NUR-634 FINAL EXAM TEST PREP
n n n n
1. Younarenexaminingnannelderlynmannandnnoticenthenfollowing:nDecreasednvibration
nsenseninnthe nfeetnandnankles,ndiminished ngagnreflex,nrightnpatellar nreflexnlessntha
nnthenleft,nandndiminishednabdominalnreflexes.nWhichnofnthesenisnabnormal?
• Decreasednvibrationnsense
• Diminishedngagnreflex
• Diminishednrightnpatellar nreflexncomparednto nthenleft
• Diminishednabdominalnreflexes
Question nPoints: n1.0n/n1.0
2. An68-year-
oldnretirednfarmer npresentsnto nyournofficenfornevaluationnofnanskinnlesion.nOnnthenright
ntemporalnarea nofnthe nforehead,nyounsee na nflattened npapule nthe nsame ncolornasnhisnskin
,ncoverednbynandrynscalenthatnisnroundnandnfeelsnhard.nHenhasnseveralnmorenofnthesensc
atterednonnthenforehead,narms,nandnlegs.nBasednonnthisndescription,nwhatnisnyournmos
tnlikelyndiagnosis?
• Actinicnkeratosis
• Seborrheicnkeratosis
• Basalncellncarcinoma
• Squamousncellncarcinoma
Question nPoints: n1.0n/n1.0
3. An14-year-
oldnjuniornhighnschoolnstudentnisnbroughtninnbynhisnmothernandnfathernbecausenhen
seemsnto nbendevelopingnbreasts.nThenmothernisnupsetnbecausenshenreadnonnthenInte
rnetnthatnsmokingnmarijuananleadsnto nbreastnenlargementninnmales.nThe
, youngnmannadamantlyndeniesnusingnanyntobacco,nalcohol,norndrugs.nHenhasnrecentlynn
oticednchangesninnhisnpenis,ntesticles,nandnpubicnhairnpattern.nOtherwise,nhisnpastnme
dicalnhistorynisnunremarkable.nHisnparentsnarenbothninngoodnhealth.nHenhasntwo nolde
rnbrothersnwho nnevernhadnthisnproblem.nOnnexamination,nyounseenanmildlynoverweig
htnteenager nwithnenlargednbreastntissuenthatnisnslightlyntender nonnbothnsides.nOtherw
isenhisnexaminationnisnnormal.nHenisnagreeablento ntakingnandrugntest.nWhatnisnthenmos
tnlikelyncausenofnhisngynecomastia?
• Breastncancer
• Imbalancenofnhormonesnofnpuberty
• Drugnuse
• Alcoholnuse
Question nPoints: n1.0n/n1.0
4. An17-year-
oldnfemalenpresentsnto nyournoffice,ncomplainingnofnanclear ndischargenfromnhernrightnb
reastnforn2nmonths.nShenstatesnthatnshennoticednitnwhennshenandnhernboyfriendnweren“
messingnaround”nandnhensqueezednhernnipple.nShencontinuesnto nhaventhisndischargena
nytimenshensqueezesnthatnnipple.nShendeniesnanyntraumanto nhernbreasts.nHernpastnme
dicalnhistorynisnunremarkable.nShendeniesnanynpregnancies.nBothnofnhernparentsnarenh
ealthy.nShendeniesnusingntobacconornillegalndrugsnandndrinksnthreento nfournbeersnanwe
ek.nOnnexamination,nhernbreastsnarensymmetricnwithnno nskinnchanges.nYounarenablent
o nexpressnclearndischargenfromnhernrightnnipple.nYounfeelnnondiscretenmassesnandnher
naxillae nare nnormal.nThe nremaindernofnher nheart,nlung,nabdominal,nandnpelvicnexamin
ationsnarenunremarkable.nAnurinenpregnancyntestnisnnegative.
Whatncausenofnnipplendischargenisnthenmostnlikelyninnherncircumstance?
• Benignnbreastnabnormality
• Breastncancer
• Nonpuerperalngalactorrhea
• Pagetsndisease
, Question nPoints: n1.0n/n1.0
5. An26-year-
oldnflightnattendantnpresentsninnfornanthirdntrimester nprenatalnvisit.nShenhasnhadnpre
natalncarensincenhernsixthnweeknofnpregnancy.nShenhasnnoncomplaintsntodaynandnher
nprenatalncourse nhasnbeennunremarkable.nTodaynher nblood npressurenandnweightnga
innarenappropriate,nandnhernurinenisnunremarkable.nYounhavenanfirst-
nyear nmedicalnstudentnshadowing nyou,nso nyounasknthe nstudentnto ngetnDoptones nandn
measurenthenpatient'snuterusninncentimeters.nThennursenpractitioner nstudentnprom
ptlynreportsnfetalnheartntonesnofn140,nbutnhenisnhavingndifficultynobtainingnthencorre
ctnmeasurement.nHenknowsnonenendnofnthentapengoesnovernthenuterinenfundus.nFro
mnwhatninferior nanatomicnpositionnshouldnthentapenbenplaced?
• Vagina
• Clitoris
• Pubicnsymphysis
• Umbilicus
Question nPoints: n1.0n/n1.0
6. An58-year-
oldngardener npresentsntonyournofficenfornevaluationnofnannewnlesionnonnhernuppernch
est.nThenlesionnappearsnto nben“stucknon”nandnisnoval,nbrown,nandnslightlynelevatednwi
thnanflatnsurface.nItnhasnanrough,nwartnlikentexturenonnpalpation.nBasednonnthisndescri
ption,nwhatnisnyournmostnlikelyndiagnosis?
• Actinicnkeratosis
• Seborrheicnkeratosis
• Basalncellncarcinoma
• Squamousncellncarcinoma
, MISSINGnANSWER
Question nPoints: n0.0n/n1.0
7. Whichnofnthenfollowingnrepresentsnage-relatednchangesninnthenlungs?
• Decreaseninnchestnwallncompliance
• Speednofnexpirationnincreases
• Increaseninnrespiratorynmusclenstrength
• Increasednelasticnrecoilnofnlungntissue
Question nPoints: n1.0n/n1.0
8. An15-month-
oldnisnbroughtnto nyounfornanfevernofn38.6ndegreesnCelsiusnandnfussiness.nThenearnexami
nationnisnasnfollows:nexternalnear,nnormalnappearancenandnno ntendernessnwithnmanipul
ation;ncanal,nnormalndiameter nwithoutnevidencenofninflammation;ntympanicnmembran
e,nbulging,nerythematous,nandnopaque.nInsufflationnisndeferrednduento npain.nWhatnisnth
enmostnlikelynconditionnhere?
• Otitisnexterna
• Cholesteatoma
• Rupturedntympanicnmembrane
• Otitisnmedia
n n n n
1. Younarenexaminingnannelderlynmannandnnoticenthenfollowing:nDecreasednvibration
nsenseninnthe nfeetnandnankles,ndiminished ngagnreflex,nrightnpatellar nreflexnlessntha
nnthenleft,nandndiminishednabdominalnreflexes.nWhichnofnthesenisnabnormal?
• Decreasednvibrationnsense
• Diminishedngagnreflex
• Diminishednrightnpatellar nreflexncomparednto nthenleft
• Diminishednabdominalnreflexes
Question nPoints: n1.0n/n1.0
2. An68-year-
oldnretirednfarmer npresentsnto nyournofficenfornevaluationnofnanskinnlesion.nOnnthenright
ntemporalnarea nofnthe nforehead,nyounsee na nflattened npapule nthe nsame ncolornasnhisnskin
,ncoverednbynandrynscalenthatnisnroundnandnfeelsnhard.nHenhasnseveralnmorenofnthesensc
atterednonnthenforehead,narms,nandnlegs.nBasednonnthisndescription,nwhatnisnyournmos
tnlikelyndiagnosis?
• Actinicnkeratosis
• Seborrheicnkeratosis
• Basalncellncarcinoma
• Squamousncellncarcinoma
Question nPoints: n1.0n/n1.0
3. An14-year-
oldnjuniornhighnschoolnstudentnisnbroughtninnbynhisnmothernandnfathernbecausenhen
seemsnto nbendevelopingnbreasts.nThenmothernisnupsetnbecausenshenreadnonnthenInte
rnetnthatnsmokingnmarijuananleadsnto nbreastnenlargementninnmales.nThe
, youngnmannadamantlyndeniesnusingnanyntobacco,nalcohol,norndrugs.nHenhasnrecentlynn
oticednchangesninnhisnpenis,ntesticles,nandnpubicnhairnpattern.nOtherwise,nhisnpastnme
dicalnhistorynisnunremarkable.nHisnparentsnarenbothninngoodnhealth.nHenhasntwo nolde
rnbrothersnwho nnevernhadnthisnproblem.nOnnexamination,nyounseenanmildlynoverweig
htnteenager nwithnenlargednbreastntissuenthatnisnslightlyntender nonnbothnsides.nOtherw
isenhisnexaminationnisnnormal.nHenisnagreeablento ntakingnandrugntest.nWhatnisnthenmos
tnlikelyncausenofnhisngynecomastia?
• Breastncancer
• Imbalancenofnhormonesnofnpuberty
• Drugnuse
• Alcoholnuse
Question nPoints: n1.0n/n1.0
4. An17-year-
oldnfemalenpresentsnto nyournoffice,ncomplainingnofnanclear ndischargenfromnhernrightnb
reastnforn2nmonths.nShenstatesnthatnshennoticednitnwhennshenandnhernboyfriendnweren“
messingnaround”nandnhensqueezednhernnipple.nShencontinuesnto nhaventhisndischargena
nytimenshensqueezesnthatnnipple.nShendeniesnanyntraumanto nhernbreasts.nHernpastnme
dicalnhistorynisnunremarkable.nShendeniesnanynpregnancies.nBothnofnhernparentsnarenh
ealthy.nShendeniesnusingntobacconornillegalndrugsnandndrinksnthreento nfournbeersnanwe
ek.nOnnexamination,nhernbreastsnarensymmetricnwithnno nskinnchanges.nYounarenablent
o nexpressnclearndischargenfromnhernrightnnipple.nYounfeelnnondiscretenmassesnandnher
naxillae nare nnormal.nThe nremaindernofnher nheart,nlung,nabdominal,nandnpelvicnexamin
ationsnarenunremarkable.nAnurinenpregnancyntestnisnnegative.
Whatncausenofnnipplendischargenisnthenmostnlikelyninnherncircumstance?
• Benignnbreastnabnormality
• Breastncancer
• Nonpuerperalngalactorrhea
• Pagetsndisease
, Question nPoints: n1.0n/n1.0
5. An26-year-
oldnflightnattendantnpresentsninnfornanthirdntrimester nprenatalnvisit.nShenhasnhadnpre
natalncarensincenhernsixthnweeknofnpregnancy.nShenhasnnoncomplaintsntodaynandnher
nprenatalncourse nhasnbeennunremarkable.nTodaynher nblood npressurenandnweightnga
innarenappropriate,nandnhernurinenisnunremarkable.nYounhavenanfirst-
nyear nmedicalnstudentnshadowing nyou,nso nyounasknthe nstudentnto ngetnDoptones nandn
measurenthenpatient'snuterusninncentimeters.nThennursenpractitioner nstudentnprom
ptlynreportsnfetalnheartntonesnofn140,nbutnhenisnhavingndifficultynobtainingnthencorre
ctnmeasurement.nHenknowsnonenendnofnthentapengoesnovernthenuterinenfundus.nFro
mnwhatninferior nanatomicnpositionnshouldnthentapenbenplaced?
• Vagina
• Clitoris
• Pubicnsymphysis
• Umbilicus
Question nPoints: n1.0n/n1.0
6. An58-year-
oldngardener npresentsntonyournofficenfornevaluationnofnannewnlesionnonnhernuppernch
est.nThenlesionnappearsnto nben“stucknon”nandnisnoval,nbrown,nandnslightlynelevatednwi
thnanflatnsurface.nItnhasnanrough,nwartnlikentexturenonnpalpation.nBasednonnthisndescri
ption,nwhatnisnyournmostnlikelyndiagnosis?
• Actinicnkeratosis
• Seborrheicnkeratosis
• Basalncellncarcinoma
• Squamousncellncarcinoma
, MISSINGnANSWER
Question nPoints: n0.0n/n1.0
7. Whichnofnthenfollowingnrepresentsnage-relatednchangesninnthenlungs?
• Decreaseninnchestnwallncompliance
• Speednofnexpirationnincreases
• Increaseninnrespiratorynmusclenstrength
• Increasednelasticnrecoilnofnlungntissue
Question nPoints: n1.0n/n1.0
8. An15-month-
oldnisnbroughtnto nyounfornanfevernofn38.6ndegreesnCelsiusnandnfussiness.nThenearnexami
nationnisnasnfollows:nexternalnear,nnormalnappearancenandnno ntendernessnwithnmanipul
ation;ncanal,nnormalndiameter nwithoutnevidencenofninflammation;ntympanicnmembran
e,nbulging,nerythematous,nandnopaque.nInsufflationnisndeferrednduento npain.nWhatnisnth
enmostnlikelynconditionnhere?
• Otitisnexterna
• Cholesteatoma
• Rupturedntympanicnmembrane
• Otitisnmedia
