NR 509 / NR509 Advanced Physical
Assessment — Midterm Review | 100
Verified Questions & Answers | 2026 Edition
3P’s EXAM
1. When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and
20/40 in the right eye using the Snellen eye chart. This means:
a) have the patient returning in two weeks for a follow up vision screen
b) dilated the eye and retest
c) refer the patient to an ophthalmologist
d) document this as a normal finding
2. The American psychiatric association’s diagnostic and statistical manual of mental disorder
defines Munchausen Syndrome By Proxy
a) a self-inflicted injury to gain attention
b) a caregiver making up or causing an illness or injury in a person under his or her
care
c) an abusive behavior that does not involve the caregiver
d) a situation in which the abuser is often inattentive and uncaring toward the victim
Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a
child, most often a mother, either makes up fake symptoms or causes real symptoms to make it
look like the child is sick.
3. Symptoms bof bdepression bare ba bside beffect bof bwhich bneurotransmitter bmedication?
a) dopamine serotonin, bnorepinephrine
b) gabapentin
c) mil
d) cortisol
4. Which blesion bis bdark braised band basymmetric bwith birregular bborder? bQuizlet bBates
bChapter b20
a) Nevus
b) Actinic bkeratosis
c) Keratoacanthoma
d) Melanoma
5. A b32 byears bold bwoman bpresents bwith bdull bpuffiness bof bthe bayes bpronounced bnot
bpitting bperiorbital bedema bthis bfinding bis bsuggestive bof bthis bcondition? bAPEA
a) Nephrotic bsyndrome
b) Myxedema
c) Cushing bsyndrome
d) Sinusitis
Myxedema bis ba bdeposition bof bmucopolysaccarides bin bthe bdermis. bIs bcommonly bfound bif
bpatients bwith badvanced bhypothyroidism. bThe bclassic bskin bchanges bare: bswelling bof bface,
,blips, beyelids, band btongue bor bswelling band bthickening bof bskin banywhere bon bthe bbody,
bespecially bin bthe blower blegs.
Myxedema bis bthe bhallmark bof bGrave’s bdisease, ban bautoimmune bform bof
bhyperthyroidism. bMyxedema bcan balso boccur bin bHashimoto’s bthyroiditis ba bform bof
bhypothyroidism.
,6. A b42 byears bold bwoman bwith ba bpast bmedical bhistory bof bmigraine bheadaches bis
brequesting bprophylactic bmedication btreatment. bWhich bmedication bshould bthe
bNurse bpractitioner bprescribe?
a) Sumatriptan b(Imitrex)
b) Amitriptyline b(Elavil)
c) Verapamil b(verelan)
d) Metoprolol b(Lopressor)
Amitriptyline b(Elavil) bis ba btricyclic bantidepresant band bis bconsidered bofflabel buse bfor
bprophylactic btreatment bof bmigrane. bSumatriptan b(Imimtrex) bIs baTriptans bused bto babort
bmigraine
7. A bpediatric bpatient bhas bareas bof bscaling bon bthe bscalp bwith bround bpatches bof
balopecia. bThis bclinical bfinding bis bconsistent bwith:
a) Tinea bcapitis
b) Seborrheic bdermatitis
c) Trichotillomania
d) Alopecia bareata
8. What bis bthe bappropriate bprophylactic bmedication bfor ban b18 byears bold bwoman
bwith ba bpast bmedical bhistory bof bmigraine bheadaches?
a) Sumatriptan b(Imitrex)
b) Propanolol b(Inderal)
c) Ibuprofeno b(motrin)
d) Dihydroergotamine b(DHE)
9. Why bwould ba bcombined bhormonal bcontraceptive bbe bcontraindicated bin ba b36 byear bold
bpatient bwith ba bpast bmedical bhistory bof btype b2 bdiabetes, bobesity, bchronic bsmoking
band bsedentary blife
a) She bis bobese
b) She bhas btype b2 bdiabetes bmellitus
c) Her bage band btobacco buse
d) She bleads ba bsedentary blifestyle
Combined boral bcontraceptive bis bcontraindicated bin bwomen bolder bthan b45, bbreastfeeding,
bsmoking, bHTN, bdiabetes bor bhx bof bstroke
10. During bthe bbreast bexamination bof ba bperimenopausal bwoman bthe bNP bdetects ba
bbloody bspontaneous b discharge bfrom bthe bright bnipple. bThis bindicates bfurther
bevaluation.
a) Fibroadenoma
b) Polycystic bbreast bdisease b Generalized bbreast bpain bor btenderness. bGreen bor bdark
bbrown bnonbloody bnipple bdischarge bthat btends bto bleak bwithout bpressure bor
bsqueezing
c) An bintraductal bpapilloma
d) Pituitary bprolactinoma
Intraductal bpapillomas bare busually bsolitary band bsmaller bthan b1 bcm. bThey bare blocated bin
, blarge blactiferous bsinuses bor bducts band bhave ba btendency bto bbleed. bQuizlet bNipple
bDischarge
Assessment — Midterm Review | 100
Verified Questions & Answers | 2026 Edition
3P’s EXAM
1. When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and
20/40 in the right eye using the Snellen eye chart. This means:
a) have the patient returning in two weeks for a follow up vision screen
b) dilated the eye and retest
c) refer the patient to an ophthalmologist
d) document this as a normal finding
2. The American psychiatric association’s diagnostic and statistical manual of mental disorder
defines Munchausen Syndrome By Proxy
a) a self-inflicted injury to gain attention
b) a caregiver making up or causing an illness or injury in a person under his or her
care
c) an abusive behavior that does not involve the caregiver
d) a situation in which the abuser is often inattentive and uncaring toward the victim
Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a
child, most often a mother, either makes up fake symptoms or causes real symptoms to make it
look like the child is sick.
3. Symptoms bof bdepression bare ba bside beffect bof bwhich bneurotransmitter bmedication?
a) dopamine serotonin, bnorepinephrine
b) gabapentin
c) mil
d) cortisol
4. Which blesion bis bdark braised band basymmetric bwith birregular bborder? bQuizlet bBates
bChapter b20
a) Nevus
b) Actinic bkeratosis
c) Keratoacanthoma
d) Melanoma
5. A b32 byears bold bwoman bpresents bwith bdull bpuffiness bof bthe bayes bpronounced bnot
bpitting bperiorbital bedema bthis bfinding bis bsuggestive bof bthis bcondition? bAPEA
a) Nephrotic bsyndrome
b) Myxedema
c) Cushing bsyndrome
d) Sinusitis
Myxedema bis ba bdeposition bof bmucopolysaccarides bin bthe bdermis. bIs bcommonly bfound bif
bpatients bwith badvanced bhypothyroidism. bThe bclassic bskin bchanges bare: bswelling bof bface,
,blips, beyelids, band btongue bor bswelling band bthickening bof bskin banywhere bon bthe bbody,
bespecially bin bthe blower blegs.
Myxedema bis bthe bhallmark bof bGrave’s bdisease, ban bautoimmune bform bof
bhyperthyroidism. bMyxedema bcan balso boccur bin bHashimoto’s bthyroiditis ba bform bof
bhypothyroidism.
,6. A b42 byears bold bwoman bwith ba bpast bmedical bhistory bof bmigraine bheadaches bis
brequesting bprophylactic bmedication btreatment. bWhich bmedication bshould bthe
bNurse bpractitioner bprescribe?
a) Sumatriptan b(Imitrex)
b) Amitriptyline b(Elavil)
c) Verapamil b(verelan)
d) Metoprolol b(Lopressor)
Amitriptyline b(Elavil) bis ba btricyclic bantidepresant band bis bconsidered bofflabel buse bfor
bprophylactic btreatment bof bmigrane. bSumatriptan b(Imimtrex) bIs baTriptans bused bto babort
bmigraine
7. A bpediatric bpatient bhas bareas bof bscaling bon bthe bscalp bwith bround bpatches bof
balopecia. bThis bclinical bfinding bis bconsistent bwith:
a) Tinea bcapitis
b) Seborrheic bdermatitis
c) Trichotillomania
d) Alopecia bareata
8. What bis bthe bappropriate bprophylactic bmedication bfor ban b18 byears bold bwoman
bwith ba bpast bmedical bhistory bof bmigraine bheadaches?
a) Sumatriptan b(Imitrex)
b) Propanolol b(Inderal)
c) Ibuprofeno b(motrin)
d) Dihydroergotamine b(DHE)
9. Why bwould ba bcombined bhormonal bcontraceptive bbe bcontraindicated bin ba b36 byear bold
bpatient bwith ba bpast bmedical bhistory bof btype b2 bdiabetes, bobesity, bchronic bsmoking
band bsedentary blife
a) She bis bobese
b) She bhas btype b2 bdiabetes bmellitus
c) Her bage band btobacco buse
d) She bleads ba bsedentary blifestyle
Combined boral bcontraceptive bis bcontraindicated bin bwomen bolder bthan b45, bbreastfeeding,
bsmoking, bHTN, bdiabetes bor bhx bof bstroke
10. During bthe bbreast bexamination bof ba bperimenopausal bwoman bthe bNP bdetects ba
bbloody bspontaneous b discharge bfrom bthe bright bnipple. bThis bindicates bfurther
bevaluation.
a) Fibroadenoma
b) Polycystic bbreast bdisease b Generalized bbreast bpain bor btenderness. bGreen bor bdark
bbrown bnonbloody bnipple bdischarge bthat btends bto bleak bwithout bpressure bor
bsqueezing
c) An bintraductal bpapilloma
d) Pituitary bprolactinoma
Intraductal bpapillomas bare busually bsolitary band bsmaller bthan b1 bcm. bThey bare blocated bin
, blarge blactiferous bsinuses bor bducts band bhave ba btendency bto bbleed. bQuizlet bNipple
bDischarge
