NR509 Final Exam Complete & Already
Graded A+
A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination. She asks you privately if
her granddaughter has started puberty yet. During the examination, the NP notes asymmetric projection of the areola and
nipple of the right chest to form a secondary mound above the level of the breast. The left breast is underdeveloped. These
assessment findings are consistent with which Tanner Stage of development?
IV
Primary prevention is defined as which of the following?
Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following statements is true about
screening for breast cancer in average-risk women?
Mammography is recommended every 2 years for women aged 50-74 with insufficient evidence for screening women over the
age of 75.
Which of the following statements is true regarding recommendations by the eighth Joint National Committee (JNC8) for adults
aged 60 and older? Select all that apply.
Target blood pressure should be </= 150/90 mmHg but notes that if treatment results in SBP <140 and is "well tolerated and
without adverse effects to health or quality of live, treatment does not need to be adjusted."
In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear optimal for notable reductions in stroke,
cardiovascular events, and all-cause mortality.
Which of the following is a useful strategy when examining young children between the ages of 1 and 4?
Have the parent facilitate the exam (e.g., removing clothes, holding the child on lap).
A 26-year-old female presents to the Emergency Department with intense abdominal pain for 6 hours, light-headedness, and a
fainting episode that finally prompted her to seek medical attention. She has a history of gallstones and is concerned that she is
having another gallbladder attack. She denies nausea and vomiting, and her last normal bowel movement was this morning.
She reports that her LMP was 10 weeks ago. Vital signs: pulse 118; blood pressure, 86/68; respiratory rate, 20/min; oxygen
saturation, 99%; and temperature, 37.3ºC orally. A β-human chorionic gonadotropin (β-hCG) blood test is pending. The NP
performs an abdominal exam prior to her pelvic exam and, on palpation of her abdomen, finds involuntary rigidity and rebound
tenderness. Which of the following is the most likely etiology for these assessment findings?
,Ruptured ectopic pregnancy
A 42-year-old female presents to the office for her annual well-woman examination. She has a history of fibrocystic breast
changes since her mid-20s, so she did not report any new issues except that her right breast feels "heavier" than usual. After a
careful history and physical examination, the NP documents the following breast findings: Breasts pendulous with diffuse
fibrocystic changes. Single firm 1 × 1 cm mass, mobile, and nontender, with overlying peau d'orange appearance in the right
breast, upper outer quadrant at 11 o'clock, 2 cm from the nipple. Which of the following is the most accurate interpretation of
these findings?
These findings suggest a cyst
An NP student conducted a clinical breast examination on a 27-year-old female with a history of fibroadenomas. The NP
palpated a rubbery, mobile, nontender mass in the right breast. The mass was located 3 cm proximal to and 3 cm to the left of
the nipple. Which of the following would be the most appropriate way to document the physical assessment findings?
rubbery, mobile, nontender mass located in the right breast, in the 10:30 position from the nipple
A 24-year-old male presents to the office for evaluation of a lump under his left nipple. He reports no other symptoms, denies
trauma or injury, and reports no known family history of a first-degree relative with breast cancer. On examination, the NP
notes a firm, 2-cm mass under his areola. What is the most likely etiology for these findings?
Breast cancer
A 34-year-old female arrives at the clinic for a prenatal, second-trimester appointment. During the interview, her behavior is
concerning for intoxication, and she smells of alcohol and cigarettes. She reveals a history of intravenous drug use "10-years
ago". How should the NP counsel this patient? Select all that apply
If a pregnant patient does not intend to quit tobacco, cutting down is still considered beneficial to the pregnancy and should be
encouraged.
Pregnant women are not routinely screened for hepatitis C, but this test should be added to the panel of prenatal blood tests
for patients with a history of intravenous drug use
A 27-year-old female presents to the outpatient clinic with acute abdominal pain and uterine bleeding. Her last menstrual
period was 6-weeks ago. She and her husband have been trying to conceive for almost one year. On physical examination, the
NP palpates an ill-defined, adnexal mass in the left lower quadrant. The urine pregnancy test results are pending. Based on the
history and examination findings, what is the most likely etiology?
Ectopic pregnancy
, The NP knows measurement of growth is one of the most important indicators of infant health. Deviations may provide an early
indication of an underlying problem. What is the minimum variation that indicates a more detailed evaluation is needed?
Beyond 2 standard deviations for age range
The NP is completing the review of systems on a 4-month-old female during a routine encounter. Which statement from the
parent may indicate a cardiac problem in the infant and require a more thorough subjective history?
"It often takes the baby more than 30 minutes to finish a bottle."
A 16-year-old male presents to the clinic with a history of a congenital right upper eyelid drooping as represented in this image.
He has no complaints and denies injury or trauma. Which cranial nerve (CN) is involved in this condition?
Patient with eyelid drooping
CNIII
Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory fibers to portions of the tympanic
membrane, auditory canal, pharynx, and the posterior third of the tongue?
CN IX
The NP should suspect injury to which cranial nerve (CN) if a patient presents with complaints of photosensitivity and uneven
pupils after being struck in the eye with a baseball?
CNIII
Which of the following statements is true regarding risks and rapid recognition of suspected stroke? Select all that apply
Obesity doubles the risk of stroke even without associated glucose intolerance
Hypertension is the leading risk factor for both ischemic and hemorrhagic stroke
Graded A+
A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination. She asks you privately if
her granddaughter has started puberty yet. During the examination, the NP notes asymmetric projection of the areola and
nipple of the right chest to form a secondary mound above the level of the breast. The left breast is underdeveloped. These
assessment findings are consistent with which Tanner Stage of development?
IV
Primary prevention is defined as which of the following?
Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following statements is true about
screening for breast cancer in average-risk women?
Mammography is recommended every 2 years for women aged 50-74 with insufficient evidence for screening women over the
age of 75.
Which of the following statements is true regarding recommendations by the eighth Joint National Committee (JNC8) for adults
aged 60 and older? Select all that apply.
Target blood pressure should be </= 150/90 mmHg but notes that if treatment results in SBP <140 and is "well tolerated and
without adverse effects to health or quality of live, treatment does not need to be adjusted."
In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear optimal for notable reductions in stroke,
cardiovascular events, and all-cause mortality.
Which of the following is a useful strategy when examining young children between the ages of 1 and 4?
Have the parent facilitate the exam (e.g., removing clothes, holding the child on lap).
A 26-year-old female presents to the Emergency Department with intense abdominal pain for 6 hours, light-headedness, and a
fainting episode that finally prompted her to seek medical attention. She has a history of gallstones and is concerned that she is
having another gallbladder attack. She denies nausea and vomiting, and her last normal bowel movement was this morning.
She reports that her LMP was 10 weeks ago. Vital signs: pulse 118; blood pressure, 86/68; respiratory rate, 20/min; oxygen
saturation, 99%; and temperature, 37.3ºC orally. A β-human chorionic gonadotropin (β-hCG) blood test is pending. The NP
performs an abdominal exam prior to her pelvic exam and, on palpation of her abdomen, finds involuntary rigidity and rebound
tenderness. Which of the following is the most likely etiology for these assessment findings?
,Ruptured ectopic pregnancy
A 42-year-old female presents to the office for her annual well-woman examination. She has a history of fibrocystic breast
changes since her mid-20s, so she did not report any new issues except that her right breast feels "heavier" than usual. After a
careful history and physical examination, the NP documents the following breast findings: Breasts pendulous with diffuse
fibrocystic changes. Single firm 1 × 1 cm mass, mobile, and nontender, with overlying peau d'orange appearance in the right
breast, upper outer quadrant at 11 o'clock, 2 cm from the nipple. Which of the following is the most accurate interpretation of
these findings?
These findings suggest a cyst
An NP student conducted a clinical breast examination on a 27-year-old female with a history of fibroadenomas. The NP
palpated a rubbery, mobile, nontender mass in the right breast. The mass was located 3 cm proximal to and 3 cm to the left of
the nipple. Which of the following would be the most appropriate way to document the physical assessment findings?
rubbery, mobile, nontender mass located in the right breast, in the 10:30 position from the nipple
A 24-year-old male presents to the office for evaluation of a lump under his left nipple. He reports no other symptoms, denies
trauma or injury, and reports no known family history of a first-degree relative with breast cancer. On examination, the NP
notes a firm, 2-cm mass under his areola. What is the most likely etiology for these findings?
Breast cancer
A 34-year-old female arrives at the clinic for a prenatal, second-trimester appointment. During the interview, her behavior is
concerning for intoxication, and she smells of alcohol and cigarettes. She reveals a history of intravenous drug use "10-years
ago". How should the NP counsel this patient? Select all that apply
If a pregnant patient does not intend to quit tobacco, cutting down is still considered beneficial to the pregnancy and should be
encouraged.
Pregnant women are not routinely screened for hepatitis C, but this test should be added to the panel of prenatal blood tests
for patients with a history of intravenous drug use
A 27-year-old female presents to the outpatient clinic with acute abdominal pain and uterine bleeding. Her last menstrual
period was 6-weeks ago. She and her husband have been trying to conceive for almost one year. On physical examination, the
NP palpates an ill-defined, adnexal mass in the left lower quadrant. The urine pregnancy test results are pending. Based on the
history and examination findings, what is the most likely etiology?
Ectopic pregnancy
, The NP knows measurement of growth is one of the most important indicators of infant health. Deviations may provide an early
indication of an underlying problem. What is the minimum variation that indicates a more detailed evaluation is needed?
Beyond 2 standard deviations for age range
The NP is completing the review of systems on a 4-month-old female during a routine encounter. Which statement from the
parent may indicate a cardiac problem in the infant and require a more thorough subjective history?
"It often takes the baby more than 30 minutes to finish a bottle."
A 16-year-old male presents to the clinic with a history of a congenital right upper eyelid drooping as represented in this image.
He has no complaints and denies injury or trauma. Which cranial nerve (CN) is involved in this condition?
Patient with eyelid drooping
CNIII
Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory fibers to portions of the tympanic
membrane, auditory canal, pharynx, and the posterior third of the tongue?
CN IX
The NP should suspect injury to which cranial nerve (CN) if a patient presents with complaints of photosensitivity and uneven
pupils after being struck in the eye with a baseball?
CNIII
Which of the following statements is true regarding risks and rapid recognition of suspected stroke? Select all that apply
Obesity doubles the risk of stroke even without associated glucose intolerance
Hypertension is the leading risk factor for both ischemic and hemorrhagic stroke
