NR 509 FINAL EXAM QUESTION AND ANSWERS

NR 509 FINAL EXAM QUESTION AND
ANSWERS



Suspicious breast mass - ans--A mobile mass that becomes fixed when the arm relaxes
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ais attached to the ribs and intercostal muscles; if fixed when the hand is pressed
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aagainst the hip, it is attached to the pectoral fascia.
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-Hard irregular poorly circumscribed nodules, fixed to the skin or underlying tissues,
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astrongly suggest cancer a a




Risk for Breast cancer - ans---*Age*
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-family history of breast/ovarian CA
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- inherited genetic mutations,
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-personal history of breast cancer a a a a a


- high levels of endogenous hormones
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- breast tissue density
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- proliferative lesions with atypia on breast biopsy, - duration of unopposed estrogen
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aexposure related to early menarche a a a a


-age of first full-term pregnancy
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- late menopause.
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- breastfeeding for less than 1 year,
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- postmenopausal obesity
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-cigarette smoking, alcohol ingestion, a a a a


- physical inactivity, and type of contraception.
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Characteristics of a breast cyst - ans-Soft to firm, round, mobile, often tender. a a a a a a a a a a a a




The best way to examine the lateral portion of the breast - ans--Have pt roll onto the
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aopposite hip a


-place her hand on her forehead.
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- keep shoulders pressed against the bed
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-palpate in the axilla, moving in a straight line down to the bra line, then move the
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afingers medially and palpate in a vertical strip up the chest to the clavicle. Continue in
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avertical overlapping strips until you reach the nipple
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Bacterial Vaginosis (BV) - ans--Caused by overgrowth of anaerobic bacteria (often from
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asex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the vaginal walls,
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ausually not profuse, may be minimala a a a a


- Fishy/musty genital odor
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, -Normal vulva and vaginal mucosa a a a a


-Scan saline wet mount for clue cells (epithelial cells with stippled borders); sniff for
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afishy odor after applying KOH ("whiff test"); test the vaginal secretions for pH > 4.5
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Candidal Vaginitis - ans--Cause: Candida albicans, a yeast (normal overgrowth of
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avaginal flora); many factors predispose, including antibiotic therapy
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-Discharge: white and curdy, may be thin but usually thick, not as profuse as
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atrichomonal infection, not malodorous a a a


- vaginal soreness, pruritus, pain on urination, dyspareunia (painful intercourse)
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-The vulva and surrounding skin are inflamed and sometimes swollen to a variable
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aextent; the vaginal mucosa is reddened, with white tenacious patches of discharge; the
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amucosa may bleed when these patches are scraped off; in mild cases, the mucosa
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alooks normal a


-Scan potassium hydroxide (KOH) preparation for the branching hyphae of Candida
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Trichomonal Vaginitis - ans--Trichomonas vaginalis, a protozoan; often but not always
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aacquired sexually a


- Discharge:Yellowish green or gray, possibly frothy; often profuse and pooled in the
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avaginal fornix; may be malodorous a a a a


-Pruritus (though not usually as severe as with Candida
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infection); pain on urination (from skin inflammation or possibly urethritis); dyspareunia
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-Vestibule and labia minora may be erythematous; the vaginal mucosa may be diffusely
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areddened, with small red granular spots or petechiae in the posterior fornix; in mild
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acases, the mucosa looks normal a a a a


- Scan saline wet mount for trichomonads
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Syphillis - ans-This ulcerated papule with an indurated edge usually appears after 3 to 6
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weeks of incubating infection from the spirochete Treponema pallidum. These lesions
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may resemble a carcinoma or crusted cold sore. Similar primary lesions are common in
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the pharynx, anus, and vagina but may escape detection since they are painless,
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nonsuppurative, and usually heal spontaneously in 3 to 6 weeks. Wear gloves during
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palpation since these chancres are infectious.
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s/s of epididymitis - ans-Acute: swollen, and notably tender, making it difficult to
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distinguish from the testis. The scrotum may be reddened and the vas deferens
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inflamed.
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Chronic: firm enlargement of the epididymis, which is sometimes tender, with thickening
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or beading of the vas deferens.
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Genital Warts (Condylomata Acuminata) - ans--Single or multiple papules or plaques of
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avariable shapes; may be round, acuminate (pointed), or thin and slender. May be
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araised, flat, or cauliflower-like (verrucous).
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-Causative organism: HPV, usually subtypes 6, 11; carcinogenic subtypes rare,
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aapproximately 5-10% of all anogenital warts. Incubation: weeks to months; infected a a a a a a a a a a


acontact may have no visible warts. a a a a a