,NR 509 Final Exam | Advanced Physical Assessment
(2026) Q&A | Chamberlain College
1. When performing a physical assessment, the first technique the nurse will always use is:
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Correct Answer: B) Inspection
Rationale: Inspection is always the initial step in physical examination, as it provides a wealth
of information through observation. Palpation, percussion, and auscultation follow. Starting
with inspection ensures the nurse notes overall appearance, symmetry, and any visible
abnormalities before hands-on techniques potentially alter findings or cause discomfort.
2. The nurse is preparing to assess a patient’s skin temperature. Which part of the hand is
best suited for this task?
A) Fingertips
B) Dorsal surface of the hand
C) Palmar surface of the hand
D) Ulnar edge of the hand
Correct Answer: B) Dorsal surface of the hand
Rationale: The dorsal surface has thinner skin and more sensitive thermoreceptors, making it
ideal for detecting subtle temperature differences. Fingertips are better for fine tactile
discrimination, the palm for general sensation, and the ulnar edge for vibration. Using the
correct hand surface improves diagnostic accuracy.
,3. Which technique uses the sense of touch to assess texture, temperature, moisture, and
swelling?
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Correct Answer: A) Palpation
Rationale: Palpation involves applying the hands to feel for characteristics such as
consistency, pulsations, and tenderness. Inspection relies on vision, percussion on sound, and
auscultation on hearing. Palpation provides direct tactile information essential for identifying
masses, organ enlargement, and skin changes.
4. A 47-year-old man reports erectile dysfunction. In this age group, the most common
etiology is:
A) Testosterone deficiency
B) Psychological factors
C) Vascular disease
D) Neurogenic causes
Correct Answer: B) Psychological factors
Rationale: In middle-aged men, psychogenic ED is often primary, especially if early morning
erections are preserved. Organic causes like testosterone deficiency, vascular insufficiency, or
neuropathy become more prevalent in older men. A thorough psychosocial history helps
differentiate psychogenic from organic ED.
5. Erectile dysfunction from psychogenic causes is suggested when the patient reports:
A) Gradual onset
, B) Loss of libido
C) Preserved early morning erections
D) Abnormal penile Doppler studies
Correct Answer: C) Preserved early morning erections
Rationale: Psychogenic ED often spares nocturnal and early morning erections, indicating
intact vascular and neural pathways. Organic ED usually presents with gradual loss and
absent morning erections. This distinction guides the need for further laboratory or vascular
evaluation.
6. The nurse is performing a breast examination. An abnormal mass fixed to the underlying
tissue will most likely cause:
A) Increased mobility with arm movement
B) Dimpling of skin or retraction when arms are lifted over the head
C) A smooth, rubbery feel with well-defined borders
D) Spontaneous clear nipple discharge
Correct Answer: B) Dimpling of skin or retraction when arms are lifted over the head
Rationale: A carcinoma may cause fibrosis and tethering of Cooper’s ligaments, resulting in
skin dimpling or retraction with positional changes. Fibroadenomas and cysts are typically
mobile. Clear discharge can be benign or pathologic, but fixation is a cardinal sign of
malignancy.
7. Fibroadenomas and cysts of the breast are typically:
A) Fixed to the chest wall
B) Very mobile
C) Associated with peau d’orange
(2026) Q&A | Chamberlain College
1. When performing a physical assessment, the first technique the nurse will always use is:
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Correct Answer: B) Inspection
Rationale: Inspection is always the initial step in physical examination, as it provides a wealth
of information through observation. Palpation, percussion, and auscultation follow. Starting
with inspection ensures the nurse notes overall appearance, symmetry, and any visible
abnormalities before hands-on techniques potentially alter findings or cause discomfort.
2. The nurse is preparing to assess a patient’s skin temperature. Which part of the hand is
best suited for this task?
A) Fingertips
B) Dorsal surface of the hand
C) Palmar surface of the hand
D) Ulnar edge of the hand
Correct Answer: B) Dorsal surface of the hand
Rationale: The dorsal surface has thinner skin and more sensitive thermoreceptors, making it
ideal for detecting subtle temperature differences. Fingertips are better for fine tactile
discrimination, the palm for general sensation, and the ulnar edge for vibration. Using the
correct hand surface improves diagnostic accuracy.
,3. Which technique uses the sense of touch to assess texture, temperature, moisture, and
swelling?
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
Correct Answer: A) Palpation
Rationale: Palpation involves applying the hands to feel for characteristics such as
consistency, pulsations, and tenderness. Inspection relies on vision, percussion on sound, and
auscultation on hearing. Palpation provides direct tactile information essential for identifying
masses, organ enlargement, and skin changes.
4. A 47-year-old man reports erectile dysfunction. In this age group, the most common
etiology is:
A) Testosterone deficiency
B) Psychological factors
C) Vascular disease
D) Neurogenic causes
Correct Answer: B) Psychological factors
Rationale: In middle-aged men, psychogenic ED is often primary, especially if early morning
erections are preserved. Organic causes like testosterone deficiency, vascular insufficiency, or
neuropathy become more prevalent in older men. A thorough psychosocial history helps
differentiate psychogenic from organic ED.
5. Erectile dysfunction from psychogenic causes is suggested when the patient reports:
A) Gradual onset
, B) Loss of libido
C) Preserved early morning erections
D) Abnormal penile Doppler studies
Correct Answer: C) Preserved early morning erections
Rationale: Psychogenic ED often spares nocturnal and early morning erections, indicating
intact vascular and neural pathways. Organic ED usually presents with gradual loss and
absent morning erections. This distinction guides the need for further laboratory or vascular
evaluation.
6. The nurse is performing a breast examination. An abnormal mass fixed to the underlying
tissue will most likely cause:
A) Increased mobility with arm movement
B) Dimpling of skin or retraction when arms are lifted over the head
C) A smooth, rubbery feel with well-defined borders
D) Spontaneous clear nipple discharge
Correct Answer: B) Dimpling of skin or retraction when arms are lifted over the head
Rationale: A carcinoma may cause fibrosis and tethering of Cooper’s ligaments, resulting in
skin dimpling or retraction with positional changes. Fibroadenomas and cysts are typically
mobile. Clear discharge can be benign or pathologic, but fixation is a cardinal sign of
malignancy.
7. Fibroadenomas and cysts of the breast are typically:
A) Fixed to the chest wall
B) Very mobile
C) Associated with peau d’orange
