2026 Latest NUR 634 Midterm Exam Test Bank
with 200 Questions and Correct Answers with
Rationales Graded A+ GCU/ NUR 634 Midterm
Exam 2026-2027 Prep Test Bank (new!)
A 62-year-old smoker complains of "coughing up small amounts of blood," so you
consider hemoptysis. Which of the following should you also consider?
A. Intestinal bleeding
B. Hematoma of the nasal septum
C. Epistaxis
D. Bruising of the tongue
ANS: C
During a musculoskeletal examination of the spine, what is the action(s) of the
erector spinae muscle group?
A. Extension of the spine
B. Flexion of the spine
C. Rotation of the spine
D. Lateral bending of the spine
ANS: A
The erector spinae muscle group is one of the deep intrinsic muscle groups of the
back that extends the spine.
A patient complaining of hemoptysis what may warrant consideration?
A. Upper GI Beed
B. Oral Bruising
C. Hematoma of nasal septum
D. Periungual infection
1
,ANS: A
*Exam HENT, GI, and lungs*
A 46-year-old executive who is obese and otherwise healthy presents to a family
medicine clinic with a 3-month course of recurrent severe abdominal pain that
usually resolves on its own after a few hours. Her last episode was prolonged
lasting 6 hours, and she is frustrated that she has had to leave or miss work on three
separate occasions. She would like a diagnosis and the problem fixed. Which
symptoms or signs would be most suggestive of a diagnosis of biliary colic?
A. Vomiting of bile
B. Poorly localized periumbilical pain
C. Associated right shoulder pain
D. Positive McBurney point tenderness
E. Exacerbating factor includes alcohol intake
ANS: C
Pain with biliary colic can produce referred pain to the right shoulder or scapula
due to irritation of the right hemidiaphragm. Alcohol is not an exacerbating factor
for biliary colic. Positive McBurney point tenderness is associated with acute
appendicitis. The Murphy sign is associated with acute cholecystitis. Vomiting bile
is associated with small bowel obstruction
A 37-year-old nurse comes for evaluation of colicky right upper quadrant
abdominal pain. The pain is associated with nausea and vomiting and occurs 1 to 2
hours after eating greasy foods. Which one of the following physical examination
descriptions would be most consistent with the diagnosis of cholecystitis?
A. Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or
masses.
B. Abdomen is soft and tender to palpation in the right lower quadrant, without
rebound or guarding.
C. Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or
guarding.
D. Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or guarding.
2
,ANS: C
In cholecystitis, the pain, which originates from the gallbladder, is located in the
right upper quadrant. Severity of pain with inspiration that is sufficient to stop
further inhalation is also known as Murphy's sign, which, if present, is further
indicative of inflammation of the gallbladder.
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
ANS: C
Feedback: A hordeolum, or sty, is a painful, tender, erythematous infection in a
gland at the margin of the eyelid.
A 55-year-old woman with a headache explains to the clinician that she has had
headaches before, but this one is unusual because of some new symptoms. Which
of the following symptoms would prompt an immediate investigation?
A. The headache comes and goes
B. The patient had a car accident and minor head trauma about 3 months ago
C. The patient lost her glasses
D. The patient also has developed fever and night sweats and thinks she lost some
weight.
E. The headache is similar in nature to prior ones she has had for decades but more
severe.
ANS: D
Concomitant fever, night sweats, and weight loss are concerning systemic
symptoms and suggest a serious underlying cause of the headaches.
3
, 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
ANS: 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
A 19-year-old-college student presents to the emergency room with fever,
headache, and neck pain/stiffness. She is concerned about the possibility of
meningococcal meningitis. Several of her dorm mates have been vaccinated, but
she hasn't been. Which of the following physical examination descriptions is most
consistent with meningitis?
A. Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with
full range of motion
B. Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous muscle spasm and limited range of motion to the right
C. Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
tender to palpation, unable to perform range of motion
D. Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
supple with full range of motion
ANS: C
Feedback: Blurred disc margins are consistent with papilledema, and neck
tenderness and lack of range of motion are consistent with neck stiffness, which in
this scenario is likely to be caused by meningeal inflammation. Later, you will
4
with 200 Questions and Correct Answers with
Rationales Graded A+ GCU/ NUR 634 Midterm
Exam 2026-2027 Prep Test Bank (new!)
A 62-year-old smoker complains of "coughing up small amounts of blood," so you
consider hemoptysis. Which of the following should you also consider?
A. Intestinal bleeding
B. Hematoma of the nasal septum
C. Epistaxis
D. Bruising of the tongue
ANS: C
During a musculoskeletal examination of the spine, what is the action(s) of the
erector spinae muscle group?
A. Extension of the spine
B. Flexion of the spine
C. Rotation of the spine
D. Lateral bending of the spine
ANS: A
The erector spinae muscle group is one of the deep intrinsic muscle groups of the
back that extends the spine.
A patient complaining of hemoptysis what may warrant consideration?
A. Upper GI Beed
B. Oral Bruising
C. Hematoma of nasal septum
D. Periungual infection
1
,ANS: A
*Exam HENT, GI, and lungs*
A 46-year-old executive who is obese and otherwise healthy presents to a family
medicine clinic with a 3-month course of recurrent severe abdominal pain that
usually resolves on its own after a few hours. Her last episode was prolonged
lasting 6 hours, and she is frustrated that she has had to leave or miss work on three
separate occasions. She would like a diagnosis and the problem fixed. Which
symptoms or signs would be most suggestive of a diagnosis of biliary colic?
A. Vomiting of bile
B. Poorly localized periumbilical pain
C. Associated right shoulder pain
D. Positive McBurney point tenderness
E. Exacerbating factor includes alcohol intake
ANS: C
Pain with biliary colic can produce referred pain to the right shoulder or scapula
due to irritation of the right hemidiaphragm. Alcohol is not an exacerbating factor
for biliary colic. Positive McBurney point tenderness is associated with acute
appendicitis. The Murphy sign is associated with acute cholecystitis. Vomiting bile
is associated with small bowel obstruction
A 37-year-old nurse comes for evaluation of colicky right upper quadrant
abdominal pain. The pain is associated with nausea and vomiting and occurs 1 to 2
hours after eating greasy foods. Which one of the following physical examination
descriptions would be most consistent with the diagnosis of cholecystitis?
A. Abdomen is soft, nontender, and nondistended, without hepatosplenomegaly or
masses.
B. Abdomen is soft and tender to palpation in the right lower quadrant, without
rebound or guarding.
C. Abdomen is soft and tender to palpation in the right upper quadrant with
inspiration, to the point of stopping inspiration, and there is no rebound or
guarding.
D. Abdomen is soft and tender to palpation in the mid-epigastric area, without
rebound or guarding.
2
,ANS: C
In cholecystitis, the pain, which originates from the gallbladder, is located in the
right upper quadrant. Severity of pain with inspiration that is sufficient to stop
further inhalation is also known as Murphy's sign, which, if present, is further
indicative of inflammation of the gallbladder.
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
ANS: C
Feedback: A hordeolum, or sty, is a painful, tender, erythematous infection in a
gland at the margin of the eyelid.
A 55-year-old woman with a headache explains to the clinician that she has had
headaches before, but this one is unusual because of some new symptoms. Which
of the following symptoms would prompt an immediate investigation?
A. The headache comes and goes
B. The patient had a car accident and minor head trauma about 3 months ago
C. The patient lost her glasses
D. The patient also has developed fever and night sweats and thinks she lost some
weight.
E. The headache is similar in nature to prior ones she has had for decades but more
severe.
ANS: D
Concomitant fever, night sweats, and weight loss are concerning systemic
symptoms and suggest a serious underlying cause of the headaches.
3
, 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
ANS: 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
A 19-year-old-college student presents to the emergency room with fever,
headache, and neck pain/stiffness. She is concerned about the possibility of
meningococcal meningitis. Several of her dorm mates have been vaccinated, but
she hasn't been. Which of the following physical examination descriptions is most
consistent with meningitis?
A. Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with
full range of motion
B. Head is normocephalic and atraumatic, fundi with sharp discs, neck with
paraspinous muscle spasm and limited range of motion to the right
C. Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
tender to palpation, unable to perform range of motion
D. Head is normocephalic and atraumatic, fundi with blurred disc margins, neck
supple with full range of motion
ANS: C
Feedback: Blurred disc margins are consistent with papilledema, and neck
tenderness and lack of range of motion are consistent with neck stiffness, which in
this scenario is likely to be caused by meningeal inflammation. Later, you will
4
