NR 509 FINAL EXAM GUIDE (2024/2025) | 100+ QUESTIONS WITH
VERIFIED ANSWERS AND RATIONALES – GRADED A+
Q1.
A 35-year-old female with a history of migraines presents to the clinic with worsening symptoms
for the past few weeks. She reports waking up at night with headaches and nausea. Her only
medication is oral contraceptives (OCPs). Otherwise, she states she is healthy.
Answer: Take a further history and perform a very careful neurological exam
Q2.
During a routine physical exam, a 9-year-old girl is noted to have asymmetric projection of the
areola and nipple of the right chest forming a secondary mound. The left breast is
underdeveloped.
Answer: Stage IV
Q3.
Primary prevention is defined as which of the following?
Answer: Interventions designed to prevent disease
Q4.
Based on USPSTF recommendations, which of the following is true about breast cancer
screening in average-risk women?
Answer: Mammography is recommended every 2 years for women aged 50–74, with
insufficient evidence for screening over age 75
Q5.
Which statements are true according to JNC 8 recommendations for adults aged 60 and older?
(Select all that apply)
Answer: - Target BP should be ≤150/90 mmHg
- For those aged 80+, BP targets of 140 to <150/70 to 80 reduce stroke, CV events, and
mortality
Q6.
Which of the following is a useful strategy when examining young children aged 1–4 years?
Answer: Have the parent facilitate the exam (e.g., removing clothes, holding the child on
lap)
Q7.
The NP is reviewing systems on a 4-month-old female. Which parent statement may indicate a
cardiac problem and require more thorough subjective history?
Answer: (To be extracted from next batch)
, Q8.
A 16-year-old male presents with a history of congenital right upper eyelid drooping. No
complaints, no trauma.
Answer: CN III (Oculomotor)
Q9.
Which cranial nerve innervates pharyngeal muscles and provides sensory input to the tympanic
membrane, auditory canal, pharynx, and posterior third of the tongue?
Answer: CN IX (Glossopharyngeal)
Q10.
The NP suspects injury to which cranial nerve if a patient presents with photosensitivity and
unequal pupils after being struck in the eye?
Answer: CN III
Q11.
A patient presents with fever, sore throat, drooling, and muffled voice. Examination reveals the
patient is leaning forward and has difficulty swallowing.
Answer: Epiglottitis
Q12.
A pregnant patient at 12 weeks reports mild abdominal cramping and spotting. What is the next
best step?
Answer: Obtain ultrasound and serum hCG levels
Q13.
During assessment of an infant, the NP notes a positive Ortolani sign. What does this indicate?
Answer: Developmental dysplasia of the hip
Q14.
A patient with long-standing hypertension has a displaced PMI. What condition is most likely?
Answer: Left ventricular hypertrophy
Q15.
Which cranial nerve is tested when assessing the gag reflex?
Answer: CN IX and CN X
Q16.
An older adult reports new hearing loss. Weber test lateralizes to the right; Rinne test shows bone
> air on the right.
Answer: Conductive hearing loss in right ear
Q17.
What is the purpose of transillumination during the exam of a scrotal mass?
Answer: To determine if the mass is fluid-filled
VERIFIED ANSWERS AND RATIONALES – GRADED A+
Q1.
A 35-year-old female with a history of migraines presents to the clinic with worsening symptoms
for the past few weeks. She reports waking up at night with headaches and nausea. Her only
medication is oral contraceptives (OCPs). Otherwise, she states she is healthy.
Answer: Take a further history and perform a very careful neurological exam
Q2.
During a routine physical exam, a 9-year-old girl is noted to have asymmetric projection of the
areola and nipple of the right chest forming a secondary mound. The left breast is
underdeveloped.
Answer: Stage IV
Q3.
Primary prevention is defined as which of the following?
Answer: Interventions designed to prevent disease
Q4.
Based on USPSTF recommendations, which of the following is true about breast cancer
screening in average-risk women?
Answer: Mammography is recommended every 2 years for women aged 50–74, with
insufficient evidence for screening over age 75
Q5.
Which statements are true according to JNC 8 recommendations for adults aged 60 and older?
(Select all that apply)
Answer: - Target BP should be ≤150/90 mmHg
- For those aged 80+, BP targets of 140 to <150/70 to 80 reduce stroke, CV events, and
mortality
Q6.
Which of the following is a useful strategy when examining young children aged 1–4 years?
Answer: Have the parent facilitate the exam (e.g., removing clothes, holding the child on
lap)
Q7.
The NP is reviewing systems on a 4-month-old female. Which parent statement may indicate a
cardiac problem and require more thorough subjective history?
Answer: (To be extracted from next batch)
, Q8.
A 16-year-old male presents with a history of congenital right upper eyelid drooping. No
complaints, no trauma.
Answer: CN III (Oculomotor)
Q9.
Which cranial nerve innervates pharyngeal muscles and provides sensory input to the tympanic
membrane, auditory canal, pharynx, and posterior third of the tongue?
Answer: CN IX (Glossopharyngeal)
Q10.
The NP suspects injury to which cranial nerve if a patient presents with photosensitivity and
unequal pupils after being struck in the eye?
Answer: CN III
Q11.
A patient presents with fever, sore throat, drooling, and muffled voice. Examination reveals the
patient is leaning forward and has difficulty swallowing.
Answer: Epiglottitis
Q12.
A pregnant patient at 12 weeks reports mild abdominal cramping and spotting. What is the next
best step?
Answer: Obtain ultrasound and serum hCG levels
Q13.
During assessment of an infant, the NP notes a positive Ortolani sign. What does this indicate?
Answer: Developmental dysplasia of the hip
Q14.
A patient with long-standing hypertension has a displaced PMI. What condition is most likely?
Answer: Left ventricular hypertrophy
Q15.
Which cranial nerve is tested when assessing the gag reflex?
Answer: CN IX and CN X
Q16.
An older adult reports new hearing loss. Weber test lateralizes to the right; Rinne test shows bone
> air on the right.
Answer: Conductive hearing loss in right ear
Q17.
What is the purpose of transillumination during the exam of a scrotal mass?
Answer: To determine if the mass is fluid-filled
