NUR 634 MIDTERM EXAM (GCU) NEWEST 2026
ACTUAL EXAM TEST BANK| NUR 634 ADVANCED
PHYSICAL ASSESSMENT MIDTERM EXAM REVIEW
WITH COMPLETE 300 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+
Two weeks ago, Mary started a job which requires carrying 40-pound
buckets. She presents with elbow pain worse on the right. On
examination, it hurts her elbows to dorsiflex her hands against resistance
when her palms face the floor. What condition does she have?
A. Medial epicondylitis (golfer's elbow)
B. Olecranon bursitis
C. Lateral epicondylitis (tennis elbow)
D. Supracondylar fracture – Correct Answer - C
Mary’s injury probably occurred by lifting heavy buckets with her palms
down (toward the bucket). This caused her chronic overuse injury at the
lateral epicondyle. Medial epicondylitis has reproducible pain when
palmar flexion against resistance is performed and also features
tenderness over the involved epicondyle. Olecranon bursitis produces
erythema and swelling over the olecranon process. A supracondylar
fracture of the humerus is a major injury and would present more
acutely.
You feel a small mass that you think is a lymph node. It is mobile in
both the up-and-down and side-to-side directions. Which of the
following is most likely?
A. Cancer
pg. 1
,B. Lymph node
C. Deep scar
D. Muscle – Correct Answer - B
A useful maneuver for discerning lymph nodes from other masses in the
neck is to check for their mobility in all directions. Many other masses
are mobile in only two directions. Cancerous masses may also be
“fixed,” or immobile
A 21-year-old college senior presents to your clinic, complaining of
shortness of breath and a nonproductive nocturnal cough. She states she
used to feel this way only with extreme exercise, but lately she has felt
this way continuously. She denies any other upper respiratory symptoms,
chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her
past medical history is significant only for seasonal allergies, for which
she takes a nasal steroid spray but is otherwise on no other medications.
She has had no surgeries. Her mother has allergies and eczema and her
father has high blood pressure. She is an only child. She denies smoking
and illegal drug use but drinks three to four alcoholic beverages per
weekend. She is a junior in finance at a local university and she has
recently started a job as a bartender in town. On examination she is in no
acute distress and her temperature is 98.6. Her blood pressure is 120/80,
her pulse is 80, and her respirations are 20. Her head, eyes, ears, nose,
and throat examinations are essentially normal. Inspection of her
anterior and posterior chest shows no abnormalities. On auscultation of
her chest, there is decreased air movement and a high-pitched whistling
on expiration in all lobes. Percussion reveals resonant lungs. Which
disorder of the thorax or lung does this best describe?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia – Correct Answer - C
pg. 2
,Asthma causes shortness of breath and a nocturnal cough. It is often
associated with a history of allergies and can be made worse by exercise
or irritants such as smoke in a bar. On auscultation there can be normal
to decreased air movement. Wheezing is heard on expiration and
sometimes inspiration. The duration of wheezing in expiration usually
correlates with severity of illness, so it is important to document this
length (e.g., wheezes heard halfway through exhalation). Realize that in
severe asthma, wheezes may not be heard because of the lack of air
movement. Paradoxically, these patients may have more wheezes after
treatment, which actually indicates an improvement in condition. Peak
flow measurements help to discern this.
If a patient has splenomegaly, what sound would be heard when
percussing the left side of the abdomen?
A. Dullness
B. Tympany
C. Fremitus
D. Hyperactive bowel sounds – Correct Answer - A
Which of the following percussion notes would you obtain over the
gastric bubble?
A. Resonance
B. Tympany
C. Hyperresonance
D. Flatness – Correct Answer - B
The gastric bubble produces one of the longest percussion notes. A
patient with COPD may have hyperresonance over his chest, while a
normal person would have resonance. Dullness is heard over a normal
liver, and flatness is heard if one percusses a large muscle
pg. 3
, A 12-year-old presents to the clinic with his father for evaluation of a
painful lump in the left eye. It started this morning. He denies any
trauma or injury. There is no visual disturbance. Upon physical
examination, there is a red raised area at the margin of the eyelid that is
tender to palpation; no tearing occurs with palpation of the lesion. Based
on this description, what is the most likely diagnosis?
A. Dacryocystitis
B. Chalazion
C. Hordeolum
D. Xanthelasma – Correct Answer - C
A hordeolum, or sty, is a painful, tender, erythematous infection in a
gland at the margin of the eyelid.
A 58-year-old man with a history of diabetes and alcohol addiction has
been sober for the last 10 months. He presents with a 4-month history of
increasing weakness, recurrent epigastric pain radiating to his back,
chronic diarrhea with stools 6-8 times daily, and weight loss of 18 lbs.
over 4 months. What is the mechanism of his most likely diagnosis?
A. Helicobacter pylori infection
B. Reduced blood supply to the bowel
C. Inflammation of the gallbladder
D. Fibrosis of the pancreas
E. Inflammation of colonic diverticulum – Correct Answer - D
Fibrosis of the pancreas is associated with chronic pancreatitis. Chronic
pancreatitis leads to fibrosis and decreased pancreatic function, which
causes diarrhea from pancreatic enzymes insufficiency and diabetes
mellitus. H.Pylori infection may cause peptic ulcer disease and
dyspepsia, which is not usually associated with diarrhea
pg. 4
ACTUAL EXAM TEST BANK| NUR 634 ADVANCED
PHYSICAL ASSESSMENT MIDTERM EXAM REVIEW
WITH COMPLETE 300 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+
Two weeks ago, Mary started a job which requires carrying 40-pound
buckets. She presents with elbow pain worse on the right. On
examination, it hurts her elbows to dorsiflex her hands against resistance
when her palms face the floor. What condition does she have?
A. Medial epicondylitis (golfer's elbow)
B. Olecranon bursitis
C. Lateral epicondylitis (tennis elbow)
D. Supracondylar fracture – Correct Answer - C
Mary’s injury probably occurred by lifting heavy buckets with her palms
down (toward the bucket). This caused her chronic overuse injury at the
lateral epicondyle. Medial epicondylitis has reproducible pain when
palmar flexion against resistance is performed and also features
tenderness over the involved epicondyle. Olecranon bursitis produces
erythema and swelling over the olecranon process. A supracondylar
fracture of the humerus is a major injury and would present more
acutely.
You feel a small mass that you think is a lymph node. It is mobile in
both the up-and-down and side-to-side directions. Which of the
following is most likely?
A. Cancer
pg. 1
,B. Lymph node
C. Deep scar
D. Muscle – Correct Answer - B
A useful maneuver for discerning lymph nodes from other masses in the
neck is to check for their mobility in all directions. Many other masses
are mobile in only two directions. Cancerous masses may also be
“fixed,” or immobile
A 21-year-old college senior presents to your clinic, complaining of
shortness of breath and a nonproductive nocturnal cough. She states she
used to feel this way only with extreme exercise, but lately she has felt
this way continuously. She denies any other upper respiratory symptoms,
chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her
past medical history is significant only for seasonal allergies, for which
she takes a nasal steroid spray but is otherwise on no other medications.
She has had no surgeries. Her mother has allergies and eczema and her
father has high blood pressure. She is an only child. She denies smoking
and illegal drug use but drinks three to four alcoholic beverages per
weekend. She is a junior in finance at a local university and she has
recently started a job as a bartender in town. On examination she is in no
acute distress and her temperature is 98.6. Her blood pressure is 120/80,
her pulse is 80, and her respirations are 20. Her head, eyes, ears, nose,
and throat examinations are essentially normal. Inspection of her
anterior and posterior chest shows no abnormalities. On auscultation of
her chest, there is decreased air movement and a high-pitched whistling
on expiration in all lobes. Percussion reveals resonant lungs. Which
disorder of the thorax or lung does this best describe?
A. Spontaneous pneumothorax
B. Chronic obstructive pulmonary disease (COPD)
C. Asthma
D. Pneumonia – Correct Answer - C
pg. 2
,Asthma causes shortness of breath and a nocturnal cough. It is often
associated with a history of allergies and can be made worse by exercise
or irritants such as smoke in a bar. On auscultation there can be normal
to decreased air movement. Wheezing is heard on expiration and
sometimes inspiration. The duration of wheezing in expiration usually
correlates with severity of illness, so it is important to document this
length (e.g., wheezes heard halfway through exhalation). Realize that in
severe asthma, wheezes may not be heard because of the lack of air
movement. Paradoxically, these patients may have more wheezes after
treatment, which actually indicates an improvement in condition. Peak
flow measurements help to discern this.
If a patient has splenomegaly, what sound would be heard when
percussing the left side of the abdomen?
A. Dullness
B. Tympany
C. Fremitus
D. Hyperactive bowel sounds – Correct Answer - A
Which of the following percussion notes would you obtain over the
gastric bubble?
A. Resonance
B. Tympany
C. Hyperresonance
D. Flatness – Correct Answer - B
The gastric bubble produces one of the longest percussion notes. A
patient with COPD may have hyperresonance over his chest, while a
normal person would have resonance. Dullness is heard over a normal
liver, and flatness is heard if one percusses a large muscle
pg. 3
, A 12-year-old presents to the clinic with his father for evaluation of a
painful lump in the left eye. It started this morning. He denies any
trauma or injury. There is no visual disturbance. Upon physical
examination, there is a red raised area at the margin of the eyelid that is
tender to palpation; no tearing occurs with palpation of the lesion. Based
on this description, what is the most likely diagnosis?
A. Dacryocystitis
B. Chalazion
C. Hordeolum
D. Xanthelasma – Correct Answer - C
A hordeolum, or sty, is a painful, tender, erythematous infection in a
gland at the margin of the eyelid.
A 58-year-old man with a history of diabetes and alcohol addiction has
been sober for the last 10 months. He presents with a 4-month history of
increasing weakness, recurrent epigastric pain radiating to his back,
chronic diarrhea with stools 6-8 times daily, and weight loss of 18 lbs.
over 4 months. What is the mechanism of his most likely diagnosis?
A. Helicobacter pylori infection
B. Reduced blood supply to the bowel
C. Inflammation of the gallbladder
D. Fibrosis of the pancreas
E. Inflammation of colonic diverticulum – Correct Answer - D
Fibrosis of the pancreas is associated with chronic pancreatitis. Chronic
pancreatitis leads to fibrosis and decreased pancreatic function, which
causes diarrhea from pancreatic enzymes insufficiency and diabetes
mellitus. H.Pylori infection may cause peptic ulcer disease and
dyspepsia, which is not usually associated with diarrhea
pg. 4
