NR 509 final exam/ nrNR509 Final
Questions & Answers.
CourseNR509
Section 1: Advanced Health Assessment
1. During a cardiovascular examination, which finding is most consistent with left-sided
heart failure?
A. Ascites and hepatomegaly B. Pulmonary crackles and dyspnea C. Isolated peripheral
neuropathy D. Unilateral calf tenderness
Correct answer: B. Pulmonary crackles and dyspnea
Rationale: Left-sided heart failure increases pulmonary venous pressure, which can cause
pulmonary congestion, crackles, orthopnea, and dyspnea.
2. A patient reports chest pain that worsens with inspiration and improves when sitting
forward. Which condition is most likely?
A. Acute pericarditis B. Gastroesophageal reflux disease C. Stable angina D. Costochondritis
Correct answer: A. Acute pericarditis
Rationale: Pericarditis classically causes sharp, pleuritic chest pain that improves when sitting up
and leaning forward. ECG findings and clinical evaluation help establish the diagnosis.
3. Which finding is most characteristic of hyperthyroidism?
,A. Bradycardia and cold intolerance B. Weight gain and constipation C. Heat intolerance, tremor,
and tachycardia D. Delayed relaxation of deep tendon reflexes
Correct answer: C. Heat intolerance, tremor, and tachycardia
Rationale: Excess thyroid hormone increases metabolic activity and sympathetic responsiveness,
often producing tachycardia, tremor, heat intolerance, and weight loss.
4. During abdominal examination, which sequence is generally recommended?
A. Palpation, percussion, inspection, auscultation B. Inspection, auscultation, percussion,
palpation C. Auscultation, palpation, inspection, percussion D. Percussion, inspection, palpation,
auscultation
Correct answer: B. Inspection, auscultation, percussion, palpation
Rationale: Auscultation is performed before percussion and palpation because these maneuvers
may alter bowel sounds. Inspection comes first.
5. Which cranial nerve is primarily assessed when testing shoulder shrug against
resistance?
A. Cranial nerve V B. Cranial nerve VII C. Cranial nerve XI D. Cranial nerve XII
Correct answer: C. Cranial nerve XI
Rationale: The spinal accessory nerve (CN XI) innervates the trapezius and sternocleidomastoid
muscles. Shoulder shrug assesses trapezius strength.
Section 2: Cardiovascular and Respiratory Assessment
6. Which auscultatory finding is most consistent with aortic stenosis?
, A. A diastolic rumbling murmur at the apex B. A systolic crescendo-decrescendo murmur at the
right upper sternal border C. A continuous machinery-like murmur D. A pericardial friction rub
Correct answer: B. A systolic crescendo-decrescendo murmur at the right upper sternal border
Rationale: Aortic stenosis typically produces a systolic ejection murmur at the right upper sternal
border, often radiating to the carotid arteries.
7. A patient has unilateral calf swelling, warmth, and tenderness. Which diagnosis should
be considered?
A. Deep vein thrombosis B. Chronic bronchitis C. Peripheral neuropathy D. Osteoarthritis
Correct answer: A. Deep vein thrombosis
Rationale: Unilateral swelling, warmth, and tenderness may indicate DVT. Clinical probability
assessment and appropriate diagnostic testing, commonly venous ultrasonography, are needed.
Physical examination alone cannot confirm or exclude DVT.
8. Which finding is most suggestive of consolidation from pneumonia?
A. Hyperresonance with absent tactile fremitus B. Increased tactile fremitus over the affected
area C. Symmetrical vesicular breath sounds throughout D. Bilaterally reduced chest expansion
without other abnormalities
Correct answer: B. Increased tactile fremitus over the affected area
Rationale: Consolidated lung tissue can transmit vocal vibrations more effectively than normally
aerated lung. Other findings may include bronchial breath sounds, egophony, and dullness to
percussion.
Questions & Answers.
CourseNR509
Section 1: Advanced Health Assessment
1. During a cardiovascular examination, which finding is most consistent with left-sided
heart failure?
A. Ascites and hepatomegaly B. Pulmonary crackles and dyspnea C. Isolated peripheral
neuropathy D. Unilateral calf tenderness
Correct answer: B. Pulmonary crackles and dyspnea
Rationale: Left-sided heart failure increases pulmonary venous pressure, which can cause
pulmonary congestion, crackles, orthopnea, and dyspnea.
2. A patient reports chest pain that worsens with inspiration and improves when sitting
forward. Which condition is most likely?
A. Acute pericarditis B. Gastroesophageal reflux disease C. Stable angina D. Costochondritis
Correct answer: A. Acute pericarditis
Rationale: Pericarditis classically causes sharp, pleuritic chest pain that improves when sitting up
and leaning forward. ECG findings and clinical evaluation help establish the diagnosis.
3. Which finding is most characteristic of hyperthyroidism?
,A. Bradycardia and cold intolerance B. Weight gain and constipation C. Heat intolerance, tremor,
and tachycardia D. Delayed relaxation of deep tendon reflexes
Correct answer: C. Heat intolerance, tremor, and tachycardia
Rationale: Excess thyroid hormone increases metabolic activity and sympathetic responsiveness,
often producing tachycardia, tremor, heat intolerance, and weight loss.
4. During abdominal examination, which sequence is generally recommended?
A. Palpation, percussion, inspection, auscultation B. Inspection, auscultation, percussion,
palpation C. Auscultation, palpation, inspection, percussion D. Percussion, inspection, palpation,
auscultation
Correct answer: B. Inspection, auscultation, percussion, palpation
Rationale: Auscultation is performed before percussion and palpation because these maneuvers
may alter bowel sounds. Inspection comes first.
5. Which cranial nerve is primarily assessed when testing shoulder shrug against
resistance?
A. Cranial nerve V B. Cranial nerve VII C. Cranial nerve XI D. Cranial nerve XII
Correct answer: C. Cranial nerve XI
Rationale: The spinal accessory nerve (CN XI) innervates the trapezius and sternocleidomastoid
muscles. Shoulder shrug assesses trapezius strength.
Section 2: Cardiovascular and Respiratory Assessment
6. Which auscultatory finding is most consistent with aortic stenosis?
, A. A diastolic rumbling murmur at the apex B. A systolic crescendo-decrescendo murmur at the
right upper sternal border C. A continuous machinery-like murmur D. A pericardial friction rub
Correct answer: B. A systolic crescendo-decrescendo murmur at the right upper sternal border
Rationale: Aortic stenosis typically produces a systolic ejection murmur at the right upper sternal
border, often radiating to the carotid arteries.
7. A patient has unilateral calf swelling, warmth, and tenderness. Which diagnosis should
be considered?
A. Deep vein thrombosis B. Chronic bronchitis C. Peripheral neuropathy D. Osteoarthritis
Correct answer: A. Deep vein thrombosis
Rationale: Unilateral swelling, warmth, and tenderness may indicate DVT. Clinical probability
assessment and appropriate diagnostic testing, commonly venous ultrasonography, are needed.
Physical examination alone cannot confirm or exclude DVT.
8. Which finding is most suggestive of consolidation from pneumonia?
A. Hyperresonance with absent tactile fremitus B. Increased tactile fremitus over the affected
area C. Symmetrical vesicular breath sounds throughout D. Bilaterally reduced chest expansion
without other abnormalities
Correct answer: B. Increased tactile fremitus over the affected area
Rationale: Consolidated lung tissue can transmit vocal vibrations more effectively than normally
aerated lung. Other findings may include bronchial breath sounds, egophony, and dullness to
percussion.
