NR 509 / NR509 Advanced Physical Assessment
Final Exam Week 5 to 8 Review
Click here https://www.stuvia.com/en-us/doc/7068846/nr-509-nr509-midterm-week-1-to-4-exam-advanced-physical-assessment-questionswith-verified-answers-latest-2025-2026-chamberlain
https://www.stuvia.com/en-us/bundle/397978/study-bundle-nr-509-nr509-midterm-exam-study-guide-test-bank-advanced-physical-assessmentquestions-with-verified-answers-latest-2025-2026-chamberlain
https://www.stuvia.com/en-us/bundle/397973/study-bundle-nr-509-nr509-final-exam-advanced-physical-assessment-questions-with-verifiedanswers-latest-2025-2026-chamberlain
https://www.stuvia.com/en-us/bundle/397979/study-bundle-nr-509-nr509-week-1-to-8-exam-review-advanced-physical-assessment-questions-withverified-answers-latest-2025-2026-chamberlain
to get full pdf or email me donc8246@gmail.com
1. Breast Exam
Answer
5-7 days after the first day of menstruation
-Inspect for symmetry, contours, and retractions
-Palpitation with patient supine with arm above head
-Palpate in ladder pattern, circular motion for each location
2. Lactation
Answer
1 / 25
Physiological secretion with pregnancy, lactation, chest wall stimula- tion,
sleep and stress.
3. Montgomery glands:
sebaceous glands that secrete a protective lipid substance during lactation
4. Galactorrhea
: Answer a milky discharge from the nipple unrelated to normal breast feeding
5. Mammary souffle:
Answer "puff of air" heard during pregnancy and lactation (venous hum)
6. Breast Cancer
Answer
Redness
-Peau d'orange: thickening and prominent pores
-Flattening instead of normal convexity
-Asymmetry
-Change in nipple direction
-Paget disease: rash, scaling, ulceration of nipple and areola
7. Breast cancer risk factors
Answer
Increasing age
-First degree family member
2 / 25
-Genetic mutations (BRCA1 & BRCA2)
-Personal history of precancerous breast mass
-Denser breast (confirmed by a mammogram)
-High dose radiation exposure
-High levels estrogen hormones
8. Abdominal Exam
: Answer Inspection-contours
Auscultation-bowel sounds/bruits
Percussion-liver size, dullness or tympany in colon
Palpation-liver size, splenomegaly, masses in colon (fecal matter, cancer, diverticulitis)
Special maneuvers- murphy (gallbladder), appendix tests
9. Abdominal Pain: Visceral:
Hollow abdominal organs forcefully contract or dis- tention
-nonspecific, difficult to localize
-Gnawing, cramping, aching
-Sweating, pallor, nausea, vomiting, restlessness
10. Abdominal Pain: Somatic/parietal:
Answer Inflammation of the parietal peritoneum
-localized or diffuse
-Steady and aching pain, more severe than visceral
-Aggravated by movement or coughing
3 / 25
11. GERD
Answer
Rising retrosternal burning pain or discomfort
-Aggravated by certain foods (alcohol, chocolate, citrus, coffee. onions, peppermint)
4 / 25
and positional changes (supine or bending forward)
-Coughing after eating or laying down
12. Risk factor for Barretts's esophagus:
Answer Esophageal cancer
13. PUD:
Common causes: H.Pylori and NSAIDs
Pain after meals (2-3 hr delay for duodenal)
GERD
Hematemesis
Melena
Treat with PPI, H2RA, antacids
14. Appendicitis:
McBurney's point: tenderness on direct palpation Rovsing:
rebound tenderness when palpating LLQ
Psoas: raise thigh (flexion), contracts psoas muscle
Obturator: flex the right thigh at the hip, bend knee, rotate leg internally, contracts
obturator muscle
Rectal exam: right side rectal tenderness
Pelvic exam: palpable appendix through the pelvis
May also presents with leukocytosis, high fever, nausea, vomiting, bowel changes
15. Diverticulitis:
Diverticulosis: benign form (pockets only) LLQ pain,
5 / 25
rebound tenderness
Constipation (abdominal mass)
Leukocytosis
Hematochezia
16. Hepatitis A: fecal/oral route, usually not chronic
17. Hepatitis B: Injection, contact with body fluid
18. Hepatitis C: Injection, blood transfusion (most prevalent chronic bloodborne
disease)
19. Alcohol hepatitis=: alcoholic cirrhosis
20. Cholecystitis
Answer
Intermittent pain caused by obstruction, blockage, or back up at the bile system.
-Usually related to gallstones
-Liver assessment (palpitation and percussion to determine size)
-Murphy's sign for cholecystitis
21. IBS (irritable bowel syndrome)
Answer
Mucous in stool
-Bloating
-Changes in frequency/consistency of stools
6 / 25
-Diagnosis of exclusion, intermittent pain for at least 12 weeks over a year, relief with
defecation, changes in stool frequency and consistency
-Commonly associated with food intolerances
22. IBD (inflammatory bowel disease)
Answer
Mucous in stool
-Bloating
-Pain with defecation
-Chronic diarrhea
-Hematochezia
-Anal fissures-Crohn's
-Colonoscopy shows skip lesion or cobblestoning (Crohn), continuous inflammation
(UC)
-Strong family link
23. Colon Cancer
Answer
Changes in stool
-Palpable mass (late stage)
-Pencil-thin stools
-Hematochezia
-(+) Cologuard/fecal tests=colonoscopy
24. Risk factors for colon cancer
Answer
African American
-Men
7 / 25
-Elderly
-IBD
-Family history
-Inactivity
-Low fiber diet
-Obesity
-Alcohol
-Cigarette smoking
25. Rectal Exam
Answer
Side lying (preferred for elderly, obese)
-Standing bent forward
-Bear down to get past external sphincter
-Asses glove for bleeding, discharge, or fecal matter
-Masses: Moveable-fecal matter Immovable-prostate nodule, hemorrhoid, or fecal
matter
-Rectal lesion, fissures, modules, skin tags
26. Prostate Cancer risk factors
Answer
Higher risk at age 40, increases rapidly after age 50
-African American higher incidence and mortality
-Agent orange
-High fat diet
8 / 25
-Obesity
-Cigarette smoking
-Cadmium exposure
27. What is the primary screening test for prostate cancer
Answer
PSA
28. What is Proctitis cause by
IBD, STIs, trauma, bacterial infections, radiation therapy (especially for prostate
cancer treatment)
29. Proctitis
Answer
Anorectal pain
-Tenesmus
-Discharge
-Bleeding
-Anal fissures
30. Hernias: Protrusion of a loop of an organ or tissue through an abnormal opening
31. Which hernias are at a higher risk for incarceration and strangulation?
Answer
Femoral hernias
32. Incarcerate hernia: contents cannot be returned to abdominal cavity
33. Stangulation: Blood supply is compromised
34. Assessment for hernias is best with
9 / 25
Answer
Patient standing
35. If fingers can go above the mass it is likely
Answer
A hydrocele
36. Cryptorchidism: undescended testicles
37. Occluded follicles / epidermoid cyst: dome-shaped white or yellow lesions
38. Testicular torsion: Tender, painful, scrotal swelling
39. Hydrocele: Fluid filled lesion, transilluminates
40. Varicocele: Varicose vein of spermatic cord, thick rope-like texture
41. Testicular Cancer
Answer
Painless nodule
-Peak incidence 15-34 years old
-Palpable inguinal lymph nodes
-Self testicular exam after warm shower
42. Pelvic Exam
Answer
Always have a chaperone
-External examination
-Don't use lubricant, especially near the end of speculum
-30 degree downward angle
-PAP smear
-Bimanual exam
43. Chlamydia: White discharge in men, yellow in women
10 /
25
44. Gonorrhea: Yellow in men and women
45. Syphilis: Primary chancre, secondary flat top lesions in women
46. Genital wart: Severely raise, can be erythematous
47. Herpes: Smaller lesion, can be normal pigmentation, erythematous, crusted
48. Pubic lice: severe excoriation
10 /