NUR-634 FINAL EXAM TEST PREP
g g g g
1. Yougaregexamininggangelderlygmangandgnoticegthegfollowing:gDecreasedgvibrati
ongsensegingthegfeetgandgankles,gdiminishedggaggreflex,grightgpatellargreflexgless
gthangthegleft,gandgdiminishedgabdominalgreflexes.gWhichgofgthesegisgabnormal
?
• Decreasedgvibrationgsense
• Diminishedggaggreflex
• Diminishedgrightgpatellargreflexgcomparedgtogthegleft
• Diminishedgabdominalgreflexes
QuestiongPoints:g1.0g/g1.0
2. Ag68-year-
oldgretiredgfarmergpresentsgtogyourgofficegforgevaluationgofgagskinglesion.gOngthegrig
htgtemporalgareagofgthegforehead,gyougseegagflattenedgpapulegthegsamegcolorgasghisg
skin,gcoveredgbygagdrygscalegthatgisgroundgandgfeelsghard.gHeghasgseveralgmoregofgt
hesegscatteredgongthegforehead,garms,gandglegs.gBasedgongthisgdescription,gwhatgisg
yourgmostglikelygdiagnosis?
• Actinicgkeratosis
• Seborrheicgkeratosis
• Basalgcellgcarcinoma
• Squamousgcellgcarcinoma
QuestiongPoints:g1.0g/g1.0
3. Ag14-year-
oldgjuniorghighgschoolgstudentgisgbroughtgingbyghisgmothergandgfathergbecausegh
egseemsgtogbegdevelopinggbreasts.gThegmothergisgupsetgbecausegshegreadgongtheg
Internetgthatgsmokinggmarijuanagleadsgtogbreastgenlargementgingmales.gThe
, younggmangadamantlygdeniesgusingganygtobacco,galcohol,gorgdrugs.gHeghasgrecently
gnoticedgchangesginghisgpenis,gtesticles,gandgpubicghairgpattern.gOtherwise,ghisgpast
gmedicalghistorygisgunremarkable.gHisgparentsgaregbothginggoodghealth.gHeghasgtwo
goldergbrothersgwhogneverghadgthisgproblem.gOngexamination,gyougseegagmildlygov
erweightgteenagergwithgenlargedgbreastgtissuegthatgisgslightlygtendergongbothgsides
.gOtherwiseghisgexaminationgisgnormal.gHegisgagreeablegtogtakinggagdruggtest.gWhat
gisgthegmostglikelygcausegofghisggynecomastia?
• Breastgcancer
• Imbalancegofghormonesgofgpuberty
• Drugguse
• Alcoholguse
QuestiongPoints:g1.0g/g1.0
4. Ag17-year-
oldgfemalegpresentsgtogyourgoffice,gcomplaininggofgagcleargdischargegfromghergrightg
breastgforg2gmonths.gShegstatesgthatgshegnoticedgitgwhengshegandghergboyfriendgwe
reg“messinggaround”gandghegsqueezedghergnipple.gShegcontinuesgtoghavegthisgdischa
rgeganytimegshegsqueezesgthatgnipple.gShegdeniesganygtraumagtoghergbreasts.gHergp
astgmedicalghistorygisgunremarkable.gShegdeniesganygpregnancies.gBothgofghergpare
ntsgareghealthy.gShegdeniesgusinggtobaccogorgillegalgdrugsgandgdrinksgthreegtogfourg
beersgagweek.gOngexamination,ghergbreastsgaregsymmetricgwithgnogskingchanges.gY
ougaregablegtogexpressgcleargdischargegfromghergrightgnipple.gYougfeelgnogdiscreteg
massesgandghergaxillaegaregnormal.gThegremaindergofghergheart,glung,gabdominal,ga
ndgpelvicgexaminationsgaregunremarkable.gAgurinegpregnancygtestgisgnegative.
Whatgcausegofgnipplegdischargegisgthegmostglikelyginghergcircumstance?
• Benigngbreastgabnormality
• Breastgcancer
• Nonpuerperalg galactorrhea
• Pagetsgdisease
, QuestiongPoints:g1.0g/g1.0
5. Ag26-year-
oldgflightgattendantgpresentsgingforgagthirdgtrimestergprenatalgvisit.gSheghasghadgpr
enatalgcaregsinceghergsixthgweekgofgpregnancy.gSheghasgnogcomplaintsgtodaygandg
hergprenatalgcourseghasgbeengunremarkable.gTodayghergbloodgpressuregandgweig
htggaingaregappropriate,gandghergurinegisgunremarkable.gYoughavegagfirst-
gyeargmedicalgstudentgshadowinggyou,gsogyougaskgthegstudentgtoggetgDoptonesgan
dgmeasuregthegpatient'sguterusgingcentimeters.gThegnursegpractitionergstudentgpr
omptlygreportsgfetalgheartgtonesgofg140,gbutghegisghavinggdifficultygobtaininggtheg
correctgmeasurement.gHegknowsgonegendgofgthegtapeggoesgovergtheguterinegfundu
s.gFromgwhatginferiorganatomicgpositiongshouldgthegtapegbegplaced?
• Vagina
• Clitoris
• Pubicgsymphysis
• Umbilicus
QuestiongPoints:g1.0g/g1.0
6. Ag58-year-
oldggardenergpresentsgtogyourgofficegforgevaluationgofgagnewglesiongonghergupperg
chest.gTheglesiongappearsgtogbeg“stuckgon”gandgisgoval,gbrown,gandgslightlygelevate
dgwithgagflatgsurface.gItghasgagrough,gwartglikegtexturegongpalpation.gBasedgongthisg
description,gwhatgisgyourgmostglikelygdiagnosis?
• Actinicgkeratosis
• Seborrheicgkeratosis
• Basalgcellgcarcinoma
• Squamousgcellgcarcinoma
, MISSINGgANSWER
QuestiongPoints:g0.0g/g1.0
7. Whichgofgthegfollowinggrepresentsgage-relatedgchangesgingtheglungs?
• Decreasegingchestgwallgcompliance
• Speedgofgexpirationgincreases
• Increasegingrespiratorygmusclegstrength
• Increasedgelasticgrecoilgofglunggtissue
QuestiongPoints:g1.0g/g1.0
8. Ag15-month-
oldgisgbroughtgtogyougforgagfevergofg38.6gdegreesgCelsiusgandgfussiness.gThegeargexa
minationgisgasgfollows:gexternalgear,gnormalgappearancegandgnogtendernessgwithgma
nipulation;gcanal,gnormalgdiametergwithoutgevidencegofginflammation;gtympanicgme
mbrane,gbulging,gerythematous,gandgopaque.gInsufflationgisgdeferredgduegtogpain.gW
hatgisgthegmostglikelygconditionghere?
• Otitisgexterna
• Cholesteatoma
• Rupturedgtympanicgmembrane
• Otitisgmedia
g g g g
1. Yougaregexamininggangelderlygmangandgnoticegthegfollowing:gDecreasedgvibrati
ongsensegingthegfeetgandgankles,gdiminishedggaggreflex,grightgpatellargreflexgless
gthangthegleft,gandgdiminishedgabdominalgreflexes.gWhichgofgthesegisgabnormal
?
• Decreasedgvibrationgsense
• Diminishedggaggreflex
• Diminishedgrightgpatellargreflexgcomparedgtogthegleft
• Diminishedgabdominalgreflexes
QuestiongPoints:g1.0g/g1.0
2. Ag68-year-
oldgretiredgfarmergpresentsgtogyourgofficegforgevaluationgofgagskinglesion.gOngthegrig
htgtemporalgareagofgthegforehead,gyougseegagflattenedgpapulegthegsamegcolorgasghisg
skin,gcoveredgbygagdrygscalegthatgisgroundgandgfeelsghard.gHeghasgseveralgmoregofgt
hesegscatteredgongthegforehead,garms,gandglegs.gBasedgongthisgdescription,gwhatgisg
yourgmostglikelygdiagnosis?
• Actinicgkeratosis
• Seborrheicgkeratosis
• Basalgcellgcarcinoma
• Squamousgcellgcarcinoma
QuestiongPoints:g1.0g/g1.0
3. Ag14-year-
oldgjuniorghighgschoolgstudentgisgbroughtgingbyghisgmothergandgfathergbecausegh
egseemsgtogbegdevelopinggbreasts.gThegmothergisgupsetgbecausegshegreadgongtheg
Internetgthatgsmokinggmarijuanagleadsgtogbreastgenlargementgingmales.gThe
, younggmangadamantlygdeniesgusingganygtobacco,galcohol,gorgdrugs.gHeghasgrecently
gnoticedgchangesginghisgpenis,gtesticles,gandgpubicghairgpattern.gOtherwise,ghisgpast
gmedicalghistorygisgunremarkable.gHisgparentsgaregbothginggoodghealth.gHeghasgtwo
goldergbrothersgwhogneverghadgthisgproblem.gOngexamination,gyougseegagmildlygov
erweightgteenagergwithgenlargedgbreastgtissuegthatgisgslightlygtendergongbothgsides
.gOtherwiseghisgexaminationgisgnormal.gHegisgagreeablegtogtakinggagdruggtest.gWhat
gisgthegmostglikelygcausegofghisggynecomastia?
• Breastgcancer
• Imbalancegofghormonesgofgpuberty
• Drugguse
• Alcoholguse
QuestiongPoints:g1.0g/g1.0
4. Ag17-year-
oldgfemalegpresentsgtogyourgoffice,gcomplaininggofgagcleargdischargegfromghergrightg
breastgforg2gmonths.gShegstatesgthatgshegnoticedgitgwhengshegandghergboyfriendgwe
reg“messinggaround”gandghegsqueezedghergnipple.gShegcontinuesgtoghavegthisgdischa
rgeganytimegshegsqueezesgthatgnipple.gShegdeniesganygtraumagtoghergbreasts.gHergp
astgmedicalghistorygisgunremarkable.gShegdeniesganygpregnancies.gBothgofghergpare
ntsgareghealthy.gShegdeniesgusinggtobaccogorgillegalgdrugsgandgdrinksgthreegtogfourg
beersgagweek.gOngexamination,ghergbreastsgaregsymmetricgwithgnogskingchanges.gY
ougaregablegtogexpressgcleargdischargegfromghergrightgnipple.gYougfeelgnogdiscreteg
massesgandghergaxillaegaregnormal.gThegremaindergofghergheart,glung,gabdominal,ga
ndgpelvicgexaminationsgaregunremarkable.gAgurinegpregnancygtestgisgnegative.
Whatgcausegofgnipplegdischargegisgthegmostglikelyginghergcircumstance?
• Benigngbreastgabnormality
• Breastgcancer
• Nonpuerperalg galactorrhea
• Pagetsgdisease
, QuestiongPoints:g1.0g/g1.0
5. Ag26-year-
oldgflightgattendantgpresentsgingforgagthirdgtrimestergprenatalgvisit.gSheghasghadgpr
enatalgcaregsinceghergsixthgweekgofgpregnancy.gSheghasgnogcomplaintsgtodaygandg
hergprenatalgcourseghasgbeengunremarkable.gTodayghergbloodgpressuregandgweig
htggaingaregappropriate,gandghergurinegisgunremarkable.gYoughavegagfirst-
gyeargmedicalgstudentgshadowinggyou,gsogyougaskgthegstudentgtoggetgDoptonesgan
dgmeasuregthegpatient'sguterusgingcentimeters.gThegnursegpractitionergstudentgpr
omptlygreportsgfetalgheartgtonesgofg140,gbutghegisghavinggdifficultygobtaininggtheg
correctgmeasurement.gHegknowsgonegendgofgthegtapeggoesgovergtheguterinegfundu
s.gFromgwhatginferiorganatomicgpositiongshouldgthegtapegbegplaced?
• Vagina
• Clitoris
• Pubicgsymphysis
• Umbilicus
QuestiongPoints:g1.0g/g1.0
6. Ag58-year-
oldggardenergpresentsgtogyourgofficegforgevaluationgofgagnewglesiongonghergupperg
chest.gTheglesiongappearsgtogbeg“stuckgon”gandgisgoval,gbrown,gandgslightlygelevate
dgwithgagflatgsurface.gItghasgagrough,gwartglikegtexturegongpalpation.gBasedgongthisg
description,gwhatgisgyourgmostglikelygdiagnosis?
• Actinicgkeratosis
• Seborrheicgkeratosis
• Basalgcellgcarcinoma
• Squamousgcellgcarcinoma
, MISSINGgANSWER
QuestiongPoints:g0.0g/g1.0
7. Whichgofgthegfollowinggrepresentsgage-relatedgchangesgingtheglungs?
• Decreasegingchestgwallgcompliance
• Speedgofgexpirationgincreases
• Increasegingrespiratorygmusclegstrength
• Increasedgelasticgrecoilgofglunggtissue
QuestiongPoints:g1.0g/g1.0
8. Ag15-month-
oldgisgbroughtgtogyougforgagfevergofg38.6gdegreesgCelsiusgandgfussiness.gThegeargexa
minationgisgasgfollows:gexternalgear,gnormalgappearancegandgnogtendernessgwithgma
nipulation;gcanal,gnormalgdiametergwithoutgevidencegofginflammation;gtympanicgme
mbrane,gbulging,gerythematous,gandgopaque.gInsufflationgisgdeferredgduegtogpain.gW
hatgisgthegmostglikelygconditionghere?
• Otitisgexterna
• Cholesteatoma
• Rupturedgtympanicgmembrane
• Otitisgmedia
