NR509 ADVANCED PHYSICAL
ASSESSMENT REVIEW QUESTIONS
AND ANSWERS 2026/2027 UPDATE ||
100% GUARANTEED PASS
1. When assessing the cardiovascular system, which heart sound is often considered a normal
finding in children and young adults but may indicate heart failure in older adults?
A. S3
B. S2
C. S1
D. S4
Answer: A
Conceptual Explanation: S3 (ventricular gallop) occurs early in diastole during rapid
ventricular filling. While normal in young people, it often signifies volume overload or
decreased ventricular compliance in older adults.
2. A patient presents with acute abdominal pain. The practitioner performs a technique
where they deeply palpate the LLQ and the patient feels pain in the RLQ. What is this sign
called?
A. Rovsing’s sign
,B. Murphy’s sign
C. Psoas sign
D. Obturator sign
Answer: A
Conceptual Explanation: Rovsing’s sign is positive when pressure on the left lower
quadrant causes pain in the right lower quadrant, suggesting peritoneal irritation or
appendicitis.
3. During a respiratory exam, percussing over an area of the lung that is filled with fluid
(effusion) will produce which sound?
A. Dullness
B. Hyperresonance
C. Tympany
D. Resonance
Answer: A
Conceptual Explanation: Dullness replaces resonance when fluid or solid tissue replaces
air-containing lung or occupies the pleural space.
4. When grading a heart murmur, a murmur that is very loud, heard with the stethoscope
partly off the chest, and associated with a palpable thrill is classified as:
A. Grade 3
, B. Grade 4
C. Grade 5
D. Grade 6
Answer: C
Conceptual Explanation: Grade 5 murmurs are very loud, heard with the stethoscope
partly off the chest, and associated with a thrill. Grade 6 is heard without the stethoscope
touching the chest.
5. Which cranial nerve is being tested when the patient is asked to shrug their shoulders
against resistance?
A. CN IX (Glossopharyngeal)
B. CN XI (Spinal Accessory)
C. CN X (Vagus)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; shoulder shrugging tests the trapezius.
6. A 65-year-old male presents with a history of hypertension. During the fundoscopic exam,
the practitioner notes ‘A-V nicking.’ This finding is characteristic of:
A. Diabetic retinopathy
ASSESSMENT REVIEW QUESTIONS
AND ANSWERS 2026/2027 UPDATE ||
100% GUARANTEED PASS
1. When assessing the cardiovascular system, which heart sound is often considered a normal
finding in children and young adults but may indicate heart failure in older adults?
A. S3
B. S2
C. S1
D. S4
Answer: A
Conceptual Explanation: S3 (ventricular gallop) occurs early in diastole during rapid
ventricular filling. While normal in young people, it often signifies volume overload or
decreased ventricular compliance in older adults.
2. A patient presents with acute abdominal pain. The practitioner performs a technique
where they deeply palpate the LLQ and the patient feels pain in the RLQ. What is this sign
called?
A. Rovsing’s sign
,B. Murphy’s sign
C. Psoas sign
D. Obturator sign
Answer: A
Conceptual Explanation: Rovsing’s sign is positive when pressure on the left lower
quadrant causes pain in the right lower quadrant, suggesting peritoneal irritation or
appendicitis.
3. During a respiratory exam, percussing over an area of the lung that is filled with fluid
(effusion) will produce which sound?
A. Dullness
B. Hyperresonance
C. Tympany
D. Resonance
Answer: A
Conceptual Explanation: Dullness replaces resonance when fluid or solid tissue replaces
air-containing lung or occupies the pleural space.
4. When grading a heart murmur, a murmur that is very loud, heard with the stethoscope
partly off the chest, and associated with a palpable thrill is classified as:
A. Grade 3
, B. Grade 4
C. Grade 5
D. Grade 6
Answer: C
Conceptual Explanation: Grade 5 murmurs are very loud, heard with the stethoscope
partly off the chest, and associated with a thrill. Grade 6 is heard without the stethoscope
touching the chest.
5. Which cranial nerve is being tested when the patient is asked to shrug their shoulders
against resistance?
A. CN IX (Glossopharyngeal)
B. CN XI (Spinal Accessory)
C. CN X (Vagus)
D. CN XII (Hypoglossal)
Answer: B
Conceptual Explanation: CN XI innervates the trapezius and sternocleidomastoid
muscles; shoulder shrugging tests the trapezius.
6. A 65-year-old male presents with a history of hypertension. During the fundoscopic exam,
the practitioner notes ‘A-V nicking.’ This finding is characteristic of:
A. Diabetic retinopathy
