MIDTERM Advanced Health Assessment
NUR 634 Exam Prep: 120+ Practice
Questions, Answers & Clinical Rationales
(Updated 2026) | GCU Nursing Study Guide
SECTION 1: PHYSICAL ASSESSMENT TECHNIQUES (Questions 1-25)
Question 1: When performing an abdominal assessment, what is the correct sequence of techniques?
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.
Question 2: Which percussion note is normally heard over the abdomen?
A) Resonance B) Hyper-resonance C) Tympany D) Dullness
Answer: C
Rationale: Tympany is the normal percussion note heard over the abdomen due to air in the stomach
and intestines. Resonance is heard over normal lung tissue, hyper-resonance indicates excessive air (as
in emphysema or pneumothorax), and dullness is heard over solid organs like the liver or spleen.
Question 3: A nurse is assessing a patient and notes a bluish discoloration of the skin and mucous
membranes. This finding is documented as:
A) Cyanosis B) Jaundice C) Pallor D) Erythema
Answer: A
Rationale: Cyanosis is a bluish discoloration of the skin and mucous membranes caused by decreased
oxygen saturation in the blood. Jaundice is yellow discoloration from elevated bilirubin, pallor is
paleness from decreased blood flow or anemia, and erythema is redness from increased blood flow.
Question 4: When assessing cranial nerve XII (hypoglossal nerve), the nurse should:
, A) Ask the patient to shrug their shoulders against resistance B) Ask the patient to stick out their tongue
and move it side to side C) Test the gag reflex D) Ask the patient to smile and show their teeth
Answer: B
Rationale: Cranial nerve XII controls tongue movement. The nurse assesses this by asking the patient to
stick out their tongue and move it side to side. Shoulder shrugging tests CN XI (spinal accessory), gag
reflex tests CN IX and X, and smiling tests CN VII (facial nerve).
Question 5: Which finding during cardiac auscultation would be considered normal?
A) S3 heart sound in an adult B) S4 heart sound C) S1 and S2 heart sounds D) Murmur at the apex
Answer: C
Rationale: S1 and S2 are the normal heart sounds. S1 represents closure of the mitral and tricuspid
valves, and S2 represents closure of the aortic and pulmonic valves. S3 can be normal in children and
young adults but is abnormal in older adults and may indicate heart failure. S4 is always abnormal and
indicates decreased ventricular compliance. Murmurs are abnormal findings.
Question 6: The medical term for "swimmer's ear" is:
A) Otitis media B) Otitis externa C) Mastoiditis D) Tympanitis
Answer: B
Rationale: Otitis externa is inflammation or infection of the external ear canal, commonly called
"swimmer's ear" because it often occurs after water exposure. Otitis media is middle ear infection,
mastoiditis is infection of the mastoid bone, and tympanitis is inflammation of the tympanic membrane.
Question 7: When performing a respiratory assessment, which finding indicates normal breath sounds
over the peripheral lung fields?
A) Bronchial B) Bronchovesicular C) Vesicular D) Tracheal
Answer: C
Rationale: Vesicular breath sounds are soft, low-pitched sounds normally heard over the peripheral lung
fields. Bronchial sounds are loud, high-pitched sounds normally heard over the trachea.
Bronchovesicular sounds are medium-pitched sounds heard over the main bronchi. Tracheal sounds are
very loud and harsh, heard over the trachea.
Question 8: A patient presents with ecchymosis on the forearms that has been present for several
months with no history of trauma. This finding is most consistent with:
NUR 634 Exam Prep: 120+ Practice
Questions, Answers & Clinical Rationales
(Updated 2026) | GCU Nursing Study Guide
SECTION 1: PHYSICAL ASSESSMENT TECHNIQUES (Questions 1-25)
Question 1: When performing an abdominal assessment, what is the correct sequence of techniques?
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.
Question 2: Which percussion note is normally heard over the abdomen?
A) Resonance B) Hyper-resonance C) Tympany D) Dullness
Answer: C
Rationale: Tympany is the normal percussion note heard over the abdomen due to air in the stomach
and intestines. Resonance is heard over normal lung tissue, hyper-resonance indicates excessive air (as
in emphysema or pneumothorax), and dullness is heard over solid organs like the liver or spleen.
Question 3: A nurse is assessing a patient and notes a bluish discoloration of the skin and mucous
membranes. This finding is documented as:
A) Cyanosis B) Jaundice C) Pallor D) Erythema
Answer: A
Rationale: Cyanosis is a bluish discoloration of the skin and mucous membranes caused by decreased
oxygen saturation in the blood. Jaundice is yellow discoloration from elevated bilirubin, pallor is
paleness from decreased blood flow or anemia, and erythema is redness from increased blood flow.
Question 4: When assessing cranial nerve XII (hypoglossal nerve), the nurse should:
, A) Ask the patient to shrug their shoulders against resistance B) Ask the patient to stick out their tongue
and move it side to side C) Test the gag reflex D) Ask the patient to smile and show their teeth
Answer: B
Rationale: Cranial nerve XII controls tongue movement. The nurse assesses this by asking the patient to
stick out their tongue and move it side to side. Shoulder shrugging tests CN XI (spinal accessory), gag
reflex tests CN IX and X, and smiling tests CN VII (facial nerve).
Question 5: Which finding during cardiac auscultation would be considered normal?
A) S3 heart sound in an adult B) S4 heart sound C) S1 and S2 heart sounds D) Murmur at the apex
Answer: C
Rationale: S1 and S2 are the normal heart sounds. S1 represents closure of the mitral and tricuspid
valves, and S2 represents closure of the aortic and pulmonic valves. S3 can be normal in children and
young adults but is abnormal in older adults and may indicate heart failure. S4 is always abnormal and
indicates decreased ventricular compliance. Murmurs are abnormal findings.
Question 6: The medical term for "swimmer's ear" is:
A) Otitis media B) Otitis externa C) Mastoiditis D) Tympanitis
Answer: B
Rationale: Otitis externa is inflammation or infection of the external ear canal, commonly called
"swimmer's ear" because it often occurs after water exposure. Otitis media is middle ear infection,
mastoiditis is infection of the mastoid bone, and tympanitis is inflammation of the tympanic membrane.
Question 7: When performing a respiratory assessment, which finding indicates normal breath sounds
over the peripheral lung fields?
A) Bronchial B) Bronchovesicular C) Vesicular D) Tracheal
Answer: C
Rationale: Vesicular breath sounds are soft, low-pitched sounds normally heard over the peripheral lung
fields. Bronchial sounds are loud, high-pitched sounds normally heard over the trachea.
Bronchovesicular sounds are medium-pitched sounds heard over the main bronchi. Tracheal sounds are
very loud and harsh, heard over the trachea.
Question 8: A patient presents with ecchymosis on the forearms that has been present for several
months with no history of trauma. This finding is most consistent with:
