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NUR 634 MIDTERM EXAM (GCU) NEWEST 2026 ACTUAL EXAM
TEST BANK| NUR 634 ADVANCED PHYSICAL ASSESSMENT
MIDTERM EXAM REVIEW WITH COMPLETE 75 REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST RECENT!!)
SECTION 1: HEALTH HISTORY & INTERVIEWING (Questions 1–12)
Question 1
A 72-year-old patient reports “dizziness.” Which additional historical element is
most critical to differentiate causes?
A) Dietary habits
B) Onset and provoking factors
C) Family history of dizziness
D) Number of medications
: Answer : B) Onset and provoking factors
Rationale: Dizziness has a broad differential including vestibular, cardiovascular,
and neurologic causes. Onset (acute vs. chronic) and provoking factors (position
change, head movement, with exertion) are essential to distinguish benign
paroxysmal positional vertigo, orthostatic hypotension, arrhythmia, or central
causes. While medication review (D) is important, it is not the most critical
immediate discriminator.
Question 2
You are taking a sexual history from a 22-year-old. Which question best opens the
discussion in a non-judgmental way?
A) “Are you sexually active?”
B) “You’re not having sex, are you?”
pg. 1
,2
C) “Many people have questions about sexual health. Is it okay if I ask a few
routine questions?”
D) “Do you use protection?”
: Answer : C) “Many people have questions about sexual health. Is it okay if I
ask a few routine questions?”
Rationale: This approach normalizes the topic, obtains permission, and reduces
patient anxiety. It is patient-centered and aligns with the “ask-first” technique
recommended for sensitive histories. Asking if the patient is sexually active (A) or
using protection (D) may feel abrupt or judgmental.
Question 3
For which of the following patients would a comprehensive health history be
appropriate?
A) A new patient with the chief complaint of “I sprained my ankle”
B) An established patient with the chief complaint of “I have an upper respiratory
infection”
C) A new patient with the chief complaint of “I am here to establish care”
D) A new patient with the chief complaint of “I cut my hand”
: Answer : C) A new patient with the chief complaint of “I am here to establish
care”
Rationale: A comprehensive health history is appropriate for a new patient
establishing care, regardless of their stated chief complaint, because the clinician
needs to obtain a complete baseline of the patient’s past medical history, family
history, social history, and review of systems. Episodic or focused histories are
used for acute, isolated problems.
Question 4
The following information is recorded in the health history: “The patient
completed 8th grade. He currently lives with his wife and two children. He works
on old cars on the weekend. He works in a glass factory during the week.” Which
category does it belong to?
pg. 2
,3
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems
: Answer : C) Personal and social history
Rationale: Personal and social history information includes educational level,
family of origin, current household status, personal interests, employment,
religious beliefs, military history, and lifestyle (including diet and exercise; use of
alcohol, tobacco, and/or drugs; and sexual preferences and history).
Question 5
Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus
erythematosus). She has noticed a raised, dark red rash on her legs. When you
press on the rash, it does not blanch. What would you tell her regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any problems.
: Answer : A) It is likely to be related to her lupus.
Rationale: A “palpable purpura” is usually associated with vasculitis, an
inflammatory condition of the blood vessels often associated with systemic
rheumatic diseases such as SLE. It can cut off circulation to any portion of the
body and can mimic many other diseases. While allergic and chemical exposures
may be possible causes, the patient’s SLE should make you consider vasculitis.
Question 6
In which of the following patients would a comprehensive health history be
appropriate? (Select all that apply)
A) A new patient with the chief complaint of “I sprained my ankle”
B) An established patient with the chief complaint of “I have an upper respiratory
pg. 3
, 4
infection”
C) A new patient with the chief complaint of “I am here to establish care”
D) A new patient with the chief complaint of “I cut my hand”
: Answer : A and C
Rationale: A comprehensive health history is appropriate for a new patient
establishing care (Option C) as well as for a new patient with an acute complaint if
the clinician does not have a prior established record; however, many exam banks
select only Option C. For an established patient with an acute URI (B), a focused
history is appropriate. For a new patient with a cut hand (D), an episodic/focused
history is appropriate.
Question 7
You have a patient who comes in that is super talkative. At the end of it all, what
tools do you have to find out what the patient actually came in for?
A) Redirect and summarize
B) Ask the patient to stop talking
C) Let the patient continue and hope they eventually tell you
D) Ask a leading question such as “Are you here for pain?”
: Answer : A) Redirect and summarize
Rationale: The most effective technique for managing a talkative patient is to
listen closely for the first few minutes to show respect and gather information,
then gently redirect by summarizing what you have heard and asking a focused
question to clarify the chief complaint. Summarization is a key interviewing skill
that builds rapport while maintaining efficiency.
Question 8
The talkative patient may ramble on when asked to expand on their concern. This
encounter can be best managed by:
A) Interrupting the patient immediately
B) Listening closely, allowing the patient to tell their story for the first 5 minutes,
pg. 4
NUR 634 MIDTERM EXAM (GCU) NEWEST 2026 ACTUAL EXAM
TEST BANK| NUR 634 ADVANCED PHYSICAL ASSESSMENT
MIDTERM EXAM REVIEW WITH COMPLETE 75 REAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST RECENT!!)
SECTION 1: HEALTH HISTORY & INTERVIEWING (Questions 1–12)
Question 1
A 72-year-old patient reports “dizziness.” Which additional historical element is
most critical to differentiate causes?
A) Dietary habits
B) Onset and provoking factors
C) Family history of dizziness
D) Number of medications
: Answer : B) Onset and provoking factors
Rationale: Dizziness has a broad differential including vestibular, cardiovascular,
and neurologic causes. Onset (acute vs. chronic) and provoking factors (position
change, head movement, with exertion) are essential to distinguish benign
paroxysmal positional vertigo, orthostatic hypotension, arrhythmia, or central
causes. While medication review (D) is important, it is not the most critical
immediate discriminator.
Question 2
You are taking a sexual history from a 22-year-old. Which question best opens the
discussion in a non-judgmental way?
A) “Are you sexually active?”
B) “You’re not having sex, are you?”
pg. 1
,2
C) “Many people have questions about sexual health. Is it okay if I ask a few
routine questions?”
D) “Do you use protection?”
: Answer : C) “Many people have questions about sexual health. Is it okay if I
ask a few routine questions?”
Rationale: This approach normalizes the topic, obtains permission, and reduces
patient anxiety. It is patient-centered and aligns with the “ask-first” technique
recommended for sensitive histories. Asking if the patient is sexually active (A) or
using protection (D) may feel abrupt or judgmental.
Question 3
For which of the following patients would a comprehensive health history be
appropriate?
A) A new patient with the chief complaint of “I sprained my ankle”
B) An established patient with the chief complaint of “I have an upper respiratory
infection”
C) A new patient with the chief complaint of “I am here to establish care”
D) A new patient with the chief complaint of “I cut my hand”
: Answer : C) A new patient with the chief complaint of “I am here to establish
care”
Rationale: A comprehensive health history is appropriate for a new patient
establishing care, regardless of their stated chief complaint, because the clinician
needs to obtain a complete baseline of the patient’s past medical history, family
history, social history, and review of systems. Episodic or focused histories are
used for acute, isolated problems.
Question 4
The following information is recorded in the health history: “The patient
completed 8th grade. He currently lives with his wife and two children. He works
on old cars on the weekend. He works in a glass factory during the week.” Which
category does it belong to?
pg. 2
,3
A) Chief complaint
B) Present illness
C) Personal and social history
D) Review of systems
: Answer : C) Personal and social history
Rationale: Personal and social history information includes educational level,
family of origin, current household status, personal interests, employment,
religious beliefs, military history, and lifestyle (including diet and exercise; use of
alcohol, tobacco, and/or drugs; and sexual preferences and history).
Question 5
Mrs. Hill is a 28-year-old African-American with a history of SLE (systemic lupus
erythematosus). She has noticed a raised, dark red rash on her legs. When you
press on the rash, it does not blanch. What would you tell her regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any problems.
: Answer : A) It is likely to be related to her lupus.
Rationale: A “palpable purpura” is usually associated with vasculitis, an
inflammatory condition of the blood vessels often associated with systemic
rheumatic diseases such as SLE. It can cut off circulation to any portion of the
body and can mimic many other diseases. While allergic and chemical exposures
may be possible causes, the patient’s SLE should make you consider vasculitis.
Question 6
In which of the following patients would a comprehensive health history be
appropriate? (Select all that apply)
A) A new patient with the chief complaint of “I sprained my ankle”
B) An established patient with the chief complaint of “I have an upper respiratory
pg. 3
, 4
infection”
C) A new patient with the chief complaint of “I am here to establish care”
D) A new patient with the chief complaint of “I cut my hand”
: Answer : A and C
Rationale: A comprehensive health history is appropriate for a new patient
establishing care (Option C) as well as for a new patient with an acute complaint if
the clinician does not have a prior established record; however, many exam banks
select only Option C. For an established patient with an acute URI (B), a focused
history is appropriate. For a new patient with a cut hand (D), an episodic/focused
history is appropriate.
Question 7
You have a patient who comes in that is super talkative. At the end of it all, what
tools do you have to find out what the patient actually came in for?
A) Redirect and summarize
B) Ask the patient to stop talking
C) Let the patient continue and hope they eventually tell you
D) Ask a leading question such as “Are you here for pain?”
: Answer : A) Redirect and summarize
Rationale: The most effective technique for managing a talkative patient is to
listen closely for the first few minutes to show respect and gather information,
then gently redirect by summarizing what you have heard and asking a focused
question to clarify the chief complaint. Summarization is a key interviewing skill
that builds rapport while maintaining efficiency.
Question 8
The talkative patient may ramble on when asked to expand on their concern. This
encounter can be best managed by:
A) Interrupting the patient immediately
B) Listening closely, allowing the patient to tell their story for the first 5 minutes,
pg. 4
