NUR 612 Exam 4
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Free NUR 612 Exam 4 Questions
Which symptoms associated with PMS are caused by:
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Ovulation
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Thickening of uterine lining
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Elevations in body temperature
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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.
According to studies, which of the following is true regarding cerebrovascular disease?
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Transient ischemic attacks have a relatively high incidence of seizures.
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Sixty percent of patients with stroke are at risk of developing seizures within 5 years.
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It accounts for 20% to 50% of seizures in older adults.
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It accounts for 10% of seizures in older adults.
Explanation
Correct Answer: C. It accounts for 20% to 50% of seizures in older adults.
Explanation of Correct Answer
Cerebrovascular disease, including ischemic and hemorrhagic strokes, is a leading cause of seizures in older adults. Studies show that it is responsible for 20% to 50% of seizures in this age group, making it one of the most important etiologies to consider when evaluating new-onset seizures in the elderly.
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.
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.
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.
Steve came in for an office visit presenting complaints of difficulty speaking, gait problems, and dizziness. Which of the following should be noted as additional signs and symptoms in the focused interview? Select all that apply.
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Use of tobacco
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Pertinent family history
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Weight gain
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Loss of consciousness
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Paresthesias
Explanation
Correct Answers:
A. Use of tobacco, B. Pertinent family history, D. Loss of consciousness, E. Paresthesias
Explanation of Correct Answers
A. Use of tobacco
Tobacco use is a major risk factor for cardiovascular and cerebrovascular disease, making it critical to note in the assessment of neurologic complaints.
B. Pertinent family history
Family history of stroke, aneurysm, or neurological disorders increases risk and should be included in the focused interview.
D. Loss of consciousness
Syncope or blackouts may indicate transient ischemic attacks, seizures, or other serious neurologic events, requiring careful documentation.
E. Paresthesias
Numbness, tingling, or abnormal sensations are important neurological symptoms that may accompany dizziness and gait changes, pointing to possible nerve or brain involvement.
How should a breast examination on a patient who had a lumpectomy for breast cancer differ from a breast examination on one who has not had breast cancer?
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Supraclavicular and infraclavicular lymph nodes are palpated
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Lateral position with hands over head is used for palpation
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Area of scar is palpated using a circular motion
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Fingertips are used to palpate for intercostal breast tissue
Explanation
Correct Answer: C. Area of scar is palpated using a circular motion
Explanation of Correct Answer
In a patient with a history of lumpectomy, special attention must be given to the surgical scar. Palpating the scar area in a circular motion is crucial to detect local recurrence, scar tissue changes, or new nodules. This step differentiates the exam from one performed on a patient without a history of breast cancer, where scar evaluation is not needed.
A practitioner collects samples for cytologic study during a vaginal exam. What type of lubricant on the speculum is least likely to interfere with specimen analysis?
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Water-soluble
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Anesthizing ointment
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Warm water
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Secretions
Explanation
Correct Answer: A. Water-soluble
Explanation of Correct Answer
Water-soluble lubricants are least likely to interfere with cytologic analysis because they do not contain oils or other substances that can obscure cells or affect staining. They allow smooth insertion of the speculum while preserving the integrity of the collected sample.
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.
Which of the following conditions presents nonproliferating lesions and does not affect future cancer risk?
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Atypical lobular hyperplasia
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Fat necrosis
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Radial scar
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Papilloma
Explanation
Correct Answer:
2. Fat necrosis
Explanation of Correct Answer
Fat necrosis of the breast is a benign, nonproliferative lesion often caused by trauma, surgery, or radiation. It presents as firm nodules that may mimic carcinoma on exam or imaging, but it carries no increased risk of future breast cancer. Histologically, it shows lipid-filled macrophages and calcifications without cellular proliferation.
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