NR509 | NR509 Advanced Physical Assessment
Exam 1 v3 | Questions with Correct Answers and
Expert Explanation for Each Question |
Chamberlain
1. Which component of the health history is defined as the primary reason the patient is
seeking care, ideally documented in the patient’s own words?
A. Review of Systems (ROS)
B. Chief Complaint (CC)
C. History of Present Illness (HPI)
D. Past Medical History (PMH)
Correct Answer: B
Expert Explanation: The Chief Complaint is a brief statement of the reason the patient is
seeking medical attention and should be recorded in quotes. It provides a focal point for the
rest of the history and physical examination. Other sections like the HPI expand on this
complaint, while the ROS is a comprehensive survey of all body systems.
2. When assessing a patient’s visual acuity using a Snellen chart, what does the denominator
‘20/40’ signify?
A. The patient can see at 20 feet what a normal eye sees at 40 feet.
B. The patient’s vision is twice as good as normal vision.
C. The patient can see at 40 feet what a normal eye sees at 20 feet.
D. The patient was standing 40 feet away from the chart.
Correct Answer: A
Expert Explanation: In Snellen visual acuity, the first number (numerator) indicates the
distance the patient is from the chart, which is standard at 20 feet. The second number
(denominator) indicates the distance at which a person with normal vision can read the
same line. A higher denominator indicates poorer vision because the patient must be closer
to see what others see from further away.
3. Which physical examination technique involves the use of the sense of touch to assess
texture, temperature, and organ location?
A. Inspection
B. Percussion
C. Palpation
,D. Auscultation
Correct Answer: C
Expert Explanation: Palpation follows inspection and uses the hands to feel for specific
characteristics of the body. It allows the clinician to determine the size, shape, and
consistency of organs or masses. Light palpation is generally performed before deep
palpation to prevent muscle guarding and patient discomfort.
4. What is the correct technique for assessing the thyroid gland using a posterior approach?
A. Stand behind the patient, have them flex the neck slightly forward, and palpate the lobes
as they swallow.
B. Have the patient lean backward and swallow while you palpate the neck from the front.
C. Use the bell of the stethoscope to listen for bruits while the patient holds their breath.
D. Palpate the trachea to check for midline deviation using the index finger.
Correct Answer: A
Expert Explanation: The posterior approach for thyroid palpation requires the clinician to
stand behind the patient to feel the lobes more effectively. Slight neck flexion relaxes the
sternocleidomastoid muscles, making the gland easier to palpate. Asking the patient to
swallow helps the thyroid move upward, allowing the clinician to assess for symmetry and
nodules.
5. Which cranial nerve is primarily responsible for the pupillary light reflex?
A. CN II (Optic) and CN III (Oculomotor)
B. CN IV (Trochlear) and CN VI (Abducens)
C. CN V (Trigeminal)
D. CN VII (Facial)
Correct Answer: A
Expert Explanation: The pupillary light reflex involves a sensory (afferent) limb and a
motor (efferent) limb. CN II carries the sensory information of light hitting the retina to the
brain. CN III provides the motor response that causes the pupil to constrict in both the
stimulated and unstimulated eye.
6. During a skin assessment, the nurse practitioner notices a flat, non-palpable lesion that is
less than 1 cm in diameter. This is documented as a:
A. Papule
B. Plaque
C. Vesicle
, D. Macule
Correct Answer: D
Expert Explanation: A macule is a flat, circumscribed area of skin discoloration that is less
than 1 cm in diameter. Examples include freckles or flat nevi. If the flat lesion is larger than
1 cm, it would be classified as a patch rather than a macule.
7. What is the recommended sequence for performing a physical examination of the
abdomen?
A. Inspection, Auscultation, Percussion, Palpation
B. Inspection, Palpation, Percussion, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Percussion, Auscultation, Inspection, Palpation
Correct Answer: A
Expert Explanation: For the abdominal exam, the sequence is modified to Inspection,
Auscultation, Percussion, and then Palpation. Auscultation is performed before percussion
and palpation to avoid stimulating bowel sounds that were not originally present. This
ensures that the assessment of bowel motility is as accurate as possible.
8. Which type of percussion note is typically heard over healthy lung tissue?
A. Tympany
B. Dullness
C. Flatness
D. Resonance
Correct Answer: D
Expert Explanation: Resonance is a low-pitched, clear, hollow sound heard over normal
lung tissue. Dullness is typically heard over solid organs like the liver or areas of
consolidation. Tympany is a drum-like sound found over air-filled structures like the
stomach.
9. A patient presents with a ‘stuffy nose’ and pain above the eyebrows. Palpation of which
sinuses is most appropriate?
A. Maxillary sinuses
B. Frontal sinuses
C. Ethmoid sinuses
D. Sphenoid sinuses
Exam 1 v3 | Questions with Correct Answers and
Expert Explanation for Each Question |
Chamberlain
1. Which component of the health history is defined as the primary reason the patient is
seeking care, ideally documented in the patient’s own words?
A. Review of Systems (ROS)
B. Chief Complaint (CC)
C. History of Present Illness (HPI)
D. Past Medical History (PMH)
Correct Answer: B
Expert Explanation: The Chief Complaint is a brief statement of the reason the patient is
seeking medical attention and should be recorded in quotes. It provides a focal point for the
rest of the history and physical examination. Other sections like the HPI expand on this
complaint, while the ROS is a comprehensive survey of all body systems.
2. When assessing a patient’s visual acuity using a Snellen chart, what does the denominator
‘20/40’ signify?
A. The patient can see at 20 feet what a normal eye sees at 40 feet.
B. The patient’s vision is twice as good as normal vision.
C. The patient can see at 40 feet what a normal eye sees at 20 feet.
D. The patient was standing 40 feet away from the chart.
Correct Answer: A
Expert Explanation: In Snellen visual acuity, the first number (numerator) indicates the
distance the patient is from the chart, which is standard at 20 feet. The second number
(denominator) indicates the distance at which a person with normal vision can read the
same line. A higher denominator indicates poorer vision because the patient must be closer
to see what others see from further away.
3. Which physical examination technique involves the use of the sense of touch to assess
texture, temperature, and organ location?
A. Inspection
B. Percussion
C. Palpation
,D. Auscultation
Correct Answer: C
Expert Explanation: Palpation follows inspection and uses the hands to feel for specific
characteristics of the body. It allows the clinician to determine the size, shape, and
consistency of organs or masses. Light palpation is generally performed before deep
palpation to prevent muscle guarding and patient discomfort.
4. What is the correct technique for assessing the thyroid gland using a posterior approach?
A. Stand behind the patient, have them flex the neck slightly forward, and palpate the lobes
as they swallow.
B. Have the patient lean backward and swallow while you palpate the neck from the front.
C. Use the bell of the stethoscope to listen for bruits while the patient holds their breath.
D. Palpate the trachea to check for midline deviation using the index finger.
Correct Answer: A
Expert Explanation: The posterior approach for thyroid palpation requires the clinician to
stand behind the patient to feel the lobes more effectively. Slight neck flexion relaxes the
sternocleidomastoid muscles, making the gland easier to palpate. Asking the patient to
swallow helps the thyroid move upward, allowing the clinician to assess for symmetry and
nodules.
5. Which cranial nerve is primarily responsible for the pupillary light reflex?
A. CN II (Optic) and CN III (Oculomotor)
B. CN IV (Trochlear) and CN VI (Abducens)
C. CN V (Trigeminal)
D. CN VII (Facial)
Correct Answer: A
Expert Explanation: The pupillary light reflex involves a sensory (afferent) limb and a
motor (efferent) limb. CN II carries the sensory information of light hitting the retina to the
brain. CN III provides the motor response that causes the pupil to constrict in both the
stimulated and unstimulated eye.
6. During a skin assessment, the nurse practitioner notices a flat, non-palpable lesion that is
less than 1 cm in diameter. This is documented as a:
A. Papule
B. Plaque
C. Vesicle
, D. Macule
Correct Answer: D
Expert Explanation: A macule is a flat, circumscribed area of skin discoloration that is less
than 1 cm in diameter. Examples include freckles or flat nevi. If the flat lesion is larger than
1 cm, it would be classified as a patch rather than a macule.
7. What is the recommended sequence for performing a physical examination of the
abdomen?
A. Inspection, Auscultation, Percussion, Palpation
B. Inspection, Palpation, Percussion, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Percussion, Auscultation, Inspection, Palpation
Correct Answer: A
Expert Explanation: For the abdominal exam, the sequence is modified to Inspection,
Auscultation, Percussion, and then Palpation. Auscultation is performed before percussion
and palpation to avoid stimulating bowel sounds that were not originally present. This
ensures that the assessment of bowel motility is as accurate as possible.
8. Which type of percussion note is typically heard over healthy lung tissue?
A. Tympany
B. Dullness
C. Flatness
D. Resonance
Correct Answer: D
Expert Explanation: Resonance is a low-pitched, clear, hollow sound heard over normal
lung tissue. Dullness is typically heard over solid organs like the liver or areas of
consolidation. Tympany is a drum-like sound found over air-filled structures like the
stomach.
9. A patient presents with a ‘stuffy nose’ and pain above the eyebrows. Palpation of which
sinuses is most appropriate?
A. Maxillary sinuses
B. Frontal sinuses
C. Ethmoid sinuses
D. Sphenoid sinuses
