NUR 634 MIDTERM EXAM / LATEST GCU NUR 634 MIDTERM EXAM
2026/2027 PRACTICE QUESTIONS AND A NEW UPDATED STUDY GUIDE
COMPLETE ACCURATE EXAM
1. A 46-year-old patient presents for an advanced health assessment and
begins describing multiple concerns, including fatigue, intermittent
headaches, difficulty sleeping, and stress at work. The patient provides a
lengthy chronological story without clearly identifying the primary reason
for the visit. Which action by the advanced practice nurse is most
appropriate to maintain structure while allowing the patient to
communicate important concerns?
A. Interrupt immediately and begin a complete review of systems
B. Allow the patient to continue indefinitely without clarification
C. Summarize the concerns already expressed and ask the patient to
identify the primary concern to address first
D. Ignore the patient's narrative and begin the physical examination
Answer: C
2. During an initial comprehensive health history, an advanced practice nurse
wants to establish the patient's reliability as a historian. Which information
is most important to document when evaluating the source of the history?
A. Whether the patient prefers written or verbal instructions
B. The patient's favorite healthcare facility
C. The patient's insurance coverage
D. The patient's ability to provide consistent, coherent, and accurate
information
Answer: D
3. A patient reports, “I have been having chest discomfort.” The nurse wants
to clarify the chief complaint without prematurely assigning a diagnosis.
Which question is most appropriate?
A. “Tell me more about the chest discomfort and what concerns you most
about it.”
B. “Is this definitely angina?”
pg. 1
, C. “Have you already had a myocardial infarction?”
D. “Does your coronary artery disease cause the pain?”
Answer: A
4. While obtaining the history of present illness, the nurse asks about onset,
location, duration, characteristics, aggravating and relieving factors, timing,
and severity. Which framework is being used to structure the symptom
assessment?
A. SAMPLE
B. OPQRST
C. PQRSTU
D. HEADSS
Answer: B
5. A patient reports abdominal pain that began suddenly after eating dinner, is
located in the right upper quadrant, radiates toward the right shoulder, and
worsens after fatty meals. Which aspect of the symptom history is
represented by the statement that the pain radiates toward the right
shoulder?
A. Severity
B. Timing
C. Location and radiation
D. Precipitating factor
Answer: C
6. A patient reports a headache as “8 out of 10.” The nurse recognizes that a
numerical pain rating primarily provides information about which
component of the symptom?
A. Severity
B. Quality
C. Radiation
D. Duration
Answer: A
pg. 2
, 7. A patient states, “The pain feels like someone is squeezing my chest.” Which
component of the symptom history is the nurse documenting?
A. Timing
B. Quality
C. Location
D. Severity
Answer: B
8. During a health history, the patient states that symptoms occur every
morning and typically last approximately 30 minutes before resolving.
Which aspect of the history is being clarified?
A. Family history
B. Severity
C. Timing and duration
D. Social history
Answer: C
9. A patient presents with fatigue. Which question best demonstrates an
appropriate open-ended approach to exploring the symptom?
A. “Is your fatigue caused by anemia?”
B. “Do you have fatigue every day?”
C. “Are you tired because you are not sleeping?”
D. “Tell me what you mean by fatigue and how it affects your usual
activities.”
Answer: D
10. During a comprehensive history, the nurse asks about previous illnesses,
hospitalizations, surgeries, injuries, allergies, and immunizations. Which
section of the history is being completed?
A. Past medical history
B. Review of systems
C. Family history
D. Social history
Answer: A
pg. 3
, 11. A patient reports that a parent died from colon cancer at age 48. Which
component of the health history should contain this information?
A. Review of systems
B. Family history
C. Past surgical history
D. Medication history
Answer: B
12. During social history assessment, which information is particularly
important when evaluating factors that may influence chronic disease risk?
A. Favorite television programs
B. Childhood nicknames
C. Tobacco, alcohol, recreational drug use, occupation, diet, exercise, and
living environment
D. Preferred clothing style
Answer: C
13. A patient tells the nurse, “I drink two beers every evening.” Which response
best supports accurate alcohol assessment?
A. “Why do you drink every day?”
B. “You need to stop drinking.”
C. “That amount is harmless.”
D. “Tell me more about how much you typically drink during a usual week.”
Answer: D
14. During medication reconciliation, a patient states that an over-the-counter
herbal product is not a medication. Which response by the nurse is most
appropriate?
A. “Only prescription medications need to be listed.”
B. “Herbal products can affect health and interact with medications, so we
should include them in your medication history.”
C. “Herbal products never cause adverse effects.”
D. “You should stop all supplements immediately.”
Answer: B
pg. 4
2026/2027 PRACTICE QUESTIONS AND A NEW UPDATED STUDY GUIDE
COMPLETE ACCURATE EXAM
1. A 46-year-old patient presents for an advanced health assessment and
begins describing multiple concerns, including fatigue, intermittent
headaches, difficulty sleeping, and stress at work. The patient provides a
lengthy chronological story without clearly identifying the primary reason
for the visit. Which action by the advanced practice nurse is most
appropriate to maintain structure while allowing the patient to
communicate important concerns?
A. Interrupt immediately and begin a complete review of systems
B. Allow the patient to continue indefinitely without clarification
C. Summarize the concerns already expressed and ask the patient to
identify the primary concern to address first
D. Ignore the patient's narrative and begin the physical examination
Answer: C
2. During an initial comprehensive health history, an advanced practice nurse
wants to establish the patient's reliability as a historian. Which information
is most important to document when evaluating the source of the history?
A. Whether the patient prefers written or verbal instructions
B. The patient's favorite healthcare facility
C. The patient's insurance coverage
D. The patient's ability to provide consistent, coherent, and accurate
information
Answer: D
3. A patient reports, “I have been having chest discomfort.” The nurse wants
to clarify the chief complaint without prematurely assigning a diagnosis.
Which question is most appropriate?
A. “Tell me more about the chest discomfort and what concerns you most
about it.”
B. “Is this definitely angina?”
pg. 1
, C. “Have you already had a myocardial infarction?”
D. “Does your coronary artery disease cause the pain?”
Answer: A
4. While obtaining the history of present illness, the nurse asks about onset,
location, duration, characteristics, aggravating and relieving factors, timing,
and severity. Which framework is being used to structure the symptom
assessment?
A. SAMPLE
B. OPQRST
C. PQRSTU
D. HEADSS
Answer: B
5. A patient reports abdominal pain that began suddenly after eating dinner, is
located in the right upper quadrant, radiates toward the right shoulder, and
worsens after fatty meals. Which aspect of the symptom history is
represented by the statement that the pain radiates toward the right
shoulder?
A. Severity
B. Timing
C. Location and radiation
D. Precipitating factor
Answer: C
6. A patient reports a headache as “8 out of 10.” The nurse recognizes that a
numerical pain rating primarily provides information about which
component of the symptom?
A. Severity
B. Quality
C. Radiation
D. Duration
Answer: A
pg. 2
, 7. A patient states, “The pain feels like someone is squeezing my chest.” Which
component of the symptom history is the nurse documenting?
A. Timing
B. Quality
C. Location
D. Severity
Answer: B
8. During a health history, the patient states that symptoms occur every
morning and typically last approximately 30 minutes before resolving.
Which aspect of the history is being clarified?
A. Family history
B. Severity
C. Timing and duration
D. Social history
Answer: C
9. A patient presents with fatigue. Which question best demonstrates an
appropriate open-ended approach to exploring the symptom?
A. “Is your fatigue caused by anemia?”
B. “Do you have fatigue every day?”
C. “Are you tired because you are not sleeping?”
D. “Tell me what you mean by fatigue and how it affects your usual
activities.”
Answer: D
10. During a comprehensive history, the nurse asks about previous illnesses,
hospitalizations, surgeries, injuries, allergies, and immunizations. Which
section of the history is being completed?
A. Past medical history
B. Review of systems
C. Family history
D. Social history
Answer: A
pg. 3
, 11. A patient reports that a parent died from colon cancer at age 48. Which
component of the health history should contain this information?
A. Review of systems
B. Family history
C. Past surgical history
D. Medication history
Answer: B
12. During social history assessment, which information is particularly
important when evaluating factors that may influence chronic disease risk?
A. Favorite television programs
B. Childhood nicknames
C. Tobacco, alcohol, recreational drug use, occupation, diet, exercise, and
living environment
D. Preferred clothing style
Answer: C
13. A patient tells the nurse, “I drink two beers every evening.” Which response
best supports accurate alcohol assessment?
A. “Why do you drink every day?”
B. “You need to stop drinking.”
C. “That amount is harmless.”
D. “Tell me more about how much you typically drink during a usual week.”
Answer: D
14. During medication reconciliation, a patient states that an over-the-counter
herbal product is not a medication. Which response by the nurse is most
appropriate?
A. “Only prescription medications need to be listed.”
B. “Herbal products can affect health and interact with medications, so we
should include them in your medication history.”
C. “Herbal products never cause adverse effects.”
D. “You should stop all supplements immediately.”
Answer: B
pg. 4
