NR 509 FINAL EXAM LEARNING WORKBOOK
2026 HEAD TO TOE PHYSICAL ASSESSMENT
AND SYSTEMS REVIEW
◉ Erectile dysfunction may be from psychogenic causes, especially
if.
Answer: early 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.
Answer: may 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.
Answer: very mobile/mobile
◉ Know that a high proportion of breast masses are noted during
________.
Answer: BSE
,◉ Breast stage 1.
Answer: preadolescent- elevation of nipple only
◉ Breast stage 2.
Answer: breast bud stage- elevation of breast and nipple as a small
mound; enlargement of areolar diameter
◉ breast stage 3.
Answer: further enlargement of elevation of breast and areola, with
no separation of their contours
◉ breast stage 4.
Answer: projection of areola and nipple to form a secondary mound
above the level of breast
◉ breast stage 5.
Answer: mature 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.
, Answer: epigastric, 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.
Answer: epigastric, radiating to back
◉ Know how hepatitis A is transmitted.
Answer: Transmitted through fecal-oral route. Fecal shedding
followed by poor handwashing contaminates water and foods
leading to infection of household and sexual contacts
◉ Stress incontinence.
Answer: the 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.
Answer: detrusor 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.
2026 HEAD TO TOE PHYSICAL ASSESSMENT
AND SYSTEMS REVIEW
◉ Erectile dysfunction may be from psychogenic causes, especially
if.
Answer: early 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.
Answer: may 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.
Answer: very mobile/mobile
◉ Know that a high proportion of breast masses are noted during
________.
Answer: BSE
,◉ Breast stage 1.
Answer: preadolescent- elevation of nipple only
◉ Breast stage 2.
Answer: breast bud stage- elevation of breast and nipple as a small
mound; enlargement of areolar diameter
◉ breast stage 3.
Answer: further enlargement of elevation of breast and areola, with
no separation of their contours
◉ breast stage 4.
Answer: projection of areola and nipple to form a secondary mound
above the level of breast
◉ breast stage 5.
Answer: mature 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.
, Answer: epigastric, 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.
Answer: epigastric, radiating to back
◉ Know how hepatitis A is transmitted.
Answer: Transmitted through fecal-oral route. Fecal shedding
followed by poor handwashing contaminates water and foods
leading to infection of household and sexual contacts
◉ Stress incontinence.
Answer: the 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.
Answer: detrusor 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.
