NR 509 / NR509 Advanced Physical
Assessment | ACTUAL EXAM | Questions &
Verified Answers | Latest Update –
Chamberlain University
1.
During inspection of the adult thorax, the nurse practitioner (NP) notes asymmetric
expansion with decreased left-sided movement. Which condition is most strongly
suggested?
A. Pneumothorax
B. Pulmonary embolism
C. Emphysema
D. Pleural effusion
Correct Answer: A
Rationale: Asymmetric expansion with decreased movement indicates loss of lung
volume or air accumulation. Pneumothorax collapses the ipsilateral lung, reducing
visible excursion. Pleural effusion produces stiffness but expansion is often equal.
Emphysema causes symmetric hyper-expansion; PE rarely affects chest wall motion.
2.
,A 6-year-old child presents with a vesicular, pruritic rash confined to the trunk. No fever
is reported. Which health history question is priority?
A. “Has the child received the varicella vaccine?”
B. “Any recent camping or wooded exposures?”
C. “Has anyone at daycare had similar lesions?”
D. “Any new medications in the past week?”
Correct Answer: C
Rationale: Vesicular, pruritic, centripetal rash in a well-appearing child is classic for
varicella. Vaccine history is relevant, but transmission risk (daycare contact) guides
contagion precautions and public-health reporting. Medication rashes are usually
urticarial or morbilliform; tick exposure produces different patterns.
3.
While auscultating the carotid artery, a bruit is detected. The NP should next:
A. Palpate the carotid pulse amplitude
B. Order immediate carotid duplex ultrasound
C. Auscultate over the subclavian artery
D. Have the patient hold breath to distinguish from venous hum
Correct Answer: D
Rationale: Having the patient stop breathing eliminates transmitted cardiac murmurs or
venous hums. True bruits persist. Pulse amplitude does not clarify etiology; duplex is
indicated only for persistent, asymptomatic bruit after exam maneuvers.
, 4.
On percussion of the adult abdomen, the NP notes tympany throughout all quadrants.
This most likely indicates:
A. Large ascites
B. Gaseous distension
C. Splenomegaly
D. Pregnancy
Correct Answer: B
Rationale: Tympany predominates over gas-filled bowel. Massive ascites produces
shifting dullness; solid organs (spleen, fetus) yield dullness. Gaseous ileus or recent
high-fiber meal explains generalized tympany.
5.
A 72-year-old woman has a lateral curvature of the thoracic spine noted on standing
examination. This is documented as:
A. Kyphosis
B. Lordosis
C. Scoliosis
D. Ankylosis
Correct Answer: C
, Rationale: Scoliosis is lateral curvature often idiopathic or degenerative. Kyphosis is
posterior rounding; lordosis is anterior lumbar sway. Ankylosis implies joint fusion
(ankylosing spondylitis).
6.
The NP attempts to elicit deep tendon reflexes but observes no response despite
reinforcement. Documentation should include:
A. 0 (absent)
B. 1+ (hypoactive)
C. 2+ (normal)
D. 3+ (hyperactive)
Correct Answer: A
Rationale: No visible contraction after reinforcement is graded 0. 1+ requires
reinforcement. 2+ is normal without reinforcement; 3+ is brisk with spread.
7.
During assessment of an infant, the NP notes a positive Ortolani maneuver. This finding
is associated with:
A. Talipes equinovarus
B. Developmental dysplasia of the hip
C. Genu varum
D. Spastic cerebral palsy
Assessment | ACTUAL EXAM | Questions &
Verified Answers | Latest Update –
Chamberlain University
1.
During inspection of the adult thorax, the nurse practitioner (NP) notes asymmetric
expansion with decreased left-sided movement. Which condition is most strongly
suggested?
A. Pneumothorax
B. Pulmonary embolism
C. Emphysema
D. Pleural effusion
Correct Answer: A
Rationale: Asymmetric expansion with decreased movement indicates loss of lung
volume or air accumulation. Pneumothorax collapses the ipsilateral lung, reducing
visible excursion. Pleural effusion produces stiffness but expansion is often equal.
Emphysema causes symmetric hyper-expansion; PE rarely affects chest wall motion.
2.
,A 6-year-old child presents with a vesicular, pruritic rash confined to the trunk. No fever
is reported. Which health history question is priority?
A. “Has the child received the varicella vaccine?”
B. “Any recent camping or wooded exposures?”
C. “Has anyone at daycare had similar lesions?”
D. “Any new medications in the past week?”
Correct Answer: C
Rationale: Vesicular, pruritic, centripetal rash in a well-appearing child is classic for
varicella. Vaccine history is relevant, but transmission risk (daycare contact) guides
contagion precautions and public-health reporting. Medication rashes are usually
urticarial or morbilliform; tick exposure produces different patterns.
3.
While auscultating the carotid artery, a bruit is detected. The NP should next:
A. Palpate the carotid pulse amplitude
B. Order immediate carotid duplex ultrasound
C. Auscultate over the subclavian artery
D. Have the patient hold breath to distinguish from venous hum
Correct Answer: D
Rationale: Having the patient stop breathing eliminates transmitted cardiac murmurs or
venous hums. True bruits persist. Pulse amplitude does not clarify etiology; duplex is
indicated only for persistent, asymptomatic bruit after exam maneuvers.
, 4.
On percussion of the adult abdomen, the NP notes tympany throughout all quadrants.
This most likely indicates:
A. Large ascites
B. Gaseous distension
C. Splenomegaly
D. Pregnancy
Correct Answer: B
Rationale: Tympany predominates over gas-filled bowel. Massive ascites produces
shifting dullness; solid organs (spleen, fetus) yield dullness. Gaseous ileus or recent
high-fiber meal explains generalized tympany.
5.
A 72-year-old woman has a lateral curvature of the thoracic spine noted on standing
examination. This is documented as:
A. Kyphosis
B. Lordosis
C. Scoliosis
D. Ankylosis
Correct Answer: C
, Rationale: Scoliosis is lateral curvature often idiopathic or degenerative. Kyphosis is
posterior rounding; lordosis is anterior lumbar sway. Ankylosis implies joint fusion
(ankylosing spondylitis).
6.
The NP attempts to elicit deep tendon reflexes but observes no response despite
reinforcement. Documentation should include:
A. 0 (absent)
B. 1+ (hypoactive)
C. 2+ (normal)
D. 3+ (hyperactive)
Correct Answer: A
Rationale: No visible contraction after reinforcement is graded 0. 1+ requires
reinforcement. 2+ is normal without reinforcement; 3+ is brisk with spread.
7.
During assessment of an infant, the NP notes a positive Ortolani maneuver. This finding
is associated with:
A. Talipes equinovarus
B. Developmental dysplasia of the hip
C. Genu varum
D. Spastic cerebral palsy
