NR509 Final Exam Questions with
100% Correct Answers (Guarantee
Pass)
1. Diverticulitis process - ANSWER Acute inflammation of colonic diver-
ticula, outpouchings 5-10 mm in di-ameter, usually in sigmoid or descend-
ing colon
2. Diverticulitis location - ANSWER Left lower quadrant
3. Diverticulitis quality - ANSWER May be cramping at first, then steady
4. Diverticulitis timing - ANSWER Often gradual onset
5. Diverticulitis relieving factors - ANSWER Analgesia, bowel rest,
antibiotics
6. Diverticulitis associated symptoms and setting - ANSWER Fever,
constipation. Also nausea, vomiting, abdominal mass with rebound
tenderness
7. Hepatitis - ANSWER -Tenderness over liver (liver inflammation)
--Hep A and B prevention: Vaccination
Hep A: spread through fecal matter and asymptomatic children
,Hep B: 1% fatality, 15-25% of chronic infection die from cirrhosis or liver
cancer (usually asymptomatic until onset of advanced liver disease).
Hep C: Mainly percutaneous exposure.
8. Overflow incontinence problem - ANSWER Detrusor contractions are
insufficient to overcome urethral resistance, causing urinary retention. The
bladder is typically flaccid and large, even after an effort to void.
9. Overflow incontinence mechanisms - ANSWER Obstruction of the bladder
outlet, as in benign prostatic hyperplasia or tumor. Weakness of the detrusor
muscle associated with peripheral nerve disease at S2-4 level.
Impaired bladder sensation that interrupts the reflex arc, as in diabetic
neuropathy.
10.Overflow incontinence symptoms - ANSWER When intravascular pressure
overcomes urethral resistance, continuous dripping or dribbling incontinence
ensues. Decreased force of the urinary stream.
Prior symptoms of partial urinary obstruction or other symptoms of peripheral
nerve disease may be present.
11.Overflow incontinence physical signs - ANSWER Examination often
reveals an enlarged, sometimes tender, bladder. Other signs include prostatic
enlargement, motor signs of peripheral nerve disease, a decrease in sensation
(including perineal sensation), and diminished to absent reflexes.
12.Functional incontinence problem - ANSWER The patient is functionally
unable to reach the toilet in time because of impaired health or
environmental conditions.
,13.Functional incontinence mechanisms - ANSWER Problems in mobility
resulting from weakness, arthritis, poor vision, or other conditions.
Environmental factors such as an unfamiliar setting, distant bathroom
facilities, bed rails, or physical restraints.
14.Functional incontinence symptoms - ANSWER Incontinence on the way to
the toilet or only in the early morning.
15.Functional incontinence physical signs - ANSWER The bladder is not
detectable on examination. Look for physical or environmental clues as the
likely cause.
16.Incontinence secondary to medications problem - ANSWER Drugs may
contribute to any type of incontinence listed.
17.Incontinence secondary to medications mechanisms - ANSWER Sedatives,
tranquilizers, anticholinergics, sympathetic blockers, and potent diuretics.
18.Incontinence secondary to medications symptoms - ANSWER Variable. A
careful history and chart review are important.
19.Incontinence secondary to medications physical signs - ANSWER Variable.
20.Colorectal cancer screening - ANSWER Adults ages 50 to 75 years—
options (grade A recommendation)
Hi-sens fecal occult blood testing annually
Sigmoidoscopy every 5 years w/ high-sensitivity FOBT every 3 years
Screening colonoscopy every 10 years
B: Adults 76-85
, Screening not advised because the benefits are small in comparison to the risks
Use individual decision making if screening an adult for the first time
C. Adults older than age 85 years—do not screen (grade D recommendation)
Screening not advised because "competing causes of mortality preclude a
mortality benefit that outweighs harms"
21.Appendicitis - ANSWER 1. McBurney point tenderness
Rovsing sign
the psoas sign
the obturator sign
--Appendicitis is twice as likely in the presence of RLQ tenderness, Rovsing
sign, and the psoas sign
--The pain of appendicitis classically begins near the umbilicus, then migrates
to the RLQ. Older adults are less likely to report this pattern.
--Localized tenderness anywhere in the RLQ, even in the right flank, suggests
appendicitis.
22.McBurney Point - ANSWER 1. McBurney point lies 2 inches from the
anterior superior spinous process of ilium on a line drawn from that process
to the umbilicus
Appendicitis is three times more likely if there is McBurney point tenderness.
23.Rovsing sign - ANSWER Press deeply and evenly in the LLQ. Then
quickly withdraw your fingers.
Pain in the RLQ during left-sided pressure is a positive Rovsing sign.
24.Psoas Sign - ANSWER --Place your hand just above the patient's right knee
and ask the patient to raise that thigh against your hand. Alternatively, ask
100% Correct Answers (Guarantee
Pass)
1. Diverticulitis process - ANSWER Acute inflammation of colonic diver-
ticula, outpouchings 5-10 mm in di-ameter, usually in sigmoid or descend-
ing colon
2. Diverticulitis location - ANSWER Left lower quadrant
3. Diverticulitis quality - ANSWER May be cramping at first, then steady
4. Diverticulitis timing - ANSWER Often gradual onset
5. Diverticulitis relieving factors - ANSWER Analgesia, bowel rest,
antibiotics
6. Diverticulitis associated symptoms and setting - ANSWER Fever,
constipation. Also nausea, vomiting, abdominal mass with rebound
tenderness
7. Hepatitis - ANSWER -Tenderness over liver (liver inflammation)
--Hep A and B prevention: Vaccination
Hep A: spread through fecal matter and asymptomatic children
,Hep B: 1% fatality, 15-25% of chronic infection die from cirrhosis or liver
cancer (usually asymptomatic until onset of advanced liver disease).
Hep C: Mainly percutaneous exposure.
8. Overflow incontinence problem - ANSWER Detrusor contractions are
insufficient to overcome urethral resistance, causing urinary retention. The
bladder is typically flaccid and large, even after an effort to void.
9. Overflow incontinence mechanisms - ANSWER Obstruction of the bladder
outlet, as in benign prostatic hyperplasia or tumor. Weakness of the detrusor
muscle associated with peripheral nerve disease at S2-4 level.
Impaired bladder sensation that interrupts the reflex arc, as in diabetic
neuropathy.
10.Overflow incontinence symptoms - ANSWER When intravascular pressure
overcomes urethral resistance, continuous dripping or dribbling incontinence
ensues. Decreased force of the urinary stream.
Prior symptoms of partial urinary obstruction or other symptoms of peripheral
nerve disease may be present.
11.Overflow incontinence physical signs - ANSWER Examination often
reveals an enlarged, sometimes tender, bladder. Other signs include prostatic
enlargement, motor signs of peripheral nerve disease, a decrease in sensation
(including perineal sensation), and diminished to absent reflexes.
12.Functional incontinence problem - ANSWER The patient is functionally
unable to reach the toilet in time because of impaired health or
environmental conditions.
,13.Functional incontinence mechanisms - ANSWER Problems in mobility
resulting from weakness, arthritis, poor vision, or other conditions.
Environmental factors such as an unfamiliar setting, distant bathroom
facilities, bed rails, or physical restraints.
14.Functional incontinence symptoms - ANSWER Incontinence on the way to
the toilet or only in the early morning.
15.Functional incontinence physical signs - ANSWER The bladder is not
detectable on examination. Look for physical or environmental clues as the
likely cause.
16.Incontinence secondary to medications problem - ANSWER Drugs may
contribute to any type of incontinence listed.
17.Incontinence secondary to medications mechanisms - ANSWER Sedatives,
tranquilizers, anticholinergics, sympathetic blockers, and potent diuretics.
18.Incontinence secondary to medications symptoms - ANSWER Variable. A
careful history and chart review are important.
19.Incontinence secondary to medications physical signs - ANSWER Variable.
20.Colorectal cancer screening - ANSWER Adults ages 50 to 75 years—
options (grade A recommendation)
Hi-sens fecal occult blood testing annually
Sigmoidoscopy every 5 years w/ high-sensitivity FOBT every 3 years
Screening colonoscopy every 10 years
B: Adults 76-85
, Screening not advised because the benefits are small in comparison to the risks
Use individual decision making if screening an adult for the first time
C. Adults older than age 85 years—do not screen (grade D recommendation)
Screening not advised because "competing causes of mortality preclude a
mortality benefit that outweighs harms"
21.Appendicitis - ANSWER 1. McBurney point tenderness
Rovsing sign
the psoas sign
the obturator sign
--Appendicitis is twice as likely in the presence of RLQ tenderness, Rovsing
sign, and the psoas sign
--The pain of appendicitis classically begins near the umbilicus, then migrates
to the RLQ. Older adults are less likely to report this pattern.
--Localized tenderness anywhere in the RLQ, even in the right flank, suggests
appendicitis.
22.McBurney Point - ANSWER 1. McBurney point lies 2 inches from the
anterior superior spinous process of ilium on a line drawn from that process
to the umbilicus
Appendicitis is three times more likely if there is McBurney point tenderness.
23.Rovsing sign - ANSWER Press deeply and evenly in the LLQ. Then
quickly withdraw your fingers.
Pain in the RLQ during left-sided pressure is a positive Rovsing sign.
24.Psoas Sign - ANSWER --Place your hand just above the patient's right knee
and ask the patient to raise that thigh against your hand. Alternatively, ask
