Chamberlain NR509 – Advanced Physical
Assessment Midterm Exam Actual Exam-
Questions & Answers (2026/2027) 100%
Verified Correct Answers with Rationales |
Graded A+ | Pass Guaranteed
Question 1 When performing the general survey, which finding would be considered most
abnormal in a 45-year-old patient?
A. Blood pressure 118/76 mmHg B. Heart rate 88 beats per minute C. Respiratory rate 24
breaths per minute at rest D. Temperature 98.6°F (37°C)
Answer: C
Rationale: Normal adult respiratory rate at rest is 12–20 breaths per minute. A rate of 24 is
tachypnea and abnormal, warranting further assessment.
Question 2 During inspection of the skin, which characteristic is most suggestive of Cushing
syndrome?
A. Central obesity with thin extremities B. Hyperpigmented creases and buccal mucosa C.
Generalized bronze discoloration D. Spider angiomas and palmar erythema
Answer: A
Rationale: Cushing syndrome classically presents with truncal (central) obesity, thin arms/legs,
moon facies, and buffalo hump due to chronic glucocorticoid excess.
Question 3 A patient reports fatigue and cold intolerance. On examination you note dry skin,
delayed relaxation of deep tendon reflexes, and periorbital edema. What is the most likely
diagnosis?
A. Hyperthyroidism B. Hypothyroidism C. Addison disease D. Pheochromocytoma
, Answer: B
Rationale: Classic signs of hypothyroidism include fatigue, cold intolerance, dry skin, delayed
reflex relaxation (hung-up reflexes), and periorbital edema (myxedema).
Question 4 When assessing jugular venous pressure, the nurse practitioner identifies the highest
point of visible pulsation in the internal jugular vein at 10 cm above the right atrium with the
patient at 45 degrees. This finding is most consistent with:
A. Normal JVP B. Elevated central venous pressure C. Hypovolemia D. Superior vena cava
obstruction
Answer: B
Rationale: Normal JVP is ≤4 cm above the sternal angle (≈9 cm above right atrium) at 45°. A
measurement of 10 cm indicates elevated central venous pressure (e.g., right heart failure,
volume overload).
Question 5 During cardiac auscultation, S3 is most commonly associated with which condition
in adults over age 40?
A. Normal finding B. Left ventricular systolic dysfunction C. Mitral valve prolapse D. Aortic
stenosis
Answer: B
Rationale: An S3 gallop in adults >40 years is pathologic and most commonly indicates left
ventricular systolic dysfunction with volume overload (heart failure).
Question 6 A 62-year-old male presents with exertional dyspnea and a crescendo-decrescendo
systolic murmur best heard at the right second intercostal space radiating to the carotids. What is
the most likely valvular abnormality?
A. Mitral regurgitation B. Aortic stenosis C. Pulmonic regurgitation D. Tricuspid stenosis
Answer: B
Rationale: A crescendo-decrescendo systolic ejection murmur at the right upper sternal border
radiating to the carotids is classic for aortic stenosis.
Assessment Midterm Exam Actual Exam-
Questions & Answers (2026/2027) 100%
Verified Correct Answers with Rationales |
Graded A+ | Pass Guaranteed
Question 1 When performing the general survey, which finding would be considered most
abnormal in a 45-year-old patient?
A. Blood pressure 118/76 mmHg B. Heart rate 88 beats per minute C. Respiratory rate 24
breaths per minute at rest D. Temperature 98.6°F (37°C)
Answer: C
Rationale: Normal adult respiratory rate at rest is 12–20 breaths per minute. A rate of 24 is
tachypnea and abnormal, warranting further assessment.
Question 2 During inspection of the skin, which characteristic is most suggestive of Cushing
syndrome?
A. Central obesity with thin extremities B. Hyperpigmented creases and buccal mucosa C.
Generalized bronze discoloration D. Spider angiomas and palmar erythema
Answer: A
Rationale: Cushing syndrome classically presents with truncal (central) obesity, thin arms/legs,
moon facies, and buffalo hump due to chronic glucocorticoid excess.
Question 3 A patient reports fatigue and cold intolerance. On examination you note dry skin,
delayed relaxation of deep tendon reflexes, and periorbital edema. What is the most likely
diagnosis?
A. Hyperthyroidism B. Hypothyroidism C. Addison disease D. Pheochromocytoma
, Answer: B
Rationale: Classic signs of hypothyroidism include fatigue, cold intolerance, dry skin, delayed
reflex relaxation (hung-up reflexes), and periorbital edema (myxedema).
Question 4 When assessing jugular venous pressure, the nurse practitioner identifies the highest
point of visible pulsation in the internal jugular vein at 10 cm above the right atrium with the
patient at 45 degrees. This finding is most consistent with:
A. Normal JVP B. Elevated central venous pressure C. Hypovolemia D. Superior vena cava
obstruction
Answer: B
Rationale: Normal JVP is ≤4 cm above the sternal angle (≈9 cm above right atrium) at 45°. A
measurement of 10 cm indicates elevated central venous pressure (e.g., right heart failure,
volume overload).
Question 5 During cardiac auscultation, S3 is most commonly associated with which condition
in adults over age 40?
A. Normal finding B. Left ventricular systolic dysfunction C. Mitral valve prolapse D. Aortic
stenosis
Answer: B
Rationale: An S3 gallop in adults >40 years is pathologic and most commonly indicates left
ventricular systolic dysfunction with volume overload (heart failure).
Question 6 A 62-year-old male presents with exertional dyspnea and a crescendo-decrescendo
systolic murmur best heard at the right second intercostal space radiating to the carotids. What is
the most likely valvular abnormality?
A. Mitral regurgitation B. Aortic stenosis C. Pulmonic regurgitation D. Tricuspid stenosis
Answer: B
Rationale: A crescendo-decrescendo systolic ejection murmur at the right upper sternal border
radiating to the carotids is classic for aortic stenosis.
