1
2026 Latest NUR 634 Midterm Exam Test Bank with 200
Questions and Correct Answers with Rationales Graded
A+ GCU/ NUR 634 Midterm Exam Prep Test Bank (new!)
This comprehensive test bank is designed to prepare you for the NUR 634 Midterm
Exam. It covers the core content areas typical of an advanced practice nursing course: advanced
health assessment, pathophysiology, pharmacology, differential diagnosis, and clinical
management of common adult health conditions. Each question includes the correct answer
and a detailed rationale to reinforce learning.
SECTION 1: ADVANCED HEALTH ASSESSMENT
1. A 55-year-old man presents with a 2-day history of severe, tearing chest pain that
radiates to his back. His blood pressure is 160/90 mm Hg in the right arm and 110/70 mm Hg
in the left arm. What is the most appropriate next step?
A) Administer aspirin and order a troponin level.
B) Obtain an immediate chest x-ray.
C) Order a stat CT angiography of the chest.
D) Reassure the patient and schedule a follow-up appointment.
✔✔ Correct Answe✔✔ C
Rationale: The presentation is classic for aortic dissection (tearing chest pain, pulse
differential). CT angiography is the definitive imaging study to confirm the diagnosis and should
not be delayed.
2. A 68-year-old woman reports a 3-month history of progressive difficulty
swallowing, first with solids and now with liquids. She has lost 10 pounds unintentionally.
What is the most appropriate initial diagnostic test?
A) Barium swallow
B) Upper endoscopy
,2
C) Esophageal manometry
D) CT scan of the chest
✔✔ Correct Answe✔✔ B
Rationale: Dysphagia with weight loss and progression from solids to liquids is
concerning for esophageal malignancy. Upper endoscopy with biopsy is the test of choice for
direct visualization and tissue diagnosis.
3. A patient presents with a painless, firm, fixed mass in the right breast. There is no
skin dimpling or nipple discharge. Which of the following is the most appropriate next step?
A) Order a screening mammogram.
B) Order a diagnostic mammogram and ultrasound.
C) Reassure the patient and schedule a follow-up in 6 months.
D) Prescribe antibiotics for possible mastitis.
✔✔ Correct Answe✔✔ B
Rationale: Any new, firm, fixed breast mass is suspicious for malignancy. Diagnostic
mammogram and ultrasound are the appropriate imaging studies to characterize the mass and
guide biopsy.
4. A 72-year-old man reports a 6-month history of progressive forgetfulness, difficulty
managing finances, and getting lost in familiar neighborhoods. Which screening tool is most
appropriate for initial cognitive assessment?
A) PHQ-9
B) GAD-7
C) Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA)
D) CAGE questionnaire
✔✔ Correct Answe✔✔ C
Rationale: The MMSE and MoCA are validated screening tools for cognitive impairment.
PHQ-9 screens for depression; GAD-7 for anxiety; CAGE for alcohol use disorder.
5. A 45-year-old woman presents with a 2-week history of fatigue, joint pain, and a
malar rash that worsens with sun exposure. Which laboratory test is most specific for
systemic lupus erythematosus (SLE)?
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A) Antinuclear antibody (ANA)
B) Anti-double-stranded DNA (anti-dsDNA)
C) Rheumatoid factor
D) Erythrocyte sedimentation rate (ESR)
✔✔ Correct Answe✔✔ B
Rationale: Anti-dsDNA is highly specific for SLE. ANA is sensitive but not specific. RF is
associated with rheumatoid arthritis; ESR is non-specific.
6. On fundoscopic examination, you note a pale, swollen optic disc with blurred
margins. This finding is most consistent with:
A) Glaucoma
B) Papilledema
C) Optic neuritis
D) Diabetic retinopathy
✔✔ Correct Answe✔✔ B
Rationale: Papilledema (swollen optic disc with blurred margins) indicates increased
intracranial pressure. Glaucoma causes cupping; optic neuritis may cause pallor; diabetic
retinopathy involves microaneurysms and hemorrhages.
7. A 60-year-old man reports a 3-month history of right shoulder pain that is worse
with overhead activity. He has full range of motion but pain with abduction. What is the most
likely diagnosis?
A) Rotator cuff tendinopathy
B) Adhesive capsulitis
C) Glenohumeral osteoarthritis
D) Cervical radiculopathy
✔✔ Correct Answe✔✔ A
Rationale: Painful arc (60-120 degrees) with full range of motion suggests rotator cuff
tendinopathy or impingement. Adhesive capsulitis causes global restriction; osteoarthritis
causes stiffness; cervical radiculopathy may cause pain radiating down the arm.
8. A patient has a positive Tinel’s sign at the wrist. This finding is associated with:
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A) Carpal tunnel syndrome
B) Ulnar nerve entrapment
C) Cubital tunnel syndrome
D) Radial nerve palsy
✔✔ Correct Answe✔✔ A
Rationale: Tinel’s sign over the median nerve at the wrist (tapping reproduces
paresthesias in the thumb, index, middle fingers) is classic for carpal tunnel syndrome.
9. A 35-year-old woman presents with a 1-week history of right lower quadrant pain,
nausea, and low-grade fever. On palpation, she has tenderness at McBurney’s point. What is
the most likely diagnosis?
A) Cholecystitis
B) Appendicitis
C) Pancreatitis
D) Diverticulitis
✔✔ Correct Answe✔✔ B
Rationale: McBurney’s point tenderness is classic for appendicitis. Cholecystitis presents
with right upper quadrant pain; pancreatitis with epigastric pain radiating to back; diverticulitis
with left lower quadrant pain.
10. A patient has a positive Romberg test. This finding indicates:
A) Cerebellar ataxia
B) Loss of proprioception (dorsal column dysfunction)
C) Vestibular dysfunction
D) Peripheral neuropathy
✔✔ Correct Answe✔✔ B
Rationale: Romberg test (standing with eyes closed) is positive if the patient sways or
falls, indicating loss of proprioception (dorsal column). Cerebellar ataxia is present with eyes
open.
SECTION 2: PHARMACOLOGY
2026 Latest NUR 634 Midterm Exam Test Bank with 200
Questions and Correct Answers with Rationales Graded
A+ GCU/ NUR 634 Midterm Exam Prep Test Bank (new!)
This comprehensive test bank is designed to prepare you for the NUR 634 Midterm
Exam. It covers the core content areas typical of an advanced practice nursing course: advanced
health assessment, pathophysiology, pharmacology, differential diagnosis, and clinical
management of common adult health conditions. Each question includes the correct answer
and a detailed rationale to reinforce learning.
SECTION 1: ADVANCED HEALTH ASSESSMENT
1. A 55-year-old man presents with a 2-day history of severe, tearing chest pain that
radiates to his back. His blood pressure is 160/90 mm Hg in the right arm and 110/70 mm Hg
in the left arm. What is the most appropriate next step?
A) Administer aspirin and order a troponin level.
B) Obtain an immediate chest x-ray.
C) Order a stat CT angiography of the chest.
D) Reassure the patient and schedule a follow-up appointment.
✔✔ Correct Answe✔✔ C
Rationale: The presentation is classic for aortic dissection (tearing chest pain, pulse
differential). CT angiography is the definitive imaging study to confirm the diagnosis and should
not be delayed.
2. A 68-year-old woman reports a 3-month history of progressive difficulty
swallowing, first with solids and now with liquids. She has lost 10 pounds unintentionally.
What is the most appropriate initial diagnostic test?
A) Barium swallow
B) Upper endoscopy
,2
C) Esophageal manometry
D) CT scan of the chest
✔✔ Correct Answe✔✔ B
Rationale: Dysphagia with weight loss and progression from solids to liquids is
concerning for esophageal malignancy. Upper endoscopy with biopsy is the test of choice for
direct visualization and tissue diagnosis.
3. A patient presents with a painless, firm, fixed mass in the right breast. There is no
skin dimpling or nipple discharge. Which of the following is the most appropriate next step?
A) Order a screening mammogram.
B) Order a diagnostic mammogram and ultrasound.
C) Reassure the patient and schedule a follow-up in 6 months.
D) Prescribe antibiotics for possible mastitis.
✔✔ Correct Answe✔✔ B
Rationale: Any new, firm, fixed breast mass is suspicious for malignancy. Diagnostic
mammogram and ultrasound are the appropriate imaging studies to characterize the mass and
guide biopsy.
4. A 72-year-old man reports a 6-month history of progressive forgetfulness, difficulty
managing finances, and getting lost in familiar neighborhoods. Which screening tool is most
appropriate for initial cognitive assessment?
A) PHQ-9
B) GAD-7
C) Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA)
D) CAGE questionnaire
✔✔ Correct Answe✔✔ C
Rationale: The MMSE and MoCA are validated screening tools for cognitive impairment.
PHQ-9 screens for depression; GAD-7 for anxiety; CAGE for alcohol use disorder.
5. A 45-year-old woman presents with a 2-week history of fatigue, joint pain, and a
malar rash that worsens with sun exposure. Which laboratory test is most specific for
systemic lupus erythematosus (SLE)?
,3
A) Antinuclear antibody (ANA)
B) Anti-double-stranded DNA (anti-dsDNA)
C) Rheumatoid factor
D) Erythrocyte sedimentation rate (ESR)
✔✔ Correct Answe✔✔ B
Rationale: Anti-dsDNA is highly specific for SLE. ANA is sensitive but not specific. RF is
associated with rheumatoid arthritis; ESR is non-specific.
6. On fundoscopic examination, you note a pale, swollen optic disc with blurred
margins. This finding is most consistent with:
A) Glaucoma
B) Papilledema
C) Optic neuritis
D) Diabetic retinopathy
✔✔ Correct Answe✔✔ B
Rationale: Papilledema (swollen optic disc with blurred margins) indicates increased
intracranial pressure. Glaucoma causes cupping; optic neuritis may cause pallor; diabetic
retinopathy involves microaneurysms and hemorrhages.
7. A 60-year-old man reports a 3-month history of right shoulder pain that is worse
with overhead activity. He has full range of motion but pain with abduction. What is the most
likely diagnosis?
A) Rotator cuff tendinopathy
B) Adhesive capsulitis
C) Glenohumeral osteoarthritis
D) Cervical radiculopathy
✔✔ Correct Answe✔✔ A
Rationale: Painful arc (60-120 degrees) with full range of motion suggests rotator cuff
tendinopathy or impingement. Adhesive capsulitis causes global restriction; osteoarthritis
causes stiffness; cervical radiculopathy may cause pain radiating down the arm.
8. A patient has a positive Tinel’s sign at the wrist. This finding is associated with:
, 4
A) Carpal tunnel syndrome
B) Ulnar nerve entrapment
C) Cubital tunnel syndrome
D) Radial nerve palsy
✔✔ Correct Answe✔✔ A
Rationale: Tinel’s sign over the median nerve at the wrist (tapping reproduces
paresthesias in the thumb, index, middle fingers) is classic for carpal tunnel syndrome.
9. A 35-year-old woman presents with a 1-week history of right lower quadrant pain,
nausea, and low-grade fever. On palpation, she has tenderness at McBurney’s point. What is
the most likely diagnosis?
A) Cholecystitis
B) Appendicitis
C) Pancreatitis
D) Diverticulitis
✔✔ Correct Answe✔✔ B
Rationale: McBurney’s point tenderness is classic for appendicitis. Cholecystitis presents
with right upper quadrant pain; pancreatitis with epigastric pain radiating to back; diverticulitis
with left lower quadrant pain.
10. A patient has a positive Romberg test. This finding indicates:
A) Cerebellar ataxia
B) Loss of proprioception (dorsal column dysfunction)
C) Vestibular dysfunction
D) Peripheral neuropathy
✔✔ Correct Answe✔✔ B
Rationale: Romberg test (standing with eyes closed) is positive if the patient sways or
falls, indicating loss of proprioception (dorsal column). Cerebellar ataxia is present with eyes
open.
SECTION 2: PHARMACOLOGY
