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Exam (elaborations)

(Answered corrcetly) NR509 Final Exam Solution Guide 2022.

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(Answered corrcetly) NR509 Final Exam Solution Guide 2022.

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NR 509 Final Exam


1. -A mobile mass that becomes fixed when the arm relaxes is attached to
the ribs and intercostal muscles; if fixed when the hand is pressed against
the hip, it is attached to the pectoral fascia.
-Hard irregular poorly circumscribed nodules, fixed to the skin or underlying
tissues, strongly suggest cancer: Suspicious breast mass
2. --*Age*
-family history of breast/ovarian CA
- inherited genetic mutations,
-personal history of breast cancer
- high levels of endogenous hormones
- breast tissue density
- proliferative lesions with atypia on breast biopsy, - duration of
unopposed estrogen exposure related to early menarche
-age of first full-term pregnancy
- late menopause.
- breastfeeding for less than 1 year,
- postmenopausal obesity
-cigarette smoking, alcohol ingestion,
- physical inactivity, and type of contraception.: Risk for Breast cancer
3. Soft to firm, round, mobile, often tender.: Characteristics of a breast cyst
4. -Have pt roll onto the opposite hip
-place her hand on her forehead.
- keep shoulders pressed against the bed
-palpate in the axilla, moving in a straight line down to the bra line, then
move the fingers medially and palpate in a vertical strip up the chest to the
clavicle. Continue in vertical overlapping strips until you reach the nipple:
The best way to examine the lateral portion of the breast
5. -Caused by overgrowth of anaerobic bacteria (often from sex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the
vaginal walls, usually not profuse, may be minimal
- Fishy/musty genital odor
-Normal vulva and vaginal mucosa
-Scan saline wet mount for clue cells (epithelial cells with stippled borders);
sniff for fishy odor after applying KOH ("whiff test"); test the vaginal
secretions for pH > 4.5: Bacterial Vaginosis (BV)
6. -Cause: Candida albicans, a yeast (normal overgrowth of vaginal
flora); many factors predispose, including antibiotic therapy
-Discharge: white and curdy, may be thin but usually thick, not as profuse
as trichomonal infection, not malodorous
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, NR 509 Final Exam

- vaginal soreness, pruritus, pain on urination, dyspareunia (painful
inter- course)
-The vulva and surrounding skin are inflamed and sometimes swollen to a
variable extent; the vaginal mucosa is reddened, with white tenacious
patches of discharge; the mucosa may bleed when these patches are
scraped off; in mild cases, the mucosa looks normal
-Scan potassium hydroxide (KOH) preparation for the branching hyphae
of Candida: Candidal Vaginitis
7. -Trichomonas vaginalis, a protozoan; often but not always acquired
sexually
- Discharge:Yellowish green or gray, possibly frothy; often profuse and
pooled in the vaginal fornix; may be malodorous
-Pruritus (though not usually as severe as with Candida
infection); pain on urination (from skin inflammation or possibly
urethritis); dyspareunia
-Vestibule and labia minora may be erythematous; the vaginal mucosa may
be diffusely reddened, with small red granular spots or petechiae in the
posterior fornix; in mild cases, the mucosa looks normal
- Scan saline wet mount for trichomonads: Trichomonal Vaginitis
8. This ulcerated papule with an indurated edge usually appears after 3 to 6
weeks of incubating infection from the spirochete Treponema pallidum.
These lesions may resemble a carcinoma or crusted cold sore. Similar
primary le- sions are common in the pharynx, anus, and vagina but may
escape detection since they are painless, nonsuppurative, and usually heal
spontaneously in 3 to 6 weeks. Wear gloves during palpation since these
chancres are infec- tious.: Syphillis
9. Acute: swollen, and notably tender, making it difficult to distinguish from
the testis. The scrotum may be reddened and the vas deferens inflamed.
Chronic: firm enlargement of the epididymis, which is sometimes tender,
with thickening or beading of the vas deferens.: s/s of epididymitis
10. -Single or multiple papules or plaques of variable shapes; may be
round, acuminate (pointed), or thin and slender. May be raised, flat, or
cauliflower-like (verrucous).
-Causative organism: HPV, usually subtypes 6, 11; carcinogenic subtypes
rare, approximately 5-10% of all anogenital warts. Incubation: weeks to
months; infected contact may have no visible warts.
-Can arise on penis, scrotum, groin, thighs, anus; usually asymptomatic,
occasionally cause itching and pain.
-May disappear without treatment.: Genital Warts (Condylomata Acuminata

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