NUR 612 Exam 4

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Free NUR 612 Exam 4 Questions

1.

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.


2.

Gayle is a 55-year-old woman who is suspected of having a brain tumor. The clinician orders diagnostic testing for thyroid-stimulating hormone (TSH) and magnetic resonance imaging (MRI) to confirm this. Which of the following statements is true regarding a brain tumor?

  • The symptom of headache is rare.

  • The etiology of brain tumors is often known.

  • A brain tumor can be a malignant or benign neoplasm.

  • Brain tumors occur more commonly in females than males.

Explanation

Correct Answer: C. A brain tumor can be a malignant or benign neoplasm

Explanation of Correct Answer

Brain tumors are abnormal growths of tissue within the brain or central nervous system. They can be malignant (cancerous) or benign (non-cancerous). Even benign brain tumors can cause significant clinical problems due to their location, potential to compress surrounding structures, and increase intracranial pressure. Diagnosis usually requires neuroimaging such as MRI and sometimes biopsy.


3.

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.


4.

When examining a middle-aged woman with a history of endometrial cancer and hysterectomy, the examiner should:

  • Avoid bimanual and palpation maneuvers

  • Obtain Pap smear from suture line

  • Omit cultures and specimens from vagina

  • Palpate internal areas before inserting speculum

Explanation

Correct Answer: B. Obtain Pap smear from suture line

Explanation of Correct Answer

In women who have had a hysterectomy for endometrial cancer, Pap smears are obtained from the vaginal cuff (suture line) to screen for any residual or recurrent malignancy. Sampling this area is critical for early detection of recurrence, as the uterine tissue has been removed. The vaginal cuff is the most likely site for malignant recurrence in these patients.


5.

The patient is asked to bear down while the examiner palpates the inguinal ring. The examiner feels a soft swelling sensation on the fingertip. The patient complains of pain while straining. These findings are consistent with which of the following?

  • Indirect hernia

  • Direct hernia

  • Femoral hernia

  • Rectal hernia

Explanation

Correct Answer: A. Indirect hernia

Explanation of Correct Answer

An indirect inguinal hernia passes through the internal inguinal ring and may extend into the scrotum. On examination, when the patient bears down, the hernia sac touches the examiner’s fingertip inside the canal. This is the classic finding for an indirect hernia. It is the most common type of inguinal hernia and often causes discomfort or pain during straining.


6.

Hypospadias is a congenital defect in which the urethral meatus is located on the ventral surface of the glans penis. This is thought to occur embryologically during urethral development during which stage of gestation?

  • 4–6 weeks

  • 8–20 weeks

  • 15–25 weeks

  • 20–30 weeks

Explanation

Correct Answer: B. 8–20 weeks

Explanation of Correct Answer

Hypospadias develops during the critical period of urethral and penile formation, which occurs between 8 and 20 weeks of gestation. During this time, the urethral folds should fuse along the ventral penis to form the urethra. Failure of complete fusion results in ectopic placement of the urethral meatus on the ventral surface.


7.

Which finding may be indicative of a pelvic mass? The cervix is:

  • Pale in color

  • Deviating to right

  • Protruding 2.5 cm into vagina

  • Pointing anteriorly

Explanation

Correct Answer: B. Deviating to right

Explanation of Correct Answer

Deviation of the cervix to one side may indicate the presence of a pelvic mass that is displacing the uterus or cervix. Masses such as ovarian tumors, fibroids, or adnexal cysts can push the cervix off midline, which is an important clinical clue during bimanual or speculum examination.


8.

The examiner inspects the scrotum of a 43-year-old man. Which of the following requires further evaluation?

  • Left testicle hangs lower than the right

  • Scrotum is darker than general skin color

  • Skin on scrotum is shiny and smooth

  • 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.


9.

68-year-old man presents with gynecomastia. Which factor is a potential cause of the problem?

  • Decrease in physical activity

  • Increased lactiferous duct glands

  • Lymphatic engorgement

  • 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.


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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