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NUR 634 MIDTERM GCU EXAM NEWEST 2026
ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) ALL
ANSWERED/ ALREADY GRADED A+/ SUMMER
FALL SEMESTER | BRAND NEW! 100% PASS | GCU
A 55-year-old smoker complains of chest pain and gestures
with a closed fist over her sternum to describe it. Which of the
following diagnoses should you consider because of her
gesture?
A. Bronchitis
B. Costochondritis
C. Pericarditis
D. Angina pectoris
Feedback: The clenched fist of Levine's sign, while not
completely specific for ischemic pain, should definitely cause you
to consider this etiology. Bronchitis is usually painless, and
pericarditis can produce a sharp pain which worsens with
inspiration. This is called pleuritic pain and can be associated
with pneumonia and other chest diseases.
Costochondritis is a parasternal pain, usually well localized. It is
exquisitely tender
Retinal detachment may be associated with all of the following
EXCEPT:
A. painless, unilateral loss in vision
B. Spontaneous recovery
C. Flashes of light
D. Context of trauma
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Optic neuritis may be associated with all the following conditions
EXCEPT:
A. Sudden, painful loss in unilateral vision
B. Associated with autoimmune disease
C. Early sign of multiple sclerosis
D. Common incidental finding on fundoscopic exam
Mrs. Fletcher comes to your office with unilateral pain during
chewing, which is chronic. She does not have facial tenderness
or tenderness of the scalp. Which of the following is the most
likely cause of her pain?
A. Trigeminal neuralgia
B. Temporomandibular joint syndrome
C. Temporal arteritis
D. Tumor of the mandible
Feedback: Temporomandibular joint syndrome is a very common
cause of pain with chewing. Ischemic pain with chewing, or jaw
claudication, can occur with temporal arteritis, but the lack of
tenderness of the scalp overlying the artery makes this less
likely. Trigeminal neuralgia can be associated with extreme
tenderness over the
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branches of the trigeminal nerve. While a tumor of the mandible
is possible, is it much less likely than the other choices.
An 8-year-old girl comes with her mother for evaluation of hair
loss. She denies pulling or twisting her hair, and her mother has
not noted this behavior at all. She does not put her hair in braids.
On physical examination, you note a clearly demarcated, round
patch of hair loss without visible scaling or inflammation. There
are no hair shafts visible.
Based on this description, what is your most likely diagnosis?
A. Alopecia areata
B. Trichotillomania
C. Tinea capitis
D. Traction alopecia
Feedback: This is a typical description for alopecia areata. There
are no risk factors for trichotillomania or for traction alopecia.
The physical examination is not consistent with tinea capitis
because the skin is intact.
A 46-year-old former salesman presents to the ER, complaining
of black stools for the past few weeks. His past medical history
is significant for cirrhosis. He has gained weight recently,
especially around his abdomen. He has smoked two packs of
cigarettes a day for 30 years and has drunk approximately 10
alcoholic beverages a day for 25 years. He has used IV heroin
and smoked crack in the past. He denies any recent use. He is
currently unemployed and has never been married. On
examination you find a man appearing older than his stated age.
His skin has a yellowish tint and he is thin, with a prominent
abdomen. You note multiple "spider angiomas" at the base of his
neck. Otherwise, his heart and lung examinations are normal. On
inspection he has dilated veins around his umbilicus. Increased
bowel sounds are heard during auscultation.
Palpation reveals diffuse tenderness that is more severe in the
, 4|Page
epigastric area. His liver is small and hard to palpation and he
has a positive fluid wave. He is positive for occult blood on his
rectal examination. What cause of black stools most likely
describes his symptoms and signs?
A. Infectious diarrhea
B. Mallory-Weiss tear
C. Esophageal varices
D. Ulcerative colitis
Varices are often found in alcoholic patients, but only when they
have a diagnosis of significant cirrhosis. This patient has
symptoms of cirrhosis, including jaundice, ascites, spider
hemangiomas, and dilated veins on his abdomen (caput medusa).
You are beginning the examination of the skin on a 25-year-old
teacher. You have previously elicited that she came to the office
for evaluation of fatigue, weight gain, and hair loss. You strongly
suspect that she has hypothyroidism. What is the expected
moisture and texture of the skin of a patient with
hypothyroidism?
NUR 634 MIDTERM GCU EXAM NEWEST 2026
ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) ALL
ANSWERED/ ALREADY GRADED A+/ SUMMER
FALL SEMESTER | BRAND NEW! 100% PASS | GCU
A 55-year-old smoker complains of chest pain and gestures
with a closed fist over her sternum to describe it. Which of the
following diagnoses should you consider because of her
gesture?
A. Bronchitis
B. Costochondritis
C. Pericarditis
D. Angina pectoris
Feedback: The clenched fist of Levine's sign, while not
completely specific for ischemic pain, should definitely cause you
to consider this etiology. Bronchitis is usually painless, and
pericarditis can produce a sharp pain which worsens with
inspiration. This is called pleuritic pain and can be associated
with pneumonia and other chest diseases.
Costochondritis is a parasternal pain, usually well localized. It is
exquisitely tender
Retinal detachment may be associated with all of the following
EXCEPT:
A. painless, unilateral loss in vision
B. Spontaneous recovery
C. Flashes of light
D. Context of trauma
,2|Page
Optic neuritis may be associated with all the following conditions
EXCEPT:
A. Sudden, painful loss in unilateral vision
B. Associated with autoimmune disease
C. Early sign of multiple sclerosis
D. Common incidental finding on fundoscopic exam
Mrs. Fletcher comes to your office with unilateral pain during
chewing, which is chronic. She does not have facial tenderness
or tenderness of the scalp. Which of the following is the most
likely cause of her pain?
A. Trigeminal neuralgia
B. Temporomandibular joint syndrome
C. Temporal arteritis
D. Tumor of the mandible
Feedback: Temporomandibular joint syndrome is a very common
cause of pain with chewing. Ischemic pain with chewing, or jaw
claudication, can occur with temporal arteritis, but the lack of
tenderness of the scalp overlying the artery makes this less
likely. Trigeminal neuralgia can be associated with extreme
tenderness over the
,3|Page
branches of the trigeminal nerve. While a tumor of the mandible
is possible, is it much less likely than the other choices.
An 8-year-old girl comes with her mother for evaluation of hair
loss. She denies pulling or twisting her hair, and her mother has
not noted this behavior at all. She does not put her hair in braids.
On physical examination, you note a clearly demarcated, round
patch of hair loss without visible scaling or inflammation. There
are no hair shafts visible.
Based on this description, what is your most likely diagnosis?
A. Alopecia areata
B. Trichotillomania
C. Tinea capitis
D. Traction alopecia
Feedback: This is a typical description for alopecia areata. There
are no risk factors for trichotillomania or for traction alopecia.
The physical examination is not consistent with tinea capitis
because the skin is intact.
A 46-year-old former salesman presents to the ER, complaining
of black stools for the past few weeks. His past medical history
is significant for cirrhosis. He has gained weight recently,
especially around his abdomen. He has smoked two packs of
cigarettes a day for 30 years and has drunk approximately 10
alcoholic beverages a day for 25 years. He has used IV heroin
and smoked crack in the past. He denies any recent use. He is
currently unemployed and has never been married. On
examination you find a man appearing older than his stated age.
His skin has a yellowish tint and he is thin, with a prominent
abdomen. You note multiple "spider angiomas" at the base of his
neck. Otherwise, his heart and lung examinations are normal. On
inspection he has dilated veins around his umbilicus. Increased
bowel sounds are heard during auscultation.
Palpation reveals diffuse tenderness that is more severe in the
, 4|Page
epigastric area. His liver is small and hard to palpation and he
has a positive fluid wave. He is positive for occult blood on his
rectal examination. What cause of black stools most likely
describes his symptoms and signs?
A. Infectious diarrhea
B. Mallory-Weiss tear
C. Esophageal varices
D. Ulcerative colitis
Varices are often found in alcoholic patients, but only when they
have a diagnosis of significant cirrhosis. This patient has
symptoms of cirrhosis, including jaundice, ascites, spider
hemangiomas, and dilated veins on his abdomen (caput medusa).
You are beginning the examination of the skin on a 25-year-old
teacher. You have previously elicited that she came to the office
for evaluation of fatigue, weight gain, and hair loss. You strongly
suspect that she has hypothyroidism. What is the expected
moisture and texture of the skin of a patient with
hypothyroidism?
