NR509 ADVANCED PHYSICAL
ASSESSMENT FINAL EXAM STUDY
GUIDE QUESTIONS AND ANSWERS
2026/2027 UPDATE || 100% GUARANTEED
PASS
1. A 65-year-old patient presents with a systolic murmur heard best at the right second
intercostal space that radiates to the neck. What is the most likely diagnosis?
A. Mitral Regurgitation
B. Pulmonary Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: C
Conceptual Explanation: Aortic Stenosis is characterized by a mid-systolic crescendo-
decrescendo murmur heard best at the right second intercostal space, often radiating to the
carotid arteries.
2. During a musculoskeletal exam, a provider performs the Lachman test. A positive result
indicates an injury to which structure?
A. Medial Collateral Ligament (MCL)
,B. Posterior Cruciate Ligament (PCL)
C. Lateral Meniscus
D. Anterior Cruciate Ligament (ACL)
Answer: D
Conceptual Explanation: The Lachman test is considered the most sensitive clinical test
for detecting an ACL tear, involving significant forward excursion of the tibia.
3. When assessing Cranial Nerve VII (Facial), which clinical finding would indicate a lower
motor neuron lesion, such as Bell’s Palsy?
A. Preservation of forehead wrinkling on the affected side
B. Inability to wrinkle the forehead on the affected side
C. Loss of sensation to the cheek
D. Deviation of the uvula
Answer: B
Conceptual Explanation: In Bell’s Palsy (LMN lesion), the entire side of the face is affected,
including the forehead. In UMN lesions (like stroke), the forehead is often spared due to
bilateral innervation.
4. A patient presents with a ‘curtain-like’ shadow over their field of vision and flashes of light.
This is most characteristic of:
A. Retinal Detachment
, B. Acute Angle Closure Glaucoma
C. Macular Degeneration
D. Cataracts
Answer: A
Conceptual Explanation: Retinal detachment often presents as sudden floaters, flashes of
light (photopsia), and a shadow or ‘curtain’ descending over the visual field.
5. Which physical exam finding is most consistent with a diagnosis of community-acquired
pneumonia?
A. Hyperresonance on percussion
B. Decreased tactile fremitus
C. Tracheal deviation to the opposite side
D. Increased tactile fremitus
Answer: D
Conceptual Explanation: Consolidation in the lung (as seen in pneumonia) increases the
transmission of vibrations, resulting in increased tactile fremitus and dullness to
percussion.
6. What is the clinical significance of a Grade IV heart murmur?
A. It is loud and associated with a palpable thrill
B. It is very faint and only heard with special effort
ASSESSMENT FINAL EXAM STUDY
GUIDE QUESTIONS AND ANSWERS
2026/2027 UPDATE || 100% GUARANTEED
PASS
1. A 65-year-old patient presents with a systolic murmur heard best at the right second
intercostal space that radiates to the neck. What is the most likely diagnosis?
A. Mitral Regurgitation
B. Pulmonary Stenosis
C. Aortic Stenosis
D. Aortic Regurgitation
Answer: C
Conceptual Explanation: Aortic Stenosis is characterized by a mid-systolic crescendo-
decrescendo murmur heard best at the right second intercostal space, often radiating to the
carotid arteries.
2. During a musculoskeletal exam, a provider performs the Lachman test. A positive result
indicates an injury to which structure?
A. Medial Collateral Ligament (MCL)
,B. Posterior Cruciate Ligament (PCL)
C. Lateral Meniscus
D. Anterior Cruciate Ligament (ACL)
Answer: D
Conceptual Explanation: The Lachman test is considered the most sensitive clinical test
for detecting an ACL tear, involving significant forward excursion of the tibia.
3. When assessing Cranial Nerve VII (Facial), which clinical finding would indicate a lower
motor neuron lesion, such as Bell’s Palsy?
A. Preservation of forehead wrinkling on the affected side
B. Inability to wrinkle the forehead on the affected side
C. Loss of sensation to the cheek
D. Deviation of the uvula
Answer: B
Conceptual Explanation: In Bell’s Palsy (LMN lesion), the entire side of the face is affected,
including the forehead. In UMN lesions (like stroke), the forehead is often spared due to
bilateral innervation.
4. A patient presents with a ‘curtain-like’ shadow over their field of vision and flashes of light.
This is most characteristic of:
A. Retinal Detachment
, B. Acute Angle Closure Glaucoma
C. Macular Degeneration
D. Cataracts
Answer: A
Conceptual Explanation: Retinal detachment often presents as sudden floaters, flashes of
light (photopsia), and a shadow or ‘curtain’ descending over the visual field.
5. Which physical exam finding is most consistent with a diagnosis of community-acquired
pneumonia?
A. Hyperresonance on percussion
B. Decreased tactile fremitus
C. Tracheal deviation to the opposite side
D. Increased tactile fremitus
Answer: D
Conceptual Explanation: Consolidation in the lung (as seen in pneumonia) increases the
transmission of vibrations, resulting in increased tactile fremitus and dullness to
percussion.
6. What is the clinical significance of a Grade IV heart murmur?
A. It is loud and associated with a palpable thrill
B. It is very faint and only heard with special effort
