NR509 ADVANCED PHYSICAL ASSESSMENT EXAM NEWEST
2025/2026 COMPLETE QUESTIONS AND CORRECT D, Exams of
Nursing
Which of the following complaints/findings is considered to be a patient identifier for
mental health screening?
a. High use of health services due to chronic unstable medical diagnoses
b. Symptoms lasting for >2 weeks
c. Acute pain syndromes of 10 days' duration that require opiates for relief
d. Substance abuse
e. A patient with type I diabetes and neuropathic pain d. Substance abuse
The focused cardiovascular assessment includes Inspection, palpation, and
auscultation of the chest, neck, and extremities. Percussion is used to determine the
borders of the heart.
A 38-year-old accountant presents to the office with a series of generalized complaints.
He relates that he feels a loss of pleasure in daily activities, has difficulty sleeping, and is
experiencing problems making decisions. Which of the following best explains the
patient's presentation?
a. Substance abuse with anhedonia
b. Bipolar disorder in the early pre-excitatory phase
c. Histrionic personality
d. Depression
e. Antisocial personality d. Depression
Concerning hallucinations, an abnormal perception experienced by a patient, which of
the following statements is true about this abnormality?
a. They include false perceptions associated with dreaming and occurring with falling
asleep and awakening.
b. Objective testing can be performed by a trained neuropsychologist to ascertain the
correct diagnosis associated with this complaint.
c. Although alcoholism may be associated with abnormalities of perception, it is not
considered a cause of hallucinations as this finding is due to its direct toxic effects.
1|Page
,d. It may occur in association with a number of conditions including delirium and
dementia, posttraumatic stress
disorder (PTSD), and schizophrenia.
e. By definition, hallucinations are confined to those abnormal perceptions that are
either auditory or visual in nature. d. It may occur in association with a number of
conditions including delirium and dementia, posttraumatic stress
disorder (PTSD), and schizophrenia.
A 24-year-old veteran returns from his second tour of duty in the Middle East. He was
witness to a number of violent military encounters and experienced the death of several
of his closest friends. He describes a number of problems including nightmares, poor
sleep pattern, and mild panic attacks. In persons with trauma- and stress-related
disorders as well as other disorders that may be associated with hallucinations and
illusions, which of the following statements is true that distinguishes these two entities
from each other?
a. Illusions occur only when awake, whereas hallucinations can occur both while awake
and while sleeping.
b. Illusions are a misinterpretation of real stimuli, whereas hallucinations are subjective
perceptions in the absence of
real stimuli.
c. Illusions involve an irrational fear or perceptions, whereas hallucinations are a
misinterpretation of real external stimuli.
d. Hallucinations may be b. Illusions are a misinterpretation of real stimuli, whereas
hallucinations are subjective perceptions in the absence of
real stimuli.
Abstract thinking is an important component of the human thought process. A person's
ability to understand questions that test his or her ability to answer appropriately is
dependent upon a number of factors.
Which one of the following answers is true in identifying a patient with concrete
thinking and a reduced ability to think abstractly?
a. An inability to correctly perform serial 7s
b. An inability to spell "world" backward
c. An inability to name the occupations of common well-known public figures such as
the President and Vice President
2|Page
,d. An inability to draw a clock correctly including all numbers and make it tell time as
requested (i.e., 10:15)
e. An inability to discern the similarity between two words (e.g., a cat and a mouse by
answering "The cat chases the
mouse.") e. An inability to discern the similarity between two words (e.g., a cat and
a mouse by answering "The cat chases the
mouse.")
Concerning a patient that may demonstrate a diagnosis of aphasia,
which of the following statements is true?
a. It involves a loss of the voice or a slurring or hoarseness of speech secondary to
pathology of the larynx or its nerve supply.
b. It is best characterized by slurred speech with an associated defect in language
control.
c. It is best characterized by involuntary, rhythmic, repetitive movements involving the
tongue and jaws making speech difficult to comprehend.
d. The ability to write a full correct sentence does not rule out the presence of aphasia in
a patient.
e. It is defined as an inability to produce or understand language. e. It is defined as an
inability to produce or understand language.
A 42-year-old fair-skinned woman of Irish origin presents with an abnormal skin growth
that was first noted 7 years ago. On examination, a 2 × 3-cm lesion is noted over her left
bicep. Which of the following historical elements most increases the suspicion that the
lesion is malignant?
a. No evolution in size since onset, but mild intermittent pruritus over the last 2 yearsb.
No evolution in size since onset, but uniformly darkly pigmented color
c. Minimal but discernible increase in size over the past 6 months
d. Presence of similar pinkish tan lesions on the sun-exposed areas including the face
and hands
e. Proximal location, that is, over the bicep rather than the distal arm c. Minimal
but discernible increase in size over the past 6 months
A 17-year-old woman presents with her parents to her primary care provider. She
desires to utilize a tanning facility ahead of an upcoming event. Her parents have heard
that this is a dangerous practice, although the tanning facility insists it is safe without
3|Page
, risk of skin cancer in the future after tanning. Which of the following is true regarding
ultraviolet (UV) light exposure and subsequent risk of skin cancer?
a. Chronic sun exposure confers greater risk for skin cancer than intermittent intensive
exposure.
b. Tanning beds and sunlamps do not increase risks of skin cancer as they utilize UV
wavelengths that are not carcinogenic.
c. Water-resistant sunscreens confer no advantage over water-soluble products.
d. Targeted messaging and practitioner reinforcement in primary care amplify sun-
protective behaviors.
e. Sunscreen with a sun protective factor (SPF) of 15 blocks ~50% of UV-B light. d.
Targeted messaging and practitioner reinforcement in primary care amplify sun-
protective behaviors.
A 52-year-old male presents for an annual examination. He discloses on review of family
history that his father has died of skin cancer since his last visit. He personally has had
two actinic keratoses frozen and has further lesions that require evaluation today. He is
very concerned about his personal and family history and would like to know more
about the potential for skin cancer to spread and become a dangerous condition. Which
of the following skin lesions is the least likely to metastasize?
a. Squamous cell carcinoma (SCC)
b. Actinic keratosis
c. Melanoma
d. Seborrheic keratosis
e. Basal cell carcinoma (BCC) d. Seborrheic keratosis
A 62-year-old manual laborer presents to an annual physical examination with concerns
about skin cancer screening. He does not have any lesions of concern but was recently
told by a friend that he should have his skin checked by a doctor yearly. What is the best
advice for this patient according to the U.S. Preventive Services Task Force (USPSTF)
recommendations on skin cancer screening from 2015?
a. The USPSTF recommends that all individual age >50 years be screened yearly for skin
cancer regardless of risk factors.
4|Page
2025/2026 COMPLETE QUESTIONS AND CORRECT D, Exams of
Nursing
Which of the following complaints/findings is considered to be a patient identifier for
mental health screening?
a. High use of health services due to chronic unstable medical diagnoses
b. Symptoms lasting for >2 weeks
c. Acute pain syndromes of 10 days' duration that require opiates for relief
d. Substance abuse
e. A patient with type I diabetes and neuropathic pain d. Substance abuse
The focused cardiovascular assessment includes Inspection, palpation, and
auscultation of the chest, neck, and extremities. Percussion is used to determine the
borders of the heart.
A 38-year-old accountant presents to the office with a series of generalized complaints.
He relates that he feels a loss of pleasure in daily activities, has difficulty sleeping, and is
experiencing problems making decisions. Which of the following best explains the
patient's presentation?
a. Substance abuse with anhedonia
b. Bipolar disorder in the early pre-excitatory phase
c. Histrionic personality
d. Depression
e. Antisocial personality d. Depression
Concerning hallucinations, an abnormal perception experienced by a patient, which of
the following statements is true about this abnormality?
a. They include false perceptions associated with dreaming and occurring with falling
asleep and awakening.
b. Objective testing can be performed by a trained neuropsychologist to ascertain the
correct diagnosis associated with this complaint.
c. Although alcoholism may be associated with abnormalities of perception, it is not
considered a cause of hallucinations as this finding is due to its direct toxic effects.
1|Page
,d. It may occur in association with a number of conditions including delirium and
dementia, posttraumatic stress
disorder (PTSD), and schizophrenia.
e. By definition, hallucinations are confined to those abnormal perceptions that are
either auditory or visual in nature. d. It may occur in association with a number of
conditions including delirium and dementia, posttraumatic stress
disorder (PTSD), and schizophrenia.
A 24-year-old veteran returns from his second tour of duty in the Middle East. He was
witness to a number of violent military encounters and experienced the death of several
of his closest friends. He describes a number of problems including nightmares, poor
sleep pattern, and mild panic attacks. In persons with trauma- and stress-related
disorders as well as other disorders that may be associated with hallucinations and
illusions, which of the following statements is true that distinguishes these two entities
from each other?
a. Illusions occur only when awake, whereas hallucinations can occur both while awake
and while sleeping.
b. Illusions are a misinterpretation of real stimuli, whereas hallucinations are subjective
perceptions in the absence of
real stimuli.
c. Illusions involve an irrational fear or perceptions, whereas hallucinations are a
misinterpretation of real external stimuli.
d. Hallucinations may be b. Illusions are a misinterpretation of real stimuli, whereas
hallucinations are subjective perceptions in the absence of
real stimuli.
Abstract thinking is an important component of the human thought process. A person's
ability to understand questions that test his or her ability to answer appropriately is
dependent upon a number of factors.
Which one of the following answers is true in identifying a patient with concrete
thinking and a reduced ability to think abstractly?
a. An inability to correctly perform serial 7s
b. An inability to spell "world" backward
c. An inability to name the occupations of common well-known public figures such as
the President and Vice President
2|Page
,d. An inability to draw a clock correctly including all numbers and make it tell time as
requested (i.e., 10:15)
e. An inability to discern the similarity between two words (e.g., a cat and a mouse by
answering "The cat chases the
mouse.") e. An inability to discern the similarity between two words (e.g., a cat and
a mouse by answering "The cat chases the
mouse.")
Concerning a patient that may demonstrate a diagnosis of aphasia,
which of the following statements is true?
a. It involves a loss of the voice or a slurring or hoarseness of speech secondary to
pathology of the larynx or its nerve supply.
b. It is best characterized by slurred speech with an associated defect in language
control.
c. It is best characterized by involuntary, rhythmic, repetitive movements involving the
tongue and jaws making speech difficult to comprehend.
d. The ability to write a full correct sentence does not rule out the presence of aphasia in
a patient.
e. It is defined as an inability to produce or understand language. e. It is defined as an
inability to produce or understand language.
A 42-year-old fair-skinned woman of Irish origin presents with an abnormal skin growth
that was first noted 7 years ago. On examination, a 2 × 3-cm lesion is noted over her left
bicep. Which of the following historical elements most increases the suspicion that the
lesion is malignant?
a. No evolution in size since onset, but mild intermittent pruritus over the last 2 yearsb.
No evolution in size since onset, but uniformly darkly pigmented color
c. Minimal but discernible increase in size over the past 6 months
d. Presence of similar pinkish tan lesions on the sun-exposed areas including the face
and hands
e. Proximal location, that is, over the bicep rather than the distal arm c. Minimal
but discernible increase in size over the past 6 months
A 17-year-old woman presents with her parents to her primary care provider. She
desires to utilize a tanning facility ahead of an upcoming event. Her parents have heard
that this is a dangerous practice, although the tanning facility insists it is safe without
3|Page
, risk of skin cancer in the future after tanning. Which of the following is true regarding
ultraviolet (UV) light exposure and subsequent risk of skin cancer?
a. Chronic sun exposure confers greater risk for skin cancer than intermittent intensive
exposure.
b. Tanning beds and sunlamps do not increase risks of skin cancer as they utilize UV
wavelengths that are not carcinogenic.
c. Water-resistant sunscreens confer no advantage over water-soluble products.
d. Targeted messaging and practitioner reinforcement in primary care amplify sun-
protective behaviors.
e. Sunscreen with a sun protective factor (SPF) of 15 blocks ~50% of UV-B light. d.
Targeted messaging and practitioner reinforcement in primary care amplify sun-
protective behaviors.
A 52-year-old male presents for an annual examination. He discloses on review of family
history that his father has died of skin cancer since his last visit. He personally has had
two actinic keratoses frozen and has further lesions that require evaluation today. He is
very concerned about his personal and family history and would like to know more
about the potential for skin cancer to spread and become a dangerous condition. Which
of the following skin lesions is the least likely to metastasize?
a. Squamous cell carcinoma (SCC)
b. Actinic keratosis
c. Melanoma
d. Seborrheic keratosis
e. Basal cell carcinoma (BCC) d. Seborrheic keratosis
A 62-year-old manual laborer presents to an annual physical examination with concerns
about skin cancer screening. He does not have any lesions of concern but was recently
told by a friend that he should have his skin checked by a doctor yearly. What is the best
advice for this patient according to the U.S. Preventive Services Task Force (USPSTF)
recommendations on skin cancer screening from 2015?
a. The USPSTF recommends that all individual age >50 years be screened yearly for skin
cancer regardless of risk factors.
4|Page
