NR 509 PHYSICAL ASSESSMENT
CERTIFICATION EVALUATION FULL
QUESTION SET AND VERIFIED SOLUTIONS
●● 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. Deconditioning of voiding reflexes ie:
frequent voluntary voiding at low bladder volumes.
●● overflow incontinence
Answer: detrusor contractions are insufficient to overcome urethral
resistance, causing urinary retention. The bladder is typically flaccid and
CERTIFICATION EVALUATION FULL
QUESTION SET AND VERIFIED SOLUTIONS
●● 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. Deconditioning of voiding reflexes ie:
frequent voluntary voiding at low bladder volumes.
●● overflow incontinence
Answer: detrusor contractions are insufficient to overcome urethral
resistance, causing urinary retention. The bladder is typically flaccid and
