Health Assessment Test 5 Flashcards
1
Q
Alveoli
A
smallest structures of mammary gland
2
Q
areola
A
darkened area surrounding nipple
3
Q
colostrum
A
thin, yellow fluid, precursor of milk, secreted for a few days after birth
4
Q
cooper’s ligaments
A
suspensory ligaments; fibrous bands extending from the inner breast surface to the chest wall muscles
5
Q
fibroadenoma
A
benign breast mass
6
Q
gynecomastia
A
excessive breast development in the male
7
Q
intraductal papilloma
A
serosanguineous nipple discharge
8
Q
inverted
A
nipples that are depressed or invaginated
9
Q
Lactiferous
A
conveying milk
10
Q
mastalgia
A
pain in breast
11
Q
mastitis
A
inflammation of the breast
12
Q
Montgomery’s glands
A
sebaceous glands in the areola, secrete protective lipid during lactation; also called tubercles of Montogomery
13
Q
Paget’s disease
A
intraductal carcinoma in the breast
14
Q
Peau d’orange
A
orange-peel appearance of breast due to edema
15
Q
Retraction
A
dimple or pucker on the skin
16
Q
Striae
A
atrophic pink, purple, or white linear streaks on the breasts, associated with pregnancy, excessive weight gain or growth during adolesence
17
Q
supernumerary nipple
A
minute extra nipple along the embryonic milk line
18
Q
tail of spence
A
extension of breast tissue into the axilla
19
Q
The reservoirs for storing milk in the breast are:a. lobulesb. alveolic. montgomery’s glandsd. lactiferous sinuses
A
d. lactiferous sinuses
20
Q
The most common site of breast tumors is:a. upper inner quadrantb. upper outer quadrantc. lower inner quadrantd. lower outer quadrant
A
B. upper outer quadrant
21
Q
During a visit for a school physical, the 13-year-old girl being examined questions the asymmetry of her breasts. The best response is:a. “One breast may grow faster than the other during development.”b. “I will give you a referral for a mammogram.”c. “You will probably have fibrocystic disease when you are older.”d. “This may be an indication of hormonal imbalance. We will check again in 6-months.”
A
a. “One breast may grow faster than the other during development.”
22
Q
When teaching the breast self-exam, you would inform the woman that the best time to conduct breast self-examination is: a. at the onset of the menstrual period.b. on the 14th day of the menstrual cycle.c. on the 4th to 7th day of the cycle.d. just before the menstrual period.
A
c. on the 4th to 7th day of the cycle.
23
Q
This is the first visit for a woman, age 38. The practitioner instructs her that a baseline mammogram is recommended for women between the ages of 35 and 39 and that the clinical examination schedule would be based on age. The recommendation for women 40 to 49 is:a. every yearb. every 2 yearsc. twice a yeard. only the baseline exam is needed unless the woman has symptoms.
A
a. every year
24
Q
The examiner is going to inspect the breasts for retraction. The best position for this part of the examination is: a. lying supine with arms at the sides.b. leaning forward with hands outstretched.c. sitting with hand pushing onto hips.d. one arm at the side, the other arm elevated.
A
c. sitting with hand pushing onto hips.
25
A bimanual technique may be the preferred approach for a woman:a. who is pregnant b. who is having the first breast examination by a health care provider.c. with pendulous breastsd. who has felt a change in the breast during self examination.
c. with pendulous breasts
26
During the examination of a 70-year-old man, you note gynecomastia. You would:a. refer for a biopsyb. refer for a mammogramc. review the medications for drugs that have gynecomastia as a side effect.d. proceed with the exam. This is a normal part of the aging process.
c. review the medications for drugs that have gynecomastia as a side effect.
27
During a breast examination, you detect a mass. Identify the description that is most consistent with cancer rather than benign breast disease.a. round, firm, well demarcated b. irregular, poorly defined, fixedc. rubbery, mobile, tenderd. lobular, clear margins, negative skin retraction.
b. irregular, poorly defined, fixed
28
During the examination of the breasts of a pregnant woman, you would expect to find:a. peau d' orange b. nipple retraction.c. a unilateral, obvious venous patternd. a blue vascular pattern over both breasts.
d. a blue vascular pattern over both breasts.
29
Which of the following women should not be referred to a physician for further evaluation?a. a 26-year-old with multiple nodules palpated in each breast.b. a 48-year-old who has a 6-month history of reddened and sore left nipple and areolar area.c. a 25-year-old with asymmetrical breasts and inversion of nipples since adolescence.d. a 64-year-old with ulcerated area at tip of right nipple, no masses, tenderness, or lymph nodes palpated.
c. a 25-year-old with asymmetrical breasts and inversion of nipples since adolescence.
30
Breast asymmetry:a. increases with age and parity.b. may be normal.c. indicates neoplasm.d. is accompanied by enlarged axillary lymph nodes.
b. may be normal
31
Any lump found in the breast should be referred for further evaluation . A benign lesion will usually have 3 of the following characteristics. Which one is characteristic of a malignant lesion?a. softb. well-defined marginsc. freely movabled. irregular shape
d. irregular shape
32
Gynecomastia is:a. enlargement of the male breastb. presence of "mast" cells in the male breastc. cancer of the male breastd. presence of supernumerary breast on the male chest
a. enlargement of the male breast
33
Which is the first physical change associated with puberty in girls?a. areolar elevationb. breast bud developmentc. height spurtd. pubic hair developmente. menarche
b. breast bud development
34
During the examination of a 30-year-old woman, she questions you about "the 2 large moles" that are below her left breast. After examining the area, how do you respond?a. "I think you should be examined by a dermatologist."b. "This appears to be a normal finding of supernumerary nipples, due to small areolae and nipples that are present."c. "These are Montgomery's glands, which are common."d. "Is there a possibility you are pregnant?"
b. "This appears to be a normal finding of supernumerary nipples, due to small areolae and nipples that are present."
35
The breasts of a neonate may be large and very visible, secreting clear or white fluid. What is the basis of this finding? a. It may be due to birth traumab. The fluid is colostrum, which is typically seen as a precursor to milkc. The cause is maternal estrogen, which crossed the placentad. This often occurs with premature thelarche
c. The cause is maternal estrogen, which crossed the placenta
36
Aneurysm
defect or sac formed by dilation in artery wall due to atherosclerosis trauma, or congenital defect
37
Anorexia
loss of appetite for food
38
Ascites
abnormal accumulation of serous fluid within the peritoneal cavity, associated with congestive heart failure, cirrhosi, cancer, or portal hypertension
39
Borborygmi
loud, gurgling bowel sounds signaling increased motility or hyperperistalsis, occurs with early bowel obstruction, gastroenteritis, diarrhea
40
Bruit
blowing, swooshing sound heard through a stethoscope when an artery is partially occluded
41
Cecum
first or proximal part of large intestine
42
Cholecystitis
inflammation of the gallbladder
43
Costal Margin
lower border of rib margin formed by the medial edges of the 8th, 9th and 10th ribs
44
Costovertebral angle (CVA)
angle formed by the 12th rib and the vertebral column on the posterior thorax, overlying the kidney
45
Diastasis recti
midline longitudinal ridge in the abdomen, a separation of abdominal rectus muscles
46
Dysphagia
difficulty swallowing
47
Epigastrium
name of abdominal region between the costal margins
48
Hepatomegaly
abnormal enlargement of liver
49
Hernia
abnormal protrusion of bowel through weakening in abdominal musculature
50
Inguinal ligament
ligament extending from pubic bone to anterior superior iliac spine, forming lower border of abdomen
51
Linea alba
midline tendinous seam joining the abdominal muscles
52
Paralytic ileus
complete absence of peristaltic movement that may follow abdominal surgery or complete bowel obstruction
53
Peritoneal friction rub
rough grating sound heard through the stethoscope over the site of peritoneal inflammation
54
Peritonitis
inflammation of peritoneum
55
Pyloric stenosis
congenital narrowing of pyloric sphincter, forming outflow obstruction of stomach
56
Pyrosis
(heartburn) burning sensation in upper abdomen due to reflux of gastric acid
57
Rectus abdominis muscles
midline abdominal muscles extending from rib cage to pubic bone
58
Scaphoid
abnormally sunken abdominal wall as with malnutrition or underweight
59
Splenomegaly
abnormal enlargement of spleen
60
Striae
(lineae albicantes) silvery white or pink scar tissue formed by stretching of abdominal skin as with pregnancy or obesity
61
Suprapubic
name of abdominal region just superior to pubic bone
62
Tympany
high-pitched, musical, drum-like, percussion note heard when percussing over the stomach and intestine
63
Umbilicus
depression on the abdomen marking site of entry of umbilical cord
64
Viscera
internal organs
65
Name the organs that are normally palpable in the abdomen.
liver, spleen, kidneys, aorta, full bladder, xiphoid process, uterus, rectus muscles, cecum, ascending colon, sigmoid colon, sacral promontory
66
Describe the proper positioning and preparation of the patient for the examination.
1) strong overhead and secondary light stand
2) expose the abdomen so that it is fully visible. drape genitalia and female breasts.
3) Have patient empty their bladder
4) keep the room warm
5) position patient supine, head on pillow, knees bent or on pillow, arm crossed on chest or at sides
6) warm your hands and stethoscope, keep your fingernails short
7) examine painful areas last
8) use distraction
67
State the rationale for performing auscultation of the abdomen before palpation or percussion.
Percussion and palpation can increase peristalsis and could give a false interpretation of bowel sounds.
68
Discuss inspection of the abdomen, including findings that should be noted.
Contour: abdominal distention
Symmetry: bulges, masses, hernias
Umbilicus: midline & inverted (normally) note eversion, enlarged, color
Skin: Striae, redness, jaundice, glistening, purple-blue striae
Pulsation or movement: aortic pulse, peristalsis
Hair distribution: pattern of pubic hair
Demeanor: restlessness, pain responses
69
Describe the procedure for auscultation of bowel sounds.
Use the diaphragm and end piece because bowel sounds are high-pitched. Hold the stethoscope lightly against skin because pushing too hard may stimulate more bowel sounds. Begin in RLQ, then RUQ, LUQ, finally LLQ.
70
Differentiate the following abdominal sounds: normal, hyperactive, and hypoactive bowel sounds, succession splash, bruit.
normal: high-pitched, gurgling, cascading sound
hyperactive: loud, high-pitched, rushing, tinking sound
hypoactive: diminished or absent sounds
succession splash: very loud splash, upper abdomen when infant rocked, indicates increased air and fluid
bruit: a pulsatile blowing sound
71
Identify and give the rationale for each of the percussion notes heard over the abdomen.
Tympany over the four quadrants.
Dullness over distended bladder, adipose tissue, fluid or mass
hyperresonance is present with gaseous distension
72
List 4 conditions that may alter normal percussion notes.
liver or spleen enlargement
dullness occurs with lung disease
dullness pushed up with ascites or pregnancy
dullness with gas distention in colon
73
Describe the procedure for percussing the liver span and the spleen.
liver span: begin in lung resonance, percuss down until dull, mark the spot. then find abdominal tympany and percuss up in the midclavicular line. Mark where it changes from tympany to dull (right costal margin) measure between marks.
Spleen: dull note 9th to 11th ICS. Percuss in the lowest interspace in the left anterior axillary line, should hear tympany. Tympany remains when patient takes a deep breath.
74
Describe these maneuvers and discuss their significance: fluid wave test, shifting dullness
FWT: place the ulnar edge of another examiner's hand or the patient's own hand firmly on the abdomen in the midline. Place your left hand on the person's right flank, right hand reach across the abdomen and give the left flank a firm strike. tests for ascites if fluid wave is felt in left hand.
SD: will hear a tympanic note as you percuss over the top of the abdomen. percuss down side of abdomen. If fluid is present, it will go from tympany to dull as you move. positive sign of a large volume of ascitic fluid.
75
Differentiate between light and deep palpation, and explain the purpose of each.
light palpation: first 4 fingers close together, depress 1 cm. purpose is to form an overall impression of the skin surface and superficial musculature. Discriminate between voluntary muscle guarding and involuntary rigidity.
deep palpation: first 4 fingers close together, depress 5-8 cm. note the location, size, consistency and mobility of any palpable organs and the presence of abnormal enlargement, tenderness and masses.
76
List 2 abnormalities that may be detected by light palpation and 2 detected by deep palpation.
Light: muscle guarding, rigidity
Deep: enlarged/tender liver, enlarged/tender spleen
77
Contrast rigidity with voluntary guarding.
Rigidity: constant, board-like hardness of the muscles
| Voluntary guarding: occurs when the person is cold, tense, or ticklish.
78
Contrast visceral pain and somatic (parietal) pain.
Visceral pain: comes from internal organs
| Somatic (parietal) pain: skin and deep tissues
79
Describe rebound tenderness.
Pain on release of abdominal pressure (during palpation). confirms rebound tenderness, which is a reliable sign of peritoneal inflammation.
80
Describe palpation of the liver, spleen, kidney.
Liver: RUQ, left hand under person's back parallel to the 11th and 12th ribs and lift up to support abdominal contents. Right hand, RUQ, parallel to midline. Hooking technique.
Spleen: LUQ, deep breath
Kidney: duck-bill position @ pt's right flank. right kidney more easily palpable.
81
Distinguish abdominal wall massess from intra-andominal masses.
A mass of the abdominal wall will become more prominent with tensing of the abdominal wall, whereas an intra-abdominal mass will become less prominent or disappear. Abdominal wall masses are most commonly hernias, neoplasms, infections & hematomas.
82
Describe the procedure and rationale for determining costovertebral angle (CVA) tenderness.
Indirect fist percussion causes tissues to vibrate instead of producing a sound. To assess kidney, place hand over 12th rib at the CVA on the back. Thump that edge with the ulnar edge of your other fist. Determines tenderness that occurs with kidney inflammation.
83
Describe the expected examination findings of the abdomen in a patient with obesity.
Uniformity, rounded,umbilicus sunken, normal bowel sounds, tympany (scattered dullness), palpation normal (just thicker).
84
Describe the expected examination findings of the abdomen in a patient with gaseous distention.
Single round curve, auscultation dependent on cause of gas, tympany over large area, may have muscle spasm of abdominal wall
85
Describe the expected examination findings of the abdomen in a patient with a tumor.
localized distention, normal bowel sounds, dull over mass (if at skin surface), defined borders
86
Describe the expected examination findings of the abdomen in a pregnant patient.
single curve, umbilicus protruding, breasts enlarged, fetal heart tones, bowel sounds diminished, tympany over intestines
87
Describe the expected examination findings of the abdomen in a patient with ascites.
single curve, everted umbilicus, bulging flanks when supine, taut, glistening skin, recent weight gain, increase in abdominal girth
88
Describe the expected examination findings of the abdomen in a patient with an enlarged liver.
tender to palpation with early heart failure, acute hepatitis, hepatic abcess
89
Describe the expected examination findings of the abdomen in a patient with an enlarged spleen.
enlarges down and toward midline, enlarged, soft, rounded edges. tender only if peritoneum is inflamed.
90
Describe the expected examination findings of the abdomen in a patient with a distended bladder.
dullness, palpable
91
Describe the expected examination findings of the abdomen in a patient with appendicitis.
starts as dull, diffuse pain in periumbilical region that later shifts to severe, sharp, persistent pain and tenderness localized in RLQ.
92
1. Select the sequence of techniques used during an examination of the abdomen.
a. percussion, inspection, palpation, auscultation
b. inspection, palpation, percussion, auscultation
c. inspection, auscultation, percussion, palpation
d. auscultation, inspection, palpation, percussion
c. inspection, auscultation, percussion, palpation
93
2. Which of the following may be noted through inspection of the abdomen?
a. fluid waves and abdominal contour
b. umbilical eversion and Murphy's sign
c. venous pattern, peristaltic waves, and abdominal contour
d. peritoneal irritation, general tympany, and peristaltic waves
c. venous pattern, peristaltic waves, and abdominal contour
94
3. Right upper quadrant tenderness may indicate pathology in the:
a. liver, pancreas, or ascending colon
b. liver and stomach
c. sigmoid colon, spleen, or rectum
d. appendix or ileocecal valve
a. liver, pancreas, or ascending colon
95
4. Hyperactive bowel sounds are:
a. High pitched
b. Rushing
c. Tinkling
d. All of the above
d. All of the above
96
5. The absence of bowel sounds is established after listening for:
a. 1 full minute
b. 3 full minutes
c. 5 full minutes
d. none of the above
c. 5 full minutes
97
6. Auscultation of the abdomen may reveal bruits of the ___ arteries.
a. aortic, renal, iliac, and femoral
b. jugular, aortic, carotid, and femoral
c. pulmonic, aortic, and portal
d. renal, iliac, internal jugular, and basilic
a. aortic, renal, iliac, and femoral
98
7. The range of normal liver span in the right midclavicular line in the adult is:
a. 2-6 cm
b. 4-8 cm
c. 8-14 cm
d. 6-12 cm
d. 6-12 cm
99
8. The left upper quadrant (LUQ) contains the:
a. liver
b. appendix
c. left ovary
d. spleen
d. spleen
100
9. Striae, which occur when the elastic fibers in the reticular layer of the skin are broken following rapid or prolonged stretching, have a distinct color when of long duration. This color is:
a. pink
b. blue
c. purple-blue
d. silvery white
d. silvery white
101
10. Auscultation of the abdomen is begun in the right lower quadrant (RLQ) because:
a. bowel sounds are always normaly present here
b. peristalsis through the descending colon is usually active
c. tis is the location of the pyloric sphincter
d. vascular sounds are best heard in this area
a. bowel sounds are always normaly present here
102
11. A dull percussion note forward of the left midaxillary line is:
a. normal, an expected finding during splenic percussion
b. expected between the 8th and 12th ribs
c. found if the examination follows a large meal
d. indicative of splenic enlargement
d. indicative of splenic enlargement
103
12. Shifting dullness is a test for:
a. Ascites
b. Splenic enlargement
c. Inflammation of the kidney
d. hepatomegaly
a. Ascites
104
13. Tenderness during abdominal palpation is expected when palpating:
a. the liver edge
b. the spleen
c. the sigmoid colon
d. the kidneys
c. the sigmoid colon
105
14. A positive Murphy's sign is best described as:
a. the pain felt when the hand of the examiner is rapidly removed from an inflamed appendix
b. pain felt when taking a deep breath when the examiner's fingers are on the approximate location of the inflamed gallbladder
c. a sharp pain felt by the patient when one hand of the examiner is used to thump the other at the costovertebral angle
d. not a valid examination technique
b. pain felt when taking a deep breath when the examiner's fingers are on the approximate location of the inflamed gallbladder
106
A positive Blumberg sign indicates:
A. a possible aortic aneurysm
B. the presence of renal artery stenosis
C. an enlarged, nodular liver
D. peritoneal inflammation
D. peritoneal inflammation
107
What is the significance of black stools? Contrast this with the significance of red blood in stools.
Black, tarry stools indicate the presence of occult blood (melena) from bleeding higher in the GI tract. The blood has been partially broken down during the digestive process. Red blood indicates bleeding in lower GI tract.
108
Chancre
red, round, superficial ulcer with a yellowish serous discharge that is a sign of syphilis
109
Condylomata acuminata
soft, pointed, fleshy papules that occur on the genitalia and are caused by the human papillomavirus (HPV)
110
Cryptorchidism
undescended testes
111
Cystitis
inflammation of the urinary bladder
112
Epididymis
structure composed of coiled ducts located over the superior and posterior surface of the testes, which stores sperm
113
Epispadias
congenital defect in which urethra opens on the dorsal (upper) side of penis instead of at the tup
114
Hernia
weak spot in abdominal muscle wall (usually in area of inguinal canal or femoral canal) through which a loop of bowel may protrude
115
Herpes Genitalis
a sexually transmitted infection characterized by clusters of small painful vesicles, caused by a virus
116
Hydrocele
cystic fluid in tunica vaginalis surrounding testis
117
Hypospadias
congenital defect in which urethra opens on the ventral (under) side of penis rather than at the tip
118
Orchitis
acute inflammation of testis, usually associated with mumps
119
Paraphimosis
foreskin is retracted and fixed behind the glans penis
120
Peyronie disease
nontender, hard plaques on the surface of the penis, associated with painful bending of penis during erection
121
Phimosis
foreskin is advanced and tightly fixed over the glans penis
122
Prepuce
(foreskin) the hood or flap of skin over the glans penis that often is surgically removed after birth by circumcision
123
Priapism
prolonged, painful erection of penis without sexual desire
124
Spermatic cord
collection of vas deferens, blood vessels, lymphatics, and nerves that ascends along the testis and through the inguinal canal into the abdomen
125
Spermatocele
retention cyst in epididymis filled with milky fluid that contains sperm
126
Torsion
sudden twisting of spermatic cord; a surgical emergency
127
Varicocele
dilated tortuous varicose veins in the spermatic cord
128
Vas deferens
duct carrying sperm from the epididymis through the abdomen and then into the urethra
129
Constipation
decrease in stool frequency, with difficult passing of very hard, dry stools
130
Fissure
painful longitudinal tear in tissue (e.g., in the superficial mucosa at the anal margin)
131
Hemorrhoid
flabby papules of skin or mucous membrane in the anal region caused by varicose vein of the hemorrhoidal plexus
132
Melena
blood in the stool
133
Pruritus
itching or burning sensation in the skin
134
Steatorrhea
excessive fat in the stool as in gastrointestinal malabsorption of fat
135
Valves of houston
set of three semilunar transverse folds that cross one-half the circumference of the rectal lumen
136
Describe the function of the cremaster muscle.
controls the size of the scrotum by responding to ambient temperature. keeps the testes at 3 degrees celsius below abdominal temperature, the best temperature for producing sperm.
137
Identify the structures that provide transport of sperm.
sperm are transported along a series of ducts: epididymus, vas deferens, spermatic cord, ejaculatory duct
138
State the length of the anal canal and the rectum in the adult, and describe the location of these structures in the lower abdomen.
The anal canal is the outlet of the GI tract and it is about 3.8 cm long in the adult.
The rectum, which is 12 cm long, is the distal portion of the large intestine.
139
Describe the size, shape, and location of the male prostate gland.
In the male, the prostate gland lies in front of the anterior wall of the rectum and 2 cm behind the symphysis pubis. It surrounds the bladder neck and the urethra and has 15 to 30 ducts that open into the urethra. It is a bilobed structure with a round or heart shape. Measures 2.5 cm long and 4 cm. in diameter.
140
List a few examples of high-fiber foods of the soluble type and of the insoluble type; what advantages do these foods have for the body?
soluble: oatmeal, oat cereal, lentils, apples, oranges, pears, oat bran
insoluble: whole wheat, whole grains, wheat bran, corn bran
advantages: normalizes bowel movemens
141
List screening measures that are recommended for early detection of colon/rectal cancer; of prostate cancer.
colonoscopy
| palpating anus, rectum, prostate
142
State the method of promoting anal sphincter relaxation to aid palpation of the anus and rectum.
Place the pad of your index finger gently against the anal verge.
143
Describe the significance of the inguinal canal and the femoral canal.
IC: narrow tunnel passing obliquely between layers of abdominal muscle. It is 4 to 6 cm long in the adult. Its openings are an internal ring and an external ring.
FC: potential space located 3 cm medial to and parallel with the temporal artery.
144
List the pros and cons of circumcision of the male newborn.
PROS: preventing phimosis and inflammation of the glans penis and foreskin, decreasing the incidence of cancer of the penis, decreases the incidence of UTI. reduces HIV acquisition, reduces HIV transmission, reduces HSV-2 and HPV
CONS: medicaid does not cover routine circumcision in 16 states. pain, bleeding, swelling, inadequate skin removal, wound infection, urinary retention.
145
Discuss ways of creating an environment that will provide psychological comfort for the man and the examiner during examination of male genitalia.
Demeanor should be confident and relaxed, unhurried yet business like. Don't discuss genitourinary history or sexual practices during exam. Use a firm, deliberate touch, not a soft, stroking one. Don't stop examination if erection occurs.
146
List teaching points to include with the teaching of testicular self-examination.
Emphasize familiarity with the young man's body.
```
T = timing, once a month
S = Shower, warm water relaxes scrotal sac
E = Examine, check for changes, report changes immediately
```
147
List laboratory tests to assess urinary function
urinalysis
| serum analysis
148
Discuss the rationale for making certain that testes have descended in the male infant.
Palpate scrotum and testes. Try not to elicit cremasteric reflex. Once palpated, they are considered descended.
149
Contrast phimosis with paraphimosis; hypospadias with epispadias
Phimosis: nonretractable foreskin forming a pointy tip with a tiny orifice
Paraphimosis: foreskin is retracted and fixed
Hypospadias: abnormal opening on ventral surface of the penis
Epispadias: abnormal opening on dorsal part of the penis
150
Describe the normal physical characteristics of the prostate gland that would be assessed by palpation:
Size, shape, surface, consistency, mobility, sensitivity
Size: 2.5 cm x 4 cm, should not protrude more than 1 cm into the rectum
Shape: heart shape with palpable central groove
Surface: smooth
Consistency: elastic, rubbery
Mobility: slightly moveable
Sensitivity: nontender to palpation
151
Describe the physical appearance and clinical significance of pilonidal cyst and anorectal fistula.
Pilonidal cyst: hair-containing cyst located in the midline over the coccyx or lower sacrum
Anorectal fissure: a painful longitudinal tear in the superficial mucosa at the anal margin. Most fissures (>90%) occur in the posterior midline area.
152
Define the condition benign prostatic hypertrophy, list the usual symptoms the man experiences with this condition, and describe the physical characteristics.
Subjective: urinary frequency, urinary hesitancy, straining to urinate, weak stream, intermittent stream, sensation of incomplete emptying, nocturia
O: A symmetric nontender enlargement, commonly occurs in males beginning in the middle years. The prostate surface feels smooth, rubbery, or firm (like the consistency of the nose) with the median sulcus obliterated
153
Describe tinea cruris.
a fungal infection in the crural fold, not extending to scrotum, occuring in postpubertal males ("jock itch") after sweating or wearing layers of occlusive clothing.
154
describe herpes simplex type 2
clusters of small vesicles with surrounding erythema, which are often painful and erupt on the flans or foreskin. These rupture to form superficial ulcers.
155
describe a syphilitic chancre
begins with 2 to 4 weeks of infection, as a small, solitary, silvery papule that erodes to a red, round or oval, superficial ulcer with a yellowish serous discharge
156
describe penile warts (condylomata acuminate, HPV)
soft, pointed, moist, fleshy, painless papules may be single or multiple in a cauliflower-like patch. Color may be gray, pale yellow, pink or black
157
Describe the physical appearance and clinical significance of epididymitis
severe pain of sudden onset in scrotum, enlarged, reddened scrotum, exquisitely tender scrotum. Tender swelling of epididymis commonly caused by prostatitis.
158
Describe the physical appearance and clinical significance of varicocele
dull pain. constant pulling or dragging feeling. usually no visible signs. when standing, scrotum feels soft, irregular mass posterior to and above testis; feels like a bag of worms
159
Describe the physical appearance and clinical significance of spermatocele
painless, usually found on examination. sperm may fluoresce. Round, freely moveable mass lying above and behind testis. Filled with thin, milky fluid that contains sperm.
160
Describe the physical appearance and clinical significance of a testicular tumor.
enlarged testes with increased weight. does not transilluminate. enlarged, smooth, ovoid, firm, maintains shape. Does not cause usual sickness discomfort
161
Describe the physical appearance and clinical significance of hydrocele.
painless swelling, enlarged, mass does transilluminate with a pink or red glow. Nontender mass. Nontender swelling of testis. Cystic.
162
Describe the anatomic course and the clinical significance of an indirect inguinal hernia
sac herniates through internal inguinal ring; can remain in canal or pass into scrotum. pain with straining; soft swelling that increases with increased intra-abdominal pressure. most common; 60% of all hernias. congenital or acquired.
163
Describe the anatomic course and the clinical significance of a direct inguinal hernia.
sac herniates directly behind and through external inguinal ring, above inguinal ligament. usually painless; round swelling close to the pubis in the area of the internal inguinal ring. less common; occurs most often in men older than 40. Acquired weakness.
164
Describe the anatomic course and the clinical significance of a femoral hernia.
sac herniates through femoral ring and canal, below inguinal ligament, more often on right side. pain may be severe; may become strangulated. least common; 4% of all hernias. Acquired due to increased abdominal pressure.
165
The examiner is going to inspect and palpate for a HERNIA. During the examination, the main is instructed to:
a. hold his breath during palpation
b. cough after the examiner has gently inserted the examination finger into the rectum
c. bear down when the examiner's finger is at the inguinal canal
d. relax in a supine position while the examination finger is inserted into the canal
c. bear down when the examiner's finger is at the inguinal canal
166
During examination of the scrotum, a normal finding would be:
a. The left testicle is firmer to palpation than the right
b. The left testicle is larger than the right
c. The left testicle hangs lower than the right
d. The left testicle is more tender to palpation than the right
c. The left testicle hangs lower than the right
167
H.T. has come to the clinic for a follow-up visit. Six months ago, he was started on a new medication. The class of medication that is most likely to cause impotence as a side effect; therefore medication classes explored by the nurse are:
a. antipyretics
b. bronchodilators
c. corticosteroids
d. antihypertensives
d. antihypertensives
168
Prostatic hypertrophy occurs frequently in older men. The symptoms that may indicate this problem are:
a. polyuria and urgency
b. dyuria and oliguria
c. straining, loss of force, and sense of residual urine
d. foul-smelling urine and dysuria
c. straining, loss of force, and sense of residual urine
169
A 64-year-old man has come for a health examination. A normal age-related change in the scrotum would be:
a. testicular atrophy
b. testicular hypertrophy
c. pendulous scrotum
d. increase in scrotal rugae
c. pendulous scrotum
170
During palpation of the testes, the normal finding would be:
a. firm to hard, and rough
b. nodular
c. 2 to 3 cm long by 2 cm wide and firm
d. firm, rubbery and smooth
d. firm, rubbery and smooth
171
A 20-year-old man has indicated that he does not perform testicular self-examination. One of the facts that should be shared with him is that testicular cancer, though rare, does occur in men ages:
a. younger than 15 years
b. 15 to 34 years
c. 35 to 55 years
d. 55 years and older
b. 15 to 34 years
172
During the examination of a full-term newborn male, a finding requiring investigation would be:
a. absent testes
b. meatus centered at the tip of the penis
c. wrinkled scrotum
d. penis 2 to 3 cm in length
a. absent testes
173
During transillumination of a scrotum, you note a nontender mass that transilluminates with a red glow. This finding is suggestive of:
a. scrotal hernia
b. scrotal edema
c. orchitis
d. hydrocele
d. hydrocele
174
How sensitive to pressure are normal testes?
a. somewhat
b. not at all
c. left is more sensitive than right
d. only when inflammation is present
a. somewhat
175
The congenital displacement of the urethral meatus to the inferior surface of the penis is:
a. hypospadias
b. epispadias
c. hypoesthesia
d. hypophysis
a. hypospadias
176
An adhesion of the prepuce to the head of the penis, making it impossible to retract, is:
a. paraphimosis
b. phimosis
c. smegma
d. dyschezia
b. phimosis
177
The first physical sign associated with puberty in boys is:
a. height spurt
b. penis lengthening
c. sperm production
d. pubic hair development
e. testes enlargement
e. testes enlargement
178
Write a narrative account of an assessment of male genitalia with healthy findings.
Voids clear, amber urine 5 or 6 times a day. No nocturia, dysuria, or hesitancy. No pain or discharge form penis. Sexually active with multiple partners. Uses prophylaxis that is satisfactory for both partners. No history of sexually transmitted infection. No lesions, inflammation, or discharge from penis is noted on examination. Testes descended without masses. No inguinal hernia.
179
In the aging male, when does infertility occur?
a. At age 60, with the sudden decline in sperm production
b. At approximately age 55 to 60, when testosterone levels are lower
c. When the male is no longer able to achieve an erection
d. There is a no specific age; men may be fertile into their 80's and 90's
d. There is a no specific age; men may be fertile into their 80's and 90's
180
A patient has soft, moist, fleshy, painless papules around the anus. The examiner suspects this condition is:
a. HSV-2
b. HPV
c. gonorrhea
d. Peyronie disease
b. HPV
181
The gastrocolic reflex is:
a. a peristaltic wave
b. the passage of meconium in the newborn
c. another term for borborygmi
d. reverse peristalsis
a. a peristaltic wave
182
The incidence of benign prostatic hypertrophy (BPH) is highest among:
a. European Americans
b. African Americans
c. Hispanics
d. Asians
b. African Americans
183
Select the best description of the anal canal.
a. a 12-cm-long portion of the large intestine
b. under involuntary control of the parasympathetic system
c. a 3.8-cm-long outlet of the gastrointestinal tract
d. an S-shaped portion of the colon
c. a 3.8-cm-long outlet of the gastrointestinal tract
184
While good nutrition is important for everyone, foods believed to help reduce risk of colon cancer are:
a. high in fiber
b. low in fat
c. high in protein
d. high in carbohydrate
a. high in fiber
185
Which finding in the prostate gland suggests prostate cancer?
a. symmetric smooth enlargement
b. extreme tenderness to palpation
c. boggy soft enlargement
d. diffuse hardness
d. diffuse hardness
186
The bulbourethral gland is assessed:
a. during an examination of a female patient
b. during an examination of both male and female patients
c. during an examination of a male patient
d. cannot be assessed with a rectal examination
c. during an examination of a male patient
187
Inspection of stool is an important part of the rectal examination. Normal stool is:
a. black in color and tarry in consistency
b. brown in color and soft in consistency
c. clay colored and dry in consistency
d. varies depending upon the individual's diet
b. brown in color and soft in consistency
188
Which symptoms suggest benign prostatic hypertrophy?
a. weight loss and bone pain
b. fever, chills, urinary frequency, and urgency
c. difficulty initiating urination and weak stream
d. dark, tarry stools
c. difficulty initiating urination and weak stream
189
A false positive may occur on fecal occult blood tests of the stool if the person has ingested significant amounts of:
a. red meat
b. candies with red dye #2
c. cranberry juice
d. red beets
a. red meat
190
Write a narrative account of a rectal assessment with normal findings.
No recent change in bowel habits. One soft, dark brown BM daily. No pain or bleeding. No medications. Diet includes 4 serving of fruit and vegetables daily. No hemrrhoids or rectal lesions noted. Sphincter tone good. No masses or tenderness on palpation. No masses, tenderness, or enlargement of prostate. Stool is Hematest negative.
191
A patient states he is frequently constipated and when he has a bowel movement, he has rectal bleeding and pain. He does not feel any mass at his anal opening. "Do I have hemorrhoids, or is there something else wrong with me?" The examiner completes a rectal examination and explains that:
a. there is an indication of rectal prolapse
b. it appears to be a pilonidal cyst
c. the symptoms are consistent with internal hemorrhoids
d. the problem is probably encopresis
c. the symptoms are consistent with internal hemorrhoids
192
A patient states he has frothy, foul-smelling stools that float on the surface of the water in the toilet bowl. What condition is this patient describing ?
a. steatorrhea
b. melena
c. dyschezia
d. a parasitic infection
a. steatorrhea
193
Adnexa
accessory organs of the uterus (i.e., ovaries and fallopian tubes)
194
Amenorrhea
absence of menstruation; termed secondary amenorrhea when menstruation has begun and then ceases; most common cause is pregnancy
195
Bartholin's glands
vestibular glands, located on either side of the vaginal orifice, that secrete a clear lubricating mucus during intercourse
196
Bloody show
dislodging of thick cervical mucus plug at end of pregnancy, which is a sign of beginning of labor
197
Caruncle
small, deep red mass protruding from urethral meatus, usually due to urethritis
198
Chadwick's sign
bluish discoloration of cervix that occurs normally in pregnancy at 6 to 8 weeks' gestation
199
Chancre
red, round, superficial ulcer with a yellowish serous discharge that is a sign of syphilis
200
Clitoris
small, elongated erectile tissue in the female, located at anterior juncture of labia minora
201
Cystocele
prolapse of urinary bladder and its vaginal mucosa into the vagina with straining or standing
202
Dysmenorrhea
abdominal cramping and pain associated with menstruation
203
Dyspareunia
painful intercourse
204
Dysuria
painful urination
205
Endometriosis
aberrant growths of endometrial tissue scattered throughout pelvis
206
Fibroid
(myoma) hard, painless nodules in uterine wall that cause uterine enlargement
207
Gonorrhea
sexually transmitted infection characterized by purulent vaginal discharge or may have no symptoms
208
Hegar sign
softening of cervix that is a sign of pregnancy, occurring at 10 to 12 weeks' gestation
209
Hematuria
red-tinged or bloody urine
210
Hymen
membranous fold of tissue partly closing vaginal orifice
211
Leukorrhea
whitish or yellowish discharge from vaginal orifice
212
Menarche
onset of first menstruation, usually between 11 and 13 years of age
213
Menopause
cessation of the menses, usually occurring around 48 to 51 years of age
214
Menorrhagia
excessively heavy menstrual flow
215
Multipara
condition of having two or more pregnancies
216
Nullipara
condition of first pregnancy
217
Papanicolaou test
painless test used to detect cervical cancer
218
Polyp
cervical polyp is bright red, soft, pedunculated growth emerging from os
219
Rectouterine pouch
(cul-de-sac of douglas) deep recess formed by the peritoneum between the rectum and cervix
220
Salpingitis
inflammation of the fallopian tubes
221
Skene's glands
paraurethral glands
222
Vaginitis
inflammation of vagina
223
Vulva
external genitalia of female
224
Rectocele
prolapse of rectum and its vaginal mucosa into vagina with straining or standing
225
List the external structures of the female genitalia.
Vulva, mons pubis, labia majora, labia aminora, frenulum, clitoris, vestibule, urethral meatus, paraurethral glands, vaginal orifice, vestibular glands, hyman
226
Describe the size, shape, and location of the internal structures of the female genitalia.
Ovaries: 2, one on each side of uterus, at the level of the anterior iliac spine. oval shaped, 3 cm x 2 cm x 1 cm.
Vagina: 9 cm, flattened, tubular canal extending from the orifice up and backward into the pelvis
Cervix: smooth, doughnut-shaped area with a small circular hole, or os
Uterus: pear-shaped, thick-walled, muscular organ. It is flattened anteroposteriorly, measuring 5.5 to 8 cm long by 3.5 to 4 cm wide and 2 to 2.5 cm thick.
Fallopian tubes: two pliable, trumpet-shaped tubes, 10 cm in length, extending from the uterine fundus laterally to the brim of the pelvis.
227
Outline the changes observed during the perimenopausal period.
irregular menses that gradually become farther apart and produce a lighter flow. Ovaries stop producing progesterone and estrogen. uterus shrinks. ages 40-55.
228
Discuss ways of creating an environment that will provide psychological comfort for both the woman and practitioner during the female genitalia examination.
empty her bladder. position the exam table away from doors. ask if she would like someone present. elevate her head and shoulders to semi-sitting. don't abduct legs too far. explain each step before doing. assure the woman that she can stop the exam any time. Gentle, firm touch, gradual movements. communicate. mirror pelvic exam.
229
Discuss selection, preparation, and insertion of the vaginal speculum.
select the proper size speculum. warm and lubricate the speculum under warm, running water. 1 hand on the patient, one hand on the equipment. tilt the width of the blades obliquely and insert the speculum past your right fingers, applying any pressure downward.
230
Discuss the procedure and rationale for bimanual examination and list normal findings for the cervix, uterus and adnexa.
adnexa is usually not palpable. lubricate the first two fingers of your gloved intravaginal hand. use both your hands to palpate the internal genitalia to assess their location, size, and mobility and to screen for any tenderness or masses. Cervix is usually painless, evenly rounded, smooth and firm. Uterus is usually firm and smooth, fundus rounded, freely moveable and nontender.
231
Characteristics of vaginal discharge associated with candidiasis (yeast infection).
thick, white, curdy, "like cottage cheese"
232
Characteristics of vaginal discharge associated with trichomoniasis.
frothy, yellow-green, foul-smelling discharge
233
Characteristics of vaginal discharge associated with bacterial vaginosis
thin, creamy, gray-white malodorous discharge
234
Characteristics of vaginal discharge associated with chlamydia.
yellow or green mucopurulent discharge
235
Characteristics of vaginal discharge associated with gonorrhea.
may have pirulent vaginal discharge.
236
List the signs and symptoms of an ectopic pregnancy.
amenorrhea or irregular vaginal bleeding, pelvic pain. softening of cervix and fundus; movement of cervix and uterus causes pain
237
List the signs and symptoms of an ovarian cyst.
usually aymptomatic. smooth, round, fluctuant, mobile, nontender mass on ovary.
238
Vaginal lubrication is provided during intercourse by:
a. the labia minora
b. sebaceous follicles
c. skene's glands
d. Bartholin's glands
d. Bartholin's glands
239
A young woman has come for her first gynecologic examination. Because she has not had any children, the examiner would expect the cervical os to appear:
a. smooth and circular
b. irregular and slitlike
c. irregular and circular
d. smooth and enlarged
a. smooth and circular
240
A woman has come for an examination because of a missed menstrual period and a positive home pregnancy test. Examination reveals a cervix that appears cyanotic. This is referred to as:
a. Goodell sign
b. Hegar sign
c. Tanner sign
d. Chadwick sign
d. Chadwick sign
241
During the examination of the genitalia of a 70-year-old woman, a normal finding would be:
a. hypertrophy of the mons pubis
b. increase in vaginal secretions
c. thin and sparse pubic hair
d. bladder prolapse
c. thin and sparse pubic hair
242
For a woman, history of her mother's health during pregnancy is important. A medication that requires frequent follow-up is:
a. corticosteriod
b. theophylline
c. diethylstilbestrol
d. aminoglycoside
c. diethylstilbestrol
243
A woman has come for health care complaining of a thick, white discharge with intense itching. These symptoms are suggestive of:
a. atrophic vaginitis
b. trichomoniasis
c. chlamydia
d. candidiasis
d. candidiasis
244
To prepare the vaginal speculum for insertion, the examiner:
a. lubricates it with a water-soluble lubricant
b. lubricates it with petrolatum
c. warms it under the light, then inserts it into the vagina
d. lubricates it with warm water
d. lubricates it with warm water
245
To insert the speculum as comfortably as possible, the examiner:
a. opens the speculum slightly and inserts in an upward direction
b. presses the intoitus down with one hand and inserts the blades obliquely with the other
c. spreads the labia with one hand , inserts the closed speculum horizontally with the other
d. pushes down on he introitus and inserts the speculum in an upward direction
b. presses the intoitus down with one hand and inserts the blades obliquely with the other
246
Before withdrawing the speculum, the examiner swabs the cervix with a swab soaked in acetic acid. This examination is done to assess for:
a. herpes simplex virus
b. contact dermatitis
c. human papillomavirus
d. carcinoma
c. human papillomavirus
247
Select the best description of the uterus:
a. anteverted, round asymmetric organ
b. pear-shaped, thick walled organ flattened anteroposteriorly
c. retroverted, almond-shaped asymmetric organ
d. midposition, thick-walled oval organ
b. pear-shaped, thick walled organ flattened anteroposteriorly
248
In placing a finger on either side of the cervix and moving it side to side, you are assessing:
a. the diameter of the fallopian tube
b. cervical motion tenderness
c. the ovaries
d. the uterus
b. cervical motion tenderness
249
Which of the following is (are) normal, common finding (s) on inspection and palapation of the vulva and perineum?
a. labia majora that are wide apart and gaping
b. palpable Bartholin's glands
c. clear, thin discharge from paraurethral glands
d. bulging at introitus during Valsalva maneuver
a. labia majora that are wide apart and gaping
250
Which of the following is the most common bacterial sexually transmitted infection in the United State?
a. chlamydia
b. gonorrhea
c. trichonmoniasis
d. syphilis
e. bacterial vaginosis
a. chlamydia
251
Write a narrative account of an assessment of female genitalia with normal findings.
Menarche at age 14, cycle 28 to 32 days of 4 to 5 days' duration. Flow moderate with no dysmenorrhea. Gravida 0/Para 0/ Ab 0. Has annual gynecologic exam. No urinary problems, no vaginal discharge. uses barrier method of birth control. Method satisfactory to self and partner.
252
What does the notation in a health record indicating the patient is a "G2 P3 Ab0" mean?
a. The woman has delivered 3 children, 2 of whom are living; her blood type is AB 0.
b. The woman has been pregnant twice with 3 children (twins and another child), and all her children are living
c. The woman has been pregnant 3 times, has 2 living, and had no spontaneous abortions
b. The woman has been pregnant twice with 3 children (twins and another child), and all her children are living
253
What problems are associated with smoking and the use of oral contraceptives?
a. increased risk of alcoholism and cirrhosis of the liver
b. thrombophlebitis and pulmonary emboli
c. infertility and weight gain
d. urinary tract infections and skin cancer
b. thrombophlebitis and pulmonary emboli
254
All of the following are in the LUQ except:
A. Spleen
B. Left kidney
C. Left lobe of the liver
D. duodenum
Duodenum
255
Positive Blumberg’s sign is:
A. Indicative of appendicitis
B. Indicative that the patient is free from peritoneal irritation
C. A lack of pain when palpating the abdomen
D. Inspiratory arrest on palpation of the liver
A. Indicative of appendicitis
256
Auscultation of the abdomen
A. Done first in the abdominal exam to prevent distortion of the bowel sounds caused by percussion and palpation
B. Is done with the bell of the stethoscope because the bowel sounds are high pitched
C. Should be started in the RUQ
D. Produces tympany
A. Done first in the abdominal exam to prevent distortion of the bowel sounds caused by percussion and palpation
257
To determine the lower border of the liver:
A. The nurse would percuss in the mid claviculatt line down from the lung and up from the abdomen until dullness was elicited
B. Palpate when the patient takes a deep breath
C. Percuss up from the abdomen in the right mid clavicular line until dullness is heard
D. Auscultate for a change in bowel sounds from tympany to resonance.
C. Percuss up from the abdomen in the right mid clavicular line until dullness is heard
258
When assessing CVA tenderness:
A. You are looking for changes in mental status
B. You use fist percussions to create vibrations
C. A normal finding is tenderness with palpation
D. Palpation is used to assess for inflammation of the kidney
B. You use fist percussions to create vibrations
259
Order of assessment of the abdomen is:
A. Palpate, percuss, auscultate, inspect
B. Inspect, percuss, auscultate, palpate
C. Inspect, auscultate, percuss, palpate
D. Inspect, palpate, percuss, auscultate
C. Inspect, auscultate, percuss, palpate
260
All of the following are true about ascites except:
A. It can occur with heart failure or liver failure
B. It can be assessed by percussing for shifting dullness
C. Testing for a fluid wave is a percussion test to differentiate between ascites and gastric distention
D. It is an accumulation of fluid in the intestines.
D. It is an accumulation of fluid in the intestines
261
When percussing over the abdomen:
A. Once in each quadrant is sufficient
B. Tympany is normally heard over the bladder
C. Dullness is normally heard over the liver
D. Hyperresonance is heard over ascites
Dullness is normally heard over the liver
262
All of the following regarding referred pain except:
A. Pain that is referred to the site of the organ during fetal development
B. Pain in the RUQ that radiates to the right scapula indicates cholecystitis
C. Umbilical pain that migrates to the RLQ is indicative of appendicitis
D. Cardiac pain can be referred to the right shoulder and arm
D. Cardiac pain can be referred to the right shoulder and arm
263
Having to urinate more frequently than normal is known as:
A. Dysuria
B. Polyuria
C. Nocturia
D. Oliguria
B. Polyuria
264
In order to do a rectal exam, your patient should preferably be:
A. In a prone position
B. In a supine position
C. In a lithotomy position
D. In a semi-fowler’s position
C. In a lithotomy position
265
All of the following regarding testicular cancer are true except:
A. It is most commonly found in males ages 15-40
B. Early tumors are often asymptomatic
C. Males with undescended testicles are at higher risk
D. Circumcision decreases the risk of testicular cancer
D. Circumcision decreases the risk of testicular cancer
266
Normal changes noted with aging include all of the following except:
A. Declining testosterone production
B. Gray pubic hair, in decreasing amounts
C. Erection maintained for a longer period of time
D. Decreased refractory state
D. Decreased refractory state
267
When interviewing an adolescent male regarding sexual history, the nurse should begin by asking if the patient uses condoms.
A. True
B. False
B. False
268
At the end of the vaginal canal is the
A. Ovaries
B. Uterus
C. Cervix
D. Rectum
C. Cervix
269
The proper position for a pelvic exam:
A. Trendelenberg feet higher than head
B. Supine
C. Right lateral recumbent
D. Lithotomy
D. Lithotomy
270
To help the woman feel more comfortable during a pelvic exam, the nurse can:
A. Elevate her head and shoulders to a semi sitting positon to facilitate eye contact
B. Move the stirrups for greatest abduction
C. Have the patient place her feet on the bed
D. Explain the exam while performing it
A. Elevate her head and shoulders to a semi sitting positon to facilitate eye contact
271
When doing an internal pelvic exam, the correct sequence is bimanual exam, speculum exam, retrovaginal exam.
A. True
B. False
B. False
272
You should document all of the following when describing the finding of a breast lump except:
A. Presence of dimpling, redness, swelling
B. Consistency
C. Size
D. Hx of breast cancer
D. Hx of breast cancer
273
The most common location for breast cancer is the upper inner quadrant of breast tissue.
A. True
B. False
B. False
274
The best time to perform SBE is right before the menstrual period:
A. True
B. False
B. False
275
The inframammory ridge is a firm transverse ridge of compressed issue in the lower quadrants felt upon palpation. This is a normal finding.
A. True
B. False
A. True
276
The recommended age to begin having a mammogram is:
A. 30
B. 35
C. 40
D. 50
C. 40
277
All of the following statements about gynecomastia are true except:
A. It is an enlargement of the breast tissue in males
B. It is a normal finding in puberty
C. It often appears in one breast
D. It is a permanent disfiguration that requires surgery
D. It is a permanent disfiguration that requires surgery
278
A sign of infection might be:
A. Enlarged, tender, moveable lymph nodes
B. Nontender, palpable lymph nodes
C. Fixed lymph nodes
A. Enlarged, tender, moveable lymph nodes
