NUR 612 Exam 4

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Free NUR 612 Exam 4 Questions

1.

A 24-year-old male has scrotal pain and marked erythema. The examiner considers epididymitis. Which other finding is most consistent with this finding?

  • Absent cremasteric reflex

  • Anorexia and nausea

  • Acute onset of severe pain

  • 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.


2.

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.


3.

Which finding on exam of a scrotal mass which is neither a testicle nor spermatic cord, suggests a problem with an incarcerated hernia?

  • Mass does not transilluminate or change in size when reduction is attempted.

  • Mass does not transilluminate but decreases in size when reduction is attempted.

  • Mass does transilluminate but does not change in size when reduction is attempted.

  • 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.


4.

Which of the following testicular characteristics is associated with syphilis or diabetic neuropathy?

  • Asymmetry or drooping

  • Bilateral enlargement

  • Insensitivity to pain

  • Migration to abdomen

Explanation

Correct Answer: C. Insensitivity to pain

Explanation of Correct Answer

In both syphilis and diabetic neuropathy, testicular insensitivity to pain can be present. Normally, the testes are highly sensitive, and even slight pressure produces discomfort. Loss of this pain response suggests neuropathic damage, which can occur in tertiary syphilis (due to nerve involvement) or as a complication of diabetic neuropathy affecting sensory innervation.


5.

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?

  • Water-soluble

  • Anesthizing ointment

  • Warm water

  • 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.


6.

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.


7.

You examine a patient and note pearly gray, smooth umbilicated lesions. The most common cause of these is:

  • Syphilis

  • Condyloma acuminata

  • Molluscum contagiosum

  • Lymphogranuloma venereum

Explanation

Correct Answer: C. Molluscum contagiosum

Explanation of Correct Answer

Molluscum contagiosum is a viral skin infection caused by a poxvirus. It presents as discrete, pearly gray or flesh-colored, dome-shaped papules with central umbilication. These lesions are often smooth, painless, and can appear on the genitals as well as other areas of the body. It spreads through direct skin-to-skin contact, including sexual contact in adults.


8.

Which finding on breast exam of a male can result from marijuana (MJ) use?

  • Galactorrhea

  • Subareolar mass

  • Gynecomastia

  • Dimpling

Explanation

Correct Answer: C. Gynecomastia

Explanation of Correct Answer

Marijuana use can disrupt hormonal balance, particularly by decreasing testosterone and increasing estrogenic activity, which can lead to gynecomastia in males. Gynecomastia is the benign enlargement of male breast glandular tissue, often presenting as a firm, subareolar mass that may be tender. This effect is typically reversible with cessation of marijuana use.


9.

What type of hernia would you typically see in a 15-year-old male?

  • Femoral

  • Umbilical

  • Direct inguinal

  • 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.


10.

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.


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