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NR 509 Final Exam Questions With Accurate Answers, Exams of Medicine

Chamberlain College of NursingMedicine

NR 509 Final Exam Questions With Accurate Answers

Typology: Exams

2024/2025

Available from 07/06/2025

BrunoFern
BrunoFern 🇺🇸

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NR 509 Final Exam Questions With Accurate Answers
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
- inherited genetic mutations,
-personal history of breast cancer
- high levels of endogenous hormones
- breast tissue density
- proliferative lesions with atypia on breast biopsy, - duration of unopposed
estrogen exposure related to early menarche
-age of first full-term pregnancy
- late menopause.
- breastfeeding for less than 1 year,
- postmenopausal obesity
-cigarette smoking, alcohol ingestion,
- physical inactivity, and type of contraception.
Characteristics of a breast cyst - accurate answers-Soft to firm, round, mobile,
often tender.
The best way to examine the lateral portion of the breast - accurate answers--
Have pt roll onto the opposite hip
-place her hand on her forehead.
- keep shoulders pressed against the bed
-palpate in the axilla, moving in a straight line down to the bra line, then move
the fingers medially and palpate in a vertical strip up the chest to the clavicle.
Continue in vertical overlapping strips until you reach the nipple
Bacterial Vaginosis (BV) - accurate answers--Caused by overgrowth of anaerobic
bacteria (often from sex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the vaginal walls,
usually not profuse, may be minimal
- Fishy/musty genital odor
-Normal vulva and vaginal mucosa
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NR 509 Final Exam Questions With Accurate Answers

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

  • inherited genetic mutations, -personal history of breast cancer
  • high levels of endogenous hormones
  • breast tissue density
  • proliferative lesions with atypia on breast biopsy, - duration of unopposed estrogen exposure related to early menarche -age of first full-term pregnancy
  • late menopause.
  • breastfeeding for less than 1 year,
  • postmenopausal obesity -cigarette smoking, alcohol ingestion,
  • physical inactivity, and type of contraception. Characteristics of a breast cyst - accurate answers-Soft to firm, round, mobile, often tender. The best way to examine the lateral portion of the breast - accurate answers-- Have pt roll onto the opposite hip -place her hand on her forehead.
  • keep shoulders pressed against the bed -palpate in the axilla, moving in a straight line down to the bra line, then move the fingers medially and palpate in a vertical strip up the chest to the clavicle. Continue in vertical overlapping strips until you reach the nipple Bacterial Vaginosis (BV) - accurate answers--Caused by overgrowth of anaerobic bacteria (often from sex)
  • Discharge: Gray or white, thin, homogenous, malodorous, coats the vaginal walls, usually not profuse, may be minimal
  • Fishy/musty genital odor -Normal vulva and vaginal mucosa

-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

  • vaginal soreness, pruritus, pain on urination, dyspareunia (painful intercourse) -The vulva and surrounding skin are inflamed and sometimes swollen to a variable extent; the vaginal mucosa is reddened, with white tenacious patches of discharge; the mucosa may bleed when these patches are scraped off; in mild cases, the mucosa looks normal -Scan potassium hydroxide (KOH) preparation for the branching hyphae of Candida Trichomonal Vaginitis - accurate answers--Trichomonas vaginalis, a protozoan; often but not always acquired sexually
  • Discharge:Yellowish green or gray, possibly frothy; often profuse and pooled in the vaginal fornix; may be malodorous -Pruritus (though not usually as severe as with Candida infection); pain on urination (from skin inflammation or possibly urethritis); dyspareunia -Vestibule and labia minora may be erythematous; the vaginal mucosa may be diffusely reddened, with small red granular spots or petechiae in the posterior fornix; in mild cases, the mucosa looks normal
  • Scan saline wet mount for trichomonads Syphillis - accurate answers-This ulcerated papule with an indurated edge usually appears after 3 to 6 weeks of incubating infection from the spirochete Treponema pallidum. These lesions may resemble a carcinoma or crusted cold sore. Similar primary lesions are common in the pharynx, anus, and vagina but may escape detection since they are painless, nonsuppurative, and usually heal spontaneously in 3 to 6 weeks. Wear gloves during palpation since these chancres are infectious. s/s of epididymitis - accurate answers-Acute: swollen, and notably tender, making it difficult to distinguish from the testis. The scrotum may be reddened and the vas deferens inflamed.

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.

  • Urge: urgency is followed by involuntary leakage due to uncontrolled detrusor contractions that overcome urethral resistance.
  • Overflow: neurologic disorders or anatomic obstruction from pelvic organs or the prostate limit bladder emptying until the bladder becomes overdistended.
  • Functional: patient is functionally unable to reach the toilet in time d/t impaired health or environmental conditions Hepatitis A transmission - accurate answers-fecal-oral route how to distinguish between a jugular venous pulsation & carotid pulse - accurate answers--IJ:Rarely palpable Soft biphasic undulating quality, usually with two elevations and characteristic inward deflection (x descent)

What causes the S3 sound? - accurate answers--Children/young adults: rapid deceleration of the column of blood against the ventricular wall.

  • Older adults: usually indicates a pathologic change in ventricular compliance. What causes a split S2 - accurate answers-During inspiration, the right heart filling time is increased, which increases right ventricular stroke volume and the duration of right ventricular ejection compared with the neighboring left ventricle. This delays the closure of the pulmonic valve, P2, splitting S2 into its two audible components. Listening for extra heart sounds (mitral stenosis) - accurate answers-left lateral decubitus cardiovascular ROS - accurate answers-SOB, syncope, edema, chest pain, orthopnea preservation - accurate answers-persistent repetition of words or ideas pancreatitis pain - accurate answers-Epigastric, may radiate straight to the back or other areas of the abdomen; 20% with severe sequelae of organ failure cricoid cartilage - accurate answers- Mongolian spots - accurate answers-areas of deep bluish-gray pigmentation most commonly on the sacral aspect of a newborn. 3 year old development - accurate answers--pedals tricycle, jumps in place. -balance on 1 foot at 4yo Lateral epicondylitis (Tennis elbow) - accurate answers-Follows repetitive extension of the wrist or pronation-supination of the forearm. Pain and tenderness develop 1 cm distal to the lateral epicondyle and possibly in the extensor muscles close to it. When the patient tries to extend the wrist against resistance, pain increases. Miliaria rubra - accurate answers-Scattered vesicles on an erythematous base, usually on the face and trunk, result from obstruction of the sweat gland ducts; this condition disappears spontaneously within weeks.

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

  • gradual onset
  • tx: analgesia, bowel rest, abx
  • sx: fever, constipation, n/v Appendicitis pain - accurate answers-RLQ pain or pain that migrates from the periumbilical region, combined with abdominal wall rigidity on palpation If you feel an abdominal mass with palpation - accurate answers-Ask the patient either to raise the head and shoulders or to strain down, thus tightening the abdominal muscles. Feel for the mass again. -intraabdominal mass is obscured by muscle contraction Abdomen assessment sequence - accurate answers-Inspect, auscultate, and percuss the abdomen. Palpate lightly, then deeply. Assess the liver and spleen by percussion and then palpation. Try to palpate the kidneys. Palpate the aorta and its pulsations. If you suspect kidney infection, percuss posteriorly over the costovertebral angles. Epigastric pain - accurate answers-Epigastric pain occurs with GERD, pancreatitis, and perforated ulcers. RUQ and upper abdominal pain are common in cholecystitis and cholangitis Causes of dk. bloody emesis - accurate answers-Hematemesis may accompany esophageal or gastric varices, Mallory-Weiss tears, or peptic ulcer disease. Chalazion - accurate answers-A subacute nontender, usually painless nodule caused by a blocked meibomian gland. May become acutely inflamed but, unlike a stye, usually points inside the eyelid rather than on the lid margin. Onychomycosis - accurate answers-fungal infection of the nail -Trichophyton rubrum (usually)

Retracted TM with effusion - accurate answers-looks like air bubbles