NR 509 / NR509 Advanced Physical Assessment | ACTUAL
EXAM | Questions & Verified Answers | Latest
Update – Chamberlain University
1. A 58-year-old man states he “can’t catch his breath” when walking to the mailbox.
Which assessment question best clarifies the functional impact of his dyspnea?
A. “Do you have chest pain?”
B. “How many flights of stairs can you climb before stopping?”
C. “Does your ankle swell?”
D. “Have you lost weight recently?”
Correct Answer: B
Rationale: Quantifying exertional tolerance (metabolic equivalents) objectifies severity
and guides differential diagnosis. Chest pain (A) localizes to cardiac etiology but not
functional capacity. Ankle edema (C) and weight loss (D) are associated signs, not
functional measures.
2. While obtaining a menstrual history from a 26-year-old, which inquiry best
screens for polymenorrhea?
A. “How many days does your period last?”
B. “How often do you change pads on the heaviest day?”
C. “What is the shortest interval between the start of two periods?”
,D. “Do you have spotting between cycles?”
Correct Answer: C
Rationale: Polymenorrhea is defined as intervals <21 days; therefore, shortest interval (C)
directly screens for it. Duration (A) and inter-menstrual bleeding (D) define menorrhagia
and metrorrhagia, respectively. Pad count (B) quantifies flow, not frequency.
3. A 6-year-old child presents with elbow pain after being swung by the arms. Which
physical finding is most consistent with nursemaid’s elbow?
A. Swelling and ecchymosis over the olecranon
B. Inability to fully extend the elbow
C. Child holds arm pronated, elbow slightly flexed, refuses supination
D. Tenderness over the medial epicondyle
Correct Answer: C
Rationale: Radial head subluxation produces the classic “limp arm” held pronated and
flexed; supination is resisted and painful. Swelling (A) and ecchymosis are absent.
Extension block (B) suggests fracture. Medial tenderness (D) is epicondylitis or
Little-League elbow.
4. Palpation of the adult thyroid is best performed with the examiner:
A. Facing the patient and pinching the trachea
B. Standing behind the patient, asking them to swallow
C. Using the thumb to push the gland laterally
,D. While the patient is lying supine with neck hyper-extended
Correct Answer: B
Rationale: Posterior approach with swallow maneuver lowers the thyroid under the
hands, facilitating nodule detection. Pinching (A) obscures subtle masses. Thumb
pressure (C) is imprecise. Supine hyper-extension (D) is used for inspection, not
palpation.
5. A 72-year-old woman is unable to identify “rose” or “peppermint” scents. Which
cranial nerve is most likely impaired?
A. I
B. II
C. VII
D. VIII
Correct Answer: A
Rationale: Olfactory nerve (CN I) mediates smell; anosmia is common with aging, prior
viral infection, or neurodegeneration. CN II (B) is vision. Facial nerve (C) is taste
anterior two-thirds. Vestibulocochlear (D) is hearing/balance.
6. During a mental-status exam, a patient recalls three unrelated words after 5
minutes. This finding indicates intact:
A. Immediate memory
B. Recent memory
, C. Remote memory
D. Procedural memory
Correct Answer: B
Rationale: Recall after 5 min tests recent (short-term) declarative memory. Immediate
memory (A) is repetition. Remote (C) is birthday, school name. Procedural (D) is riding a
bike.
7. A college student has a 2 cm, mobile, non-tender anterior cervical lymph node
present for 3 weeks. The most appropriate next action is to:
A. Prescribe antibiotics empirically
B. Re-evaluate in 2 months
C. Obtain monospot and CBC
D. Refer for excisional biopsy
Correct Answer: C
Rationale: Persistent node >2 cm warrants infectious/hematologic screening. Monospot
rules out EBV; CBC detects atypical lymphocytosis or cytopenias. Empiric antibiotics
(A) are inappropriate without toxicity. Watchful waiting (B) delays diagnosis of
lymphoma. Biopsy (D) is reserved if work-up is negative and node persists >4–6 weeks.
8. A 40-year-old man has unilateral ptosis that worsens with repeated upward gaze.
This finding is pathognomonic for:
A. Third-nerve palsy
EXAM | Questions & Verified Answers | Latest
Update – Chamberlain University
1. A 58-year-old man states he “can’t catch his breath” when walking to the mailbox.
Which assessment question best clarifies the functional impact of his dyspnea?
A. “Do you have chest pain?”
B. “How many flights of stairs can you climb before stopping?”
C. “Does your ankle swell?”
D. “Have you lost weight recently?”
Correct Answer: B
Rationale: Quantifying exertional tolerance (metabolic equivalents) objectifies severity
and guides differential diagnosis. Chest pain (A) localizes to cardiac etiology but not
functional capacity. Ankle edema (C) and weight loss (D) are associated signs, not
functional measures.
2. While obtaining a menstrual history from a 26-year-old, which inquiry best
screens for polymenorrhea?
A. “How many days does your period last?”
B. “How often do you change pads on the heaviest day?”
C. “What is the shortest interval between the start of two periods?”
,D. “Do you have spotting between cycles?”
Correct Answer: C
Rationale: Polymenorrhea is defined as intervals <21 days; therefore, shortest interval (C)
directly screens for it. Duration (A) and inter-menstrual bleeding (D) define menorrhagia
and metrorrhagia, respectively. Pad count (B) quantifies flow, not frequency.
3. A 6-year-old child presents with elbow pain after being swung by the arms. Which
physical finding is most consistent with nursemaid’s elbow?
A. Swelling and ecchymosis over the olecranon
B. Inability to fully extend the elbow
C. Child holds arm pronated, elbow slightly flexed, refuses supination
D. Tenderness over the medial epicondyle
Correct Answer: C
Rationale: Radial head subluxation produces the classic “limp arm” held pronated and
flexed; supination is resisted and painful. Swelling (A) and ecchymosis are absent.
Extension block (B) suggests fracture. Medial tenderness (D) is epicondylitis or
Little-League elbow.
4. Palpation of the adult thyroid is best performed with the examiner:
A. Facing the patient and pinching the trachea
B. Standing behind the patient, asking them to swallow
C. Using the thumb to push the gland laterally
,D. While the patient is lying supine with neck hyper-extended
Correct Answer: B
Rationale: Posterior approach with swallow maneuver lowers the thyroid under the
hands, facilitating nodule detection. Pinching (A) obscures subtle masses. Thumb
pressure (C) is imprecise. Supine hyper-extension (D) is used for inspection, not
palpation.
5. A 72-year-old woman is unable to identify “rose” or “peppermint” scents. Which
cranial nerve is most likely impaired?
A. I
B. II
C. VII
D. VIII
Correct Answer: A
Rationale: Olfactory nerve (CN I) mediates smell; anosmia is common with aging, prior
viral infection, or neurodegeneration. CN II (B) is vision. Facial nerve (C) is taste
anterior two-thirds. Vestibulocochlear (D) is hearing/balance.
6. During a mental-status exam, a patient recalls three unrelated words after 5
minutes. This finding indicates intact:
A. Immediate memory
B. Recent memory
, C. Remote memory
D. Procedural memory
Correct Answer: B
Rationale: Recall after 5 min tests recent (short-term) declarative memory. Immediate
memory (A) is repetition. Remote (C) is birthday, school name. Procedural (D) is riding a
bike.
7. A college student has a 2 cm, mobile, non-tender anterior cervical lymph node
present for 3 weeks. The most appropriate next action is to:
A. Prescribe antibiotics empirically
B. Re-evaluate in 2 months
C. Obtain monospot and CBC
D. Refer for excisional biopsy
Correct Answer: C
Rationale: Persistent node >2 cm warrants infectious/hematologic screening. Monospot
rules out EBV; CBC detects atypical lymphocytosis or cytopenias. Empiric antibiotics
(A) are inappropriate without toxicity. Watchful waiting (B) delays diagnosis of
lymphoma. Biopsy (D) is reserved if work-up is negative and node persists >4–6 weeks.
8. A 40-year-old man has unilateral ptosis that worsens with repeated upward gaze.
This finding is pathognomonic for:
A. Third-nerve palsy
