NR 509 / NR509 ADVANCED PHYSICAL ASSESSMENT FINAL
EXAM QUIZ BANK (2021/2022) – CHAMBERLAIN COLLEGE |
HIGHLY RATED QUESTIONS & VERIFIED GRADE A
ANSWERS
1. What is the most likely cause of a high-pitched, musical wheeze heard on expiration
during a respiratory exam?
A. Pneumonia
B. Asthma
C. Chronic obstructive pulmonary disease (COPD)
D. Pulmonary edema
Correct Answer: B
Rationale: High-pitched, musical wheezes on expiration are characteristic of asthma due
to bronchoconstriction and airway narrowing. Pneumonia typically presents with
crackles, COPD with low-pitched wheezes or rhonchi, and pulmonary edema with coarse
crackles.
2. During a cardiac exam, a split S2 is best heard at which location?
A. Apex of the heart
B. Second right intercostal space
C. Fifth left intercostal space
D. Midclavicular line
Correct Answer: B
Rationale: A split S2 is best heard at the second right intercostal space (pulmonic area)
during inspiration, as it reflects the asynchronous closure of the aortic and pulmonic
valves.
3. A 65-year-old male presents with unilateral leg swelling and tenderness. Which
physical exam finding supports a diagnosis of deep vein thrombosis (DVT)?
A. Negative Homan’s sign
B. Pitting edema bilaterally
C. Warm, erythematous skin over the calf
D. Absent pedal pulses
Correct Answer: C
Rationale: Warm, erythematous skin over the calf, along with swelling and tenderness, is
consistent with DVT. Homan’s sign is unreliable, bilateral edema suggests a systemic
cause, and absent pulses indicate arterial issues.
4. When assessing cranial nerve XII (hypoglossal), what action should the patient
perform?
A. Shrug shoulders against resistance
B. Protrude tongue and move it side to side
C. Follow a moving object with eyes
D. Puff cheeks symmetrically
Correct Answer: B
Rationale: Cranial nerve XII controls tongue movement. Protruding the tongue and
, moving it side to side assesses for deviation or weakness, indicating hypoglossal nerve
function.
5. A 10-year-old child presents with a sore throat and fever. Which finding on throat
exam suggests streptococcal pharyngitis?
A. Cobblestoning of posterior pharynx
B. Tonsillar exudates and petechiae on soft palate
C. Clear nasal discharge
D. Ulcerations on buccal mucosa
Correct Answer: B
Rationale: Tonsillar exudates and petechiae on the soft palate are classic findings in
streptococcal pharyngitis. Cobblestoning suggests allergic rhinitis, clear discharge is
nonspecific, and ulcerations may indicate viral infection.
6. What is the correct sequence for abdominal assessment?
A. Percussion, palpation, inspection, auscultation
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, palpation, percussion
D. Palpation, percussion, auscultation, inspection
Correct Answer: B
Rationale: The correct sequence is inspection, auscultation, percussion, palpation to
avoid altering bowel sounds or causing discomfort that could affect findings.
7. A 45-year-old female reports chest pain. Which finding during a cardiovascular
exam suggests angina pectoris?
A. Pain reproducible with palpation
B. Relief with rest or nitroglycerin
C. Constant pain lasting hours
D. Pain radiating to the right shoulder
Correct Answer: B
Rationale: Angina pectoris is characterized by chest pain relieved by rest or
nitroglycerin, typically lasting minutes. Reproducible pain suggests musculoskeletal
causes, constant pain may indicate myocardial infarction, and right shoulder radiation is
atypical.
8. When assessing a patient’s gait, which finding indicates cerebellar dysfunction?
A. Shuffling gait with small steps
B. Wide-based, unsteady gait
C. High-stepping gait
D. Dragging of one leg
Correct Answer: B
Rationale: A wide-based, unsteady gait is characteristic of cerebellar dysfunction,
impairing coordination. Shuffling suggests Parkinson’s, high-stepping indicates
peripheral neuropathy, and dragging may suggest stroke.
9. Which maneuver is used to assess for appendicitis in a patient with right lower
quadrant pain?
A. Murphy’s sign
B. Rovsing’s sign
C. Psoas sign
D. All of the above
, Correct Answer: D
Rationale: Rovsing’s sign (pain in RLQ with LLQ palpation), Psoas sign (pain with hip
flexion against resistance), and rebound tenderness are used to assess appendicitis.
Murphy’s sign is specific for cholecystitis.
10. A 30-year-old male presents with unilateral hearing loss. Which test differentiates
conductive from sensorineural hearing loss?
A. Weber test
B. Romberg test
C. Dix-Hallpike maneuver
D. Tinel’s sign
Correct Answer: A
Rationale: The Weber test, combined with the Rinne test, differentiates conductive
(lateralization to affected ear) from sensorineural (lateralization to unaffected ear) hearing
loss. Other tests assess balance, vertigo, or nerve compression.
11. What is the expected finding when percussing a healthy lung field?
A. Dullness
B. Resonance
C. Hyperresonance
D. Tympany
Correct Answer: B
Rationale: Resonance is the normal sound over healthy lung fields due to air-filled
spaces. Dullness suggests consolidation, hyperresonance indicates pneumothorax, and
tympany is typical over the abdomen.
12. A 55-year-old female presents with fatigue and weight gain. Which thyroid exam
finding suggests hypothyroidism?
A. Thyroid bruit
B. Diffuse goiter with firm texture
C. Single palpable nodule
D. Soft, nontender thyroid
Correct Answer: B
Rationale: A diffuse goiter with a firm texture is common in hypothyroidism, often due
to Hashimoto’s thyroiditis. A bruit suggests hyperthyroidism, a nodule may indicate
malignancy, and a soft thyroid is normal.
13. During a musculoskeletal exam, what does a positive drawer test indicate?
A. Meniscal tear
B. Anterior cruciate ligament (ACL) injury
C. Patellar dislocation
D. Achilles tendon rupture
Correct Answer: B
Rationale: A positive drawer test (anterior tibial displacement) indicates an ACL injury.
Meniscal tears cause joint line tenderness, patellar issues cause apprehension, and
Achilles rupture limits plantarflexion.
14. Which cranial nerve is assessed by testing the gag reflex?
A. Cranial nerve V
B. Cranial nerve VII
C. Cranial nerve IX
EXAM QUIZ BANK (2021/2022) – CHAMBERLAIN COLLEGE |
HIGHLY RATED QUESTIONS & VERIFIED GRADE A
ANSWERS
1. What is the most likely cause of a high-pitched, musical wheeze heard on expiration
during a respiratory exam?
A. Pneumonia
B. Asthma
C. Chronic obstructive pulmonary disease (COPD)
D. Pulmonary edema
Correct Answer: B
Rationale: High-pitched, musical wheezes on expiration are characteristic of asthma due
to bronchoconstriction and airway narrowing. Pneumonia typically presents with
crackles, COPD with low-pitched wheezes or rhonchi, and pulmonary edema with coarse
crackles.
2. During a cardiac exam, a split S2 is best heard at which location?
A. Apex of the heart
B. Second right intercostal space
C. Fifth left intercostal space
D. Midclavicular line
Correct Answer: B
Rationale: A split S2 is best heard at the second right intercostal space (pulmonic area)
during inspiration, as it reflects the asynchronous closure of the aortic and pulmonic
valves.
3. A 65-year-old male presents with unilateral leg swelling and tenderness. Which
physical exam finding supports a diagnosis of deep vein thrombosis (DVT)?
A. Negative Homan’s sign
B. Pitting edema bilaterally
C. Warm, erythematous skin over the calf
D. Absent pedal pulses
Correct Answer: C
Rationale: Warm, erythematous skin over the calf, along with swelling and tenderness, is
consistent with DVT. Homan’s sign is unreliable, bilateral edema suggests a systemic
cause, and absent pulses indicate arterial issues.
4. When assessing cranial nerve XII (hypoglossal), what action should the patient
perform?
A. Shrug shoulders against resistance
B. Protrude tongue and move it side to side
C. Follow a moving object with eyes
D. Puff cheeks symmetrically
Correct Answer: B
Rationale: Cranial nerve XII controls tongue movement. Protruding the tongue and
, moving it side to side assesses for deviation or weakness, indicating hypoglossal nerve
function.
5. A 10-year-old child presents with a sore throat and fever. Which finding on throat
exam suggests streptococcal pharyngitis?
A. Cobblestoning of posterior pharynx
B. Tonsillar exudates and petechiae on soft palate
C. Clear nasal discharge
D. Ulcerations on buccal mucosa
Correct Answer: B
Rationale: Tonsillar exudates and petechiae on the soft palate are classic findings in
streptococcal pharyngitis. Cobblestoning suggests allergic rhinitis, clear discharge is
nonspecific, and ulcerations may indicate viral infection.
6. What is the correct sequence for abdominal assessment?
A. Percussion, palpation, inspection, auscultation
B. Inspection, auscultation, percussion, palpation
C. Auscultation, inspection, palpation, percussion
D. Palpation, percussion, auscultation, inspection
Correct Answer: B
Rationale: The correct sequence is inspection, auscultation, percussion, palpation to
avoid altering bowel sounds or causing discomfort that could affect findings.
7. A 45-year-old female reports chest pain. Which finding during a cardiovascular
exam suggests angina pectoris?
A. Pain reproducible with palpation
B. Relief with rest or nitroglycerin
C. Constant pain lasting hours
D. Pain radiating to the right shoulder
Correct Answer: B
Rationale: Angina pectoris is characterized by chest pain relieved by rest or
nitroglycerin, typically lasting minutes. Reproducible pain suggests musculoskeletal
causes, constant pain may indicate myocardial infarction, and right shoulder radiation is
atypical.
8. When assessing a patient’s gait, which finding indicates cerebellar dysfunction?
A. Shuffling gait with small steps
B. Wide-based, unsteady gait
C. High-stepping gait
D. Dragging of one leg
Correct Answer: B
Rationale: A wide-based, unsteady gait is characteristic of cerebellar dysfunction,
impairing coordination. Shuffling suggests Parkinson’s, high-stepping indicates
peripheral neuropathy, and dragging may suggest stroke.
9. Which maneuver is used to assess for appendicitis in a patient with right lower
quadrant pain?
A. Murphy’s sign
B. Rovsing’s sign
C. Psoas sign
D. All of the above
, Correct Answer: D
Rationale: Rovsing’s sign (pain in RLQ with LLQ palpation), Psoas sign (pain with hip
flexion against resistance), and rebound tenderness are used to assess appendicitis.
Murphy’s sign is specific for cholecystitis.
10. A 30-year-old male presents with unilateral hearing loss. Which test differentiates
conductive from sensorineural hearing loss?
A. Weber test
B. Romberg test
C. Dix-Hallpike maneuver
D. Tinel’s sign
Correct Answer: A
Rationale: The Weber test, combined with the Rinne test, differentiates conductive
(lateralization to affected ear) from sensorineural (lateralization to unaffected ear) hearing
loss. Other tests assess balance, vertigo, or nerve compression.
11. What is the expected finding when percussing a healthy lung field?
A. Dullness
B. Resonance
C. Hyperresonance
D. Tympany
Correct Answer: B
Rationale: Resonance is the normal sound over healthy lung fields due to air-filled
spaces. Dullness suggests consolidation, hyperresonance indicates pneumothorax, and
tympany is typical over the abdomen.
12. A 55-year-old female presents with fatigue and weight gain. Which thyroid exam
finding suggests hypothyroidism?
A. Thyroid bruit
B. Diffuse goiter with firm texture
C. Single palpable nodule
D. Soft, nontender thyroid
Correct Answer: B
Rationale: A diffuse goiter with a firm texture is common in hypothyroidism, often due
to Hashimoto’s thyroiditis. A bruit suggests hyperthyroidism, a nodule may indicate
malignancy, and a soft thyroid is normal.
13. During a musculoskeletal exam, what does a positive drawer test indicate?
A. Meniscal tear
B. Anterior cruciate ligament (ACL) injury
C. Patellar dislocation
D. Achilles tendon rupture
Correct Answer: B
Rationale: A positive drawer test (anterior tibial displacement) indicates an ACL injury.
Meniscal tears cause joint line tenderness, patellar issues cause apprehension, and
Achilles rupture limits plantarflexion.
14. Which cranial nerve is assessed by testing the gag reflex?
A. Cranial nerve V
B. Cranial nerve VII
C. Cranial nerve IX
