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NR509 Week 4 Midterm Exam Due March 2026 Complete
Actual Exam Questions 1- 100 NR-509 Advanced Physical
Assessment NR 509 Midterm and Finals Examplify Online
Proctored Exam Questions and Answers | 100% Pass
Guaranteed | Graded A+
Domain 1: Interviewing, Health History, and General Survey (Q1-10)
Q1. A 55-year-old patient presents with a 3-week history of fatigue. The nurse
practitioner asks, "What do you mean when you say you feel tired?" This is an
example of which interviewing technique?
A. Clarification
B. Confrontation
C. Reflection
D. Facilitation
Correct Answer: A
Rationale: Clarification asks the patient to explain or elaborate on a vague or
ambiguous statement, ensuring the clinician understands the patient's experience
accurately.
Q1 – Rotation. A patient says, "I just can't take it anymore." The nurse
practitioner responds, "You feel overwhelmed right now?" This is an example of:
A. Clarification
B. Reflection
C. Empathy
D. Summarization
Correct Answer: B
Rationale: Reflection echoes the patient's implied feelings, encouraging them to
recognize and express emotions. It helps build rapport.
pg. 1
,2
Q2. The review of systems (ROS) is best described as:
A. A detailed chronological account of the present illness
B. A head-to-toe series of questions about past and present symptoms organized
by body system
C. A list of all previous diagnoses, surgeries, and hospitalizations
D. An assessment of the patient's psychological and social history
Correct Answer: B
Rationale: The ROS is a systematic inventory of symptoms organized by body
system, designed to uncover problems the patient may have forgotten or not
thought to mention. It is part of the health history, not the physical exam.
Q2 – Rotation. Which of the following belongs in the past medical history, not the
review of systems?
A. "Have you had any chest pain in the past month?"
B. "Do you have a history of high blood pressure?"
C. "Have you noticed any changes in your vision?"
D. "Do you have any shortness of breath?"
Correct Answer: B
Rationale: Established diagnoses belong in past medical history. The ROS elicits
current or recent symptoms. This distinction is critical for accurate
documentation.
Q3. During the general survey, the nurse practitioner notes the patient has a
stooped posture, walks with short shuffling steps, and has minimal arm swing
bilaterally. These findings are most consistent with:
A. Cerebellar ataxia
B. Parkinson's disease
C. Osteoarthritis of the hips
D. Peripheral neuropathy
Correct Answer: B
Rationale: The triad of stooped posture, shuffling gait (festination), and reduced
pg. 2
,3
arm swing is classic for Parkinson's disease, an extrapyramidal movement
disorder caused by dopamine deficiency in the basal ganglia.
Q3 – Rotation. A patient with a wide-based, unsteady gait, who cannot walk heel-
to-toe in a straight line, is demonstrating:
A. Parkinsonian gait
B. Tandem gait abnormality suggestive of cerebellar dysfunction
C. Antalgic gait
D. Steppage gait
Correct Answer: B
Rationale: Difficulty with tandem gait (heel-to-toe walking) indicates cerebellar
ataxia. The cerebellum coordinates smooth, balanced movements; dysfunction
produces a wide-based, unsteady gait.
Q4. A patient with chronic atrial fibrillation has blood pressure measured by an
automated device that gives three different readings: 132/78, 118/72, and 142/85
mm Hg. The most accurate approach to documenting this patient's blood
pressure is:
A. Average the three readings and document the mean
B. Take multiple manual measurements and document the range or use 24-hour
ambulatory monitoring
C. Use only the first reading as it is most reliable
D. Document the patient as hypertensive based on the highest reading
Correct Answer: B
Rationale: Atrial fibrillation causes beat-to-beat variability in stroke volume,
leading to inconsistent blood pressure readings. A single automated reading is
unreliable. Manual measurement with multiple readings or 24-hour ambulatory
monitoring provides a more accurate estimate.
Q5. Orthostatic vital signs are indicated for a patient complaining of:
A. Headache and nausea
B. Dizziness upon standing
pg. 3
, 4
C. Bilateral lower extremity edema
D. Intermittent claudication
Correct Answer: B
Rationale: Orthostatic (postural) vital signs assess for a significant drop in blood
pressure or increase in heart rate when changing from supine to standing
position. They are indicated for patients reporting dizziness, lightheadedness, or
syncope upon standing.
Q5 – Rotation. Orthostatic hypotension is diagnosed when there is a sustained
reduction of systolic blood pressure of at least ____ mm Hg within 3 minutes of
standing.
A. 10
B. 15
C. 20
D. 30
Correct Answer: C
Rationale: Orthostatic hypotension is defined as a drop in SBP ≥20 mm Hg or DBP
≥10 mm Hg within 3 minutes of standing. This is a sign of autonomic dysfunction,
volume depletion, or medication effect.
Q6. The most common cause of inaccurate blood pressure measurement is:
A. Using the wrong arm
B. Using a cuff that is too small for the patient's arm circumference
C. Deflating the cuff too slowly
D. Measuring blood pressure on the left arm
Correct Answer: B
Rationale: "Undercuffing" (using a cuff too small) is the most common error and
leads to falsely elevated readings. The bladder of the cuff should cover at least
80% of the arm circumference. Over-cuffing may produce falsely low readings.
Q7. A patient with a body mass index (BMI) of 38 kg/m² is best classified as:
A. Overweight
pg. 4
NR509 Week 4 Midterm Exam Due March 2026 Complete
Actual Exam Questions 1- 100 NR-509 Advanced Physical
Assessment NR 509 Midterm and Finals Examplify Online
Proctored Exam Questions and Answers | 100% Pass
Guaranteed | Graded A+
Domain 1: Interviewing, Health History, and General Survey (Q1-10)
Q1. A 55-year-old patient presents with a 3-week history of fatigue. The nurse
practitioner asks, "What do you mean when you say you feel tired?" This is an
example of which interviewing technique?
A. Clarification
B. Confrontation
C. Reflection
D. Facilitation
Correct Answer: A
Rationale: Clarification asks the patient to explain or elaborate on a vague or
ambiguous statement, ensuring the clinician understands the patient's experience
accurately.
Q1 – Rotation. A patient says, "I just can't take it anymore." The nurse
practitioner responds, "You feel overwhelmed right now?" This is an example of:
A. Clarification
B. Reflection
C. Empathy
D. Summarization
Correct Answer: B
Rationale: Reflection echoes the patient's implied feelings, encouraging them to
recognize and express emotions. It helps build rapport.
pg. 1
,2
Q2. The review of systems (ROS) is best described as:
A. A detailed chronological account of the present illness
B. A head-to-toe series of questions about past and present symptoms organized
by body system
C. A list of all previous diagnoses, surgeries, and hospitalizations
D. An assessment of the patient's psychological and social history
Correct Answer: B
Rationale: The ROS is a systematic inventory of symptoms organized by body
system, designed to uncover problems the patient may have forgotten or not
thought to mention. It is part of the health history, not the physical exam.
Q2 – Rotation. Which of the following belongs in the past medical history, not the
review of systems?
A. "Have you had any chest pain in the past month?"
B. "Do you have a history of high blood pressure?"
C. "Have you noticed any changes in your vision?"
D. "Do you have any shortness of breath?"
Correct Answer: B
Rationale: Established diagnoses belong in past medical history. The ROS elicits
current or recent symptoms. This distinction is critical for accurate
documentation.
Q3. During the general survey, the nurse practitioner notes the patient has a
stooped posture, walks with short shuffling steps, and has minimal arm swing
bilaterally. These findings are most consistent with:
A. Cerebellar ataxia
B. Parkinson's disease
C. Osteoarthritis of the hips
D. Peripheral neuropathy
Correct Answer: B
Rationale: The triad of stooped posture, shuffling gait (festination), and reduced
pg. 2
,3
arm swing is classic for Parkinson's disease, an extrapyramidal movement
disorder caused by dopamine deficiency in the basal ganglia.
Q3 – Rotation. A patient with a wide-based, unsteady gait, who cannot walk heel-
to-toe in a straight line, is demonstrating:
A. Parkinsonian gait
B. Tandem gait abnormality suggestive of cerebellar dysfunction
C. Antalgic gait
D. Steppage gait
Correct Answer: B
Rationale: Difficulty with tandem gait (heel-to-toe walking) indicates cerebellar
ataxia. The cerebellum coordinates smooth, balanced movements; dysfunction
produces a wide-based, unsteady gait.
Q4. A patient with chronic atrial fibrillation has blood pressure measured by an
automated device that gives three different readings: 132/78, 118/72, and 142/85
mm Hg. The most accurate approach to documenting this patient's blood
pressure is:
A. Average the three readings and document the mean
B. Take multiple manual measurements and document the range or use 24-hour
ambulatory monitoring
C. Use only the first reading as it is most reliable
D. Document the patient as hypertensive based on the highest reading
Correct Answer: B
Rationale: Atrial fibrillation causes beat-to-beat variability in stroke volume,
leading to inconsistent blood pressure readings. A single automated reading is
unreliable. Manual measurement with multiple readings or 24-hour ambulatory
monitoring provides a more accurate estimate.
Q5. Orthostatic vital signs are indicated for a patient complaining of:
A. Headache and nausea
B. Dizziness upon standing
pg. 3
, 4
C. Bilateral lower extremity edema
D. Intermittent claudication
Correct Answer: B
Rationale: Orthostatic (postural) vital signs assess for a significant drop in blood
pressure or increase in heart rate when changing from supine to standing
position. They are indicated for patients reporting dizziness, lightheadedness, or
syncope upon standing.
Q5 – Rotation. Orthostatic hypotension is diagnosed when there is a sustained
reduction of systolic blood pressure of at least ____ mm Hg within 3 minutes of
standing.
A. 10
B. 15
C. 20
D. 30
Correct Answer: C
Rationale: Orthostatic hypotension is defined as a drop in SBP ≥20 mm Hg or DBP
≥10 mm Hg within 3 minutes of standing. This is a sign of autonomic dysfunction,
volume depletion, or medication effect.
Q6. The most common cause of inaccurate blood pressure measurement is:
A. Using the wrong arm
B. Using a cuff that is too small for the patient's arm circumference
C. Deflating the cuff too slowly
D. Measuring blood pressure on the left arm
Correct Answer: B
Rationale: "Undercuffing" (using a cuff too small) is the most common error and
leads to falsely elevated readings. The bladder of the cuff should cover at least
80% of the arm circumference. Over-cuffing may produce falsely low readings.
Q7. A patient with a body mass index (BMI) of 38 kg/m² is best classified as:
A. Overweight
pg. 4
