GCU NUR 634 Midterm Exam 2026/2027 – Grand Canyon University College of
Nursing Advanced Health Assessment and Diagnostic Reasoning With Skills Lab
– Complete Study Guide, Practice Questions, Detailed Answers, Rationales,
Clinical Assessment Review, SOAP Documentation, Differential Diagnosis,
Physical Examination Techniques, and High-Yield Exam Preparation Resource
SECTION 1: HEALTH HISTORY & COMMUNICATION (Questions 1-15)
Question 1
When documenting a SOAP note, which component should include the patient's
direct quotes?
A) Objective
B) Assessment
C) Plan
D) Subjective
Correct Answer: D
Rationale: The subjective portion records the patient's own words, including the
chief complaint and history of present illness. Direct quotes from the patient
should be documented in the subjective section to accurately capture the
patient's perspective. Objective data includes measurable findings, assessment is
the provider's analysis, and plan outlines treatment .
Question 2
What is the most appropriate opening question when beginning a health history
interview?
A) "Are you having any pain?"
B) "Tell me about your health concerns today."
C) "What medications are you taking?"
D) "Do you have any allergies?"
Correct Answer: B
Rationale: An open-ended question allows the patient to describe their concerns
in their own words and provides the most complete information. It establishes
,rapport and allows the patient to guide the initial narrative. Closed-ended
questions limit the information obtained and may miss important details .
Question 3
Which of the following is an example of a leading question that should be
avoided?
A) "How would you describe your pain?"
B) "When did the pain start?"
C) "The pain is in your chest, right?"
D) "What makes the pain better?"
Correct Answer: C
Rationale: A leading question suggests the answer or contains bias. Asking "The
pain is in your chest, right?" suggests the answer and may not accurately reflect
the patient's experience. Open-ended questions should be used to gather
unbiased information .
Question 4
What does the "P" in the OPQRST mnemonic stand for?
A) Pain
B) Provocation/Palliation
C) Pulse
D) Position
Correct Answer: B
Rationale: OPQRST is used for pain assessment: Onset, Provocation/Palliation,
Quality, Region/Radiation, Severity, and Timing. Provocation/Palliation identifies
what makes the pain better or worse .
Question 5
What is the difference between a sign and a symptom?
,A) A sign is objective; a symptom is subjective
B) A sign is subjective; a symptom is objective
C) Both are objective
D) Both are subjective
Correct Answer: A
Rationale: Signs are objective findings that can be observed or measured (e.g.,
fever, rash, abnormal lung sounds). Symptoms are subjective complaints reported
by the patient (e.g., pain, nausea, dizziness). Understanding this distinction is
fundamental to health assessment .
Question 6
Which statement best describes the "chief complaint"?
A) Nurse's impression of the problem
B) The patient's main reason for seeking care, in quotes
C) The provider's diagnosis
D) Objective data collected during assessment
Correct Answer: B
Rationale: The chief complaint should be documented in the patient's own words
as closely as possible, using quotation marks. It is the primary reason the patient
is seeking care and should be concise .
Question 7
What is the purpose of the CAGE questionnaire?
A) To assess depression
B) To screen for alcohol use disorder
C) To assess anxiety
D) To screen for cognitive impairment
Correct Answer: B
, Rationale: The CAGE questionnaire is a screening tool for alcohol use disorder:
Cut down, Annoyed, Guilty, Eye-opener. It has high sensitivity for identifying
problem drinking and is widely used in clinical settings .
Question 8
What is the purpose of the PHQ-9?
A) To screen for anxiety
B) To screen for depression
C) To screen for alcohol use
D) To screen for cognitive impairment
Correct Answer: B
Rationale: The PHQ-9 (Patient Health Questionnaire-9) is a validated screening
tool for depression. It assesses nine DSM-5 criteria for major depressive disorder
over the past two weeks and is commonly used in primary care .
Question 9
What should be included in the Past Medical History?
A) Current medications
B) Allergies
C) Chronic conditions and hospitalizations
D) All of the above
Correct Answer: D
Rationale: The Past Medical History includes current medications, allergies,
chronic conditions, previous hospitalizations, surgeries, and significant illnesses.
All of these components are essential for a complete health history .
Question 10
When assessing a patient with vague muscle complaints and fatigue with no
mechanism of injury, what is important to screen for?
Nursing Advanced Health Assessment and Diagnostic Reasoning With Skills Lab
– Complete Study Guide, Practice Questions, Detailed Answers, Rationales,
Clinical Assessment Review, SOAP Documentation, Differential Diagnosis,
Physical Examination Techniques, and High-Yield Exam Preparation Resource
SECTION 1: HEALTH HISTORY & COMMUNICATION (Questions 1-15)
Question 1
When documenting a SOAP note, which component should include the patient's
direct quotes?
A) Objective
B) Assessment
C) Plan
D) Subjective
Correct Answer: D
Rationale: The subjective portion records the patient's own words, including the
chief complaint and history of present illness. Direct quotes from the patient
should be documented in the subjective section to accurately capture the
patient's perspective. Objective data includes measurable findings, assessment is
the provider's analysis, and plan outlines treatment .
Question 2
What is the most appropriate opening question when beginning a health history
interview?
A) "Are you having any pain?"
B) "Tell me about your health concerns today."
C) "What medications are you taking?"
D) "Do you have any allergies?"
Correct Answer: B
Rationale: An open-ended question allows the patient to describe their concerns
in their own words and provides the most complete information. It establishes
,rapport and allows the patient to guide the initial narrative. Closed-ended
questions limit the information obtained and may miss important details .
Question 3
Which of the following is an example of a leading question that should be
avoided?
A) "How would you describe your pain?"
B) "When did the pain start?"
C) "The pain is in your chest, right?"
D) "What makes the pain better?"
Correct Answer: C
Rationale: A leading question suggests the answer or contains bias. Asking "The
pain is in your chest, right?" suggests the answer and may not accurately reflect
the patient's experience. Open-ended questions should be used to gather
unbiased information .
Question 4
What does the "P" in the OPQRST mnemonic stand for?
A) Pain
B) Provocation/Palliation
C) Pulse
D) Position
Correct Answer: B
Rationale: OPQRST is used for pain assessment: Onset, Provocation/Palliation,
Quality, Region/Radiation, Severity, and Timing. Provocation/Palliation identifies
what makes the pain better or worse .
Question 5
What is the difference between a sign and a symptom?
,A) A sign is objective; a symptom is subjective
B) A sign is subjective; a symptom is objective
C) Both are objective
D) Both are subjective
Correct Answer: A
Rationale: Signs are objective findings that can be observed or measured (e.g.,
fever, rash, abnormal lung sounds). Symptoms are subjective complaints reported
by the patient (e.g., pain, nausea, dizziness). Understanding this distinction is
fundamental to health assessment .
Question 6
Which statement best describes the "chief complaint"?
A) Nurse's impression of the problem
B) The patient's main reason for seeking care, in quotes
C) The provider's diagnosis
D) Objective data collected during assessment
Correct Answer: B
Rationale: The chief complaint should be documented in the patient's own words
as closely as possible, using quotation marks. It is the primary reason the patient
is seeking care and should be concise .
Question 7
What is the purpose of the CAGE questionnaire?
A) To assess depression
B) To screen for alcohol use disorder
C) To assess anxiety
D) To screen for cognitive impairment
Correct Answer: B
, Rationale: The CAGE questionnaire is a screening tool for alcohol use disorder:
Cut down, Annoyed, Guilty, Eye-opener. It has high sensitivity for identifying
problem drinking and is widely used in clinical settings .
Question 8
What is the purpose of the PHQ-9?
A) To screen for anxiety
B) To screen for depression
C) To screen for alcohol use
D) To screen for cognitive impairment
Correct Answer: B
Rationale: The PHQ-9 (Patient Health Questionnaire-9) is a validated screening
tool for depression. It assesses nine DSM-5 criteria for major depressive disorder
over the past two weeks and is commonly used in primary care .
Question 9
What should be included in the Past Medical History?
A) Current medications
B) Allergies
C) Chronic conditions and hospitalizations
D) All of the above
Correct Answer: D
Rationale: The Past Medical History includes current medications, allergies,
chronic conditions, previous hospitalizations, surgeries, and significant illnesses.
All of these components are essential for a complete health history .
Question 10
When assessing a patient with vague muscle complaints and fatigue with no
mechanism of injury, what is important to screen for?
