NR 509 FINAL EXAM NR509 ADVANCED PHYSICAL

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NR 509 FINAL EXAM /NR509 ADVANCED PHYSICAL

ASSESSMENT FINAL EXAM NEWEST 2024-2025

ACTUAL EXAM COMPLETE ALL 100 QUESTIONS

AND CORRECT DETAILED ANSWERS ( VERIFIED

ANSWERS) |ALREADY GRADED A+

FINAL A 23-year-old woman comes to the respirology clinic for follow-up of her chronic sinusitis and bronchiectasis that is associated with a rare congenital condition called Kartagener syndrome. The preceptor notes that she has situs inversus and asks for a physical exam. Which of the following descriptions best fits with findings on the abdominal exam?

• Tympany to percussion in the right upper quadrant, dullness

to percussion of the left upper quadrant

• Protuberant abdomen that has scattered areas of tympany and

dullness; stool is felt on palpation

• Liver dullness in the right upper quadrant that is displaced

downward by the low diaphragm due to chronic obstructive pulmonary disease 1 / 4

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• Dullness to percussion of the left lower anterior chest wall

roughly at the anterior axillary line

• A change in percussion from tympany to dullness in the left

lower anterior chest wall on inspiration - ANSWER- a.Tympany to percussion in the right upper quadrant, dullness to percussion of the left upper quadrant

An otherwise healthy 28-year-old lawyer presents to the Emergency Department with a 1-day history of severe abdominal pain. The emergency physician suspects appendicitis and general surgery is consulted. The resident believes the patient has signs of peritonitis on exam. Which of the following physical exam findings supports peritonitis?

• Voluntary contraction of the abdominal wall that persists over

several examinations

• Pressing down onto the abdomen firmly and slowly and

withdrawing the hand quickly produces pain

• Abdominal pain that increases with hip flexion
• Localized pain over McBurney point, which lies 2 inches

from the anterior superior iliac spinous process on a line drawn from the umbilicus

• Pain with internal rotation of the right hip - ANSWER- b.

Pressing down onto the abdomen firmly and slowly and withdrawing the hand quickly produces pain 2 / 4

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A 58-year-old man with a history of diabetes and alcohol addiction has been sober for the last 10 months. He presents with a 4-month history of increasing weakness, recurrent epigastric pain radiating to his back, chronic diarrhea with stools 6-8 times daily, and weight loss of 18 lb over 4 months. What is the mechanism of his most likely diagnosis?

• Helicobacter pylori infection
• Inflammation of the gallbladder
• Inflammation of colonic diverticulum
• Reduced blood supply to the bowel
• Fibrosis of the pancreas - ANSWER- e. Fibrosis of the

pancreas

A 46-year-old executive who is obese and otherwise healthy presents to a family medicine clinic with a 3-month course of recurrent severe abdominal pain that usually resolves on its own after a few hours. Her last episode was prolonged lasting 6 hours, and she is frustrated that she has had to leave or miss work on three separate occasions. She would like a diagnosis and the problem fixed. Which symptoms or signs would be most suggestive of a diagnosis of biliary colic?

• Exacerbating factor includes alcohol intake 3 / 4

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• Positive McBurney point tenderness
• Poorly localized periumbilical pain
• Vomiting of bile
• Associated right shoulder pain - ANSWER- e. Associated

right shoulder pain

A 67-year-old electronics technician with a history of hypertension and type 2 diabetes presents for his yearly physical examination and complains of progressively worsening erectile dysfunction (ED). While counseling him, the clinician mentions that multiple processes must take place to achieve an erection.Which of the following structures would be most affected by vascular deficiencies related to his preexisting medical conditions and is likely contributing to his symptoms?

• Corpora cavernosa
• Ejaculatory duct
• Epididymis
• Seminal vesicle
• Vas deferens - ANSWER- a. Corpora cavernosa

A 29-year-old graduate student states that he is able to achieve an erection and ejaculate during sexual intercourse; however, he does not experience any pleasurable sensation of orgasm. He is

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