NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
NEWEST 2025/2026 COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |BRAND NEW
VERSION!!
A concerned mother brings her 9-year-old daughter to the clinic with several days
of a diffuse rash on the trunk. The child was previously healthy and is current on
her vaccinations. The mother relates a history of decreased appetite, easy fatigue,
and low-grade subjective fevers. On examination, temperature is recorded at
100.5ºF, the rash is confirmed as described by the mother, and additional physical
findings of a strawberry tongue and erythema of the palms and soles are noted.
Nonpainful peeling of the skin of the child's fingertips is noted incidentally. Based
on the history and physical findings, which is the most likely diagnosis and course
of action?
a. Nonspecific viral exanthem, for which observant management is advised
b. Contact dermatitis, for which antihistamines are indicated
c. Measles, for which review of the vaccination history is critical
d. Kawasaki disease, for which close monitoring and possibly hospitalization might
be required
e. Strep throat, for which amoxicillin is indicated
d. Kawasaki disease, for which close monitoring and possibly hospitalization might
be required
A 16-year-old male high school student presents with a primary concern of acne.
He relates a history of 2 years of moderate mild acne and closed comedones
(whiteheads), which have recently worsened such that a classmate started calling
him a pirate due to a large pustule that developed at the tip of his nose. He has
increasing outbreaks of cyst-like acne as well as a generally poor complexion with
pitting and scarring from prior outbreaks. Which of the following best describes
this condition in the adolescent population?
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, NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
a. Acne vulgaris affects <50% of the adolescent population.
b. Acne vulgaris is associated with an identified virus for which there is no
definitive treatment.
c. Acne vulgaris is associated with blockage of sebaceous glands, stress, humidity,
and heavy sweating as well as other contributory factors.
d. The primary hormonal stimulus for acne vulgaris is estrogen, causing
preferentially worse cases in females and males with lower testosterone levels.
e. Acne vulgaris is always associated with underlying endocrine disorders and/or
pituitary dysfunction.
c. Acne vulgaris is associated with blockage of sebaceous glands, stress, humidity,
and heavy sweating as well as other contributory factors.
A 72-year-old woman presents with concerns about several ruby-red spots on her
chest and abdomen. She reports that these are growing in both size and number
over time. On examination, the provider notes a number of cherry angiomas at
the locations indicated by the patient. No other abnormalities are noted. Which of
the following best describes the clinical characteristics and significance of a cherry
angioma?
a. Cherry angiomas never show blanching under pressure.
b. Cherry angiomas are associated with liver disease and B vitamin deficiencies.
c. Cherry angiomas are benign and may increase in size and number with aging.
d. Cherry angiomas rarely occur on the trunk and are most often noted on the legs
near veins.
e. Cherry angiomas are a marker for underlying pathology that requires additional
evaluation.
c. Cherry angiomas are benign and may increase in size and number with aging.
A 28-year-old male business executive presents to a primary care provider with
concerns about hair loss. He is otherwise healthy without chronic medical
conditions or current medications. He has a chart history of allergy to sulfa
medications, although this happened when he was a young child, and he does not
2|Page
, NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
recall the incident or the reaction. He is unsure at what age his father went bald,
as he never remembers his father having hair. He remarks jokingly that he is losing
more hair than his dogs at home, who shed frequently but are otherwise healthy.
On examination, he has a single uniform oval patch of hair loss over the left
temporal area without any scaling, inflammation, or other skin changes where the
hair is missing. Which of the following is the most likely explanation for his hair
loss?
a. Male pattern baldness, as evidenced by his father's baldness at a young age
b. Tinea capitis, as evidenced by his exposure to animals that may carry this
pathogen
c. Trichotillomania, as evidenced by his anxiety and need to diffuse uncomfortable
situations with inappropriate humor
d. Alopecia areata, as evidenced by patchy hair loss without associated skin
changes
e. Drug rash, as evidenced by his allergy to sulfa drugs
d. Alopecia areata, as evidenced by patchy hair loss without associated skin
changes
A 33-year-old nurse presents with a history of weight gain, decreased energy, and
menorrhagia over the past several months. Review of her family history reveals
Hashimoto thyroiditis and hypothyroidism in four female first-degree relatives (her
mother and three sisters). Which of the following skin findings best supports a
diagnosis of clinical hypothyroidism?
a. Discoid rash, alopecia, oral ulcers, and Raynaud phenomenon
b. Warm moist skin, hyperpigmentation, and pretibial myxedema
c. Dry skin, myxedema, alopecia of the eyebrows, and brittle nails
d. Spider angiomas, telangiectasia, palmar erythema, and Terry nails
e. Thickened, taut skin with sclerodactyly and telangiectasia
c. Dry skin, myxedema, alopecia of the eyebrows, and brittle nails
3|Page
, NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
A 74-year-old man is being seen because of a 1-day history of a painful right eye.
He also mentions that he has blurred vision in that eye. He thought something
had blown into his eye, but after flushing it out, the pain and blurred vision
remains. What is the best course of action?
a. Reassure him that pain from a foreign body can remain for a day or two (even
after the foreign body is removed).
b. Perform a vision examination.
c. Perform a complete neurological examination.
d. Refer to an ophthalmologist emergently with the possibility of corneal ulcer,
uveitis, or acute glaucoma.
e. Check his blood pressure.
d. Refer to an ophthalmologist emergently with the possibility of corneal ulcer,
uveitis, or acute glaucoma.
An 87-year-old woman who is generally healthy and cognitively sharp complains
to the clinician of slow loss of vision, with similar problems in both eyes,
particularly when she looks straight ahead. She is having difficulty reading of late.
What is a reasonable response to her?
a. "This is a common occurrence with aging and unlikely to have a diagnosis."
b. "This is an unusual occurrence, even among elderly, and may be due to a
problem within the brain (since it is bilateral)."
c. "Are you experiencing depression or stress?"
d. "This may be the onset of macular degeneration, which an ophthalmologist
should confirm."
e. "This is a classic 'floater' and no cause for concern."
d. "This may be the onset of macular degeneration, which an ophthalmologist
should confirm."
A 70-year-old man complains of double vision. Which of the following associated
symptoms or signs would be worrying about an underlying neurological problem
(as opposed to pathology in the eye)?
4|Page
NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
NEWEST 2025/2026 COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) |BRAND NEW
VERSION!!
A concerned mother brings her 9-year-old daughter to the clinic with several days
of a diffuse rash on the trunk. The child was previously healthy and is current on
her vaccinations. The mother relates a history of decreased appetite, easy fatigue,
and low-grade subjective fevers. On examination, temperature is recorded at
100.5ºF, the rash is confirmed as described by the mother, and additional physical
findings of a strawberry tongue and erythema of the palms and soles are noted.
Nonpainful peeling of the skin of the child's fingertips is noted incidentally. Based
on the history and physical findings, which is the most likely diagnosis and course
of action?
a. Nonspecific viral exanthem, for which observant management is advised
b. Contact dermatitis, for which antihistamines are indicated
c. Measles, for which review of the vaccination history is critical
d. Kawasaki disease, for which close monitoring and possibly hospitalization might
be required
e. Strep throat, for which amoxicillin is indicated
d. Kawasaki disease, for which close monitoring and possibly hospitalization might
be required
A 16-year-old male high school student presents with a primary concern of acne.
He relates a history of 2 years of moderate mild acne and closed comedones
(whiteheads), which have recently worsened such that a classmate started calling
him a pirate due to a large pustule that developed at the tip of his nose. He has
increasing outbreaks of cyst-like acne as well as a generally poor complexion with
pitting and scarring from prior outbreaks. Which of the following best describes
this condition in the adolescent population?
1|Page
, NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
a. Acne vulgaris affects <50% of the adolescent population.
b. Acne vulgaris is associated with an identified virus for which there is no
definitive treatment.
c. Acne vulgaris is associated with blockage of sebaceous glands, stress, humidity,
and heavy sweating as well as other contributory factors.
d. The primary hormonal stimulus for acne vulgaris is estrogen, causing
preferentially worse cases in females and males with lower testosterone levels.
e. Acne vulgaris is always associated with underlying endocrine disorders and/or
pituitary dysfunction.
c. Acne vulgaris is associated with blockage of sebaceous glands, stress, humidity,
and heavy sweating as well as other contributory factors.
A 72-year-old woman presents with concerns about several ruby-red spots on her
chest and abdomen. She reports that these are growing in both size and number
over time. On examination, the provider notes a number of cherry angiomas at
the locations indicated by the patient. No other abnormalities are noted. Which of
the following best describes the clinical characteristics and significance of a cherry
angioma?
a. Cherry angiomas never show blanching under pressure.
b. Cherry angiomas are associated with liver disease and B vitamin deficiencies.
c. Cherry angiomas are benign and may increase in size and number with aging.
d. Cherry angiomas rarely occur on the trunk and are most often noted on the legs
near veins.
e. Cherry angiomas are a marker for underlying pathology that requires additional
evaluation.
c. Cherry angiomas are benign and may increase in size and number with aging.
A 28-year-old male business executive presents to a primary care provider with
concerns about hair loss. He is otherwise healthy without chronic medical
conditions or current medications. He has a chart history of allergy to sulfa
medications, although this happened when he was a young child, and he does not
2|Page
, NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
recall the incident or the reaction. He is unsure at what age his father went bald,
as he never remembers his father having hair. He remarks jokingly that he is losing
more hair than his dogs at home, who shed frequently but are otherwise healthy.
On examination, he has a single uniform oval patch of hair loss over the left
temporal area without any scaling, inflammation, or other skin changes where the
hair is missing. Which of the following is the most likely explanation for his hair
loss?
a. Male pattern baldness, as evidenced by his father's baldness at a young age
b. Tinea capitis, as evidenced by his exposure to animals that may carry this
pathogen
c. Trichotillomania, as evidenced by his anxiety and need to diffuse uncomfortable
situations with inappropriate humor
d. Alopecia areata, as evidenced by patchy hair loss without associated skin
changes
e. Drug rash, as evidenced by his allergy to sulfa drugs
d. Alopecia areata, as evidenced by patchy hair loss without associated skin
changes
A 33-year-old nurse presents with a history of weight gain, decreased energy, and
menorrhagia over the past several months. Review of her family history reveals
Hashimoto thyroiditis and hypothyroidism in four female first-degree relatives (her
mother and three sisters). Which of the following skin findings best supports a
diagnosis of clinical hypothyroidism?
a. Discoid rash, alopecia, oral ulcers, and Raynaud phenomenon
b. Warm moist skin, hyperpigmentation, and pretibial myxedema
c. Dry skin, myxedema, alopecia of the eyebrows, and brittle nails
d. Spider angiomas, telangiectasia, palmar erythema, and Terry nails
e. Thickened, taut skin with sclerodactyly and telangiectasia
c. Dry skin, myxedema, alopecia of the eyebrows, and brittle nails
3|Page
, NR 509 ADVANCED PHYSICAL ASSESSMENT FINAL EXAM
A 74-year-old man is being seen because of a 1-day history of a painful right eye.
He also mentions that he has blurred vision in that eye. He thought something
had blown into his eye, but after flushing it out, the pain and blurred vision
remains. What is the best course of action?
a. Reassure him that pain from a foreign body can remain for a day or two (even
after the foreign body is removed).
b. Perform a vision examination.
c. Perform a complete neurological examination.
d. Refer to an ophthalmologist emergently with the possibility of corneal ulcer,
uveitis, or acute glaucoma.
e. Check his blood pressure.
d. Refer to an ophthalmologist emergently with the possibility of corneal ulcer,
uveitis, or acute glaucoma.
An 87-year-old woman who is generally healthy and cognitively sharp complains
to the clinician of slow loss of vision, with similar problems in both eyes,
particularly when she looks straight ahead. She is having difficulty reading of late.
What is a reasonable response to her?
a. "This is a common occurrence with aging and unlikely to have a diagnosis."
b. "This is an unusual occurrence, even among elderly, and may be due to a
problem within the brain (since it is bilateral)."
c. "Are you experiencing depression or stress?"
d. "This may be the onset of macular degeneration, which an ophthalmologist
should confirm."
e. "This is a classic 'floater' and no cause for concern."
d. "This may be the onset of macular degeneration, which an ophthalmologist
should confirm."
A 70-year-old man complains of double vision. Which of the following associated
symptoms or signs would be worrying about an underlying neurological problem
(as opposed to pathology in the eye)?
4|Page
