NR 509 FINAL EXAM SAMPLE
QUESTIONS AND VERIFIED
ANSWERS 2025/2026 EXAM
A 31-year-old female presents to the clinic with a worsening stiff,
painful neck. On inspection, the patients head is laterally deviated
toward the shoulder and rotated. Given this specific physical assessment
finding, what condition should the NP suspect as a differential
diagnosis?
A-torticollis
B-ankylosing spondylitis
C-osteoarthritis (OA)
D-spondylolisthesis
E-thoracic kyphosis
A
Torticollis
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA).
Which of the following are expected assessment findings consistent with
the diagnosis?
,A-Swelling of the synovial tissue in joints and tendon sheaths
B-The first metatarsophalangeal joint is frequently involved.
C-Asymmetrical joint distribution.
D-Tophi present in the subcutaneous tissue
E-Stiffness follows joint activity.
A
Swelling of the synovial tissue in joints and tendon sheaths
A 66-year-old female presents to the office for a focused visit to discuss
hypertension management strategies. During the interview, the patient
asks the MP if she could be screened today for cervical cancer/HPV.
Review of her medical record reveals she was screened at ages 57, 60,
and 63, with no abnormal findings, and no history of cancer. What is the
best action the NP should take regarding the patients request for
screening?
A-Deny her request, inform her that she is past due for cervical
cancer/HPV screening, and
schedule another visit in 6 months.
B-Honor her request, perform the screening today, and reschedule the
appointment to discuss
hypertension management strategies.
C-Deny her request, inform the patient that she has had three negative
screenings in the last 10 years
and no longer requires screening, and focus on the reason
for the visit.
D-Deny her request, inform the patient she is not due to be screened for
two more years, and focus on
the reason for the visit.
,E-Honor her request, perform the screening today, and inform her that if
the results are negative, she
will no longer require screening
C
Deny her request, inform the patient that she has had three negative
screenings in the last 10 years
and no longer requires screening, and focus on the reason
for the visit.
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
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
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
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
QUESTIONS AND VERIFIED
ANSWERS 2025/2026 EXAM
A 31-year-old female presents to the clinic with a worsening stiff,
painful neck. On inspection, the patients head is laterally deviated
toward the shoulder and rotated. Given this specific physical assessment
finding, what condition should the NP suspect as a differential
diagnosis?
A-torticollis
B-ankylosing spondylitis
C-osteoarthritis (OA)
D-spondylolisthesis
E-thoracic kyphosis
A
Torticollis
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA).
Which of the following are expected assessment findings consistent with
the diagnosis?
,A-Swelling of the synovial tissue in joints and tendon sheaths
B-The first metatarsophalangeal joint is frequently involved.
C-Asymmetrical joint distribution.
D-Tophi present in the subcutaneous tissue
E-Stiffness follows joint activity.
A
Swelling of the synovial tissue in joints and tendon sheaths
A 66-year-old female presents to the office for a focused visit to discuss
hypertension management strategies. During the interview, the patient
asks the MP if she could be screened today for cervical cancer/HPV.
Review of her medical record reveals she was screened at ages 57, 60,
and 63, with no abnormal findings, and no history of cancer. What is the
best action the NP should take regarding the patients request for
screening?
A-Deny her request, inform her that she is past due for cervical
cancer/HPV screening, and
schedule another visit in 6 months.
B-Honor her request, perform the screening today, and reschedule the
appointment to discuss
hypertension management strategies.
C-Deny her request, inform the patient that she has had three negative
screenings in the last 10 years
and no longer requires screening, and focus on the reason
for the visit.
D-Deny her request, inform the patient she is not due to be screened for
two more years, and focus on
the reason for the visit.
,E-Honor her request, perform the screening today, and inform her that if
the results are negative, she
will no longer require screening
C
Deny her request, inform the patient that she has had three negative
screenings in the last 10 years
and no longer requires screening, and focus on the reason
for the visit.
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
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
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
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
