NR509 Final Exam Questions and Verified
Answers| 100% Correct – Chamberlain
2024/2025
A 30-year-old female presents to the clinic with complaints of a bad-smelling vaginal discharge with some mild
itching for about 3 weeks. She denies pain with urination or with sexual intercourse. She also reports that the smell
increased after intercourse and during her period last week. After a careful history and physical assessment, the
NP documents the following pelvic and anorectal examination findings: Bilateral shotty inguinal adenopathy.
External genitalia without erythema or lesions. Vaginal mucosa and cervix coated with thin white homogeneous
discharge with a mild fishy odor. After swabbing the cervix, no discharge is visible in the cervical os. Uterus midline;
no adnexal masses. Rectal vault without masses. Stool brown and negative for fecal blood. pH of vaginal discharge
>4.5. Which of the following is the most accurate interpretation of these findings?
These findings suggest bacterial vaginosis
The NP knows it is possible to palpate multiple structures in relation to the inguinal canal and related hernias while
performing a physical examination on male patients. Which of the following is not palpable during an external
examination of the abdominal wall or inguinal region?
Internal inguinal rings
What are the most predominant risk factors for prostate cancer?
Age
Ethnicity
Family history
A patient presents with right-upper quadrant (RUQ) pain but does not have any tenderness on palpation in the
RUQ. The NP is suspicious of acute cholecystitis. The NP knows to perform which assessment test next?
Murphy Sign
Pain in the right-lower quadrant (RLQ) during deep, even palpation of the left-lower quadrant (LLQ) then quickly
withdrawing your fingers indicates what positive assessment finding?
,Blumberg sign
The NP suspects a patient has appendicitis. Identify the physical examination maneuver done by applying pressure
halfway between the umbilicus and the anterior spine of the ilium?
McBurney Sign
Which assessment finding would be most suggestive of a diagnosis of biliary colic?
Associated right shoulder pain
Which of the following physical assessment finding is most suggestive of peritonitis secondary to a ruptured
appendix?
Pressing down onto the abdomen firmly and quickly withdrawals the hand produces pain
A 76-year-old female presents to the office for an annual physical. Upon reviewing her history, she had a positive
FOBT on one occasion at age 66 years. Subsequent colonoscopy revealed internal hemorrhoids and sigmoid
diverticuli only. She has no firstdegree relatives with a history of colorectal cancer or adenomatous polyps. What is
the U.S. Preventive Services Task Force (USPSTF) screening recommendation for this particular patient?
Do not screen routinely
A 30-year-old male is admitted to the hospital for abdominal pain. He reports steady, aching pain that began
suddenly around his naval and now involves the lower abdomen. He also reports a decreased appetite with nausea
but no vomiting. After a careful history and physical examination, the NP documents the following abdominal
findings: The abdomen is flat, firm, and rigid, with increased tenderness and guarding in the right lower quadrant.
No bowel sounds heard. Liver percusses to 7 cm in the midclavicular line; edge not felt. Spleen and kidneys not
felt. No palpable masses. No CVA tenderness. Psoas sign positive. Blumberg sign positive. Which of the following is
the most accurate interpretation of these findings?
These findings suggest acute peritonitis
, The NP student is precepting with a provider in a geriatric-based clinic. The provider asks the student if he is
familiar with the 10-Minute Geriatric Screener. Which of the following statements best demonstrates that the NP
understands this assessment tool?
The tool assesses for functional deficits which are strong predictors of patient outcomes in the elderly.
The NP conducted a physical assessment on a 79-year-old male who lives independently in subsidized housing. The
documentation for the Head, Eyes, Ears, Nose, Throat (HEENT) findings are as follows: Scalp without lesions. Skull
NC/AT. Conjunctiva pink, sclera muddy. Pupils 2 mm constricting to 1 mm, round, regular, equally reactive to light
and accommodation. Extraocular movements intact. Disc margins sharp, without hemorrhages or exudates. Mild
arteriolar narrowing. TMs with good cone of light. Weber midline. AC > BC. Nasal mucosa erythematous, septum
deviated to the right, turbinates mildly enlarged. No sinus tenderness. Oral mucosa pink. Dentition fair. Caries
present. Tongue midline, slight beefy redness. Pharynx is mildly erythematous with cobblestoning. Which of the
following is the most accurate interpretation of the findings?
The patient has chronic allergies
The staff NP in a nursing home is conducting a physical assessment on an 84-year-old male resident who is
pleasant, active, and cooperative. The skin findings in this image are observed during the examination. The staff
and patient deny any known injury or trauma. The NP should document these findings as consistent with which of
the following?
ADA Description: Extensor surface of the right forearm with emphasis on well-demarcated vividly purple macules
and patches
Actinic purpura
An 80-year-old woman who lives alone at home presents with concerns about maintaining her independent living
status. She continues to drive and care for herself and her pet dog but reports two falls over the past 4 months.
During one fall, she struck her head, causing a contusion over the right eye. She attributes these episodes to
environmental factors. Once she tripped over a rug, and once she misjudged the depth of the curb while crossing
the street. Which of the following would be the best approach to this patient?
Perform a comprehensive assessment of fall risk and plan preventive interventions
.
Concerning alcohol consumption in older adults, which of the following is true?
Answers| 100% Correct – Chamberlain
2024/2025
A 30-year-old female presents to the clinic with complaints of a bad-smelling vaginal discharge with some mild
itching for about 3 weeks. She denies pain with urination or with sexual intercourse. She also reports that the smell
increased after intercourse and during her period last week. After a careful history and physical assessment, the
NP documents the following pelvic and anorectal examination findings: Bilateral shotty inguinal adenopathy.
External genitalia without erythema or lesions. Vaginal mucosa and cervix coated with thin white homogeneous
discharge with a mild fishy odor. After swabbing the cervix, no discharge is visible in the cervical os. Uterus midline;
no adnexal masses. Rectal vault without masses. Stool brown and negative for fecal blood. pH of vaginal discharge
>4.5. Which of the following is the most accurate interpretation of these findings?
These findings suggest bacterial vaginosis
The NP knows it is possible to palpate multiple structures in relation to the inguinal canal and related hernias while
performing a physical examination on male patients. Which of the following is not palpable during an external
examination of the abdominal wall or inguinal region?
Internal inguinal rings
What are the most predominant risk factors for prostate cancer?
Age
Ethnicity
Family history
A patient presents with right-upper quadrant (RUQ) pain but does not have any tenderness on palpation in the
RUQ. The NP is suspicious of acute cholecystitis. The NP knows to perform which assessment test next?
Murphy Sign
Pain in the right-lower quadrant (RLQ) during deep, even palpation of the left-lower quadrant (LLQ) then quickly
withdrawing your fingers indicates what positive assessment finding?
,Blumberg sign
The NP suspects a patient has appendicitis. Identify the physical examination maneuver done by applying pressure
halfway between the umbilicus and the anterior spine of the ilium?
McBurney Sign
Which assessment finding would be most suggestive of a diagnosis of biliary colic?
Associated right shoulder pain
Which of the following physical assessment finding is most suggestive of peritonitis secondary to a ruptured
appendix?
Pressing down onto the abdomen firmly and quickly withdrawals the hand produces pain
A 76-year-old female presents to the office for an annual physical. Upon reviewing her history, she had a positive
FOBT on one occasion at age 66 years. Subsequent colonoscopy revealed internal hemorrhoids and sigmoid
diverticuli only. She has no firstdegree relatives with a history of colorectal cancer or adenomatous polyps. What is
the U.S. Preventive Services Task Force (USPSTF) screening recommendation for this particular patient?
Do not screen routinely
A 30-year-old male is admitted to the hospital for abdominal pain. He reports steady, aching pain that began
suddenly around his naval and now involves the lower abdomen. He also reports a decreased appetite with nausea
but no vomiting. After a careful history and physical examination, the NP documents the following abdominal
findings: The abdomen is flat, firm, and rigid, with increased tenderness and guarding in the right lower quadrant.
No bowel sounds heard. Liver percusses to 7 cm in the midclavicular line; edge not felt. Spleen and kidneys not
felt. No palpable masses. No CVA tenderness. Psoas sign positive. Blumberg sign positive. Which of the following is
the most accurate interpretation of these findings?
These findings suggest acute peritonitis
, The NP student is precepting with a provider in a geriatric-based clinic. The provider asks the student if he is
familiar with the 10-Minute Geriatric Screener. Which of the following statements best demonstrates that the NP
understands this assessment tool?
The tool assesses for functional deficits which are strong predictors of patient outcomes in the elderly.
The NP conducted a physical assessment on a 79-year-old male who lives independently in subsidized housing. The
documentation for the Head, Eyes, Ears, Nose, Throat (HEENT) findings are as follows: Scalp without lesions. Skull
NC/AT. Conjunctiva pink, sclera muddy. Pupils 2 mm constricting to 1 mm, round, regular, equally reactive to light
and accommodation. Extraocular movements intact. Disc margins sharp, without hemorrhages or exudates. Mild
arteriolar narrowing. TMs with good cone of light. Weber midline. AC > BC. Nasal mucosa erythematous, septum
deviated to the right, turbinates mildly enlarged. No sinus tenderness. Oral mucosa pink. Dentition fair. Caries
present. Tongue midline, slight beefy redness. Pharynx is mildly erythematous with cobblestoning. Which of the
following is the most accurate interpretation of the findings?
The patient has chronic allergies
The staff NP in a nursing home is conducting a physical assessment on an 84-year-old male resident who is
pleasant, active, and cooperative. The skin findings in this image are observed during the examination. The staff
and patient deny any known injury or trauma. The NP should document these findings as consistent with which of
the following?
ADA Description: Extensor surface of the right forearm with emphasis on well-demarcated vividly purple macules
and patches
Actinic purpura
An 80-year-old woman who lives alone at home presents with concerns about maintaining her independent living
status. She continues to drive and care for herself and her pet dog but reports two falls over the past 4 months.
During one fall, she struck her head, causing a contusion over the right eye. She attributes these episodes to
environmental factors. Once she tripped over a rug, and once she misjudged the depth of the curb while crossing
the street. Which of the following would be the best approach to this patient?
Perform a comprehensive assessment of fall risk and plan preventive interventions
.
Concerning alcohol consumption in older adults, which of the following is true?
