NUR 612 Exam 4

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Free NUR 612 Exam 4 Questions

1.

Which symptoms associated with PMS are caused by:

  • Ovulation

  • Thickening of uterine lining

  • Elevations in body temperature

  • Fluctuations in hormone levels

Explanation

Correct Answer: D. Fluctuations in hormone levels

Explanation of Correct Answer

Premenstrual syndrome (PMS) is primarily caused by cyclical fluctuations in estrogen and progesterone levels during the menstrual cycle. These hormonal changes affect the central nervous system, mood regulation, and fluid balance, lea ding to symptoms such as irritability, mood swings, bloating, breast tenderness, and fatigue. The symptoms typically occur in the luteal phase, just before menstruation.


2.

A patient who has difficulty writing or drawing is most likely to have what condition?

  • Temporal lobe damage

  • Peripheral neuropathy

  • Organic brain syndrome

  • Psychiatric hallucinations

Explanation

Correct Answer: B. Peripheral neuropathy

Explanation of Correct Answer

Peripheral neuropathy affects the peripheral nerves, leading to weakness, numbness, and loss of fine motor control in the hands. Since writing and drawing require precise coordination, patients with neuropathy may struggle due to impaired sensation or muscle weakness. This makes peripheral neuropathy the most likely cause when the primary difficulty lies in motor execution rather than cognitive processing.


3.

During an examination for a hernia an adult male should:

  • Be asked to stand

  • Be in a supine position

  • Sit on the table with heels together

  • Assume a knee-chest position on the exam table

Explanation

Correct Answer: A. Be asked to stand

Explanation of Correct Answer

Hernias are best evaluated with the patient standing, as gravity and intra-abdominal pressure make protrusions more noticeable. While standing, the patient may also be asked to cough or bear down (Valsalva maneuver), which further increases abdominal pressure and allows the examiner to detect bulges in the inguinal or femoral regions.


4.

A patient 3 weeks postpartum reports sore nipples and is breastfeeding. The examiner observes dry, cracked nipples. Which question would be helpful?

  • Do you pump?

  • How do you clean your breasts?

  • Have you been able to bond with your baby?

  • What medications have you been taking?

Explanation

Correct Answer: B. How do you clean your breasts?

Explanation of Correct Answer

Improper nipple care, such as frequent washing with soap or use of harsh cleansers, can dry out the skin and worsen cracking. Asking how the patient cleans her breasts helps identify practices that may be contributing to nipple soreness and guides education on gentle cleaning (usually just water) and proper nipple care during breastfeeding.


5.

Which finding on a female breast requires further investigation?

  • Wrinkled areolas

  • Prominent Montgomery tubules

  • One breast larger than the other

  • Unilateral venous network

Explanation

Correct Answer: D. Unilateral venous network

Explanation of Correct Answer

A unilateral prominent venous network can indicate increased blood flow due to an underlying pathology, such as malignancy. When new or asymmetric venous patterns appear on one breast, it warrants further evaluation with imaging and clinical correlation to rule out breast cancer.


6.

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.

  • Muscle strength

  • Hypersensitivity

  • Sensory loss

  • Muscle tone

  • 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.


7.

A patient scores a 3 on a mini-cog assessment instrument for dementia. What does this score indicate?

  • Advanced dementia

  • Early dementia

  • Need for further evaluation

  • Negative screen for dementia

Explanation

Correct Answer: D. Negative screen for dementia

Explanation of Correct Answer

The Mini-Cog combines a three-word recall and clock-drawing test. Scores range from 0 to 5. A score of 0–2 suggests possible cognitive impairment and the need for further evaluation, while a score of 3–5 generally indicates a negative screen for dementia. Therefore, a score of 3 means the patient screened negative and does not currently show signs of dementia requiring diagnostic follow-up.


8.

Which of the following is the single most signal symptom for possible breast cancer?

  • Breast discharge

  • Nipple retraction

  • Breast redness

  • Breast mass

Explanation

Correct Answer: D. Breast mass

Explanation of Correct Answer

A palpable breast mass is the most significant clinical symptom and the primary signal for possible breast cancer. While many breast lumps are benign, a new, hard, irregular, or immobile mass warrants immediate evaluation through imaging and possibly biopsy. Early detection of a mass significantly improves outcomes and survival rates.


9.

While palpating the introitus of the vagina, the patient jumps and complains of severe tenderness. A mass is palpated that is warm to touch.

  • Cancer of cervix

  • Inflammation of Bartholin glands

  • Cystocele

  • Acute genital wart infection

Explanation

Correct Answer: B. Inflammation of Bartholin glands

Explanation of Correct Answer

Inflammation of the Bartholin glands, also known as a Bartholin gland abscess, presents as a tender, warm, and often fluctuant mass at the posterior-lateral aspect of the vaginal introitus. Patients typically report acute pain, and palpation elicits significant tenderness. This condition is usually caused by bacterial infection and may require antibiotics or surgical drainage.


10.

In which of the following situations is transillumination of the scrotum indicated?

  • Presence of syphilis chancre is noted

  • Indirect hernia is palpated

  • The examiner suspects a mass

  • The examiner palpates the testes

Explanation

Correct Answer: C. The examiner suspects a mass

Explanation of Correct Answer

Transillumination of the scrotum is performed when a scrotal mass is suspected. By shining a light through the scrotum, the examiner can distinguish between fluid-filled conditions (such as a hydrocele, which transilluminates) and solid masses (such as tumors, which do not transilluminate). This aids in determining the nature of the scrotal abnormality.


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