1|Page
NR 509 ADVANCED PHYSICAL ASSESSMENT –
360 HIGH-YIELD PRACTICE QUESTIONS
LATEST EDITION: 2026-2027
FORMAT: MULTIPLE CHOICE QUESTIONS
WITH ANSWERS & RATIONALES
===================================================
=============================
TABLE OF CONTENTS
===================================================
=============================
Domain 1: Advanced Interviewing & Health History .................... 45
questions
Domain 2: Advanced Physical Examination Techniques ................... 60
questions
Domain 3: Head, Eyes, Ears, Nose, Throat (HEENT) & Neck ..............
35 questions
Domain 4: Cardiovascular System .................................... 40 questions
Domain 5: Respiratory System ....................................... 30 questions
Domain 6: Abdominal & Gastrointestinal System ....................... 30
questions
Domain 7: Musculoskeletal & Neurologic Systems ...................... 35
questions
,2|Page
Domain 8: Skin, Nails, & Lymphatics ................................ 20 questions
Domain 9: Genitourinary, Reproductive, & Breast ..................... 25
questions
Domain 10: Geriatric, Pediatric, & Special Populations ............... 20
questions
Domain 11: Clinical Reasoning, Differential Diagnosis, &
Documentation 20 questions
TOTAL: 360 QUESTIONS
===================================================
=============================
DOMAIN 1: ADVANCED INTERVIEWING & HEALTH HISTORY
(Questions 1-45)
===================================================
=============================
1. A 58-year-old male reports episodic chest pressure. Using
OLDCARTS, which question best assesses duration?
A) "Does the pain radiate to your jaw?"
B) "How long does each episode last?"
C) "What makes it better or worse?"
D) "On a scale of 0–10?"
Answer: B
,3|Page
Rationale: Duration is directly assessed by asking how long each
episode lasts. OLDCARTS: Onset, Location, Duration, Character,
Aggravating/Alleviating, Radiation, Timing, Severity.
2. A 72-year-old with dementia cannot provide history. Best collateral
source?
A) 3-year-old ER records
B) Spouse who lives with her
C) Pharmacy refills only
D) Neighbor who visits weekly
Answer: B
Rationale: A live-in caregiver/spouse provides the most reliable and
current information about functional status, memory changes, and daily
symptoms.
3. Best initial IPV screening question?
A) "Do you feel safe in your relationship?"
B) "Have you been in a fight?"
C) "Does your partner yell?"
D) "Why those bruises?"
Answer: A
Rationale: The HITS or SAFE tools start with a non-judgmental safety
question. "Do you feel safe?" is validated and least accusatory.
, 4|Page
4. A patient reports "passing out." What is the most specific question for
syncope vs seizure?
A) "Did you bite your tongue?"
B) "Were you tired afterward?"
C) "Did you have palpitations before?"
D) "Did you see flashing lights?"
Answer: A
Rationale: Tongue biting (especially lateral) strongly suggests seizure
rather than syncope. Post-ictal confusion also suggests seizure.
5. Which medication is most associated with cough as an adverse effect?
A) Metoprolol
B) Lisinopril
C) Amlodipine
D) Atorvastatin
Answer: B
Rationale: ACE inhibitors (lisinopril, enalapril) cause dry cough via
bradykinin accumulation. Occurs in 5-20% of patients.
6. A 45-year-old reports fatigue. Which review of systems question is
most high-yield for depression?
A) "Any chest pain?"
B) "Any changes in sleep or appetite?"
NR 509 ADVANCED PHYSICAL ASSESSMENT –
360 HIGH-YIELD PRACTICE QUESTIONS
LATEST EDITION: 2026-2027
FORMAT: MULTIPLE CHOICE QUESTIONS
WITH ANSWERS & RATIONALES
===================================================
=============================
TABLE OF CONTENTS
===================================================
=============================
Domain 1: Advanced Interviewing & Health History .................... 45
questions
Domain 2: Advanced Physical Examination Techniques ................... 60
questions
Domain 3: Head, Eyes, Ears, Nose, Throat (HEENT) & Neck ..............
35 questions
Domain 4: Cardiovascular System .................................... 40 questions
Domain 5: Respiratory System ....................................... 30 questions
Domain 6: Abdominal & Gastrointestinal System ....................... 30
questions
Domain 7: Musculoskeletal & Neurologic Systems ...................... 35
questions
,2|Page
Domain 8: Skin, Nails, & Lymphatics ................................ 20 questions
Domain 9: Genitourinary, Reproductive, & Breast ..................... 25
questions
Domain 10: Geriatric, Pediatric, & Special Populations ............... 20
questions
Domain 11: Clinical Reasoning, Differential Diagnosis, &
Documentation 20 questions
TOTAL: 360 QUESTIONS
===================================================
=============================
DOMAIN 1: ADVANCED INTERVIEWING & HEALTH HISTORY
(Questions 1-45)
===================================================
=============================
1. A 58-year-old male reports episodic chest pressure. Using
OLDCARTS, which question best assesses duration?
A) "Does the pain radiate to your jaw?"
B) "How long does each episode last?"
C) "What makes it better or worse?"
D) "On a scale of 0–10?"
Answer: B
,3|Page
Rationale: Duration is directly assessed by asking how long each
episode lasts. OLDCARTS: Onset, Location, Duration, Character,
Aggravating/Alleviating, Radiation, Timing, Severity.
2. A 72-year-old with dementia cannot provide history. Best collateral
source?
A) 3-year-old ER records
B) Spouse who lives with her
C) Pharmacy refills only
D) Neighbor who visits weekly
Answer: B
Rationale: A live-in caregiver/spouse provides the most reliable and
current information about functional status, memory changes, and daily
symptoms.
3. Best initial IPV screening question?
A) "Do you feel safe in your relationship?"
B) "Have you been in a fight?"
C) "Does your partner yell?"
D) "Why those bruises?"
Answer: A
Rationale: The HITS or SAFE tools start with a non-judgmental safety
question. "Do you feel safe?" is validated and least accusatory.
, 4|Page
4. A patient reports "passing out." What is the most specific question for
syncope vs seizure?
A) "Did you bite your tongue?"
B) "Were you tired afterward?"
C) "Did you have palpitations before?"
D) "Did you see flashing lights?"
Answer: A
Rationale: Tongue biting (especially lateral) strongly suggests seizure
rather than syncope. Post-ictal confusion also suggests seizure.
5. Which medication is most associated with cough as an adverse effect?
A) Metoprolol
B) Lisinopril
C) Amlodipine
D) Atorvastatin
Answer: B
Rationale: ACE inhibitors (lisinopril, enalapril) cause dry cough via
bradykinin accumulation. Occurs in 5-20% of patients.
6. A 45-year-old reports fatigue. Which review of systems question is
most high-yield for depression?
A) "Any chest pain?"
B) "Any changes in sleep or appetite?"
