NUR 634 MIDTERM EXAM 2026-
v v v v
2027 GRAND CANYON UNIVERSITY WITH 200 REAL EXAM Q
v v v v v v v v
UESTIONS AND CORRECT VERIFIED ANSWERS WITH RATIO
v v v v v v
NALES/ NUR 634 ADVANCED HEALTH ASSESSMENT LATEST
v v v v v v v
MIDTERM EXAM (NEWEST!) v v
vAnv8-year-
oldvgirlvcomesvwithvhervmothervforvevaluationvofvhairvloss.vShevdeniesvpullingvorvtwistingvhervhair,vandv
hervmothervhasvnotvnotedvthisvbehaviorvatvall.vShevdoesvnotvputvhervhairvinvbraids.vOnvphysicalvexamin
ation,vyouvnotevavclearlyvdemarcated,vroundvpatchvofvhairvlossvwithoutvvisiblevscalingvorvinflammation.
vTherevarevnovhairvshaftsvvisible.vBasedvonvthisvdescription,vwhatvisvyourvmostvlikelyvdiagnosis?
A. Alopeciavareata
B. Trichotillomania
C. Tineavcapitis
D. Tractionvalopecia
v ANS:vA
Feedback:vThisvisvavtypicalvdescriptionvforvalopeciavareata.vTherevarevnovriskvfactorsvforvtrichotillomani
avorvforvtractionvalopecia.vThevphysicalvexaminationvisvnotvconsistentvwithvtineavcapitisvbecausevthevski
nvisvintact.
Av46-year-
oldvformervsalesmanvpresentsvtovthevER,vcomplainingvofvblackvstoolsvforvthevpastvfewvweeks.vHisvpastv
medicalvhistoryvisvsignificantvforvcirrhosis.vHevhasvgainedvweightvrecently,vespeciallyvaroundvhisvabdo
men.vHevhasvsmokedvtwovpacksvofvcigarettesvavdayvforv30vyearsvandvhasvdrunkvapproximatelyv10valco
holicvbeveragesvavdayvforv25vyears.vHevhasvusedvIVvheroinvandvsmokedvcrackvinvthevpast.vHevdeniesvan
yvrecentvuse.vHevisvcurrentlyvunemployedvandvhasvnevervbeenvmarried.vOnvexaminationvyouvfindvavma
nvappearingvoldervthanvhisvstatedvage.vHisvskinvhasvavyellowishvtintvandvhevisvthin,vwithvavprominentvab
domen.vYouvnotevmultiplev"spidervangiomas"vatvthevbasevofvhisvneck.
Otherwise,vhisvheartvandvlungvexaminationsvarevnormal.vOnvinspectionvhevhasvdilatedvveinsvaroundvhi
svumbilicus.vIncreasedvbowelvsoundsvarevheardvduringvauscultation.vPalpationvrevealsvdiffusevtendern
essvthatvisvmorevseverevinvthevepigastricvarea.vHisvlivervisvsmallvandvhardvtovpalpationvandvhevhasvavposi
tivevfluidvwave.vHevisvpositivevforvoccultvbloodvonvhisvrectalvexamination.vWhatvcausevofvblackvstoolsvm
ostvlikelyvdescribesvhisvsymptomsvandvsigns?
A. Infectiousvdiarrhea
B. Mallory-Weissvtear
C. Esophagealvvarices
D. Ulcerativevcolitis
v ANS:vC
,Varicesvarevoftenvfoundvinvalcoholicvpatients,vbutvonlyvwhenvtheyvhavevavdiagnosisvofvsignificantvcirrh
osis.vThisvpatientvhasvsymptomsvofvcirrhosis,vincludingvjaundice,vascites,vspidervhemangiomas,vandvdil
atedvveinsvonvhisvabdomenv(caputvmedusa).
Youvarevbeginningvthevexaminationvofvthevskinvonvav25-year-
oldvteacher.vYouvhavevpreviouslyvelicitedvthatvshevcamevtovthevofficevforvevaluationvofvfatigue,vweightv
gain,vandvhairvloss.vYouvstronglyvsuspectvthatvshevhasvhypothyroidism.vWhatvisvthevexpectedvmoisturev
andvtexturevofvthevskinvofvavpatientvwithvhypothyroidism?
A. Moistvandvsmooth
B. Moistvandvrough
C. Dryvandvsmooth
D. Dryvandvrough
v ANS:vD
42-year-
oldvfloristvcomesvtovyourvoffice,vcomplainingvofvchronicvconstipationvforvthevlastv6vmonths.vShevhasvha
dvnovnausea,vvomiting,vorvdiarrheavandvnovabdominalvpainvorvcramping.vShevdeniesvanyvrecentvillness
esvorvinjuries.vShevdeniesvanyvchangesvtovhervdietvorvexercisevprogram.vShevisvonvnovnewvmedications.v
Duringvthevreviewvofvsystemsvyouvnotevthatvshevhasvfeltvfatigued,vhadvsomevweightv gain,vhasvirregular
vperiods,vandvhasvcoldvintolerance.vHervpastvmedicalvhistoryvisvsignificantvforvonevvaginalvdeliveryvandv
twovcesareanvsections.vShevisvmarried,vhasvthreevchildren,vandvownsvavflowervshop.vShevdeniesvtobacc
o,valcohol,vorvdrugvuse.vHervmothervhasvtypev2vdiabetesvandvhervfathervhasvcoronaryvarteryvdisease.vTh
erevisvnovfamilyvhistoryvofvcancers.vOnvexaminationvshevappearsvherv statedvage.vHervvitalvsignsvarevnor
mal.vHervhead,veyes,vears,vnose,vthroat,vandvneckvexaminationsvarevnormal.vHervcardiac,vlung,vandvabd
ominalvexaminationsvarevalsovunremarkable.vHervrectalvoccultvbloodvtestvisvnegative.vHervdeepvtendon
vreflexesvarevdelayedvinvresponsevtovavblowvwithvthevhammer,vespeciallyvthevAchillesvtendons.vWhatvisv
thevbestvchoicevforvthevcausevofvhervconstipation?
A.vLargevbowelvobstruction
B.vIrritablevbowelvsyndrome
C.vRectalvcancer
D.vHypothyroidism
v ANS:vD
Avdaycarevworkervpresentsvtovyourvofficevwithvjaundice.vShevdeniesvIVvdrugvuse,vbloodvtransfusion,v
andvtravelvandvhasvnotvbeenvsexuallyvactivevforvthevpastv10vmonths.vWhichvtypevofvhepatitisvisvmostvl
ikely?
,A.vHepatitisvA
B.vHepatitisvB
C.vHepatitisvC
D.vHepatitisvDv
ANS:vA
Feedback:vThevlackvofvcontactvwithvbloodvandvbodyvfluidsvmakesvhepatitisvB,vC,vandvDvunlikely.vShevreg
ularlyvchangesvthevdiapersvofvhervclientsvandvisvatvriskvforvhepatitisvA.vVaccinevagainstvhepatitisvAvisvreco
mmendedvforvdaycarevworkers
Avyoungvmanvcomesvtovyouvwithvanvextremelyvpruriticvrashvovervhisvkneesvandvelbowsvwhichvhasvcom
evandvgonevforvseveralvyears.vItvseemsvtovbevworsevinvthevwintervandvimprovesvwithvsomevsunvexposur
e.vOnvexamination,vyouvnoticevscabbingvandvcrustingvwithvsomevsilveryvscale,vandvyouvarevobservantv
enoughvtovnoticevsmallv"pits"vinvhisvnails.vWhatvwouldvaccountvforvthesevfindings?
A.vEczema
B.vPityriasisvrosea
C.vPsoriasis
D.vTineavinfectionv
ANS:vC
Feedback:vThisvisvavclassicvpresentationvofvplaquevpsoriasis.vEczemavisvusuallyvovervthevflexorvsurfacesv
andvdoesvnotvscale,vwhereasvpsoriasisvaffectsvthevextensorvsurfaces.vPityriasisvusuallyvisvlimitedvtovthev
trunkvandvproximalvextremities.vTineavhasvavmuchvfinervscalevassociatedvwithvit,valmostvlikevpowder,va
ndvisvfoundvinvdarkvandvmoistvareas
Mr.vMartinvisvav72-year-
oldvsmokervwhovcomesvtovyouvforvhisvhypertensionvvisit.vYouvnotevthatvwithvdeepvpalpationvyouvfeelva
vpulsatilevmassvwhichvisvaboutv4vcentimetersvinvdiameter.vWhatvshouldvyouvdovnext?
B.vReassessvbyvexaminationvinv6vmonths
C.vReassessvbyvexaminationvinv3vmonths
D.vRefervtovavvascularvsurgeonvAN
S:vA
Feedback:vAvpulsatilevmassvinvthisvmanvshouldvbevfollowedvupvwithvultrasoundvasvsoonvasvpossible.vHis
vriskvofvaorticvrupturevisvatvleastv15vtimesvgreatervifvhisvaortavmeasuresvmorevthanv4vcentimeters.vIt
, wouldvbevinappropriatevtovrecheckvhimvatvavlatervtimevwithoutvtakingvaction.vLikewise,vreferralvtovavva
scularvsurgeonvbeforevultrasoundvmayvbevpremature.
**AorticvAneurysm**
Av8-year-
oldvpatientvpresentsvtovthevofficevforvevaluationvofvavrash.vAtvfirst,vtherevwasvonlyvonevlargevpatch,vbut
vthenvmorevlesionsveruptedvsuddenlyvonvthevbackvandvtorso;vthevlesionsvitch.vOnvphysicalvexaminatio
n,vyouvnotevthatvthevpatternvofveruptionvisvlikevavChristmasvtreevandvthatvtherevarevavvarietyvofverythe
matousvpapulesvandvmaculesvonvthevcleavagevlinesvofvthevback.vBasedvonvthisvdescription,vwhatvisvthe
vmostvlikelyvdiagnosis?
A.vPityriasisvrosea
B.vTineavversicolor
C.vPsoriasis
D.vAtopicveczemav
ANS:vA
Av28-year-
oldvpatientvcomesvtovthevofficevforvevaluationvofvavrash.vAtvfirstvtherevwasvonlyvonevlargevpatch,vbutvth
envmorevlesionsveruptedvsuddenlyvonvthevbackvandvtorso;vthevlesionsvitch.vOnvphysicalvexamination,vy
ouvnotevthatvthevpatternvofveruptionvisvlikevavChristmasvtreevandvthatvtherevarevavvarietyvofverythemat
ousvpapulesvandvmaculesvonvthevcleavagevlinesvofvthevback.vBasedvonvthisvdescription,vwhatvisvthevmo
stvlikelyvdiagnosis?
A.vPityriasisvrosea
B.vTineavversicolor
C.vPsoriasis
D.vAtopicveczemav
ANS:vA
Feedback:vThisvisvavclassicvdescriptionvofvpityriasisvrosea.vThevdescriptionvofvavlargevsinglevorv“herald”v
patchvprecedingvtheveruptionvisvavgoodvwayvtovdistinguishvthisvrashvfromvothervconditions.
Avlightvisvpointedvatvavpatient'svpupil,vwhichvcontracts.vItvisvalsovnotedvthatvthevothervpupilvcontractsvas
vwell,vthoughvitvisvnotvexposedvtovbrightvlight.vWhichvofvthevfollowingvtermsvdescribesvthisvlattervphen
omenon?
v v v v
2027 GRAND CANYON UNIVERSITY WITH 200 REAL EXAM Q
v v v v v v v v
UESTIONS AND CORRECT VERIFIED ANSWERS WITH RATIO
v v v v v v
NALES/ NUR 634 ADVANCED HEALTH ASSESSMENT LATEST
v v v v v v v
MIDTERM EXAM (NEWEST!) v v
vAnv8-year-
oldvgirlvcomesvwithvhervmothervforvevaluationvofvhairvloss.vShevdeniesvpullingvorvtwistingvhervhair,vandv
hervmothervhasvnotvnotedvthisvbehaviorvatvall.vShevdoesvnotvputvhervhairvinvbraids.vOnvphysicalvexamin
ation,vyouvnotevavclearlyvdemarcated,vroundvpatchvofvhairvlossvwithoutvvisiblevscalingvorvinflammation.
vTherevarevnovhairvshaftsvvisible.vBasedvonvthisvdescription,vwhatvisvyourvmostvlikelyvdiagnosis?
A. Alopeciavareata
B. Trichotillomania
C. Tineavcapitis
D. Tractionvalopecia
v ANS:vA
Feedback:vThisvisvavtypicalvdescriptionvforvalopeciavareata.vTherevarevnovriskvfactorsvforvtrichotillomani
avorvforvtractionvalopecia.vThevphysicalvexaminationvisvnotvconsistentvwithvtineavcapitisvbecausevthevski
nvisvintact.
Av46-year-
oldvformervsalesmanvpresentsvtovthevER,vcomplainingvofvblackvstoolsvforvthevpastvfewvweeks.vHisvpastv
medicalvhistoryvisvsignificantvforvcirrhosis.vHevhasvgainedvweightvrecently,vespeciallyvaroundvhisvabdo
men.vHevhasvsmokedvtwovpacksvofvcigarettesvavdayvforv30vyearsvandvhasvdrunkvapproximatelyv10valco
holicvbeveragesvavdayvforv25vyears.vHevhasvusedvIVvheroinvandvsmokedvcrackvinvthevpast.vHevdeniesvan
yvrecentvuse.vHevisvcurrentlyvunemployedvandvhasvnevervbeenvmarried.vOnvexaminationvyouvfindvavma
nvappearingvoldervthanvhisvstatedvage.vHisvskinvhasvavyellowishvtintvandvhevisvthin,vwithvavprominentvab
domen.vYouvnotevmultiplev"spidervangiomas"vatvthevbasevofvhisvneck.
Otherwise,vhisvheartvandvlungvexaminationsvarevnormal.vOnvinspectionvhevhasvdilatedvveinsvaroundvhi
svumbilicus.vIncreasedvbowelvsoundsvarevheardvduringvauscultation.vPalpationvrevealsvdiffusevtendern
essvthatvisvmorevseverevinvthevepigastricvarea.vHisvlivervisvsmallvandvhardvtovpalpationvandvhevhasvavposi
tivevfluidvwave.vHevisvpositivevforvoccultvbloodvonvhisvrectalvexamination.vWhatvcausevofvblackvstoolsvm
ostvlikelyvdescribesvhisvsymptomsvandvsigns?
A. Infectiousvdiarrhea
B. Mallory-Weissvtear
C. Esophagealvvarices
D. Ulcerativevcolitis
v ANS:vC
,Varicesvarevoftenvfoundvinvalcoholicvpatients,vbutvonlyvwhenvtheyvhavevavdiagnosisvofvsignificantvcirrh
osis.vThisvpatientvhasvsymptomsvofvcirrhosis,vincludingvjaundice,vascites,vspidervhemangiomas,vandvdil
atedvveinsvonvhisvabdomenv(caputvmedusa).
Youvarevbeginningvthevexaminationvofvthevskinvonvav25-year-
oldvteacher.vYouvhavevpreviouslyvelicitedvthatvshevcamevtovthevofficevforvevaluationvofvfatigue,vweightv
gain,vandvhairvloss.vYouvstronglyvsuspectvthatvshevhasvhypothyroidism.vWhatvisvthevexpectedvmoisturev
andvtexturevofvthevskinvofvavpatientvwithvhypothyroidism?
A. Moistvandvsmooth
B. Moistvandvrough
C. Dryvandvsmooth
D. Dryvandvrough
v ANS:vD
42-year-
oldvfloristvcomesvtovyourvoffice,vcomplainingvofvchronicvconstipationvforvthevlastv6vmonths.vShevhasvha
dvnovnausea,vvomiting,vorvdiarrheavandvnovabdominalvpainvorvcramping.vShevdeniesvanyvrecentvillness
esvorvinjuries.vShevdeniesvanyvchangesvtovhervdietvorvexercisevprogram.vShevisvonvnovnewvmedications.v
Duringvthevreviewvofvsystemsvyouvnotevthatvshevhasvfeltvfatigued,vhadvsomevweightv gain,vhasvirregular
vperiods,vandvhasvcoldvintolerance.vHervpastvmedicalvhistoryvisvsignificantvforvonevvaginalvdeliveryvandv
twovcesareanvsections.vShevisvmarried,vhasvthreevchildren,vandvownsvavflowervshop.vShevdeniesvtobacc
o,valcohol,vorvdrugvuse.vHervmothervhasvtypev2vdiabetesvandvhervfathervhasvcoronaryvarteryvdisease.vTh
erevisvnovfamilyvhistoryvofvcancers.vOnvexaminationvshevappearsvherv statedvage.vHervvitalvsignsvarevnor
mal.vHervhead,veyes,vears,vnose,vthroat,vandvneckvexaminationsvarevnormal.vHervcardiac,vlung,vandvabd
ominalvexaminationsvarevalsovunremarkable.vHervrectalvoccultvbloodvtestvisvnegative.vHervdeepvtendon
vreflexesvarevdelayedvinvresponsevtovavblowvwithvthevhammer,vespeciallyvthevAchillesvtendons.vWhatvisv
thevbestvchoicevforvthevcausevofvhervconstipation?
A.vLargevbowelvobstruction
B.vIrritablevbowelvsyndrome
C.vRectalvcancer
D.vHypothyroidism
v ANS:vD
Avdaycarevworkervpresentsvtovyourvofficevwithvjaundice.vShevdeniesvIVvdrugvuse,vbloodvtransfusion,v
andvtravelvandvhasvnotvbeenvsexuallyvactivevforvthevpastv10vmonths.vWhichvtypevofvhepatitisvisvmostvl
ikely?
,A.vHepatitisvA
B.vHepatitisvB
C.vHepatitisvC
D.vHepatitisvDv
ANS:vA
Feedback:vThevlackvofvcontactvwithvbloodvandvbodyvfluidsvmakesvhepatitisvB,vC,vandvDvunlikely.vShevreg
ularlyvchangesvthevdiapersvofvhervclientsvandvisvatvriskvforvhepatitisvA.vVaccinevagainstvhepatitisvAvisvreco
mmendedvforvdaycarevworkers
Avyoungvmanvcomesvtovyouvwithvanvextremelyvpruriticvrashvovervhisvkneesvandvelbowsvwhichvhasvcom
evandvgonevforvseveralvyears.vItvseemsvtovbevworsevinvthevwintervandvimprovesvwithvsomevsunvexposur
e.vOnvexamination,vyouvnoticevscabbingvandvcrustingvwithvsomevsilveryvscale,vandvyouvarevobservantv
enoughvtovnoticevsmallv"pits"vinvhisvnails.vWhatvwouldvaccountvforvthesevfindings?
A.vEczema
B.vPityriasisvrosea
C.vPsoriasis
D.vTineavinfectionv
ANS:vC
Feedback:vThisvisvavclassicvpresentationvofvplaquevpsoriasis.vEczemavisvusuallyvovervthevflexorvsurfacesv
andvdoesvnotvscale,vwhereasvpsoriasisvaffectsvthevextensorvsurfaces.vPityriasisvusuallyvisvlimitedvtovthev
trunkvandvproximalvextremities.vTineavhasvavmuchvfinervscalevassociatedvwithvit,valmostvlikevpowder,va
ndvisvfoundvinvdarkvandvmoistvareas
Mr.vMartinvisvav72-year-
oldvsmokervwhovcomesvtovyouvforvhisvhypertensionvvisit.vYouvnotevthatvwithvdeepvpalpationvyouvfeelva
vpulsatilevmassvwhichvisvaboutv4vcentimetersvinvdiameter.vWhatvshouldvyouvdovnext?
B.vReassessvbyvexaminationvinv6vmonths
C.vReassessvbyvexaminationvinv3vmonths
D.vRefervtovavvascularvsurgeonvAN
S:vA
Feedback:vAvpulsatilevmassvinvthisvmanvshouldvbevfollowedvupvwithvultrasoundvasvsoonvasvpossible.vHis
vriskvofvaorticvrupturevisvatvleastv15vtimesvgreatervifvhisvaortavmeasuresvmorevthanv4vcentimeters.vIt
, wouldvbevinappropriatevtovrecheckvhimvatvavlatervtimevwithoutvtakingvaction.vLikewise,vreferralvtovavva
scularvsurgeonvbeforevultrasoundvmayvbevpremature.
**AorticvAneurysm**
Av8-year-
oldvpatientvpresentsvtovthevofficevforvevaluationvofvavrash.vAtvfirst,vtherevwasvonlyvonevlargevpatch,vbut
vthenvmorevlesionsveruptedvsuddenlyvonvthevbackvandvtorso;vthevlesionsvitch.vOnvphysicalvexaminatio
n,vyouvnotevthatvthevpatternvofveruptionvisvlikevavChristmasvtreevandvthatvtherevarevavvarietyvofverythe
matousvpapulesvandvmaculesvonvthevcleavagevlinesvofvthevback.vBasedvonvthisvdescription,vwhatvisvthe
vmostvlikelyvdiagnosis?
A.vPityriasisvrosea
B.vTineavversicolor
C.vPsoriasis
D.vAtopicveczemav
ANS:vA
Av28-year-
oldvpatientvcomesvtovthevofficevforvevaluationvofvavrash.vAtvfirstvtherevwasvonlyvonevlargevpatch,vbutvth
envmorevlesionsveruptedvsuddenlyvonvthevbackvandvtorso;vthevlesionsvitch.vOnvphysicalvexamination,vy
ouvnotevthatvthevpatternvofveruptionvisvlikevavChristmasvtreevandvthatvtherevarevavvarietyvofverythemat
ousvpapulesvandvmaculesvonvthevcleavagevlinesvofvthevback.vBasedvonvthisvdescription,vwhatvisvthevmo
stvlikelyvdiagnosis?
A.vPityriasisvrosea
B.vTineavversicolor
C.vPsoriasis
D.vAtopicveczemav
ANS:vA
Feedback:vThisvisvavclassicvdescriptionvofvpityriasisvrosea.vThevdescriptionvofvavlargevsinglevorv“herald”v
patchvprecedingvtheveruptionvisvavgoodvwayvtovdistinguishvthisvrashvfromvothervconditions.
Avlightvisvpointedvatvavpatient'svpupil,vwhichvcontracts.vItvisvalsovnotedvthatvthevothervpupilvcontractsvas
vwell,vthoughvitvisvnotvexposedvtovbrightvlight.vWhichvofvthevfollowingvtermsvdescribesvthisvlattervphen
omenon?
