NR509 ADVANCED PHYSICAL
ASSESSMENT MIDTERM EXAM
QUESTIONS AND ANSWERS 2026/2027
UPDATE || 100% GUARANTEED PASS
1. During a cardiac assessment, the nurse practitioner notes a physiological splitting of the S2
heart sound. Which of the following describes the mechanism of this finding?
A. The aortic valve closes slightly after the pulmonic valve during expiration.
B. The mitral valve closes slightly before the tricuspid valve during expiration.
C. The pulmonic valve closes slightly before the aortic valve during inspiration.
D. The aortic valve closes slightly before the pulmonic valve during inspiration.
Answer: D
Conceptual Explanation: Physiological splitting of S2 is a normal finding where the aortic
valve (A2) closes slightly before the pulmonic valve (P2) due to increased venous return to
the right heart during inspiration.
2. When assessing for tactile fremitus, the nurse practitioner expects to find increased
vibrations in which of the following conditions?
A. Pleural effusion
B. Pneumothorax
,C. Lobar pneumonia
D. Obstructed bronchus
Answer: C
Conceptual Explanation: Tactile fremitus is increased in conditions where lung tissue is
consolidated, such as lobar pneumonia, because sound travels better through solid/liquid
media than air.
3. A patient presents with acute right upper quadrant pain. The nurse practitioner performs a
physical maneuver by deeply palpating the RUQ while the patient takes a deep breath. A
sharp halt in inspiration is noted. This is known as:
A. Rovsing’s sign
B. McBurney’s sign
C. Psoas sign
D. Murphy’s sign
Answer: D
Conceptual Explanation: Murphy’s sign is positive when the patient stops breathing in
(inspiratory arrest) during deep palpation of the gallbladder area, suggesting acute
cholecystitis.
, 4. In a Rinne test, a patient with conductive hearing loss in the right ear will demonstrate
which of the following results?
A. Air conduction is longer than bone conduction in the right ear.
B. Air conduction is longer than bone conduction in the left ear only.
C. Bone conduction is longer than or equal to air conduction in the right ear.
D. The sound lateralizes to the left ear.
Answer: C
Conceptual Explanation: In conductive hearing loss, bone conduction (BC) is equal to or
longer than air conduction (AC) because the sound bypasses the obstructed external or
middle ear.
5. Which cranial nerve is responsible for the motor function of the muscles of facial
expression?
A. Cranial Nerve V (Trigeminal)
B. Cranial Nerve VII (Facial)
C. Cranial Nerve VI (Abducens)
D. Cranial Nerve IX (Glossopharyngeal)
Answer: B
Conceptual Explanation: Cranial Nerve VII (Facial) controls the muscles used for facial
expressions; CN V is primarily sensory for the face and motor for mastication.
ASSESSMENT MIDTERM EXAM
QUESTIONS AND ANSWERS 2026/2027
UPDATE || 100% GUARANTEED PASS
1. During a cardiac assessment, the nurse practitioner notes a physiological splitting of the S2
heart sound. Which of the following describes the mechanism of this finding?
A. The aortic valve closes slightly after the pulmonic valve during expiration.
B. The mitral valve closes slightly before the tricuspid valve during expiration.
C. The pulmonic valve closes slightly before the aortic valve during inspiration.
D. The aortic valve closes slightly before the pulmonic valve during inspiration.
Answer: D
Conceptual Explanation: Physiological splitting of S2 is a normal finding where the aortic
valve (A2) closes slightly before the pulmonic valve (P2) due to increased venous return to
the right heart during inspiration.
2. When assessing for tactile fremitus, the nurse practitioner expects to find increased
vibrations in which of the following conditions?
A. Pleural effusion
B. Pneumothorax
,C. Lobar pneumonia
D. Obstructed bronchus
Answer: C
Conceptual Explanation: Tactile fremitus is increased in conditions where lung tissue is
consolidated, such as lobar pneumonia, because sound travels better through solid/liquid
media than air.
3. A patient presents with acute right upper quadrant pain. The nurse practitioner performs a
physical maneuver by deeply palpating the RUQ while the patient takes a deep breath. A
sharp halt in inspiration is noted. This is known as:
A. Rovsing’s sign
B. McBurney’s sign
C. Psoas sign
D. Murphy’s sign
Answer: D
Conceptual Explanation: Murphy’s sign is positive when the patient stops breathing in
(inspiratory arrest) during deep palpation of the gallbladder area, suggesting acute
cholecystitis.
, 4. In a Rinne test, a patient with conductive hearing loss in the right ear will demonstrate
which of the following results?
A. Air conduction is longer than bone conduction in the right ear.
B. Air conduction is longer than bone conduction in the left ear only.
C. Bone conduction is longer than or equal to air conduction in the right ear.
D. The sound lateralizes to the left ear.
Answer: C
Conceptual Explanation: In conductive hearing loss, bone conduction (BC) is equal to or
longer than air conduction (AC) because the sound bypasses the obstructed external or
middle ear.
5. Which cranial nerve is responsible for the motor function of the muscles of facial
expression?
A. Cranial Nerve V (Trigeminal)
B. Cranial Nerve VII (Facial)
C. Cranial Nerve VI (Abducens)
D. Cranial Nerve IX (Glossopharyngeal)
Answer: B
Conceptual Explanation: Cranial Nerve VII (Facial) controls the muscles used for facial
expressions; CN V is primarily sensory for the face and motor for mastication.
