NU650 through Midterm Exam Questions with Verified
Answers |2026/2027 Update | A+ Graded
A patient appears in the clinic with a cough that began 24 hours prior to coming to this visit. The
nurse evaluates the patient based on the most common cause of an acute cough, which is
A. chronic bronchitis
B. asthma
C. viral respiratory infection
D. pneumonia - Answer -C
A 21-year-old college senior presents to your clinic, complaining of SOB 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, CP, GI
symptoms, or urinary tract symptoms. PMH significant only for seasonal allergies. On exam she
is in no acute distress; temp is 98.6, BP is 120/80, her pulse is 80, and her RR is 20. 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 - Answer -C
A 47-year-old receptionist comes to your office, complaining of fever, shortness of breath, and a
productive cough with golden sputum. She says she had a cold last week and her symptoms
have only gotten worse, despite using over-the-counter cold remedies. She looks ill, temp is
elevated, at 101; BP and pulse unremarkable. Edema of the nasal turbinates. On auscultation
1|Page
,she has decreased air movement, and coarse crackles are heard over LLL. There is dullness on
percussion, increased fremitus during palpation, and egophony and whispered pectoriloquy on
auscultation. What disorder of the thorax or lung best describes her symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - Answer -D
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 SOB. Denies any recent traumas or illnesses. PMH
unremarkable. On examination you see a tall, thin young man in obvious distress. He is
diaphoretic and RR 35. On auscultation you hear no breath sounds on the right side of his
superior chest wall. On percussion he is hyperresonant over RUL. Palpation: absent fremitus
over the RUL.
What disorder of the thorax or lung best describes his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - Answer -A
A 62-year-old construction worker presents to your clinic, complaining of almost a year of
chronic cough and occasional shortness of breath. Although he has had worsening of symptoms
occasionally with a cold, his symptoms have stayed about the same. The cough has occasional
mucous drainage but never any blood. He denies any chest pain. PMH significant for high BP
and arthritis. 2 pack/day smoker x45 years packs a day for the past 45 years. On examination
you see a man looking slightly older than his stated age. His BP is 130/80, pulse 88. He is
breathing comfortably -RR 12. On examination of his chest, the diameter seems enlarged.
Breath sounds are decreased throughout all lobes. Rhonchi are heard over all lung fields. There
2|Page
,is no area of dullness and no increased or decreased fremitus. What thorax or lung disorder is
most likely causing his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disea - Answer -B
A 36-year-old teacher presents to your clinic, complaining of sharp, knifelike pain on the left
side of her chest x2 days. Breathing and lying down make the pain worse, while sitting forward
helps her pain. Tylenol and ibuprofen have not helped. Her pain does not radiate to any other
area. She denies any upper respiratory or gastrointestinal symptoms. PMH systemic lupus. On
examination you find her to be distressed, leaning over and holding her left arm and hand to
her left chest. BP 130/70, RR 12, and pulse 90. On auscultation her lung fields have normal
breath sounds. A scratching noise is heard at the lower left sternal border, coincident with
systole; leaning forward relieves some of her pain. What disorder of the chest best describes
this disorder?
A) Angina pectoris
B) Pericarditis
C) Dissecting aortic aneurysm
D) Pleural pain - Answer -B
A 68-year-old retired postman presents to your clinic, complaining of dull, intermittent left-sided
chest pain over the last few weeks. The pain occurs after he mows his lawn or chops wood. Pain
radiates to the left side of his jaw but nowhere else. He has felt light-headed and nauseated
with the pain but has had no other symptoms. He states when he sits down for several minutes
the pain goes away. Ibuprofen, Tylenol, and antacids have not improved his
symptoms. PMH of HTN and arthritis. Smoking hx. Exam: healthy-
appearing and breathing comfortably. BP 140/90, pulse 80. His lungs have normal breath
sounds and no abnormalities. Normal S1 and S2; no S3 or S4. Which disorder of the chest best
describes these symptoms?
A) Angina pectoris
3|Page
, B) Pericarditis
C) Dissecting aortic aneurysm
D) Pleural pain - Answer -A
A 75-year-old retired teacher presents to your clinic, complaining of severe, unrelenting anterior
chest pain radiating to her back. She describes it as if someone is "ripping out her heart." It
began less than an hour ago. She states she is feeling very nauseated and may pass out. Denies
any trauma or recent illnesses. PMH: difficult-to-control HTN & CAD requiring 2 stents. Exam:
great deal of distress. She is lying on the table, curled up, holding her
left and right arms against her chest and is restless, trying to find a comfortable position. BP
180/110 R arm and 130/60 L arm, and pulse 120. Right carotid pulse is bounding but the left
carotid pulse is weak. Afebrile, RR 24. Lungs are clear and her cardiac exam unremarkable. What
disorder of the chest best describes her symptoms?
A) Angina pectoris
B) Pericarditis
C) Dissecting aortic aneurysm
D) Pleural pain - Answer -C
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right-sided
chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds,
taking his breath away. He states he feels like he has to breathe shallowly to keep it from
recurring. The only thing that makes it better is lying quietly on his right side. It is much worse
when he takes a deep breath. 2 weeks ago he had an upper respiratory infection with a severe
hacking cough. Exam: lying on his right side but appears quite comfortable. Temp, BP, pulse, and
RR unremarkable. Normal breath sounds, percussion unremarkable. Ribs are nontender. What
disorder of the chest best describes his symptoms?
A) Pericarditis
B) Chest wall pain
4|Page
Answers |2026/2027 Update | A+ Graded
A patient appears in the clinic with a cough that began 24 hours prior to coming to this visit. The
nurse evaluates the patient based on the most common cause of an acute cough, which is
A. chronic bronchitis
B. asthma
C. viral respiratory infection
D. pneumonia - Answer -C
A 21-year-old college senior presents to your clinic, complaining of SOB 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, CP, GI
symptoms, or urinary tract symptoms. PMH significant only for seasonal allergies. On exam she
is in no acute distress; temp is 98.6, BP is 120/80, her pulse is 80, and her RR is 20. 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 - Answer -C
A 47-year-old receptionist comes to your office, complaining of fever, shortness of breath, and a
productive cough with golden sputum. She says she had a cold last week and her symptoms
have only gotten worse, despite using over-the-counter cold remedies. She looks ill, temp is
elevated, at 101; BP and pulse unremarkable. Edema of the nasal turbinates. On auscultation
1|Page
,she has decreased air movement, and coarse crackles are heard over LLL. There is dullness on
percussion, increased fremitus during palpation, and egophony and whispered pectoriloquy on
auscultation. What disorder of the thorax or lung best describes her symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - Answer -D
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 SOB. Denies any recent traumas or illnesses. PMH
unremarkable. On examination you see a tall, thin young man in obvious distress. He is
diaphoretic and RR 35. On auscultation you hear no breath sounds on the right side of his
superior chest wall. On percussion he is hyperresonant over RUL. Palpation: absent fremitus
over the RUL.
What disorder of the thorax or lung best describes his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - Answer -A
A 62-year-old construction worker presents to your clinic, complaining of almost a year of
chronic cough and occasional shortness of breath. Although he has had worsening of symptoms
occasionally with a cold, his symptoms have stayed about the same. The cough has occasional
mucous drainage but never any blood. He denies any chest pain. PMH significant for high BP
and arthritis. 2 pack/day smoker x45 years packs a day for the past 45 years. On examination
you see a man looking slightly older than his stated age. His BP is 130/80, pulse 88. He is
breathing comfortably -RR 12. On examination of his chest, the diameter seems enlarged.
Breath sounds are decreased throughout all lobes. Rhonchi are heard over all lung fields. There
2|Page
,is no area of dullness and no increased or decreased fremitus. What thorax or lung disorder is
most likely causing his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disea - Answer -B
A 36-year-old teacher presents to your clinic, complaining of sharp, knifelike pain on the left
side of her chest x2 days. Breathing and lying down make the pain worse, while sitting forward
helps her pain. Tylenol and ibuprofen have not helped. Her pain does not radiate to any other
area. She denies any upper respiratory or gastrointestinal symptoms. PMH systemic lupus. On
examination you find her to be distressed, leaning over and holding her left arm and hand to
her left chest. BP 130/70, RR 12, and pulse 90. On auscultation her lung fields have normal
breath sounds. A scratching noise is heard at the lower left sternal border, coincident with
systole; leaning forward relieves some of her pain. What disorder of the chest best describes
this disorder?
A) Angina pectoris
B) Pericarditis
C) Dissecting aortic aneurysm
D) Pleural pain - Answer -B
A 68-year-old retired postman presents to your clinic, complaining of dull, intermittent left-sided
chest pain over the last few weeks. The pain occurs after he mows his lawn or chops wood. Pain
radiates to the left side of his jaw but nowhere else. He has felt light-headed and nauseated
with the pain but has had no other symptoms. He states when he sits down for several minutes
the pain goes away. Ibuprofen, Tylenol, and antacids have not improved his
symptoms. PMH of HTN and arthritis. Smoking hx. Exam: healthy-
appearing and breathing comfortably. BP 140/90, pulse 80. His lungs have normal breath
sounds and no abnormalities. Normal S1 and S2; no S3 or S4. Which disorder of the chest best
describes these symptoms?
A) Angina pectoris
3|Page
, B) Pericarditis
C) Dissecting aortic aneurysm
D) Pleural pain - Answer -A
A 75-year-old retired teacher presents to your clinic, complaining of severe, unrelenting anterior
chest pain radiating to her back. She describes it as if someone is "ripping out her heart." It
began less than an hour ago. She states she is feeling very nauseated and may pass out. Denies
any trauma or recent illnesses. PMH: difficult-to-control HTN & CAD requiring 2 stents. Exam:
great deal of distress. She is lying on the table, curled up, holding her
left and right arms against her chest and is restless, trying to find a comfortable position. BP
180/110 R arm and 130/60 L arm, and pulse 120. Right carotid pulse is bounding but the left
carotid pulse is weak. Afebrile, RR 24. Lungs are clear and her cardiac exam unremarkable. What
disorder of the chest best describes her symptoms?
A) Angina pectoris
B) Pericarditis
C) Dissecting aortic aneurysm
D) Pleural pain - Answer -C
A 25-year-old accountant presents to your clinic, complaining of intermittent lower right-sided
chest pain for several days. He describes it as knifelike and states it only lasts for 3 to 5 seconds,
taking his breath away. He states he feels like he has to breathe shallowly to keep it from
recurring. The only thing that makes it better is lying quietly on his right side. It is much worse
when he takes a deep breath. 2 weeks ago he had an upper respiratory infection with a severe
hacking cough. Exam: lying on his right side but appears quite comfortable. Temp, BP, pulse, and
RR unremarkable. Normal breath sounds, percussion unremarkable. Ribs are nontender. What
disorder of the chest best describes his symptoms?
A) Pericarditis
B) Chest wall pain
4|Page
