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NSG 3280 Exam 4 : NSG 3280 Exam 4 Practice Questions &
Answers
1) A nurse is educating a group of young adults on risk factors for HPV infection. Which individual is at greatest risk? A. A 30-year-old woman in a monogamous marriage B. A 22-year-old with multiple sexual partners C. A 40-year-old man with no sexual history D. A 19-year-old abstinent college student Correct answer: B Rationale: The highest prevalence of HPV is in individuals ages 16–25 who have multiple sexual partners. Option A is lower risk due to a monogamous relationship. Option C is unlikely given no reported sexual history. Option D is at very low risk due to abstinence. 2) A patient presents with inability to retract the foreskin over the glans penis. The nurse identifies this condition as: A. Phimosis B. Paraphimosis C. Priapism D. Peyronie’s disease Correct answer: A Rationale: Phimosis is the inability to retract the foreskin, which can predispose to penile cancer. Paraphimosis is when the foreskin is retracted and cannot be returned, creating a urologic emergency. Priapism is a prolonged painful erection. Peyronie’s disease involves fibrous plaques in the penis causing curvature. 3) Which genital condition is considered a urological emergency due to risk of vascular compromise? A. Phimosis B. Paraphimosis C. Balanitis D. Hydrocele
Correct answer: B Rationale: Paraphimosis causes venous congestion, swelling, and edema of the glans, making it a urologic emergency. Phimosis is not emergent unless recurrent infections occur. Balanitis is inflammation of the glans and foreskin. Hydrocele is a fluid-filled sac around the testis, not emergent. 4) Erectile dysfunction can result from decreased secretion of which hormone? A. Testosterone B. Luteinizing hormone C. Estrogen D. Progesterone Correct answer: B Rationale: Low luteinizing hormone leads to decreased stimulation of testosterone production, contributing to erectile dysfunction. Testosterone is the end hormone affected, not the root cause. Estrogen and progesterone are not primary factors in male erectile function. 5) A penile tumescence test evaluates for which disorder? A. Testicular torsion B. Erectile dysfunction C. Prostate cancer D. Varicocele Correct answer: B Rationale: The penile tumescence test monitors nocturnal erections to distinguish psychogenic from organic erectile dysfunction. Testicular torsion is diagnosed with Doppler ultrasound. Prostate cancer requires PSA or biopsy. Varicocele is identified by physical exam or ultrasound. 6) What cellular damage contributes to erectile dysfunction development? A. Damage to osteoblasts B. Damage to vascular endothelial cells C. Damage to fibroblasts D. Damage to Schwann cells Correct answer: B
Rationale: Testicular cancer most often develops in late adolescence to early adulthood. Childhood tumors are rare. Middle-age and elderly onset is uncommon compared to younger adults. 10) What genital disorder is strongly correlated with testicular cancer? A. Cryptorchidism B. Varicocele C. Hydrocele D. Epididymitis Correct answer: A Rationale: Cryptorchidism (undescended testes) is a strong risk factor for testicular cancer. Varicocele and hydrocele are benign. Epididymitis is infectious but not a cancer risk. 11) Most prostate cancers are classified as: A. Sarcomas B. Adenocarcinomas C. Squamous cell carcinomas D. Transitional cell carcinomas Correct answer: B Rationale: The majority of prostate cancers are adenocarcinomas. Sarcomas are rare connective tissue cancers. Squamous and transitional carcinomas are less common in the prostate. 12) What is often the first sign of prostate cancer? A. Dysuria B. Bone pain C. Hematuria D. Nocturia Correct answer: B Rationale: Bone pain, especially in the spine, hips, or ribs, is often the first sign due to metastasis. Dysuria and nocturia are associated with benign prostatic hyperplasia. Hematuria is nonspecific.
13) The organism causing gonorrhea is: A. Gram-positive cocci B. Gram-negative cocci C. Gram-positive bacilli D. Gram-negative bacilli Correct answer: B Rationale: Neisseria gonorrhoeae is a gram-negative diplococcus. Grampositive cocci include staphylococcus and streptococcus. Gram-positive bacilli include clostridium. Gram-negative bacilli include E. coli. 14) After cyst and abscess formation in gonorrhea, what occurs next? A. Urethral stricture from fibrosis B. Development of hydrocele C. Epididymal torsion D. Prostate enlargement Correct answer: A Rationale: Gonorrhea leads to fibrous tissue formation causing urethral scarring. Hydrocele and torsion are unrelated complications. Prostate enlargement is linked to BPH, not gonorrhea. 15) Chlamydia and gonorrhea in women often lead to: A. Urethral stricture B. Pelvic inflammatory disease C. Bartholin gland cyst D. Endometriosis Correct answer: B Rationale: Untreated chlamydia and gonorrhea cause pelvic inflammatory disease, which can lead to infertility. Urethral stricture is more common in men. Bartholin cysts are not directly caused by STIs. Endometriosis is not infectious. 16) Ophthalmia neonatorum is caused by: A. Neisseria gonorrhoeae
Rationale: Ischemic (low-flow) priapism is always painful due to impaired venous outflow. Nonischemic (high-flow) is often painless. Psychogenic and intermittent types are not standard medical terms. 20) Phimosis with chronic inflammation increases the risk of what cancer? A. Squamous cell carcinoma B. Adenocarcinoma C. Basal cell carcinoma D. Transitional cell carcinoma Correct answer: A Rationale: Chronic phimosis increases risk of squamous cell carcinoma of the penis. Adenocarcinoma is more typical of prostate. Basal cell carcinoma is a skin cancer. Transitional carcinoma is bladder-related. 21) Which condition involves protrusion of the bladder wall into the vagina? A. Rectocele B. Uterine prolapse C. Cystocele D. Vaginitis Correct answer: C Rationale: Cystocele is bladder protrusion into the vagina due to weakened pelvic tissues. Rectocele is rectum bulging into vaginal wall. Uterine prolapse is descent of uterus. Vaginitis is inflammation. 22) Rectocele occurs due to a defect in: A. Urethra B. Vaginal wall C. Cervix D. Pelvic floor muscles Correct answer: B
Rationale: Rectocele is a defect in the vaginal wall that allows rectal tissue to bulge into it. Urethra and cervix are unrelated. Pelvic floor muscles contribute more to uterine prolapse. 23) Which hormones contribute to the growth of uterine leiomyomas? A. Estrogen and human growth hormone B. Progesterone and prolactin C. Cortisol and aldosterone D. Thyroxine and calcitonin Correct answer: A Rationale: Estrogen and human growth hormone influence uterine fibroid formation. Progesterone contributes but not as directly. Cortisol, aldosterone, and thyroid hormones are unrelated. 24) A benign growth of endometrial tissue outside the uterine cavity is called: A. Endometritis B. Endometriosis C. Adenomyosis D. Leiomyoma Correct answer: B Rationale: Endometriosis is endometrial tissue growing outside the uterus. Endometritis is inflammation inside. Adenomyosis is endometrial tissue growing into the uterine muscle. Leiomyoma is a fibroid tumor. 25) Which female genital cancer has the highest mortality due to late detection? A. Cervical cancer B. Ovarian cancer C. Endometrial cancer D. Vaginal cancer Correct answer: B
D. Urethra Correct answer: C Rationale: Rectocele is a defect of the vaginal wall that permits the rectum to bulge downward into the lower vaginal canal. Pelvic floor muscles (e.g., pubococcygeus) contribute to support but the defect described is the wall; cervical and urethral pathology do not explain the posterior bulge into the vagina.
- A patient presents with itching, erythema, and discharge involving the vulva and vaginal canal. This clinical picture best fits: A. Vulvovaginitis B. Cervicitis C. Endometritis D. Bartholinitis Correct answer: A Rationale: Vulvovaginitis denotes inflammation of both vulva and vagina. Cervicitis is localized to the cervix, often with contact bleeding. Endometritis is intrauterine inflammation presenting with uterine tenderness and systemic signs, often postpartum or post-procedure. Bartholinitis is localized pain/swelling of Bartholin glands near the introitus rather than diffuse vulvo-vaginal inflammation.
- Acute pain, swelling near the posterior introitus, and dyspareunia most strongly suggest inflammation of which glands? A. Skene glands B. Bartholin glands C. Cowper glands D. Thyroid gland Correct answer: B Rationale: Bartholinitis is inflammation of one or both Bartholin glands, presenting with painful swelling and possible exudate at the duct orifice. Skene glands are periurethral and present with dysuria/urethral symptoms. Cowper glands are male bulbourethral glands. The thyroid is unrelated.
- Which hormones most directly contribute to tumor formation in uterine leiomyomas? A. Estrogen and human growth hormone B. Progesterone and prolactin C. Cortisol and aldosterone D. T3 and T Correct answer: A Rationale: Estrogen and human growth hormone promote leiomyoma growth. Progesterone can modulate symptoms but is not identified here as the main pairing. Cortisol/aldosterone and thyroid hormones are unrelated to fibroid formation.
- A benign growth of endometrial tissue outside the uterine cavity is termed: A. Adenomyosis B. Endometritis C. Endometriosis D. Leiomyoma Correct answer: C Rationale: Endometriosis is ectopic implantation of endometrial tissue outside the uterus. Adenomyosis is endometrial glands within the myometrium. Endometritis is endometrial inflammation typically postprocedure or postpartum. Leiomyoma is a smooth-muscle uterine tumor (fibroid).
- Which gynecologic malignancy has the highest mortality because symptoms often present late? A. Cervical cancer B. Ovarian cancer C. Endometrial cancer D. Vulvar cancer Correct answer: B Rationale: Ovarian cancer typically presents with vague, late-stage symptoms, resulting in higher mortality. Cervical cancer is often detected by screening; endometrial cancer frequently
Rationale: BRCA1/2 mutations significantly raise breast/ovarian cancer risk. APC/MLH1 relate to colorectal cancer syndromes. KRAS/BRAF are oncogenes for various tumors (e.g., melanoma, colon). PTEN/TP53 mutations affect tumor suppression but are not the key pairing highlighted here.
- Why does a longer lifetime menstrual history increase breast cancer risk? A. Greater exposure to estrogen B. Increased prolactin pulses C. Decreased androgens D. Increased oxytocin during lactation Correct answer: A Rationale: Longer cumulative estrogen exposure from early menarche/late menopause increases breast cancer risk. Prolactin, androgen decline, and oxytocin are not primary mechanisms in this context.
- Which operation removes the breast, regional lymphatic system, and underlying pectoral muscles? A. Simple mastectomy B. Lumpectomy C. Radical mastectomy D. Modified radical mastectomy Correct answer: C Rationale: Radical mastectomy entails removal of the breast, lymphatics, and pectoralis muscles. Simple mastectomy removes breast tissue only; lumpectomy is breast-conserving. Modified radical removes breast and axillary nodes but preserves pectoral muscles.
- What microvascular change reflects aging in the capillary beds? A. Basement membrane thins B. Basement membrane thickens C. Adventitia calcifies exclusively D. Endothelium hyperplasia is universal Correct answer: B
Rationale: Aging microvasculature shows basement membrane thickening. Adventitial calcification and universal endothelial hyperplasia are not the characteristic change cited; thinning is the opposite of the expected trend.
- Which age-related change diminishes baroreceptor responses and contributes to orthostatic drops in blood pressure? A. Increased vessel elasticity B. Decreased vessel elasticity with increased fibrosis C. Increased nitric oxide bioavailability D. Reduced collagen in arterial walls Correct answer: B Rationale: With aging, decreased elastin and increased collagen/fibrosis thicken the intima/media and reduce compliance, blunting baroreceptor responsiveness and predisposing to orthostatic hypotension. Increased elasticity or NO is opposite; reduced collagen contradicts the noted increase.
- Increased systemic vascular resistance that the left ventricle must overcome is known as: A. Preload B. Afterload C. Contractility D. Stroke volume Correct answer: B Rationale: Afterload is the resistance the LV must overcome to eject blood into the aorta. Preload is ventricular filling pressure/volume. Contractility is intrinsic force generation. Stroke volume is the amount ejected per beat, influenced by the prior factors.
- Which pulmonary change with aging predisposes to early airway closure and increased residual volume? A. Loss of elastic recoil and stiff chest wall B. Increased ciliary number and function C. Decreased residual volume with hypercompliant chest D. Alveolar septal proliferation
Rationale: A diminished perception of sensory stimulation contributes to constipation in aging. The other options would tend to increase motility or secretions, reducing constipation risk.
- Aging-related slowing of reaction time is primarily attributed to degeneration of which structure? A. Dorsal root ganglia B. Myelin sheath C. Neuromuscular junction D. Cerebellar Purkinje cells exclusively Correct answer: B Rationale: Degeneration of the myelin sheath slows nerve conduction, reducing reaction time. While other neural elements can change with age, the review highlights myelin degeneration; dorsal roots and NMJs are not the primary cited mechanisms.
- Which cell type drives bone resorption, contributing to agerelated bone loss? A. Osteoblast B. Osteoclast C. Chondrocyte D. Fibroblast Correct answer: B Rationale: Osteoclasts resorb bone, and when their activity exceeds osteoblast formation, bone mass declines with age. Osteoblasts create bone; chondrocytes form cartilage; fibroblasts create connective tissue but not bone resorption.
- Demineralization and increased marrow space in aging bones result from which combined changes? A. Increased bone formation and decreased resorption B. Decreased resorption and decreased formation C. Increased resorption and decreased formation D. Increased formation and increased mineralization Correct answer: C
Rationale: The review notes increased bone resorption with decreased formation, leading to demineralization and more marrow space. The other combinations fail to produce the observed bone loss.
- Which skin change in older adults can delay absorption of transdermal or subcutaneous medications? A. Increased dermal vascularity B. Decreased vascularity and circulation C. Increased sweat gland activity D. Thicker hypodermis with robust perfusion Correct answer: B Rationale: Reduced cutaneous blood flow (vascularity/circulation) slows drug absorption. Increased vascularity or perfusion would enhance absorption; sweat gland activity is less relevant than perfusion to systemic uptake.
- Which combination best explains age-related decrease in arterial elasticity and increased fibrosis? A. Decreased elastin and increased collagen B. Increased elastin and decreased collagen C. Unchanged elastin with decreased collagen D. Unchanged collagen with increased elastin Correct answer: A Rationale: The review attributes reduced vessel elasticity and increased fibrosis to decreased elastin and increased collagen content. The other combinations would not decrease compliance as described.
- Prolonged bedrest in an older adult most likely accelerates which musculoskeletal outcome? A. Bone mass gain B. Maintenance of baseline bone density C. Age-related bone loss D. Improved marrow cellularity
D. Femoral artery and renal artery Correct answer: B Rationale: High-pressure arterial baroreceptors reside in the carotid sinus and aortic arch to modulate autonomic responses to blood pressure changes. The other vascular beds are not the classic locations.
- A man with sickle cell anemia presents with a persistent, painful erection. Which associated condition is most likely? A. Non-ischemic priapism B. Ischemic priapism C. Peyronie disease D. Testicular torsion Correct answer: B Rationale: Sickle cell disease predisposes to ischemic (low-flow) priapism that is painful and emergent due to venous outflow obstruction and hypoxia. Non-ischemic priapism is often painless after trauma. Peyronie disease causes penile curvature. Torsion causes acute scrotal pain rather than a rigid erection.
- During corporal aspiration in ischemic priapism, which color of blood is typically obtained? A. Bright red B. Pink frothy C. Dark, almost black D. Clear serous Correct answer: C Rationale: Venous stasis and hypoxia in ischemic priapism produce very dark blood on aspiration. Bright red suggests oxygenated arterial blood (more typical of non-ischemic states). Pink frothy indicates pulmonary edema, and clear serous fluid is unrelated.
- Which sexually transmitted infection is classified as a nongonococcal STI in the review? A. Treponema pallidum B. Chlamydia trachomatis
C. Neisseria gonorrhoeae D. Haemophilus ducreyi Correct answer: B Rationale: Chlamydia trachomatis is cited as a nongonococcal STI. Treponema causes syphilis; Neisseria is the gonococcus; Haemophilus ducreyi causes chancroid.
- Which STI is described as an infection of the vascular system with potential CNS and cardiovascular complications? A. Chlamydia B. Trichomoniasis C. Syphilis D. Gonorrhea Correct answer: C Rationale: Syphilis (Treponema pallidum) is highlighted as involving vascular structures and later causing neurosyphilis and aortitis. Chlamydia and gonorrhea cause mucosal infections; trichomoniasis is a protozoal vaginitis/urethritis.
- Following cyst and abscess formation in gonorrhea, which complication results from fibrotic healing? A. Hydrocele B. Urethral stricture C. Varicocele D. Epididymal torsion Correct answer: B Rationale: Fibrous tissue hardening can scar the urethra, causing urethral stricture. Hydrocele is fluid accumulation; varicocele is venous dilation; torsion is acute twisting of the spermatic cord.
- Which demographic is most associated with peak incidence of testicular cancer? A. Boys under 10 years B. Late adolescence to early adulthood C. Men aged 45–60 years
