NR 509 FINAL Exam 4 Questions with answers, Exams of Nursing

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NR 509 FINAL Exam 4 Questions with

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When measuring a pregnant woman's abdomen where should the tape be placed? ✔from the symphysis pubis to the uterus/fundus A 3-year-old can do in regard to jumping and balancing? ✔pedals a tricycle, jumps in place, feeds self with utensils. Hip protects against? ✔genital warts and cervical cancer Concerns of irregular rectal masses? ✔rectal cancer What valve is at the apex of the heart? ✔the tricuspid Which vaccines are safe during pregnancy? ✔pneumococcal, meningococcal, hep b, a dap 27-36 weeks. Lymph nodes for strep ✔anterior cervical lymph nodes What are Mongolian spots? ✔blue/Gray macules on presacral back and posterior thighs. Usually fade in first few years. Must rule out child abuse What position should the patient be in for aortic ✔supine with head at 30 degrees Stress incontinence ✔the inability to control the voiding of urine under physical stress such as running, sneezing, laughing, or coughing Urge incontinence

✔state in which a person experiences involuntary passage of urine that occurs soon after a strong sense of urgency to void Perseveration ✔persistent repetition of the same word or idea in response to different questions Which heart chamber can you feel right below the xiphoid process? ✔right ventricle Where is the cricoid cartilage located? ✔c Carotid pulsations ✔palpable Vigorous thrust Not eliminated with pressure Pulsation does not change with position Not affected by inspiration Internal jugular pulsations ✔rarely palpable; pulsations eliminated by light pressure on veins above sternal end of clavicle; height of pulsations changed by position; height of pulsations falls with inspiration; 2 elevations and 2 troughs per heartbeat Tanner stages of breast development ✔pg. Stage 1: prepubertal Stage 2: breast bud stage with elevation of breast and papilla; enlargement of areola Stage 3: further enlargement of breast and areola; no separation of their contour Stage 4: areola and papilla for a secondary mound above the level of breast Stage 5: mature stage: projection of papilla only, related to recession of areola Hepatitis a is transmitted by ✔ingestion of food contaminated by faeces Pancreatitis pain is located where? ✔upper abdomen A woman who is 8 weeks pregnant is in the clinic for a check up. The fnp reads her chart that her cervix is... Cyanotic. The fnp knows that the woman is exhibiting sign and sign

✔Goodell’s sign and Chadwick sign Goodell's sign ✔softening of the cervix Chadwick's sign ✔bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion. Scrotum function ✔holds testicles at temperature a few degrees below body temperature so sperm can live Prostate gland ✔a gland surrounding the neck of the bladder in male mammals and releasing prostatic fluid. Which of these statements is true regarding the penis? ✔corpus spongiosum expands into a cone of erectile tissue called the glans. When performing breast examination why is it important to inspect the upper outer quadrant? ✔its where most tumours develop What protects the fetes of pregnant women from infections? ✔acidic mucus plug Mucus plug ✔a collection of thick mucus in the cervix that prevents bacteria from entering the uterus What causes axillary node enlargement ✔recent breast infection Kya Hogue ✔ Metrorrhagia ✔bleeding between periods

Pain at the lateral epicondyle is? ✔tennis elbow or repetitive extension of the wrist or pronation or supination of the forearm. S/s of bacterial vaginosis ✔-fishy smelling discharge which is watery and Gray, vaginal spotting S/s of candida vaginitis ✔yeasty white curd pruritus soreness pain with urination. Trichomonas vaginitis ✔yellow, green, Gray, maybe frothy. May be malodorous pruritus, pain on urination, dyspareunia. Always acquired sexually. Malaria rubra ✔acute inflammatory disorder of the sweat glands, resulting in the eruption of red vesicles and burning, itching skin from excessive heat exposure Characteristics of a breast cyst ✔soft to firm round mobile often tender. Peritonitis ✔inflammation of the peritoneum (membrane lining the abdominal cavity and surrounding the organs within it) S/s of diverticulitis ✔llq cramping pain Nausea Fever Increased wbc abdominal distention Occult blood When auscultating s3 and s4 the patient should be in what position? ✔left lateral decubitus Ros: cardiovascular system ✔any swelling, sob, pnd, dyspnea or orthopnea. Infection of Bartholin’s gland presents?

✔tense hot tender abscess with pus emerging from the duct or erythema. S/s of appendicitis ✔persistent rlq pain, pain in umbilical region, rupture of appendix: sudden severe pain Presentation of genital syphilis ✔ulcerated papule with indurated edges. May resemble a carcinoma or crusted cold sore. Signs of proctitis ✔inflammation of the anus itching pain or rectal abscess. Causes of hematemesis ✔blood altered by gastric acid Causes of the s3 heart sound? ✔the most common cause of the s3 is congestive heart failure, less common is valvular regurgitation and left to right shunts. Thrombophlebitis ✔inflammation of the vein associated with thrombus formation i.e., swelling redness, warmth. Chalazion ✔a nodule or cyst, usually on the upper eyelid, caused by obstruction in a sebaceous gland Lungs in the elderly ✔stiffer lose recoil residual volume increases as the alveoli increase. Diastasis recti ✔separation of the longitudinal muscles of the abdomen (rectus abdominis) during pregnancy. Macula ✔yellowish region on the retina lateral to and slightly below the optic disc. Has photo receptors that detect light and interpret images.

Sequence of abdominal examination ✔inspection, auscultation, Percuss, palpate. Large purplish bruises are called ✔senile purpura S/s of epididymitis ✔painful scrotal edema, nausea, vomiting, chills, and fever What do you do if you cannot feel a newborns testicles. ✔gently milk it down. Risk factors for prostate cancer ✔age ethnicity, family hx, Signs of chicken pox ✔hard crust red spot and blister. S/s of candidiasis ✔® pruritus ® dyspareunia ® vulvar erythema and edema ® thick white floccular nonadherent vaginal discharge ® ph<4. ® no amine odor ® koh - pseudohyphae ® wet mount - pseudohyphae Depression screening with vague symptoms. ✔physical symptoms account for 50% When to order a abi ✔> 65 years of age leg and symptoms with exertion, non-healing wounds hx of diabetes or smoking when age is > 50. Lymph node group involved with detecting breast cancer ✔axillary nodes, or central nodes. Differential dx for epigastric pain

✔dyspepsia, stomach ulcer, bowel obstruction, acute pancreatitis, gallstones, cholecystitis Bounding pulse ✔a pulse with an increased volume that feels very strong and full 3+ Milestones for a 8 mos old child ✔can say mama papa indicates wants, feeds self. Risk factors for cad ✔smoking, htn, hdl (ldl>100, >70 for dm), male gender, age over 60 (this value is debatable), family hx heart conditions, sedentary lifestyle Condylomata acuminata ✔soft, pointed, fleshy papules that occur on the genitalia and are caused by the human papillomavirus (hpv) Brief memory test ✔todays weather current medications lab tests. Delirium vs dementia ✔1. Delirium- acute, dramatic onset, common causes= illness, toxin, withdrawal, usually reversible. Poor attention and fluctating arousal level.

2. Dementia: chronic, insidious onset, usually not reversible, attention usually unaffected and normal arousal level. S/s of venous ulcers ✔red base with shiny tight warm and hot discolored skin. Causes of venous insufficiency ✔dvt (leaflets become thickened and contracted so that they are incapable of preventing retrograde flow; then secondary incompetence develops in distal valves because high pressures distend the vein and separate the leaflets) Primary valvular incompetence Buerger test -lower limb arterial insufficiency ✔return of color 10 seconds - venous filling 15 seconds -both legs 90 degrees

Causes of s2 splitting ✔during unsynchronized closure of the aortic and pulmonary valves during inspiration. Rectal polyp ✔protruding growth from the rectal mucous membrane that is fairly common Rectal cancer ✔1 proximal non metastatic treated with lower anterior resection+radiation and chemo in node +ve, 2 distal rectal cancer treated with local resection sphincter sparing operation or abdomino-perineal resection called extensivradical operation Rectal cancer ✔a 64 year old male presents with bloody stools. Digital rectal exam reveals a step off at blumer's shelf. What is your diagnosis? Functional syndromes ✔problems that appear to have a physiological basis, but with normal structures. Irritable bowel syndrome, tmj, fibromyalgia, chronic fatigue. Examining the lateral portion of the breast ✔patient rolls on opposite hip placing her hand on her forehead keeping shoulders flat. Finding an abdominal mass ✔ask the patient to raise head and shoulders and strain down. Risk factors for breast cancer ✔personal history. Age. Mother, sister, daughter with breast cancer. Atypical or precancerous lesions on biopsy. Nulliparity or first child at or older than 30 years. Fibroadenoma ✔a round, firm, rubbery mass that arises from excess growth of glandular and connective tissue in the breast Cysts ✔fluid, infection, or other matter under the skin Fibrocystic changes cancer

✔nodular ropelike irregular firm mobile or fixed. S/s gestational htn ✔1. Oliguria, blurred vision, proteinuria, facial edema Oncychomycosis ✔fungal infection of the finger or toenail plate Many species of fungus, tends to be a dermatophyte Nail surface is soft, dry and powdery and can easily be scraped away Nail bed is raised S&s of rectal prolapse ✔appearing as a doughnut or rosette of red tissue. S/s of elder abuse ✔bruises, black eyes, welts, lacerations, bone fractures, broken bones, skull fractures, open wounds, cuts, punctures, untreated injuries in various stages of healing, signs of being restrained, sudden change in behavior S/s of bph ✔-inc frequency of voiding w/ dec output -nocturia -hesitancy/difficulty starting stream -acute urinary retention -bladder distention When to administer tetanus ✔> 19 years of age and boosters every 10 years. S/s of depression ✔depressed mood, insomnia, excessive sleeping, indecisiveness, decreased ability to concentrate, suicidal ideation, increase or decrease in motor activity, increase or decrease in wt. And agnosia. Atopic dermatitis ✔excess inflammation; dry skin, redness, and itching from allergies and irritants. S/s of prostatitis ✔-men > 50 yo with c/o lbp or suprapubic pain -difficulty starting or stopping urine flow

-increased frequency and urgency -decreased urine flow -urethral discharge -fever, chills -arthralgia -impotence S/s of ectopic pregnancy ✔bleeding, abdominal/pelvic pain, +/- adnexal mass, +/- syncope