GCU NUR 634 250 ACTUAL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALE LATEST UPDATE 2026
ALREADY GRADED A+
This comprehensive 250-question exam bank thoroughly covers GCU NUR
634 Advanced Health Assessment and Diagnostic Reasoning, providing
extensive preparation for advanced practice nursing students. It
systematically tests knowledge of comprehensive health histories, SOAP
documentation, and the correct sequence of abdominal assessment
(inspection, auscultation, percussion, palpation). Key topics include cranial
nerve testing, cardiac auscultation (S1, S2, murmurs), pulmonary assessment
(crackles, egophony, fremitus), musculoskeletal evaluation (rotator cuff,
meniscus, ACL tests), and neurological examination (Romberg, cerebellar
testing). The questions address diagnostic reasoning for conditions including
cholecystitis (Murphy's sign), meningitis (nuchal rigidity), Parkinson's
disease, and thyroid disorders. Additionally, the bank covers laboratory
interpretation, ECG findings, and evidence-based approaches for common
acute and chronic conditions.
1) A new patient presents to establish care. Which type of health history is most
appropriate?
A) Focused history
B) Follow-up history
C) Comprehensive health history
D) Emergency history
Answer: C
Rationale: A comprehensive health history is appropriate for new patients
establishing care, as it provides a complete baseline of the patient's health status,
including past medical history, family history, social history, and review of
systems .
2) In a SOAP note, which component contains the patient's direct quotes and
descriptions of symptoms?
A) Objective
B) Assessment
,C) Plan
D) Subjective
Answer: D
Rationale: The subjective portion records the patient's own words (chief complaint,
history). Objective data is what the clinician observes or measures .
3) A patient states, "I feel really tired." In a SOAP note, this is recorded as:
A) Objective data
B) Subjective data
C) Assessment data
D) Plan data
Answer: B
Rationale: Subjective data is what the patient experiences and reports (History),
while objective data is what the clinician observes or measures (Physical
Exam/Labs) .
4) The correct sequence for abdominal assessment is:
A) Inspection, palpation, percussion, auscultation
B) Inspection, auscultation, percussion, palpation
C) Palpation, inspection, auscultation, percussion
D) Auscultation, inspection, palpation, percussion
Answer: B
Rationale: The correct sequence for abdominal assessment is inspection,
auscultation, percussion, then palpation. This sequence is different from other body
systems because palpation and percussion can alter bowel sounds, so auscultation
should be performed before these techniques .
5) A patient is suspected of having a urinary tract infection (UTI). Which finding is
expected?
A) No proteins in the urine
B) Presence of nitrites and leukocytes
C) Presence of glucose
D) Presence of ketones
Answer: B
Rationale: A urinalysis for a UTI typically shows nitrites (bacteria) and leukocytes
(white blood cells). Protein is not specific to a UTI; glucose and ketones are related
to diabetes or metabolic issues .
6) A patient presents with acute strep pharyngitis. Which symptom is most likely
absent?
,A) No cough
B) Cough
C) Rhinorrhea
D) Hoarseness
Answer: B
Rationale: The absence of a cough is a distinguishing feature of strep pharyngitis.
Viral pharyngitis is more likely to present with cough and rhinorrhea .
7) A patient with polymyalgia rheumatica would most likely present with:
A) Joint pain and stiffness
B) Muscle weakness
C) Skin rash
D) Weight loss
Answer: A
Rationale: Polymyalgia rheumatica is characterized by pain and stiffness in the
shoulders, hips, and neck. It is an inflammatory condition seen in older adults .
8) What is the significance of finding "shotty" lymph nodes in the neck?
A) They indicate malignancy
B) They represent benign change from a viral illness
C) They indicate bacterial infection
D) They indicate autoimmune disease
Answer: B
Rationale: "Shotty" lymph nodes are small, mobile, palpable lymph nodes that are
benign and often seen following viral infections .
9) Heberden nodes are small bony growths found at which joints?
A) Proximal interphalangeal (PIP) joints
B) Distal interphalangeal (DIP) joints
C) Metacarpophalangeal (MCP) joints
D) Wrist joints
Answer: B
Rationale: Heberden nodes are small bony growths at the distal interphalangeal
(DIP) joints, commonly seen in osteoarthritis .
10) A patient has pupils that are reactive to light (direct and consensual) but
unequal in size. This condition is called:
A) Anisocoria
B) Mydriasis
C) Miosis
, D) Marcus Gunn pupil
Answer: A
Rationale: Anisocoria is the condition of having unequal pupil sizes. It can be
benign (physiologic anisocoria) or indicate a neurological problem. The pupillary
response to light is usually normal in physiologic anisocoria .
11) A large left supraclavicular lymph node (Virchow's node) is indicative of:
A) Benign viral infection
B) Serious pathology, often malignancy
C) Local infection
D) Autoimmune disease
Answer: B
Rationale: Virchow's node (left supraclavicular lymph node) is associated with
serious pathology, often gastrointestinal or thoracic malignancy .
12) AV nicking during a retinal exam is seen in which condition?
A) Diabetes
B) Hypertension
C) Glaucoma
D) Macular degeneration
Answer: B
Rationale: AV nicking refers to the appearance of the retinal vein being
compressed by an arteriole. It is a sign of chronic hypertension and is associated
with increased cardiovascular risk .
13) A finding of "clicking in the TMJ" is documented as:
A) Crepitus
B) Dislocation
C) Subluxation
D) Trismus
Answer: A
Rationale: Crepitus is the term used to describe a grating, crackling, or clicking
sensation in a joint. In the TMJ, this may indicate a displacement of the joint .
14) A patient with a suspected rotator cuff tear would most likely have:
A) Pain with abduction and external rotation
B) Pain with adduction and internal rotation
C) No pain with movement
D) Pain only at rest
Answer: A
ANSWERS WITH RATIONALE LATEST UPDATE 2026
ALREADY GRADED A+
This comprehensive 250-question exam bank thoroughly covers GCU NUR
634 Advanced Health Assessment and Diagnostic Reasoning, providing
extensive preparation for advanced practice nursing students. It
systematically tests knowledge of comprehensive health histories, SOAP
documentation, and the correct sequence of abdominal assessment
(inspection, auscultation, percussion, palpation). Key topics include cranial
nerve testing, cardiac auscultation (S1, S2, murmurs), pulmonary assessment
(crackles, egophony, fremitus), musculoskeletal evaluation (rotator cuff,
meniscus, ACL tests), and neurological examination (Romberg, cerebellar
testing). The questions address diagnostic reasoning for conditions including
cholecystitis (Murphy's sign), meningitis (nuchal rigidity), Parkinson's
disease, and thyroid disorders. Additionally, the bank covers laboratory
interpretation, ECG findings, and evidence-based approaches for common
acute and chronic conditions.
1) A new patient presents to establish care. Which type of health history is most
appropriate?
A) Focused history
B) Follow-up history
C) Comprehensive health history
D) Emergency history
Answer: C
Rationale: A comprehensive health history is appropriate for new patients
establishing care, as it provides a complete baseline of the patient's health status,
including past medical history, family history, social history, and review of
systems .
2) In a SOAP note, which component contains the patient's direct quotes and
descriptions of symptoms?
A) Objective
B) Assessment
,C) Plan
D) Subjective
Answer: D
Rationale: The subjective portion records the patient's own words (chief complaint,
history). Objective data is what the clinician observes or measures .
3) A patient states, "I feel really tired." In a SOAP note, this is recorded as:
A) Objective data
B) Subjective data
C) Assessment data
D) Plan data
Answer: B
Rationale: Subjective data is what the patient experiences and reports (History),
while objective data is what the clinician observes or measures (Physical
Exam/Labs) .
4) The correct sequence for abdominal assessment is:
A) Inspection, palpation, percussion, auscultation
B) Inspection, auscultation, percussion, palpation
C) Palpation, inspection, auscultation, percussion
D) Auscultation, inspection, palpation, percussion
Answer: B
Rationale: The correct sequence for abdominal assessment is inspection,
auscultation, percussion, then palpation. This sequence is different from other body
systems because palpation and percussion can alter bowel sounds, so auscultation
should be performed before these techniques .
5) A patient is suspected of having a urinary tract infection (UTI). Which finding is
expected?
A) No proteins in the urine
B) Presence of nitrites and leukocytes
C) Presence of glucose
D) Presence of ketones
Answer: B
Rationale: A urinalysis for a UTI typically shows nitrites (bacteria) and leukocytes
(white blood cells). Protein is not specific to a UTI; glucose and ketones are related
to diabetes or metabolic issues .
6) A patient presents with acute strep pharyngitis. Which symptom is most likely
absent?
,A) No cough
B) Cough
C) Rhinorrhea
D) Hoarseness
Answer: B
Rationale: The absence of a cough is a distinguishing feature of strep pharyngitis.
Viral pharyngitis is more likely to present with cough and rhinorrhea .
7) A patient with polymyalgia rheumatica would most likely present with:
A) Joint pain and stiffness
B) Muscle weakness
C) Skin rash
D) Weight loss
Answer: A
Rationale: Polymyalgia rheumatica is characterized by pain and stiffness in the
shoulders, hips, and neck. It is an inflammatory condition seen in older adults .
8) What is the significance of finding "shotty" lymph nodes in the neck?
A) They indicate malignancy
B) They represent benign change from a viral illness
C) They indicate bacterial infection
D) They indicate autoimmune disease
Answer: B
Rationale: "Shotty" lymph nodes are small, mobile, palpable lymph nodes that are
benign and often seen following viral infections .
9) Heberden nodes are small bony growths found at which joints?
A) Proximal interphalangeal (PIP) joints
B) Distal interphalangeal (DIP) joints
C) Metacarpophalangeal (MCP) joints
D) Wrist joints
Answer: B
Rationale: Heberden nodes are small bony growths at the distal interphalangeal
(DIP) joints, commonly seen in osteoarthritis .
10) A patient has pupils that are reactive to light (direct and consensual) but
unequal in size. This condition is called:
A) Anisocoria
B) Mydriasis
C) Miosis
, D) Marcus Gunn pupil
Answer: A
Rationale: Anisocoria is the condition of having unequal pupil sizes. It can be
benign (physiologic anisocoria) or indicate a neurological problem. The pupillary
response to light is usually normal in physiologic anisocoria .
11) A large left supraclavicular lymph node (Virchow's node) is indicative of:
A) Benign viral infection
B) Serious pathology, often malignancy
C) Local infection
D) Autoimmune disease
Answer: B
Rationale: Virchow's node (left supraclavicular lymph node) is associated with
serious pathology, often gastrointestinal or thoracic malignancy .
12) AV nicking during a retinal exam is seen in which condition?
A) Diabetes
B) Hypertension
C) Glaucoma
D) Macular degeneration
Answer: B
Rationale: AV nicking refers to the appearance of the retinal vein being
compressed by an arteriole. It is a sign of chronic hypertension and is associated
with increased cardiovascular risk .
13) A finding of "clicking in the TMJ" is documented as:
A) Crepitus
B) Dislocation
C) Subluxation
D) Trismus
Answer: A
Rationale: Crepitus is the term used to describe a grating, crackling, or clicking
sensation in a joint. In the TMJ, this may indicate a displacement of the joint .
14) A patient with a suspected rotator cuff tear would most likely have:
A) Pain with abduction and external rotation
B) Pain with adduction and internal rotation
C) No pain with movement
D) Pain only at rest
Answer: A
