NUR 612 Exam 4
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Free NUR 612 Exam 4 Questions
A patient 3 weeks postpartum reports sore nipples and is breastfeeding. The examiner observes dry, cracked nipples. Which question would be helpful?
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Do you pump?
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How do you clean your breasts?
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Have you been able to bond with your baby?
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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.
Which of the following hernias occur more often in females and is the least common of all hernias?
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Indirect
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Direct
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Femoral
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Ventral
Explanation
Correct Answer: C. Femoral
Explanation of Correct Answer
Femoral hernias are rare, making up only about 2–4% of all hernias, and are the least common type overall. They occur more often in females due to the wider bony structure of the female pelvis. Femoral hernias protrude through the femoral canal, just below the inguinal ligament, and have a high risk of strangulation, making recognition and prompt management critical.
While palpating the introitus of the vagina, the patient jumps and complains of severe tenderness. A mass is palpated that is warm to touch.
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Cancer of cervix
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Inflammation of Bartholin glands
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Cystocele
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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.
According to studies, RLS is a condition for which there is no cure. Which of the following are recommended for the management of RLS symptoms? Select all that apply.
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New bed
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Group therapy
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Glass of wine every night to fall asleep
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Exercise
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Massage
Explanation
Correct Answers: D. Exercise, E. Massage
Explanation of Correct Answers
D. Exercise
Moderate, regular physical activity has been shown to improve circulation and reduce restless legs syndrome (RLS) symptoms, especially when performed earlier in the day. Overexertion, however, can worsen symptoms, so balance is important.
E. Massage
Leg massages can help relieve discomfort, improve blood flow, and relax muscles, making them a supportive nonpharmacological strategy for RLS management.
Which finding on exam of a scrotal mass which is neither a testicle nor spermatic cord, suggests a problem with an incarcerated hernia?
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Mass does not transilluminate or change in size when reduction is attempted.
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Mass does not transilluminate but decreases in size when reduction is attempted.
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Mass does transilluminate but does not change in size when reduction is attempted.
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Mass does transilluminate and changes size when reduction is attempted.
Explanation
Correct Answer: A. Mass does not transilluminate or change in size when reduction is attempted.
Explanation of Correct Answer
An incarcerated hernia occurs when abdominal contents protrude into the scrotum and become trapped, unable to be reduced back into the abdomen. On exam, the mass will not transilluminate (because it is filled with bowel, not fluid) and will not decrease in size with attempted reduction. This is a red flag for a surgical emergency, especially if associated with pain or signs of strangulation.
Which finding may indicate diabetes?
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The vas deferens feels lumpy or beaded
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The testicle feels hard with a lump
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Sebaceous cysts are present on the scrotal skin
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The urethra has a slit-like orifice
Explanation
Correct Answer: A. The vas deferens feels lumpy or beaded
Explanation of Correct Answer
A lumpy or beaded vas deferens may suggest diabetic vasculopathy or scarring due to chronic inflammation. Long-standing diabetes can lead to vascular and nerve damage, which can manifest as thickening or irregularities of the vas deferens on palpation. This finding warrants further evaluation for diabetic complications.
Which finding is suggestive of PID?
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Enlargement of ovaries
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Everted cervix
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Pain resulting from movement of cervix
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Unilateral labial swelling, redness, tenderness
Explanation
Correct Answer: C. Pain resulting from movement of cervix
Explanation of Correct Answer
Pelvic inflammatory disease (PID) commonly causes cervical motion tenderness (CMT), which is pain elicited when the cervix is moved during bimanual examination. This is a hallmark clinical sign of PID, reflecting inflammation of the uterus, fallopian tubes, and surrounding pelvic structures, often due to sexually transmitted infections like Chlamydia trachomatis or Neisseria gonorrhoeae.
What type of hernia would you typically see in a 15-year-old male?
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Femoral
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Umbilical
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Direct inguinal
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Indirect inguinal
Explanation
Correct Answer: D. Indirect inguinal
Explanation of Correct Answer
An indirect inguinal hernia is the most common type seen in children and adolescents, including 15-year-old males. It occurs when abdominal contents protrude through the inguinal canal due to a congenital defect in the processus vaginalis that fails to close. This hernia follows the pathway of the spermatic cord and may extend into the scrotum.
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.
68-year-old man presents with gynecomastia. Which factor is a potential cause of the problem?
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Decrease in physical activity
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Increased lactiferous duct glands
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Lymphatic engorgement
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A decrease in testosterone
Explanation
Correct Answer: D. A decrease in testosterone
Explanation of Correct Answer
Gynecomastia in older men is most often caused by a hormonal imbalance, specifically a relative decrease in testosterone and/or an increase in estrogen activity. Lower testosterone levels reduce androgenic inhibition of breast tissue growth, allowing glandular tissue proliferation. This is a common cause of gynecomastia in elderly males.
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