NR 509 Final Exam Test Question and Answers
Suspicious breast mass
Answer: -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
Risk for Breast cancer
Answer: --*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.
Characteristics of a breast cyst
Answer: Soft to firm, round, mobile, often tender.
The best way to examine the lateral portion of the breast
Answer: -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
Bacterial Vaginosis (BV)
Answer: -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
Candidal Vaginitis
Answer: -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
- vaginal soreness, pruritus, pain on urination, dyspareunia (painful intercourse)
-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
Trichomonal Vaginitis
Answer: -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
Syphillis
Answer: 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 lesions 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 infectious.
s/s of epididymitis
Answer: 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.
Genital Warts (Condylomata Acuminata)
Answer: -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.
Risk for prostate CA
Answer: Age, ethnicity, and family history are the strongest risk factors for prostate cancer.
s/s prostatitis
Answer: -fever
-frequency, urgency, dysuria, incomplete voiding,
-sometimes low back pain
- gland feels tender, swollen, "boggy," and warm
Suspicious breast mass
Answer: -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
Risk for Breast cancer
Answer: --*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.
Characteristics of a breast cyst
Answer: Soft to firm, round, mobile, often tender.
The best way to examine the lateral portion of the breast
Answer: -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
Bacterial Vaginosis (BV)
Answer: -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
Candidal Vaginitis
Answer: -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
- vaginal soreness, pruritus, pain on urination, dyspareunia (painful intercourse)
-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
Trichomonal Vaginitis
Answer: -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
Syphillis
Answer: 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 lesions 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 infectious.
s/s of epididymitis
Answer: 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.
Genital Warts (Condylomata Acuminata)
Answer: -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.
Risk for prostate CA
Answer: Age, ethnicity, and family history are the strongest risk factors for prostate cancer.
s/s prostatitis
Answer: -fever
-frequency, urgency, dysuria, incomplete voiding,
-sometimes low back pain
- gland feels tender, swollen, "boggy," and warm
