NU 325 Final Exam Chamberlain College of Nursing Comprehensive Health Assessment
Review Questions & Answers
epispadias |- |answersMeatus |opens |on |the |dorsal |(upper) |side |of |glans |or |shaft |above |a |broad, |spade-
xzlike |penis. |Rare; |less |common |than |hypospadias |but |more |disabling |because |of |associated |urinary |
incontinence |and |separation |of |pubic |bones.
hypospadia |- |answers(1 |in |300 |baby |boys) |a |congenital |disorder |of |the |urethra |in |which |the |urethral |
meatus |opens |on |the |ventral |(under) |side |of |the |glans |or |shaft; |about |90% |of |openings |are |on |or |
near |the |head |of |the |penis |with |a |groove |extending |from |the |meatus |to |the |expected |location |at |the |
tip; |shiny |tissue |extends |from |the |meatus |to |the |tip |and |the |foreskin |is |not |fully |developed, |leaving |
the |ventral |side |of |the |glans |uncovered; |circumcision |can |proceed |if |parents |desire |this; |surgical |
correction |of |hypospadias |can |be |at |age |3 |months |or |older
testicular |torsion |- |answersexcruciating |unilateral |pain |in |testicle |of |sudden |onset, |often |during |sleep |
or |following |trauma; |may |also |have |lower |abdominal |pain, |nausea |and |vomiting, |no |fever
Inspection: |red, |swollen |scrotum, |one |testis |(usually |left); |higher |owing |to |rotation |and |shortening
Palpation: |cord |feels |thick, |swollen, |tender; |epididymis |may |be |anterior; |cremasteric |reflex |absent |on |
side |of |torsion; |sudden |twisting |of |spermatic |cord; |occurs |late |in |childhood, |early |adolescence; |rare |
after |age |of |20 |years; |torsion |usually |on |left |side; |faulty |anchoring |of |testis |on |wall |of |scrotum |allows |
testis |to |rotate; |the |anterior |testis |rotates |medially |toward |the |other |testis; |blood |supply |is |cut |off, |
resulting |in |ischemia |and |engorgement; |an |emergency |requiring |surgery; |testis |can |become |
gangrenous |in |a |few |hours
epidiymitis |- |answerssevere |pain |of |sudden |onset |in |scrotum, |relieved |by |elevation |(positive |Prehn |
sign); |also |rapid |swelling, |fever
Inspection: |enlarged |scrotum; |reddened
Palpation: |exquisitely |tender; |epididymis |enlarged, |indurated; |hard |to |distinguish |from |testis; |
overlying |scrotal |skin |may |be |thick |and |edematous
Laboratory: |white |blood |cells |and |bacteria |in |urine
-tender |swelling |of |epididymis
acute |infection |of |epididymis |commonly |caused |by |prostatitis; |after |prostatectomy |because |of |trauma
|of |urethral |instrumentation; |or |from |chlamydia, |gonorrhea, |or |other |bacterial |infection; |often |difficult
|to |distinguish |between |epididymitis |and |testicular |torsion
priapism |- |answersprolonged |painful |erection |of |penis |without |sexual |stimulation |and |unrelieved |by |
intercourse |or |masturbation; |when |lasting |4 |hours |or |longer |can |cause |ischemia |of |penis, |fibrosis |of |
tissue, |erectile |dysfunction; |can |occur |as |a |rare |side |effect |of |drugs |for |ercitite |dysfunction |and |street
|drugs; |with |sickle-cell |trait |or |disease; |with |leukemia |in |which |excess |white |blood |cells |produce |
,engorgement; |with |malignancy; |from |local |trauma; |or |as |a |result |of |spinal |cord |injuries |with |
autonomic |nervous |system |dysfunction
Where |does |sperm |production |occur? |- |answersseminiferous |tubules |of |the |testes
Know |the |check |off |guidelines |for |neuro: |how |do |you |perform |the |test, |what |are |you |looking |for, |
what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |answersLOOK |AT |CHECKOFF
|SHEET
How |do |you |assess |the |mental |status? |- |answers
What |is |a |flat |affect? |- |answersa |lack |of |emotional |responsiveness
Know |the |check |off |guidelines |for |cardiac: |how |do |you |perform |the |test, |what |are |you |looking |for, |
what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |answersLook |at |checkoff |
sheet
Know |blood |flow |through |the |heart |- |answers
orthopnea |- |answersdifficulty |breathing |when |supine; |the |need |to |assume |a |more |upright |position |to |
breathe |state |the |number |of |pillows |needed |to |achieve |comfort |(ex: |two-pillow |orthopnea)
paroxysmal |nocturnal |dyspnea |- |answersawakened |from |sleep |with |shortness |of |breath |and |needing |
to |be |upright |to |achieve |comfort; |occurs |with |heart |failure; |lying |down |increases |volume |of |
intrathoracic |blood, |and |the |weakened |heart |cannot |accommodate |the |increased |load; |typically |the |
person |awakens |after |2 |hours |of |sleep |with |the |perception |of |needing |fresh |air
-diaphoresis
-cyanosis |signals |hypoxia
aortic |aneurysim |- |answersmore |than |95% |of |these |are |located |below |the |renal |arteries |and |extend |
to |the |umbilicus; |a |focal |bulging |>5 |cm |is |palpable |in |about |80% |of |cases |during |routine |physical |
examination |and |feels |like |a |pulsating |mass |in |the |upper |abdomen |just |to |the |left |of |midline; |you |will
|hear |a |bruit; |femoral |pulses |are |present |but |decreased
orthostatic |hypertension |- |answersa |sudden |drop |in |BP |when |rising |to |sit |or |stand
Know |the |check |off |guidelines |for |abdomen: |how |do |you |perform |the |test, |what |are |you |looking |for, |
what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |answersCHECKOFF |SHEET
Iliopsoas |muscle |test |- |answersperform |when |acute |abdominal |pain |of |the |appendix |is |suspected |- |
while |the |person |is |supine, |lift |the |right |leg |straight |up, |flexing |at |the |hip, |then |push |down |over |the |
lower |part |of |the |right |thigh |as |the |person |tries |to |hold |the |leg |up. |When |the |test |is |negative, |a |
person |feels |no |change.
Obuturator |sign |- |answerslift |the |person's |right |leg, |flexing |at |the |hip, |90 |degrees |at |the |knee; |hold |
their |ankle, |and |rotate |the |leg |internally |and |externally; |there |should |be |no |pain; |this |test |is |less |
specific |and |a |positive |test |would |produce |pain |and |can |indicate |appendicitis
, murphy's |sign |- |answersHold |your |fingers |under |the |liver |border, |ask |the |person |to |take |a |deep |
breath. |- |a |normal |response |is |to |complete |the |deep |breath |without |pain. |This |sign |is |less |accurate |in
|patients |older |than |60 |- |25% |of |them |have |no |abdominal |tenderness
Blumberg |Sign: |Rebound |Test |- |answerschoose |a |site |remote |from |the |painful |area, |hold |you |hand |90
|degrees, |or |perpendicular |to |the |abdomen, |push |down |slowly |and |deeply, |then |lift |up |quickly |- |this |
makes |structures |that |are |independent |by |palpation |rebound |suddenly |- |pain |is |a |positive |test |- |
perform |at |end |of |exam |because |it |can |cause |severe |pain |and |muscle |rigidity
-tenderness |in |the |RLQ |- |Blumberg's |sign |- |may |indicate |appendicitis
boroborygmus |- |answersLoud, |gurgling |sounds |increased |by |motility
What |is |the |appearance |of |blood |when |it |occurs |in |the |lower |GI |tract? |- |answersStool |may |have |red |
blood |from |lower |GI |bleeding |or |bleeding |around |the |anus
What |is |the |appearance |of |blood |when |it |occurs |in |the |upper |GI |tract? |- |answersBlack |stools |may |be |
tarry |due |to |occult |blood |(melena) |from |upper |GI |tract
Chadwick's |sign |- |answersbluish, |purplish |discoloration |and |congested |look |of |the |vaginal |wall |and |
cervix |from |increased |vascularity |and |engorgement; |cyanosis |of |vaginal |mucosa |and |cervix; |can |occur |
in |pregnancy
recommended |weight |gain |in |pregnancy |- |answers25-35lbs |unless |overweight |before |pregnancy |(i |
didn't |find |this |in |the |book)
estimating |delivery |date |- |answers-280 |days |from |the |first |day |of |the |last |menstrual |period, |may |be |
calculated |by |using |Nägele's |rule, |that |is, |determine |the |first |day |of |the |last |normal |menstrual |period |
(normal |in |timing, |length, |premenstrual |symptoms, |and |amount |of |flow |and |cramping). |Using |the |first
|day |of |the |LMP, |add |7 |days, |and |subtract |3 |months. |This |date |is |it.
Know |the |check |off |guidelines |head |and |neck |in |regards |to |the |eye: |how |do |you |perform |the |test, |
what |are |you |looking |for, |what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |
answerscheckoff |sheet
strabismus |- |answers(squint, |crossed |eye); |causes |deconjugate |vision |because |one |eye |deviates |off |
the |fixation |point; |to |avoid |diplopia |or |unclear |images, |the |brain |begins |to |suppress |data |from |the |
weak |eye |(a |suppression |scotoma), |causing |visual |acuity |in |this |otherwise |normal |eye |to |begin |to |
deteriorate |from |disuse; |early |recognition |and |treatment |are |essential |to |restore |binocular |vision; |
diagnosis |after |6 |years |has |a |poor |prognosis; |test |malalignment |by |the |corneal |light |reflex |and |the |
cover |test; |screen |between |age |3 |& |5
anisocoria |- |answersunequal |pupil |size; |this |exist |normally |in |5% |of |the |population, |however, |consider
|central |nervous |system |disease
Know |the |check |off |guidelines |for |respiratory: |how |do |you |perform |the |test, |what |are |you |looking |
for, |what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |answerscheckoff |sheet
angle |of |louis |- |answersthe |articulation |of |the |manubrium |and |body |of |the |sternum, |continuous |with |
the |second |rib; |useful |place |to |start |counting |ribs, |which |helps |localize |a |respiratory |finding |
Review Questions & Answers
epispadias |- |answersMeatus |opens |on |the |dorsal |(upper) |side |of |glans |or |shaft |above |a |broad, |spade-
xzlike |penis. |Rare; |less |common |than |hypospadias |but |more |disabling |because |of |associated |urinary |
incontinence |and |separation |of |pubic |bones.
hypospadia |- |answers(1 |in |300 |baby |boys) |a |congenital |disorder |of |the |urethra |in |which |the |urethral |
meatus |opens |on |the |ventral |(under) |side |of |the |glans |or |shaft; |about |90% |of |openings |are |on |or |
near |the |head |of |the |penis |with |a |groove |extending |from |the |meatus |to |the |expected |location |at |the |
tip; |shiny |tissue |extends |from |the |meatus |to |the |tip |and |the |foreskin |is |not |fully |developed, |leaving |
the |ventral |side |of |the |glans |uncovered; |circumcision |can |proceed |if |parents |desire |this; |surgical |
correction |of |hypospadias |can |be |at |age |3 |months |or |older
testicular |torsion |- |answersexcruciating |unilateral |pain |in |testicle |of |sudden |onset, |often |during |sleep |
or |following |trauma; |may |also |have |lower |abdominal |pain, |nausea |and |vomiting, |no |fever
Inspection: |red, |swollen |scrotum, |one |testis |(usually |left); |higher |owing |to |rotation |and |shortening
Palpation: |cord |feels |thick, |swollen, |tender; |epididymis |may |be |anterior; |cremasteric |reflex |absent |on |
side |of |torsion; |sudden |twisting |of |spermatic |cord; |occurs |late |in |childhood, |early |adolescence; |rare |
after |age |of |20 |years; |torsion |usually |on |left |side; |faulty |anchoring |of |testis |on |wall |of |scrotum |allows |
testis |to |rotate; |the |anterior |testis |rotates |medially |toward |the |other |testis; |blood |supply |is |cut |off, |
resulting |in |ischemia |and |engorgement; |an |emergency |requiring |surgery; |testis |can |become |
gangrenous |in |a |few |hours
epidiymitis |- |answerssevere |pain |of |sudden |onset |in |scrotum, |relieved |by |elevation |(positive |Prehn |
sign); |also |rapid |swelling, |fever
Inspection: |enlarged |scrotum; |reddened
Palpation: |exquisitely |tender; |epididymis |enlarged, |indurated; |hard |to |distinguish |from |testis; |
overlying |scrotal |skin |may |be |thick |and |edematous
Laboratory: |white |blood |cells |and |bacteria |in |urine
-tender |swelling |of |epididymis
acute |infection |of |epididymis |commonly |caused |by |prostatitis; |after |prostatectomy |because |of |trauma
|of |urethral |instrumentation; |or |from |chlamydia, |gonorrhea, |or |other |bacterial |infection; |often |difficult
|to |distinguish |between |epididymitis |and |testicular |torsion
priapism |- |answersprolonged |painful |erection |of |penis |without |sexual |stimulation |and |unrelieved |by |
intercourse |or |masturbation; |when |lasting |4 |hours |or |longer |can |cause |ischemia |of |penis, |fibrosis |of |
tissue, |erectile |dysfunction; |can |occur |as |a |rare |side |effect |of |drugs |for |ercitite |dysfunction |and |street
|drugs; |with |sickle-cell |trait |or |disease; |with |leukemia |in |which |excess |white |blood |cells |produce |
,engorgement; |with |malignancy; |from |local |trauma; |or |as |a |result |of |spinal |cord |injuries |with |
autonomic |nervous |system |dysfunction
Where |does |sperm |production |occur? |- |answersseminiferous |tubules |of |the |testes
Know |the |check |off |guidelines |for |neuro: |how |do |you |perform |the |test, |what |are |you |looking |for, |
what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |answersLOOK |AT |CHECKOFF
|SHEET
How |do |you |assess |the |mental |status? |- |answers
What |is |a |flat |affect? |- |answersa |lack |of |emotional |responsiveness
Know |the |check |off |guidelines |for |cardiac: |how |do |you |perform |the |test, |what |are |you |looking |for, |
what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |answersLook |at |checkoff |
sheet
Know |blood |flow |through |the |heart |- |answers
orthopnea |- |answersdifficulty |breathing |when |supine; |the |need |to |assume |a |more |upright |position |to |
breathe |state |the |number |of |pillows |needed |to |achieve |comfort |(ex: |two-pillow |orthopnea)
paroxysmal |nocturnal |dyspnea |- |answersawakened |from |sleep |with |shortness |of |breath |and |needing |
to |be |upright |to |achieve |comfort; |occurs |with |heart |failure; |lying |down |increases |volume |of |
intrathoracic |blood, |and |the |weakened |heart |cannot |accommodate |the |increased |load; |typically |the |
person |awakens |after |2 |hours |of |sleep |with |the |perception |of |needing |fresh |air
-diaphoresis
-cyanosis |signals |hypoxia
aortic |aneurysim |- |answersmore |than |95% |of |these |are |located |below |the |renal |arteries |and |extend |
to |the |umbilicus; |a |focal |bulging |>5 |cm |is |palpable |in |about |80% |of |cases |during |routine |physical |
examination |and |feels |like |a |pulsating |mass |in |the |upper |abdomen |just |to |the |left |of |midline; |you |will
|hear |a |bruit; |femoral |pulses |are |present |but |decreased
orthostatic |hypertension |- |answersa |sudden |drop |in |BP |when |rising |to |sit |or |stand
Know |the |check |off |guidelines |for |abdomen: |how |do |you |perform |the |test, |what |are |you |looking |for, |
what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |answersCHECKOFF |SHEET
Iliopsoas |muscle |test |- |answersperform |when |acute |abdominal |pain |of |the |appendix |is |suspected |- |
while |the |person |is |supine, |lift |the |right |leg |straight |up, |flexing |at |the |hip, |then |push |down |over |the |
lower |part |of |the |right |thigh |as |the |person |tries |to |hold |the |leg |up. |When |the |test |is |negative, |a |
person |feels |no |change.
Obuturator |sign |- |answerslift |the |person's |right |leg, |flexing |at |the |hip, |90 |degrees |at |the |knee; |hold |
their |ankle, |and |rotate |the |leg |internally |and |externally; |there |should |be |no |pain; |this |test |is |less |
specific |and |a |positive |test |would |produce |pain |and |can |indicate |appendicitis
, murphy's |sign |- |answersHold |your |fingers |under |the |liver |border, |ask |the |person |to |take |a |deep |
breath. |- |a |normal |response |is |to |complete |the |deep |breath |without |pain. |This |sign |is |less |accurate |in
|patients |older |than |60 |- |25% |of |them |have |no |abdominal |tenderness
Blumberg |Sign: |Rebound |Test |- |answerschoose |a |site |remote |from |the |painful |area, |hold |you |hand |90
|degrees, |or |perpendicular |to |the |abdomen, |push |down |slowly |and |deeply, |then |lift |up |quickly |- |this |
makes |structures |that |are |independent |by |palpation |rebound |suddenly |- |pain |is |a |positive |test |- |
perform |at |end |of |exam |because |it |can |cause |severe |pain |and |muscle |rigidity
-tenderness |in |the |RLQ |- |Blumberg's |sign |- |may |indicate |appendicitis
boroborygmus |- |answersLoud, |gurgling |sounds |increased |by |motility
What |is |the |appearance |of |blood |when |it |occurs |in |the |lower |GI |tract? |- |answersStool |may |have |red |
blood |from |lower |GI |bleeding |or |bleeding |around |the |anus
What |is |the |appearance |of |blood |when |it |occurs |in |the |upper |GI |tract? |- |answersBlack |stools |may |be |
tarry |due |to |occult |blood |(melena) |from |upper |GI |tract
Chadwick's |sign |- |answersbluish, |purplish |discoloration |and |congested |look |of |the |vaginal |wall |and |
cervix |from |increased |vascularity |and |engorgement; |cyanosis |of |vaginal |mucosa |and |cervix; |can |occur |
in |pregnancy
recommended |weight |gain |in |pregnancy |- |answers25-35lbs |unless |overweight |before |pregnancy |(i |
didn't |find |this |in |the |book)
estimating |delivery |date |- |answers-280 |days |from |the |first |day |of |the |last |menstrual |period, |may |be |
calculated |by |using |Nägele's |rule, |that |is, |determine |the |first |day |of |the |last |normal |menstrual |period |
(normal |in |timing, |length, |premenstrual |symptoms, |and |amount |of |flow |and |cramping). |Using |the |first
|day |of |the |LMP, |add |7 |days, |and |subtract |3 |months. |This |date |is |it.
Know |the |check |off |guidelines |head |and |neck |in |regards |to |the |eye: |how |do |you |perform |the |test, |
what |are |you |looking |for, |what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |
answerscheckoff |sheet
strabismus |- |answers(squint, |crossed |eye); |causes |deconjugate |vision |because |one |eye |deviates |off |
the |fixation |point; |to |avoid |diplopia |or |unclear |images, |the |brain |begins |to |suppress |data |from |the |
weak |eye |(a |suppression |scotoma), |causing |visual |acuity |in |this |otherwise |normal |eye |to |begin |to |
deteriorate |from |disuse; |early |recognition |and |treatment |are |essential |to |restore |binocular |vision; |
diagnosis |after |6 |years |has |a |poor |prognosis; |test |malalignment |by |the |corneal |light |reflex |and |the |
cover |test; |screen |between |age |3 |& |5
anisocoria |- |answersunequal |pupil |size; |this |exist |normally |in |5% |of |the |population, |however, |consider
|central |nervous |system |disease
Know |the |check |off |guidelines |for |respiratory: |how |do |you |perform |the |test, |what |are |you |looking |
for, |what |are |normal |and |abnormal |results, |what |could |the |results |indicate? |- |answerscheckoff |sheet
angle |of |louis |- |answersthe |articulation |of |the |manubrium |and |body |of |the |sternum, |continuous |with |
the |second |rib; |useful |place |to |start |counting |ribs, |which |helps |localize |a |respiratory |finding |
