FINAL EXAM: NR509 / NR 509
(LATEST VERSION )
ADVANCED PHYSICAL
ASSESSMENT EXAM 2025
LATEST NEWEST UPDATE WITH
ACTUAL QUESTIONS AND
DETAILED VERIFIED ANSWERS
WITH RATIONALES (100%
CORRECT) //BRAND NEW!!
/ALREADY GRADED A+ WITH
GUARANTEED SUCCESS AFTER
DOWNLOAD (ALL YOU NEED TO
PASS YOUR EXAMS
, Tympany to percussion in the right upper quadrant, dullness to percussion of the left upper
quadrant
A 23-year-old woman comes to the respirology clinic for follow-up of her chronic sinusitis
and bronchiectasis that is associated with a rare congenital condition called Kartagener
syndrome. The preceptor notes that she has situs inversus and asks for a physical exam.
Which of the following descriptions best fits with findings on the abdominal exam?
Pressing down onto the abdomen firmly and slowly and withdrawing the hand quickly
produces pain
An otherwise healthy 28-year-old lawyer presents to the Emergency Department with a 1-day
history of severe abdominal pain. The emergency physician suspects appendicitis and general
surgery is consulted. The resident believes the patient has signs of peritonitis on exam. Which
of the following physical exam findings supports peritonitis?
Fibrosis of the pancreas
A 58-year-old man with a history of diabetes and alcohol addiction has been sober for the last
10 months. He presents with a 4-month history of increasing weakness, recurrent epigastric
pain radiating to his back, chronic diarrhea with stools 6-8 times daily, and weight loss of 18
lb over 4 months. What is the mechanism of his most likely diagnosis?
Associated right shoulder pain
A 46-year-old executive who is obese and otherwise healthy presents to a family medicine
clinic with a 3-month course of recurrent severe abdominal pain that usually resolves on its
own acter a few hours. Her last episode was prolonged lasting 6 hours, and she is frustrated
that she has had to leave or miss work on three separate occasions. She would like a diagnosis
and the problem fixed. Which symptoms or signs would be most suggestive of a diagnosis of
biliary colic?
The anal canal has a rich somatosensory innervation, making poorly directed examinations
painful in this area
A 62-year-old male who is undergoing evaluation for possible prostate cancer strongly
declines a rectal examination, stating that, "Some trainee once did that and it hurt badly."
Which of the following is true about the innervation of the anus and rectum that may explain
this patient's experience of discomfort?
The median lobe of the prostate is located anterior to the urethra and is not palpable on DRE
, A 54-year-old male with a strong family history of breast and prostate cancer presents to his
primary care provider to discuss prostate screening. His father died at age 73 years from
prostate cancer that was not detected on routine digital rectal examinations (DRES), and he
would like to minimize his chance of a similar occurrence. Which of the following is true
regarding the anatomy and screening of the prostate by DRE?
Cervix
A third-year medical student rotating on the internal medicine service performs a digital
rectal examination (DRE) on a 56-year-old female patient. The patient has been admitted for
suspicion of a myocardial infarction, and confirmation that there is no blood in the stool is
required before anticoagulation can be started. The student reports that the fecal occult blood
test was negative but notes that he palpated a structure through the anterior rectum that he
could not identify. The attending physician confirms normal anatomy and reviews with the
student that the most likely identity of the structure palpable is which of the following?
Recent onset of small-caliber stools
A 45 - year - old female executive reports to her primary care provider that she has recently
experienced a change in the patterns of her bowel movements . She expresses a great concern
as her family history includes a maternal aunt who died of colon cancer at age 49 years ; her
mother has had colonoscopies every 3 years with numerous adenomatous polyps removed .
Which of the following historical elements would be the most concerning for colon cancer in
this patient ?
The patient should undergo colonoscopy for his bowel condition, which confers risk of colon
cancer
A 49-year-old customer service representative presents to his gastroenterologist for follow-up
of his long-standing inflammatory bowel disease (IBD). He was diagnosed with ulcerative
colitis (UC) at age 37 years and has had irregular care for this condition since then. His sole
colonoscopy was done at the time of diagnosis 12 years ago. His only relevant family history
is of prostate cancer in his father; his mother and sisters are healthy. Which of the following
is true about recommended screening for colon cancer in this patient?
Normal anatomy of the mucosal surface
A 49-year-old male with well-controlled HIV undergoes a proctoscopic examination as
routine screening for anal cancer. The patient is asymptomatic and specifically denies
complaints of frequent urination (frequency), large volume of urination (polyuria), or
repeated urination at night (nocturia). Under direct visualization, the clinician observes a
(LATEST VERSION )
ADVANCED PHYSICAL
ASSESSMENT EXAM 2025
LATEST NEWEST UPDATE WITH
ACTUAL QUESTIONS AND
DETAILED VERIFIED ANSWERS
WITH RATIONALES (100%
CORRECT) //BRAND NEW!!
/ALREADY GRADED A+ WITH
GUARANTEED SUCCESS AFTER
DOWNLOAD (ALL YOU NEED TO
PASS YOUR EXAMS
, Tympany to percussion in the right upper quadrant, dullness to percussion of the left upper
quadrant
A 23-year-old woman comes to the respirology clinic for follow-up of her chronic sinusitis
and bronchiectasis that is associated with a rare congenital condition called Kartagener
syndrome. The preceptor notes that she has situs inversus and asks for a physical exam.
Which of the following descriptions best fits with findings on the abdominal exam?
Pressing down onto the abdomen firmly and slowly and withdrawing the hand quickly
produces pain
An otherwise healthy 28-year-old lawyer presents to the Emergency Department with a 1-day
history of severe abdominal pain. The emergency physician suspects appendicitis and general
surgery is consulted. The resident believes the patient has signs of peritonitis on exam. Which
of the following physical exam findings supports peritonitis?
Fibrosis of the pancreas
A 58-year-old man with a history of diabetes and alcohol addiction has been sober for the last
10 months. He presents with a 4-month history of increasing weakness, recurrent epigastric
pain radiating to his back, chronic diarrhea with stools 6-8 times daily, and weight loss of 18
lb over 4 months. What is the mechanism of his most likely diagnosis?
Associated right shoulder pain
A 46-year-old executive who is obese and otherwise healthy presents to a family medicine
clinic with a 3-month course of recurrent severe abdominal pain that usually resolves on its
own acter a few hours. Her last episode was prolonged lasting 6 hours, and she is frustrated
that she has had to leave or miss work on three separate occasions. She would like a diagnosis
and the problem fixed. Which symptoms or signs would be most suggestive of a diagnosis of
biliary colic?
The anal canal has a rich somatosensory innervation, making poorly directed examinations
painful in this area
A 62-year-old male who is undergoing evaluation for possible prostate cancer strongly
declines a rectal examination, stating that, "Some trainee once did that and it hurt badly."
Which of the following is true about the innervation of the anus and rectum that may explain
this patient's experience of discomfort?
The median lobe of the prostate is located anterior to the urethra and is not palpable on DRE
, A 54-year-old male with a strong family history of breast and prostate cancer presents to his
primary care provider to discuss prostate screening. His father died at age 73 years from
prostate cancer that was not detected on routine digital rectal examinations (DRES), and he
would like to minimize his chance of a similar occurrence. Which of the following is true
regarding the anatomy and screening of the prostate by DRE?
Cervix
A third-year medical student rotating on the internal medicine service performs a digital
rectal examination (DRE) on a 56-year-old female patient. The patient has been admitted for
suspicion of a myocardial infarction, and confirmation that there is no blood in the stool is
required before anticoagulation can be started. The student reports that the fecal occult blood
test was negative but notes that he palpated a structure through the anterior rectum that he
could not identify. The attending physician confirms normal anatomy and reviews with the
student that the most likely identity of the structure palpable is which of the following?
Recent onset of small-caliber stools
A 45 - year - old female executive reports to her primary care provider that she has recently
experienced a change in the patterns of her bowel movements . She expresses a great concern
as her family history includes a maternal aunt who died of colon cancer at age 49 years ; her
mother has had colonoscopies every 3 years with numerous adenomatous polyps removed .
Which of the following historical elements would be the most concerning for colon cancer in
this patient ?
The patient should undergo colonoscopy for his bowel condition, which confers risk of colon
cancer
A 49-year-old customer service representative presents to his gastroenterologist for follow-up
of his long-standing inflammatory bowel disease (IBD). He was diagnosed with ulcerative
colitis (UC) at age 37 years and has had irregular care for this condition since then. His sole
colonoscopy was done at the time of diagnosis 12 years ago. His only relevant family history
is of prostate cancer in his father; his mother and sisters are healthy. Which of the following
is true about recommended screening for colon cancer in this patient?
Normal anatomy of the mucosal surface
A 49-year-old male with well-controlled HIV undergoes a proctoscopic examination as
routine screening for anal cancer. The patient is asymptomatic and specifically denies
complaints of frequent urination (frequency), large volume of urination (polyuria), or
repeated urination at night (nocturia). Under direct visualization, the clinician observes a
