NR509 / NR 509 FINAL EXAM (Latest
Version 2025/2026) Advanced Physical
Assessment | Questions & Correct Answers |
100% Correct | Grade A - Chamberlain
A 45-year-old female presents to the primary care clinic. She complains of recently
experiencing a change in the patterns of her bowel movements. Her PMH is
significant for bleeding ulcers as well as Crohns disease. Her family medical
history includes a maternal aunt who died of colon cancer at age 49 years. Which
of the following historical elements would be most concerning for colon cancer in
this patient?
A-recent onset of small-caliber stools
B-new-onset anal fissures
C-recent history of black, tarry stools
D-long-term history of hemorrhoids
E-remote history of anal pruritus - ANSWER A
recent onset of small-caliber stools
Which of the following physical assessment finding is most suggestive of
peritonitis secondary to a ruptured appendix?
A pain with internal rotation of the right hip
B abdominal pain that increases with hip flexion
,C localized pain over McBurney point, which lies 2 inches from the anterior
superior iliac spinous process
on a line drawn from the umbilicus
D pressing down onto the abdomen firmly and quickly withdraws the hand
produces pain
E voluntary contraction of the abdominal wall that persists over several
examinations - ANSWER D
pressing down onto the abdomen firmly and quickly withdraws the hand produces
pain
A-21year -old female presents for her first annual exam. She reports concern
because her female partner was recently diagnosed with condyloma acuminata and
wonders if she could also be infected. If true what physical assessment findings
would the NP expect to find during the speculum examination
A several shallow ulcers with a red base
B translucent nodules
C bright red, soft lesions arising from the cervical canal
D small red granular spots or petechiae on the cervix
E - raised friable or lobed lesions - ANSWER E
raised friable or lobed lesions
A 35-year-old female with a history of migraines presents to the clinic with
worsening symptoms for the past few weeks. She reports waking up at night with
headaches and nausea. Her only medication history is oral contraceptive pills
(OPs). Otherwise, she states she is
healthy. Which of the following actions if taken by the NP is the best next step?
A Reassure her that this is a common pattern with migraines
B Evaluate her for possible sinus infection.
,C Order studies to evaluate potential transient ischemic attacks (TIAs) because she
is on OCPs.
D Take a further history and perform a very careful neurological examination.
E Prescribe a strong medication for her migraines. - ANSWER D
Take a further history and perform a very careful neurological examination.
The NP is observing a full-term infant male. He can pull to a stand, use "mama" or
"dada" specifically, and indicates his wants by vocalization and pointing. Based on
your
observations, determine his developmental age
A 12 months
B 4 months
C 8 months
D 10 months
E 6 months - ANSWER A
12 MONTHS
During an evaluation of an athletic 30-year-old female, the NP conducts an active
range of motion evaluation at the neck. All of the following muscles are being
assessed when the
patient is asked to extend, flex, and rotate the neck, EXCEPT?
A sacrospinalis
B sternocleidomastoid (SCM)
C trapezius
D splenius capitis
E splenius cervicis - ANSWER A
sacrospinalis
, What structure in the spine is primarily responsible for supporting the bodys
weight?
A spinous process
B vertebral body
C transverse process
D vertebral arch
E intervertebral disk - ANSWER B
vertebral body
Pain in the right-lower quadrant (RLQ) during deep, even palpation of the left-
lower quadrant (LLQ) then quickly withdrawing your fingers indicates what
positive assessment
A psoas sign
B Murphy sign
C Blumberg sign
D Roving sign
E McBurney sign - ANSWER C
Blumberg sign
Cervical motion tenderness and/or adnexal tenderness are hallmarks of all the
following
conditions, EXCEPT?
A pelvic inflammatory disease
B bacterial vaginosis
C endometriosis
D ectopic pregnancy
E appendicitis - ANSWER B
Bacterial Vaginosis
Version 2025/2026) Advanced Physical
Assessment | Questions & Correct Answers |
100% Correct | Grade A - Chamberlain
A 45-year-old female presents to the primary care clinic. She complains of recently
experiencing a change in the patterns of her bowel movements. Her PMH is
significant for bleeding ulcers as well as Crohns disease. Her family medical
history includes a maternal aunt who died of colon cancer at age 49 years. Which
of the following historical elements would be most concerning for colon cancer in
this patient?
A-recent onset of small-caliber stools
B-new-onset anal fissures
C-recent history of black, tarry stools
D-long-term history of hemorrhoids
E-remote history of anal pruritus - ANSWER A
recent onset of small-caliber stools
Which of the following physical assessment finding is most suggestive of
peritonitis secondary to a ruptured appendix?
A pain with internal rotation of the right hip
B abdominal pain that increases with hip flexion
,C localized pain over McBurney point, which lies 2 inches from the anterior
superior iliac spinous process
on a line drawn from the umbilicus
D pressing down onto the abdomen firmly and quickly withdraws the hand
produces pain
E voluntary contraction of the abdominal wall that persists over several
examinations - ANSWER D
pressing down onto the abdomen firmly and quickly withdraws the hand produces
pain
A-21year -old female presents for her first annual exam. She reports concern
because her female partner was recently diagnosed with condyloma acuminata and
wonders if she could also be infected. If true what physical assessment findings
would the NP expect to find during the speculum examination
A several shallow ulcers with a red base
B translucent nodules
C bright red, soft lesions arising from the cervical canal
D small red granular spots or petechiae on the cervix
E - raised friable or lobed lesions - ANSWER E
raised friable or lobed lesions
A 35-year-old female with a history of migraines presents to the clinic with
worsening symptoms for the past few weeks. She reports waking up at night with
headaches and nausea. Her only medication history is oral contraceptive pills
(OPs). Otherwise, she states she is
healthy. Which of the following actions if taken by the NP is the best next step?
A Reassure her that this is a common pattern with migraines
B Evaluate her for possible sinus infection.
,C Order studies to evaluate potential transient ischemic attacks (TIAs) because she
is on OCPs.
D Take a further history and perform a very careful neurological examination.
E Prescribe a strong medication for her migraines. - ANSWER D
Take a further history and perform a very careful neurological examination.
The NP is observing a full-term infant male. He can pull to a stand, use "mama" or
"dada" specifically, and indicates his wants by vocalization and pointing. Based on
your
observations, determine his developmental age
A 12 months
B 4 months
C 8 months
D 10 months
E 6 months - ANSWER A
12 MONTHS
During an evaluation of an athletic 30-year-old female, the NP conducts an active
range of motion evaluation at the neck. All of the following muscles are being
assessed when the
patient is asked to extend, flex, and rotate the neck, EXCEPT?
A sacrospinalis
B sternocleidomastoid (SCM)
C trapezius
D splenius capitis
E splenius cervicis - ANSWER A
sacrospinalis
, What structure in the spine is primarily responsible for supporting the bodys
weight?
A spinous process
B vertebral body
C transverse process
D vertebral arch
E intervertebral disk - ANSWER B
vertebral body
Pain in the right-lower quadrant (RLQ) during deep, even palpation of the left-
lower quadrant (LLQ) then quickly withdrawing your fingers indicates what
positive assessment
A psoas sign
B Murphy sign
C Blumberg sign
D Roving sign
E McBurney sign - ANSWER C
Blumberg sign
Cervical motion tenderness and/or adnexal tenderness are hallmarks of all the
following
conditions, EXCEPT?
A pelvic inflammatory disease
B bacterial vaginosis
C endometriosis
D ectopic pregnancy
E appendicitis - ANSWER B
Bacterial Vaginosis
