoulders or strain down tightens the abdominal
muscles to determine if the mass is intra-abdominal or within the abdominal wall.
2. An intra-abdominal mass becomes obscured by muscle contraction, while a mass in the
abdominal wall becomes more prominent.
3. This simple maneuver should be performed before ordering imaging or specialist referral.
8: You are evaluating a 40-year-old banker for coronary heart disease risk factors. He has a history
of hypertension, which is well-controlled on his current medications. He does not smoke; he does 45
minutes of aerobic exercise five times weekly. You are calculating his 10-year coronary heart disease
risk. Which of the following conditions is considered to be a coronary heart disease risk equivalent?
A. Hypertension
B. Peripheral arterial disease
C. Systemic lupus erythematosus
D. Chronic obstructive pulmonary disease (COPD)
Correct Answer: B. Peripheral arterial disease
1. Peripheral arterial disease (PAD) is considered a coronary heart disease risk equivalent because
patients with PAD have similar risk of myocardial infarction and cardiovascular death as those
with established coronary artery disease.
2. Other risk equivalents include diabetes mellitus, abdominal aortic aneurysm, and symptomatic
carotid artery disease.
3. Hypertension is a risk factor but not a risk equivalent unless target organ damage is present.
Q&A | Grade A | 100% Correct (Verified Answers) – Chamberlain University
Subject: Advanced Physical Assessment – NR509 Final TD
Source: Chamberlain University College of Nursing – 2026/2027 Curriculum
Format: Q&A Guide with Rationale • Advanced Health Assessment • NP Board Prep
1: A young man feels something in his scrotum and comes to you for clarification. On your
examination, you note what feels like a "bag of worms" in the left scrotum, superior to the testicles.
Which of the following is most likely?
A. Hydrocele of the spermatic cord
B. Varicocele
C. Testicular carcinoma
D. A normal vas deferens
Correct Answer: B. Varicocele
1. The "bag of worms" sensation is classic for varicocele, which represents varicosities within the
spermatic cord, often on the left side.
2. Varicoceles are common in normal men, typically resolve in the supine position, and can
contribute to infertility due to increased scrotal temperature.
3. A hydrocele would be a painless mass on the spermatic cord, while testicular carcinoma
typically presents as a firm, irregular, painless mass.
2: Which of the following changes are expected in vision as part of the normal aging process?
A. Cataracts
B. Glaucoma
C. Macular degeneration
D. Blurring of near vision
Correct Answer: D. Blurring of near vision
1. The lens loses its elasticity over time as part of the normal aging process, resulting in
presbyopia and blurring of near vision.
2. This condition typically becomes noticeable around age 40-45 and progresses with age.
3. Cataracts, glaucoma, and macular degeneration are pathologic conditions, not normal age-
related changes.
,3: A 68-year-old mechanic presents to the emergency room for shortness of breath. You are
concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated.
Which one of the following conditions is a potential cause of elevated JVP?
A. Left-sided heart failure
B. Mitral stenosis
C. Constrictive pericarditis
D. Aortic aneurysm
Correct Answer: C. Constrictive pericarditis
1. Constrictive pericarditis impairs diastolic filling of the ventricles, leading to elevated right
atrial pressure and elevated JVP.
2. Other causes of elevated JVP include heart failure, tricuspid stenosis, chronic pulmonary
hypertension, superior vena cava obstruction, and cardiac tamponade.
3. Left-sided heart failure alone does not typically elevate JVP unless right-sided failure also
develops.
4: Which of the following lymph node groups is most commonly involved in breast cancer?
A. Lateral
B. Subscapular
C. Pectoral
D. Central
Correct Answer: D. Central
1. The central axillary lymph nodes are most commonly involved in breast cancer metastasis
because they receive drainage from the other axillary node groups.
2. Breast cancer typically spreads first to the axillary lymph nodes before systemic dissemination.
3. The pectoral (anterior) nodes receive primary drainage from the breast, but the central nodes
are most frequently palpably enlarged due to confluence of lymphatic channels.
5: You are beginning the examination of the skin on a 25-year-old teacher. You have previously
elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly
suspect that she has hypothyroidism. What is the expected moisture and texture of the skin of a
patient with hypothyroidism?
A. Moist and smooth
B. Moist and rough
C. Dry and smooth
D. Dry and rough
Correct Answer: D. Dry and rough
1. Hypothyroidism causes decreased metabolic rate, leading to reduced sweat and sebum
production, resulting in dry, rough, and often scaly skin.
2. Other skin findings include cool extremities, coarse hair, and non-pitting edema (myxedema).
3. Hyperthyroidism typically presents with moist, smooth, warm skin due to increased metabolic
activity and sweating.
, 6: Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus
erythematosus). She has noticed a raised, dark red rash on her legs. When you press on the rash, it
doesn't blanch. What would you tell her regarding her rash?
A. It is likely to be related to her lupus.
B. It is likely to be related to an exposure to a chemical.
C. It is likely to be related to an allergic reaction.
D. It should not cause any problems.
Correct Answer: A. It is likely to be related to her lupus.
1. Non-blanching, raised, dark red rashes in SLE may represent vasculitis or cutaneous
manifestations of lupus activity.
2. Lupus can cause palpable purpura, livedo reticularis, and other skin lesions related to immune
complex deposition.
3. Chemical exposure or allergic reactions typically cause blanching erythema or urticaria, not
non-blanching rashes.
7: You are palpating the abdomen and feel a small mass. Which of the following would you do next?
A. Ultrasound
B. Examination with the abdominal muscles tensed
C. Surgery referral
D. Determine size by percussion
Correct Answer: B. Examination with the abdominal muscles tensed
1. Asking the patient to raise the head and shoulders or strain down tightens the abdominal
muscles to determine if the mass is intra-abdominal or within the abdominal wall.
2. An intra-abdominal mass becomes obscured by muscle contraction, while a mass in the
abdominal wall becomes more prominent.
3. This simple maneuver should be performed before ordering imaging or specialist referral.
8: You are evaluating a 40-year-old banker for coronary heart disease risk factors. He has a history
of hypertension, which is well-controlled on his current medications. He does not smoke; he does 45
minutes of aerobic exercise five times weekly. You are calculating his 10-year coronary heart disease
risk. Which of the following conditions is considered to be a coronary heart disease risk equivalent?
A. Hypertension
B. Peripheral arterial disease
C. Systemic lupus erythematosus
D. Chronic obstructive pulmonary disease (COPD)
Correct Answer: B. Peripheral arterial disease
1. Peripheral arterial disease (PAD) is considered a coronary heart disease risk equivalent because
patients with PAD have similar risk of myocardial infarction and cardiovascular death as those
with established coronary artery disease.
2. Other risk equivalents include diabetes mellitus, abdominal aortic aneurysm, and symptomatic
carotid artery disease.
3. Hypertension is a risk factor but not a risk equivalent unless target organ damage is present.
