NR 509 Final 2022
Know that in a 47-year-old man ED is usually ___________ rather than testosterone - psychologic
Erectile dysfunction may be from psychogenic causes, especially if - 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 - 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 - very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - BSE
Breast stage 1 - preadolescent- elevation of nipple only
Breast stage 2 - breast bud stage- elevation of breast and nipple as a small mound; enlargement of
areolar diameter
breast stage 3 - further enlargement of elevation of breast and areola, with no separation of their
contours
breast stage 4 - projection of areola and nipple to form a secondary mound above the level of breast
breast stage 5 - 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 - 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 - epigastric, radiating to back
Know how hepatitis A is transmitted - 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 - 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 - 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 - detrusor contractions are insufficient to overcome urethral resistance, causing
urinary retention. The bladder is typically flaccid and large, even after an effort to void. Mechanisms:
obstruction of the bladder outlet ie: BPH or tumor. Weakness of the detrusor muscle associated with
peripheral nerve disease at S2-4 level. Impaired bladder sensation that interrupts the reflex arc ie:
diabetic neuropathy.
functional incontinence - the patient is functionally able to reach the toilet in time because of impaired
health or environmental conditions. Mechanism: problems in mobility resulting from weakness, arthritis,
poor vision, or other conditions. Also environmental factors such as an unfamiliar setting, distant
bathroom facilities, bed rails, or physical restraints.
Incontinence secondary to medications - drugs may contribute to any type of incontinence listed. Ex:
sedatives, tranquilizers, anticholinergics, sympathetic blockers, and potent diuretics
Know where lymph nodes should be with strep - · Strep throat àstreptococcal pharyngitis, bacterial
infection that may cause a sore, scratchy throat
Know that in a 47-year-old man ED is usually ___________ rather than testosterone - psychologic
Erectile dysfunction may be from psychogenic causes, especially if - 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 - 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 - very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - BSE
Breast stage 1 - preadolescent- elevation of nipple only
Breast stage 2 - breast bud stage- elevation of breast and nipple as a small mound; enlargement of
areolar diameter
breast stage 3 - further enlargement of elevation of breast and areola, with no separation of their
contours
breast stage 4 - projection of areola and nipple to form a secondary mound above the level of breast
breast stage 5 - 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 - 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 - epigastric, radiating to back
Know how hepatitis A is transmitted - 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 - 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 - 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 - detrusor contractions are insufficient to overcome urethral resistance, causing
urinary retention. The bladder is typically flaccid and large, even after an effort to void. Mechanisms:
obstruction of the bladder outlet ie: BPH or tumor. Weakness of the detrusor muscle associated with
peripheral nerve disease at S2-4 level. Impaired bladder sensation that interrupts the reflex arc ie:
diabetic neuropathy.
functional incontinence - the patient is functionally able to reach the toilet in time because of impaired
health or environmental conditions. Mechanism: problems in mobility resulting from weakness, arthritis,
poor vision, or other conditions. Also environmental factors such as an unfamiliar setting, distant
bathroom facilities, bed rails, or physical restraints.
Incontinence secondary to medications - drugs may contribute to any type of incontinence listed. Ex:
sedatives, tranquilizers, anticholinergics, sympathetic blockers, and potent diuretics
Know where lymph nodes should be with strep - · Strep throat àstreptococcal pharyngitis, bacterial
infection that may cause a sore, scratchy throat
