NR 509 MIDTERM EXAM PRACTICE:
ADVANCED PHYSICAL ASSESSMENT
QUESTIONS WITH VERIFIED ANSWERS
(LATEST 2026/ 2027)- CHAMBERLAIN
1. During a physical examination, the nurse practitioner notes a positive Rovsing sign. Which
of the following conditions is most likely?
A. Acute cholecystitis
B. Nephrolithiasis
C. Acute appendicitis
D. Splenic rupture
Answer: C
Conceptual Explanation: Rovsing sign is positive when pressure applied to the left lower
quadrant increases pain in the right lower quadrant, suggestive of appendicitis.
2. When assessing the jugular venous pressure (JVP), the sternal angle is used as a reference
point. A JVP measured at what distance above the sternal angle is considered abnormal?
A. Greater than 1 cm
B. Greater than 3 cm
C. Greater than 5 cm
,D. Greater than 7 cm
Answer: B
Conceptual Explanation: A JVP measurement of more than 3 cm above the sternal angle
(or more than 8 cm total distance from the right atrium) is considered elevated.
3. A patient presents with a ‘curtain-like’ loss of vision in one eye. This symptom is most
characteristic of which condition?
A. Open-angle glaucoma
B. Macular degeneration
C. Retinal detachment
D. Cataracts
Answer: C
Conceptual Explanation: Retinal detachment often presents as a sudden, painless loss of
vision described as a shadow or curtain being pulled over the visual field.
4. Which heart sound is associated with rapid ventricular filling and is often considered a sign
of heart failure in older adults?
A. S1
B. S2
C. S4
D. S3
, Answer: D
Conceptual Explanation: S3 (ventricular gallop) occurs during the early rapid filling
phase of diastole and is often a sign of volume overload or heart failure in adults.
5. The nurse practitioner performs the Weber test on a patient who complains of hearing loss
in the right ear. The sound lateralizes to the right ear. This finding suggests:
A. Sensorineural hearing loss in the right ear
B. Sensorineural hearing loss in the left ear
C. Normal hearing
D. Conductive hearing loss in the right ear
Answer: D
Conceptual Explanation: In the Weber test, sound lateralizing to the impaired ear
indicates conductive hearing loss, as the ‘bad’ ear is not distracted by ambient noise.
6. Which of the following findings is most consistent with a diagnosis of pneumonia during a
respiratory assessment?
A. Hyperresonance on percussion
B. Increased tactile fremitus and egophony
C. Decreased tactile fremitus
D. Tracheal deviation
Answer: B
ADVANCED PHYSICAL ASSESSMENT
QUESTIONS WITH VERIFIED ANSWERS
(LATEST 2026/ 2027)- CHAMBERLAIN
1. During a physical examination, the nurse practitioner notes a positive Rovsing sign. Which
of the following conditions is most likely?
A. Acute cholecystitis
B. Nephrolithiasis
C. Acute appendicitis
D. Splenic rupture
Answer: C
Conceptual Explanation: Rovsing sign is positive when pressure applied to the left lower
quadrant increases pain in the right lower quadrant, suggestive of appendicitis.
2. When assessing the jugular venous pressure (JVP), the sternal angle is used as a reference
point. A JVP measured at what distance above the sternal angle is considered abnormal?
A. Greater than 1 cm
B. Greater than 3 cm
C. Greater than 5 cm
,D. Greater than 7 cm
Answer: B
Conceptual Explanation: A JVP measurement of more than 3 cm above the sternal angle
(or more than 8 cm total distance from the right atrium) is considered elevated.
3. A patient presents with a ‘curtain-like’ loss of vision in one eye. This symptom is most
characteristic of which condition?
A. Open-angle glaucoma
B. Macular degeneration
C. Retinal detachment
D. Cataracts
Answer: C
Conceptual Explanation: Retinal detachment often presents as a sudden, painless loss of
vision described as a shadow or curtain being pulled over the visual field.
4. Which heart sound is associated with rapid ventricular filling and is often considered a sign
of heart failure in older adults?
A. S1
B. S2
C. S4
D. S3
, Answer: D
Conceptual Explanation: S3 (ventricular gallop) occurs during the early rapid filling
phase of diastole and is often a sign of volume overload or heart failure in adults.
5. The nurse practitioner performs the Weber test on a patient who complains of hearing loss
in the right ear. The sound lateralizes to the right ear. This finding suggests:
A. Sensorineural hearing loss in the right ear
B. Sensorineural hearing loss in the left ear
C. Normal hearing
D. Conductive hearing loss in the right ear
Answer: D
Conceptual Explanation: In the Weber test, sound lateralizing to the impaired ear
indicates conductive hearing loss, as the ‘bad’ ear is not distracted by ambient noise.
6. Which of the following findings is most consistent with a diagnosis of pneumonia during a
respiratory assessment?
A. Hyperresonance on percussion
B. Increased tactile fremitus and egophony
C. Decreased tactile fremitus
D. Tracheal deviation
Answer: B
