NR509 Advanced Physical Assessment Midterm Exam With Answers (32 Solved Questions)

Name: NR509 Advanced Physical Assessment Midterm Exam With Answers (32 Solved Questions)
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NR 509 - Advanced Physical Assessment
Midterm Exam
1.A mother brings her 2-month-old daughter in for an examination and says, My
daughter rolled over against the wall, and now I have noticed that she has this spot
that is soft on the top of her head. Is something terribly wrong? The nurses best
response would be:
A. Perhaps that could be a result of your dietary intake during pregnancy.
B. Your baby may have craniosynostosis, a disease of the sutures of the brain.
C. That soft spot may be an indication of cretinism or congenital hypothyroidism.
D. That soft spot is normal, and actually allows for growth of the brain during the
first year of your babys life.
ANS: D
2. Membrane-covered soft spots allow for growth of the brain during the first year
of life. They gradually ossify; the triangular-shaped posterior fontanel is closed by
1 to 2 months, and the diamond-shaped anterior fontanel closes between 9 months
and 2 years.

The nurse notices that a patients palpebral fissures are not symmetric. On
examination, the nurse may find that damage has occurred to which cranial nerve
(CN)?
a. III
b. V
c. VII
d. VIII
ANS: C
Facial muscles are mediated by CN VII; asymmetry of palpebral fissures may be
attributable to damage to CN VII (Bell palsy).
3. A patient is unable to differentiate between sharp and dull stimulation to both
sides of her face. The nurse suspects:
a. Bell palsy.
b. Damage to the trigeminal nerve.
c. Frostbite with resultant paresthesia to the cheeks.
d. Scleroderma.
ANS: B
Facial sensations of pain or touch are mediated by CN V, which is the trigeminal

nerve. Bell palsy is associated with CN VII damage. Frostbite and scleroderma are
not associated with this problem.
4. When examining the face of a patient, the nurse is aware that the two pairs of
salivary glands that are accessible to examination are the ___________ and
___________ glands.
a. Occipital; submental
b. Parotid; jugulodigastric
c. Parotid; submandibular
d. Submandibular; occipital
ANS: C
Two pairs of salivary glands accessible to examination on the face are the parotid
glands, which are in the cheeks over the mandible, anterior to and below the ear;
and the submandibular glands, which are beneath the mandible at the angle of the
jaw. The parotid glands are normally nonpalpable.
5. A patient comes to the clinic complaining of neck and shoulder pain and is
unable to turn her head. The nurse suspects damage to CN ______ and proceeds
with the examination by _____________.
a. XI; palpating the anterior and posterior triangles
b. XI; asking the patient to shrug her shoulders against resistance

c. XII; percussing the sternomastoid and submandibular neck muscles
d. XII; assessing for a positive Romberg sign
ANS: B
The major neck muscles are the sternomastoid and the trapezius. They are
innervated by CN XI, the spinal accessory. The innervated muscles assist with
head rotation and head flexion, movement of the shoulders, and extension and
turning of the head.
6. When examining a patients CN function, the nurse remembers that the muscles
in the neck that are innervated by CN XI are the:
a. Sternomastoid and trapezius.
b. Spinal accessory and omohyoid.
c. Trapezius and sternomandibular.
d. Sternomandibular and spinal accessory.
ANS: A
The major neck muscles are the sternomastoid and the trapezius. They are
innervated by CN XI, the spinal accessory.
7. A patient says that she has recently noticed a lump in the front of her neck below
her Adams apple that seems to be getting bigger. During the assessment, the
finding that leads the nurse to suspect that this may not be a cancerous thyroid

nodule is that the lump (nodule):
a. Is tender.
b. Is mobile and not hard.
c. Disappears when the patient smiles.
d. Is hard and fixed to the surrounding structures.
ANS: B
Painless, rapidly growing nodules may be cancerous, especially the appearance of
a single nodule in a young person. However, cancerous nodules tend to be hard and
fixed to surrounding structures, not mobile.
11. The nurse is aware that the four areas in the body where lymph nodes are
accessible are the:
a. Head, breasts, groin, and abdomen.
b. Arms, breasts, inguinal area, and legs.
c. Head and neck, arms, breasts, and axillae.
d. Head and neck, arms, inguinal area, and axillae.
ANS: D
Nodes are located throughout the body, but they are accessible to examination only
in four areas: head and neck, arms, inguinal region, and axillae.

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A mother brings her newborn in for an assessment and asks, Is there something
wrong with my baby? His head seems so big. Which statement is true regarding
the relative proportions of the head and trunk of the newborn?
a. At birth, the head is one fifth the total length.
b. Head circumference should be greater than chest circumference at birth.
c. The head size reaches 90% of its final size when the child is 3 years old.
d. When the anterior fontanel closes at 2 months, the head will be more
proportioned to the body.
ANS: B
The nurse recognizes that during the fetal period, head growth predominates. Head
size is greater than chest circumference at birth, and the head size grows during
childhood, reaching 90% of its final size when the child is age 6 years.
A patient, an 85-year-old woman, is complaining about the fact that the bones in
her face have become more noticeable. What explanation should the nurse give
her?
a. Diets low in protein and high in carbohydrates may cause enhanced facial bones.
b. Bones can become more noticeable if the person does not use a dermatologically
approved moisturizer.
c. More noticeable facial bones are probably due to a combination of factors

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University

Chamberlain College of Nursing

Subject

Medicine

NR509 Advanced Physical Assessment Midterm Exam With Answers (32 Solved Questions)

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