GCU NUR 634 Midterm EXAM LATEST
2025/2026 ACTUAL SUMMER-FALL
SEMESTER EXAM GRADED A+
1. A 42-year-old patient reports fatigue, shortness of breath on exertion, and
palpitations. The nurse notes pale conjunctiva and tachycardia. What is the
most likely next nursing action?
A. Reassure the patient that these are normal aging changes.
B. Assess for anemia and obtain further history and diagnostics.
C. Discharge the patient with rest instructions only.
D. Encourage increased sodium intake.
Correct Answer: B. Assess for anemia and obtain further history and
diagnostics.
Rationale: Fatigue, pallor, and tachycardia suggest possible anemia or another
oxygen-carrying deficit, so the nurse should gather more assessment data and
prepare for workup.
2. A patient becomes defensive and discriminatory toward the APRN student
during the interview. What is the best response?
A. End the encounter immediately without documentation.
B. Respond professionally, maintain boundaries, and continue focused assessment
if safe.
C. Argue to correct the patient’s behavior.
D. Ignore the behavior and ask unrelated questions.
Correct Answer: B. Respond professionally, maintain boundaries, and
continue focused assessment if safe.
Rationale: The nurse should remain calm, set respectful limits, and keep the
encounter professional while preserving patient care.
3. A 29-year-old patient presents with multiple healing cuts on the forearm
and says, “I fell.” What is the priority nursing concern?
A. Hair grooming
B. Possible self-harm and safety risk
C. Food insecurity only
,D. Hearing loss
Correct Answer: B. Possible self-harm and safety risk.
Rationale: Unexplained injuries raise concern for self-harm, and safety assessment
is the first priority.
4. A patient with a new diagnosis asks, “Why should I trust this treatment
plan?” What evidence-based practice element should the nurse use first?
A. Personal opinion
B. Best available research evidence
C. Hospital tradition
D. Family preference only
Correct Answer: B. Best available research evidence.
Rationale: Evidence-based practice integrates research evidence, clinical
expertise, and patient values.
5. A patient has chronic knee pain and says, “I don’t want surgery, but I want
to keep walking my dog.” What should guide the care plan most?
A. Provider preference only
B. Patient values and goals
C. Insurance company preference
D. Staff convenience
Correct Answer: B. Patient values and goals.
Rationale: Patient-centered care requires integrating the patient’s priorities into
the plan.
6. A 58-year-old with diabetes reports blurred vision, thirst, and frequent
urination. What is the best next step?
A. Assume the symptoms are unrelated
B. Assess blood glucose and medication adherence
C. Recommend only eye drops
D. Tell the patient to reduce exercise
Correct Answer: B. Assess blood glucose and medication adherence.
Rationale: These are classic hyperglycemia symptoms, and the nurse should
assess glucose control and treatment adherence.
7. A patient’s chest pain is described as crushing, radiates to the left arm, and
is associated with diaphoresis. What should the nurse do first?
A. Ask the patient to complete a written survey
B. Initiate urgent assessment and notify the provider/emergency response
, C. Offer oral fluids and rest only
D. Schedule a follow-up next week
Correct Answer: B. Initiate urgent assessment and notify the
provider/emergency response.
Rationale: These are possible myocardial ischemia symptoms and require
immediate action.
8. A patient says, “I’ve been feeling down, but I still go to work every day.”
Which assessment is most appropriate next?
A. Ask about sleep, appetite, concentration, and suicidal thoughts
B. Ask about shoe size
C. Ask about allergies only
D. Ask about recent travel only
Correct Answer: A. Ask about sleep, appetite, concentration, and suicidal
thoughts.
Rationale: Depressive symptoms require assessment of severity and safety.
9. A patient with hypertension says they stopped taking medication because “I
feel fine.” What is the best nurse response?
A. “That’s okay if you feel okay.”
B. “Let’s talk about why hypertension can still damage organs even without
symptoms.”
C. “You are being noncompliant and must follow orders.”
D. “Take double doses when you remember.”
Correct Answer: B. “Let’s talk about why hypertension can still damage
organs even without symptoms.”
Rationale: Education should be nonjudgmental and focused on disease risk and
understanding.
10. A patient with suspected pneumonia has fever, productive cough, and
crackles in the right lower lobe. Which assessment finding supports worsening
respiratory status?
A. Oxygen saturation dropping from 96% to 89%
B. Improved appetite
C. Increased urination
D. Slightly warm hands
Correct Answer: A. Oxygen saturation dropping from 96% to 89%.
2025/2026 ACTUAL SUMMER-FALL
SEMESTER EXAM GRADED A+
1. A 42-year-old patient reports fatigue, shortness of breath on exertion, and
palpitations. The nurse notes pale conjunctiva and tachycardia. What is the
most likely next nursing action?
A. Reassure the patient that these are normal aging changes.
B. Assess for anemia and obtain further history and diagnostics.
C. Discharge the patient with rest instructions only.
D. Encourage increased sodium intake.
Correct Answer: B. Assess for anemia and obtain further history and
diagnostics.
Rationale: Fatigue, pallor, and tachycardia suggest possible anemia or another
oxygen-carrying deficit, so the nurse should gather more assessment data and
prepare for workup.
2. A patient becomes defensive and discriminatory toward the APRN student
during the interview. What is the best response?
A. End the encounter immediately without documentation.
B. Respond professionally, maintain boundaries, and continue focused assessment
if safe.
C. Argue to correct the patient’s behavior.
D. Ignore the behavior and ask unrelated questions.
Correct Answer: B. Respond professionally, maintain boundaries, and
continue focused assessment if safe.
Rationale: The nurse should remain calm, set respectful limits, and keep the
encounter professional while preserving patient care.
3. A 29-year-old patient presents with multiple healing cuts on the forearm
and says, “I fell.” What is the priority nursing concern?
A. Hair grooming
B. Possible self-harm and safety risk
C. Food insecurity only
,D. Hearing loss
Correct Answer: B. Possible self-harm and safety risk.
Rationale: Unexplained injuries raise concern for self-harm, and safety assessment
is the first priority.
4. A patient with a new diagnosis asks, “Why should I trust this treatment
plan?” What evidence-based practice element should the nurse use first?
A. Personal opinion
B. Best available research evidence
C. Hospital tradition
D. Family preference only
Correct Answer: B. Best available research evidence.
Rationale: Evidence-based practice integrates research evidence, clinical
expertise, and patient values.
5. A patient has chronic knee pain and says, “I don’t want surgery, but I want
to keep walking my dog.” What should guide the care plan most?
A. Provider preference only
B. Patient values and goals
C. Insurance company preference
D. Staff convenience
Correct Answer: B. Patient values and goals.
Rationale: Patient-centered care requires integrating the patient’s priorities into
the plan.
6. A 58-year-old with diabetes reports blurred vision, thirst, and frequent
urination. What is the best next step?
A. Assume the symptoms are unrelated
B. Assess blood glucose and medication adherence
C. Recommend only eye drops
D. Tell the patient to reduce exercise
Correct Answer: B. Assess blood glucose and medication adherence.
Rationale: These are classic hyperglycemia symptoms, and the nurse should
assess glucose control and treatment adherence.
7. A patient’s chest pain is described as crushing, radiates to the left arm, and
is associated with diaphoresis. What should the nurse do first?
A. Ask the patient to complete a written survey
B. Initiate urgent assessment and notify the provider/emergency response
, C. Offer oral fluids and rest only
D. Schedule a follow-up next week
Correct Answer: B. Initiate urgent assessment and notify the
provider/emergency response.
Rationale: These are possible myocardial ischemia symptoms and require
immediate action.
8. A patient says, “I’ve been feeling down, but I still go to work every day.”
Which assessment is most appropriate next?
A. Ask about sleep, appetite, concentration, and suicidal thoughts
B. Ask about shoe size
C. Ask about allergies only
D. Ask about recent travel only
Correct Answer: A. Ask about sleep, appetite, concentration, and suicidal
thoughts.
Rationale: Depressive symptoms require assessment of severity and safety.
9. A patient with hypertension says they stopped taking medication because “I
feel fine.” What is the best nurse response?
A. “That’s okay if you feel okay.”
B. “Let’s talk about why hypertension can still damage organs even without
symptoms.”
C. “You are being noncompliant and must follow orders.”
D. “Take double doses when you remember.”
Correct Answer: B. “Let’s talk about why hypertension can still damage
organs even without symptoms.”
Rationale: Education should be nonjudgmental and focused on disease risk and
understanding.
10. A patient with suspected pneumonia has fever, productive cough, and
crackles in the right lower lobe. Which assessment finding supports worsening
respiratory status?
A. Oxygen saturation dropping from 96% to 89%
B. Improved appetite
C. Increased urination
D. Slightly warm hands
Correct Answer: A. Oxygen saturation dropping from 96% to 89%.
