1
NR 509 Midterm Exam Study Guide
(2023/2024) – Chamberlain Advanced
Physical Assessment | Verified Questions
with 100% Correct Answers
NR509 Advanced Physical Assessment Questions
1. What is the first step in conducting a comprehensive health history during a
physical assessment?
a. Perform a physical exam
b. Obtain the patient’s chief complaint
c. Review laboratory results
d. Assess vital signs
Answer: b. Obtain the patient’s chief complaint.
Rationale: The health history begins with identifying the patient’s chief complaint, the
primary reason for the visit, to guide the assessment. This focuses subsequent history
taking and physical exam. Physical exam, lab results, and vital signs follow the history.
2. Which technique is used to assess for tactile fremitus during a respiratory exam?
a. Auscultation
b. Palpation
c. Percussion
d. Inspection
Answer: b. Palpation.
Rationale: Tactile fremitus is assessed by palpating the chest while the patient says
“ninety-nine.” Increased fremitus suggests consolidation (e.g., pneumonia), while
decreased fremitus indicates pleural effusion or pneumothorax. Auscultation assesses
breath sounds, percussion evaluates resonance, and inspection observes chest movement.
3. A patient reports chest pain. Which question best clarifies the symptom using the
OLDCARTS mnemonic?
a. What medications are you taking?
b. When did the pain start, and what makes it worse?
c. Have you had a recent injury?
d. Do you have a family history of heart disease?
Answer: b. When did the pain start, and what makes it worse?
Rationale: OLDCARTS (Onset, Location, Duration, Characteristics, Associated
symptoms, Relieving/aggravating factors, Timing, Severity) guides symptom analysis.
Option b addresses onset and aggravating factors, key components of OLDCARTS.
Other options are relevant but less specific to symptom clarification.
4. During a cardiovascular exam, where should the nurse place the stethoscope to
auscultate the aortic area?
, 2
a. Second intercostal space, right sternal border
b. Second intercostal space, left sternal border
c. Fifth intercostal space, midclavicular line
d. Fourth intercostal space, left sternal border
Answer: a. Second intercostal space, right sternal border.
Rationale: The aortic area is auscultated at the second intercostal space, right sternal
border, to assess aortic valve sounds. Option b is the pulmonic area, option c is the mitral
area, and option d is the tricuspid area.
5. What is the expected finding when percussing a healthy lung?
a. Dullness
b. Resonance
c. Tympany
d. Hyperresonance
Answer: b. Resonance.
Rationale: Percussion of a healthy lung produces resonance, a low-pitched, hollow sound
due to air-filled lung tissue. Dullness suggests consolidation (e.g., pneumonia), tympany
indicates air in the abdomen, and hyperresonance suggests pneumothorax.
6. A patient has a high-pitched, wheezing sound during auscultation. What condition is
most likely?
a. Pneumonia
b. Asthma
c. Pleural effusion
d. Pulmonary edema
Answer: b. Asthma.
Rationale: Wheezing, a high-pitched sound, indicates narrowed airways, commonly
associated with asthma due to bronchoconstriction. Pneumonia causes crackles, pleural
effusion reduces breath sounds, and pulmonary edema produces crackles or rales.
7. Which cranial nerve is assessed by asking the patient to stick out their tongue?
a. Cranial nerve V
b. Cranial nerve VII
c. Cranial nerve IX
d. Cranial nerve XII
Answer: d. Cranial nerve XII.
Rationale: Cranial nerve XII (hypoglossal) controls tongue movement. Deviation or
weakness suggests nerve dysfunction. Cranial nerve V assesses jaw movement, VII facial
movement, and IX swallowing and gag reflex.
8. What is the purpose of the Romberg test during a neurological exam?
a. Assess muscle strength
b. Evaluate balance and proprioception
c. Test visual acuity
d. Check reflex response
Answer: b. Evaluate balance and proprioception.
Rationale: The Romberg test assesses balance and proprioception by having the patient
stand with eyes closed. Swaying indicates cerebellar or proprioceptive dysfunction. Other
options test different neurological functions.
NR 509 Midterm Exam Study Guide
(2023/2024) – Chamberlain Advanced
Physical Assessment | Verified Questions
with 100% Correct Answers
NR509 Advanced Physical Assessment Questions
1. What is the first step in conducting a comprehensive health history during a
physical assessment?
a. Perform a physical exam
b. Obtain the patient’s chief complaint
c. Review laboratory results
d. Assess vital signs
Answer: b. Obtain the patient’s chief complaint.
Rationale: The health history begins with identifying the patient’s chief complaint, the
primary reason for the visit, to guide the assessment. This focuses subsequent history
taking and physical exam. Physical exam, lab results, and vital signs follow the history.
2. Which technique is used to assess for tactile fremitus during a respiratory exam?
a. Auscultation
b. Palpation
c. Percussion
d. Inspection
Answer: b. Palpation.
Rationale: Tactile fremitus is assessed by palpating the chest while the patient says
“ninety-nine.” Increased fremitus suggests consolidation (e.g., pneumonia), while
decreased fremitus indicates pleural effusion or pneumothorax. Auscultation assesses
breath sounds, percussion evaluates resonance, and inspection observes chest movement.
3. A patient reports chest pain. Which question best clarifies the symptom using the
OLDCARTS mnemonic?
a. What medications are you taking?
b. When did the pain start, and what makes it worse?
c. Have you had a recent injury?
d. Do you have a family history of heart disease?
Answer: b. When did the pain start, and what makes it worse?
Rationale: OLDCARTS (Onset, Location, Duration, Characteristics, Associated
symptoms, Relieving/aggravating factors, Timing, Severity) guides symptom analysis.
Option b addresses onset and aggravating factors, key components of OLDCARTS.
Other options are relevant but less specific to symptom clarification.
4. During a cardiovascular exam, where should the nurse place the stethoscope to
auscultate the aortic area?
, 2
a. Second intercostal space, right sternal border
b. Second intercostal space, left sternal border
c. Fifth intercostal space, midclavicular line
d. Fourth intercostal space, left sternal border
Answer: a. Second intercostal space, right sternal border.
Rationale: The aortic area is auscultated at the second intercostal space, right sternal
border, to assess aortic valve sounds. Option b is the pulmonic area, option c is the mitral
area, and option d is the tricuspid area.
5. What is the expected finding when percussing a healthy lung?
a. Dullness
b. Resonance
c. Tympany
d. Hyperresonance
Answer: b. Resonance.
Rationale: Percussion of a healthy lung produces resonance, a low-pitched, hollow sound
due to air-filled lung tissue. Dullness suggests consolidation (e.g., pneumonia), tympany
indicates air in the abdomen, and hyperresonance suggests pneumothorax.
6. A patient has a high-pitched, wheezing sound during auscultation. What condition is
most likely?
a. Pneumonia
b. Asthma
c. Pleural effusion
d. Pulmonary edema
Answer: b. Asthma.
Rationale: Wheezing, a high-pitched sound, indicates narrowed airways, commonly
associated with asthma due to bronchoconstriction. Pneumonia causes crackles, pleural
effusion reduces breath sounds, and pulmonary edema produces crackles or rales.
7. Which cranial nerve is assessed by asking the patient to stick out their tongue?
a. Cranial nerve V
b. Cranial nerve VII
c. Cranial nerve IX
d. Cranial nerve XII
Answer: d. Cranial nerve XII.
Rationale: Cranial nerve XII (hypoglossal) controls tongue movement. Deviation or
weakness suggests nerve dysfunction. Cranial nerve V assesses jaw movement, VII facial
movement, and IX swallowing and gag reflex.
8. What is the purpose of the Romberg test during a neurological exam?
a. Assess muscle strength
b. Evaluate balance and proprioception
c. Test visual acuity
d. Check reflex response
Answer: b. Evaluate balance and proprioception.
Rationale: The Romberg test assesses balance and proprioception by having the patient
stand with eyes closed. Swaying indicates cerebellar or proprioceptive dysfunction. Other
options test different neurological functions.
