NR 509 FINAL EXAM WITH CORRECT
QUESTIONS AND ANSWERS 2025
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
CORRECT-ANSWERSpsychologic
Erectile dysfunction may be from psychogenic causes, especially if - CORRECT-
ANSWERSearly 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 -
CORRECT-ANSWERSmay 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 - CORRECT-ANSWERSvery mobile/mobile
Know that a high proportion of breast masses are noted during ________ - CORRECT-
ANSWERSBSE
Breast stage 1 - CORRECT-ANSWERSpreadolescent- elevation of nipple only
Breast stage 2 - CORRECT-ANSWERSbreast bud stage- elevation of breast and nipple
as a small mound; enlargement of areolar diameter
breast stage 3 - CORRECT-ANSWERSfurther enlargement of elevation of breast and
areola, with no separation of their contours
breast stage 4 - CORRECT-ANSWERSprojection of areola and nipple to form a
secondary mound above the level of breast
, breast stage 5 - CORRECT-ANSWERSmature 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 - CORRECT-ANSWERSepigastric,
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 - CORRECT-
ANSWERSepigastric, radiating to back
Know how hepatitis A is transmitted - CORRECT-ANSWERSTransmitted through fecal-
oral route. Fecal shedding followed by poor handwashing contaminates water and foods
leading to infection of household and sexual contacts
Stress incontinence - CORRECT-ANSWERSthe 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 - CORRECT-ANSWERSdetrusor 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 - CORRECT-ANSWERSdetrusor 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 - CORRECT-ANSWERSthe 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 - CORRECT-ANSWERSdrugs 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 - CORRECT-ANSWERS· 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 - CORRECT-ANSWERStdap, 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 - CORRECT-
ANSWERS· Any masses with irregular borders suspicious for rectal cancer
QUESTIONS AND ANSWERS 2025
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
CORRECT-ANSWERSpsychologic
Erectile dysfunction may be from psychogenic causes, especially if - CORRECT-
ANSWERSearly 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 -
CORRECT-ANSWERSmay 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 - CORRECT-ANSWERSvery mobile/mobile
Know that a high proportion of breast masses are noted during ________ - CORRECT-
ANSWERSBSE
Breast stage 1 - CORRECT-ANSWERSpreadolescent- elevation of nipple only
Breast stage 2 - CORRECT-ANSWERSbreast bud stage- elevation of breast and nipple
as a small mound; enlargement of areolar diameter
breast stage 3 - CORRECT-ANSWERSfurther enlargement of elevation of breast and
areola, with no separation of their contours
breast stage 4 - CORRECT-ANSWERSprojection of areola and nipple to form a
secondary mound above the level of breast
, breast stage 5 - CORRECT-ANSWERSmature 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 - CORRECT-ANSWERSepigastric,
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 - CORRECT-
ANSWERSepigastric, radiating to back
Know how hepatitis A is transmitted - CORRECT-ANSWERSTransmitted through fecal-
oral route. Fecal shedding followed by poor handwashing contaminates water and foods
leading to infection of household and sexual contacts
Stress incontinence - CORRECT-ANSWERSthe 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 - CORRECT-ANSWERSdetrusor 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 - CORRECT-ANSWERSdetrusor 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 - CORRECT-ANSWERSthe 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 - CORRECT-ANSWERSdrugs 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 - CORRECT-ANSWERS· 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 - CORRECT-ANSWERStdap, 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 - CORRECT-
ANSWERS· Any masses with irregular borders suspicious for rectal cancer
