Exam (elaborations)

NR509 / NR 509 FINAL EXAMS EXAM 2 WITH 250 LATEST UPDATED EXAM QUESTIONS AND ACCURATE ANSWERS | RATIONALES ALREADY GRADED A+ (NR 509 LATEST EXAM VERSION | BRAND NEW!!)

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NR509 / NR 509

NR509 / NR 509 FINAL EXAMS EXAM 2 WITH 250 LATEST UPDATED EXAM QUESTIONS AND ACCURATE ANSWERS | RATIONALES ALREADY GRADED A+ (NR 509 LATEST EXAM VERSION | BRAND NEW!!) An overweight 26-year-old public servant presents to the Emergency Department with 12 hours of intense abdominal pain, light-he...

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Uploaded on December 10, 2024
Number of pages 123
Written in 2024/2025
Type Exam (elaborations)
Contains Questions & answers

nr509 nr 509 final exams

Institution NR509 / NR 509
Course NR509 / NR 509

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NR509 / NR 509 FINAL EXAMS 2024-
g g g g g g

2025 EXAM 2 WITH 250 LATEST UPDATED
g g g g g g

g EXAM QUESTIONS AND ACCURATE ANS
g g g g

WERS | RATIONALES ALREADY GRADED
g g g g

g A+ (NR 509 LATEST EXAM VERSION | BRA
g g g g g g g

ND NEW!!)
g

Angoverweightg26-year-

oldgpublicgservantgpresentsgtogthegEmergencygDepartmentgwithg12ghoursgofgintensegabdo

minalgpain,glight-

headedness,gandgagfaintinggepisodegthatgfinallygpromptedghergtogseekgmedicalgattention.gS

heghasgagstronggfamilyghistorygofggallstonesgandgisgconcernedgaboutgthisgpossibility.gShegh

asgnotghadganygvomitinggorgdiarrhea.gSheghadgagnormalgbowelgmovementgthisgmorning.gHe

rgβ-humangchorionicggonadotroping(β-

hCG)gisgpositivegatgtriage.gShegreportsgthatgherglastgperiodgwasg10gweeksgago.gHergvitalgsig

nsgatgtriagegaregpulse,g118;gbloodgpressure,g86/68;grespiratorygrate,g20/min;goxygengsatura

tion,g99%;gandgtemperature,g37.3ºCgorally.gThegcliniciangperformsgangabdominalgexamgpri

orgtoghergpelvicgexamgand,gongpalpationgofghergabdomen,gfindsginvoluntarygrigiditygandgrebo

undgtenderness.gWhatgisgthegmostglikelygdiagnosis?

a.gRupturedgtubalg(orgectopic)gpregnancy

,b.gAcutegcholecystitis

c.gRupturedgappendix

d.gPerfg-gANSWER-ga.gRupturedgtubalg(orgectopic)gpregnancy

Rationale:gThegconstellationgofgabdominalgpain,gsyncope,gtachycardia,ghypotension,gpositi

vegβ-

hCG,gandgfindingsgsuggestivegofgperitonealginflammation/irritationgstronglygsuggestgagrupt

uredgectopicgpregnancygwithgsignificantgintra-

abdominalgbleedinggleadinggtogperitonealgsigns.gThisgcasegisgemergentgandgrequiresgimme

diategtreatmentgofgherghypotensiongandgpresumedgbloodglossgasgwellgasggynecologicalgcon

sultgforgemergentgsurgery

Ag63-year-

oldgjanitorgwithgaghistorygofgadenomatousgcolonicgpolypsgpresentsgforgagwellgvisit.gBasicglab

sgaregperformedgtogscreengforgdiabetesgmellitusgandgdyslipidemia.gElectrolytesgandglivergen

zymesgweregalsogmeasured.gHisglabsgaregallgnormalgexpectgforgmoderategelevationsgofgasp

artategaminotransferase,galaninegaminotransferase,gγ-

glutamylgtransferase,gandgalkalinegphosphatasegasgwellgasgagmildlygelevatedgtotalgbilirubin.

Hegpresentsgforgagfollow-
g

upgappointmentgandgthegcliniciangperformsgangabdominalgexamgtogassessghisgliver.gWhichg

ofgthegfollowinggfindingsgwouldgbegmostgconsistentgwithghepatomegaly?

a.gLivergspangofg11gcmgatgthegmidclaviculargline

b.gLivergspangofg8gcmgatgthegmidsternalgline

,c.gDullnessgtogpercussiongovergagspangofg11gcmgatgthegmidclaviculargline

d.gDullnessgtogpercussiongovergagspangofg8gcmgatgthegmidsternalgline

e.gLivergpalpableg3gcmgbelowgthegrightgcostalgmargin,gmidgclaviculargline,gongexpiratg-

ANSWER-
g

e.gLivergpalpableg3gcmgbelowgthegrightgcostalgmargin,gmidgclaviculargline,gongexpira
g

tion

Rationale:gTheglivergbeinggpalpableg3gcmgbelowgthegrightgcostalgmargin,gmidclaviculargline,g

wouldgbegconsideredgnormalgonginspirationgwhengtheglivergisgpushedgdowngintogthegabdomi

nalgcavitygonginspiration,gbutgisgabnormalgongexpiration.

Ag63-year-oldgunderweightgadministrativegclerkgwithgag50-pack-

yeargsmokingghistorygpresentsgwithgagseveralgmonthghistorygofgrecurrentgepigastricgabdomi

nalgdiscomfort.gShegfeelsgfairlygwellgotherwisegandgdeniesganygnausea,gvomiting,gdiarrhea,g

orgconstipation.gShegreportsgthatgagfirstgcousingdiedgfromgagrupturedganeurysmgatgageg68gy

ears.gHergvitalgsignsgaregpulse,g86;gbloodgpressure,g148/92;grespiratorygrate,g16;goxygengs

aturation,g95%;gandgtemperature,g36.2ºC.gHergbodygmassgindexgisg17.6.gOngexam,ghergab

dominalgaortagisgprominent,gwhichgisgconcerninggforgangabdominalgaorticganeurysmg(AAA).

WhichgofgthegfollowinggisghergmostgsignificantgriskgfactorgforgangAAA?
g

a.gFemaleggender

b.gHistorygofgsmoking

c.gUnderweight

d.gFamilyghistorygofgrupturedganeurysm

, e.gHypertensiong-gANSWER-gb.gHistorygofgsmoking

Rationale:gHistorygofgsmokinggisghergmostgsignificantgriskgfactorgforgangAAA.gMaleggender,g

notgfemaleggender,gisgconsideredgasgriskgfactor.gUnderweightgisgnotgagriskgfactorgforgAAA.gF

amilyghistorygofgrupturedganeurysmgisgvaguegandgcouldgbegagcerebralganeurysm.gFurther,gh

ergfamilyghistorygisgingagfirst-degreegcousingnotgagfirst-

degreegrelativeg(biologicgparents,gsiblings,gandgchildren).gHypertensiongcouldgcontributegto

atherosclerosis,gwhichgisgagriskgfactor.gFurther,gagdiagnosisgofghypertensiongisgnotgbasedgo
g

ngonegelevatedgbloodgpressuregreading.

Ag76-year-

oldgretiredgmangwithgaghistorygofgprostategcancergandghypertensionghasgbeengscreenedgan

nuallygforgcolongcancergusingghighgsensitivitygfecalgoccultgbloodgtestingg(FOBT).gHegpresen

tsgforgfollow-

upgofghisghypertension,gduringgwhichgthegcliniciangscansghisgchartgtogensureghegisgupgtogdat

egwithghisgpreventiveghealthgcare.gHeghasgagpositivegFOBTgongonegoccasiongatgageg66gyear

sgandgsubsequentlygwentgforgagcolonoscopy.gInternalghemorrhoidsgandgsigmoidgdiverticulig

weregfoundgongcolonoscopy.gHeghasgnogfirst-

degreegrelativesgwithgaghistorygofgcolorectalgcancergorgadenomatousgpolyps.gWhatgaregtheg

U.S.gPreventivegServicesgTaskgForceg(USPSTF)gscreeninggrecommendationsgforgthisgpati

ent?

a.gDognotgscreengroutinely

b.gContinuegannualgFOBTgscreeningguntilgageg80gyears

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Exam (elaborations)

NR509 / NR 509 FINAL EXAMS EXAM 2 WITH 250 LATEST UPDATED EXAM QUESTIONS AND ACCURATE ANSWERS | RATIONALES ALREADY GRADED A+ (NR 509 LATEST EXAM VERSION | BRAND NEW!!)

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