NR 509 Final Exam Test Questions and Answers
Breast Exam
Answer: -5-7 days after the first day of menstruation
-Inspect for symmetry, contours, and retractions
-Palpitation with patient supine with arm above head
-Palpate in ladder pattern, circular motion for each location
Lactation
Answer: -Physiological secretion with pregnancy, lactation, chest wall stimulation, sleep and stress.
Montgomery glands
Answer: sebaceous glands that secrete a protective lipid substance during lactation
Galactorrhea
Answer: a milky discharge from the nipple unrelated to normal breast feeding
Mammary souffle
Answer: "puff of air" heard during pregnancy and lactation (venous hum)
Breast Cancer
Answer: -Redness
-Peau d'orange: thickening and prominent pores
-Flattening instead of normal convexity
-Asymmetry
-Change in nipple direction
-Paget disease: rash, scaling, ulceration of nipple and areola
Breast cancer risk factors
Answer: -Increasing age
-First degree family member
-Genetic mutations (BRCA1 & BRCA2)
-Personal history of precancerous breast mass
-Denser breast (confirmed by a mammogram)
-High dose radiation exposure
-High levels estrogen hormones
Abdominal Exam
Answer: Inspection-contours
Auscultation-bowel sounds/bruits
Percussion-liver size, dullness or tympany in colon
Palpation-liver size, splenomegaly, masses in colon (fecal matter, cancer, diverticulitis)
Special maneuvers- murphy (gallbladder), appendix tests
Abdominal Pain: Visceral
Answer: Hollow abdominal organs forcefully contract or distention
-nonspecific, difficult to localize
,-Gnawing, cramping, aching
-Sweating, pallor, nausea, vomiting, restlessness
Abdominal Pain: Somatic/parietal
Answer: Inflammation of the parietal peritoneum
-localized or diffuse
-Steady and aching pain, more severe than visceral
-Aggravated by movement or coughing
GERD
Answer: -Rising retrosternal burning pain or discomfort
-Aggravated by certain foods (alcohol, chocolate, citrus, coffee. onions, peppermint) and positional
changes (supine or bending forward)
-Coughing after eating or laying down
Risk factor for Barretts's esophagus
Answer: Esophageal cancer
PUD
Answer: Common causes: H.Pylori and NSAIDs
Pain after meals (2-3 hr delay for duodenal)
GERD
Hematemesis
Melena
Treat with PPI, H2RA, antacids
Appendicitis
Answer: McBurney's point: tenderness on direct palpation
Rovsing: rebound tenderness when palpating LLQ
Psoas: raise thigh (flexion), contracts psoas muscle
Obturator: flex the right thigh at the hip, bend knee, rotate leg internally, contracts obturator muscle
Rectal exam: right side rectal tenderness
Pelvic exam: palpable appendix through the pelvis
May also presents with leukocytosis, high fever, nausea, vomiting, bowel changes
Diverticulitis
Answer: Diverticulosis: benign form (pockets only)
LLQ pain, rebound tenderness
Constipation (abdominal mass)
Leukocytosis
Hematochezia
Hepatitis A
Answer: fecal/oral route, usually not chronic
Hepatitis B
Answer: Injection, contact with body fluid
, Hepatitis C
Answer: Injection, blood transfusion (most prevalent chronic bloodborne disease)
Alcohol hepatitis=
Answer: alcoholic cirrhosis
Cholecystitis
Answer: -Intermittent pain caused by obstruction, blockage, or back up at the bile system.
-Usually related to gallstones
-Liver assessment (palpitation and percussion to determine size)
-Murphy's sign for cholecystitis
IBS (irritable bowel syndrome)
Answer: -Mucous in stool
-Bloating
-Changes in frequency/consistency of stools
-Diagnosis of exclusion, intermittent pain for at least 12 weeks over a year, relief with defecation,
changes in stool frequency and consistency
-Commonly associated with food intolerances
IBD (inflammatory bowel disease)
Answer: -Mucous in stool
-Bloating
-Pain with defecation
-Chronic diarrhea
-Hematochezia
-Anal fissures-Crohn's
-Colonoscopy shows skip lesion or cobblestoning (Crohn), continuous inflammation (UC)
-Strong family link
Colon Cancer
Answer: -Changes in stool
-Palpable mass (late stage)
-Pencil-thin stools
-Hematochezia
-(+) Cologuard/fecal tests=colonoscopy
Risk factors for colon cancer
Answer: -African American
-Men
-Elderly
-IBD
-Family history
-Inactivity
-Low fiber diet
-Obesity
-Alcohol
-Cigarette smoking
Breast Exam
Answer: -5-7 days after the first day of menstruation
-Inspect for symmetry, contours, and retractions
-Palpitation with patient supine with arm above head
-Palpate in ladder pattern, circular motion for each location
Lactation
Answer: -Physiological secretion with pregnancy, lactation, chest wall stimulation, sleep and stress.
Montgomery glands
Answer: sebaceous glands that secrete a protective lipid substance during lactation
Galactorrhea
Answer: a milky discharge from the nipple unrelated to normal breast feeding
Mammary souffle
Answer: "puff of air" heard during pregnancy and lactation (venous hum)
Breast Cancer
Answer: -Redness
-Peau d'orange: thickening and prominent pores
-Flattening instead of normal convexity
-Asymmetry
-Change in nipple direction
-Paget disease: rash, scaling, ulceration of nipple and areola
Breast cancer risk factors
Answer: -Increasing age
-First degree family member
-Genetic mutations (BRCA1 & BRCA2)
-Personal history of precancerous breast mass
-Denser breast (confirmed by a mammogram)
-High dose radiation exposure
-High levels estrogen hormones
Abdominal Exam
Answer: Inspection-contours
Auscultation-bowel sounds/bruits
Percussion-liver size, dullness or tympany in colon
Palpation-liver size, splenomegaly, masses in colon (fecal matter, cancer, diverticulitis)
Special maneuvers- murphy (gallbladder), appendix tests
Abdominal Pain: Visceral
Answer: Hollow abdominal organs forcefully contract or distention
-nonspecific, difficult to localize
,-Gnawing, cramping, aching
-Sweating, pallor, nausea, vomiting, restlessness
Abdominal Pain: Somatic/parietal
Answer: Inflammation of the parietal peritoneum
-localized or diffuse
-Steady and aching pain, more severe than visceral
-Aggravated by movement or coughing
GERD
Answer: -Rising retrosternal burning pain or discomfort
-Aggravated by certain foods (alcohol, chocolate, citrus, coffee. onions, peppermint) and positional
changes (supine or bending forward)
-Coughing after eating or laying down
Risk factor for Barretts's esophagus
Answer: Esophageal cancer
PUD
Answer: Common causes: H.Pylori and NSAIDs
Pain after meals (2-3 hr delay for duodenal)
GERD
Hematemesis
Melena
Treat with PPI, H2RA, antacids
Appendicitis
Answer: McBurney's point: tenderness on direct palpation
Rovsing: rebound tenderness when palpating LLQ
Psoas: raise thigh (flexion), contracts psoas muscle
Obturator: flex the right thigh at the hip, bend knee, rotate leg internally, contracts obturator muscle
Rectal exam: right side rectal tenderness
Pelvic exam: palpable appendix through the pelvis
May also presents with leukocytosis, high fever, nausea, vomiting, bowel changes
Diverticulitis
Answer: Diverticulosis: benign form (pockets only)
LLQ pain, rebound tenderness
Constipation (abdominal mass)
Leukocytosis
Hematochezia
Hepatitis A
Answer: fecal/oral route, usually not chronic
Hepatitis B
Answer: Injection, contact with body fluid
, Hepatitis C
Answer: Injection, blood transfusion (most prevalent chronic bloodborne disease)
Alcohol hepatitis=
Answer: alcoholic cirrhosis
Cholecystitis
Answer: -Intermittent pain caused by obstruction, blockage, or back up at the bile system.
-Usually related to gallstones
-Liver assessment (palpitation and percussion to determine size)
-Murphy's sign for cholecystitis
IBS (irritable bowel syndrome)
Answer: -Mucous in stool
-Bloating
-Changes in frequency/consistency of stools
-Diagnosis of exclusion, intermittent pain for at least 12 weeks over a year, relief with defecation,
changes in stool frequency and consistency
-Commonly associated with food intolerances
IBD (inflammatory bowel disease)
Answer: -Mucous in stool
-Bloating
-Pain with defecation
-Chronic diarrhea
-Hematochezia
-Anal fissures-Crohn's
-Colonoscopy shows skip lesion or cobblestoning (Crohn), continuous inflammation (UC)
-Strong family link
Colon Cancer
Answer: -Changes in stool
-Palpable mass (late stage)
-Pencil-thin stools
-Hematochezia
-(+) Cologuard/fecal tests=colonoscopy
Risk factors for colon cancer
Answer: -African American
-Men
-Elderly
-IBD
-Family history
-Inactivity
-Low fiber diet
-Obesity
-Alcohol
-Cigarette smoking
