GCU NUR 634 MIDTERM EXAM / ACTUAL EXAM
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1
A 68-year-old male presents with exertional dyspnea and bilateral ankle edema.
Which physical assessment finding most strongly supports left-sided heart failure?
A. Hepatomegaly
B. Pulmonary crackles
C. Jugular venous distention
D. Ascites
Correct Answer: B
Rationale: Pulmonary crackles result from fluid accumulation in the alveoli, a
hallmark of left-sided heart failure. Jugular venous distention, hepatomegaly, and
ascites are more consistent with right-sided failure.
Question 2
During cardiac auscultation, an S3 heart sound is most commonly associated with
which condition in adults?
A. Mitral valve stenosis
B. Normal aging
C. Ventricular volume overload
D. Pericarditis
Correct Answer: C
Rationale: An S3 is produced by rapid ventricular filling and is associated with
volume overload states such as heart failure in adults. It is not a normal age-related
finding.
,Question 3
A patient reports intermittent claudication. Which assessment technique best
confirms peripheral arterial disease?
A. Capillary refill assessment
B. Ankle-brachial index
C. Homans’ sign
D. Venous Doppler ultrasound
Correct Answer: B
Rationale: The ankle-brachial index compares systolic pressures in the ankle and
arm and is the most reliable noninvasive screening tool for peripheral arterial
disease.
Question 4
A 55-year-old female presents with a palpable thyroid nodule. Which finding is
most concerning for malignancy?
A. Soft, mobile nodule
B. Painful enlargement
C. Firm, fixed nodule
D. Symmetric thyroid enlargement
Correct Answer: C
Rationale: Firm, fixed, and non-tender nodules raise concern for thyroid
malignancy, whereas mobile or painful nodules are more often benign or
inflammatory.
Question 5
Which lung sound is described as low-pitched, continuous, and most prominent
during expiration?
A. Crackles
B. Pleural friction rub
,C. Wheezes
D. Stridor
Correct Answer: C
Rationale: Wheezes are continuous, musical sounds caused by narrowed airways
and are most prominent during expiration.
Question 6
A patient with chronic obstructive pulmonary disease (COPD) is expected to
demonstrate which thoracic configuration?
A. Pectus excavatum
B. Barrel chest
C. Kyphoscoliosis
D. Funnel chest
Correct Answer: B
Rationale: A barrel chest results from chronic lung hyperinflation, commonly seen
in patients with COPD.
Question 7
During abdominal assessment, which finding suggests ascites?
A. Hyperactive bowel sounds
B. Tympany on percussion
C. Shifting dullness
D. Guarding
Correct Answer: C
Rationale: Shifting dullness occurs when fluid in the abdomen moves with
position changes, indicating ascites.
, Question 8
A 45-year-old patient reports heartburn and regurgitation. Which assessment
finding supports gastroesophageal reflux disease (GERD)?
A. Right upper quadrant tenderness
B. Epigastric tenderness after meals
C. Rebound tenderness
D. Murphy’s sign
Correct Answer: B
Rationale: GERD commonly presents with epigastric discomfort following meals
due to acid reflux.
Question 9
Which neurological assessment best evaluates cerebellar function?
A. Deep tendon reflexes
B. Cranial nerve II testing
C. Finger-to-nose testing
D. Light touch sensation
Correct Answer: C
Rationale: The finger-to-nose test assesses coordination and cerebellar function.
Question 10
A positive Babinski reflex in an adult indicates dysfunction of which system?
A. Peripheral nervous system
B. Cerebellar pathways
C. Upper motor neurons
D. Lower motor neurons
Correct Answer: C
Rationale: A positive Babinski sign in adults indicates upper motor neuron disease
or central nervous system pathology.
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1
A 68-year-old male presents with exertional dyspnea and bilateral ankle edema.
Which physical assessment finding most strongly supports left-sided heart failure?
A. Hepatomegaly
B. Pulmonary crackles
C. Jugular venous distention
D. Ascites
Correct Answer: B
Rationale: Pulmonary crackles result from fluid accumulation in the alveoli, a
hallmark of left-sided heart failure. Jugular venous distention, hepatomegaly, and
ascites are more consistent with right-sided failure.
Question 2
During cardiac auscultation, an S3 heart sound is most commonly associated with
which condition in adults?
A. Mitral valve stenosis
B. Normal aging
C. Ventricular volume overload
D. Pericarditis
Correct Answer: C
Rationale: An S3 is produced by rapid ventricular filling and is associated with
volume overload states such as heart failure in adults. It is not a normal age-related
finding.
,Question 3
A patient reports intermittent claudication. Which assessment technique best
confirms peripheral arterial disease?
A. Capillary refill assessment
B. Ankle-brachial index
C. Homans’ sign
D. Venous Doppler ultrasound
Correct Answer: B
Rationale: The ankle-brachial index compares systolic pressures in the ankle and
arm and is the most reliable noninvasive screening tool for peripheral arterial
disease.
Question 4
A 55-year-old female presents with a palpable thyroid nodule. Which finding is
most concerning for malignancy?
A. Soft, mobile nodule
B. Painful enlargement
C. Firm, fixed nodule
D. Symmetric thyroid enlargement
Correct Answer: C
Rationale: Firm, fixed, and non-tender nodules raise concern for thyroid
malignancy, whereas mobile or painful nodules are more often benign or
inflammatory.
Question 5
Which lung sound is described as low-pitched, continuous, and most prominent
during expiration?
A. Crackles
B. Pleural friction rub
,C. Wheezes
D. Stridor
Correct Answer: C
Rationale: Wheezes are continuous, musical sounds caused by narrowed airways
and are most prominent during expiration.
Question 6
A patient with chronic obstructive pulmonary disease (COPD) is expected to
demonstrate which thoracic configuration?
A. Pectus excavatum
B. Barrel chest
C. Kyphoscoliosis
D. Funnel chest
Correct Answer: B
Rationale: A barrel chest results from chronic lung hyperinflation, commonly seen
in patients with COPD.
Question 7
During abdominal assessment, which finding suggests ascites?
A. Hyperactive bowel sounds
B. Tympany on percussion
C. Shifting dullness
D. Guarding
Correct Answer: C
Rationale: Shifting dullness occurs when fluid in the abdomen moves with
position changes, indicating ascites.
, Question 8
A 45-year-old patient reports heartburn and regurgitation. Which assessment
finding supports gastroesophageal reflux disease (GERD)?
A. Right upper quadrant tenderness
B. Epigastric tenderness after meals
C. Rebound tenderness
D. Murphy’s sign
Correct Answer: B
Rationale: GERD commonly presents with epigastric discomfort following meals
due to acid reflux.
Question 9
Which neurological assessment best evaluates cerebellar function?
A. Deep tendon reflexes
B. Cranial nerve II testing
C. Finger-to-nose testing
D. Light touch sensation
Correct Answer: C
Rationale: The finger-to-nose test assesses coordination and cerebellar function.
Question 10
A positive Babinski reflex in an adult indicates dysfunction of which system?
A. Peripheral nervous system
B. Cerebellar pathways
C. Upper motor neurons
D. Lower motor neurons
Correct Answer: C
Rationale: A positive Babinski sign in adults indicates upper motor neuron disease
or central nervous system pathology.
