test 4

Question 1

assessment for testes

Answer 1

• left scrotum lower than right
• lift sac to inspect the posterior surface
• lesions not present, except for sebaceous cyst. (yellowish, 1 cm nodules, firm, nontender and often multiple
• palpate each scrotal half between your thumb and first two fingers
• normally feel oval, firm and rubbery, and smooth and equal bilaterally. move freely and slightly tender to moderate presssure
• each epididymis normally feels discrete, softer than the testis, smooth and nontender

Question 2

menopause

Answer 2

• ending of menstruation
• peri-menopause 35-50 yrs old
• SIGNS AND SYMPTOMS
• night sweats
• insomnia
• thinning of vaginal tissues
• vaginal dryness
• “hot flashes”
• mood swings
• estrogen replacement therapy (ert or hrt)

Question 3

steps in a gynecological exam

Answer 3

• no sex for 24 hrs prior to exam
• place in lithotomy position
• vaginal speculum warmed and lubricated with warm water is used
• inspect labia majora and minor for: ,symmetry, irritation, cysts, lesions, color a dark pink, tissue moist
• perineum should be observed for episiotomy scar if pt has delivered a baby vaginally

Question 4

vaginal discharge

Answer 4

• clear, non-irritating=normal discharge
• thick, white discharge causing pruritis (itchiness) related to yeast infections (candidas or monilia)
• thin foul smelling idscharge causing pruritis related to trichymonis infection
• STD
• self-care behaviors
• yearly papanicolaou (pap test)
• yearly gyno exam

Question 5

health history and complaints of “room spinning around”

Answer 5

• headaches: location, duration and intensity (use pain scale); frequency, type-sharp, dull, throbbing etc.;treatment w/results(meds); accompanying symptoms such as dizziness, nausea, vomiting, eyesight disturbances; head injury; LOC
• dizziness/vertigo: feelings of lightheadedness, swimming sensation, faint feelings;
• vertigo: rotational spinning sensation
• does the room spin (subjective)
• do you feel like you are spinning (subjective vertigo)

Question 6

seizures

Answer 6

• also known as convulsions, epilepsy
• ask about: onset, treatment, frequency; date of last seizure; any associated symptoms;
• aura: an auditory, visual or motor premonition of a seizure. cold breeze, bright light.
• medication taken for seizures

Question 7

nursing care for seizure disorders

Answer 7

*padded bed, side rails up, put patient on side, do not hold them down

Question 8

nursing for distended bladder

Answer 8

• PALPATE BELOW PUBIC SYMPHYSIS: BLADDER SHOULD NOT BE FELT; IF PALPABLE: DISTENTION
• PERCUSSION USED IF FULL BLADDER IS FELT

Question 9

bicep reflex testing

Answer 9

• support patientforearm on yours
• place thumb on bicep tendon
• strike a blow on your thumb/flexion of forearm

Question 10

glosgow coma scale

Answer 10

• objective assessment/defines LOC
• 3 areas: eye opening, motor resonse , verbal response
• rated separately/give a #/numbers are added/reflects brains functional level
• fully alert, normal person-score 15
• score of 7 or less-coma

Question 11

test men over 50

Answer 11

*ALL MEN OVER 50 SHOULD HAVE A YEARLY RECTAL EXAM AND PSA TEST (PROSTRATE SPECIFIC ANTIGEN)

Question 12

genital self examination-young male

Answer 12

*test every month
*shower or bath (warm hands)
cold hands stimulate a muscular (cremasteric) reflex, retracting the scrotal contents
*hold scrotum in palm of hand, gently feel two testicles using thumb and first two fingers, if hurts too much pressure
*egg shaped and movable
*if firm, painless lump, a hard area, or an overall enlarged testicles-call dr.

Question 13

susceptibility to uti

Answer 13

*woman more susceptible-shorter urethra

Question 14

deep tendon reflexes during physical

Answer 14

• myotatic

* patella or knee jerk

Question 15

difference between rheumatoid vs osteoarthritis joint pain

Answer 15

• rheumatoid arthritis: chronic pain, swelling, warmth

* osteoarthritis: pain & stiffness in moving

Question 16

MUSCULAR CHANGES IN ELDERLY

Answer 16

• DECREASE IN HEIGHT W/RIB CAGE DISTENDING ONTO HIPS CAUSING LOSS OF WAIST
• DECREASE IN MUSCLE MASS ESPECIALLY IF EXERCISE DECREASED
• KYPHOSIS: CURVING OF SPINE CAUSES BOWING OF BACK; HUNCHBACK; SLOUCHING POSTURE
• SLIGHT FLEXION OF KNEES & HIPS-FORWARD POSTURE

Question 17

RHEUMATOID ARTHRITIS (RA)

Answer 17

• SYSTEMIC INFLAMMATORY DISEASE OF THE JOINTS & SURROUNDING CONNECTIVE TISSUE
• EARLY MORNING SYMPTOMS MOST SEVERE
• STIFFNESS, SWELLING, PAIN AND REDNESS MAY BE PRESENT

Question 18

OSTEOARTHRITIS

Answer 18

• DEGENERATIVE WEAR AND TEAR DISEASE OF JOINTS
• NON-INFLAMMATORY, PROGRESSIVE DEGENERATION OF WEIGHT BEARING JOINTS
• ARTICULAR CARTILAGE DAMAGED AND THERE IS OVER GROWTH OF NEW BONE R/T INCREASED FRICTION (OSTEOPHYTES)
• LOSS OF CALCIUM IN BONES CAUSING WEAKNESS OF BONES AND INCREASED CHANCES OF FRACTURES
• MORE PROMINENT IN WOMAN AFTER MENOPAUSE BECAUSE OF LOSS OF ESTROGEN
• DIAGNOSIS BY BONE DENSITY TEST

Question 19

DYSURIA

Answer 19

*PAIN OR BURNING ON VOIDING OR DIFFICULTY VOIDING W/RETENTION

Question 20

IMPOTENCE

Answer 20

ERECTILE DYSFUNCTION

• MEDS TAKEN (EX VIAGRA)
• RECREATIONAL DRUGS
• CHRONIC ILLNESS(DIABETES)
• PSYCHO-SOCIAL PROBLEMS

Question 21

HYPERTROPHY OF PROSTRATE

Answer 21

• BENIGN PROSTATIC HYPERTROPHY (BPH)
• ENLARGEMENT OF PROSTRATE GLAND, WHICH IS WRAPPED AROUND URETHRA, BLOCKS THE FLOW OF URINE CAUSING: HESITANCY, DRIBBLING, URGENCY AND FREQUENCY, FEELING THE NEED TO VOID AFTER COMPLETION OF VOIDING; RETENTION OF URINE
• ANY TREATMENT
• SELF-CARE BEHAVIORS
• LAST PROSTRATE-SPECIFIC ANTIGENS TEST (PSA)
• LAST EXAM W/RECTAL EXAM

Question 22

MUSCULOSKELETAL EXAM

Answer 22

• INSPECTION: SIZE AND CONTOUR OVER JOINTS; SKIN AND TISSUE OVER JOINT
• PALPATION: SKIN TEMP; MUSCLE, BONY ARTICULATIONS
• RANGE OF MOTION
• MUSCLE TESTING: APPLY OPPOSING FORCE; GRADING MUSCLE STRENGTH

Question 23

PHYSICAL ASSESSMENT OF TEMPROMANDIBULAR JOINT

Answer 23

• PALPATE JOINT AT EARS NEAR THE TRAGUS AND ZYGOMATIC ARCH
• NOTE ANY CLICKING, TENDERNESS, ABNORMAL MOVEMENT WHEN PT OPENS AND CLOSES MOUTH
• PALPATE THE TEMPORAL ARTERY JUST ABOVE THE TEMPOROMANDIBULAR JOINT NEAR LEVEL OF EYES

Question 24

CORNEA REFLEX TESTING

Answer 24

• NORM: EYELID CLOSES ON REFLEX

* PROTECTIVE MECHANISM; TESTS FOR BLINKING

Question 25

ROM ASSESSMENT

Answer 25

* DELTOID: PT HOLD ARM UP/EXAMINER PUSHES DOWN * BICEPS: PT EXTEND ARM & ATTEMPT FLEX ARM/EXAMINER HOLD FOREARM IN EXTENDED POSITION * TRICEPS: PT FLEX ARM & TRY EXTEND ARM AGAINST EXAMINERS ATTEMPT TO KEEP ARM FLEXED * WRISTS & FINGERS: PT SPREADS FINGERS WHILE EXAMINER TRIES TO KEEP THEM CLOSED * HAND GRIPS: PT. GRABS INDEX FINGER & MIDDLE FINGERS OF EXAMINIER & EXAMINER TRIES TO PULL THEM OUT * HIPS: PT RAISE 1 LEG AT A TIME/EXAMINER TRIES TO HOLD DOWN * HAMSTRING: PT FLEXES BOTH KNEES WHILE LYING DOWN/EXAMINER TRIES TO EXTEND LEGS * QUADRICEPS: PT EXTENDS KNEE PARTIALLY/EXAMINER ATTEMPTS TO EXTEND THEM * ANKLE & FEET: PT ATTEMPTS TO DORSIFLEX & EXTEND FEET AGAINST EXAMINERS RESISTENCE

Question 26

TESTING & FUNCTION OF CRANIAL NERVES: CRANIAL 1

Answer 26

* CRANIAL 1 "OLFACTORY NERVE": * HAVE PT SNIFF TO ESTABLISH PATENCY OF NOSE * PT. CLOSE EYES * PT. OCCLUDE ONE NOSTRIL & GIVE AROMIC AGENT TO OPEN NOSTRIL * ASK PT. TO IDENTIFY ODOR * ASSESS OTHER NOSTRIL W/DIFFERENT AGENT

Question 27

CRANIAL 2 "OPTIC"

Answer 27

* TEST ACUITY FOR SNELLEN OR JAEGER CHART * TEST COLOR VISION * OPHTHALMOSCOPIC EXAMINATION OF INTERIOR OF EYE AND RETINA * VISUAL ACUITY VIA SNELLEN CHART OR JAEGER CHART: OBSERVE FOR: SQUINTING, LEANING FORWARD OR BACKWARD, INACCURATE READING; PERFORM W/WO GLASSES OR CONTACTS: SNELLEN CHART; JAEGER CARD