NR 509 FINAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) 2025 LATEST
UPDATED AGRADE
Question 1
Which of the following characteristics of a breast mass would strongly suggest cancer?
A) Soft, firm, mobile, and often tender mass.
B) A mobile mass that becomes fixed when the arm relaxes, but moves with pectoral fascia.
C) Hard, irregular, poorly circumscribed nodules, fixed to the skin or underlying tissues.
D) A cyst that is round, mobile, and tender.
E) A mass that disappears and reappears with the menstrual cycle.
Correct Answer: C) Hard, irregular, poorly circumscribed nodules, fixed to the skin or
underlying tissues.
Rationale: Malignant breast masses are typically described as hard, irregular, poorly
circumscribed (indistinct borders), and fixed to the skin or underlying tissues (such as the
ribs, intercostal muscles, or pectoral fascia). Mobile, soft, round, tender masses are more
characteristic of benign conditions like cysts or fibroadenomas.
Question 2
Which of the following is considered a significant risk factor for breast cancer?
A) Breastfeeding for more than 1 year.
B) Early menarche and late menopause.
C) Personal history of ovarian cysts.
D) Postmenopausal weight loss.
E) Low levels of endogenous hormones.
Correct Answer: B) Early menarche and late menopause.
Rationale: Risk factors for breast cancer include age, family history, inherited genetic
mutations, personal history of breast cancer, high levels of endogenous hormones, breast
tissue density, proliferative lesions with atypia on biopsy, duration of unopposed estrogen
exposure (related to early menarche and late menopause), age of first full-term pregnancy,
breastfeeding for less than 1 year, postmenopausal obesity, cigarette smoking, alcohol
ingestion, physical inactivity, and type of contraception. Early menarche and late
menopause increase the lifetime exposure to estrogen, which is a risk factor.
Question 3
Which of the following best describes the characteristics of a typical breast cyst?
A) Hard, irregular, non-mobile, and non-tender.
B) Soft to firm, round, mobile, and often tender.
C) Fixed to the chest wall, with dimpling of the skin.
D) Poorly circumscribed, with associated nipple discharge.
E) Only found in postmenopausal women.
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Correct Answer: B) Soft to firm, round, mobile, and often tender.
Rationale: Breast cysts are commonly described as soft to firm, round, mobile masses that
are often tender, especially before menstruation. They are typically well-defined and can
vary in size.
Question 4
To effectively examine the lateral portion of the breast, which positioning technique should the
nurse instruct the patient to use?
A) Have the patient lie supine with arms at her sides.
B) Have the patient sit upright with arms raised above her head.
C) Have the patient roll onto the opposite hip, place her hand on her forehead, and press
shoulders against the bed.
D) Have the patient lean forward with arms extended.
E) Palpate while the patient is standing, with arms relaxed.
Correct Answer: C) Have the patient roll onto the opposite hip, place her hand on her
forehead, and press shoulders against the bed.
Rationale: This specific positioning (rolling onto the opposite hip, hand on forehead,
shoulders pressed against the bed) is designed to flatten the breast tissue and bring the
lateral portion into better palpation range, allowing for a thorough examination in vertical
overlapping strips from the axilla down to the bra line and up to the clavicle.
Question 5
A patient presents with a gray or white, thin, homogenous, malodorous vaginal discharge that
coats the vaginal walls, especially noticeable after sexual intercourse. Vaginal pH is > 4.5. On
wet mount, clue cells are seen, and a "whiff test" is positive. These findings are consistent with:
A) Candidal Vaginitis.
B) Trichomonal Vaginitis.
C) Bacterial Vaginosis (BV).
D) Gonorrhea.
E) Chlamydia.
Correct Answer: C) Bacterial Vaginosis (BV).
Rationale: The description perfectly matches the classic presentation and diagnostic criteria
for Bacterial Vaginosis (BV): malodorous (fishy/musty) gray-white discharge, vaginal pH >
4.5, and the presence of clue cells on a saline wet mount, with a positive whiff test.
Question 6
A patient complains of vaginal soreness, pruritus, and dyspareunia. On examination, the vulva
and surrounding skin are inflamed, and the vaginal mucosa is reddened with white, tenacious
patches of discharge. A KOH preparation reveals branching hyphae. These findings are
characteristic of:
A) Bacterial Vaginosis (BV).
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B) Trichomonal Vaginitis.
C) Candidal Vaginitis.
D) Atrophic Vaginitis.
E) Herpes Simplex Virus.
Correct Answer: C) Candidal Vaginitis.
Rationale: The symptoms of vaginal soreness, pruritus, dyspareunia, inflamed vulva,
reddened vaginal mucosa with white tenacious patches, and the finding of branching
hyphae on KOH preparation are all definitive for Candidal Vaginitis (yeast infection).
Question 7
A patient presents with a yellowish-green or gray, frothy, profuse, and malodorous vaginal
discharge. The vaginal mucosa is diffusely reddened, with small red granular spots (petechiae) in
the posterior fornix. A saline wet mount shows motile protozoa. These findings are consistent
with:
A) Bacterial Vaginosis (BV).
B) Candidal Vaginitis.
C) Trichomonal Vaginitis.
D) Gonorrhea.
E) Chlamydia.
Correct Answer: C) Trichomonal Vaginitis.
Rationale: The key features described – yellowish-green/gray, frothy, profuse, malodorous
discharge, diffuse vaginal redness, petechiae on the cervix/fornix ("strawberry cervix"),
and motile trichomonads on saline wet mount – are all characteristic of Trichomonal
Vaginitis.
Question 8
A patient presents with a painless, nonsuppurative ulcerated papule with an indurated (hardened)
edge on the penis. This lesion appeared approximately 4 weeks after unprotected sexual contact
and typically heals spontaneously within a few weeks. This is characteristic of:
A) Genital Warts.
B) Genital Herpes.
C) Syphilis (chancre).
D) Chancroid.
E) Lymphogranuloma Venereum.
Correct Answer: C) Syphilis (chancre).
Rationale: The description of a painless, indurated, ulcerated papule (chancre) appearing 3-
6 weeks after exposure and healing spontaneously is the classic presentation of primary
syphilis, caused by Treponema pallidum. It is highly infectious.
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Question 9
A male patient complains of acute, swollen, and notably tender testes, making it difficult to
distinguish from the epididymis. The scrotum may be reddened and the vas deferens inflamed.
These findings are suggestive of:
A) Testicular cancer.
B) Hydrocele.
C) Epididymitis.
D) Varicocele.
E) Orchitis.
Correct Answer: C) Epididymitis.
Rationale: Epididymitis is an inflammation of the epididymis, typically presenting with
acute onset of scrotal pain, swelling, and tenderness, often radiating to the groin. The
epididymis becomes difficult to distinguish from the testis due to inflammation. Orchitis is
inflammation of the testis itself.
Question 10
A male patient presents with single or multiple papules or plaques of variable shapes on the
penis, scrotum, and groin. They may be round, pointed (acuminate), or cauliflower-like
(verrucous). These are usually asymptomatic and may disappear without treatment. This
presentation is consistent with:
A) Syphilis chancres.
B) Genital Herpes.
C) Genital Warts (Condylomata Acuminata).
D) Chancroid.
E) Molluscum Contagiosum.
Correct Answer: C) Genital Warts (Condylomata Acuminata).
Rationale: The description of single or multiple papules or plaques, varying in shape
(round, pointed, cauliflower-like) on the genital area, caused by HPV (usually subtypes 6
and 11), and often asymptomatic, is characteristic of Genital Warts (Condylomata
Acuminata).
Question 11
Which of the following is considered the strongest risk factor for prostate cancer?
A) High-fat diet.
B) Smoking history.
C) Age, ethnicity, and family history.
D) Benign prostatic hyperplasia (BPH).
E) History of sexually transmitted infections.
Correct Answer: C) Age, ethnicity, and family history.
Rationale: Age (risk increases with age), ethnicity (higher incidence in African American
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) 2025 LATEST
UPDATED AGRADE
Question 1
Which of the following characteristics of a breast mass would strongly suggest cancer?
A) Soft, firm, mobile, and often tender mass.
B) A mobile mass that becomes fixed when the arm relaxes, but moves with pectoral fascia.
C) Hard, irregular, poorly circumscribed nodules, fixed to the skin or underlying tissues.
D) A cyst that is round, mobile, and tender.
E) A mass that disappears and reappears with the menstrual cycle.
Correct Answer: C) Hard, irregular, poorly circumscribed nodules, fixed to the skin or
underlying tissues.
Rationale: Malignant breast masses are typically described as hard, irregular, poorly
circumscribed (indistinct borders), and fixed to the skin or underlying tissues (such as the
ribs, intercostal muscles, or pectoral fascia). Mobile, soft, round, tender masses are more
characteristic of benign conditions like cysts or fibroadenomas.
Question 2
Which of the following is considered a significant risk factor for breast cancer?
A) Breastfeeding for more than 1 year.
B) Early menarche and late menopause.
C) Personal history of ovarian cysts.
D) Postmenopausal weight loss.
E) Low levels of endogenous hormones.
Correct Answer: B) Early menarche and late menopause.
Rationale: Risk factors for breast cancer include age, family history, inherited genetic
mutations, personal history of breast cancer, high levels of endogenous hormones, breast
tissue density, proliferative lesions with atypia on biopsy, duration of unopposed estrogen
exposure (related to early menarche and late menopause), age of first full-term pregnancy,
breastfeeding for less than 1 year, postmenopausal obesity, cigarette smoking, alcohol
ingestion, physical inactivity, and type of contraception. Early menarche and late
menopause increase the lifetime exposure to estrogen, which is a risk factor.
Question 3
Which of the following best describes the characteristics of a typical breast cyst?
A) Hard, irregular, non-mobile, and non-tender.
B) Soft to firm, round, mobile, and often tender.
C) Fixed to the chest wall, with dimpling of the skin.
D) Poorly circumscribed, with associated nipple discharge.
E) Only found in postmenopausal women.
,[Type here]
Correct Answer: B) Soft to firm, round, mobile, and often tender.
Rationale: Breast cysts are commonly described as soft to firm, round, mobile masses that
are often tender, especially before menstruation. They are typically well-defined and can
vary in size.
Question 4
To effectively examine the lateral portion of the breast, which positioning technique should the
nurse instruct the patient to use?
A) Have the patient lie supine with arms at her sides.
B) Have the patient sit upright with arms raised above her head.
C) Have the patient roll onto the opposite hip, place her hand on her forehead, and press
shoulders against the bed.
D) Have the patient lean forward with arms extended.
E) Palpate while the patient is standing, with arms relaxed.
Correct Answer: C) Have the patient roll onto the opposite hip, place her hand on her
forehead, and press shoulders against the bed.
Rationale: This specific positioning (rolling onto the opposite hip, hand on forehead,
shoulders pressed against the bed) is designed to flatten the breast tissue and bring the
lateral portion into better palpation range, allowing for a thorough examination in vertical
overlapping strips from the axilla down to the bra line and up to the clavicle.
Question 5
A patient presents with a gray or white, thin, homogenous, malodorous vaginal discharge that
coats the vaginal walls, especially noticeable after sexual intercourse. Vaginal pH is > 4.5. On
wet mount, clue cells are seen, and a "whiff test" is positive. These findings are consistent with:
A) Candidal Vaginitis.
B) Trichomonal Vaginitis.
C) Bacterial Vaginosis (BV).
D) Gonorrhea.
E) Chlamydia.
Correct Answer: C) Bacterial Vaginosis (BV).
Rationale: The description perfectly matches the classic presentation and diagnostic criteria
for Bacterial Vaginosis (BV): malodorous (fishy/musty) gray-white discharge, vaginal pH >
4.5, and the presence of clue cells on a saline wet mount, with a positive whiff test.
Question 6
A patient complains of vaginal soreness, pruritus, and dyspareunia. On examination, the vulva
and surrounding skin are inflamed, and the vaginal mucosa is reddened with white, tenacious
patches of discharge. A KOH preparation reveals branching hyphae. These findings are
characteristic of:
A) Bacterial Vaginosis (BV).
,[Type here]
B) Trichomonal Vaginitis.
C) Candidal Vaginitis.
D) Atrophic Vaginitis.
E) Herpes Simplex Virus.
Correct Answer: C) Candidal Vaginitis.
Rationale: The symptoms of vaginal soreness, pruritus, dyspareunia, inflamed vulva,
reddened vaginal mucosa with white tenacious patches, and the finding of branching
hyphae on KOH preparation are all definitive for Candidal Vaginitis (yeast infection).
Question 7
A patient presents with a yellowish-green or gray, frothy, profuse, and malodorous vaginal
discharge. The vaginal mucosa is diffusely reddened, with small red granular spots (petechiae) in
the posterior fornix. A saline wet mount shows motile protozoa. These findings are consistent
with:
A) Bacterial Vaginosis (BV).
B) Candidal Vaginitis.
C) Trichomonal Vaginitis.
D) Gonorrhea.
E) Chlamydia.
Correct Answer: C) Trichomonal Vaginitis.
Rationale: The key features described – yellowish-green/gray, frothy, profuse, malodorous
discharge, diffuse vaginal redness, petechiae on the cervix/fornix ("strawberry cervix"),
and motile trichomonads on saline wet mount – are all characteristic of Trichomonal
Vaginitis.
Question 8
A patient presents with a painless, nonsuppurative ulcerated papule with an indurated (hardened)
edge on the penis. This lesion appeared approximately 4 weeks after unprotected sexual contact
and typically heals spontaneously within a few weeks. This is characteristic of:
A) Genital Warts.
B) Genital Herpes.
C) Syphilis (chancre).
D) Chancroid.
E) Lymphogranuloma Venereum.
Correct Answer: C) Syphilis (chancre).
Rationale: The description of a painless, indurated, ulcerated papule (chancre) appearing 3-
6 weeks after exposure and healing spontaneously is the classic presentation of primary
syphilis, caused by Treponema pallidum. It is highly infectious.
, [Type here]
Question 9
A male patient complains of acute, swollen, and notably tender testes, making it difficult to
distinguish from the epididymis. The scrotum may be reddened and the vas deferens inflamed.
These findings are suggestive of:
A) Testicular cancer.
B) Hydrocele.
C) Epididymitis.
D) Varicocele.
E) Orchitis.
Correct Answer: C) Epididymitis.
Rationale: Epididymitis is an inflammation of the epididymis, typically presenting with
acute onset of scrotal pain, swelling, and tenderness, often radiating to the groin. The
epididymis becomes difficult to distinguish from the testis due to inflammation. Orchitis is
inflammation of the testis itself.
Question 10
A male patient presents with single or multiple papules or plaques of variable shapes on the
penis, scrotum, and groin. They may be round, pointed (acuminate), or cauliflower-like
(verrucous). These are usually asymptomatic and may disappear without treatment. This
presentation is consistent with:
A) Syphilis chancres.
B) Genital Herpes.
C) Genital Warts (Condylomata Acuminata).
D) Chancroid.
E) Molluscum Contagiosum.
Correct Answer: C) Genital Warts (Condylomata Acuminata).
Rationale: The description of single or multiple papules or plaques, varying in shape
(round, pointed, cauliflower-like) on the genital area, caused by HPV (usually subtypes 6
and 11), and often asymptomatic, is characteristic of Genital Warts (Condylomata
Acuminata).
Question 11
Which of the following is considered the strongest risk factor for prostate cancer?
A) High-fat diet.
B) Smoking history.
C) Age, ethnicity, and family history.
D) Benign prostatic hyperplasia (BPH).
E) History of sexually transmitted infections.
Correct Answer: C) Age, ethnicity, and family history.
Rationale: Age (risk increases with age), ethnicity (higher incidence in African American
