NR 509 Final Exam (New 2023-2024)
Advanced Physical Assessment: Chamberlain
Collage of Nursing (100% Correct Answers
,Already Graded A+)with All Questions
Answered
Tanner staging of breast development - ANS--1: preadolescent- elevation of nipple only
2: Breast bud stage: elevation of breast and nipple as a small mound; enlargement of
areolar diameter
3: Further enlargement of elevation of breast and areola, with no separation of their
contours
4: Projection of areola and nipple to form a secondary mound above the level of breast
5: Mature stage: projection of nipple only; areola has receded to general contour of the
breast (although in some normal individuals the areola continues to form a secondary
mound)
Breast masses - ANS--Most often found by women during self examination
Irregular rectal mass - ANS--Masses with irregular borders are suspicious for rectal
cancer
s/s rectal prolapse - ANS--On straining for a bowel movement, the rectal mucosa, with
or without its muscular wall, may prolapse through the anus, appearing as a doughnut
or rosette of red tissue. A prolapse involving only mucosa is relatively small and shows
radiating folds, as illustrated. When the entire bowel wall is involved, the prolapse is
larger and covered by concentrically circular folds.
Hemorrhoids vs polyps vs CA - ANS---H-(internal-prolapsed)reddish, moist, protruding
masses, (external) pain with defecation and sitting, tender, swollen, bluish, ovoid mass
is visible at the anal margin.
-P- on the stalk, or mucosal surface, soft, difficult to feel often
-C- firm, nodular, rolled edge
Erectile dysfunction - ANS--In a 47 yo male, it is most often psychologic and not
testosterone related.
s/s of proctitis - ANS--Anorectal pain, itching, tenesmus, or discharge or bleeding from
infection or rectal abscess suggest proctitis.
-anal fissures
, Forms of urinary incontinence - ANS---Stress: Increased abdominal pressure causes
bladder pressure to exceed urethral resistance—there is poor urethral sphincter tone or
poor support of bladder neck.
- Urge: urgency is followed by involuntary leakage due to uncontrolled detrusor
contractions that overcome urethral resistance.
- Overflow: neurologic disorders or anatomic obstruction from pelvic organs or the
prostate limit bladder emptying until the bladder becomes overdistended.
- Functional: patient is functionally unable to reach the toilet in time d/t impaired health
or environmental conditions
Hepatitis A transmission - ANS--fecal-oral route
Suspicious breast mass - ANS---A mobile mass that becomes fixed when the arm
relaxes is attached to the ribs and intercostal muscles; if fixed when the hand is pressed
against the hip, it is attached to the pectoral fascia.
-Hard irregular poorly circumscribed nodules, fixed to the skin or underlying tissues,
strongly suggest cancer
Risk for Breast cancer - ANS----*Age*
-family history of breast/ovarian CA
- inherited genetic mutations,
-personal history of breast cancer
- high levels of endogenous hormones
- breast tissue density
- proliferative lesions with atypia on breast biopsy, - duration of unopposed estrogen
exposure related to early menarche
-age of first full-term pregnancy
- late menopause.
- breastfeeding for less than 1 year,
- postmenopausal obesity
-cigarette smoking, alcohol ingestion,
- physical inactivity, and type of contraception.
Characteristics of a breast cyst - ANS--Soft to firm, round, mobile, often tender.
The best way to examine the lateral portion of the breast - ANS---Have pt roll onto the
opposite hip
-place her hand on her forehead.
- keep shoulders pressed against the bed
-palpate in the axilla, moving in a straight line down to the bra line, then move the
fingers medially and palpate in a vertical strip up the chest to the clavicle. Continue in
vertical overlapping strips until you reach the nipple
-Scan potassium hydroxide (KOH) preparation for the branching hyphae of Candida
Advanced Physical Assessment: Chamberlain
Collage of Nursing (100% Correct Answers
,Already Graded A+)with All Questions
Answered
Tanner staging of breast development - ANS--1: preadolescent- elevation of nipple only
2: Breast bud stage: elevation of breast and nipple as a small mound; enlargement of
areolar diameter
3: Further enlargement of elevation of breast and areola, with no separation of their
contours
4: Projection of areola and nipple to form a secondary mound above the level of breast
5: Mature stage: projection of nipple only; areola has receded to general contour of the
breast (although in some normal individuals the areola continues to form a secondary
mound)
Breast masses - ANS--Most often found by women during self examination
Irregular rectal mass - ANS--Masses with irregular borders are suspicious for rectal
cancer
s/s rectal prolapse - ANS--On straining for a bowel movement, the rectal mucosa, with
or without its muscular wall, may prolapse through the anus, appearing as a doughnut
or rosette of red tissue. A prolapse involving only mucosa is relatively small and shows
radiating folds, as illustrated. When the entire bowel wall is involved, the prolapse is
larger and covered by concentrically circular folds.
Hemorrhoids vs polyps vs CA - ANS---H-(internal-prolapsed)reddish, moist, protruding
masses, (external) pain with defecation and sitting, tender, swollen, bluish, ovoid mass
is visible at the anal margin.
-P- on the stalk, or mucosal surface, soft, difficult to feel often
-C- firm, nodular, rolled edge
Erectile dysfunction - ANS--In a 47 yo male, it is most often psychologic and not
testosterone related.
s/s of proctitis - ANS--Anorectal pain, itching, tenesmus, or discharge or bleeding from
infection or rectal abscess suggest proctitis.
-anal fissures
, Forms of urinary incontinence - ANS---Stress: Increased abdominal pressure causes
bladder pressure to exceed urethral resistance—there is poor urethral sphincter tone or
poor support of bladder neck.
- Urge: urgency is followed by involuntary leakage due to uncontrolled detrusor
contractions that overcome urethral resistance.
- Overflow: neurologic disorders or anatomic obstruction from pelvic organs or the
prostate limit bladder emptying until the bladder becomes overdistended.
- Functional: patient is functionally unable to reach the toilet in time d/t impaired health
or environmental conditions
Hepatitis A transmission - ANS--fecal-oral route
Suspicious breast mass - ANS---A mobile mass that becomes fixed when the arm
relaxes is attached to the ribs and intercostal muscles; if fixed when the hand is pressed
against the hip, it is attached to the pectoral fascia.
-Hard irregular poorly circumscribed nodules, fixed to the skin or underlying tissues,
strongly suggest cancer
Risk for Breast cancer - ANS----*Age*
-family history of breast/ovarian CA
- inherited genetic mutations,
-personal history of breast cancer
- high levels of endogenous hormones
- breast tissue density
- proliferative lesions with atypia on breast biopsy, - duration of unopposed estrogen
exposure related to early menarche
-age of first full-term pregnancy
- late menopause.
- breastfeeding for less than 1 year,
- postmenopausal obesity
-cigarette smoking, alcohol ingestion,
- physical inactivity, and type of contraception.
Characteristics of a breast cyst - ANS--Soft to firm, round, mobile, often tender.
The best way to examine the lateral portion of the breast - ANS---Have pt roll onto the
opposite hip
-place her hand on her forehead.
- keep shoulders pressed against the bed
-palpate in the axilla, moving in a straight line down to the bra line, then move the
fingers medially and palpate in a vertical strip up the chest to the clavicle. Continue in
vertical overlapping strips until you reach the nipple
-Scan potassium hydroxide (KOH) preparation for the branching hyphae of Candida
