NR509 Final Exam Advanced Physical Assessment (2026/2027) | Verified Q&A +
Rationales | Chamberlain
Master your NR509 Final with this comprehensive 2026/2027 study guide featuring
verified exam questions and in-depth clinical rationales specifically for Chamberlain
University. This review covers high-yield head-to-toe assessment techniques, including
specialty maneuvers for abdominal pain, heart murmur identification, and cranial nerve
testing. Designed for advanced practice nursing students, it provides the essential
diagnostic pearls and documentation tips needed to achieve an A+ on your final
predictor.
1. A patient presents with "painless" gross hematuria. In an older adult, this
finding is considered a "red flag" for which of the following?
A) Nephrolithiasis
B) Bladder Cancer
C) Acute Prostatitis
D) Glomerulonephritis
Answer: B) Bladder Cancer
Rationale: Painless hematuria in an adult is considered a malignancy of the urinary tract
(bladder or kidney) until proven otherwise.
2. Which maneuver is used to assess for a "meniscal tear" by rotating the flexed
knee and feeling for a click?
A) Lachman Test
B) McMurray Test
C) Drawer Test
D) Thompson Test
Answer: B) McMurray Test
Rationale: The McMurray test specifically evaluates the meniscus; the Lachman and
Drawer tests evaluate the ACL.
,3. A "Positive Murphy’s Sign" is best described as:
A) Pain upon release of pressure in the LLQ
B) Pain when the right hip is internally rotated
C) Arrest of inspiration during gallbladder palpation
D) Pain when dropping from toes to heels
Answer: C) Arrest of inspiration during gallbladder palpation
Rationale: This indicates acute cholecystitis when the inflamed gallbladder contacts the
examiner's hand.
4. When assessing "Cranial Nerve VII (Facial)," the nurse practitioner should ask
the patient to:
A) Stick out the tongue
B) Shrug the shoulders
C) Smile, frown, and puff out cheeks
D) Identify a scent
Answer: C) Smile, frown, and puff out cheeks
Rationale: CN VII controls the muscles of facial expression.
5. A "Positive Phalen Test" at the wrist is indicative of:
A) De Quervain's Tenosynovitis
B) Carpal Tunnel Syndrome
C) Rheumatoid Arthritis
D) Ganglion Cyst
Answer: B) Carpal Tunnel Syndrome
Rationale: Flexing the wrists at 90 degrees for 60 seconds reproduces symptoms of
median nerve compression.
6. Which heart sound is associated with "atrial contraction into a stiff, non-
compliant ventricle"?
A) S1
B) S2
C) S3
D) S4
,Answer: D) S4
Rationale: S4 is an atrial gallop, commonly heard in patients with LVH or long-standing
hypertension.
7. A "Positive Rovsing’s Sign" is defined as:
A) Pain in the RLQ when the LLQ is palpated
B) Pain in the RUQ when the RLQ is palpated
C) Rebound tenderness at McBurney's Point
D) Pain with internal rotation of the hip
Answer: A) Pain in the RLQ when the LLQ is palpated
Rationale: This indicates peritoneal irritation, specifically appendicitis.
8. During a funduscopic exam, you note "AV Nicking." This is a characteristic
finding of:
A) Diabetic Retinopathy
B) Chronic Hypertension
C) Glaucoma
D) Macular Degeneration
Answer: B) Chronic Hypertension
Rationale: Thickened arteries compress the veins at the crossing points, a sign of
hypertensive vascular damage.
9. "Egophony" is considered positive when:
A) The spoken "E" sounds like an "A" during lung auscultation
B) The patient whispers "1-2-3" clearly
C) Vibrations are felt while the patient speaks
D) Percussion is dull over the lung fields
Answer: A) The spoken "E" sounds like an "A" during lung auscultation
Rationale: This indicates lung consolidation, such as pneumonia.
10. A "Positive Prehn’s Sign" (relief of pain with scrotal elevation) helps
differentiate:
A) Testicular torsion from Inguinal Hernia
B) Epididymitis from Testicular Torsion
, C) Hydrocele from Varicocele
D) Prostatitis from UTI
Answer: B) Epididymitis from Testicular Torsion
Rationale: Pain is usually relieved in epididymitis but not in torsion (which is a surgical
emergency).
11. Which cranial nerve is being tested when you ask a patient to "shrug their
shoulders" against resistance?
A) CN IX
B) CN X
C) CN XI
D) CN XII
Answer: C) CN XI (Spinal Accessory)
12. A "Positive Obturator Sign" is a physical finding of:
A) Gallstones
B) Ruptured Spleen
C) Appendicitis
D) Kidney Stones
Answer: C) Appendicitis
Rationale: Irritation of the obturator muscle by an inflamed appendix causes pain during
internal rotation of the flexed right hip.
13. "Tophi" on the ear or joints are a clinical marker for:
A) Rheumatoid Arthritis
B) Osteoarthritis
C) Chronic Gout
D) Psoriasis
Answer: C) Chronic Gout
Rationale: Tophi are deposits of monosodium urate crystals.
14. A "Positive Romberg Test" occurs when the patient:
A) Sways with eyes open
Rationales | Chamberlain
Master your NR509 Final with this comprehensive 2026/2027 study guide featuring
verified exam questions and in-depth clinical rationales specifically for Chamberlain
University. This review covers high-yield head-to-toe assessment techniques, including
specialty maneuvers for abdominal pain, heart murmur identification, and cranial nerve
testing. Designed for advanced practice nursing students, it provides the essential
diagnostic pearls and documentation tips needed to achieve an A+ on your final
predictor.
1. A patient presents with "painless" gross hematuria. In an older adult, this
finding is considered a "red flag" for which of the following?
A) Nephrolithiasis
B) Bladder Cancer
C) Acute Prostatitis
D) Glomerulonephritis
Answer: B) Bladder Cancer
Rationale: Painless hematuria in an adult is considered a malignancy of the urinary tract
(bladder or kidney) until proven otherwise.
2. Which maneuver is used to assess for a "meniscal tear" by rotating the flexed
knee and feeling for a click?
A) Lachman Test
B) McMurray Test
C) Drawer Test
D) Thompson Test
Answer: B) McMurray Test
Rationale: The McMurray test specifically evaluates the meniscus; the Lachman and
Drawer tests evaluate the ACL.
,3. A "Positive Murphy’s Sign" is best described as:
A) Pain upon release of pressure in the LLQ
B) Pain when the right hip is internally rotated
C) Arrest of inspiration during gallbladder palpation
D) Pain when dropping from toes to heels
Answer: C) Arrest of inspiration during gallbladder palpation
Rationale: This indicates acute cholecystitis when the inflamed gallbladder contacts the
examiner's hand.
4. When assessing "Cranial Nerve VII (Facial)," the nurse practitioner should ask
the patient to:
A) Stick out the tongue
B) Shrug the shoulders
C) Smile, frown, and puff out cheeks
D) Identify a scent
Answer: C) Smile, frown, and puff out cheeks
Rationale: CN VII controls the muscles of facial expression.
5. A "Positive Phalen Test" at the wrist is indicative of:
A) De Quervain's Tenosynovitis
B) Carpal Tunnel Syndrome
C) Rheumatoid Arthritis
D) Ganglion Cyst
Answer: B) Carpal Tunnel Syndrome
Rationale: Flexing the wrists at 90 degrees for 60 seconds reproduces symptoms of
median nerve compression.
6. Which heart sound is associated with "atrial contraction into a stiff, non-
compliant ventricle"?
A) S1
B) S2
C) S3
D) S4
,Answer: D) S4
Rationale: S4 is an atrial gallop, commonly heard in patients with LVH or long-standing
hypertension.
7. A "Positive Rovsing’s Sign" is defined as:
A) Pain in the RLQ when the LLQ is palpated
B) Pain in the RUQ when the RLQ is palpated
C) Rebound tenderness at McBurney's Point
D) Pain with internal rotation of the hip
Answer: A) Pain in the RLQ when the LLQ is palpated
Rationale: This indicates peritoneal irritation, specifically appendicitis.
8. During a funduscopic exam, you note "AV Nicking." This is a characteristic
finding of:
A) Diabetic Retinopathy
B) Chronic Hypertension
C) Glaucoma
D) Macular Degeneration
Answer: B) Chronic Hypertension
Rationale: Thickened arteries compress the veins at the crossing points, a sign of
hypertensive vascular damage.
9. "Egophony" is considered positive when:
A) The spoken "E" sounds like an "A" during lung auscultation
B) The patient whispers "1-2-3" clearly
C) Vibrations are felt while the patient speaks
D) Percussion is dull over the lung fields
Answer: A) The spoken "E" sounds like an "A" during lung auscultation
Rationale: This indicates lung consolidation, such as pneumonia.
10. A "Positive Prehn’s Sign" (relief of pain with scrotal elevation) helps
differentiate:
A) Testicular torsion from Inguinal Hernia
B) Epididymitis from Testicular Torsion
, C) Hydrocele from Varicocele
D) Prostatitis from UTI
Answer: B) Epididymitis from Testicular Torsion
Rationale: Pain is usually relieved in epididymitis but not in torsion (which is a surgical
emergency).
11. Which cranial nerve is being tested when you ask a patient to "shrug their
shoulders" against resistance?
A) CN IX
B) CN X
C) CN XI
D) CN XII
Answer: C) CN XI (Spinal Accessory)
12. A "Positive Obturator Sign" is a physical finding of:
A) Gallstones
B) Ruptured Spleen
C) Appendicitis
D) Kidney Stones
Answer: C) Appendicitis
Rationale: Irritation of the obturator muscle by an inflamed appendix causes pain during
internal rotation of the flexed right hip.
13. "Tophi" on the ear or joints are a clinical marker for:
A) Rheumatoid Arthritis
B) Osteoarthritis
C) Chronic Gout
D) Psoriasis
Answer: C) Chronic Gout
Rationale: Tophi are deposits of monosodium urate crystals.
14. A "Positive Romberg Test" occurs when the patient:
A) Sways with eyes open
