NR509 Advanced Physical Assessment Quiz
Bank 2025/2026 - 120 Questions
SECTION A: COMPREHENSIVE HEALTH ASSESSMENT (25 Q)
1. Advanced Health History (SATA)
During a comprehensive geriatric assessment, which history domains are
essential for 2025 evidence-based care? (Choose 3)
☐ A. Fall risk assessment with Tinetti Performance-Oriented Mobility
Assessment
☐ B. Financial status including retirement income sources
☐ C. Cognitive screening using Mini-Cog with clock drawing
☐ D. Social isolation evaluation using Lubben Social Network Scale
☐ E. Childhood vaccination history review
Answer: A, C, D - 2025 AGS Guidelines mandate fall risk, cognitive screening, and social
isolation assessment for comprehensive geriatric care.
Rationale: These domains directly impact patient safety, independence, and quality of
life in older adults; financial status (B) and childhood vaccines (E) are not priority
domains in geriatric assessment.
2. Complex Documentation
Correct SOAP documentation for abnormal finding:
A. "Patient appears anxious"
B. "HR 110, anxious appearance, requests information"
C. "Anxious patient with tachycardia"
D. "Probably anxious due to lack of information"
Answer: B - Objective data (HR) + subjective (requests) + assessment (anxious
appearance) = proper SOAP format.
,Rationale: SOAP requires objective data first, then subjective, then assessment; avoids
judgmental language.
3. Cultural Competence (2026 Update)
Most appropriate when assessing transgender patient during chest examination:
A. "Do you have breast cancer in your family?"
B. "Do you prefer I examine your chest or call it something else?"
C. "When did you have your breasts removed?"
D. "Do you still have female anatomy?"
Answer: B - 2026 UCSF Guidelines recommend patient-defined terminology and choice
in examination approach.
Rationale: Respects patient identity and avoids assumptions about surgical history or
anatomy; uses open-ended language.
4. Risk Assessment
HEART Score components include all EXCEPT:
A. History
B. ECG
C. Age
D. Troponin
E. CRP
Answer: E - HEART Score = History, ECG, Age, Risk factors, Troponin; CRP not included.
Rationale: 2025 ESC Guidelines confirm HEART Score for chest pain risk stratification;
CRP is inflammatory marker but not component.
5. Evidence-Based Principles
Most reliable evidence source for physical assessment techniques:
A. Textbook from 2020
B. 2025 AHA/ACC Clinical Practice Guidelines
C. Social media nursing discussions
D. Personal experience only
Answer: B - 2025 Guidelines represent current evidence-based standards.
, Rationale: Guidelines undergo systematic review and expert consensus; most current
and reliable.
SECTION B: SYSTEM-SPECIFIC ADVANCED ASSESSMENT (45 Q)
Neurological Advanced (8 Q)
6. Cranial Nerves (SATA)
Correct techniques for cranial nerve assessment: (Choose 3)
☐ A. CN III: "Follow my finger" horizontal/vertical movement
☐ B. CN V: Corneal reflex with cotton wisp
☐ C. CN VIII: Whisper test at 2 feet
☐ D. CN XII: "Stick out your tongue" while observing deviation
☐ E. CN II: Confrontation test at 6 feet
Answer: A, B, D - Correct techniques for CN III, V, XII assessment.
Rationale: CN VIII uses Rinne/Weber (not whisper at 2 feet); CN II uses confrontation at
2 feet (not 6).
7. Cerebellar Function (Priority)
65-year-old with gait unsteadiness, positive Romberg. Next assessment:
A. Finger-to-nose test
B. Heel-to-shin test
C. Gait assessment with tandem walking
D. Dix-Hallpike maneuver
Answer: C - Positive Romberg suggests proprioceptive deficit; tandem gait assesses
cerebellar function.
Rationale: Tandem walking is most specific for cerebellar/proprioceptive function;
Dix-Hallpike for BPPV.
8. Sensory Testing
Correct pattern for diabetic neuropathy screening:
A. Stocking-glove distribution
Bank 2025/2026 - 120 Questions
SECTION A: COMPREHENSIVE HEALTH ASSESSMENT (25 Q)
1. Advanced Health History (SATA)
During a comprehensive geriatric assessment, which history domains are
essential for 2025 evidence-based care? (Choose 3)
☐ A. Fall risk assessment with Tinetti Performance-Oriented Mobility
Assessment
☐ B. Financial status including retirement income sources
☐ C. Cognitive screening using Mini-Cog with clock drawing
☐ D. Social isolation evaluation using Lubben Social Network Scale
☐ E. Childhood vaccination history review
Answer: A, C, D - 2025 AGS Guidelines mandate fall risk, cognitive screening, and social
isolation assessment for comprehensive geriatric care.
Rationale: These domains directly impact patient safety, independence, and quality of
life in older adults; financial status (B) and childhood vaccines (E) are not priority
domains in geriatric assessment.
2. Complex Documentation
Correct SOAP documentation for abnormal finding:
A. "Patient appears anxious"
B. "HR 110, anxious appearance, requests information"
C. "Anxious patient with tachycardia"
D. "Probably anxious due to lack of information"
Answer: B - Objective data (HR) + subjective (requests) + assessment (anxious
appearance) = proper SOAP format.
,Rationale: SOAP requires objective data first, then subjective, then assessment; avoids
judgmental language.
3. Cultural Competence (2026 Update)
Most appropriate when assessing transgender patient during chest examination:
A. "Do you have breast cancer in your family?"
B. "Do you prefer I examine your chest or call it something else?"
C. "When did you have your breasts removed?"
D. "Do you still have female anatomy?"
Answer: B - 2026 UCSF Guidelines recommend patient-defined terminology and choice
in examination approach.
Rationale: Respects patient identity and avoids assumptions about surgical history or
anatomy; uses open-ended language.
4. Risk Assessment
HEART Score components include all EXCEPT:
A. History
B. ECG
C. Age
D. Troponin
E. CRP
Answer: E - HEART Score = History, ECG, Age, Risk factors, Troponin; CRP not included.
Rationale: 2025 ESC Guidelines confirm HEART Score for chest pain risk stratification;
CRP is inflammatory marker but not component.
5. Evidence-Based Principles
Most reliable evidence source for physical assessment techniques:
A. Textbook from 2020
B. 2025 AHA/ACC Clinical Practice Guidelines
C. Social media nursing discussions
D. Personal experience only
Answer: B - 2025 Guidelines represent current evidence-based standards.
, Rationale: Guidelines undergo systematic review and expert consensus; most current
and reliable.
SECTION B: SYSTEM-SPECIFIC ADVANCED ASSESSMENT (45 Q)
Neurological Advanced (8 Q)
6. Cranial Nerves (SATA)
Correct techniques for cranial nerve assessment: (Choose 3)
☐ A. CN III: "Follow my finger" horizontal/vertical movement
☐ B. CN V: Corneal reflex with cotton wisp
☐ C. CN VIII: Whisper test at 2 feet
☐ D. CN XII: "Stick out your tongue" while observing deviation
☐ E. CN II: Confrontation test at 6 feet
Answer: A, B, D - Correct techniques for CN III, V, XII assessment.
Rationale: CN VIII uses Rinne/Weber (not whisper at 2 feet); CN II uses confrontation at
2 feet (not 6).
7. Cerebellar Function (Priority)
65-year-old with gait unsteadiness, positive Romberg. Next assessment:
A. Finger-to-nose test
B. Heel-to-shin test
C. Gait assessment with tandem walking
D. Dix-Hallpike maneuver
Answer: C - Positive Romberg suggests proprioceptive deficit; tandem gait assesses
cerebellar function.
Rationale: Tandem walking is most specific for cerebellar/proprioceptive function;
Dix-Hallpike for BPPV.
8. Sensory Testing
Correct pattern for diabetic neuropathy screening:
A. Stocking-glove distribution
