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NUR 634 MIDTERM EXAM WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED RATIONALES ANSWERS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|BRAND NEW!!!|GUARANTEED PASS |LATEST UPDATE
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NUR 634
NUR 634 MIDTERM EXAM WITH
ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED RATIONALES
ANSWERS |FREQUENTLY TESTED
QUESTIONS AND SOLUTIONS |ALREADY
GRADED A+|BRAND
NEW!!!|GUARANTEED PASS |LATEST
UPDATE
NUR 634 MIDTERM EXAM 2024-2025 WITH
ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED RATIONALES
ANSWERS |FREQUENTLY TESTED
QUESTIONS AND SOLUTIONS |ALREADY
GRADED A+|BRAND
NEW!!!|GUARANTEED PASS |LATEST
UPDATE
A light is pointed at a patient's pupil, which contracts. It is also noted that the other pupil contracts as
well, though it is not exposed to bright light. This is considered a ____________ reaction. Lack of this
response may indicate head trauma.
A. Direct reaction
B. Consensual reaction
C. Near reaction
D. Accommodation
ANS: B
Left sided chest pain that is sharp and knife like that is worse with inspiration is most likely
A. Unstable angina
B. Pericarditis
C. Acute cholecystitis
D. Dissecting aortic aneurysm
ANS: B
A patient presents with claudication symptoms and diminished pulses. Which of the following is
consistent with chronic arterial insufficiency?
A. Pallor of the foot when raised to 60 degrees for one minute
B. Return of color to the skin within 5 seconds of allowing legs to dangle
C. Filling of the veins of the ankles within 10 seconds of allowing the legs to dangle
D. Hyperpigmentation of the skin
1|Page
,ANS: A
Feedback: Pallor of the soles after one minute of elevation is a reliable sign of arterial insufficiency.
Return of the color to the skin should occur within 10 seconds of dangling, and the filling of veins
should occur within 15 seconds. Hyperpigmentation of the skin is usually seen in venous insufficiency.
A 67-year-old lawyer comes to your clinic for an annual examination. He denies any history of eye
trauma. He denies any visual changes. You inspect his eyes and find a triangular thickening of the bulbar
conjunctiva across the outer surface of the cornea. He has a normal pupillary reaction to light and
accommodation. Based on this description, what is the most likely diagnosis?
A. Corneal arcus
B. Cataracts
C. Corneal scar
D. Pterygium
ANS: D
A pterygium is a triangular thickening of the bulbar conjunctiva that grows slowly across the outer
surface of the cornea, usually from the nasal side. Reddening may occur, and it may interfere with
vision as it encroaches on the pupil. Otherwise, treatment is unnecessary
Urge incontinence can be secondary to which condition
A. GERD
B. Renal insufficiency
C. Stool impaction
D. Renal stones
ANS: C
A patient presents with ear pain. She is an avid swimmer. The history includes pain and drainage from
the left ear. On examination, she has pain when the ear is manipulated, including manipulation of the
tragus. The canal is narrowed and erythematous, with some white debris in the canal. The rest of the
examination is normal. What diagnosis would you assign this patient?
A. Otitis media
B. External otitis
C. Perforation of the tympanum
D. Cholesteatoma
ANS: B
Feedback: These are classic history and examination findings for a patient suffering from external
otitis. Otitis media would not usually have pain with movement of the external ear, nor drainage
unless the eardrum was perforated. In this case the examination of the eardrum is recorded as
normal. Cholesteatoma is a growth behind the eardrum and would not account for these symptoms.
Otitis media would classically be accompanied by a bulging, erythematous eardrum
2|Page
,Mrs. Buckley is a 75-year-old widow who wants you to look at her teeth because over the past 2 weeks
she has had right-sided jaw pain when eating. It does not occur otherwise. She also has had a headache
with blurred vision. Which of the following should be considered?
A. Palpation of her temples
B. Dental referral
C. Ultrasound of the gallbladder
D. Inquiry about anosmia
ANS: A
Feedback: This story can be consistent with temporal arteritis, which can cause blindness in 15% of
those affected. Early recognition is crucial. Most of these patients will have tenderness over one or
both of the temporal arteries, and some have diminished temporal pulses as well. Early treatment
with corticosteroids is indicated. It can also be associated with polymyalgia rheumatic, a condition
which causes pain in the shoulder girdles and pelvis
**patients can also have headaches and blurred vision**
Diminished radial pulses may be seen in patients with which of the following?
A. Aortic insufficiency
B. Hyperthyroidism
C. Arterial emboli
D. Early "warm" septic shock
ANS: C
A grandmother brings her 13-year-old grandson to you for evaluation. She noticed last week when he
took off his shirt that his breastbone seemed collapsed. He seems embarrassed and tells you that it has
been that way for quite a while. He states he has no symptoms from it and he just tries not to take off
his shirt in front of anyone. He denies any shortness of breath, chest pain, or lightheadedness on
exertion. His past medical history is unremarkable. He is in sixth grade and just moved in with his
grandmother after his father was deployed to the Middle East. His mother died several years ago in a car
accident. He states that he does not smoke and has never touched alcohol. On examination you see a
teenage boy appearing his stated age. On visual examination of his chest, you see that the lower portion
of the sternum is depressed. Auscultation of the lungs and heart are unremarkable. What disorder of
the thorax best
ANS: B
Funnel chest is caused by a depression in the lower portion of the sternum. If severe enough there can
be compression of the heart and great vessels, leading to murmurs on auscultation. This is usually only
a cosmetic problem, but corrective surgeries can be performed if necessary.
A 29-year-old waiter comes to the clinic for a 2-month history of a cough. When he lowers his gown so
the clinician can listen to his lungs, the clinician notices a depression of the lower part of his sternum.
Which of the following best describes the appearance of his chest?
3|Page
, A. Thoracic kyphoscoliosis
B. Pectus excavatum
C. Barrel Chest
D. Flail Chest
E. Pigeon Chest
ANS: B
Pectus excavatum is a congenital abnormality in which the inferior part of the sternum is displaced
inward. In a barrel chest there is an increased anteroposterior diameter (seen in pt with COPD).
A high-pitched non-radiating murmur at the 2nd right intracoastal space during systole
A. Aortic stenosis
B. Pulmonic stenosis
C. Mitral valve stenosis
D. Tricuspid vale stenosis
ANS: A
*Patient is more at risk for left-sided heart failure*
You notice a patient has a strong pulse and then a weak pulse. This pattern continues. Which of the
following is likely?
A. Emphysema
B. Asthma exacerbation
C. Severe left heart failure
D. Cardiac tamponade
ANS: C
Feedback: This finding is consistent with pulsus alternans, which is associated with severe left heart
failure. Occasionally, a monitor will read only half of the beats because half are too weak to detect.
There may also be electrical alternans on EKG. This can be detected by using a blood pressure cuff and
lowering the pressure slowly. At one point the rate of Korotkoff sounds will double, because the
weaker beats can then “make it through.” The other findings are associated with paradoxical pulse.
What does pain at the anatomical "snuffbox" with wrist and ulnar deviation suggest?
"Snuffbox" tenderness with the wrist in ulnar deviation and pain at the scaphoid tubercle are suspicious
for occult scaphoid fracture. Poor blood supply increases risk of scaphoid bone avascular necrosis,
making this a diagnosis that should not be missed
4|Page
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