NR509 Final Exam: Breast & Axillae & Abdominal
Examination Techniques Advanced Physical
Assessment (NR-509) Chamberlain
1. A patient reports wheartburn, sour taste, and substernal chest pain that worsens
when bending over. This suggests:
A. Peptic ulcer disease
B. Hiatal hernia
C. Esophageal varices
D. Gastric cancer
Answer: B
Rationale: Hiatal hernia occurs when part of the stomach protrudes into the thoracic
cavity, causing reflux symptoms worsened by lying down, bending, or coughing.
2. The most common risk factors for peptic ulcer disease are:
A. spicy foods and caffeine
B. H. pylori infection and NSAID use
C. alcohol and high-fat diet
D. stress and obesity
Answer: B
Rationale: H. pylori and NSAIDs are the leading causes of peptic ulcers by damaging the
mucosal barrier or increasing acid secretion.
3. A patient with a duodenal ulcer typically experiences pain:
A. immediately after eating
B. when the stomach is empty, relieved by food
C. only at night with vomiting
D. radiating to the back
Answer: B
Rationale: Duodenal ulcers are associated with increased acid secretion; pain occurs
when the stomach is empty and improves with food intake.
, 4. Which individual is at highest risk for cholelithiasis?
A. 25-year-old male athlete
B. 45-year-old obese female
C. 70-year-old male with COPD
D. 30-year-old pregnant female
Answer: B
Rationale: Gallstones are more common in middle-aged, obese, multiparous females.
"Fair, female, fat, fertile, forty" are classic risk factors.
5. Which virus is transmitted primarily through the fecal-oral route?
A. Hepatitis B
B. Hepatitis C
C. Hepatitis A
D. HIV
Answer: C
Rationale: HAV is spread by contaminated food, water, or poor sanitation. HBV and HCV
are blood/body fluid transmitted.
6. In hepatic encephalopathy, which substance is elevated in the blood?
A. Creatinine
B. Ammonia
C. Bilirubin
D. Lipase
Answer: B
Rationale: The failing liver cannot convert ammonia to urea, leading to elevated
ammonia levels and altered mental status, asterixis, and coma.
7. A patient with cirrhosis develops ascites and esophageal varices. These are
complications of:
A. portal hypertension
B. renal failure
C. heart failure
D. pancreatitis
Answer: A
Rationale: Cirrhosis causes portal hypertension, leading to fluid shifts (ascites) and
shunting of blood into esophageal veins (varices).
Examination Techniques Advanced Physical
Assessment (NR-509) Chamberlain
1. A patient reports wheartburn, sour taste, and substernal chest pain that worsens
when bending over. This suggests:
A. Peptic ulcer disease
B. Hiatal hernia
C. Esophageal varices
D. Gastric cancer
Answer: B
Rationale: Hiatal hernia occurs when part of the stomach protrudes into the thoracic
cavity, causing reflux symptoms worsened by lying down, bending, or coughing.
2. The most common risk factors for peptic ulcer disease are:
A. spicy foods and caffeine
B. H. pylori infection and NSAID use
C. alcohol and high-fat diet
D. stress and obesity
Answer: B
Rationale: H. pylori and NSAIDs are the leading causes of peptic ulcers by damaging the
mucosal barrier or increasing acid secretion.
3. A patient with a duodenal ulcer typically experiences pain:
A. immediately after eating
B. when the stomach is empty, relieved by food
C. only at night with vomiting
D. radiating to the back
Answer: B
Rationale: Duodenal ulcers are associated with increased acid secretion; pain occurs
when the stomach is empty and improves with food intake.
, 4. Which individual is at highest risk for cholelithiasis?
A. 25-year-old male athlete
B. 45-year-old obese female
C. 70-year-old male with COPD
D. 30-year-old pregnant female
Answer: B
Rationale: Gallstones are more common in middle-aged, obese, multiparous females.
"Fair, female, fat, fertile, forty" are classic risk factors.
5. Which virus is transmitted primarily through the fecal-oral route?
A. Hepatitis B
B. Hepatitis C
C. Hepatitis A
D. HIV
Answer: C
Rationale: HAV is spread by contaminated food, water, or poor sanitation. HBV and HCV
are blood/body fluid transmitted.
6. In hepatic encephalopathy, which substance is elevated in the blood?
A. Creatinine
B. Ammonia
C. Bilirubin
D. Lipase
Answer: B
Rationale: The failing liver cannot convert ammonia to urea, leading to elevated
ammonia levels and altered mental status, asterixis, and coma.
7. A patient with cirrhosis develops ascites and esophageal varices. These are
complications of:
A. portal hypertension
B. renal failure
C. heart failure
D. pancreatitis
Answer: A
Rationale: Cirrhosis causes portal hypertension, leading to fluid shifts (ascites) and
shunting of blood into esophageal veins (varices).
