NU 325 FINAL EXAM QUESTIONS AND
ANSWERS
cerumen - ANSWER-- yellow, waxy material that lubricates and protects the ear
- wet, honey-brown wax → occurs in Caucasians and AA
- dry, flaky white wax → occurs in East Asians and Native Americans
Peau d'Orange - ANSWER-Breast tissue: edema exaggerates the hair follicles,
giving a "pigskin" or "orange-peel" look
when is a breast mass suspicious of cancer during an exam - ANSWER-solitary,
unilateral, nontender mass. Single focus in one area, although it may be interspersed
w/ other nodules.
Solid, hard, dense, and fixed to underlying tissues or skin as cancer becomes
invasive. Borders are irregular and poorly delineated. Grows constantly. Often
painless, although the person may have pain. Most common in upper outer
quadrant. Firm and hard irregular axillary nodes as cancer advances; skin dimpling,
nipple retraction, elevation and discharge
Know blood flow through the heart - ANSWER-inferior/superior vena cava → RA →
tricuspid valve/semilunar → RV → pulmonic valve → pulmonary artery → lungs →
pulmonary vein → LA → mitral valve → LV → aortic valve → aorta → body
orthopnea - ANSWER-difficulty of breathing when laying down
the need to be upright position to breath. *note # of pillows used
Paroxysmal nocturnal dyspnea - ANSWER-awakening from sleep w/ SOB. Pt wakes
up after 1-2 hours of sleep w/ the perception of needing fresh air (drowning
syndrome)
aortic aneurysm - ANSWER-unilateral distention of external jugular veins (JVD);
murmur is harsh, systolic, or continuous and accented w/ systole.
Marked pulsations/prominent lateral pulsations can indicate aortic aneurysm
orthostatic hypotension - ANSWER-sudden drop in systole more than 20 mmHg or
diastole more than 10 mmHg, in BP when rising to sit or stand
iliopsoas - ANSWER-- supine, lift right leg straight up, flexing at the hip, push down
over lower part of thigh as person tries to hold leg up.
- negative = pt feels no pain
- positive = pt feels pain; pain in RLQ is indicative of appendicitis
obturator - ANSWER-lift right leg, flexing at the hip, and 90 degrees at the knee.
Hold pt ankle and rotate leg internally and externally. There should be no pain; less
specific than iliopsoas test but could indicate appendicitis as well
Murphy's tests - ANSWER-Check gallbladder/cholestasis. Ask pt to take a deep
breath while palpating the right subcostal area.
, Inflammation of the gallbladder will result in pain (positive sign)
blumberg's sign - ANSWER-"rebound tenderness"
indicative to peritonitis
positive = pain on release
borborygmi - ANSWER-loud, gurgling sounds;
increased motility
early mechanical bowel obstruction (high-pitched)
gastroenteritis, brisk diarrhea, laxative used
subsiding paralytic ileus
upper GI bleeding - ANSWER-black, tarry stool due to occult blood
vomiting blood or coffee grounds
lower GI bleeding - ANSWER-bright red blood in stool
dark blood mixed with stool
how do you assess the mental status? - ANSWER-ABCT
appearance (posture, dress, grooming, hygiene) behavior (LOC, facial expression,
speech, mood) cognitive function (judgement, recent and remote memory)
thought process (thought content/perception)
flat affect - ANSWER-lack of emotional response; no expression of feeling, voice is
monotone and face immobile
epispadias - ANSWER-- dorsal location of meatus; meatus opens on the dorsal
(upper) side of the glans penis
- less common that hypospadias but more disabling b/c of associated urinary
incontinence and separation of the pubic bones
hypospadia - ANSWER-ventral location of meatus; urethral opens on the ventral
(under) side of the glans or shaft or at the penoscrotal junction. A groove extends
from the meatus to the normal location at the tip. This congenital defect is important
to recognize at birth. The newborn should not be circumcised b/c surgical correction
may need to use foreskin tissue to extend urethral length
testicular torsion - ANSWER-- spermatic cord get twisted and cuts off blood flow to
testicles. Often during sleep or following trauma
- S&S: sudden onset excruciating pain in testicle, N/V, NO fever
- obj. findings- red, swollen, one testes (usually left) is higher due to rotation and
shortening
systolic number (top #) - ANSWER-indicates how much pressure your blood is
exerting a/g your artery walls when the heart beats
diastolic number (bottom #) - ANSWER-indicates how much pressure your blood is
exerting a/g your artery walls while the heart is resting b/n beats
uvula - ANSWER-rises on phonation, midline to soft palate, CN 9 (glossopharyngeal)
ANSWERS
cerumen - ANSWER-- yellow, waxy material that lubricates and protects the ear
- wet, honey-brown wax → occurs in Caucasians and AA
- dry, flaky white wax → occurs in East Asians and Native Americans
Peau d'Orange - ANSWER-Breast tissue: edema exaggerates the hair follicles,
giving a "pigskin" or "orange-peel" look
when is a breast mass suspicious of cancer during an exam - ANSWER-solitary,
unilateral, nontender mass. Single focus in one area, although it may be interspersed
w/ other nodules.
Solid, hard, dense, and fixed to underlying tissues or skin as cancer becomes
invasive. Borders are irregular and poorly delineated. Grows constantly. Often
painless, although the person may have pain. Most common in upper outer
quadrant. Firm and hard irregular axillary nodes as cancer advances; skin dimpling,
nipple retraction, elevation and discharge
Know blood flow through the heart - ANSWER-inferior/superior vena cava → RA →
tricuspid valve/semilunar → RV → pulmonic valve → pulmonary artery → lungs →
pulmonary vein → LA → mitral valve → LV → aortic valve → aorta → body
orthopnea - ANSWER-difficulty of breathing when laying down
the need to be upright position to breath. *note # of pillows used
Paroxysmal nocturnal dyspnea - ANSWER-awakening from sleep w/ SOB. Pt wakes
up after 1-2 hours of sleep w/ the perception of needing fresh air (drowning
syndrome)
aortic aneurysm - ANSWER-unilateral distention of external jugular veins (JVD);
murmur is harsh, systolic, or continuous and accented w/ systole.
Marked pulsations/prominent lateral pulsations can indicate aortic aneurysm
orthostatic hypotension - ANSWER-sudden drop in systole more than 20 mmHg or
diastole more than 10 mmHg, in BP when rising to sit or stand
iliopsoas - ANSWER-- supine, lift right leg straight up, flexing at the hip, push down
over lower part of thigh as person tries to hold leg up.
- negative = pt feels no pain
- positive = pt feels pain; pain in RLQ is indicative of appendicitis
obturator - ANSWER-lift right leg, flexing at the hip, and 90 degrees at the knee.
Hold pt ankle and rotate leg internally and externally. There should be no pain; less
specific than iliopsoas test but could indicate appendicitis as well
Murphy's tests - ANSWER-Check gallbladder/cholestasis. Ask pt to take a deep
breath while palpating the right subcostal area.
, Inflammation of the gallbladder will result in pain (positive sign)
blumberg's sign - ANSWER-"rebound tenderness"
indicative to peritonitis
positive = pain on release
borborygmi - ANSWER-loud, gurgling sounds;
increased motility
early mechanical bowel obstruction (high-pitched)
gastroenteritis, brisk diarrhea, laxative used
subsiding paralytic ileus
upper GI bleeding - ANSWER-black, tarry stool due to occult blood
vomiting blood or coffee grounds
lower GI bleeding - ANSWER-bright red blood in stool
dark blood mixed with stool
how do you assess the mental status? - ANSWER-ABCT
appearance (posture, dress, grooming, hygiene) behavior (LOC, facial expression,
speech, mood) cognitive function (judgement, recent and remote memory)
thought process (thought content/perception)
flat affect - ANSWER-lack of emotional response; no expression of feeling, voice is
monotone and face immobile
epispadias - ANSWER-- dorsal location of meatus; meatus opens on the dorsal
(upper) side of the glans penis
- less common that hypospadias but more disabling b/c of associated urinary
incontinence and separation of the pubic bones
hypospadia - ANSWER-ventral location of meatus; urethral opens on the ventral
(under) side of the glans or shaft or at the penoscrotal junction. A groove extends
from the meatus to the normal location at the tip. This congenital defect is important
to recognize at birth. The newborn should not be circumcised b/c surgical correction
may need to use foreskin tissue to extend urethral length
testicular torsion - ANSWER-- spermatic cord get twisted and cuts off blood flow to
testicles. Often during sleep or following trauma
- S&S: sudden onset excruciating pain in testicle, N/V, NO fever
- obj. findings- red, swollen, one testes (usually left) is higher due to rotation and
shortening
systolic number (top #) - ANSWER-indicates how much pressure your blood is
exerting a/g your artery walls when the heart beats
diastolic number (bottom #) - ANSWER-indicates how much pressure your blood is
exerting a/g your artery walls while the heart is resting b/n beats
uvula - ANSWER-rises on phonation, midline to soft palate, CN 9 (glossopharyngeal)
