NR 509 Final Exam Questions
with Answers
Suspicious breast mass - ANSWER- -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 - ANSWER- --*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 - ANSWER- Soft to firm, round, mobile, often tender.
The best way to examine the lateral portion of the breast - ANSWER- -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) - ANSWER- -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 > 4.5
, Candidal Vaginitis - ANSWER- -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 - ANSWER- -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 - ANSWER- 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 - ANSWER- Acute: swollen, and notably tender, making it difficult to
distinguish from the testis. The scrotum may be reddened and the vas deferens
inflamed.
Chronic: firm enlargement of the epididymis, which is sometimes tender, with thickening
or beading of the vas deferens.
Genital Warts (Condylomata Acuminata) - ANSWER- -Single or multiple papules or
plaques of variable shapes; may be round, acuminate (pointed), or thin and slender.
May be raised, flat, or cauliflower-like (verrucous).
-Causative organism: HPV, usually subtypes 6, 11; carcinogenic subtypes rare,
approximately 5-10% of all anogenital warts. Incubation: weeks to months; infected
contact may have no visible warts.
-Can arise on penis, scrotum, groin, thighs, anus; usually asymptomatic, occasionally
cause itching and pain.
-May disappear without treatment.
with Answers
Suspicious breast mass - ANSWER- -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 - ANSWER- --*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 - ANSWER- Soft to firm, round, mobile, often tender.
The best way to examine the lateral portion of the breast - ANSWER- -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) - ANSWER- -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 > 4.5
, Candidal Vaginitis - ANSWER- -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 - ANSWER- -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 - ANSWER- 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 - ANSWER- Acute: swollen, and notably tender, making it difficult to
distinguish from the testis. The scrotum may be reddened and the vas deferens
inflamed.
Chronic: firm enlargement of the epididymis, which is sometimes tender, with thickening
or beading of the vas deferens.
Genital Warts (Condylomata Acuminata) - ANSWER- -Single or multiple papules or
plaques of variable shapes; may be round, acuminate (pointed), or thin and slender.
May be raised, flat, or cauliflower-like (verrucous).
-Causative organism: HPV, usually subtypes 6, 11; carcinogenic subtypes rare,
approximately 5-10% of all anogenital warts. Incubation: weeks to months; infected
contact may have no visible warts.
-Can arise on penis, scrotum, groin, thighs, anus; usually asymptomatic, occasionally
cause itching and pain.
-May disappear without treatment.
