Page 1 of 91
GCU NUR 634 Midterm Exam – Advanced
Health Assessment EXAM COMPLETE 300
QUESTIONS WITH DETAILED SOLUTIONS JUST
RELEASED THIS YEAR
GCU NUR 634 Midterm Exam – Advanced Health Assessment
300 Randomized, Scenario-Based Multiple-Choice Questions
Course: NUR 634 – Advanced Health Assessment
Institution: Grand Canyon University – College of Nursing
Program: Family Nurse Practitioner (MSN)
SECTION 1: Health History & Communication (Questions 1-25)
1. A 68-year-old female presents for her annual wellness visit. Which opening question best
establishes rapport and elicits a comprehensive health narrative?
A) "Are you having any pain today?"
B) "What medications are you currently taking?"
C) "Tell me about your health concerns today."
D) "Do you have any allergies?"
Correct Answer: C
An open-ended question allows the patient to describe concerns in their own words, establishing
rapport and providing the most complete information; it lets the patient guide the initial
narrative.
2. A student asks you about the difference between signs and symptoms. Which statement
accurately describes this distinction?
A) A sign is subjective; a symptom is objective
B) A sign is objective; a symptom is subjective
C) Both are objective findings
D) Both are subjective complaints
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Correct Answer: B
Signs are objective findings observed or measured (fever, rash, abnormal lung sounds);
symptoms are subjective complaints reported by the patient (pain, nausea, dizziness).
3. A 45-year-old male presents with chest discomfort. Which question is an example of a
leading question that should be avoided during history taking?
A) "How would you describe the pain?"
B) "When did the pain start?"
C) "The pain is in your chest, right?"
D) "What makes the pain better or worse?"
Correct Answer: C
"The pain is in your chest, right?" suggests the answer and introduces bias; leading questions
may not accurately reflect the patient's experience.
4. A 72-year-old patient with multiple chronic conditions is asked about medication
adherence. What is the most effective way to assess this?
A) "Do you take your medications every day?"
B) "You take your medications as prescribed, don't you?"
C) "Tell me about your experience taking your medications."
D) "Why do you miss your medications?"
Correct Answer: C
Open-ended, non-judgmental questions elicit more accurate information about adherence;
closed or leading questions may produce socially desirable but inaccurate responses.
5. A 55-year-old female presents with a family history of breast and ovarian cancer. The best
tool to document this information is:
A) A growth chart
B) A genogram
C) A medication list
D) An immunization record
Correct Answer: B
A genogram is a pictorial display of family relationships and medical history across generations,
identifying hereditary patterns and risk factors.
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6. A 34-year-old male reports "a lot of stress lately." Which question best explores the impact
of stress on his health?
A) "Everyone has stress. What do you do for fun?"
B) "How is this stress affecting your daily life and health?"
C) "You should try to relax more."
D) "Do you have any family history of mental illness?"
Correct Answer: B
Exploring the functional impact of stress on daily life and health provides clinically relevant
information and validates the patient's experience.
7. During a health history interview, the patient becomes tearful when discussing a recent
loss. The best response is:
A) "Let's move on to the next question."
B) "I can see this is difficult. Take your time."
C) "You need to stay focused on your health."
D) "Would you like a tissue?"
Correct Answer: B
Validating the patient's emotional response and allowing time demonstrates empathy, preserves
rapport, and may elicit important information.
8. A 28-year-old female reports fatigue, weight gain, and cold intolerance. Which additional
symptom would most strongly suggest hypothyroidism?
A) Palpitations
B) Heat intolerance
C) Constipation
D) Weight loss
Correct Answer: C
Constipation is a classic symptom of hypothyroidism, along with fatigue, weight gain, and cold
intolerance; palpitations and heat intolerance suggest hyperthyroidism.
9. A 60-year-old male with a 40-pack-year smoking history presents with a cough. Which
question is most important to ask?
A) "Is the cough productive?"
B) "How long have you had this cough?"
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C) "Have you noticed any blood in your sputum?"
D) "Does anyone in your family have lung disease?"
Correct Answer: C
Hemoptysis is a red flag in a patient with significant smoking history, potentially indicating lung
cancer; this question addresses the most serious concern.
10. A 42-year-old female reports intermittent chest pain that worsens with inspiration and
improves when leaning forward. This history is most consistent with:
A) Angina pectoris
B) Pericarditis
C) Myocardial infarction
D) Pulmonary embolism
Correct Answer: B
Pericarditis pain is typically pleuritic (worsens with inspiration) and improves with leaning
forward; this positional component is a key distinguishing feature.
11. A 65-year-old patient reports "forgetting things more often." Which question best
differentiates normal aging from cognitive impairment?
A) "Do you sometimes misplace your keys?"
B) "Has anyone expressed concern about your memory?"
C) "Do you forget names occasionally?"
D) "How often do you forget to take your medications?"
Correct Answer: B
Concern expressed by others is a red flag for cognitive impairment; while occasional
forgetfulness is normal aging, functional decline and others' concern warrant evaluation.
12. A 30-year-old female reports "heart racing" and "feeling like I'm going to die." These
episodes occur suddenly. This history is most consistent with:
A) Atrial fibrillation
B) Panic attack
C) Hyperthyroidism
D) Mitral valve prolapse
4
SUCCESS!
GCU NUR 634 Midterm Exam – Advanced
Health Assessment EXAM COMPLETE 300
QUESTIONS WITH DETAILED SOLUTIONS JUST
RELEASED THIS YEAR
GCU NUR 634 Midterm Exam – Advanced Health Assessment
300 Randomized, Scenario-Based Multiple-Choice Questions
Course: NUR 634 – Advanced Health Assessment
Institution: Grand Canyon University – College of Nursing
Program: Family Nurse Practitioner (MSN)
SECTION 1: Health History & Communication (Questions 1-25)
1. A 68-year-old female presents for her annual wellness visit. Which opening question best
establishes rapport and elicits a comprehensive health narrative?
A) "Are you having any pain today?"
B) "What medications are you currently taking?"
C) "Tell me about your health concerns today."
D) "Do you have any allergies?"
Correct Answer: C
An open-ended question allows the patient to describe concerns in their own words, establishing
rapport and providing the most complete information; it lets the patient guide the initial
narrative.
2. A student asks you about the difference between signs and symptoms. Which statement
accurately describes this distinction?
A) A sign is subjective; a symptom is objective
B) A sign is objective; a symptom is subjective
C) Both are objective findings
D) Both are subjective complaints
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Correct Answer: B
Signs are objective findings observed or measured (fever, rash, abnormal lung sounds);
symptoms are subjective complaints reported by the patient (pain, nausea, dizziness).
3. A 45-year-old male presents with chest discomfort. Which question is an example of a
leading question that should be avoided during history taking?
A) "How would you describe the pain?"
B) "When did the pain start?"
C) "The pain is in your chest, right?"
D) "What makes the pain better or worse?"
Correct Answer: C
"The pain is in your chest, right?" suggests the answer and introduces bias; leading questions
may not accurately reflect the patient's experience.
4. A 72-year-old patient with multiple chronic conditions is asked about medication
adherence. What is the most effective way to assess this?
A) "Do you take your medications every day?"
B) "You take your medications as prescribed, don't you?"
C) "Tell me about your experience taking your medications."
D) "Why do you miss your medications?"
Correct Answer: C
Open-ended, non-judgmental questions elicit more accurate information about adherence;
closed or leading questions may produce socially desirable but inaccurate responses.
5. A 55-year-old female presents with a family history of breast and ovarian cancer. The best
tool to document this information is:
A) A growth chart
B) A genogram
C) A medication list
D) An immunization record
Correct Answer: B
A genogram is a pictorial display of family relationships and medical history across generations,
identifying hereditary patterns and risk factors.
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6. A 34-year-old male reports "a lot of stress lately." Which question best explores the impact
of stress on his health?
A) "Everyone has stress. What do you do for fun?"
B) "How is this stress affecting your daily life and health?"
C) "You should try to relax more."
D) "Do you have any family history of mental illness?"
Correct Answer: B
Exploring the functional impact of stress on daily life and health provides clinically relevant
information and validates the patient's experience.
7. During a health history interview, the patient becomes tearful when discussing a recent
loss. The best response is:
A) "Let's move on to the next question."
B) "I can see this is difficult. Take your time."
C) "You need to stay focused on your health."
D) "Would you like a tissue?"
Correct Answer: B
Validating the patient's emotional response and allowing time demonstrates empathy, preserves
rapport, and may elicit important information.
8. A 28-year-old female reports fatigue, weight gain, and cold intolerance. Which additional
symptom would most strongly suggest hypothyroidism?
A) Palpitations
B) Heat intolerance
C) Constipation
D) Weight loss
Correct Answer: C
Constipation is a classic symptom of hypothyroidism, along with fatigue, weight gain, and cold
intolerance; palpitations and heat intolerance suggest hyperthyroidism.
9. A 60-year-old male with a 40-pack-year smoking history presents with a cough. Which
question is most important to ask?
A) "Is the cough productive?"
B) "How long have you had this cough?"
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C) "Have you noticed any blood in your sputum?"
D) "Does anyone in your family have lung disease?"
Correct Answer: C
Hemoptysis is a red flag in a patient with significant smoking history, potentially indicating lung
cancer; this question addresses the most serious concern.
10. A 42-year-old female reports intermittent chest pain that worsens with inspiration and
improves when leaning forward. This history is most consistent with:
A) Angina pectoris
B) Pericarditis
C) Myocardial infarction
D) Pulmonary embolism
Correct Answer: B
Pericarditis pain is typically pleuritic (worsens with inspiration) and improves with leaning
forward; this positional component is a key distinguishing feature.
11. A 65-year-old patient reports "forgetting things more often." Which question best
differentiates normal aging from cognitive impairment?
A) "Do you sometimes misplace your keys?"
B) "Has anyone expressed concern about your memory?"
C) "Do you forget names occasionally?"
D) "How often do you forget to take your medications?"
Correct Answer: B
Concern expressed by others is a red flag for cognitive impairment; while occasional
forgetfulness is normal aging, functional decline and others' concern warrant evaluation.
12. A 30-year-old female reports "heart racing" and "feeling like I'm going to die." These
episodes occur suddenly. This history is most consistent with:
A) Atrial fibrillation
B) Panic attack
C) Hyperthyroidism
D) Mitral valve prolapse
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