Final Exam: NR509 / NR-509 (Latest 2025
/ 2026) Advanced Physical Assessment |
Study Set Questions with Answers | 100%
Correct | Grade A - Chamberlain
A 35-year-old female with a history of migraines presents to the clinic with worsening
symptoms for the past few weeks. She reports waking up at night with headaches and
nausea. Her only medication history is oral contraceptive pills (OCPs). Otherwise, she states
she is healthy. Which of the following actions if taken by the NP is the best next step?
Take a further history and perform a very careful neurological exam
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
A 32-year-old primigravid woman is at 27 weeks gestation. She presents with nausea,
vomiting, urinary frequency, discomfort in the lower abdomen, tenderness over the
suprapubic area, and severe constipation. Which of the following is true regarding these
pregnancy symptoms?
Iron supplementation, hormonal changes, slowed intestinal transit, physical pressure from the
gravid uterus, and increased blood volume all contribute to abdominal symptoms in pregnant
women.
A 24-year-old female presents to the clinic concerned that she may be pregnant. Her LMP was
7-weeks ago, and the urine human chorionic gonadotropin (HCG) test is positive. What can
the NP expect to find on physical examination, assuming a normal pregnancy? Select all that
apply
,an internal cervical os closed to the width of a fingertip
a bluish hue to the cervix
A 20-year-old female presents to the clinic with symptoms of fatigue, nausea, and an increase
in urination. She is sexually active, and her male partner uses condoms occasionally. A urine
pregnancy test is positive. Her last menstrual period was 3 months ago (6/20/2021). Using the
Naegele rule, what is the estimated date of delivery (EDD, or due date)?
3/27/22
The NP is conducting a physical assessment on a woman in her 26th week of pregnancy.
Which of the examination finding is worrisome for a potential, emergent condition?
Facial edema
The NP is documenting the obstetric history of a patient. Her history includes two
spontaneous miscarriages at 16- and 24-weeks' gestation, four living children (one set of
twins) who were delivered at term, and a current pregnancy. How would this be
documented?
G6P3024
An 11-month-old infant male is accompanied to the clinic by his father. The father is
concerned about the skin rash on this son's arms represented in this image. Family history is
significant for a 4-year-old sibling with atopic dermatitis and asthma. Which of the following is
the best documentation of the integument findings?
Erythematous, patches and plaques involving the extensor surfaces of the bilateral antecubital
fossa. Mild, secondary excoriations present with serous exudate. No streaking. Scant purulent
drainage
A mother brings her 15-day-old female infant to the outpatient clinic for evaluation of a rash
that appeared suddenly after visiting family in Florida. It 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. The physical assessment findings are represented in this image. Based on the history
and examination findings, what is the likely etiology? ADA Description: Infant with a red,
facial rash.
miliaria rubra
The NP assesses for the Moro Reflex as part of an infant routine physical examination. The NP
should suspect a neurologic disease if the reflex has not disappeared by what specific
timeframe?
,16 weeks
A 2-month-old female is accompanied by her parents for her first visit to the practice. When
reviewing the hospital medical records of her birth, the NP notes documentation regarding
significantly edematous hands and feet present at birth. Upon physical examination of the
infant, the NP finds skin folds that run along the sides of the neck down to the shoulders.
Which of the following should be assessed and monitored by the NP and parents related to
these findings? Select all that apply.
The infant's growth chart with concern for height and length.
The infant's ability to properly latch during breastfeeding.
The infant's fluid gain or loss.
The NP is observing a female pediatric patient during a routine physical. She can jump in place
and balance on one foot. She speaks in full sentences and her mother states that she can feed
herself. Based on your observations and the history, determine her developmental age
4 years
The NP is observing a full-term infant male. He can pull to a stand, use "mama" and "dada"
specifically, and indicates his wants by vocalization and pointing. Based on your observations,
determine his developmental age.
12 months
Of the following statements, which is accurate regarding growth and assessment charts
published by the National Center for Health Statistics? Select all that apply.
All charts include height, weight, and head circumference for children up to 36 months.
Growth charts are available for children with specific conditions such as Down syndrome or
Turner syndrome.
Growth charts are available for use in infants born prematurely.
A 25-year-old male presents to the clinic with a complaint of severe rectal pain during
defecation. The pain is so severe he waits several days before having a bowel movement. He
has a history of ulcerative colitis (UC). He also reports being in an active sexual new
relationship with a male partner. After conducting a history and physical exam, the NP
documents the following anorectal findings: Perirectal area inflamed; no ulcerations, open
sores, fissures, or verruca. Scant, whiteyellow, mucoid, rectal discharge noted. Unable to
, examine external sphincter, rectal vault, or prostate because of spasm of the external
sphincter and marked inflammation and tenderness of anal canal. Which of the following is
the most accurate interpretation of these findings?
These findings suggest infectious proctitis
A 54-year-old female with a history of migraines since childhood presents to the clinic with
chronic intermittent, progressive pulsatile headaches which are similar in nature to prior
attacks and precipitated by current life stressors. The headaches are accompanied by nausea
and vomiting. She denies constitutional symptoms. On examination, she has elevated blood
pressure but otherwise a normal cardiovascular, neurologic, and fundoscopic examination.
Based on the history and physical examination findings, which diagnoses are appropriate for
the differential diagnosis (DDx) list? Select all that apply.
Migraine
Tension
A 50-year-old female presents to the clinic for evaluation of neck stiffness and aching pain.
She was a restrained driver in a low-speed, rear-end, motor vehicle collision 1 day ago. The
pain started several hours after the accident. On physical examination, you note muscle
spasms over the paraspinous muscles on the left side of the neck, as well as pain reported
during active range of motion of the cervical spine. No neurological deficits are noted. Which
of the following is the most accurate interpretation of these findings?
These findings suggest cervical strain
Which muscle(s) are being assessed during active rotation of the neck?
Sternocleidomastoid
A 34-year-old female presents to the office with left elbow pain following rigorous training for
a tennis match. Tenderness is noted with palpation in the area on the image marked by the
red circle. What correlative diagnosis does this assessment finding indicate? ADA Description:
Left elbow with emphasis on the small, tuberculated eminence, curved a little forward, about
1 cm from the joint.
lateral epicondylitis
A 35-year-old male presents to the clinic for a routine physical examination. His only
complaint is a feeling of heaviness in his scrotum. He denies injury or trauma. After
conducting a history and physical, the NP documents the following genitourinary (GU)
findings: Uncircumcised penis; prepuce easily retractable. No penile discharge or lesions. No
scrotal swelling or discoloration. Testes descended bilaterally; right testicle smooth; 1 × 1 cm
/ 2026) Advanced Physical Assessment |
Study Set Questions with Answers | 100%
Correct | Grade A - Chamberlain
A 35-year-old female with a history of migraines presents to the clinic with worsening
symptoms for the past few weeks. She reports waking up at night with headaches and
nausea. Her only medication history is oral contraceptive pills (OCPs). Otherwise, she states
she is healthy. Which of the following actions if taken by the NP is the best next step?
Take a further history and perform a very careful neurological exam
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
A 32-year-old primigravid woman is at 27 weeks gestation. She presents with nausea,
vomiting, urinary frequency, discomfort in the lower abdomen, tenderness over the
suprapubic area, and severe constipation. Which of the following is true regarding these
pregnancy symptoms?
Iron supplementation, hormonal changes, slowed intestinal transit, physical pressure from the
gravid uterus, and increased blood volume all contribute to abdominal symptoms in pregnant
women.
A 24-year-old female presents to the clinic concerned that she may be pregnant. Her LMP was
7-weeks ago, and the urine human chorionic gonadotropin (HCG) test is positive. What can
the NP expect to find on physical examination, assuming a normal pregnancy? Select all that
apply
,an internal cervical os closed to the width of a fingertip
a bluish hue to the cervix
A 20-year-old female presents to the clinic with symptoms of fatigue, nausea, and an increase
in urination. She is sexually active, and her male partner uses condoms occasionally. A urine
pregnancy test is positive. Her last menstrual period was 3 months ago (6/20/2021). Using the
Naegele rule, what is the estimated date of delivery (EDD, or due date)?
3/27/22
The NP is conducting a physical assessment on a woman in her 26th week of pregnancy.
Which of the examination finding is worrisome for a potential, emergent condition?
Facial edema
The NP is documenting the obstetric history of a patient. Her history includes two
spontaneous miscarriages at 16- and 24-weeks' gestation, four living children (one set of
twins) who were delivered at term, and a current pregnancy. How would this be
documented?
G6P3024
An 11-month-old infant male is accompanied to the clinic by his father. The father is
concerned about the skin rash on this son's arms represented in this image. Family history is
significant for a 4-year-old sibling with atopic dermatitis and asthma. Which of the following is
the best documentation of the integument findings?
Erythematous, patches and plaques involving the extensor surfaces of the bilateral antecubital
fossa. Mild, secondary excoriations present with serous exudate. No streaking. Scant purulent
drainage
A mother brings her 15-day-old female infant to the outpatient clinic for evaluation of a rash
that appeared suddenly after visiting family in Florida. It 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. The physical assessment findings are represented in this image. Based on the history
and examination findings, what is the likely etiology? ADA Description: Infant with a red,
facial rash.
miliaria rubra
The NP assesses for the Moro Reflex as part of an infant routine physical examination. The NP
should suspect a neurologic disease if the reflex has not disappeared by what specific
timeframe?
,16 weeks
A 2-month-old female is accompanied by her parents for her first visit to the practice. When
reviewing the hospital medical records of her birth, the NP notes documentation regarding
significantly edematous hands and feet present at birth. Upon physical examination of the
infant, the NP finds skin folds that run along the sides of the neck down to the shoulders.
Which of the following should be assessed and monitored by the NP and parents related to
these findings? Select all that apply.
The infant's growth chart with concern for height and length.
The infant's ability to properly latch during breastfeeding.
The infant's fluid gain or loss.
The NP is observing a female pediatric patient during a routine physical. She can jump in place
and balance on one foot. She speaks in full sentences and her mother states that she can feed
herself. Based on your observations and the history, determine her developmental age
4 years
The NP is observing a full-term infant male. He can pull to a stand, use "mama" and "dada"
specifically, and indicates his wants by vocalization and pointing. Based on your observations,
determine his developmental age.
12 months
Of the following statements, which is accurate regarding growth and assessment charts
published by the National Center for Health Statistics? Select all that apply.
All charts include height, weight, and head circumference for children up to 36 months.
Growth charts are available for children with specific conditions such as Down syndrome or
Turner syndrome.
Growth charts are available for use in infants born prematurely.
A 25-year-old male presents to the clinic with a complaint of severe rectal pain during
defecation. The pain is so severe he waits several days before having a bowel movement. He
has a history of ulcerative colitis (UC). He also reports being in an active sexual new
relationship with a male partner. After conducting a history and physical exam, the NP
documents the following anorectal findings: Perirectal area inflamed; no ulcerations, open
sores, fissures, or verruca. Scant, whiteyellow, mucoid, rectal discharge noted. Unable to
, examine external sphincter, rectal vault, or prostate because of spasm of the external
sphincter and marked inflammation and tenderness of anal canal. Which of the following is
the most accurate interpretation of these findings?
These findings suggest infectious proctitis
A 54-year-old female with a history of migraines since childhood presents to the clinic with
chronic intermittent, progressive pulsatile headaches which are similar in nature to prior
attacks and precipitated by current life stressors. The headaches are accompanied by nausea
and vomiting. She denies constitutional symptoms. On examination, she has elevated blood
pressure but otherwise a normal cardiovascular, neurologic, and fundoscopic examination.
Based on the history and physical examination findings, which diagnoses are appropriate for
the differential diagnosis (DDx) list? Select all that apply.
Migraine
Tension
A 50-year-old female presents to the clinic for evaluation of neck stiffness and aching pain.
She was a restrained driver in a low-speed, rear-end, motor vehicle collision 1 day ago. The
pain started several hours after the accident. On physical examination, you note muscle
spasms over the paraspinous muscles on the left side of the neck, as well as pain reported
during active range of motion of the cervical spine. No neurological deficits are noted. Which
of the following is the most accurate interpretation of these findings?
These findings suggest cervical strain
Which muscle(s) are being assessed during active rotation of the neck?
Sternocleidomastoid
A 34-year-old female presents to the office with left elbow pain following rigorous training for
a tennis match. Tenderness is noted with palpation in the area on the image marked by the
red circle. What correlative diagnosis does this assessment finding indicate? ADA Description:
Left elbow with emphasis on the small, tuberculated eminence, curved a little forward, about
1 cm from the joint.
lateral epicondylitis
A 35-year-old male presents to the clinic for a routine physical examination. His only
complaint is a feeling of heaviness in his scrotum. He denies injury or trauma. After
conducting a history and physical, the NP documents the following genitourinary (GU)
findings: Uncircumcised penis; prepuce easily retractable. No penile discharge or lesions. No
scrotal swelling or discoloration. Testes descended bilaterally; right testicle smooth; 1 × 1 cm
