NR509 | NR509 Advanced Physical Assessment
Exam 1 v2 | Questions with Correct Answers and
Expert Explanation for Each Question |
Chamberlain
1. When conducting a comprehensive health history, which of the following is considered
subjective data?
A. A blood pressure reading of 140/90 mmHg
B. Hyperactive bowel sounds in all four quadrants
C. Presence of a macular rash on the chest
D. The patient’s report of a throbbing headache
Correct Answer: D
Expert Explanation: Subjective data consists of information provided by the patient that
cannot be directly observed by the examiner. In this case, a headache is a symptom
described by the patient and is therefore subjective. Objective data, such as blood pressure
and physical exam findings, are signs that the clinician can measure or see.
2. Which technique of physical examination is generally performed first in most body
systems?
A. Palpation
B. Percussion
C. Auscultation
D. Inspection
Correct Answer: D
Expert Explanation: Inspection is the first step of the physical examination process and
involves a deliberate, purposeful observation of the patient. This step allows the clinician to
gather significant data before touching the patient. The standard order is inspection,
palpation, percussion, and auscultation, except during the abdominal exam.
3. A patient presents with a ‘stiff neck’ and a high fever. Which physical exam maneuver
would the clinician perform to check for meningeal irritation?
A. Murphy’s sign
B. Brudzinski’s sign
C. Phalen’s maneuver
,D. McBurney’s point tenderness
Correct Answer: B
Expert Explanation: Brudzinski’s sign is a clinical sign used to identify meningitis where
involuntary flexion of the hips and knees occurs when the neck is flexed. This response
indicates irritation of the meninges surrounding the spinal cord and brain. Other tests like
Murphy’s sign are used for gallbladder issues, not neurological irritation.
4. In the ABCDE mnemonic for skin cancer assessment, what does the ‘E’ stand for?
A. Elevation
B. Erythema
C. Exudate
D. Evolution
Correct Answer: D
Expert Explanation: Evolution refers to any change in the size, shape, color, or symptoms
of a mole or skin lesion over time. This is a critical component of melanoma screening
because rapid changes often signal malignancy. The other letters stand for Asymmetry,
Border irregularity, Color variation, and Diameter.
5. During an ear examination, the clinician performs the Weber test. If the patient has
conductive hearing loss in the right ear, where will the sound lateralize?
A. To the right ear
B. To the left ear
C. Equally to both ears
D. The sound will not be heard at all
Correct Answer: A
Expert Explanation: In conductive hearing loss, the Weber test lateralizes to the impaired
ear because the ‘room noise’ is blocked out, making the bone-conducted sound seem
louder. In sensorineural loss, the sound lateralizes to the good ear. Understanding this
distinction is vital for localizing auditory pathology.
6. Which part of the hand is most sensitive for assessing vibrations during palpation?
A. Ulnar surface
B. Fingertips
C. Dorsal surface
D. Palmar surface at the base of the fingers
, Correct Answer: A
Expert Explanation: The ulnar surface of the hand and the base of the fingers
(metacarpophalangeal joints) are the most sensitive areas for detecting vibrations, such as
fremitus. The dorsal surface is best for temperature, while fingertips are best for fine tactile
discrimination. Correct use of hand surfaces ensures accurate data collection during the
physical exam.
7. A 45-year-old male presents with a chief complaint of a persistent cough. Which part of the
health history should include his 20-pack-year smoking history?
A. History of Present Illness (HPI)
B. Review of Systems (ROS)
C. Social History
D. Past Medical History
Correct Answer: C
Expert Explanation: Social history encompasses lifestyle factors such as tobacco use,
alcohol consumption, and occupational exposures. A smoking history is quantified in pack-
years to assess the risk for pulmonary and cardiovascular diseases. Documenting this
correctly allows for a comprehensive risk profile for the patient.
8. Which of the following describes a ‘primary’ skin lesion?
A. Ulcer
B. Erosion
C. Crust
D. Pustule
Correct Answer: D
Expert Explanation: A pustule is a primary lesion, which is a lesion that arises from
previously normal skin. Ulcers, crusts, and erosions are considered secondary lesions
because they result from changes in a primary lesion over time. Distinguishing between
primary and secondary lesions is essential for accurate dermatological diagnosis.
9. When assessing the pupillary light reflex, the clinician shines a light into the right eye and
observes the left pupil constrict. This is known as:
A. Direct reflex
B. Consensual reflex
C. Accommodation
D. Convergence
Exam 1 v2 | Questions with Correct Answers and
Expert Explanation for Each Question |
Chamberlain
1. When conducting a comprehensive health history, which of the following is considered
subjective data?
A. A blood pressure reading of 140/90 mmHg
B. Hyperactive bowel sounds in all four quadrants
C. Presence of a macular rash on the chest
D. The patient’s report of a throbbing headache
Correct Answer: D
Expert Explanation: Subjective data consists of information provided by the patient that
cannot be directly observed by the examiner. In this case, a headache is a symptom
described by the patient and is therefore subjective. Objective data, such as blood pressure
and physical exam findings, are signs that the clinician can measure or see.
2. Which technique of physical examination is generally performed first in most body
systems?
A. Palpation
B. Percussion
C. Auscultation
D. Inspection
Correct Answer: D
Expert Explanation: Inspection is the first step of the physical examination process and
involves a deliberate, purposeful observation of the patient. This step allows the clinician to
gather significant data before touching the patient. The standard order is inspection,
palpation, percussion, and auscultation, except during the abdominal exam.
3. A patient presents with a ‘stiff neck’ and a high fever. Which physical exam maneuver
would the clinician perform to check for meningeal irritation?
A. Murphy’s sign
B. Brudzinski’s sign
C. Phalen’s maneuver
,D. McBurney’s point tenderness
Correct Answer: B
Expert Explanation: Brudzinski’s sign is a clinical sign used to identify meningitis where
involuntary flexion of the hips and knees occurs when the neck is flexed. This response
indicates irritation of the meninges surrounding the spinal cord and brain. Other tests like
Murphy’s sign are used for gallbladder issues, not neurological irritation.
4. In the ABCDE mnemonic for skin cancer assessment, what does the ‘E’ stand for?
A. Elevation
B. Erythema
C. Exudate
D. Evolution
Correct Answer: D
Expert Explanation: Evolution refers to any change in the size, shape, color, or symptoms
of a mole or skin lesion over time. This is a critical component of melanoma screening
because rapid changes often signal malignancy. The other letters stand for Asymmetry,
Border irregularity, Color variation, and Diameter.
5. During an ear examination, the clinician performs the Weber test. If the patient has
conductive hearing loss in the right ear, where will the sound lateralize?
A. To the right ear
B. To the left ear
C. Equally to both ears
D. The sound will not be heard at all
Correct Answer: A
Expert Explanation: In conductive hearing loss, the Weber test lateralizes to the impaired
ear because the ‘room noise’ is blocked out, making the bone-conducted sound seem
louder. In sensorineural loss, the sound lateralizes to the good ear. Understanding this
distinction is vital for localizing auditory pathology.
6. Which part of the hand is most sensitive for assessing vibrations during palpation?
A. Ulnar surface
B. Fingertips
C. Dorsal surface
D. Palmar surface at the base of the fingers
, Correct Answer: A
Expert Explanation: The ulnar surface of the hand and the base of the fingers
(metacarpophalangeal joints) are the most sensitive areas for detecting vibrations, such as
fremitus. The dorsal surface is best for temperature, while fingertips are best for fine tactile
discrimination. Correct use of hand surfaces ensures accurate data collection during the
physical exam.
7. A 45-year-old male presents with a chief complaint of a persistent cough. Which part of the
health history should include his 20-pack-year smoking history?
A. History of Present Illness (HPI)
B. Review of Systems (ROS)
C. Social History
D. Past Medical History
Correct Answer: C
Expert Explanation: Social history encompasses lifestyle factors such as tobacco use,
alcohol consumption, and occupational exposures. A smoking history is quantified in pack-
years to assess the risk for pulmonary and cardiovascular diseases. Documenting this
correctly allows for a comprehensive risk profile for the patient.
8. Which of the following describes a ‘primary’ skin lesion?
A. Ulcer
B. Erosion
C. Crust
D. Pustule
Correct Answer: D
Expert Explanation: A pustule is a primary lesion, which is a lesion that arises from
previously normal skin. Ulcers, crusts, and erosions are considered secondary lesions
because they result from changes in a primary lesion over time. Distinguishing between
primary and secondary lesions is essential for accurate dermatological diagnosis.
9. When assessing the pupillary light reflex, the clinician shines a light into the right eye and
observes the left pupil constrict. This is known as:
A. Direct reflex
B. Consensual reflex
C. Accommodation
D. Convergence
