NR509 | NR509 Advanced Physical Assessment
Final Exam v3 | Questions with Correct Answers
and Expert Explanation for Each Question |
Chamberlain
1. When assessing for acute cholecystitis, which physical examination maneuver is most
appropriate?
A. McBurney’s point palpation
B. Psoas sign
C. Rovsing’s sign
D. Murphy’s sign
Correct Answer: D
Expert Explanation: Murphy’s sign is specifically used to evaluate the gallbladder for
inflammation or stones. To perform this, the examiner palpates the right upper quadrant
and asks the patient to take a deep breath. A positive sign is indicated when the patient
suddenly stops breathing in due to sharp pain as the gallbladder touches the examiner’s
fingers.
2. Testing the gag reflex is an assessment of which cranial nerves?
A. CN V and VII
B. CN III and IV
C. CN XI and XII
D. CN IX and X
Correct Answer: D
Expert Explanation: The gag reflex involves both the glossopharyngeal (CN IX) and vagus
(CN X) nerves. The glossopharyngeal nerve provides the sensory component that detects
the stimulus at the back of the throat. The vagus nerve provides the motor component that
causes the muscles of the throat to contract.
3. Where is the mitral valve best auscultated on the chest wall?
A. Fifth intercostal space, left midclavicular line
B. Second intercostal space, left sternal border
C. Fourth intercostal space, left sternal border
D. Second intercostal space, right sternal border
,Correct Answer: A
Expert Explanation: The mitral valve is best heard at the apex of the heart, which is the
point of maximal impulse. This location is typically found at the fifth intercostal space along
the left midclavicular line. Auscultating at this site allows the clinician to best hear S1 and
any murmurs associated with the mitral valve.
4. During a respiratory assessment, the clinician hears a low-pitched, snoring sound that
clears with coughing. What is this sound?
A. Wheezes
B. Crackles
C. Rhonchi
D. Stridor
Correct Answer: C
Expert Explanation: Rhonchi are continuous, low-pitched rattling sounds that often
resemble snoring. They are caused by secretions or obstructions in the larger airways.
Unlike wheezes or crackles, rhonchi can often be cleared or altered when the patient
coughs.
5. A positive Brudzinski’s sign is most indicative of which condition?
A. Meningitis
B. Appendicitis
C. Sciatica
D. Cervical disc herniation
Correct Answer: A
Expert Explanation: Brudzinski’s sign is a clinical sign used to identify meningeal
irritation. It is positive when passive flexion of the neck results in involuntary flexion of the
hips and knees. This reflex occurs because the movement stretches the inflamed meninges,
causing a protective pain response.
6. Which of the following is the correct technique for assessing the thyroid gland?
A. Palpate only from the anterior position
B. Ask the patient to hyperextend the neck and hold their breath
C. Ask the patient to take a sip of water and swallow while palpating
D. Use the bell of the stethoscope to palpate for nodules
Correct Answer: C
, Expert Explanation: Palpating the thyroid gland while the patient swallows water allows
the clinician to feel the gland move upward against the fingers. This movement makes it
easier to identify the size, shape, and consistency of the thyroid. Proper assessment often
involves palpating from a posterior position to better feel the lobes.
7. A 24-year-old male presents with a sudden onset of scrotal pain and a missing cremasteric
reflex. This is most likely:
A. Epididymitis
B. Hydrocele
C. Testicular torsion
D. Inguinal hernia
Correct Answer: C
Expert Explanation: Testicular torsion is a medical emergency characterized by the
twisting of the spermatic cord, cutting off blood supply. The absence of the cremasteric
reflex on the affected side is a highly sensitive finding for this condition. Immediate surgical
consultation is required to salvage the testicle.
8. Which cranial nerve is responsible for lateral movement of the eye?
A. CN III
B. CN VI
C. CN IV
D. CN VII
Correct Answer: B
Expert Explanation: The abducens nerve (CN VI) innervates the lateral rectus muscle of
the eye. This muscle is responsible for moving the eye outward or laterally. Dysfunction in
CN VI would result in the inability to abduct the eye, often leading to double vision.
9. What does a positive Romberg test indicate?
A. Loss of cerebellar function
B. Loss of proprioception or vestibular function
C. Muscle weakness in the lower extremities
D. Increased intracranial pressure
Correct Answer: B
Expert Explanation: The Romberg test evaluates the patient’s ability to maintain balance
with their eyes closed, which removes visual input. If the patient loses balance, it suggests a
problem with proprioception (the sense of body position) or the vestibular system. It is not
Final Exam v3 | Questions with Correct Answers
and Expert Explanation for Each Question |
Chamberlain
1. When assessing for acute cholecystitis, which physical examination maneuver is most
appropriate?
A. McBurney’s point palpation
B. Psoas sign
C. Rovsing’s sign
D. Murphy’s sign
Correct Answer: D
Expert Explanation: Murphy’s sign is specifically used to evaluate the gallbladder for
inflammation or stones. To perform this, the examiner palpates the right upper quadrant
and asks the patient to take a deep breath. A positive sign is indicated when the patient
suddenly stops breathing in due to sharp pain as the gallbladder touches the examiner’s
fingers.
2. Testing the gag reflex is an assessment of which cranial nerves?
A. CN V and VII
B. CN III and IV
C. CN XI and XII
D. CN IX and X
Correct Answer: D
Expert Explanation: The gag reflex involves both the glossopharyngeal (CN IX) and vagus
(CN X) nerves. The glossopharyngeal nerve provides the sensory component that detects
the stimulus at the back of the throat. The vagus nerve provides the motor component that
causes the muscles of the throat to contract.
3. Where is the mitral valve best auscultated on the chest wall?
A. Fifth intercostal space, left midclavicular line
B. Second intercostal space, left sternal border
C. Fourth intercostal space, left sternal border
D. Second intercostal space, right sternal border
,Correct Answer: A
Expert Explanation: The mitral valve is best heard at the apex of the heart, which is the
point of maximal impulse. This location is typically found at the fifth intercostal space along
the left midclavicular line. Auscultating at this site allows the clinician to best hear S1 and
any murmurs associated with the mitral valve.
4. During a respiratory assessment, the clinician hears a low-pitched, snoring sound that
clears with coughing. What is this sound?
A. Wheezes
B. Crackles
C. Rhonchi
D. Stridor
Correct Answer: C
Expert Explanation: Rhonchi are continuous, low-pitched rattling sounds that often
resemble snoring. They are caused by secretions or obstructions in the larger airways.
Unlike wheezes or crackles, rhonchi can often be cleared or altered when the patient
coughs.
5. A positive Brudzinski’s sign is most indicative of which condition?
A. Meningitis
B. Appendicitis
C. Sciatica
D. Cervical disc herniation
Correct Answer: A
Expert Explanation: Brudzinski’s sign is a clinical sign used to identify meningeal
irritation. It is positive when passive flexion of the neck results in involuntary flexion of the
hips and knees. This reflex occurs because the movement stretches the inflamed meninges,
causing a protective pain response.
6. Which of the following is the correct technique for assessing the thyroid gland?
A. Palpate only from the anterior position
B. Ask the patient to hyperextend the neck and hold their breath
C. Ask the patient to take a sip of water and swallow while palpating
D. Use the bell of the stethoscope to palpate for nodules
Correct Answer: C
, Expert Explanation: Palpating the thyroid gland while the patient swallows water allows
the clinician to feel the gland move upward against the fingers. This movement makes it
easier to identify the size, shape, and consistency of the thyroid. Proper assessment often
involves palpating from a posterior position to better feel the lobes.
7. A 24-year-old male presents with a sudden onset of scrotal pain and a missing cremasteric
reflex. This is most likely:
A. Epididymitis
B. Hydrocele
C. Testicular torsion
D. Inguinal hernia
Correct Answer: C
Expert Explanation: Testicular torsion is a medical emergency characterized by the
twisting of the spermatic cord, cutting off blood supply. The absence of the cremasteric
reflex on the affected side is a highly sensitive finding for this condition. Immediate surgical
consultation is required to salvage the testicle.
8. Which cranial nerve is responsible for lateral movement of the eye?
A. CN III
B. CN VI
C. CN IV
D. CN VII
Correct Answer: B
Expert Explanation: The abducens nerve (CN VI) innervates the lateral rectus muscle of
the eye. This muscle is responsible for moving the eye outward or laterally. Dysfunction in
CN VI would result in the inability to abduct the eye, often leading to double vision.
9. What does a positive Romberg test indicate?
A. Loss of cerebellar function
B. Loss of proprioception or vestibular function
C. Muscle weakness in the lower extremities
D. Increased intracranial pressure
Correct Answer: B
Expert Explanation: The Romberg test evaluates the patient’s ability to maintain balance
with their eyes closed, which removes visual input. If the patient loses balance, it suggests a
problem with proprioception (the sense of body position) or the vestibular system. It is not
