NR 509 / NR509 Exam 3 (2026–2027 Updated) Advanced Physical Assessment | Questions and Answers | Verified Solutions | 100% Accurate | Grade A – Chamberlain

NR 509 / NR509 Exam 3 (2026–2027 Updated) Advanced Physical Assessment | Questions and Answers | Verified Solutions | 100% Accurate | Grade A – Chamberlain Q. The nurse is bathing an 80-year-old man and notices that his skin is wrinkled, thin, lax, and dry. This finding would be related to which factor? a. Increased vascularity of the skin in the elderly b. Increased numbers of sweat and sebaceous glands in the elderly c. An increase in elastin and a decrease in subcutaneous fat in the elderly d. An increased loss of elastin and a decrease in subcutaneous fat in the elderly ANSWER An increased loss of elastin and a decrease in subcutaneous fat in the elderly Q. A patient comes to the clinic and tells the nurse that he has been confined to his recliner chair for about three days with his feet down and he wants the nurse to evaluate his feet. During the assessment, the nurse might expect to find a. pallor. b. coolness. c. distended veins d. prolonged capillary filling time. ANSWER distended veins Q. The nurse notices that a school-aged child has bluish-white, red-based spots in her mouth that are elevated about 1 mm to 3 mm. What other signs would the nurse expect to find in this patient? a. A pink, papular rash on the face and neck b. Pruritic vesicles over her trunk and neck c. Hyperpigmentation on the chest, abdomen, and the back of the arms d. A red-purple, maculopapular, blotchy rash behind the ears and on the face ANSWER A red-purple, maculopapular, blotchy rash behind the ears and on the face Q. The nurse notices that a patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. When documenting this finding, the nurse would report this as a a. bulla. b. wheal. c. wheal. d. papule. ANSWER papule. Q. A 65-year-old man with emphysema and bronchitis has come to the clinic for a follow-up appointment. On assessment, the nurse might expect to see which assessment finding? a. Anasarca b. Scleroderma c. Pedal erythema d. Clubbing of the nails ANSWER Clubbing of the nails Q. A 19-year-old college student is brought to the emergency department with a severe headache he describes as "like nothing I've ever had before." His temperature is 104° F, and he has a stiff neck. The nurse looks for other signs and symptoms of which problem? a. Head injury b. Cluster headache c. Migraine headache d. Meningeal inflammation ANSWER Meningeal inflammation Q. During an examination of a female patient, the nurse notes lymphadenopathy and suspects an acute infection. Acutely infected lymph nodes would be a. clumped. teral. c. firm but freely movable. d. firm and nontender. ANSWER firm but freely movable. Q. A patient visits the clinic because he has recently noticed that the left side of his mouth is paralyzed. He states that he cannot raise his eyebrow or whistle. The nurse suspects that he has a. Cushing's syndrome. b. Parkinson disease. c. Bell's palsy. d. had a cerebrovascular accident (stroke). ANSWER had a cerebrovascular accident (stroke). Q. A male patient with a history of AIDS has come in for an examination and he states, "I think that I have the mumps." The nurse would begin by examining the a. thyroid gland. b. parotid gland. c. cervical lymph nodes. d. mouth and skin for lesions. ANSWER parotid gland Q. When examining the eye, the nurse notices that the patient's eyelid margins approximate completely. The nurse recognizes that this assessment finding a. is expected. b. may indicate a problem with extraocular muscles. c. may result in problems with tearing. d. indicates increased intraocular pressure. ANSWER is expected Q. During an assessment, the nurse notices that an elderly patient has tears rolling down his face from his left eye. Closer examination shows that the lower lid is loose and rolling outward. The patient complains of his eye feeling "dry and itchy." Which action by the nurse is correct? a. Assess the eye for a possible foreign body. b. Document the finding as ptosis. c. Assess for other signs of ectropion. d. Contact the prescriber because these are signs of basal cell carcinoma. ANSWER Assess for other signs of ectropion. Q. An ophthalmic examination reveals papilledema. The nurse is aware that this finding indicates a. retinal detachment. b. diabetic retinopathy. c. acute-angle glaucoma. d. increased intracranial pressure. ANSWER increased intracranial pressure. Q. The nurse is performing an eye assessment on an 80-year-old patient. Which of these findings is considered abnormal? a. A decrease in tear production b. Unequal pupillary constriction in response to light c. The presence of arcus senilis seen around the cornea d. Loss of the outer hair on the eyebrows due to a decrease in hair follicles ANSWER Unequal pupillary constriction in response to light Q. A patient has been shown to have a sensorineural hearing loss. During the assessment, it would be important for the nurse to a. speak loudly so he can hear the questions b. assess for middle ear infection as a possible cause. c. ask the patient what medications he is currently taking. d. look for the source of the obstruction in the external ear. ANSWER ask the patient what medications he is currently taking. Q. A patient has been admitted after an accident at work. During the assessment, the patient is having trouble hearing and states, "I don't know what the matter is. All of a sudden, I can't hear you out of my left ear!" What should the nurse do next? a. Make note of this finding for report to the next shift. b. Prepare to remove cerumen from the patient's ear. c. Notify the patient's healthcare provider. d. Irrigate the ear with rubbing alcohol. ANSWER Notify the patient's healthcare provider Q. An assessment of a 23-year-old patient reveals the following: an auricle that is tender and reddish-blue in color with small vesicles. Additional information the nurse would need to know includes which of these? a. Any change in the ability to hear b. Any recent drainage from the ear c. Recent history of trauma to the ear d. Any prolonged exposure to extreme cold ANSWER Any prolonged exposure to extreme cold Q. The nurse is performing an ear examination of an 80-year-old patient. Which of these would be considered a normal finding? a. A high-tone frequency loss b. Increased elasticity of the pinna c. a thin, translucent membrane d. A shiny, pink tympanic membrane ANSWER A high-tone frequency loss Q. The nurse is assessing a 3-year-old for "drainage from the nose." On assessment, it is found that there is a purulent drainage from the left nares that has a very foul odor and no drainage from the right nares. The child is afebrile with no other symptoms. What should the nurse do next? a. Refer to the physician for an antibiotic order. b. Have the mother bring the child back in 1 week. c. Perform an otoscopic examination of the left nares. d. Tell the mother that this is normal for children of this age. ANSWER Perform an otoscopic examination of the left nares. Q. The nurse is assessing a patient in the hospital who has received numerous antibiotics and notices that his tongue appears to be black and hairy. In response to his concern, what would the nurse say? a. "We will need to get a biopsy and see what the cause is." b. "This is an overgrowth of hair and will go away in a few days." c. "This is a fungal infection caused by all the antibiotics you've received." d. "This is probably caused by the same bacteria you had in your lungs." ANSWER "This is a fungal infection caused by all the antibiotics you've received." Q. The nurse is obtaining a history on a 3-month-old infant. During the interview, the mother states, "I think she is getting her first tooth because she has started drooling a lot." The nurse's best response would be a. "You're right, drooling is usually a sign of the first tooth." b. "It would be unusual for a 3-month-old to be getting her first tooth." c. "This could be the sign of a problem with the salivary glands." d. "She is just starting to salivate and hasn't learned to swallow the saliva." ANSWER "She is just starting to salivate and hasn't learned to swallow the saliva." Q. A woman who is in the second trimester of pregnancy mentions that she has had "more nosebleeds than ever" since she became pregnant. The nurse recognizes that this is due to a. a problem with the patient's coagulation system. b. increased vascularity in the upper respiratory tract as a result of the pregnancy. c. increased susceptibility to colds and nasal irritation. d. inappropriate use of nasal sprays. ANSWER increased vascularity in the upper respiratory tract as a result of the pregnancy. Q. A 45-year-old man is in the clinic for a physical examination. During the abdominal assessment, the nurse percusses the abdomen and notices an area of dullness above the right costal margin of about 10 cm. The nurse should a. document the presence of hepatomegaly. b. ask additional history questions regarding his alcohol intake. c. describe this as an enlarged liver and refer him to a physician. d. consider this a normal finding and proceed with the examination. ANSWER consider this a normal finding and proceed with the examination. Q. The nurse is reviewing statistics for lactose intolerance. In the United States, the incidence of lactose intolerance is higher in adults of which ethnic group? a. African-Americans b. Hispanics c. Whites d. Asians ANSWER African-Americans During an abdominal assessment, the nurse would consider which of these findings as normal? a. The presence of a bruit in the femoral area b. A tympanic percussion note in the umbilical region c. A palpable spleen between the ninth and eleventh ribs in the left midaxillary line d. A dull percussion note in the left upper quadrant at the midclavicular line A tympanic percussion note in the umbilical region During a health history, the patient tells the nurse, "I have pain all the time in my stomach. It's worse two hours after I eat, but it gets better if I eat again!" The nurse suspects that the patient has which condition, based on these symptoms? a. Appendicitis b. Gastric ulcer c. Duodenal ulcer d. Cholecystitis Duodenal ulcer What are the 4 steps of the physiology of pain? 1. Transduction 2. Transmission 3. Perception 4. Modulation Transduction is the ____ of pain receptors and converted into ______ activation, nociceptors Transmission is process of pain signal traveling from ____ to _____ injury site, brain Perception is when a person... responds to the pain Modulation is how the body alters the _____ of pain through _____ sensation, neuromodulators Cutaneous pain is (superficial/deep) and typically involves the ____ superficial, skin Somatic pain is ____ pain originating in tendons, vessels, bones, ligaments, or nerves diffuse/scattered Visceral is poorly ____ and originates in the thorax, abdomen, or cranium localized Neuropathic pain is caused by lesion/disease of ____ CNS/PNS True or False: Nociplastic pain is nociceptive and neuropathic in nature False Intractable pain is resistant to ____ therapy What may be some physiologic responses to pain? vital sign changes sympathetic response parasympathetic response What may be some factors that affect emotional responses to pain? coping skills quality of pain culture age, sex, gender support system anxiety environment past exposure Define OLDCARTS. Onset Location Duration Characteristics Aggravating factors Relieving factors Treatment Severity What are nonpharmacological nursing interventions for pain? Remove ____ Promote ____ Hot/Cold Distraction Guided ____ Music/sound therapy cause, rest, imagery Sarcopenia is age-related loss of ________ muscle-mass Sigmund Freud's psychoanalytical development has to do with resolving conflicts from what 5 stages? Oral, anal, phallic, latency, genital What's Jean Piaget's 4 stages? Sensorimotor, preoperative, postoperative, concrete Erik Erikson has 8 stages presenting a _____ crisis to resolve (such as Trust vs Mistrust) developmental Robert J. Havighurst has ______ based on maturation Tasks Roger Gould talks about letting go of _______ False assumptions Daniel Levinson involves alterations between _____ and ______ periods Stable, transitional Lawrence Kohlberg talks about moral development at three levels with six stages: Pre conventional (_____) Conventional (______) Post conventional (_______) Consequences, social rules, abstract principles Coral Gilligan's moral development the development of _____ focusing on care, relationships, and responsibility Women James Fowlers' faith development discusses ____ and _____ beliefs and there are 7 stages Faith, spiritual What are major health concerns for the young adult? Self harm, STIs, substance use Nursing considerations for the young adult include encouraging... preventative screenings Middle adult nursing considerations include treating _____ illnesses, encouraging screenings, and ______ assessments chronic, psychosocial Older adult nursing considerations include managing _____ illness, polypharmacy, accidental ____, _____ function, and elder abuse chronic, injuries, cognitive To promote health in the older adult, reinforce a balanced _____, daily _____, avoiding _____, provide supplements, and social interaction diet, activity, substance use Discharge education begins upon _____ admission What factors impact learning? age/developmental level family support financial considerations culture/language health literacy What is the "Ask Me 3" for patient education? What is my main problem? What do I need to do? Why is it important for me to do this? How can you evaluate learning? Direct questioning Observation Return demonstration Timing Reinforce and revise The definition of health is state of complete _____, ____, and ____ wellbeing; not just the absence of ____ physical, mental, social; disease Disease refers to ____ changes whereas illness is unique _____ to disease pathological, response What factors affect health and illness? Basic human needs Human dimensions Self-concept Risk factors Primary interventions focus on: _____ and _____ Secondary interventions focus on: _____ Tertiary interventions begins after _____, focuses on _____ promoting, preventing screenings illness, treating While sperm production begins in puberty, ova productions begins and ends in _____ utero Where does testosterone come from? testes, adrenal glands, ovaries Where does estrogen come from? testes, conversion of testosterone, ovaries, adrenal glands, placenta during pregnancy Where does progesterone come from? ovaries, adrenal glands Day 4-14 of menstruation is the ____ phase follicular Day 15-28 of menstruation is the _____ phase luteal Day 28+ (2-7) of menstruation is the ____ phase menses What are influences on sexual health? Culture Meds/substances Media representation Religion Comorbidities Physical and behavioral development What are symptoms of chlamydia/gonorrhea? dysuria, pelvic pain, discharge What are symptoms of HIV? early: flu-like symptoms later: weight loss, recurrent fever, skin lesions, chronic infection, diarrhea What are symptoms of syphilis? chancre, rash, end-organ damage What are the 5 P's of a sexual health nursing assessment? Partners Practices Prevention of STI Past history Pregnancy prevention What is the name for the product that occurs when manufacturers partially hydrogenate liquid oils? Trans fat What are some interventions nurses can do with patients concerning nutrition? Teaching nutritional information Monitoring nutritional status Stimulating appetite Assisting with eating Providing oral nutrition Providing long-term nutritional support What are key concepts of self-concept? Personal identity Self-esteem Body image Role performance What is the order of Maslow's Hierarchy of Needs (bottom to top)? Physiological Safety/security Love/belonging Self esteem Self-actualization Disenfranchised grief is not openly ______ acknowledged What factors affect loss and grief? Developmental Family Socioeconomic Culture, gender, religion Cause of death What are the 5 stages of dying and grief? Denial Anger Bargaining Depression Acceptance What are clinical signs of impending death? Difficulty talking/swallowing Nausea Incontinence Loss of movement Decreased body temp Weak pulse Decreasing BP Noisy respirations Restlessness Cooling, cyanosis What are physiological stressors? Chemical Physical Infectious Nutritional Hypoxic Genetic What are psychosocial stressors? Accidents Traumatic events of loved ones Rapid world changes Social isolation Fear of aggression Historical events Age 35-43 focus on... self-reflection Age 43-50 focus on... life's limits, relationships, community Age 50-60 focus on... companionship, self-satisfaction, health What are common health changes in middle adulthood? Alcoholism Cancer Cardiovascular Cerebrovascular Depression Diabetes Injury Metabolic Respiratory What are common health changes in older adulthood? Vulnerable to issues Concerns around polypharmacy, injuries, dementia, delirium, depression, elder abuse What is the SPICES assessment tool for older adults? Sleep disorders Problems with eating Incontinence Confusion Evidence of falls Skin breakdown