2026 UPDATED QUESTIONS DOWNLOAD
NUR 634 Advanced Health Assessment Midterm Master Bank 2025/2026 Q&A | Cardiac,
Respiratory, Neurological & Abdominal Exam Prep
Master the 2025/2026 NUR 634 Midterm with this ultimate exam bank featuring over high-yield
practice questions and verified rationales. This comprehensive study guide covers advanced diagnostic
reasoning, physical examination techniques across the lifespan, and critical differential diagnoses for
cardiac, respiratory, and neurological systems. Designed specifically for graduate nursing students,
these materials ensure you are fully prepared to excel in your Advanced Health Assessment course
and clinical rotations.
1. A patient presents with "acute, intense epigastric pain" that radiates to the back and
left scapula, accompanied by nausea and vomiting. Which physical exam finding would
be a priority to assess for based on this history?
A. Murphy’s sign
B. Grey Turner’s sign (flank ecchymosis)
C. Psoas sign
D. Rovsing’s sign
Answer: B
Rationale: Acute epigastric pain radiating to the back is highly suggestive of acute pancreatitis.
Assessing for Grey Turner’s sign (flank bruising) or Cullen’s sign (periumbilical bruising) helps
identify hemorrhagic pancreatitis, a critical complication.
2. A 15-year-old female has a BMI of 19.5 kg/m². Her mother is concerned she is
underweight. What is the most appropriate response?
A. Refer her to a nutritionist for anorexia.
B. Reassure the mother that this is a normal body weight.
C. Advise the patient to increase caloric intake.
D. Screen the patient for a possible eating disorder immediately.
Answer: B
Rationale: A BMI between 18.5 and 24.9 is considered within the normal range for adults and
adolescents. Reassurance is appropriate unless other clinical signs of malnutrition are
present.
3. During a cardiac exam, you note a "high-pitched, blowing" murmur heard best at the
second right intercostal space during systole. It does not radiate. In an 82-year-old
patient, this is most likely:
A. Aortic stenosis
B. Mitral regurgitation
C. Aortic sclerosis
D. Mitral valve prolapse
, 2026 UPDATED QUESTIONS DOWNLOAD
Answer: C
Rationale: Aortic sclerosis (thickening of the valve without significant stenosis) is found in
many normal elderly patients. Unlike aortic stenosis, it typically does not radiate to the carotids
and does not affect the carotid upstroke.
4. When performing an ear exam on a 15-month-old with a fever, you see a "bulging,
erythematous, and opaque" tympanic membrane. What is the most likely diagnosis?
A. Otitis externa
B. Serous otitis media
C. Acute otitis media (AOM)
D. Cerumen impaction
Answer: C
Rationale: A bulging, red, and opaque eardrum is the classic presentation for AOM. Serous
otitis media usually involves fluid without the acute signs of inflammation like redness and
bulging.
5. A patient’s "past medical history" includes information that is considered:
A. Objective data
B. Subjective data
C. Comprehensive survey data
D. Introspective data
Answer: B
Rationale: All history components, including past medical history, are subjective because they
rely on the patient's report of their experiences and feelings.
6. Which of the following is a "positive" sign of pregnancy?
A. Amenorrhea
B. Breast tenderness
C. Fetal heart tones heard via Doppler
D. Positive urine hCG test
Answer: C
Rationale: Positive signs are those that confirm the presence of a fetus (fetal heart tones, fetal
movement felt by examiner, ultrasound). Amenorrhea and hCG tests are "presumptive" or
"probable" signs but can have other causes.
7. A 46-year-old male with cirrhosis complains of "black stools." He has a 30-pack-year
smoking history and drinks 10 alcoholic beverages daily. What is the most likely source
of his bleeding?
A. Hemorrhoids
B. Esophageal varices
C. Colon cancer
D. Anal fissure
Answer: B
, 2026 UPDATED QUESTIONS DOWNLOAD
Rationale: In a patient with cirrhosis and a history of heavy alcohol use, melena (black stools)
often points to an upper GI bleed, with ruptured esophageal varices being a life-threatening
possibility due to portal hypertension.
8. When assessing for "Tactile Fremitus," which condition would cause an ABNORMAL
increase in vibrations?
A. Pleural effusion
B. Pneumothorax
C. Pneumonia (Consolidation)
D. COPD
Answer: C
Rationale: Consolidation (solidification of lung tissue with fluid/cells) transmits sound vibrations
better than air, leading to increased fremitus. Fluid or air in the pleural space
(effusion/pneumothorax) blocks vibration.
9. A patient presents with "sudden, painless unilateral vision loss." This is a
characteristic red flag for:
A. Acute glaucoma
B. Retinal artery occlusion
C. Corneal abrasion
D. Iritis
Answer: B
Rationale: Painless, sudden loss of vision is often vascular (like retinal artery or vein occlusion)
or structural (retinal detachment). Glaucoma and iritis are typically very painful.
10. Which cranial nerve is responsible for "downward and inward" eye movement?
A. CN III (Oculomotor)
B. CN IV (Trochlear)
C. CN VI (Abducens)
D. CN II (Optic)
Answer: B
Rationale: The trochlear nerve innervates the superior oblique muscle, which moves the eye
down toward the nose. Damage often results in diplopia (double vision) when looking down.
11. A 58-year-old patient has an "oval, brown, slightly elevated" lesion on her chest that
looks "stuck on" with a wart-like texture. This is most likely:
A. Basal cell carcinoma
B. Seborrheic keratosis
C. Actinic keratosis
D. Melanoma
Answer: B
Rationale: The "stuck-on" appearance is the classic descriptor for seborrheic keratosis, a
benign skin growth common in older adults.
, 2026 UPDATED QUESTIONS DOWNLOAD
12. In the "PQRST" mnemonic for pain assessment, which component involves asking
the patient if the pain "spreads to other areas"?
A. P (Provocative/Palliative)
B. Q (Quality)
C. R (Region/Radiation)
D. S (Severity)
Answer: C
Rationale: Radiation refers to the pattern of symptom spread from the original site to other
parts of the body.
13. A patient with "myasthenia gravis" has a drooping eyelid. This clinical finding is
known as:
A. Ectropion
B. Entropion
C. Ptosis
D. Exophthalmos
Answer: C
Rationale: Ptosis is the drooping of the upper eyelid, which can be caused by neuromuscular
disorders like myasthenia gravis or nerve damage (CN III).
14. What does "hyper-resonance" during lung percussion typically indicate?
A. Normal lung tissue
B. Fluid in the pleural space
C. Lung consolidation
D. Hyperinflation (COPD or Asthma)
Answer: D
Rationale: Hyper-resonance is a lower-pitched, louder sound heard when there is too much air
in the lungs, as seen in emphysema or an acute asthma attack.
15. A patient has a "rough, grayish-white" opacity on the cornea. This is most likely a:
A. Cataract
B. Corneal scar
C. Pterygium
D. Chalazion
Answer: B
Rationale: A corneal scar is a superficial grayish-white opacity. A cataract is an opacity of the
lens behind the pupil, not the cornea itself.
16. Which part of the stethoscope is best for listening to "low-pitched" sounds like S3
or S4?
A. Diaphragm
B. Bell
C. Earpieces
NUR 634 Advanced Health Assessment Midterm Master Bank 2025/2026 Q&A | Cardiac,
Respiratory, Neurological & Abdominal Exam Prep
Master the 2025/2026 NUR 634 Midterm with this ultimate exam bank featuring over high-yield
practice questions and verified rationales. This comprehensive study guide covers advanced diagnostic
reasoning, physical examination techniques across the lifespan, and critical differential diagnoses for
cardiac, respiratory, and neurological systems. Designed specifically for graduate nursing students,
these materials ensure you are fully prepared to excel in your Advanced Health Assessment course
and clinical rotations.
1. A patient presents with "acute, intense epigastric pain" that radiates to the back and
left scapula, accompanied by nausea and vomiting. Which physical exam finding would
be a priority to assess for based on this history?
A. Murphy’s sign
B. Grey Turner’s sign (flank ecchymosis)
C. Psoas sign
D. Rovsing’s sign
Answer: B
Rationale: Acute epigastric pain radiating to the back is highly suggestive of acute pancreatitis.
Assessing for Grey Turner’s sign (flank bruising) or Cullen’s sign (periumbilical bruising) helps
identify hemorrhagic pancreatitis, a critical complication.
2. A 15-year-old female has a BMI of 19.5 kg/m². Her mother is concerned she is
underweight. What is the most appropriate response?
A. Refer her to a nutritionist for anorexia.
B. Reassure the mother that this is a normal body weight.
C. Advise the patient to increase caloric intake.
D. Screen the patient for a possible eating disorder immediately.
Answer: B
Rationale: A BMI between 18.5 and 24.9 is considered within the normal range for adults and
adolescents. Reassurance is appropriate unless other clinical signs of malnutrition are
present.
3. During a cardiac exam, you note a "high-pitched, blowing" murmur heard best at the
second right intercostal space during systole. It does not radiate. In an 82-year-old
patient, this is most likely:
A. Aortic stenosis
B. Mitral regurgitation
C. Aortic sclerosis
D. Mitral valve prolapse
, 2026 UPDATED QUESTIONS DOWNLOAD
Answer: C
Rationale: Aortic sclerosis (thickening of the valve without significant stenosis) is found in
many normal elderly patients. Unlike aortic stenosis, it typically does not radiate to the carotids
and does not affect the carotid upstroke.
4. When performing an ear exam on a 15-month-old with a fever, you see a "bulging,
erythematous, and opaque" tympanic membrane. What is the most likely diagnosis?
A. Otitis externa
B. Serous otitis media
C. Acute otitis media (AOM)
D. Cerumen impaction
Answer: C
Rationale: A bulging, red, and opaque eardrum is the classic presentation for AOM. Serous
otitis media usually involves fluid without the acute signs of inflammation like redness and
bulging.
5. A patient’s "past medical history" includes information that is considered:
A. Objective data
B. Subjective data
C. Comprehensive survey data
D. Introspective data
Answer: B
Rationale: All history components, including past medical history, are subjective because they
rely on the patient's report of their experiences and feelings.
6. Which of the following is a "positive" sign of pregnancy?
A. Amenorrhea
B. Breast tenderness
C. Fetal heart tones heard via Doppler
D. Positive urine hCG test
Answer: C
Rationale: Positive signs are those that confirm the presence of a fetus (fetal heart tones, fetal
movement felt by examiner, ultrasound). Amenorrhea and hCG tests are "presumptive" or
"probable" signs but can have other causes.
7. A 46-year-old male with cirrhosis complains of "black stools." He has a 30-pack-year
smoking history and drinks 10 alcoholic beverages daily. What is the most likely source
of his bleeding?
A. Hemorrhoids
B. Esophageal varices
C. Colon cancer
D. Anal fissure
Answer: B
, 2026 UPDATED QUESTIONS DOWNLOAD
Rationale: In a patient with cirrhosis and a history of heavy alcohol use, melena (black stools)
often points to an upper GI bleed, with ruptured esophageal varices being a life-threatening
possibility due to portal hypertension.
8. When assessing for "Tactile Fremitus," which condition would cause an ABNORMAL
increase in vibrations?
A. Pleural effusion
B. Pneumothorax
C. Pneumonia (Consolidation)
D. COPD
Answer: C
Rationale: Consolidation (solidification of lung tissue with fluid/cells) transmits sound vibrations
better than air, leading to increased fremitus. Fluid or air in the pleural space
(effusion/pneumothorax) blocks vibration.
9. A patient presents with "sudden, painless unilateral vision loss." This is a
characteristic red flag for:
A. Acute glaucoma
B. Retinal artery occlusion
C. Corneal abrasion
D. Iritis
Answer: B
Rationale: Painless, sudden loss of vision is often vascular (like retinal artery or vein occlusion)
or structural (retinal detachment). Glaucoma and iritis are typically very painful.
10. Which cranial nerve is responsible for "downward and inward" eye movement?
A. CN III (Oculomotor)
B. CN IV (Trochlear)
C. CN VI (Abducens)
D. CN II (Optic)
Answer: B
Rationale: The trochlear nerve innervates the superior oblique muscle, which moves the eye
down toward the nose. Damage often results in diplopia (double vision) when looking down.
11. A 58-year-old patient has an "oval, brown, slightly elevated" lesion on her chest that
looks "stuck on" with a wart-like texture. This is most likely:
A. Basal cell carcinoma
B. Seborrheic keratosis
C. Actinic keratosis
D. Melanoma
Answer: B
Rationale: The "stuck-on" appearance is the classic descriptor for seborrheic keratosis, a
benign skin growth common in older adults.
, 2026 UPDATED QUESTIONS DOWNLOAD
12. In the "PQRST" mnemonic for pain assessment, which component involves asking
the patient if the pain "spreads to other areas"?
A. P (Provocative/Palliative)
B. Q (Quality)
C. R (Region/Radiation)
D. S (Severity)
Answer: C
Rationale: Radiation refers to the pattern of symptom spread from the original site to other
parts of the body.
13. A patient with "myasthenia gravis" has a drooping eyelid. This clinical finding is
known as:
A. Ectropion
B. Entropion
C. Ptosis
D. Exophthalmos
Answer: C
Rationale: Ptosis is the drooping of the upper eyelid, which can be caused by neuromuscular
disorders like myasthenia gravis or nerve damage (CN III).
14. What does "hyper-resonance" during lung percussion typically indicate?
A. Normal lung tissue
B. Fluid in the pleural space
C. Lung consolidation
D. Hyperinflation (COPD or Asthma)
Answer: D
Rationale: Hyper-resonance is a lower-pitched, louder sound heard when there is too much air
in the lungs, as seen in emphysema or an acute asthma attack.
15. A patient has a "rough, grayish-white" opacity on the cornea. This is most likely a:
A. Cataract
B. Corneal scar
C. Pterygium
D. Chalazion
Answer: B
Rationale: A corneal scar is a superficial grayish-white opacity. A cataract is an opacity of the
lens behind the pupil, not the cornea itself.
16. Which part of the stethoscope is best for listening to "low-pitched" sounds like S3
or S4?
A. Diaphragm
B. Bell
C. Earpieces
