NR509 FINAL EXAM| COMPLETE QUESTIONS WITH EXPERT
SOLUTIONS|2026 LATEST UPDATED |GET A+
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
(Answer)psychologic
Erectile dysfunction may be from psychogenic causes, especially if - (Answer)early morning
erection is preserved.
it may also reflect decreased testosterone, decreased blood flow in the hypogastric arterial
system, impaired neural innervation, and diabetes
When performing a breast exam, know what abnormal masses should do when the arm -
(Answer)may be fixed to skin or underlying tissues (may cause dimpling of skin or retraction
when arms are lifted over head or hands are pressed against hips)
Fibroadenoma and cysts mobility - (Answer)very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - (Answer)BSE
Breast stage 1 - (Answer)preadolescent- elevation of nipple only
Breast stage 2 - (Answer)breast bud stage- elevation of breast and nipple as a small mound;
enlargement of areolar diameter
breast stage 3 - (Answer)further enlargement of elevation of breast and areola, with no
separation of their contours
breast stage 4 - (Answer)projection of areola and nipple to form a secondary mound above the
level of breast
,breast stage 5 - (Answer)mature stage- projection of nipple only; areola has receded to general
contour of the breast (although in some individuals the areola continues to form a secondary
mound)
Know where pain is located with pancreatitis: acute - (Answer)epigastric, may radiation straight
to the back of other areas of the abdomen; 20% with severe sequelae of organ failure
Know where pain is located with pancreatitis: chronic - (Answer)epigastric, radiating to back
Know how hepatitis A is transmitted - (Answer)Transmitted through fecal-oral route. Fecal
shedding followed by poor handwashing contaminates water and foods leading to infection of
household and sexual contacts
Stress incontinence - (Answer)the urethral sphincter is weakened so that transient increases in
intra-abdominal pressure raise the bladder pressure to levels that exceed urethral resistance.
Causes include childbirth and surgery, postmenopausal atrophy of the mucosa, and urethral
infection. May follow prostate surgery in men.
urge incontinence - (Answer)detrusor contractions are stronger than normal and overcome the
normal urethral resistance. The bladder is typically small. Mechanisms: Decreased cortical
inhibition of detrusor contractions from stroke, brain tumor, dementia, and lesions of the spinal
cord above sacral level. Also hyperexcitability of sensory pathways ie: bladder infections,
tumors, and fecal impaction. Deconditioning of voiding reflexes ie: frequent voluntary voiding at
low bladder volumes.
overflow incontinence - (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. Mechanisms: obstruction of the bladder outlet ie: BPH or tumor. Weakness of the
detrusor muscle associated with peripheral nerve disease at S2-4 level. Impaired bladder
sensation that interrupts the reflex arc ie: diabetic neuropathy.
,functional incontinence - (Answer)the patient is functionally able to reach the toilet in time
because of impaired health or environmental conditions. Mechanism: problems in mobility
resulting from weakness, arthritis, poor vision, or other conditions. Also environmental factors
such as an unfamiliar setting, distant bathroom facilities, bed rails, or physical restraints.
Incontinence secondary to medications - (Answer)drugs may contribute to any type of
incontinence listed. Ex: sedatives, tranquilizers, anticholinergics, sympathetic blockers, and
potent diuretics
Know where lymph nodes should be with strep - (Answer)· Strep throat àstreptococcal
pharyngitis, bacterial infection that may cause a sore, scratchy throat
· Common childhood infection has a classic presentation of erythema of the posterior pharynx
and palatal petechiae
· Enlarged swollen cervical lymph nodes -> superficial cervical lymph nodes
Superficial cervical -> superficial to the sternocleidomastoid
What vaccines are safe during pregnancy - (Answer)tdap, flu, Pneumococcal, meningococcal,
Hepatitis B, rho gam
*NOT MMR, polio, or varicella
Know what to be concerned about if you note an irregular rectal mass - (Answer)· Any masses
with irregular borders suspicious for rectal cancer
A tender purulent reddened mass with fever or chills suggests an anal abscess. Abscesses
tunneling to the skin surface from the anus or rectum may form a clogged or draining ano-rectal
fistula. Fistulas may ooze blood, pus, or feculent mucus. Consider anoscopy or sigmoidoscopy
for better visualization.
, Know what HPV Vac protects against - (Answer)· Prevents infection from HPV subtypes 16, 18, 6
& 11 which cause 90 % of genital warts
· The bivalent vaccine prevents infection from subtypes 16 and 18.
· Recommended for prevention of cervical, vulvar, and vaginal cancers and precancers in
females as well as anal cancer, precancers, and genital warts in both female and males
· Vaccinated women should still get cervical cancer screening because vaccines do not prevent
all HPV subtypes
· Condoms do not eliminate the risk of cervical HPV infection
Recommended for those with compromised immune systems including HIV
Know what a 3-year-old can do in regard to jumping and balancing - (Answer)· Climbs well, runs
easily
· Pedals a tricycle
· Walks up and down stairs, one foot on each step
Know where to place measuring tape when measuring uterus in a pregnant patient - (Answer)·
Measure the fundal height if gestational age is >20 weeks - fundus should reach the umbilicus
· Place tape measure on pubic symphysis and place the "zero" end of the tape measure when
you can firmly feel that bone.
· Extend the tape measure to the very top of uterine fundus and note the number of cm
measured.
o Subject to error between 16-36 weeks
· Number should roughly equal the number of weeks of gestation
o If fundal height is >4cm than expected -multiple gestation, large fetus, extra amniotic fluid,
uterine leiomyoma
o If fundal height is < 4cm than expected - low-level amniotic fluid, missed abortion,
intrauterine growth retardation, or fetal anomaly
The _______ _______ occupies most of the anterior cardiac surface - (Answer)right ventricle
SOLUTIONS|2026 LATEST UPDATED |GET A+
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
(Answer)psychologic
Erectile dysfunction may be from psychogenic causes, especially if - (Answer)early morning
erection is preserved.
it may also reflect decreased testosterone, decreased blood flow in the hypogastric arterial
system, impaired neural innervation, and diabetes
When performing a breast exam, know what abnormal masses should do when the arm -
(Answer)may be fixed to skin or underlying tissues (may cause dimpling of skin or retraction
when arms are lifted over head or hands are pressed against hips)
Fibroadenoma and cysts mobility - (Answer)very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - (Answer)BSE
Breast stage 1 - (Answer)preadolescent- elevation of nipple only
Breast stage 2 - (Answer)breast bud stage- elevation of breast and nipple as a small mound;
enlargement of areolar diameter
breast stage 3 - (Answer)further enlargement of elevation of breast and areola, with no
separation of their contours
breast stage 4 - (Answer)projection of areola and nipple to form a secondary mound above the
level of breast
,breast stage 5 - (Answer)mature stage- projection of nipple only; areola has receded to general
contour of the breast (although in some individuals the areola continues to form a secondary
mound)
Know where pain is located with pancreatitis: acute - (Answer)epigastric, may radiation straight
to the back of other areas of the abdomen; 20% with severe sequelae of organ failure
Know where pain is located with pancreatitis: chronic - (Answer)epigastric, radiating to back
Know how hepatitis A is transmitted - (Answer)Transmitted through fecal-oral route. Fecal
shedding followed by poor handwashing contaminates water and foods leading to infection of
household and sexual contacts
Stress incontinence - (Answer)the urethral sphincter is weakened so that transient increases in
intra-abdominal pressure raise the bladder pressure to levels that exceed urethral resistance.
Causes include childbirth and surgery, postmenopausal atrophy of the mucosa, and urethral
infection. May follow prostate surgery in men.
urge incontinence - (Answer)detrusor contractions are stronger than normal and overcome the
normal urethral resistance. The bladder is typically small. Mechanisms: Decreased cortical
inhibition of detrusor contractions from stroke, brain tumor, dementia, and lesions of the spinal
cord above sacral level. Also hyperexcitability of sensory pathways ie: bladder infections,
tumors, and fecal impaction. Deconditioning of voiding reflexes ie: frequent voluntary voiding at
low bladder volumes.
overflow incontinence - (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. Mechanisms: obstruction of the bladder outlet ie: BPH or tumor. Weakness of the
detrusor muscle associated with peripheral nerve disease at S2-4 level. Impaired bladder
sensation that interrupts the reflex arc ie: diabetic neuropathy.
,functional incontinence - (Answer)the patient is functionally able to reach the toilet in time
because of impaired health or environmental conditions. Mechanism: problems in mobility
resulting from weakness, arthritis, poor vision, or other conditions. Also environmental factors
such as an unfamiliar setting, distant bathroom facilities, bed rails, or physical restraints.
Incontinence secondary to medications - (Answer)drugs may contribute to any type of
incontinence listed. Ex: sedatives, tranquilizers, anticholinergics, sympathetic blockers, and
potent diuretics
Know where lymph nodes should be with strep - (Answer)· Strep throat àstreptococcal
pharyngitis, bacterial infection that may cause a sore, scratchy throat
· Common childhood infection has a classic presentation of erythema of the posterior pharynx
and palatal petechiae
· Enlarged swollen cervical lymph nodes -> superficial cervical lymph nodes
Superficial cervical -> superficial to the sternocleidomastoid
What vaccines are safe during pregnancy - (Answer)tdap, flu, Pneumococcal, meningococcal,
Hepatitis B, rho gam
*NOT MMR, polio, or varicella
Know what to be concerned about if you note an irregular rectal mass - (Answer)· Any masses
with irregular borders suspicious for rectal cancer
A tender purulent reddened mass with fever or chills suggests an anal abscess. Abscesses
tunneling to the skin surface from the anus or rectum may form a clogged or draining ano-rectal
fistula. Fistulas may ooze blood, pus, or feculent mucus. Consider anoscopy or sigmoidoscopy
for better visualization.
, Know what HPV Vac protects against - (Answer)· Prevents infection from HPV subtypes 16, 18, 6
& 11 which cause 90 % of genital warts
· The bivalent vaccine prevents infection from subtypes 16 and 18.
· Recommended for prevention of cervical, vulvar, and vaginal cancers and precancers in
females as well as anal cancer, precancers, and genital warts in both female and males
· Vaccinated women should still get cervical cancer screening because vaccines do not prevent
all HPV subtypes
· Condoms do not eliminate the risk of cervical HPV infection
Recommended for those with compromised immune systems including HIV
Know what a 3-year-old can do in regard to jumping and balancing - (Answer)· Climbs well, runs
easily
· Pedals a tricycle
· Walks up and down stairs, one foot on each step
Know where to place measuring tape when measuring uterus in a pregnant patient - (Answer)·
Measure the fundal height if gestational age is >20 weeks - fundus should reach the umbilicus
· Place tape measure on pubic symphysis and place the "zero" end of the tape measure when
you can firmly feel that bone.
· Extend the tape measure to the very top of uterine fundus and note the number of cm
measured.
o Subject to error between 16-36 weeks
· Number should roughly equal the number of weeks of gestation
o If fundal height is >4cm than expected -multiple gestation, large fetus, extra amniotic fluid,
uterine leiomyoma
o If fundal height is < 4cm than expected - low-level amniotic fluid, missed abortion,
intrauterine growth retardation, or fetal anomaly
The _______ _______ occupies most of the anterior cardiac surface - (Answer)right ventricle
