NUR 634 Midterm Exam Test Bank
NUR 634 MIDTERM EXAM TEST BANK WITH 200 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES GRADED A+ GCU/ NUR 634
MIDTERM EXAM PREP TEST BANK NEWEST 2026| ALREADY GRADED
A+||BRAND NEW VERSION!!
A 77-year-old retired bus driver comes to your clinic for a physical examination at
his wife's request. He has recently been losing weight and has felt very fatigued.
He has had no chest pain, shortness of breath, nausea, vomiting, or fever. His past
medical history includes colon cancer, for which he had surgery, and arthritis. He
has been married for over 40 years. He denies any tobacco or drug use and has
not drunk alcohol in over 40 years. His parents both died of cancer in their 60s. On
examination his vital signs are normal. His head, cardiac, and pulmonary
examinations are unremarkable. On abdominal examination you hear normal
bowel sounds, but when you palpate his liver it is abnormal. His rectal
examination is positive for occult blood. What further abnormality of the liver was
likely found on examination?
A. Smooth, large, nontender liver
B. Irregular, large liver
C. Smooth, large, tender liver
D. Irregular, small, nontender
ANS: B
Feedback: With his past history of colon cancer and with recent weight loss and
fatigue, a relapse of his colon cancer would be expected. Colon cancer usually
metastasizes to the liver, creating hard, irregular nodules, which can sometimes be
palpated on examination. A smooth, large liver which is tender is often seen in
hepatitis.
1|Page
, NUR 634 Midterm Exam Test Bank
A 21-year-old college senior presents to your clinic, complaining of shortness of
breath and a nonproductive nocturnal cough. She states she used to feel this way
only with extreme exercise, but lately she has felt this way continuously. She
denies any other upper respiratory symptoms, chest pain, gastrointestinal
symptoms, or urinary tract symptoms. Her past medical history is significant only
for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on
no other medications. She has had no surgeries. Her mother has allergies and
eczema and her father has high blood pressure. She is an only child. She denies
smoking and illegal drug use but drinks three to four alcoholic beverages per
weekend. She is a junior in finance at a local university and she has recently
started a job as a bartender in town. On examination she is in no acute distress
and her temperature is 98.6. Her blood pressure is 120/80, her pulse is 80, and
her respirations are 20. Her head, eyes, ears, nose, and throat examinations are
essentially normal. Inspection of her anterior and posterior chest shows no
abnormalities. On auscultation of her chest, there is decreased air movement and
a high-pitched whistling on expiration in all lobes. Percussion reveals resonant
lungs. Which disorder of the thorax or lung does this best describe?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia
ANS: C
Feedback: Asthma causes shortness of breath and a nocturnal cough. It is often
associated with a history of allergies and can be made worse by exercise or
irritants such as smoke in a bar. On auscultation there can be normal to decreased
air movement. Wheezing is heard on expiration and sometimes inspiration. The
duration of wheezing in expiration usually correlates with severity of illness, so it is
important to document this length (e.g., wheezes heard halfway through
exhalation). Realize that in severe asthma, wheezes may not be heard because of
the lack of air movement. Paradoxically, these patients may have more wheezes
2|Page
, NUR 634 Midterm Exam Test Bank
after treatment, which actually indicates an improvement in condition. Peak flow
measurements help to discern this.
A 17-year-old high school senior presents to your clinic in acute respiratory
distress. Between shallow breaths he states he was at home finishing his
homework when he suddenly began having right-sided chest pain and severe
shortness of breath. He denies any recent traumas or illnesses. His past medical
history is unremarkable. He doesn't smoke but drinks several beers on the
weekend. He has tried marijuana several times but denies any other illegal drugs.
He is an honors student and is on the basketball team. His parents are both in
good health. He denies any recent weight gain, weight loss, fever, or night sweats.
On examination you see a tall, thin young man in obvious distress. He is
diaphoretic and is breathing at a rate of 35 breaths per minute. On auscultation
you hear no breath sounds on the right side of his superior chest wall. On
percussion he is hyperresonant over the right upper lobe. With palpation he has
absent fremitus over the right upper lobe. What disorder of the thorax or lung
best describes his symptoms?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia
ANS: A
Feedback: In left-sided heart failure, fluid starts “backing up” into the lungs
because the heart is unable to handle the volume. The excess fluid collects in the
dependent areas, causing crackles in the bases of the lower lobes. Sitting up allows
patients to breathe easier. The two main causes are chronic high blood pressure
and coronary artery disease, which lead to myocardial ischemia and decreased
contractility of the heart.
3|Page
, NUR 634 Midterm Exam Test Bank
A 60-year-old baker presents to your clinic, complaining of increasing shortness of
breath and nonproductive cough over the last month. She feels like she can't do as
much activity as she used to do without becoming tired. She even has to sleep
upright in her recliner at night to be able to breathe comfortably. She denies any
chest pain, nausea, or sweating. Her past medical history is significant for high
blood pressure and coronary artery disease. She had a hysterectomy in her 40s for
heavy vaginal bleeding. She is married and is retiring from the local bakery soon.
She denies any tobacco, alcohol, or drug use. Her mother died of a stroke and her
father died from prostate cancer. She denies any recent upper respiratory illness,
and she has had no other symptoms. On examination she is in no acute distress.
Her blood pressure is 160/100 and her pulse is 100. She is afebrile and her
respiratory rate is 16. With auscultation she has distant air sounds and she has
late inspiratory crackles in both lower lobes. On cardiac examination the S1 and S2
are distant and an S3 is heard over the apex. What disorder of the chest best
describes her symptoms?
A. Pneumonia
B. Chronic obstructive pulmonary disease (COPD)
C. Pleural pain
D. Left-sided heart failure
ANS: D
When a patient is suspected of having medial epicondylitis (pitcher's, golfer's, or
Little League elbow) where would they experience pain?
Wrist flexion against resistance increases the pain.
A differential to consider if a patient is having fever, shortness of breath,
productive cough, and hemoptysis?
A. COPD
4|Page
NUR 634 MIDTERM EXAM TEST BANK WITH 200 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES GRADED A+ GCU/ NUR 634
MIDTERM EXAM PREP TEST BANK NEWEST 2026| ALREADY GRADED
A+||BRAND NEW VERSION!!
A 77-year-old retired bus driver comes to your clinic for a physical examination at
his wife's request. He has recently been losing weight and has felt very fatigued.
He has had no chest pain, shortness of breath, nausea, vomiting, or fever. His past
medical history includes colon cancer, for which he had surgery, and arthritis. He
has been married for over 40 years. He denies any tobacco or drug use and has
not drunk alcohol in over 40 years. His parents both died of cancer in their 60s. On
examination his vital signs are normal. His head, cardiac, and pulmonary
examinations are unremarkable. On abdominal examination you hear normal
bowel sounds, but when you palpate his liver it is abnormal. His rectal
examination is positive for occult blood. What further abnormality of the liver was
likely found on examination?
A. Smooth, large, nontender liver
B. Irregular, large liver
C. Smooth, large, tender liver
D. Irregular, small, nontender
ANS: B
Feedback: With his past history of colon cancer and with recent weight loss and
fatigue, a relapse of his colon cancer would be expected. Colon cancer usually
metastasizes to the liver, creating hard, irregular nodules, which can sometimes be
palpated on examination. A smooth, large liver which is tender is often seen in
hepatitis.
1|Page
, NUR 634 Midterm Exam Test Bank
A 21-year-old college senior presents to your clinic, complaining of shortness of
breath and a nonproductive nocturnal cough. She states she used to feel this way
only with extreme exercise, but lately she has felt this way continuously. She
denies any other upper respiratory symptoms, chest pain, gastrointestinal
symptoms, or urinary tract symptoms. Her past medical history is significant only
for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on
no other medications. She has had no surgeries. Her mother has allergies and
eczema and her father has high blood pressure. She is an only child. She denies
smoking and illegal drug use but drinks three to four alcoholic beverages per
weekend. She is a junior in finance at a local university and she has recently
started a job as a bartender in town. On examination she is in no acute distress
and her temperature is 98.6. Her blood pressure is 120/80, her pulse is 80, and
her respirations are 20. Her head, eyes, ears, nose, and throat examinations are
essentially normal. Inspection of her anterior and posterior chest shows no
abnormalities. On auscultation of her chest, there is decreased air movement and
a high-pitched whistling on expiration in all lobes. Percussion reveals resonant
lungs. Which disorder of the thorax or lung does this best describe?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia
ANS: C
Feedback: Asthma causes shortness of breath and a nocturnal cough. It is often
associated with a history of allergies and can be made worse by exercise or
irritants such as smoke in a bar. On auscultation there can be normal to decreased
air movement. Wheezing is heard on expiration and sometimes inspiration. The
duration of wheezing in expiration usually correlates with severity of illness, so it is
important to document this length (e.g., wheezes heard halfway through
exhalation). Realize that in severe asthma, wheezes may not be heard because of
the lack of air movement. Paradoxically, these patients may have more wheezes
2|Page
, NUR 634 Midterm Exam Test Bank
after treatment, which actually indicates an improvement in condition. Peak flow
measurements help to discern this.
A 17-year-old high school senior presents to your clinic in acute respiratory
distress. Between shallow breaths he states he was at home finishing his
homework when he suddenly began having right-sided chest pain and severe
shortness of breath. He denies any recent traumas or illnesses. His past medical
history is unremarkable. He doesn't smoke but drinks several beers on the
weekend. He has tried marijuana several times but denies any other illegal drugs.
He is an honors student and is on the basketball team. His parents are both in
good health. He denies any recent weight gain, weight loss, fever, or night sweats.
On examination you see a tall, thin young man in obvious distress. He is
diaphoretic and is breathing at a rate of 35 breaths per minute. On auscultation
you hear no breath sounds on the right side of his superior chest wall. On
percussion he is hyperresonant over the right upper lobe. With palpation he has
absent fremitus over the right upper lobe. What disorder of the thorax or lung
best describes his symptoms?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia
ANS: A
Feedback: In left-sided heart failure, fluid starts “backing up” into the lungs
because the heart is unable to handle the volume. The excess fluid collects in the
dependent areas, causing crackles in the bases of the lower lobes. Sitting up allows
patients to breathe easier. The two main causes are chronic high blood pressure
and coronary artery disease, which lead to myocardial ischemia and decreased
contractility of the heart.
3|Page
, NUR 634 Midterm Exam Test Bank
A 60-year-old baker presents to your clinic, complaining of increasing shortness of
breath and nonproductive cough over the last month. She feels like she can't do as
much activity as she used to do without becoming tired. She even has to sleep
upright in her recliner at night to be able to breathe comfortably. She denies any
chest pain, nausea, or sweating. Her past medical history is significant for high
blood pressure and coronary artery disease. She had a hysterectomy in her 40s for
heavy vaginal bleeding. She is married and is retiring from the local bakery soon.
She denies any tobacco, alcohol, or drug use. Her mother died of a stroke and her
father died from prostate cancer. She denies any recent upper respiratory illness,
and she has had no other symptoms. On examination she is in no acute distress.
Her blood pressure is 160/100 and her pulse is 100. She is afebrile and her
respiratory rate is 16. With auscultation she has distant air sounds and she has
late inspiratory crackles in both lower lobes. On cardiac examination the S1 and S2
are distant and an S3 is heard over the apex. What disorder of the chest best
describes her symptoms?
A. Pneumonia
B. Chronic obstructive pulmonary disease (COPD)
C. Pleural pain
D. Left-sided heart failure
ANS: D
When a patient is suspected of having medial epicondylitis (pitcher's, golfer's, or
Little League elbow) where would they experience pain?
Wrist flexion against resistance increases the pain.
A differential to consider if a patient is having fever, shortness of breath,
productive cough, and hemoptysis?
A. COPD
4|Page
