NR 509 Midterm Exam Questions with
Verified Answers: Advanced Physical
Assessment - Chamberlain
Question 1
A 68-year-old retired administrative assistant complains of a 3-month history of
recurring pain after ambulating that radiates from her back in the upper lumbar
region into both buttocks, bilateral thighs, and mid-calf regions. Her pain is typically
improved by sitting or by leaning forward. The origin of her pain is likely secondary to
which of the following?
a. Peripheral arterial disease (PAD)
b. Venous stasis
c. Acute arterial occlusion
d. Neurogenic claudication
e. Abdominal aortic aneurysm
Correct Answer
d. Neurogenic claudication
Question 2
A theoretical laboratory test for infection with HIV is known to have high sensitivity.
This means that the test has which of the following?
a. Good ability to rule in HIV in those who do have HIV
b. Good ability to rule out HIV in those who do not have HIV
c. High intraobserver reliability
d. High interobserver reliability
e. Good ability to diagnose AIDS
Correct Answer
b. Good ability to rule out HIV in those who do not have HIV
Page 1 of 190
,Question 3
A 73-year-old retired salesman presents to the Emergency Department complaining
of chest pain that started about 2 hours ago. Electrocardiogram, cardiac enzymes, and
chest x-ray are normal. The nurse notes that his blood pressures in the right arm are
significantly lower than of blood pressures in his left arm. Based on history and
physical examination, which of the following will most likely explain his signs and
symptoms?
a. Dissecting aortic aneurysm
b. Coarctation of the aorta
c. Myocardial infarction (MI)
d. Pulmonary embolism (PE)
e. Pericarditis
Correct Answer
a. Dissecting aortic aneurysm
Question 4
One important examination technique involves using the third fingers of each hand to
determine the health of internal organs. What is the name of this technique?
a. Auscultation
b. Percussion
c. Inspection
d. Palpation
e. Listening
Correct Answer
b. Percussion
Question 5
Differential diagnosis
Correct Answer
List of possible diagnoses supported by problem list
Page 2 of 190
,Question 6
Vagus nerve:
Correct Answer
10 Digestion and heart rate.
Question 7
A 39-year-old architect comes to the clinic for a 2-day history of fever, chills, cough
productive of green sputum, and dyspnea. He has no history of serious illness. His
temperature is 101.2oF. His other vital signs are within normal limits. Late inspiratory
crackles are heard on auscultation over the left lower lung posteriorly. When the
clinician listens over that area and instructs the patient to say "ee," it sounds like "A."
Which of the following would most likely be found on percussion of his lungs?
a. Flatness
b. Hyperresonance
c. Stridor
d. Tympany
e. Dullness
Correct Answer
e. Dullness
Question 8
Auditory/vestibular nerve:
Correct Answer
8 Sense of hearing and balance.
Page 3 of 190
, Question 9
A 68-year-old retired college professor presents for routine physical examination.
After the patient has been reading a novel in the waiting room for ~20 minutes, the
technician records his blood pressure in both arms using an automated device. The
technician notes a 20-mm Hg difference in systolic blood pressure between the right
and left arms; he repeats the readings 10 minutes later and records the same
asymmetrical systolic blood pressure. Which of the following is true regarding this
physical finding?
a. An arm-to-arm difference of up to 20 mm Hg in systolic blood pressure is
considered the upper limits of normal.
b. The difference is likely secondary to white coat hypertension and should be
followed up with three subsequent monthly readings to confirm.
c. The patient should undergo ambulatory blood pressure monitoring in both arms
for 24 hours to confirm conflicting measurements in the office.
d. This finding
Correct Answer
d. This finding is clearly abnormal and requires immediate evaluation for possible
cardiovascular emergency.
Question 10
A 29-year-old female professional athlete presents to a new primary care provider
with chronic menstrual complaints. She remarks to the nursing staff that, in the past,
she has experienced a dismissal of her complaints because of her high level of
physical fitness and conditioning. She is seeking a care provider who will explore the
issue in more detail and work with her particular concerns. Which of the following is
the description of the patient-centered care this individual seeks?
a. Structured and clinician-centered with open-ended questions
b. Validating and empathetic with open-ended questions
c. Dismissive and concrete with open-ended questions
d. Affirming and reassuring with close-ended questions
e. Factual and structured with active listening
Correct Answer
b. Validating and empathetic with open-ended questions
Page 4 of 190
Verified Answers: Advanced Physical
Assessment - Chamberlain
Question 1
A 68-year-old retired administrative assistant complains of a 3-month history of
recurring pain after ambulating that radiates from her back in the upper lumbar
region into both buttocks, bilateral thighs, and mid-calf regions. Her pain is typically
improved by sitting or by leaning forward. The origin of her pain is likely secondary to
which of the following?
a. Peripheral arterial disease (PAD)
b. Venous stasis
c. Acute arterial occlusion
d. Neurogenic claudication
e. Abdominal aortic aneurysm
Correct Answer
d. Neurogenic claudication
Question 2
A theoretical laboratory test for infection with HIV is known to have high sensitivity.
This means that the test has which of the following?
a. Good ability to rule in HIV in those who do have HIV
b. Good ability to rule out HIV in those who do not have HIV
c. High intraobserver reliability
d. High interobserver reliability
e. Good ability to diagnose AIDS
Correct Answer
b. Good ability to rule out HIV in those who do not have HIV
Page 1 of 190
,Question 3
A 73-year-old retired salesman presents to the Emergency Department complaining
of chest pain that started about 2 hours ago. Electrocardiogram, cardiac enzymes, and
chest x-ray are normal. The nurse notes that his blood pressures in the right arm are
significantly lower than of blood pressures in his left arm. Based on history and
physical examination, which of the following will most likely explain his signs and
symptoms?
a. Dissecting aortic aneurysm
b. Coarctation of the aorta
c. Myocardial infarction (MI)
d. Pulmonary embolism (PE)
e. Pericarditis
Correct Answer
a. Dissecting aortic aneurysm
Question 4
One important examination technique involves using the third fingers of each hand to
determine the health of internal organs. What is the name of this technique?
a. Auscultation
b. Percussion
c. Inspection
d. Palpation
e. Listening
Correct Answer
b. Percussion
Question 5
Differential diagnosis
Correct Answer
List of possible diagnoses supported by problem list
Page 2 of 190
,Question 6
Vagus nerve:
Correct Answer
10 Digestion and heart rate.
Question 7
A 39-year-old architect comes to the clinic for a 2-day history of fever, chills, cough
productive of green sputum, and dyspnea. He has no history of serious illness. His
temperature is 101.2oF. His other vital signs are within normal limits. Late inspiratory
crackles are heard on auscultation over the left lower lung posteriorly. When the
clinician listens over that area and instructs the patient to say "ee," it sounds like "A."
Which of the following would most likely be found on percussion of his lungs?
a. Flatness
b. Hyperresonance
c. Stridor
d. Tympany
e. Dullness
Correct Answer
e. Dullness
Question 8
Auditory/vestibular nerve:
Correct Answer
8 Sense of hearing and balance.
Page 3 of 190
, Question 9
A 68-year-old retired college professor presents for routine physical examination.
After the patient has been reading a novel in the waiting room for ~20 minutes, the
technician records his blood pressure in both arms using an automated device. The
technician notes a 20-mm Hg difference in systolic blood pressure between the right
and left arms; he repeats the readings 10 minutes later and records the same
asymmetrical systolic blood pressure. Which of the following is true regarding this
physical finding?
a. An arm-to-arm difference of up to 20 mm Hg in systolic blood pressure is
considered the upper limits of normal.
b. The difference is likely secondary to white coat hypertension and should be
followed up with three subsequent monthly readings to confirm.
c. The patient should undergo ambulatory blood pressure monitoring in both arms
for 24 hours to confirm conflicting measurements in the office.
d. This finding
Correct Answer
d. This finding is clearly abnormal and requires immediate evaluation for possible
cardiovascular emergency.
Question 10
A 29-year-old female professional athlete presents to a new primary care provider
with chronic menstrual complaints. She remarks to the nursing staff that, in the past,
she has experienced a dismissal of her complaints because of her high level of
physical fitness and conditioning. She is seeking a care provider who will explore the
issue in more detail and work with her particular concerns. Which of the following is
the description of the patient-centered care this individual seeks?
a. Structured and clinician-centered with open-ended questions
b. Validating and empathetic with open-ended questions
c. Dismissive and concrete with open-ended questions
d. Affirming and reassuring with close-ended questions
e. Factual and structured with active listening
Correct Answer
b. Validating and empathetic with open-ended questions
Page 4 of 190
