NR 509 FINAL QUESTION WITH
VERIFIED CORRECT ANSWERS
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
correct answer-psychologic
Erectile dysfunction may be from psychogenic causes, especially if - correct 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
When performing a breast exam, know what abnormal masses should do when the arm
- correct answer-may be fixed to skin or underlying tissues (may cause dimpling of skin
or retraction when arms are lifted over head or hands are pressed against hips)
Fibroadenoma and cysts mobility - correct answer-very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - correct
answer-BSE
Breast stage 1 - correct answer-preadolescent- elevation of nipple only
Breast stage 2 - correct answer-breast bud stage- elevation of breast and nipple as a
small mound; enlargement of areolar diameter
breast stage 3 - correct answer-further enlargement of elevation of breast and areola,
with no separation of their contours
breast stage 4 - correct answer-projection of areola and nipple to form a secondary
mound above the level of breast
breast stage 5 - correct 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)
Know where pain is located with pancreatitis: acute - correct answer-epigastric, may
radiation straight to the back of other areas of the abdomen; 20% with severe sequelae
of organ failure
Know where pain is located with pancreatitis: chronic - correct answer-epigastric,
radiating to back
, Know how hepatitis A is transmitted - correct answer-Transmitted through fecal-oral
route. Fecal shedding followed by poor handwashing contaminates water and foods
leading to infection of household and sexual contacts
Stress incontinence - correct answer-the urethral sphincter is weakened so that
transient increases in intra-abdominal pressure raise the bladder pressure to levels that
exceed urethral resistance. Causes include childbirth and surgery, postmenopausal
atrophy of the mucosa, and urethral infection. May follow prostate surgery in men.
urge incontinence - correct answer-detrusor contractions are stronger than normal and
overcome the normal urethral resistance. The bladder is typically small. Mechanisms:
Decreased cortical inhibition of detrusor contractions from stroke, brain tumor,
dementia, and lesions of the spinal cord above sacral level. Also hyperexcitability of
sensory pathways ie: bladder infections, tumors, and fecal impaction. Deconditioning of
voiding reflexes ie: frequent voluntary voiding at low bladder volumes.
overflow incontinence - correct answer-detrusor contractions are insufficient to
overcome urethral resistance, causing urinary retention. The bladder is typically flaccid
and large, even after an effort to void. Mechanisms: obstruction of the bladder outlet ie:
BPH or tumor. Weakness of the detrusor muscle associated with peripheral nerve
disease at S2-4 level. Impaired bladder sensation that interrupts the reflex arc ie:
diabetic neuropathy.
functional incontinence - correct 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.
Incontinence secondary to medications - correct answer-drugs may contribute to any
type of incontinence listed. Ex: sedatives, tranquilizers, anticholinergics, sympathetic
blockers, and potent diuretics
Know where lymph nodes should be with strep - correct answer-· Strep throat
àstreptococcal pharyngitis, bacterial infection that may cause a sore, scratchy throat
· Common childhood infection has a classic presentation of erythema of the posterior
pharynx and palatal petechiae
· Enlarged swollen cervical lymph nodes -> superficial cervical lymph nodes
Superficial cervical -> superficial to the sternocleidomastoid
What vaccines are safe during pregnancy - correct answer-tdap, flu, Pneumococcal,
meningococcal, Hepatitis B, rho gam
*NOT MMR, polio, or varicella
Know what to be concerned about if you note an irregular rectal mass - correct answer-·
Any masses with irregular borders suspicious for rectal cancer
VERIFIED CORRECT ANSWERS
Know that in a 47-year-old man ED is usually ___________ rather than testosterone -
correct answer-psychologic
Erectile dysfunction may be from psychogenic causes, especially if - correct 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
When performing a breast exam, know what abnormal masses should do when the arm
- correct answer-may be fixed to skin or underlying tissues (may cause dimpling of skin
or retraction when arms are lifted over head or hands are pressed against hips)
Fibroadenoma and cysts mobility - correct answer-very mobile/mobile
Know that a high proportion of breast masses are noted during ________ - correct
answer-BSE
Breast stage 1 - correct answer-preadolescent- elevation of nipple only
Breast stage 2 - correct answer-breast bud stage- elevation of breast and nipple as a
small mound; enlargement of areolar diameter
breast stage 3 - correct answer-further enlargement of elevation of breast and areola,
with no separation of their contours
breast stage 4 - correct answer-projection of areola and nipple to form a secondary
mound above the level of breast
breast stage 5 - correct 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)
Know where pain is located with pancreatitis: acute - correct answer-epigastric, may
radiation straight to the back of other areas of the abdomen; 20% with severe sequelae
of organ failure
Know where pain is located with pancreatitis: chronic - correct answer-epigastric,
radiating to back
, Know how hepatitis A is transmitted - correct answer-Transmitted through fecal-oral
route. Fecal shedding followed by poor handwashing contaminates water and foods
leading to infection of household and sexual contacts
Stress incontinence - correct answer-the urethral sphincter is weakened so that
transient increases in intra-abdominal pressure raise the bladder pressure to levels that
exceed urethral resistance. Causes include childbirth and surgery, postmenopausal
atrophy of the mucosa, and urethral infection. May follow prostate surgery in men.
urge incontinence - correct answer-detrusor contractions are stronger than normal and
overcome the normal urethral resistance. The bladder is typically small. Mechanisms:
Decreased cortical inhibition of detrusor contractions from stroke, brain tumor,
dementia, and lesions of the spinal cord above sacral level. Also hyperexcitability of
sensory pathways ie: bladder infections, tumors, and fecal impaction. Deconditioning of
voiding reflexes ie: frequent voluntary voiding at low bladder volumes.
overflow incontinence - correct answer-detrusor contractions are insufficient to
overcome urethral resistance, causing urinary retention. The bladder is typically flaccid
and large, even after an effort to void. Mechanisms: obstruction of the bladder outlet ie:
BPH or tumor. Weakness of the detrusor muscle associated with peripheral nerve
disease at S2-4 level. Impaired bladder sensation that interrupts the reflex arc ie:
diabetic neuropathy.
functional incontinence - correct 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.
Incontinence secondary to medications - correct answer-drugs may contribute to any
type of incontinence listed. Ex: sedatives, tranquilizers, anticholinergics, sympathetic
blockers, and potent diuretics
Know where lymph nodes should be with strep - correct answer-· Strep throat
àstreptococcal pharyngitis, bacterial infection that may cause a sore, scratchy throat
· Common childhood infection has a classic presentation of erythema of the posterior
pharynx and palatal petechiae
· Enlarged swollen cervical lymph nodes -> superficial cervical lymph nodes
Superficial cervical -> superficial to the sternocleidomastoid
What vaccines are safe during pregnancy - correct answer-tdap, flu, Pneumococcal,
meningococcal, Hepatitis B, rho gam
*NOT MMR, polio, or varicella
Know what to be concerned about if you note an irregular rectal mass - correct answer-·
Any masses with irregular borders suspicious for rectal cancer
