NR 509 Final Exam Question & Answer
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
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
