Midterm Exam: NR 509/ NR509 Advanced
Physical Assessment Midterm Exam
Questions with Verified Answers (Latest
Revised edition)- Chamberlain
1. A 42-year-old architect presents with widespread pain complaints, including headaches
almost daily, pain at the site of an old motor vehicle accident injury, and generalized
achiness and hypersensitivity throughout the body. He recounts that his first episodes of
ongoing pain occurred in his early 20s, and he has been to many practitioners over several
years seeking a firm diagnosis and adequate treatment of his complaints. Which of the
following statements is true regarding chronic pain?
Answer: Chronic pain is defined as pain not due to cancer or a
recognized medical condition that persists for >3-6 months.
2. Disparities in pain treatment have been well described in numerous studies comparing
Caucasian patients to those of African American and Hispanic origin. Which of the
following statements is true concerning this issue?
Answer: biases of the treating clinician are associated with
undertreatment of pain in minority patients and non-english speakers.
3. A 39-year-old architect comes to the clinic for a 2-day history of fever, chills, cough
productive of green sputum, and dyspnea. He has no history of serious illness. His
temperature is 101.2ºF. His other vital signs are within normal limits. Late inspiratory
crackles are heard on auscultation over the left lower lung posteriorly. When the clinician
listens over that area and instructs the patient to say "ee," it sounds like "A." Which of the
following would most likely be found on percussion of his lungs?
Answer: Dullness
4. A student is practicing the performance of a lung examination on a classmate. Which of
the following is the correct order for performing the components of the lung examination?
, Answer: Inspect, Palpate, Percussion, Auscultation
5. A 14-year-old high school student comes to the clinic for a 3-month history of periodic
dyspnea when playing basketball. It resolves shortly after resting. He has not had fever,
chills, cough, sputum production, or chest pain. He has no history of serious illness.
Based on the boy's history, asthma is suspected. Which of the following sounds heard on
expiration during lung auscultation would be most suggestive of asthma?
Answer: Wheezes
6. A clinician is percussing the lungs of a patient with chronic obstructive pulmonary disease
to see if they sound hyperresonant. Which of the following is an example of good
technique for percussion?
Answer: Strike using the tip of the third finger
7. A 29-year-old waiter comes to the clinic for a 2-month history of a cough. When he
lowers his gown so the clinician can listen to his lungs, the clinician notices a depression
of the lower part of his sternum. Which of the following best describes the appearance of
his chest?
Answer: Pectus Excavatum
8. A 13-year-old girl is brought by her mother to the clinic one day before the start of eighth
grade because of a 3-day history of episodes of shortness of breath. When she gets the
shortness of breath, she also notices tingling around her lips. She has no fever, cough,
sputum production, or chest pain. She has no history of serious illness and takes no
medications. Vital signs are within normal limits. Cardiac, lung, and extremity
examinations show no abnormalities. Which of the following is the most likely diagnosis?
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Answer: Anxiety
9. A 70-year-old patient has suspected chronic obstructive pulmonary disease. The clinician
instructs the patient to take a deep breath in, and then with his mouth open, breathe out as
fast and completely as he can. For what is the clinician checking?
Answer: Forced expiratory time
10. After examining a patient who is in the hospital for shortness of breath, the clinician
records the following for lung examination: "There is dullness to percussion over the
right lung base. Breath sounds are absent at the right lung base. There are no crackles,
wheezes, or rhonchi. There are no transmitted voice sounds." Which of the following is
the most likely diagnosis?
Answer: Atelectasis
11. A 16-year-old boy is brought to the Emergency Department (ED) after a motor vehicle
accident for shortness of breath for 1 hour. A chest x-ray shows a rib fracture and a
pneumothorax on the right side. The ED physician decides that a chest tube needs to be
placed in the fourth intercostal space. How does he determine where the fourth intercostal
space is?
Answer: He finds the sternal angle and then moves his fingers
laterally to the second rib. He then walks down to the second
intercostal space, third rib, third intercostal space, fourth rib and
then the fourth intercostal space.
12. A 68-year-old retired administrative assistant complains of a 3-month history of recurring
pain after ambulating that radiates from her back in the upper lumbar region into both
buttocks, bilateral thighs, and mid-calf regions. Her pain is typically improved by sitting
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Physical Assessment Midterm Exam
Questions with Verified Answers (Latest
Revised edition)- Chamberlain
1. A 42-year-old architect presents with widespread pain complaints, including headaches
almost daily, pain at the site of an old motor vehicle accident injury, and generalized
achiness and hypersensitivity throughout the body. He recounts that his first episodes of
ongoing pain occurred in his early 20s, and he has been to many practitioners over several
years seeking a firm diagnosis and adequate treatment of his complaints. Which of the
following statements is true regarding chronic pain?
Answer: Chronic pain is defined as pain not due to cancer or a
recognized medical condition that persists for >3-6 months.
2. Disparities in pain treatment have been well described in numerous studies comparing
Caucasian patients to those of African American and Hispanic origin. Which of the
following statements is true concerning this issue?
Answer: biases of the treating clinician are associated with
undertreatment of pain in minority patients and non-english speakers.
3. A 39-year-old architect comes to the clinic for a 2-day history of fever, chills, cough
productive of green sputum, and dyspnea. He has no history of serious illness. His
temperature is 101.2ºF. His other vital signs are within normal limits. Late inspiratory
crackles are heard on auscultation over the left lower lung posteriorly. When the clinician
listens over that area and instructs the patient to say "ee," it sounds like "A." Which of the
following would most likely be found on percussion of his lungs?
Answer: Dullness
4. A student is practicing the performance of a lung examination on a classmate. Which of
the following is the correct order for performing the components of the lung examination?
, Answer: Inspect, Palpate, Percussion, Auscultation
5. A 14-year-old high school student comes to the clinic for a 3-month history of periodic
dyspnea when playing basketball. It resolves shortly after resting. He has not had fever,
chills, cough, sputum production, or chest pain. He has no history of serious illness.
Based on the boy's history, asthma is suspected. Which of the following sounds heard on
expiration during lung auscultation would be most suggestive of asthma?
Answer: Wheezes
6. A clinician is percussing the lungs of a patient with chronic obstructive pulmonary disease
to see if they sound hyperresonant. Which of the following is an example of good
technique for percussion?
Answer: Strike using the tip of the third finger
7. A 29-year-old waiter comes to the clinic for a 2-month history of a cough. When he
lowers his gown so the clinician can listen to his lungs, the clinician notices a depression
of the lower part of his sternum. Which of the following best describes the appearance of
his chest?
Answer: Pectus Excavatum
8. A 13-year-old girl is brought by her mother to the clinic one day before the start of eighth
grade because of a 3-day history of episodes of shortness of breath. When she gets the
shortness of breath, she also notices tingling around her lips. She has no fever, cough,
sputum production, or chest pain. She has no history of serious illness and takes no
medications. Vital signs are within normal limits. Cardiac, lung, and extremity
examinations show no abnormalities. Which of the following is the most likely diagnosis?
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
Answer: Anxiety
9. A 70-year-old patient has suspected chronic obstructive pulmonary disease. The clinician
instructs the patient to take a deep breath in, and then with his mouth open, breathe out as
fast and completely as he can. For what is the clinician checking?
Answer: Forced expiratory time
10. After examining a patient who is in the hospital for shortness of breath, the clinician
records the following for lung examination: "There is dullness to percussion over the
right lung base. Breath sounds are absent at the right lung base. There are no crackles,
wheezes, or rhonchi. There are no transmitted voice sounds." Which of the following is
the most likely diagnosis?
Answer: Atelectasis
11. A 16-year-old boy is brought to the Emergency Department (ED) after a motor vehicle
accident for shortness of breath for 1 hour. A chest x-ray shows a rib fracture and a
pneumothorax on the right side. The ED physician decides that a chest tube needs to be
placed in the fourth intercostal space. How does he determine where the fourth intercostal
space is?
Answer: He finds the sternal angle and then moves his fingers
laterally to the second rib. He then walks down to the second
intercostal space, third rib, third intercostal space, fourth rib and
then the fourth intercostal space.
12. A 68-year-old retired administrative assistant complains of a 3-month history of recurring
pain after ambulating that radiates from her back in the upper lumbar region into both
buttocks, bilateral thighs, and mid-calf regions. Her pain is typically improved by sitting
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