NUR 612 Exam 4
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Free NUR 612 Exam 4 Questions
The examiner asks the patient to complete this statement: "A bird is to air as a fish is to _________." This is an example of what type of testing?
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Calculation
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Analogies
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Judgment
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Mood and feelings
Explanation
Correct Answer: B. Analogies
Explanation of Correct Answer
This question is an example of testing analogical reasoning, a component of abstract thinking. The patient is asked to recognize the relationship between two words (bird and air) and apply the same relationship to another pair (fish and water). Such tasks are used in mental status examinations to assess higher-level cognitive functioning and abstract reasoning.
A 38-year-old woman is diagnosed with mastitis. What is the likely causative agent?
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Staphylococcus aureus
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Streptococcus
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Neisseria gonorrhoeae
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E. coli
Explanation
Correct Answer: A. Staphylococcus aureus
Explanation of Correct Answer
Mastitis, an infection of the breast tissue, is most commonly caused by Staphylococcus aureus. It frequently occurs in lactating women due to bacteria entering through cracked or sore nipples. Symptoms include localized breast pain, erythema, swelling, warmth, and sometimes fever. Prompt treatment with appropriate antibiotics is necessary to prevent abscess formation.
Which item in the patient history is considered a risk factor for cancer of the penis?
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Circumcised at birth
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History of condyloma acuminatum infectionsHad congenital hydrocele
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Had congenital hydrocele
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History of untreated epispadius
Explanation
Correct Answer: B. History of condyloma acuminatum infections
Explanation of Correct Answer
Condyloma acuminatum is caused by human papillomavirus (HPV), particularly types 16 and 18, which are strongly associated with penile cancer. Chronic HPV infection increases the risk of malignant transformation of penile epithelial cells, making this a significant risk factor.
Symptoms consistent with underlying ductal malignancy include:
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Erythema, heat, pain around one nipple
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Red, scaling, crusty patch on one nipple
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Bilateral inflammation, tenderness, and sticky multicolored nipple discharge
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Gynecomastia, deepening color of nipple
Explanation
Correct Answer: B. Red, scaling, crusty patch on one nipple
Explanation of Correct Answer
A red, scaling, crusty patch on one nipple is characteristic of Paget disease of the breast, which is associated with underlying ductal carcinoma. It often begins on the nipple and spreads to the areola, resembling eczema but failing to resolve with topical treatments. This is a hallmark symptom of ductal malignancy.
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.
A patient with Alzheimer’s disease classically displays which of the following?
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Alternating periods of mania and stupor
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Hallucinations and decorticate posturing
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Disintegration of personality
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Rapid onset of symptoms
Explanation
Correct Answer: C. Disintegration of personality
Explanation of Correct Answer
Alzheimer’s disease is a progressive neurodegenerative disorder that gradually impairs memory, cognition, behavior, and personality. Over time, patients experience disorientation, loss of judgment, social withdrawal, and disintegration of personality. These changes occur slowly and insidiously, distinguishing Alzheimer’s from other acute or fluctuating neurological conditions.
Nipple compression should be included as part of the breast examination for which of the following patients?
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23-year-old concerned about lumps and tenderness
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35-year-old lactating with very sore nipples
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48-year-old reporting 2 episodes of bloody discharge from the right nipple
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60-year-old with gynecomastia
Explanation
Correct Answer: C. 48-year-old reporting 2 episodes of bloody discharge from the right nipple
Explanation of Correct Answer
Nipple compression is not a routine part of breast examination, but it is indicated when there is a history of nipple discharge. In this case, the 48-year-old patient reporting bloody discharge should undergo nipple compression to evaluate the nature, color, and origin of the discharge. Pathologic discharge—especially unilateral and bloody—raises concern for intraductal papilloma or malignancy.
A patient who has difficulty writing or drawing is most likely to have what condition?
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Temporal lobe damage
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Peripheral neuropathy
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Organic brain syndrome
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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.
While examining the breast of a 52-year-old woman, the examiner notes nipple discharge. Which of the following diagnostic tests would be appropriate?
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Cytologic examination of discharge
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C&S
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WBC count
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Estrogen level
Explanation
Correct Answer: A. Cytologic examination of discharge
Explanation of Correct Answer
Cytologic examination of nipple discharge is used to evaluate for abnormal or malignant cells. In women over 50, spontaneous, unilateral, bloody, or serous nipple discharge may indicate underlying intraductal papilloma or breast carcinoma. Cytology helps identify neoplastic changes and guides further diagnostic evaluation such as imaging or biopsy.
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.
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