NR-509 \ NR509 \ NR 509 ADVANCED
PHYSICAL ASSESSMENT PRACTICE MIDTERM 1
2025 QUESTIONS AND ANSWERS PLUS
RATIONALES| GUARANTEED PASS | LATEST
UPDATE | CHAMBERLAIN UNIVERSITY
1. During an otoscopic exam of an adult, the examiner should:
- Pull the pinna down and back
- Pull the pinna up and back
- Insert the otoscope straight in without angling
- Use the largest speculum to inspect the tympanic membrane
Rationale: In adults, the ear canal is angled upward, so the pinna is pulled up and back to straighten the canal for better visualization.
2. When auscultating the heart, S1 corresponds with:
- Opening of the aortic valve
- Closure of the mitral and tricuspid valves 1 / 4
- Closure of the aortic and pulmonic valves
- Onset of diastole
Rationale: S1, the “lub” sound, marks the closure of the AV valves (mitral and tricuspid) at the beginning of systole.
- Which of the following best describes egophony?
- A whistling sound during expiration
- E-to-A changes when auscultating the lungs
- A gurgling sound over the bronchi
- Decreased breath sounds over lung bases
Rationale: Egophony is a change from "E" to "A" heard through the stethoscope, often indicating lung consolidation.
4. When palpating the thyroid gland, it is normally:
- Easily palpable and tender
- Large and lobulated
- Not easily palpable
- Painful on swallowing
Rationale: A normal thyroid is often non-palpable or only slightly palpable,
smooth, and non-tender.
- Which finding is most consistent with a tension pneumothorax? 2 / 4
- Dull percussion over lung field
- Tracheal deviation away from the affected side
- Bilateral wheezes
- Increased tactile fremitus
Rationale: A tension pneumothorax can cause the trachea to shift away due to
pressure build-up in the thorax.
6. The best technique for detecting early ascites is:
- Rebound tenderness
- Palpation of the liver edge
- Assessment of shifting dullness
- Hyperresonance over flanks
Rationale: Shifting dullness is used to detect fluid in the abdomen, a sign of
ascites.
- Which cranial nerve is tested by having the patient stick out their tongue?
- Cranial Nerve V
- Cranial Nerve IX
- Cranial Nerve XII
- Cranial Nerve X
Rationale: CN XII (Hypoglossal nerve) controls tongue movement. Deviation may
indicate a lesion.
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- A patient with COPD may present with which chest finding?
- Funnel chest
- Barrel chest
- Pectus excavatum
- Asymmetric thoracic expansion
Rationale: Barrel chest is commonly seen in COPD due to hyperinflation of the
lungs over time.
9. A positive Murphy's sign suggests:
- Appendicitis
- Cholecystitis
- Pancreatitis
- Gastritis
Rationale: Murphy’s sign is pain with palpation under the right costal margin
during inspiration, suggesting gallbladder inflammation.
- Which technique is best for detecting a palpable liver edge?
- Ballottement technique
- Hooking technique
- Light palpation
- One-handed palpation at the midline
Rationale: The hooking technique helps assess the liver edge in obese or
muscular individuals.
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