NUR 634 Final Exam Test Preparation - Advanced Health
Assessment and Diagnostic Reasoning with Skills Lab | Complete
Exam Guide with Answers and Rationales – 2026 Latest Update –
Grand Canyon University.
QUESTION 1
A 58-year-old male presents with intermittent chest discomfort described as
“pressure” that occurs during exertion and resolves with rest. He has a history
of hypertension and hyperlipidemia. Vital signs are stable. Which is the most
likely diagnosis?
A. Gastroesophageal reflux disease
B. Stable angina
C. Pericarditis
D. Pneumonia
Correct Answer: B. Stable angina
Explanation:
Stable angina presents as predictable chest pressure triggered by exertion and
relieved by rest. It is due to transient myocardial ischemia without infarction.
QUESTION 2
A 45-year-old woman reports fatigue, weight gain, cold intolerance, and
constipation. Physical exam reveals dry skin and bradycardia. What is the
most appropriate initial diagnostic test?
A. Serum cortisol
B. TSH and free T4
C. ECG
D. Serum calcium
Correct Answer: B. TSH and free T4
pg. 1
,Explanation:
Symptoms are consistent with hypothyroidism. TSH and free T4 are first-line
diagnostic tests to evaluate thyroid function.
QUESTION 3
A 67-year-old patient presents with sudden unilateral weakness and slurred
speech lasting 30 minutes, now resolved. What is the most likely diagnosis?
A. Stroke
B. Transient ischemic attack
C. Bell’s palsy
D. Seizure disorder
Correct Answer: B. Transient ischemic attack
Explanation:
TIA presents with transient neurological deficits that resolve within 24 hours
without permanent damage.
QUESTION 4
A patient presents with fever, flank pain, and costovertebral angle tenderness.
Urinalysis shows WBCs and nitrites. What is the most likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Kidney stones
D. Appendicitis
Correct Answer: B. Pyelonephritis
Explanation:
Upper urinary tract infection presents with systemic symptoms and CVA
tenderness.
pg. 2
,QUESTION 5
A 30-year-old woman presents with tremors, heat intolerance, weight loss,
and exophthalmos. What lab finding is expected?
A. Elevated TSH
B. Low T3/T4
C. Elevated T3/T4 with suppressed TSH
D. Low cortisol
Correct Answer: C. Elevated T3/T4 with suppressed TSH
Explanation:
Findings are consistent with Graves’ disease, a hyperthyroid state.
QUESTION 6
A 70-year-old smoker presents with chronic productive cough and dyspnea.
Which condition is most likely?
A. Asthma
B. COPD
C. Pneumothorax
D. Pulmonary embolism
Correct Answer: B. COPD
Explanation:
COPD is strongly associated with smoking and presents with chronic
bronchitis and emphysema symptoms.
QUESTION 7
A patient presents with severe right lower quadrant pain, fever, and rebound
tenderness. What is the most likely diagnosis?
pg. 3
, A. Cholecystitis
B. Appendicitis
C. Diverticulitis
D. Pancreatitis
Correct Answer: B. Appendicitis
Explanation:
Classic presentation includes RLQ pain, fever, and peritoneal signs.
QUESTION 8
A 55-year-old patient has crushing chest pain radiating to the left arm with
diaphoresis. What is the priority diagnostic test?
A. Chest X-ray
B. Troponin levels
C. MRI brain
D. Urinalysis
Correct Answer: B. Troponin levels
Explanation:
Troponin is the most specific marker for myocardial infarction.
QUESTION 9
A patient has progressive difficulty swallowing both solids and liquids. What
condition is most likely?
A. Esophageal cancer
B. Achalasia
C. GERD
D. Peptic ulcer disease
Correct Answer: B. Achalasia
pg. 4
Assessment and Diagnostic Reasoning with Skills Lab | Complete
Exam Guide with Answers and Rationales – 2026 Latest Update –
Grand Canyon University.
QUESTION 1
A 58-year-old male presents with intermittent chest discomfort described as
“pressure” that occurs during exertion and resolves with rest. He has a history
of hypertension and hyperlipidemia. Vital signs are stable. Which is the most
likely diagnosis?
A. Gastroesophageal reflux disease
B. Stable angina
C. Pericarditis
D. Pneumonia
Correct Answer: B. Stable angina
Explanation:
Stable angina presents as predictable chest pressure triggered by exertion and
relieved by rest. It is due to transient myocardial ischemia without infarction.
QUESTION 2
A 45-year-old woman reports fatigue, weight gain, cold intolerance, and
constipation. Physical exam reveals dry skin and bradycardia. What is the
most appropriate initial diagnostic test?
A. Serum cortisol
B. TSH and free T4
C. ECG
D. Serum calcium
Correct Answer: B. TSH and free T4
pg. 1
,Explanation:
Symptoms are consistent with hypothyroidism. TSH and free T4 are first-line
diagnostic tests to evaluate thyroid function.
QUESTION 3
A 67-year-old patient presents with sudden unilateral weakness and slurred
speech lasting 30 minutes, now resolved. What is the most likely diagnosis?
A. Stroke
B. Transient ischemic attack
C. Bell’s palsy
D. Seizure disorder
Correct Answer: B. Transient ischemic attack
Explanation:
TIA presents with transient neurological deficits that resolve within 24 hours
without permanent damage.
QUESTION 4
A patient presents with fever, flank pain, and costovertebral angle tenderness.
Urinalysis shows WBCs and nitrites. What is the most likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Kidney stones
D. Appendicitis
Correct Answer: B. Pyelonephritis
Explanation:
Upper urinary tract infection presents with systemic symptoms and CVA
tenderness.
pg. 2
,QUESTION 5
A 30-year-old woman presents with tremors, heat intolerance, weight loss,
and exophthalmos. What lab finding is expected?
A. Elevated TSH
B. Low T3/T4
C. Elevated T3/T4 with suppressed TSH
D. Low cortisol
Correct Answer: C. Elevated T3/T4 with suppressed TSH
Explanation:
Findings are consistent with Graves’ disease, a hyperthyroid state.
QUESTION 6
A 70-year-old smoker presents with chronic productive cough and dyspnea.
Which condition is most likely?
A. Asthma
B. COPD
C. Pneumothorax
D. Pulmonary embolism
Correct Answer: B. COPD
Explanation:
COPD is strongly associated with smoking and presents with chronic
bronchitis and emphysema symptoms.
QUESTION 7
A patient presents with severe right lower quadrant pain, fever, and rebound
tenderness. What is the most likely diagnosis?
pg. 3
, A. Cholecystitis
B. Appendicitis
C. Diverticulitis
D. Pancreatitis
Correct Answer: B. Appendicitis
Explanation:
Classic presentation includes RLQ pain, fever, and peritoneal signs.
QUESTION 8
A 55-year-old patient has crushing chest pain radiating to the left arm with
diaphoresis. What is the priority diagnostic test?
A. Chest X-ray
B. Troponin levels
C. MRI brain
D. Urinalysis
Correct Answer: B. Troponin levels
Explanation:
Troponin is the most specific marker for myocardial infarction.
QUESTION 9
A patient has progressive difficulty swallowing both solids and liquids. What
condition is most likely?
A. Esophageal cancer
B. Achalasia
C. GERD
D. Peptic ulcer disease
Correct Answer: B. Achalasia
pg. 4
