NR509 | NR509 Advanced Physical Assessment
Exam 1 v1 | Questions with Correct Answers and
Expert Explanation for Each Question |
Chamberlain
1. A patient presents with a complaint of a sharp pain in the right lower quadrant of the
abdomen. Under which section of the SOAP note should the nurse practitioner document this
information?
A. Subjective
B. Objective
C. Assessment
D. Plan
Correct Answer: A
Expert Explanation: Subjective data includes information that the patient tells the
clinician, such as symptoms and history. This specific complaint describes the patient’s
personal experience of pain rather than a physical finding discovered during the exam.
Accurate documentation in the subjective section is crucial for forming a correct diagnosis
later.
2. When assessing a patient’s skin, the nurse practitioner notes a flat, non-palpable lesion
that is less than 1 cm in diameter. Which term best describes this finding?
A. Papule
B. Vesicle
C. Pustule
D. Macule
Correct Answer: D
Expert Explanation: A macule is a flat, circumscribed area of skin discoloration that is not
raised or depressed. It is typically less than 1 cm in diameter, such as a freckle or a flat
mole. If the flat lesion were larger than 1 cm, it would be classified as a patch.
3. The nurse practitioner is performing the Weber test on a patient. The patient reports
hearing the sound better in the right ear. What does this finding indicate?
A. Normal hearing in both ears
B. Conductive hearing loss in the right ear
C. Sensorineural hearing loss in the right ear
,D. Conductive hearing loss in the left ear
Correct Answer: B
Expert Explanation: The Weber test involves placing a vibrating tuning fork on the
midline of the skull. In conductive hearing loss, the sound lateralizes to the impaired ear
because background noise is blocked. Conversely, in sensorineural loss, the sound
lateralizes to the ‘good’ or unimpaired ear.
4. Which of the following techniques is most appropriate for assessing a patient for tactile
fremitus?
A. Palpating with the ulnar surface of the hands
B. Percussing the intercostal spaces
C. Auscultating with the bell of the stethoscope
D. Inspecting for chest wall expansion
Correct Answer: A
Expert Explanation: Tactile fremitus is assessed by palpating the chest wall while the
patient repeats a phrase like ‘ninety-nine.’ The clinician uses the ulnar surface or the ball of
the hand because these areas are sensitive to vibrations. Increased fremitus suggests
consolidation, while decreased fremitus may indicate air or fluid in the pleural space.
5. During a cardiac assessment, where is the best location to auscultate the mitral valve?
A. Second intercostal space, right sternal border
B. Second intercostal space, left sternal border
C. Fourth intercostal space, left sternal border
D. Fifth intercostal space, left midclavicular line
Correct Answer: D
Expert Explanation: The mitral valve is best heard at the apex of the heart, located at the
fifth intercostal space at the left midclavicular line. This is also the location where the point
of maximal impulse (PMI) is typically palpated. Auscultating here allows the clinician to
hear the first heart sound (S1) most clearly.
6. A 65-year-old patient presents with a cough and shortness of breath. The nurse
practitioner notes a ‘barrel chest’ during inspection. This finding is most commonly associated
with which condition?
A. Pneumonia
B. Congestive heart failure
C. Emphysema
, D. Pulmonary embolism
Correct Answer: C
Expert Explanation: A barrel chest is characterized by an increased anteroposterior
diameter compared to the lateral diameter. It results from long-term air trapping and
hyperinflation of the lungs, which is a hallmark of chronic obstructive pulmonary disease
(COPD) or emphysema. This structural change indicates a chronic respiratory condition
rather than an acute infectious process.
7. The nurse practitioner is assessing a patient’s visual acuity using a Snellen chart. The
patient’s vision is recorded as 20/40. What does this mean?
A. The patient can see at 20 feet what a normal person sees at 40 feet.
B. The patient can see at 40 feet what a normal person sees at 20 feet.
C. The patient has perfect vision in the right eye.
D. The patient’s vision is two times better than average.
Correct Answer: A
Expert Explanation: The Snellen chart score represents the distance at which the patient
is standing (20 feet) over the distance at which a normal eye could read the same line. A
score of 20/40 indicates that the patient’s vision is worse than normal because they must
be closer to see what others see from further away. Vision screening is a standard part of a
comprehensive physical assessment.
8. When palpating the lymph nodes of the neck, which finding would be most concerning for
malignancy?
A. Small, mobile, and non-tender nodes
B. Hard, fixed, and non-tender nodes
C. Soft, tender, and enlarged nodes
D. Shotty nodes in a child
Correct Answer: B
Expert Explanation: Malignant lymph nodes are typically characterized by being hard,
fixed to underlying structures, and painless. In contrast, nodes that are tender and mobile
often indicate an inflammatory or infectious process. Always perform a thorough follow-up
if a fixed, non-tender node is discovered during an exam.
9. The S2 heart sound represents the closure of which valves?
A. Aortic and Pulmonic
B. Mitral and Tricuspid
Exam 1 v1 | Questions with Correct Answers and
Expert Explanation for Each Question |
Chamberlain
1. A patient presents with a complaint of a sharp pain in the right lower quadrant of the
abdomen. Under which section of the SOAP note should the nurse practitioner document this
information?
A. Subjective
B. Objective
C. Assessment
D. Plan
Correct Answer: A
Expert Explanation: Subjective data includes information that the patient tells the
clinician, such as symptoms and history. This specific complaint describes the patient’s
personal experience of pain rather than a physical finding discovered during the exam.
Accurate documentation in the subjective section is crucial for forming a correct diagnosis
later.
2. When assessing a patient’s skin, the nurse practitioner notes a flat, non-palpable lesion
that is less than 1 cm in diameter. Which term best describes this finding?
A. Papule
B. Vesicle
C. Pustule
D. Macule
Correct Answer: D
Expert Explanation: A macule is a flat, circumscribed area of skin discoloration that is not
raised or depressed. It is typically less than 1 cm in diameter, such as a freckle or a flat
mole. If the flat lesion were larger than 1 cm, it would be classified as a patch.
3. The nurse practitioner is performing the Weber test on a patient. The patient reports
hearing the sound better in the right ear. What does this finding indicate?
A. Normal hearing in both ears
B. Conductive hearing loss in the right ear
C. Sensorineural hearing loss in the right ear
,D. Conductive hearing loss in the left ear
Correct Answer: B
Expert Explanation: The Weber test involves placing a vibrating tuning fork on the
midline of the skull. In conductive hearing loss, the sound lateralizes to the impaired ear
because background noise is blocked. Conversely, in sensorineural loss, the sound
lateralizes to the ‘good’ or unimpaired ear.
4. Which of the following techniques is most appropriate for assessing a patient for tactile
fremitus?
A. Palpating with the ulnar surface of the hands
B. Percussing the intercostal spaces
C. Auscultating with the bell of the stethoscope
D. Inspecting for chest wall expansion
Correct Answer: A
Expert Explanation: Tactile fremitus is assessed by palpating the chest wall while the
patient repeats a phrase like ‘ninety-nine.’ The clinician uses the ulnar surface or the ball of
the hand because these areas are sensitive to vibrations. Increased fremitus suggests
consolidation, while decreased fremitus may indicate air or fluid in the pleural space.
5. During a cardiac assessment, where is the best location to auscultate the mitral valve?
A. Second intercostal space, right sternal border
B. Second intercostal space, left sternal border
C. Fourth intercostal space, left sternal border
D. Fifth intercostal space, left midclavicular line
Correct Answer: D
Expert Explanation: The mitral valve is best heard at the apex of the heart, located at the
fifth intercostal space at the left midclavicular line. This is also the location where the point
of maximal impulse (PMI) is typically palpated. Auscultating here allows the clinician to
hear the first heart sound (S1) most clearly.
6. A 65-year-old patient presents with a cough and shortness of breath. The nurse
practitioner notes a ‘barrel chest’ during inspection. This finding is most commonly associated
with which condition?
A. Pneumonia
B. Congestive heart failure
C. Emphysema
, D. Pulmonary embolism
Correct Answer: C
Expert Explanation: A barrel chest is characterized by an increased anteroposterior
diameter compared to the lateral diameter. It results from long-term air trapping and
hyperinflation of the lungs, which is a hallmark of chronic obstructive pulmonary disease
(COPD) or emphysema. This structural change indicates a chronic respiratory condition
rather than an acute infectious process.
7. The nurse practitioner is assessing a patient’s visual acuity using a Snellen chart. The
patient’s vision is recorded as 20/40. What does this mean?
A. The patient can see at 20 feet what a normal person sees at 40 feet.
B. The patient can see at 40 feet what a normal person sees at 20 feet.
C. The patient has perfect vision in the right eye.
D. The patient’s vision is two times better than average.
Correct Answer: A
Expert Explanation: The Snellen chart score represents the distance at which the patient
is standing (20 feet) over the distance at which a normal eye could read the same line. A
score of 20/40 indicates that the patient’s vision is worse than normal because they must
be closer to see what others see from further away. Vision screening is a standard part of a
comprehensive physical assessment.
8. When palpating the lymph nodes of the neck, which finding would be most concerning for
malignancy?
A. Small, mobile, and non-tender nodes
B. Hard, fixed, and non-tender nodes
C. Soft, tender, and enlarged nodes
D. Shotty nodes in a child
Correct Answer: B
Expert Explanation: Malignant lymph nodes are typically characterized by being hard,
fixed to underlying structures, and painless. In contrast, nodes that are tender and mobile
often indicate an inflammatory or infectious process. Always perform a thorough follow-up
if a fixed, non-tender node is discovered during an exam.
9. The S2 heart sound represents the closure of which valves?
A. Aortic and Pulmonic
B. Mitral and Tricuspid
