NUR 612 Exam 4
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Free NUR 612 Exam 4 Questions
Which statement made by a 37-year-old would make the examiner suspect fibrocystic disease?
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Lump in my breast that is nontender
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Right breast is larger than left
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Nipples are darker than before baby was born
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I feel a lump in my breast right before my period.
Explanation
Correct Answer: D. I feel a lump in my breast right before my period.
Explanation of Correct Answer
Fibrocystic breast disease is characterized by cyclic breast changes that fluctuate with the menstrual cycle. Lumps often become more noticeable, tender, or painful right before menstruation due to hormonal stimulation causing cystic enlargement. This timing is a hallmark feature distinguishing fibrocystic disease from other breast conditions.
A 65-year-old woman is brought to the clinic by family. They report they have noticed a change in her mental abilities over the past 2 weeks. Normally they say she is independent, intelligent, and very socially oriented. Medical history is unremarkable except for congestive heart failure, for which she takes digoxin. She has had no major changes in her health. What questions would be most important for the examiner to ask the woman's family?
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Is there a family hx of Alzheimer’s?
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How much alcohol does she drink in an average week?
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When was her digoxin level last checked?
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Did you know that the mental function begins to decline after the age of 60?
Explanation
Correct Answer: C. When was her digoxin level last checked?
Explanation of Correct Answer
Digoxin toxicity is a well-documented cause of acute confusion, delirium, and cognitive changes in older adults. Since the woman’s mental status has changed rapidly over just two weeks, a reversible cause must be considered before diagnosing a chronic neurocognitive disorder such as dementia. Checking when her digoxin level was last measured is critical, as toxicity can occur even at therapeutic doses in older adults due to reduced renal clearance and drug interactions. Prompt evaluation of her digoxin level could explain her acute mental changes and guide treatment.
The examiner inspects the scrotum of a 43-year-old man. Which of the following requires further evaluation?
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Left testicle hangs lower than the right
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Scrotum is darker than general skin color
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Skin on scrotum is shiny and smooth
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Scrotum has a midline raphe
Explanation
Correct Answer: C. Skin on scrotum is shiny and smooth
Explanation of Correct Answer
Shiny, smooth scrotal skin may indicate scrotal edema, which can be associated with systemic conditions such as heart failure, liver disease, or renal disease, or local problems like infection or lymphatic obstruction. Because this is not a normal finding, it requires further evaluation to determine the underlying cause.
Which type of assessment should be used to evaluate the mental status of a patient with head trauma?
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PHQ
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Perceptual distortion assessment
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Glasgow Coma Scale
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Functional Assessment
Explanation
Correct Answer: C. Glasgow Coma Scale
Explanation of Correct Answer
The Glasgow Coma Scale (GCS) is the standard tool for evaluating mental status in patients with head trauma. It assesses three key areas: eye opening, verbal response, and motor response. The total score (ranging from 3 to 15) helps determine the severity of brain injury and guides clinical management. A lower score indicates more severe impairment of consciousness.
When other symptoms are presented with atrophic vaginitis, a biopsy is used as the diagnostic test to rule out which of the following diagnoses? Select all that apply.
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Urinary tract infection (UTI)
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Lichen sclerosis
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Lichen planus
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Squamous cell hyperplasia
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Sexually transmitted infection (STI)
Explanation
Correct Answers: B. Lichen sclerosis, C. Lichen planus, D. Squamous cell hyperplasia
Explanation of Correct Answers
B. Lichen sclerosis
This chronic inflammatory skin condition can mimic atrophic vaginitis and carries a risk of vulvar squamous cell carcinoma. Biopsy is required for confirmation.
C. Lichen planus
Lichen planus can cause vulvovaginal irritation and atrophy-like symptoms. Biopsy helps differentiate it from atrophic vaginitis and guide management.
D. Squamous cell hyperplasia
This condition causes vulvar thickening and irritation and is a precancerous lesion. Biopsy is necessary to confirm the diagnosis and rule out malignancy.
Mrs. Pope presents with twitching and burning sensations in her right leg that cause difficulty in walking. Initial suspicion is peripheral neuropathy. The proper diagnosis of peripheral neuropathy begins with a detailed history and physical examination. Which of the following information in her social history may be a cause of her symptoms? Select all that apply.
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Current occupation
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Going out to dinner
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Use of shoes with good support
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Substance abuse
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Use of supplements
Explanation
Correct Answers: A. Current occupation, D. Substance abuse, E. Use of supplements
Explanation of Correct Answers
A. Current occupation
Jobs involving repetitive trauma, exposure to toxins, or prolonged standing can contribute to peripheral nerve injury and neuropathy, making occupation an important factor in history-taking.
D. Substance abuse
Alcohol and certain illicit drugs are well-known causes of peripheral neuropathy due to direct neurotoxicity and nutritional deficiencies (especially thiamine).
E. Use of supplements
Overuse of some supplements, such as vitamin B6 (pyridoxine), can cause neuropathy, while deficiencies of other vitamins (B12, folate) may also contribute.
A 24-year-old male has scrotal pain and marked erythema. The examiner considers epididymitis. Which other finding is most consistent with this finding?
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Absent cremasteric reflex
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Anorexia and nausea
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Acute onset of severe pain
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Urethral discharge
Explanation
Correct Answer: D. Urethral discharge
Explanation of Correct Answer
Epididymitis is commonly associated with sexually transmitted infections such as chlamydia or gonorrhea in young men. Urethral discharge is a frequent accompanying symptom, along with dysuria, fever, and gradual onset scrotal pain. The epididymis is usually swollen and tender, and scrotal erythema is common.
Jessie is a 54-year-old patient with a history of atrophic vaginitis. Which of the following should be included in her patient education? Select all that apply.
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Use of water-soluble lubricants
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Benefits of sexual-aid stimulators
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Benefits of regular sexual activity
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Identifying and addressing age-related changes
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Use of over-the-counter (OTC) medications for pain and discomfort
Explanation
Correct Answers:
A. Use of water-soluble lubricants, B. Benefits of sexual-aid stimulators, C. Benefits of regular sexual activity, D. Identifying and addressing age-related changes
Explanation of Correct Answers
A. Use of water-soluble lubricants
These are recommended to reduce dryness and discomfort during sexual activity, improving vaginal comfort without irritating tissues.
B. Benefits of sexual-aid stimulators
Sexual-aid devices can increase blood flow and promote lubrication, helping alleviate symptoms of atrophic vaginitis.
C. Benefits of regular sexual activity
Ongoing sexual activity promotes blood circulation and helps maintain vaginal elasticity and lubrication, reducing the severity of atrophic changes.
D. Identifying and addressing age-related changes
Patient education should include awareness of menopausal changes such as thinning vaginal walls, dryness, and discomfort, empowering patients to manage symptoms proactively.
While performing a breast examination on a 68-year-old woman, the examiner expects to find what?
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Breast tissue with multiple, firm large lumps
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Breast tissue has granular feel
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The tail of Spence is not longer observed
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Axillary lymph nodes are enlarged
Explanation
Correct Answer: B. Breast tissue has granular feel
Explanation of Correct Answer
In older women, particularly postmenopausal, breast tissue atrophies and is replaced by fibrous and fatty tissue. The tissue may feel granular or nodular due to fibrosis and decreased glandular content. This is a normal age-related change and not indicative of malignancy.
To rule out age-related benign symptoms, motor functions should be inspected for body position and involuntary movements. Which of the following should be included in the assessment of motor function? Select all that apply.
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Muscle strength
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Hypersensitivity
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Sensory loss
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Muscle tone
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Reflexes
Explanation
Correct Answers:
A. Muscle strength, D. Muscle tone, E. Reflexes
Explanation of Correct Answers
A. Muscle strength
Assessing muscle strength helps identify weakness or asymmetry, which may indicate neurological or musculoskeletal issues rather than normal aging.
D. Muscle tone
Tone reflects the resistance felt during passive movement. Changes such as rigidity or spasticity can signal neurological disease, making tone an essential part of motor assessment.
E. Reflexes
Deep tendon reflexes provide information about the integrity of motor pathways. Abnormalities (hyporeflexia or hyperreflexia) may reveal underlying neurological dysfunction.
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