NR 509 Final Exam Test Question and Answers
"hot potato" voice is accompanied by enlarged tonsils with exudates can be caused by?
Answer: tonsillitis can be caused by bacteria, such as Streptococcus or Staphylococcus, or viruses
aphasia
Answer: impairment of language, usually caused by left hemisphere damage either to Broca's area
(impairing speaking) or to Wernicke's area (impairing understanding).
at what age do most children walk by? run well by? pedal a tricycle?
Answer: 15 months, 2 years, 4 years
bacterial vaginosis
Answer: -bacterial overgrowth from anaerobic bacteria, often transmitted sexually
-discharge gray or white, thin, malodorous, coats vaginal walls,
-unpleasant, fishy or musty odor, occurs after intercourse
-vulva and vaginal mucosa usually appear normal
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)
Cancer of the rectum
Answer: usually firm, nodular, rolled edge.
Candid Vaginitis
Answer: -caused by candid albicans
-discharge white and curdy, may be think but usually thick, not malodorous
-pruritis, vaginal soreness, pain on urination s/t skin inflammation, dyspareunia
-vulva and surrounding skin usually inflamed
causes of urethritis in women?
Answer: c. trachomatis, and n. gonorrhoeae
,circumlocutions
Answer: when phrases and sentences are substituted for a word the person cannot think of (what you
write with, pen)
Delirium
Answer: acute, worse at night, lasts hours to weeks, disrupted sleep, general illness and/or drugs
present, disturbed LOC, hesitant/slow/rapid/incoherent speech, disorganized thought process,
immediate and recent memory impaired, delusions common
Dementia
Answer: insidious, slowly progressive, lasts months to years, fragmented sleep, general illness often
absent, LOC usually normal, difficulty finding words, flat, depressed, recent memory and new learning
impaired
Describe bipolar disorders?
Answer: present with both depressive episodes, such as in major depressive disorder (MDD), as well as
manic or hypomanic episodes. Symptoms of manic episodes include euphoric/irritable mood,
grandiosity, decreased need for sleep, talkativeness, racing thoughts, distractibility, increased goal-
directed behavior or agitation, and an increase in reckless pleasure-seeking (having unprotected sex,
spending excess money, foolish investments)
describe vascular dementia?
Answer: -vascular risk factors,
-stepwise decline
-gait changes and focal findings
Direct inguinal hernias
Answer: arise more medially due to weakness in the floor of the inguinal canal and are associated with
straining and heavy lifting
dysarthria
Answer: difficulty forming words
dysphonia
Answer: impaired volume, quality, or pitch of voice
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
Fibroadenoma and cysts mobility
Answer: very mobile/mobile
functional incontinence
Answer: 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.
,How can DM II be screened?
Answer: A1C >6.5%, fasting BG > 126, oral glucose tolerance test >200
how can you test for aphasia?
Answer: word comprehension
repetition-repeat one syllable words
naming-ask the patient to name parts of a watch
reading comprehension-ask to read paragraph out loud
writing-write a sentence
how can you test for middle ear effusion?
Answer: tympanic membrane fails to move perceptibly as you introduce positive or negative pressure
how do you assess the abdomen?
Answer: Inspect, Auscultate, Percuss, Palpate
how do you conduct a BSE?
Answer: -systemic up and down search pattern, varying palpation pressure and circular motion with
finger pads
How do you do Naegele's rule?
Answer: take LMP, add 7 days, subtract 3 months and add a year
how do you evaluate possible groin hernia?
Answer: ask the pt. to lie down if the mass disappears by returning to the abdomen itself it is likely an
indirect hernia.
how do you examine the rectum of a woman?
Answer: usually in lithotomy position after examining genitalia.
if only rectal exam needed, lateral position satisfactory
note the cervix may be palpated, through anterior rectal wall. Uterus, or tampon may be palpable as
well, don't mistake for mass
how do you know if a heart murmur in a child is benign?
Answer: no associated abnormal findings and growth regular
how do you look in the ear of a child?
Answer: pull the auricle up and out
how do you measure for the fundus of the uterus?
Answer: With a plastic or paper tape measure, locate the pubic symphysis and place the "zero" end of
the tape measure where you can firmly feel that bone. Then extend the tape measure to the very top of
uterine fundus and note the number of centimeters measured. Though subject to error between 16 and
36 weeks, measurement of the fundal height in centimeters should roughly equal the number of weeks
of gestation.
, how do you palpate for a femoral hernia?
Answer: place fingers on the anterior thigh in the region medical to the femoral canal. locate the
femoral pulse in upper portion of thigh and move medially toward the pubic tubercle and ask the
patient to strain down and cough, noting any swelling or tenderness.
how do you palpate the lateral breast?
Answer: -have the patient roll onto opposite hip, with hands on forehead and shoulders against table
-begin palpating in axilla moving in straight line down to bra line, then move medially and palpate up
vertical strip up the chest tot he clavicle
-continue vertical overlapping strips until you reach the nipple, then reposition the patient to flatten the
medial portion of the breast
how do you perform a bimanual exam?
Answer: -Lubricate the index and middle fingers of one of your gloved hands, and, from a standing
position, insert your lubricated fingers into the vagina, again exerting pressure primarily posteriorly.
Your thumb should be abducted, your third and fourth fingers flexed into your palm. Pressing inward on
the perineum with your flexed fingers causes little, if any, discomfort and allows you to position your
palpating fingers correctly. Note any lesions or tenderness in the vaginal wall, including the region of the
urethra and the bladder anteriorly.
-Stool in the rectum may simulate a rectovaginal mass, but, unlike a malignant mass, it can usually be
dented by digital pressure. Rectovaginal examination confirms the distinction.
Palpate the cervix, Normally, the cervix can be moved somewhat without pain. Feel the fornixes around
the cervix and note any nodularity, immobility, and tenderness in this area.
-Cervical motion tenderness and/or adnexal tenderness are hallmarks of PID, ectopic pregnancy, and
appendicitis.
-Nodularity, immobility, and tenderness in the fornixes may result from endometriosis.
-Palpate the uterus. Place your other hand on the lower abdomen just above the symphysis pubis. While
you elevate the cervix and uterus with your pelvic hand, press your abdominal hand in and down, trying
to grasp the uterus between your two hands Note its size, shape, consistency, and mobility, and identify
any tenderness or masses.
How is Hep B transmitted?
Answer: blood, semen, vaginal secretions
"B" for body fluids
How is hep C transferred?
Answer: mainly through percutaneous exposure, injected drug use, blood transfusion, organ transplant
prior to 1992, long term dialysis,
How is IBS diagnosed?
Answer: Exclude other causes,
-requires intermittent pain for 12 weeks of the prior 12 months with relief from defecation, change in
frequency of bowel movements, change in form of stool (loose, watery, pellet-like),
how many words can a 18 month say? how many can a 2 year old say? A 4 year old?
Answer: 10-20 words, two to three word sentances, form complex sentences
"hot potato" voice is accompanied by enlarged tonsils with exudates can be caused by?
Answer: tonsillitis can be caused by bacteria, such as Streptococcus or Staphylococcus, or viruses
aphasia
Answer: impairment of language, usually caused by left hemisphere damage either to Broca's area
(impairing speaking) or to Wernicke's area (impairing understanding).
at what age do most children walk by? run well by? pedal a tricycle?
Answer: 15 months, 2 years, 4 years
bacterial vaginosis
Answer: -bacterial overgrowth from anaerobic bacteria, often transmitted sexually
-discharge gray or white, thin, malodorous, coats vaginal walls,
-unpleasant, fishy or musty odor, occurs after intercourse
-vulva and vaginal mucosa usually appear normal
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)
Cancer of the rectum
Answer: usually firm, nodular, rolled edge.
Candid Vaginitis
Answer: -caused by candid albicans
-discharge white and curdy, may be think but usually thick, not malodorous
-pruritis, vaginal soreness, pain on urination s/t skin inflammation, dyspareunia
-vulva and surrounding skin usually inflamed
causes of urethritis in women?
Answer: c. trachomatis, and n. gonorrhoeae
,circumlocutions
Answer: when phrases and sentences are substituted for a word the person cannot think of (what you
write with, pen)
Delirium
Answer: acute, worse at night, lasts hours to weeks, disrupted sleep, general illness and/or drugs
present, disturbed LOC, hesitant/slow/rapid/incoherent speech, disorganized thought process,
immediate and recent memory impaired, delusions common
Dementia
Answer: insidious, slowly progressive, lasts months to years, fragmented sleep, general illness often
absent, LOC usually normal, difficulty finding words, flat, depressed, recent memory and new learning
impaired
Describe bipolar disorders?
Answer: present with both depressive episodes, such as in major depressive disorder (MDD), as well as
manic or hypomanic episodes. Symptoms of manic episodes include euphoric/irritable mood,
grandiosity, decreased need for sleep, talkativeness, racing thoughts, distractibility, increased goal-
directed behavior or agitation, and an increase in reckless pleasure-seeking (having unprotected sex,
spending excess money, foolish investments)
describe vascular dementia?
Answer: -vascular risk factors,
-stepwise decline
-gait changes and focal findings
Direct inguinal hernias
Answer: arise more medially due to weakness in the floor of the inguinal canal and are associated with
straining and heavy lifting
dysarthria
Answer: difficulty forming words
dysphonia
Answer: impaired volume, quality, or pitch of voice
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
Fibroadenoma and cysts mobility
Answer: very mobile/mobile
functional incontinence
Answer: 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.
,How can DM II be screened?
Answer: A1C >6.5%, fasting BG > 126, oral glucose tolerance test >200
how can you test for aphasia?
Answer: word comprehension
repetition-repeat one syllable words
naming-ask the patient to name parts of a watch
reading comprehension-ask to read paragraph out loud
writing-write a sentence
how can you test for middle ear effusion?
Answer: tympanic membrane fails to move perceptibly as you introduce positive or negative pressure
how do you assess the abdomen?
Answer: Inspect, Auscultate, Percuss, Palpate
how do you conduct a BSE?
Answer: -systemic up and down search pattern, varying palpation pressure and circular motion with
finger pads
How do you do Naegele's rule?
Answer: take LMP, add 7 days, subtract 3 months and add a year
how do you evaluate possible groin hernia?
Answer: ask the pt. to lie down if the mass disappears by returning to the abdomen itself it is likely an
indirect hernia.
how do you examine the rectum of a woman?
Answer: usually in lithotomy position after examining genitalia.
if only rectal exam needed, lateral position satisfactory
note the cervix may be palpated, through anterior rectal wall. Uterus, or tampon may be palpable as
well, don't mistake for mass
how do you know if a heart murmur in a child is benign?
Answer: no associated abnormal findings and growth regular
how do you look in the ear of a child?
Answer: pull the auricle up and out
how do you measure for the fundus of the uterus?
Answer: With a plastic or paper tape measure, locate the pubic symphysis and place the "zero" end of
the tape measure where you can firmly feel that bone. Then extend the tape measure to the very top of
uterine fundus and note the number of centimeters measured. Though subject to error between 16 and
36 weeks, measurement of the fundal height in centimeters should roughly equal the number of weeks
of gestation.
, how do you palpate for a femoral hernia?
Answer: place fingers on the anterior thigh in the region medical to the femoral canal. locate the
femoral pulse in upper portion of thigh and move medially toward the pubic tubercle and ask the
patient to strain down and cough, noting any swelling or tenderness.
how do you palpate the lateral breast?
Answer: -have the patient roll onto opposite hip, with hands on forehead and shoulders against table
-begin palpating in axilla moving in straight line down to bra line, then move medially and palpate up
vertical strip up the chest tot he clavicle
-continue vertical overlapping strips until you reach the nipple, then reposition the patient to flatten the
medial portion of the breast
how do you perform a bimanual exam?
Answer: -Lubricate the index and middle fingers of one of your gloved hands, and, from a standing
position, insert your lubricated fingers into the vagina, again exerting pressure primarily posteriorly.
Your thumb should be abducted, your third and fourth fingers flexed into your palm. Pressing inward on
the perineum with your flexed fingers causes little, if any, discomfort and allows you to position your
palpating fingers correctly. Note any lesions or tenderness in the vaginal wall, including the region of the
urethra and the bladder anteriorly.
-Stool in the rectum may simulate a rectovaginal mass, but, unlike a malignant mass, it can usually be
dented by digital pressure. Rectovaginal examination confirms the distinction.
Palpate the cervix, Normally, the cervix can be moved somewhat without pain. Feel the fornixes around
the cervix and note any nodularity, immobility, and tenderness in this area.
-Cervical motion tenderness and/or adnexal tenderness are hallmarks of PID, ectopic pregnancy, and
appendicitis.
-Nodularity, immobility, and tenderness in the fornixes may result from endometriosis.
-Palpate the uterus. Place your other hand on the lower abdomen just above the symphysis pubis. While
you elevate the cervix and uterus with your pelvic hand, press your abdominal hand in and down, trying
to grasp the uterus between your two hands Note its size, shape, consistency, and mobility, and identify
any tenderness or masses.
How is Hep B transmitted?
Answer: blood, semen, vaginal secretions
"B" for body fluids
How is hep C transferred?
Answer: mainly through percutaneous exposure, injected drug use, blood transfusion, organ transplant
prior to 1992, long term dialysis,
How is IBS diagnosed?
Answer: Exclude other causes,
-requires intermittent pain for 12 weeks of the prior 12 months with relief from defecation, change in
frequency of bowel movements, change in form of stool (loose, watery, pellet-like),
how many words can a 18 month say? how many can a 2 year old say? A 4 year old?
Answer: 10-20 words, two to three word sentances, form complex sentences
