NR 509 ACTUAL FINAL EXAM STUDY GUIDE 300+QUESTIONS
WITH ACCURATE ANSWERS ALREADY GRADED A+| EXAM
2025/2026 LATEST SUMMER-FALL SEMESTER (REAL EXAM
INSIGHT) 100% VERIFIED
A 23-year-old female presents to the clinic. She has decided to discontinue using condoms and
would like a different birth control option. Her last pelvic exam was 2 years ago when she had a negative Pap
smear and STI screening. Her LMP was 2 days ago, and she is still spotting.
She last had sex with her boyfriend 1 week ago. Condoms were used The NP elects to postpone her speculum
exam during this office encounter. What is the best evidence-based rationale for the decision to postpone her
exam?
A She had a normal Pap smear within the last 3 years.
B She has been using condoms.
C She has only one current partner and does not need STI testing.
D She should not be sexually active
E She is on her menses.
E
She is on her menses.
The NP is assessing a 42-year-old female who presents to the clinic with recurring headaches. What is an
effective question to ask the patient?
A "Have you experienced any memory loss?"
B "Do you have any aura prior to the headaches?"
C "Are you feeling stressed?"
D "How old were you when you first got a headache?"
E "Have you ever seen anyone have a stroke?"
B
,"Do you have any aura prior to the headaches?"
17-year-old male presents to the clinic for a follow-up appointment. He fractured his left arm 8 weeks ago and
remains in a cast. Upon inspection, the NP finds that his shoulder heights are unequal and there is winging of the
scapula. The NP suspects contralateral weakness and muscle wasting as the etiology for the winged scapula.
Which of the following physical assessment maneuvers should the NP perform to confirm the suspension?
A Assess the lateral bending movement of his neck.
B Compare the strength of his trapezia muscles.
C Assess his ability to touch his toes.
D Check for listing of his trunk.
E Assess his ability to extend his back
B
Compare the strength of his trapezia muscles.
An 88-year-old female presents to the clinic with joint pain and deformities secondary to osteoarthritis. On
examination, the NP notes the abnormal findings highlighted by the red oval on this image. Which of the
following is the most accurate interpretation of these findings?
ADA Description: Left hand with deformed and swollen finger joints.
A These findings are Janeway lesions
B These findings are Heberden nodes
C These findings are mucoid cysts
D These findings Osler nodes.
E These findings are Bouchard nodes
B
,These findings are Heberden nodes
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?
A psoas sign fifi
B Murphy sign
C Blumberg sign
D Roving sign
E McBurney sign
B
Murphy sign
A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination. She asks
you privately if her granddaughter has started puberty yet. During the examination, the NP notes asymmetric
projection of the areola and nipple of the right chest to form a secondary mound above the level of the breast.
The left breast is underdeveloped. These assessment findings are consistent with which Tanner Stage of
development?
IV
Primary prevention is defined as which of the following?
Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following statements
is true about screening for breast cancer in average-risk women?
, Mammography is recommended every 2 years for women aged 50-74 with insufficient evidence for screening
women over the age of 75.
Which of the following statements is true regarding recommendations by the eighth Joint National Committee
(JNC8) for adults aged 60 and older? Select all that apply.
Target blood pressure should be </= 150/90 mmHg but notes that if treatment results in SBP <140 and is "well
tolerated and without adverse effects to health or quality of live, treatment does not need to be adjusted."
In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear optimal for notable reductions
in stroke, cardiovascular events, and all-cause mortality.
Which of the following is a useful strategy when examining young children between the ages of 1 and 4?
Have the parent facilitate the exam (e.g., removing clothes, holding the child on lap).
The NP is completing the review of systems on a 4-month-old female during a routine encounter. Which
statement from the parent may indicate a cardiac problem in the infant and require a more thorough subjective
history?
"It often takes the baby more than 30 minutes to finish a bottle."
A 16-year-old male presents to the clinic with a history of a congenital right upper eyelid drooping as
represented in this image. He has no complaints and denies injury or trauma. Which cranial nerve (CN) is
involved in this condition?
Patient with eyelid drooping
CNIII
Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory fibers to portions of the
tympanic membrane, auditory canal, pharynx, and the posterior third of the tongue?
CN IX
WITH ACCURATE ANSWERS ALREADY GRADED A+| EXAM
2025/2026 LATEST SUMMER-FALL SEMESTER (REAL EXAM
INSIGHT) 100% VERIFIED
A 23-year-old female presents to the clinic. She has decided to discontinue using condoms and
would like a different birth control option. Her last pelvic exam was 2 years ago when she had a negative Pap
smear and STI screening. Her LMP was 2 days ago, and she is still spotting.
She last had sex with her boyfriend 1 week ago. Condoms were used The NP elects to postpone her speculum
exam during this office encounter. What is the best evidence-based rationale for the decision to postpone her
exam?
A She had a normal Pap smear within the last 3 years.
B She has been using condoms.
C She has only one current partner and does not need STI testing.
D She should not be sexually active
E She is on her menses.
E
She is on her menses.
The NP is assessing a 42-year-old female who presents to the clinic with recurring headaches. What is an
effective question to ask the patient?
A "Have you experienced any memory loss?"
B "Do you have any aura prior to the headaches?"
C "Are you feeling stressed?"
D "How old were you when you first got a headache?"
E "Have you ever seen anyone have a stroke?"
B
,"Do you have any aura prior to the headaches?"
17-year-old male presents to the clinic for a follow-up appointment. He fractured his left arm 8 weeks ago and
remains in a cast. Upon inspection, the NP finds that his shoulder heights are unequal and there is winging of the
scapula. The NP suspects contralateral weakness and muscle wasting as the etiology for the winged scapula.
Which of the following physical assessment maneuvers should the NP perform to confirm the suspension?
A Assess the lateral bending movement of his neck.
B Compare the strength of his trapezia muscles.
C Assess his ability to touch his toes.
D Check for listing of his trunk.
E Assess his ability to extend his back
B
Compare the strength of his trapezia muscles.
An 88-year-old female presents to the clinic with joint pain and deformities secondary to osteoarthritis. On
examination, the NP notes the abnormal findings highlighted by the red oval on this image. Which of the
following is the most accurate interpretation of these findings?
ADA Description: Left hand with deformed and swollen finger joints.
A These findings are Janeway lesions
B These findings are Heberden nodes
C These findings are mucoid cysts
D These findings Osler nodes.
E These findings are Bouchard nodes
B
,These findings are Heberden nodes
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?
A psoas sign fifi
B Murphy sign
C Blumberg sign
D Roving sign
E McBurney sign
B
Murphy sign
A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination. She asks
you privately if her granddaughter has started puberty yet. During the examination, the NP notes asymmetric
projection of the areola and nipple of the right chest to form a secondary mound above the level of the breast.
The left breast is underdeveloped. These assessment findings are consistent with which Tanner Stage of
development?
IV
Primary prevention is defined as which of the following?
Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following statements
is true about screening for breast cancer in average-risk women?
, Mammography is recommended every 2 years for women aged 50-74 with insufficient evidence for screening
women over the age of 75.
Which of the following statements is true regarding recommendations by the eighth Joint National Committee
(JNC8) for adults aged 60 and older? Select all that apply.
Target blood pressure should be </= 150/90 mmHg but notes that if treatment results in SBP <140 and is "well
tolerated and without adverse effects to health or quality of live, treatment does not need to be adjusted."
In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear optimal for notable reductions
in stroke, cardiovascular events, and all-cause mortality.
Which of the following is a useful strategy when examining young children between the ages of 1 and 4?
Have the parent facilitate the exam (e.g., removing clothes, holding the child on lap).
The NP is completing the review of systems on a 4-month-old female during a routine encounter. Which
statement from the parent may indicate a cardiac problem in the infant and require a more thorough subjective
history?
"It often takes the baby more than 30 minutes to finish a bottle."
A 16-year-old male presents to the clinic with a history of a congenital right upper eyelid drooping as
represented in this image. He has no complaints and denies injury or trauma. Which cranial nerve (CN) is
involved in this condition?
Patient with eyelid drooping
CNIII
Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory fibers to portions of the
tympanic membrane, auditory canal, pharynx, and the posterior third of the tongue?
CN IX
