ANSWER CNIII - Assessment - Chamberlain A 16-year-old male pre...

NR509 / NR 509 Final Exam (Latest

2025 / 2026): Advanced Physical

Assessment - Chamberlain A 16-year-old male presents to the clinic with a history of a congenital right upper eyelid drooping as represented in this image. He has no complaints and denies injury or trauma. Which cranial nerve (CN) is involved in this condition? -

ANSWER CNIII

A 35-year-old female with a history of migraines presents to the clinic with worsening symptoms for the past few weeks. She reports waking up at night with headaches and nausea. Her only medication history is oral contraceptive pills (OCPs). Otherwise, she states she is healthy. Which of the following actions if taken by the NP is the best next step?

• Take a further history and perform a very careful neurological examination
• Prescribe a strong medication for her migraines
• Reassure her that this is a common pattern with migraines
• Order studies to evaluate potential transient ischemic attacks (TIAs) because she

is on OCPs

• Treat her for sinusitis - ANSWER a. Take a further history and

perform a very careful neurological exam.

Explanation: The history of nightly awakening and nausea is concerning for

increased intracranial pressure from a tumor or other mass. (Brain tumor is not common in a 35-year-old.) A careful neurological examination may uncover deficits.A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination. She asks you privately if her granddaughter has started 1 / 3

puberty yet. During the examination, the NP notes asymmetric projection of the areola and nipple of the right chest to form a secondary mound above the level of the breast. The left breast is underdeveloped. These assessment findings are consistent with which Tanner Stage of development? - ANSWER Tanner Stage 4.

Explanation: Tanner Stage 4 is typically seen in girls around age 9-10, and is

characterized by the development of breast buds (asymmetric projection of the areola and nipple of the right chest to form a secondary mound above the level of the breast) and the beginning of pubic hair growth. It is also referred to as the "pre- pubertal stage" and is the first stage of breast development. The left breast being underdeveloped indicated that the girl is in Tanner Stage 4, as this is a common characteristic of this stage of development Primary prevention is defined as: - ANSWER Interventions designed to prevent disease Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, what is true about screening for breast cancer in average-risk women? - ANSWER Mammography is recommended every 2 years for women aged 50-74 with insufficient evidence for screening women over the age of 75.Which of the following statements is true regarding recommendations by the eighth Joint National Committee (JNC8) for adults aged 60 and older? Select all that apply. - ANSWER - Target blood pressure should be

• In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear

optimal for notable reductions in stroke, cardiovascular events, and all-cause mortality. 2 / 3

Which of the following is a useful strategy when examining young children between the ages of 1 and 4? - ANSWER Have the parent facilitate the exam (e.g., removing clothes, holding the child on lap).The NP is completing the review of systems on a 4-month-old female during a routine encounter. Which statement from the parent may indicate a cardiac problem in the infant and require a more thorough subjective history?

• "The baby gets the hiccups often."
• "It often takes the baby more than 30 minutes to finish a bottle."
• "The baby's heart seems to beat rapidly sometimes."
• "Sometimes the baby sounds congested." - ANSWER "It often

takes the baby more than 30 minutes to finish a bottle." Explanation: This statement from the parent may indicate a cardiac problem in the infant, such as congestive heart failure. Congestive heart failure can lead to poor feeding and poor weight gain, which can result in the infant taking longer than usual to finish a bottle. A more thorough subjective history should be taken, including questions about the baby's feeding and weight gain, the presence of respiratory symptoms, and any other signs and symptoms of a cardiac problem.Additionally, a physical examination and diagnostic tests, such as an electrocardiogram (ECG) or echocardiogram, may be necessary to evaluate for a cardiac problem.Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory fibers to portions of the tympanic membrane, auditory canal, pharynx, and the posterior third of the tongue? - ANSWER CN IX (Glossopharyngeal) The NP should suspect injury to which cranial nerve (CN) if a patient presents with complaints of photosensitivity and uneven pupils after being struck in the eye with a baseball? - ANSWER CNIII (Oculomotor)

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