GCU NUR 634 MIDTERM Exam Newest
/GCU NUR 634 MIDTERM Exam
Preparation
**1. A 72-year-old woman presents with a sacral ulcer showing full-
thickness skin loss and visible subcutaneous tissue, but no bone or
muscle exposure. What is the correct stage?**
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
**Answer: C. Stage 3**
**Rationale:** Stage 3 pressure ulcers involve full-thickness skin loss
with damage to or necrosis of subcutaneous tissue. They extend down
to the fascia but do not expose bone, tendon, or muscle (which would
be Stage 4) .
**2. A 49-year-old reports brief spinning sensations triggered by head
movement and no hearing loss. What is the most likely diagnosis?**
A. Benign paroxysmal positional vertigo (BPPV)
B. Vestibular neuronitis
C. Ménière’s disease
D. Acoustic neuroma
,**Answer: A. BPPV**
**Rationale:** BPPV is characterized by brief, intense vertigo triggered
by specific position changes (e.g., rolling over in bed). It is not
associated with hearing loss, unlike Ménière’s disease .
**3. A patient cuts her finger and dramatically claims her “career is
ruined,” crying loudly. Which personality type best fits?**
A. Narcissistic
B. Paranoid
C. Histrionic
D. Avoidant
**Answer: C. Histrionic**
**Rationale:** Histrionic personality disorder is characterized by
excessive emotionality and attention-seeking behavior. The patient’s
theatrical overreaction to a minor injury is classic for this trait .
**4. In a SOAP note, which section records the patient’s exact words in
quotation marks?**
A. Chief Complaint
B. Objective
C. Assessment
D. Plan
**Answer: A. Chief Complaint**
,**Rationale:** The Chief Complaint (CC) is a brief statement in the
patient’s own words describing the reason for the visit. Quotation
marks are used to ensure the subjective nature of the complaint is
documented verbatim .
**5. A 65-year-old with a history of CHF presents with worsening
dyspnea and pink, frothy sputum. Lung auscultation reveals bilateral
late-inspiratory crackles that do not clear with coughing. How do you
describe this finding?**
A. Atelectatic crackles
B. Fine late-inspiratory crackles (pulmonary edema)
C. Coarse early-inspiratory crackles (bronchitis)
D. Rhonchi
**Answer: B. Fine late-inspiratory crackles**
**Rationale:** Fine, late-inspiratory crackles (similar to Velcro being
pulled apart) are caused by the explosive opening of small airways and
alveoli filled with fluid, indicative of pulmonary edema or fibrosis .
**6. When percussing the abdomen, tympany predominates
because:**
A. Most of the abdomen contains air-filled intestines
B. The liver occupies most of the abdomen
C. It indicates ascites
D. It signals organ enlargement
**Answer: A. Most of the abdomen contains air-filled intestines**
, **Rationale:** Tympany is the predominant percussion note over the
abdomen due to the presence of air in the stomach and intestines.
Dullness is typically heard over solid organs like the liver .
**7. A patient presents with sudden, severe testicular pain, nausea, and
vomiting. The testis is elevated and tender. What is the priority?**
A. Schedule an ultrasound for the morning
B. Assess for cremasteric reflex
C. Prescribe antibiotics
D. Immediate surgical referral
**Answer: D. Immediate surgical referral**
**Rationale:** Sudden onset of severe testicular pain with an absent
cremasteric reflex is indicative of testicular torsion. This is a urologic
emergency requiring detorsion within 4-6 hours to salvage the testis .
**8. A 61-year-old woman with ovarian cancer presents with leg
swelling and recent dyspnea. What is your primary concern?**
A. Arterial occlusion
B. Ovarian metastasis
C. Pulmonary embolism (PE)
D. Lymphangitis
**Answer: C. Pulmonary Embolism (PE)**
**Rationale:** Malignancy (especially ovarian and pancreatic) is a
hypercoagulable state. The combination of unilateral leg swelling (DVT)
/GCU NUR 634 MIDTERM Exam
Preparation
**1. A 72-year-old woman presents with a sacral ulcer showing full-
thickness skin loss and visible subcutaneous tissue, but no bone or
muscle exposure. What is the correct stage?**
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
**Answer: C. Stage 3**
**Rationale:** Stage 3 pressure ulcers involve full-thickness skin loss
with damage to or necrosis of subcutaneous tissue. They extend down
to the fascia but do not expose bone, tendon, or muscle (which would
be Stage 4) .
**2. A 49-year-old reports brief spinning sensations triggered by head
movement and no hearing loss. What is the most likely diagnosis?**
A. Benign paroxysmal positional vertigo (BPPV)
B. Vestibular neuronitis
C. Ménière’s disease
D. Acoustic neuroma
,**Answer: A. BPPV**
**Rationale:** BPPV is characterized by brief, intense vertigo triggered
by specific position changes (e.g., rolling over in bed). It is not
associated with hearing loss, unlike Ménière’s disease .
**3. A patient cuts her finger and dramatically claims her “career is
ruined,” crying loudly. Which personality type best fits?**
A. Narcissistic
B. Paranoid
C. Histrionic
D. Avoidant
**Answer: C. Histrionic**
**Rationale:** Histrionic personality disorder is characterized by
excessive emotionality and attention-seeking behavior. The patient’s
theatrical overreaction to a minor injury is classic for this trait .
**4. In a SOAP note, which section records the patient’s exact words in
quotation marks?**
A. Chief Complaint
B. Objective
C. Assessment
D. Plan
**Answer: A. Chief Complaint**
,**Rationale:** The Chief Complaint (CC) is a brief statement in the
patient’s own words describing the reason for the visit. Quotation
marks are used to ensure the subjective nature of the complaint is
documented verbatim .
**5. A 65-year-old with a history of CHF presents with worsening
dyspnea and pink, frothy sputum. Lung auscultation reveals bilateral
late-inspiratory crackles that do not clear with coughing. How do you
describe this finding?**
A. Atelectatic crackles
B. Fine late-inspiratory crackles (pulmonary edema)
C. Coarse early-inspiratory crackles (bronchitis)
D. Rhonchi
**Answer: B. Fine late-inspiratory crackles**
**Rationale:** Fine, late-inspiratory crackles (similar to Velcro being
pulled apart) are caused by the explosive opening of small airways and
alveoli filled with fluid, indicative of pulmonary edema or fibrosis .
**6. When percussing the abdomen, tympany predominates
because:**
A. Most of the abdomen contains air-filled intestines
B. The liver occupies most of the abdomen
C. It indicates ascites
D. It signals organ enlargement
**Answer: A. Most of the abdomen contains air-filled intestines**
, **Rationale:** Tympany is the predominant percussion note over the
abdomen due to the presence of air in the stomach and intestines.
Dullness is typically heard over solid organs like the liver .
**7. A patient presents with sudden, severe testicular pain, nausea, and
vomiting. The testis is elevated and tender. What is the priority?**
A. Schedule an ultrasound for the morning
B. Assess for cremasteric reflex
C. Prescribe antibiotics
D. Immediate surgical referral
**Answer: D. Immediate surgical referral**
**Rationale:** Sudden onset of severe testicular pain with an absent
cremasteric reflex is indicative of testicular torsion. This is a urologic
emergency requiring detorsion within 4-6 hours to salvage the testis .
**8. A 61-year-old woman with ovarian cancer presents with leg
swelling and recent dyspnea. What is your primary concern?**
A. Arterial occlusion
B. Ovarian metastasis
C. Pulmonary embolism (PE)
D. Lymphangitis
**Answer: C. Pulmonary Embolism (PE)**
**Rationale:** Malignancy (especially ovarian and pancreatic) is a
hypercoagulable state. The combination of unilateral leg swelling (DVT)
