NR 509 Final Exam questions with complete solutions

NR 509 Final Exam questions with complete solutions Suspicious fbreast fmass f- f f f fcorrect fanswer.-A fmobile fmass fthat fbecomes ffixed fwhen fthe farm frelaxes fis fattached fto fthe fribs fand fintercostal fmuscles; fif ffixed fwhen fthe fhand fis fpressed fagainst fthe fhip, fit fis fattached fto fthe fpectoral ffascia. -Hard firregular fpoorly fcircumscribed fnodules, ffixed fto fthe fskin for funderlying ftissues, fstrongly fsuggest fcancer Risk ffor fBreast fcancer f- f f f fcorrect fanswer.--*Age* -family fhistory fof fbreast/ovarian fCA - finherited fgenetic fmutations, f -personal fhistory fof fbreast fcancer f - fhigh flevels fof fendogenous fhormones f - fbreast ftissue fdensity - fproliferative flesions fwith fatypia fon fbreast fbiopsy, f- fduration fof funopposed festrogen fexposure frelated fto fearly fmenarche -age fof ffirst ffull-term fpregnancy - flate fmenopause. f - fbreastfeeding ffor fless fthan f1 fyear, - fpostmenopausal fobesity -cigarette fsmoking, falcohol fingestion, f - fphysical finactivity, fand ftype fof fcontraception. Characteristics fof fa fbreast fcyst f- f f f fcorrect fanswer.Soft fto ffirm, fround, fmobile, foften ftender. The fbest fway fto fexamine fthe flateral fportion fof fthe fbreast f- f f f fcorrect fanswer.-Have fpt froll fonto fthe fopposite fhip -place fher fhand fon fher fforehead. - fkeep fshoulders fpressed fagainst fthe fbed f -palpate fin fthe faxilla, fmoving fin fa fstraight fline fdown fto fthe fbra fline, fthen fmove fthe ffingers fmedially fand fpalpate fin fa fvertical fstrip fup fthe fchest fto fthe fclavicle. fContinue fin fvertical foverlapping fstrips funtil fyou freach fthe fnipple Bacterial fVaginosis f(BV) f- f f f fcorrect fanswer.-Caused fby fovergrowth fof fanaerobic fbacteria f(often ffrom fsex) - fDischarge: fGray for fwhite, fthin, fhomogenous, fmalodorous, fcoats fthe fvaginal fwalls, fusually fnot fprofuse, fmay fbe fminimal - fFishy/musty fgenital fodor -Normal fvulva fand fvaginal fmucosa -Scan fsaline fwet fmount ffor fclue fcells f(epithelial fcells fwith fstippled fborders); fsniff ffor ffishy fodor fafter fapplying fKOH f("whiff ftest"); ftest fthe fvaginal fsecretions ffor fpH f f4.5 Candidal fVaginitis f- f f f fcorrect fanswer.-Cause: fCandida falbicans, fa fyeast f(normal fovergrowth fof fvaginal fflora); fmany ffactors fpredispose, fincluding fantibiotic ftherapy -Discharge: fwhite fand fcurdy, fmay fbe fthin fbut fusually fthick, fnot fas fprofuse fas ftrichomonal finfection, fnot fmalodorous - fvaginal fsoreness, fpruritus, fpain fon furination, fdyspareunia f(painful fintercourse) -The fvulva fand fsurrounding fskin fare finflamed fand fsometimes fswollen fto fa fvariable fextent; fthe fvaginal fmucosa fis freddened, fwith fwhite ftenacious fpatches fof fdischarge; fthe fmucosa fmay fbleed fwhen fthese fpatches fare fscraped foff; fin fmild fcases, fthe fmucosa flooks fnormal -Scan fpotassium fhydroxide f(KOH) fpreparation ffor fthe fbranching fhyphae fof fCandida Trichomonal fVaginitis f- f f f fcorrect fanswer.-Trichomonas fvaginalis, fa fprotozoan; foften fbut fnot falways facquired fsexually - fDischarge:Yellowish fgreen for fgray, fpossibly ffrothy; foften fprofuse fand fpooled fin fthe fvaginal ffornix; fmay fbe fmalodorous -Pruritus f(though fnot fusually fas fsevere fas fwith fCandida infection); fpain fon furination f(from fskin finflammation for fpossibly furethritis); fdyspareunia -Vestibule fand flabia fminora fmay fbe ferythematous; fthe fvaginal fmucosa fmay fbe fdiffusely freddened, fwith fsmall fred fgranular fspots for fpetechiae fin fthe fposterior ffornix; fin fmild fcases, fthe fmucosa flooks fnormal - fScan fsaline fwet fmount ffor ftrichomonads Syphillis f- f f f fcorrect fanswer.This fulcerated fpapule fwith fan findurated fedge fusually fappears fafter f3 fto f6 fweeks fof fincubating finfection ffrom fthe fspirochete fTreponema fpallidum. fThese flesions fmay fresemble fa fcarcinoma for fcrusted fcold fsore. fSimilar fprimary flesions fare fcommon fin fthe fpharynx, fanus, fand fvagina fbut fmay fescape fdetection fsince fthey fare fpainless, fnonsuppurative, fand fusually fheal fspontaneously fin f3 fto f6 fweeks. fWear fgloves fduring fpalpation fsince fthese fchancres fare finfectious. s/s fof fepididymitis f- f f f fcorrect fanswer.Acute: fswollen, fand fnotably ftender, fmaking fit fdifficult fto fdistinguish ffrom fthe ftestis. fThe fscrotum fmay fbe freddened fand fthe fvas fdeferens finflamed. Chronic: ffirm fenlargement fof fthe fepididymis, fwhich fis fsometimes ftender, fwith fthickening for fbeading fof fthe fvas fdeferens. Genital fWarts f(Condylomata fAcuminata) f- f f f fcorrect fanswer.-Single for fmultiple fpapules for fplaques fof fvariable fshapes; fmay fbe fround, facuminate f(pointed), for fthin fand fslender. fMay fbe fraised, fflat, for fcauliflower-like f(verrucous). -Causative forganism: fHPV, fusually fsubtypes f6, f11; fcarcinogenic fsubtypes frare, fapproximately f5-10% fof fall fanogenital fwarts. fIncubation: fweeks fto fmonths; finfected fcontact fmay fhave fno fvisible fwarts. -Can farise fon fpenis, fscrotum, fgroin, fthighs, fanus; fusually fasymptomatic, foccasionally fcause fitching fand fpain. f -May fdisappear fwithout ftreatment. Risk ffor fprostate fCA f- f f f fcorrect fanswer.Age, fethnicity, fand ffamily fhistory fare fthe fstrongest frisk ffactors ffor fprostate fcancer. s/s fprostatitis f- f f f fcorrect fanswer.-fever f -frequency, furgency, fdysuria, fincomplete fvoiding, f -sometimes flow fback fpain f - fgland ffeels ftender, fswollen, f"boggy," fand fwarm s/s fBPH f- f f f fcorrect fanswer.- firritative f(urgency, ffrequency, fnocturia), f -obstructive f(decreased fstream, fincomplete femptying, fstraining), for fboth, f - fgland fmay fbe fnormal fin fsize, for fmay ffeel fsymmetrically fenlarged, fsmooth, fand ffirm, fthough fslightly felastic; fthere fmay fbe fobliteration fof fthe fmedian fsulcus fand fmore fnotable fprotrusion finto fthe frectal flumen. Measuring fa fpregnant futerus f- f f f fcorrect fanswer.With fa fplastic for fpaper ftape fmeasure, flocate fthe fpubic fsymphysis fand fplace fthe f"zero" fend fof fthe ftape fmeasure fwhere fyou fcan ffirmly ffeel fthat fbone f(Fig. f19-12). fThen fextend fthe ftape fmeasure fto fthe fvery ftop fof futerine ffundus fand fnote fthe fnumber fof fcentimeters fmeasured. s/s fgestational fHTN f- f f f fcorrect lic fblood fpressure f(SBP) f140 fmm fHg for fdiastolic fblood fpressure f(DBP) f90 fmm fHg ffirst fdocumented fafter f20 fweeks, fwithout fproteinuria for fpreeclampsia, fthat fresolves fby f12 fweeks fpostpartum. s/s fectopic fpregnancy f- f f f fcorrect fanswer.-Abdominal fpain -adnexal ftenderness -abnormal futerine fbleeding how fa fBartholin fgland finfection fpresents f- f f f fcorrect fanswer.Causes fof fa fBartholin fgland finfection finclude ftrauma, fgonococci, fanaerobes flike fbacteroides fand fpeptostreptococci, fand fC. ftrachomatis. fAcutely, fthe fgland fappears fas fa ftense, fhot, fvery ftender fabscess. fLook ffor fpus femerging ffrom fthe fduct for ferythema faround fthe fduct fopening. fChronically, fa fnontender fcyst fis ffelt fthat fmay fbe flarge for fsmall. Bleeding fbetween fperiods f- f f f fcorrect fanswer.Metrorrhagia Vaccines fsafe fin fpregnancy f- f f f fcorrect ococcal, fmeningococcal, fand fhepatitis fB. fHepatitis fA fand fB, fmeningococcal fpolysaccharide fand fconjugate, fand fpneumococcal fpolysaccharide fvaccines fcan fbe fgiven, fif findicated. -inactivated finfluenza -Tdap When fto fgive fthe ftetanus fvaccine f- f f f fcorrect fanswer.All fadults faged f≥19 fyears, fincluding fthose faged f≥65 fyears: fAll fadults faged f≥19 fyears fwho fhave fnot fbeen fvaccinated fwith fTdap fshould freceive fa fsingle fdose fof fTdap fregardless fof fthe ftime finterval fsince flast freceiving fTd. fAfter freceiving fTdap, fthey fshould freceive fTd fboosters fat f10-year fintervals. fFor fadults faged f≥65 fyears, fthis fwill freduce fthe flikelihood fof ftransmission fto finfants faged f12 fmonths. HPV fvaccine f- f f f fcorrect fanswer.-The fquadrivalent fvaccine fprevents finfection ffrom fHPV fsub-types f16 fand f18, fas fwell fas f6 fand f11, fwhich fcause f90% fof fgenital fwarts f(prevents fcervical fca falso) -The fbivalent fvaccine fprevents finfection ffrom fsubtypes f16 fand f18. Tanner fstaging fof fbreast fdevelopment f- f f f fcorrect fanswer.1: fpreadolescent- felevation fof fnipple fonly 2: fBreast fbud fstage: felevation fof fbreast fand fnipple fas fa fsmall fmound; fenlargement fof fareolar fdiameter 3: fFurther fenlargement fof felevation fof fbreast fand fareola, fwith fno fseparation fof ftheir fcontours 4: fProjection fof fareola fand fnipple fto fform fa fsecondary fmound fabove fthe flevel fof fbreast 5: fMature fstage: fprojection fof fnipple fonly; fareola fhas freceded fto fgeneral fcontour fof fthe fbreast f(although fin fsome fnormal findividuals fthe fareola fcontinues fto fform fa fsecondary fmound) Breast fmasses f- f f f fcorrect fanswer.Most foften ffound fby fwomen fduring fself fexamination Irregular frectal fmass f- f f f fcorrect fanswer.Masses fwith firregular fborders fare fsuspicious ffor frectal fcancer s/s frectal fprolapse f- f f f fcorrect fanswer.On fstraining ffor fa fbowel fmovement, fthe frectal fmucosa, fwith for fwithout fits fmuscular fwall, fmay fprolapse fthrough fthe fanus, fappearing fas fa fdoughnut for frosette fof fred ftissue. fA fprolapse finvolving fonly fmucosa fis frelatively fsmall fand fshows fradiating ffolds, fas fillustrated. fWhen fthe fentire fbowel fwall fis finvolved, fthe fprolapse fis flarger fand fcovered fby fconcentrically fcircular ffolds. Hemorrhoids fvs fpolyps fvs fCA f- f f f fcorrect fanswer.-H-(internal-prolapsed)reddish, fmoist, fprotruding fmasses, f(external) fpain fwith fdefecation fand fsitting, ftender, fswollen, fbluish, fovoid fmass fis fvisible fat fthe fanal fmargin. -P- fon fthe fstalk, for fmucosal fsurface, fsoft, fdifficult fto ffeel foften -C- ffirm, fnodular, frolled fedge Erectile fdysfunction f- f f f fcorrect fanswer.In fa f47 fyo fmale, fit fis fmost foften fpsychologic fand fnot ftestosterone frelated. s/s fof fproctitis f- f f f fcorrect fanswer.Anorectal fpain, fitching, ftenesmus, for fdischarge for fbleeding ffrom finfection for frectal fabscess fsuggest fproctitis. -anal ffissures