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NUR 634 Midterm Examination Questions and Answers: Grand Canyon University 2024/2025 update
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NUR 634 Midterm Examination Questions and Answers: Grand Canyon University 2024/2025 update
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Nur-634 Midterm 20231. For which of the following patients would a com- ANS: C
prehensive health history be appropriate?
Feedback: This pa-
A. A new patient with the chief complaint of "I tient is here to es-
sprained my ankle" tablish care, and be-
B. An established patient with the chief complaint cause she is new to
of "I have an upper respiratory infection" you, a comprehen-
C. A new patient with the chief complaint of "I am sive health history is
here to establish care" appropriate.
D. A new patient with the chief complaint of "I cut
my hand"
2. The following information is recorded in the health ANS: C
history: "The patient completed 8th grade. He cur-
rently lives with his wife and two children. He Feedback: Person-
works on old cars on the weekend. He works in al and social his-
a glass factory during the week." Which category tory information in-
does it belong to? cludes educational
level, family of ori-
A. Chief complaint gin, current house-
B. Present illness hold status, person-
C. Personal and social history al interests, employ-
D. Review of systems ment, religious be-
liefs, military history,
and lifestyle (includ-
ing diet and exercise
habits; use of alco-
hol, tobacco, and/or
drugs; and sexual
preferences and his-
tory). All of this infor-
mation is document-
ed in this example
3. Mrs. Hill is a 28-year-old African-American with a ANS: A
history of SLE (systemic lupus erythematosus).
She has noticed a raised, dark red rash on her legs. Feedback: A "palpa-
When you press on the rash, it doesn't blanch. ble purpura" is usu-
What would you tell her regarding her rash? ally associated with
, Nur-634 Midterm 2023
a vasculitis. This is
A. It is likely to be related to her lupus. an inflammatory con-
B. It is likely to be related to an exposure to a dition of the blood
chemical. vessels often asso-
C. It is likely to be related to an allergic reaction. ciated with systemic
D. It should not cause any problems. rheumatic disease. It
can cut off circulation
to any portion of the
body and can mimic
many other diseases
in this manner. While
allergic and chemi-
cal exposures may be
a possible cause of
the rash, this patient's
SLE should make you
consider vasculitis
4. Two weeks ago, Mary started a job which requires ANS: C
carrying 40-pound buckets. She presents with el-
bow pain worse on the right. On examination, it Feedback: Mary's in-
hurts her elbows to dorsiflex her hands against jury probably oc-
resistance when her palms face the floor. What curred by lifting heavy
condition does she have? buckets with her
palms down (to-
A. Medial epicondylitis (golfer's elbow) ward the bucket). This
B. Olecranon bursitis caused her chronic
C. Lateral epicondylitis (tennis elbow) overuse injury at the
D. Supracondylar fracture lateral epicondyle.
Medial epicondylitis
has reproducible pain
when palmar flexion
against resistance is
performed and also
features tenderness
over the involved epi-
condyle. Olecranon
bursitis produces ery-
thema and swelling
, Nur-634 Midterm 2023
over the olecranon
process. A supra-
condylar fracture of
the humerus is a ma-
jor injury and would
present more acutely.
5. Mrs. T. comes for her regular visit to the clinic. She ANS: B
is on your schedule because her regular provider
is on vacation, and she wanted to be seen. You Feedback: You can
have heard about her many times from your col- also say, "I want to
league and are aware that she is a very talkative make sure I take
person. Which of the following is a helpful tech- good care of this
nique to improve the quality of the interview for problem because it
both the provider and the patient? is very important. We
may need to talk
A. Allow the patient to speak uninterrupted for the about the others at
duration of the appointment. the next appointment.
B. Briefly summarize what you heard from the pa- Is that okay with
tient in the first 5 minutes and then try to have her you?" This is a tech-
focus on one aspect of what she told you. nique that can help
C. Set the time limit at the beginning of the inter- you to change the
view and stick with it, no matter what occurs in the subject but, at the
course of the interview. same time, validate
D. Allow your impatience to show so that the pa- the patient's con-
tient picks up on your nonverbal cue that the ap- cerns; it also can pro-
pointment needs to end. vide more structure to
the interview
6. You feel a small mass that you think is a lymph ANS: B
node. It is mobile in both the up-and-down and
side-to-side directions. Which of the following is Feedback: A use-
most likely? ful maneuver for dis-
cerning lymph nodes
A. Cancer from other masses in
B. Lymph node the neck is to check
C. Deep scar for their mobility in all
D. Muscle directions. Many oth-
er masses are mo-
, Nur-634 Midterm 2023
bile in only two di-
rections. Cancerous
masses may also be
"fixed," or immobile
7. A 77-year-old retired bus driver comes to your ANS: B
clinic for a physical examination at his wife's re-
quest. He has recently been losing weight and Feedback: With his
has felt very fatigued. He has had no chest pain, past history of colon
shortness of breath, nausea, vomiting, or fever. cancer and with re-
His past medical history includes colon cancer, for cent weight loss and
which he had surgery, and arthritis. He has been fatigue, a relapse
married for over 40 years. He denies any tobacco of his colon can-
or drug use and has not drunk alcohol in over cer would be ex-
40 years. His parents both died of cancer in their pected. Colon can-
60s. On examination his vital signs are normal. cer usually metasta-
His head, cardiac, and pulmonary examinations sizes to the liver, cre-
are unremarkable. On abdominal examination you ating hard, irregular
hear normal bowel sounds, but when you palpate nodules, which can
his liver it is abnormal. His rectal examination is sometimes be palpat-
positive for occult blood. What further abnormality ed on examination.
of the liver was likely found on examination? A smooth, large liver
which is tender is of-
A. Smooth, large, nontender liver ten seen in hepatitis.
B. Irregular, large liver
C. Smooth, large, tender liver
D. Irregula
8. A 21-year-old college senior presents to your clin- ANS: C
ic, complaining of shortness of breath and a non-
productive nocturnal cough. She states she used Feedback: Asthma
to feel this way only with extreme exercise, but causes shortness of
lately she has felt this way continuously. She de- breath and a noctur-
nies any other upper respiratory symptoms, chest nal cough. It is often
pain, gastrointestinal symptoms, or urinary tract associated with a his-
symptoms. Her past medical history is significant tory of allergies and
only for seasonal allergies, for which she takes a can be made worse
nasal steroid spray but is otherwise on no other by exercise or irri-
medications. She has had no surgeries. Her moth- tants such as smoke
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