NR 509 Final Exam 2025| Chamberlain
University| Actual Exam Questions and
Correct Answers
Question 1: A 6-year-old female presents to the clinic with sore throat. The point of care test for
Group A Streptococcal infection is positive. Which of the following indicates the expected
lymphadenopathy presentation in this case?
A) Tender, enlarged anterior cervical nodes
B) Non-tender, small submandibular nodes
C) Firm, fixed posterior cervical nodes
D) No lymphadenopathy expected
Correct Answer: A) Tender, enlarged anterior cervical nodes
Explanation: Group A Streptococcus (GAS) pharyngitis typically causes tender, enlarged
anterior cervical lymph nodes due to local infection and inflammation. Non-tender or fixed nodes
are less likely, and lymphadenopathy is expected in GAS infections.
Question 2: Which of the following changes are observed in vision as part of the normal aging
process?
A) Presbyopia
B) Macular degeneration
C) Retinal detachment
D) Glaucoma
Correct Answer: A) Presbyopia
Explanation: Presbyopia, the loss of near vision due to decreased lens elasticity, is a normal
aging change. Macular degeneration, retinal detachment, and glaucoma are pathological
conditions, not normal aging processes.
Question 3: Identify the anatomical structure in this image between both of the examiner’s hands
and fingertips.
,A) Thyroid gland
B) Trachea
C) Sternocleidomastoid muscle
D) Cannot assess without an image
Correct Answer: D) Cannot assess without an image
Explanation: Without an image, the anatomical structure between the examiner’s hands cannot
be identified. Possible structures in the neck include the thyroid, trachea, or sternocleidomastoid,
but visual confirmation is required.
Question 4: A 19-year-old African-American female presents to the clinic with moderate to
severe right lower quadrant abdominal pain for the last 2 days. She has been experiencing nausea
and vomiting but is unsure if she has had a fever. Which of the following is a possible
differential diagnosis?
A) Appendicitis
B) Urinary tract infection
C) Diverticulitis
D) Cholecystitis
Correct Answer: A) Appendicitis
Explanation: Right lower quadrant pain with nausea and vomiting in a young female strongly
suggests appendicitis. Diverticulitis and cholecystitis typically occur in older patients or involve
different locations, and urinary tract infections cause dysuria or flank pain.
Question 5: A 15-day-old infant girl is brought to the outpatient clinic by her mother on a
Monday morning. The mother is concerned about a rash that seems to have appeared suddenly
after spending the previous weekend in Florida visiting family. The time of year is August and
the house did not have air conditioning. The infant is afebrile, eating and drinking well, and does
not appear to be in distress. You note scattered vesicles on an erythematous base involving the
infant’s face and trunk. Based on the history and physical examination findings, what is the
likely diagnosis?
A) Miliaria rubra
B) Varicella
C) Erythema toxicum neonatorum
D) Impetigo
, Correct Answer: A) Miliaria rubra
Explanation: Scattered vesicles on an erythematous base in a neonate, triggered by heat in a
non-air-conditioned environment, suggest miliaria rubra (heat rash). Varicella is unlikely without
fever, erythema toxicum occurs earlier, and impetigo involves pustules.
Question 6: A 48-year-old high school librarian comes to your clinic, complaining of 1 week of
heavy discharge causing severe itching. She is not presently sexually active and has had no
burning with urination. The symptoms started several days after her last period. She just finished
a course of antibiotics for a sinus infection. Her past medical history consists of type 2 diabetes
and high blood pressure. She is widowed and has three children. She denies tobacco, alcohol, or
drug use. Her mother has high blood pressure and her father died of diabetes complications. On
examination you see a healthy appearing woman. Her blood pressure is 130/80 and her pulse is
70. Her head, eyes, ears, nose, throat, cardiac, lung, and abdominal examinations are
unremarkable. Palpation of the inguinal lymph nodes is unremarkable. On visualization of the
vulva, a thick, white, curdy discharge is seen at the introitus. On speculum examination there is a
copious amount of this discharge. The pH of the discharge is 4.1 and the KOH whiff test is
negative, with no unusual smell. Wet prep shows budding hyphae. What vaginitis does this
patient most likely have?
A) Bacterial vaginosis
B) Trichomoniasis
C) Candida vaginitis
D) Atrophic vaginitis
Correct Answer: C) Candida vaginitis
Explanation: Thick, white, curdy discharge, severe itching, pH 4.1, negative KOH whiff test,
and budding hyphae on wet prep indicate Candida vaginitis, often triggered by antibiotics.
Bacterial vaginosis and trichomoniasis have different pH and microscopy findings, and atrophic
vaginitis is unlikely in a premenopausal woman.
Question 7: A 32-year-old female presents with a complaint of a singular breast mass. The nurse
practitioner collects a thorough history and physical examination of the client’s breast and
related systems. Based on the characteristics of a soft, round, mobile, and tender mass, as well as
the client’s age, select the most likely cause of the breast mass.
A) Fibroadenoma
B) Breast cancer
C) Fibrocystic changes
University| Actual Exam Questions and
Correct Answers
Question 1: A 6-year-old female presents to the clinic with sore throat. The point of care test for
Group A Streptococcal infection is positive. Which of the following indicates the expected
lymphadenopathy presentation in this case?
A) Tender, enlarged anterior cervical nodes
B) Non-tender, small submandibular nodes
C) Firm, fixed posterior cervical nodes
D) No lymphadenopathy expected
Correct Answer: A) Tender, enlarged anterior cervical nodes
Explanation: Group A Streptococcus (GAS) pharyngitis typically causes tender, enlarged
anterior cervical lymph nodes due to local infection and inflammation. Non-tender or fixed nodes
are less likely, and lymphadenopathy is expected in GAS infections.
Question 2: Which of the following changes are observed in vision as part of the normal aging
process?
A) Presbyopia
B) Macular degeneration
C) Retinal detachment
D) Glaucoma
Correct Answer: A) Presbyopia
Explanation: Presbyopia, the loss of near vision due to decreased lens elasticity, is a normal
aging change. Macular degeneration, retinal detachment, and glaucoma are pathological
conditions, not normal aging processes.
Question 3: Identify the anatomical structure in this image between both of the examiner’s hands
and fingertips.
,A) Thyroid gland
B) Trachea
C) Sternocleidomastoid muscle
D) Cannot assess without an image
Correct Answer: D) Cannot assess without an image
Explanation: Without an image, the anatomical structure between the examiner’s hands cannot
be identified. Possible structures in the neck include the thyroid, trachea, or sternocleidomastoid,
but visual confirmation is required.
Question 4: A 19-year-old African-American female presents to the clinic with moderate to
severe right lower quadrant abdominal pain for the last 2 days. She has been experiencing nausea
and vomiting but is unsure if she has had a fever. Which of the following is a possible
differential diagnosis?
A) Appendicitis
B) Urinary tract infection
C) Diverticulitis
D) Cholecystitis
Correct Answer: A) Appendicitis
Explanation: Right lower quadrant pain with nausea and vomiting in a young female strongly
suggests appendicitis. Diverticulitis and cholecystitis typically occur in older patients or involve
different locations, and urinary tract infections cause dysuria or flank pain.
Question 5: A 15-day-old infant girl is brought to the outpatient clinic by her mother on a
Monday morning. The mother is concerned about a rash that seems to have appeared suddenly
after spending the previous weekend in Florida visiting family. The time of year is August and
the house did not have air conditioning. The infant is afebrile, eating and drinking well, and does
not appear to be in distress. You note scattered vesicles on an erythematous base involving the
infant’s face and trunk. Based on the history and physical examination findings, what is the
likely diagnosis?
A) Miliaria rubra
B) Varicella
C) Erythema toxicum neonatorum
D) Impetigo
, Correct Answer: A) Miliaria rubra
Explanation: Scattered vesicles on an erythematous base in a neonate, triggered by heat in a
non-air-conditioned environment, suggest miliaria rubra (heat rash). Varicella is unlikely without
fever, erythema toxicum occurs earlier, and impetigo involves pustules.
Question 6: A 48-year-old high school librarian comes to your clinic, complaining of 1 week of
heavy discharge causing severe itching. She is not presently sexually active and has had no
burning with urination. The symptoms started several days after her last period. She just finished
a course of antibiotics for a sinus infection. Her past medical history consists of type 2 diabetes
and high blood pressure. She is widowed and has three children. She denies tobacco, alcohol, or
drug use. Her mother has high blood pressure and her father died of diabetes complications. On
examination you see a healthy appearing woman. Her blood pressure is 130/80 and her pulse is
70. Her head, eyes, ears, nose, throat, cardiac, lung, and abdominal examinations are
unremarkable. Palpation of the inguinal lymph nodes is unremarkable. On visualization of the
vulva, a thick, white, curdy discharge is seen at the introitus. On speculum examination there is a
copious amount of this discharge. The pH of the discharge is 4.1 and the KOH whiff test is
negative, with no unusual smell. Wet prep shows budding hyphae. What vaginitis does this
patient most likely have?
A) Bacterial vaginosis
B) Trichomoniasis
C) Candida vaginitis
D) Atrophic vaginitis
Correct Answer: C) Candida vaginitis
Explanation: Thick, white, curdy discharge, severe itching, pH 4.1, negative KOH whiff test,
and budding hyphae on wet prep indicate Candida vaginitis, often triggered by antibiotics.
Bacterial vaginosis and trichomoniasis have different pH and microscopy findings, and atrophic
vaginitis is unlikely in a premenopausal woman.
Question 7: A 32-year-old female presents with a complaint of a singular breast mass. The nurse
practitioner collects a thorough history and physical examination of the client’s breast and
related systems. Based on the characteristics of a soft, round, mobile, and tender mass, as well as
the client’s age, select the most likely cause of the breast mass.
A) Fibroadenoma
B) Breast cancer
C) Fibrocystic changes
