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NR 509 Final Exam Questions With Accurate Answers
Typology: Exams
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Suspicious breast mass - accurate answers--A mobile mass that becomes fixed when the arm relaxes is attached to the ribs and intercostal muscles; if fixed when the hand is pressed against the hip, it is attached to the pectoral fascia. -Hard irregular poorly circumscribed nodules, fixed to the skin or underlying tissues, strongly suggest cancer Risk for Breast cancer - accurate answers---Age -family history of breast/ovarian CA
-Scan saline wet mount for clue cells (epithelial cells with stippled borders); sniff for fishy odor after applying KOH ("whiff test"); test the vaginal secretions for pH
Candidal Vaginitis - accurate answers--Cause: Candida albicans, a yeast (normal overgrowth of vaginal flora); many factors predispose, including antibiotic therapy -Discharge: white and curdy, may be thin but usually thick, not as profuse as trichomonal infection, not malodorous
how a Bartholin gland infection presents - accurate answers-Causes of a Bartholin gland infection include trauma, gonococci, anaerobes like bacteroides and peptostreptococci, and C. trachomatis. Acutely, the gland appears as a tense, hot, very tender abscess. Look for pus emerging from the duct or erythema around the duct opening. Chronically, a nontender cyst is felt that may be large or small. Bleeding between periods - accurate answers-Metrorrhagia Vaccines safe in pregnancy - accurate answers-pneumococcal, meningococcal, and hepatitis B. Hepatitis A and B, meningococcal polysaccharide and conjugate, and pneumococcal polysaccharide vaccines can be given, if indicated. -inactivated influenza -Tdap When to give the tetanus vaccine - accurate answers-All adults aged ≥19 years, including those aged ≥65 years: All adults aged ≥19 years who have not been vaccinated with Tdap should receive a single dose of Tdap regardless of the time interval since last receiving Td. After receiving Tdap, they should receive Td boosters at 10-year intervals. For adults aged ≥65 years, this will reduce the likelihood of transmission to infants aged <12 months. HPV vaccine - accurate answers--The quadrivalent vaccine prevents infection from HPV sub-types 16 and 18, as well as 6 and 11, which cause 90% of genital warts (prevents cervical ca also) -The bivalent vaccine prevents infection from subtypes 16 and 18. Tanner staging of breast development - accurate answers-1: preadolescent- elevation of nipple only 2: Breast bud stage: elevation of breast and nipple as a small mound; enlargement of areolar diameter 3: Further enlargement of elevation of breast and areola, with no separation of their contours 4: Projection of areola and nipple to form a secondary mound above the level of breast 5: Mature stage: projection of nipple only; areola has receded to general contour of the breast (although in some normal individuals the areola continues to form a secondary mound) Breast masses - accurate answers-Most often found by women during self examination
Irregular rectal mass - accurate answers-Masses with irregular borders are suspicious for rectal cancer s/s rectal prolapse - accurate answers-On straining for a bowel movement, the rectal mucosa, with or without its muscular wall, may prolapse through the anus, appearing as a doughnut or rosette of red tissue. A prolapse involving only mucosa is relatively small and shows radiating folds, as illustrated. When the entire bowel wall is involved, the prolapse is larger and covered by concentrically circular folds. Hemorrhoids vs polyps vs CA - accurate answers--H-(internal-prolapsed)reddish, moist, protruding masses, (external) pain with defecation and sitting, tender, swollen, bluish, ovoid mass is visible at the anal margin. -P- on the stalk, or mucosal surface, soft, difficult to feel often -C- firm, nodular, rolled edge Erectile dysfunction - accurate answers-In a 47 yo male, it is most often psychologic and not testosterone related. s/s of proctitis - accurate answers-Anorectal pain, itching, tenesmus, or discharge or bleeding from infection or rectal abscess suggest proctitis. -anal fissures Forms of urinary incontinence - accurate answers--Stress: Increased abdominal pressure causes bladder pressure to exceed urethral resistance—there is poor urethral sphincter tone or poor support of bladder neck.
What causes the S3 sound? - accurate answers--Children/young adults: rapid deceleration of the column of blood against the ventricular wall.
atopic dermatitis (eczema) - accurate answers-Erythema, scaling, dry skin, and intense itching Peritonitis s/s - accurate answers-Early voluntary guarding may be replaced by involuntary muscular rigidity and signs of peritoneal inflammation. There may also be RLQ pain on quick withdrawal or deferred rebound tenderness. Diverticulitis pain - accurate answers--LLQ -cramping at first, then steady
Retracted TM with effusion - accurate answers-looks like air bubbles