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Nursing 507 > Nursing 507- Exam 4 Q's > Flashcards

Nursing 507- Exam 4 Q's Flashcards

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1
Q

Bob a 55 yr olf male presents to your clinic with complaints of hesitancy & straining with urination.

What question is least important to ask

A. any fever

B. onset & duration

C. pain

D. abd discomfort

A

D. abd discomfort

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2
Q

The rectal exam on Bob reveals a prostate gland which is enlarged, smooth & slightly elastic but nontender to palpation. You have determined he has the following diagnosis?

A. Prostate cancer

B. inguinal hernia

C. acute prostatitis

D. BPH

A

D. BPH

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3
Q

A 52 year old elementary school bus driver has rectal itching, rectal irritation & rectal discomfort, which is made worse by straining with bowel movements. She has no previous history of bowel dysfunction except for constipation. She also experiences occasional bright red rectal bleeding when constipated. Her history is significant for frequent tension headaches for which she takes ibuprofen as needed. Nonprescription meds include a multivitamin daily, vitamin A, beta carotene & vitamin C in large doses for the antioxidants & free radicals. The physical exam reveals a bluish, firm varix, protruding around the superior portion of the anus. There are no excoriations, lacerations, fissures, rashes, or other lesions noted. Her family history is negative for polyps or colon cancer.

A

hemorrhoids

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4
Q

Based on your knowledge of this dx, what would you be sure to include in pt. education?

A. rectal ca+ screening recommendations, prevention against constipation, diet changes

B. discussion of low fat, high fiber diet

C. preventive measures for constipation, hemocult testing

D. high fiber diet, hemocult testing

A

A. rectal ca+ screening recommendations, prevention against constipation, diet changes

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5
Q

When should this pt. return for a follow-up visit?

A. PRN

B. Three weeks

C. If pain increased & other sx’s persist & intensify

D. 2 months

A

C. If pain increased & other sx’s persist & intensify

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6
Q

Clancy is a 17 yr old male who presents to the emergency room with c/o pain & swelling in his left testicle. The pain was sudden & is rated as an 8/10. He denies dysuria, frequency, urgency, urethral discharge, fever or chills. He has no significant PMH. Denies sexual activity. The physical exam reveals a very painful left testis that is significantly higher in the scrotum than the right testis. VS BP 110/60, HR 96, RR 18, temp 98.7

The most likely dx is?

A

testicular torsion

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7
Q

Your plan of care for Clancy should include?

A. narcotics & ice

B. immediate consultation & surgery referral

C. scrotal support

D. broad-spectrum antibiotics

A

B. immediate consultation & surgery referral

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8
Q

Alex Bell is a 63 y/o male in excellent health who appears for an urgent visit. He states that yesterday he was lifting free weights in his home, standing upright while lifting, & he heard a “pop” then felt a “bulge in the left groin.” The physical exam supports your suspected dx of a hernia

The most common type of hernia in men is?

A. Inguinal

B. Umbilical

C. Ventral

D. Femoral

A

A. Inguinal

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9
Q

You have decided the hernia is asymptomatic & easily reducible. What pt. edu will you give Alex?

A. Discuss the need for immediate surgery

B. Discuss watching the hernia, discuss S/S of incarceration & strangulation return in 1 month

C. return PRN

D. explain the type of hernia & tell him “nothing needs to be done.”

A

B. Discuss watching the hernia, discuss S/S of incarceration & strangulation return in 1 month

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10
Q

Sara a 21 y/o female presents to your office for her first GYNO exam

How will you ensure that Sara is comfortable with you & the exam?

A. laugh & kid around with her

B. be firm & quiet

C. establish rapport, give explanations, present a caring & professional attitude

D. Allow Sara to tell you when to proceed with the exam but explain nothing

A

C. establish rapport, give explanations, present a caring & professional attitude

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11
Q

During the exam, Sara states that she has periods every 28 days, they last for 5 days, & she has some mild cramping on day 1 that is relieved with OTC Motrin. Where does this info belong?

A. chief complaint

B. objective data

C. ROS (GU)

D. none of the above

A

C. ROS (GU)

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12
Q

Sara reveals that she is scared & is afraid to proceed with the physical exam. HOw will you deal with this situation?

A. Reschedule her for another day

B. Acknowledge her fears but be firm & proceed anyway

C. ignore her concerns & proceed with the exam

D. acknowledge her fears, explain the entire exam, allow her to see the equipment, & proceed at her pace

A

D. acknowledge her fears, explain the entire exam, allow her to see the equipment, & proceed at her pace

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13
Q

Sara’s exam is now over & Sara states that it was not as scary as she thought it would be. What do you do next?

A. Explain the procedure for the follow up exam

B. acknowledge her statement & explain the procedure for follow up exams & receiving her pap smear results

C. smile & leave the room

D. make jokes about the tense situation

A

B. acknowledge her statement & explain the procedure for follow up exams & receiving her pap smear results

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14
Q

Debbie Patton is a 21 y/o white female who presents to your office for her first annual exam. She is currently sexually active but does not utilize any form of birth control. During the history she asks what is the function of the pap smear. How should you reply to this question?

A. The pap smear is a screen for infectious diseases

B. the pap smear is a screen for cervical cancer

C. The pap smear is a diagnostic/definitive for infectious diseases

D. The pap smear is a diagnostic definitive test for cervical cancer

A

B. the pap smear is a screen for cervical cancer

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15
Q

You complete the annual exam on Debbie without difficulty. What preventive education will you give to Debbie?

A. discuss importance of yearly exams

B. discuss importance of birth control, STD protection & yearly exams

C. Discuss the importance of birth control, STD prevention, yearly exams, exercise, CA intake, & SBE

D. Discuss importance of STD protection & SBE

A

C. Discuss the importance of birth control, STD prevention, yearly exams, exercise, CA intake, & SBE

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16
Q

Tamara a 40 yr old female presents for a prenatal exam at 8 wks from LMP

A mild systolic flow murmur is noted on the exam. This indicates a (n)?

A. abnormal finding & needing echocardiogram

B. an expected finding

C. an expected finding but need for echocardiogram

D, none of the above

A

B. an expected finding

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17
Q

The breast exam on Tamara reveals a 1 cm firm mass in the right upper outer quadrant (RUQQ). The next step is?

A. Breast ultrasound

B. Mammogram

C. Repeat breast exam on next visit

D. None of the above

A

A. Breast ultrasound

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18
Q

The testis & epididymis is palpated between the thumb & 1st 2 fingers for which of the following findings?

A. painless nodules & edema

B. pain on deep pressure & discharge

C. cystic structures & pain on deep pressure

D. taut scrotal skin & cordlike vessels

A

A. painless nodules & edema

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19
Q

Which of the following is the best approach if on palpation, the rectal sphincter tightens?

A. reassure pt. & insert finger quickly while pt. holds breath

B. reassure pt. & use gentle but firm pressure to open the sphincter

C. reassure pt. & give medication to help with relaxation of the sphincter

D. Reassure pt. & wait for a moment for sphincter to relax

A

B. reassure pt. & use gentle but firm pressure to open the sphincter

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20
Q

Which of the following is the correct technique for examining a right inguinal hernia

A. Pt. stands & clinician examines of the rt side

B. pt. sits & clinician examines on the rt side

C. pt. stand & clinician examines n the left side

D. pt. sits & clinician examines on the left side

A

A. Pt. stands & clinician examines of the rt side

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21
Q

Which of the following is the method used to calculate due date, in which the rule of thumb is to add 7 days to the 1st day of the LNMP, subtract 3 months & add 1 year?

A. Murphy’s law

B. Allen’s test

C. Naegele’s rule

D. Ayre test

A

C. Naegele’s rule

22
Q

Using Tanner’s sex maturity rating scale, which of the following characteristics would represent stage 5 in a female adolescent?

A. sparse growth of hair chiefly along the labia

B. course & curly hair mainly along the labia

C. coarse, curly hair spreading over the symphysis pubic

D. thick, coarse, curly hair covering the pubic area & the inner thighs

A

D. thick, coarse, curly hair covering the pubic area & the inner thighs

23
Q

A 15 yr old HS stu wising to join the school’s football & basketball teams presents to your office for a sports physical. As part of the physical you must perform a hernia check. You notice that his right scrotum is markedly larger than his left scrotum. He denies pain or tenderness, fever, night sweats, or recent weight loss. On palpation of the scrotum you fell a fluid-filled mass in the right scrotum & you can get above the mass with your fingers. What is your most likely dx?

A. hydrocele

B. testicular tumor

C. a varicocele

D. an epidermoid cyst

A

A. hydrocele

24
Q

Barbara a 28 yr old housewife presents for an annual checkup. When queried she mentions she has noticed bleeding in btw her periodsfor the past several months. She has been pregnant 5X’s & given birth to 5 infants. She is sexually active in a monogamous relationship with her husband. On physical exam of the uterus you palpate an irregular nodule that is approximately 3 cm in diameter. Based on this info, what is your most likely dx?

A. Myoma or fibroid

B. cervical ca+

C. uterine ca+

D. cystocele

A

A. Myoma or fibroid

25
Q

You are performing a routine checkup on Shelby who is 37 wks pregnant. Her BP is 110/65 mmHG. The size of the uterus is appropriate for her dates; fetal heartrate is in the 140’s. She has trace pedal edema. You perform an exam for the size of the fetus & its position. What is this maneuver called?

A. Naegele’s maneuver

B. leopold’s maneuver

C. Bickley’s maneuver

D. Bates maneuver

A

B. leopold’s maneuver

26
Q

An 80 yr old retired secretary present to the ED room because of difficulty having a bowel movement, stating that “it feels like something is coming out of me.” She denies fever or chills or weight loss, she has had constipation & has used an OTC stool softener & increasedher water intake. She denies pain with defection. On physical exam of the anus, u see a doughnut of red tissue, with concentrically circular folds where the anus should be. What is your most likely dx?

A. thrombosed external hemorrhoid

B anal fissure

C. rectal prolapse

D. rectal cancer

A

C. rectal prolapse

27
Q

As part of a routine check up, you are examining the prostate of a 55 yr old man. He denies nocturia or urinary hesitancy. During palpation of the prostate gland & feel a mass. Which 1 of the descriptors would you use to characterize this mass?

A. color

B. size

C. presence of discharge

D. presence of a rash

A

B. size

28
Q

Ashlee a 22 yr old presents to your office because she has not had a menstrual cycle in 3 months. She is sexually active in a monogamous relationship. You perform a physical exam & determine that she is pregnant. What did you see and or/feel on exam of the cervix & uterus?

A. pink cervical os, firm to palpation

B. cyanotic cervical os, soft to palpation

C. pink cervical os, soft to palpation

D. cyanotic cervical os; firm to palpation

A

B. cyanotic cervical os, soft to palpation

29
Q

You are performing a routine physical exam on a 70 yr old retired banker. During the exam of the prostate, you palpate a mass that is 1 cm in diameter, hard, & nontender to palpation. The pt. has had a 6 month history of fatigue. He denies weight loss or night sweats. What is your most likely dx?

A. BPH

B. internal hemorrhoid

C. prostatitis

D. prostate ca+

A

D. prostate ca+

30
Q

The healthy prostate gland can be described as?

A. painful to palpation, swollen

B. asymmetrical & enlarged

C. heart-shaped with a palpable median sulcus

D. irregular shaped with a distince area of nodular hardness

A

C. heart-shaped with a palpable median sulcus

31
Q

You have determined the sexual maturity rating for an adolescent male as stage 4 based Tanner’s sex maturity rating scale. Which of the following characteristics would identify stage 4?

A. dark, coarse curly hair spread sparsely over the pubic symphsis, slightly larges testes, slightly enlarged penis with development of the glans

B. coarse & curly hair over the public symphysis with enlarged testes, darkened scrotal skin, & enlarge penis with development of the glans

C. large amounts of coarse & curly hair over the pubic symphysis & inner thighs, with the penis & scrotal sac fully developed

D. large amounts of coarse & curly hair over the pubic symphysis, inner thighs, & lower half of the abd with the penis & scrotal sac uflly developed

A

B. coarse & curly hair over the public symphysis with enlarged testes, darkened scrotal skin, & enlarge penis with development of the glans

32
Q

A 20 yr old college student comes into the clinic with sx’s of fatigue, nausea, & increase in urination. Her LNPM was approximately 3 months ago on January 20, 2021. She is currently sexually active & states she always uses condoms. Her PMH is unremarkable. One exam you see a young, anxious appearing female. Her VS, HEENT, resp, cardio, abd exam are unremarkable. Pelvic exam reveals a soft cervic & a 14 wk sized uterus. Urine pregnancy is positive. You inform her of the pregnancy & using Naegel’s rule, give her the estimated date of confinement . What date did you give her?

A. Oct 20, 2021

B. Oct 27, 2021

C. Nov 20, 2021

D. Nov 27, 2021

A

B. Oct 27, 2021

33
Q

A pt. who is 3 months pregnant has had swollen feet for a month in which both pretibial & ankle edema is assessed as less than 3. What is the name given to this type of edema

A. pathologic edema

B. modified edema

C. false edema

D. physiologic edema

A

D. physiologic edema

34
Q

In the normal aging women, which of the following could be a probable cause for a complaint of pain during intercourse?

A. decreased vaginal lubrication

B. decreased uterine size

C. decreased ability to get pregnant

D. decreased frequency of intercourse

A

A. decreased vaginal lubrication

35
Q

Which of the following would help a patient relax during a gynecologic exam?

A. tell her if she relaxes & has no questions the exam will go more quickly

B. tell her what will happen during the exam & allow her to ask questions

C. have her empty her bladder & use a cool speculum

D. have her relax her arms over her head & use quick movements

A

B. tell her what will happen during the exam & allow her to ask questions

36
Q

Which of the following questions is pertinent for a gynecologic exam on an 18 year old female who c/o lower abd cramping for 3 days & her LNMP was 26 days ago (asked 1st)

A. do you have joint pain or stiffness at certain times of the day?

B. do you usually have a lot of cramping before your periods?

C. have you had any burning sensations an hour or so before meals?

D. do you have a pins & needles sensation in your legs?

A

B. do you usually have a lot of cramping before your periods?

37
Q

Your 15 yr old male pt. presents to your office with c/o N&V & a bulge in the scrotum while standing. During palpation of the scrotal sac, he c/o pain & tenderness. You decide he most likely has?

A. hydrocele

B. Strangulated hernia

C. Incarcerated hernia

D. None of these above

A

B. Strangulated hernia

38
Q

A hydrocele is described as

A. a painless nodule

B. a tender mass on the epididymis

C. a nontender, fluid-filled mass within the tunica vaginalis

D. a rope-like structure

A

C. a nontender, fluid-filled mass within the tunica vaginalis

39
Q

Which of the following q’s is the least important to ask a 16 yr olf male pt. with a h/o gonorrhea (asked last)

A. did you have pain or swelling in the scrotum or testes?

B. Have you had any discharge from or sores on the penis

C. Have you had pain or urination or pain in the lower abd

D. Did you have any problems developing secondary sex characteristics?

A

D. Did you have any problems developing secondary sex characteristics?

40
Q

You are performing a routine exam on Rosa, a pregnant women who is 24 wks gestation. She had early prenatal care, has not medical problems, and has an uncomplicated pregnancy to date. Her last menstrual period (LNMP) correlates with the gestational age of her pregnancy. You would expect the following to be true at her 24-week checkup

A. Rosa will feel the baby move

B. The fundal height will be 20 cm

C. The fetal heart rate will be 60 bpm

D. The uterus will be anteverted & pear-shaped

A

A. Rosa will feel the baby move

41
Q

Which of the following statements describes the purpose of the bimanual exam in a female pt.?

A. assess the size of the uterus, ovaries, & prostate gland

B. assess the placement of the uterus, masses on the ovaries, & characteristics on the surface of the cervix

C. assess presence of rectoceles, obstructions in the vagina, & intact sphincters

D. assess nodularity in the vag wall, ovarian masses & position of the uterus

A

D. assess nodularity in the vag wall, ovarian masses & position of the uterus

42
Q

During palpation of the 3rd Leopold maneuver of the fetal head is descending into the pelvic inlet, the RN should feel the fetal part as?

A. rough firm but irregular

B. irregular with kicking movements

C. smooth, firm, rounded

D. globular, smooth & hard

A

D. globular, smooth & hard

43
Q

Which of the following descriptions cannot be observed on exam of the external female genitalia?

A. inflamed bartholin’s glands

B. nodules on the labia minora

C. color of the cervix

D. size of the clitoris

A

C. color of the cervix

44
Q

Mrs. Kelly presents for her usual prenatal checkup. You measure the fundal height at 24 cm. What would you estimate the length of her gestation to be?

A. 20 wks

B. 24 wks

C. 26 wks

D. 32 wks

A

B. 24 wks

45
Q

Calvin an 18 ur olf HS student present to you roffice for eval of acute onset of pain in the left testicle. Calvin has had no problems until this morning. The pain is intermittent, sharp, & radiates into the left groin. On the physical exam the testicle feels swollen is tender to palpation & is retracted into the scrotum. What is your most likely dx?

A. epididymitis

B. testicular torsion

C. acute orchitis

D. testicular ca+

A

B. testicular torsion

46
Q

Based on your knowledge or testicular ca+ when should you begin teaching males to perform TSR (testicular self-exam)

A. at age 30

B. at puberty

C. at age 10

D. at age 45

A

B. at puberty

47
Q

When discussion past medical history during a gyno exam, which of the following areas should be discussed with the pt.?

A.. meds for constipation & past episodes of depression

B. activities for relaxation & amount of sleep each evening

C. birth control pills & past episodes of sexually transmitted diseases

D. activities with recreational drugs & religious beliefs

A

C. birth control pills & past episodes of sexually transmitted diseases

48
Q

Which of the following represents metrorrhagia?

A. fewer than 21 days between menses

B. excessive flow

C. scant bleeding

D. bleeding between periods

A

D. bleeding between periods

49
Q

Tamara a 19 yr old college student presents for eval of vag discharge. She has been in a monogamous relationship since becoming sexually active & is married to her partner. She denies that either has been unfaithful. She denies fever, chills. She states the discharge is thick, white & curd like and although there is no odor she has intense itching. Pelvic exam reveals inflamed vulva with slightly red vaginal mucousa. The discharge is thick & white. There is no cervical motion tenderness. The uterus is midline, nontender to palpation and without adnexal masses. Based on this info what is your dx?

A. Bacterial vaginosis

B. Trichomonas vaginalis

C. Candida vaginitis

D. Cystocele

A

C. Candida vaginitis

50
Q

What is the name given to the early sign of pregnancy in which the cervix appears cyanotic & has pronounced softening of cervix on palpation?

A. chadwick’s sign

B. chloama

C. hegars sign

D. cervic souffle

A

A. chadwick’s sign

51
Q

On exam of the rectum which of the following cannot be palpated?

A. uterine cervix

B. tenderness of peritoneal inflammation

C. nodulatiry of peritoneal metastasis

D. prostate gland

A

B. tenderness of peritoneal inflammation

52
Q

For which of the following is the prostate gland assessed for?

A. size & consistency

B. size enlarged nodes nearby

C. nodularity of peritoneal metastasis

D. venous patterns

A

A. size & consistency

Nursing 507 (8 decks)

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