UPGRADEC ELSEVIER HESI A2 A.pdf, Study notes of Biology

UPGRADEC ELSEVIER HESI A2 A.pdf

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when54you54examine54them.54What54should54you54do?54-54CORRECT54ANSWER54-
Ask54how54she54acquired54them.
A5458-year-
old54man54comes54to54your54office54complaining54of54bilateral54back54pain54that54now54a
wakens54him54at54night.54This54has54been54steadily54increasing54for54the54past54254mont
hs.54Which54one54of54the54following54is54the54most54reassuring54in54this54patient54with54b
ack54pain?54-54CORRECT54ANSWER54-Pain54that54is54bilateral
The54Phalen's54test54is54used54to54evaluate:54-54CORRECT54ANSWER54-
inflammation54of54the54median54nerve
Which54of54the54following54would54lead54you54to54suspect54a54hydrocele54versus54other54
causes54of54scrotal54swelling?54-54CORRECT54ANSWER54-
A54positive54transillumination54test
You54are54examining54a54newborn54and54note54that54the54right54testicle54is54not54in54the5
4scrotum.54What54should54you54do54next?54-54CORRECT54ANSWER54-
Attempt54to54bring54down54the54testis54from54the54inguinal54canal
A5450-year-
old54truck54driver54comes54to54your54clinic54for54a54work54physical.54He54has54had54no54
upper54respiratory,54cardiac,54pulmonary,54gastrointestinal,54urinary,54or54musculoskelet
al54system54complaints.54His54past54medical54history54is54significant54for54mild54arthritis5
4and54prior54knee54surgery54in54college.54He54is54married54and54just54changed54jobs,54
working54for54a54different54trucking54company.54He54smokes54one54pack54of54cigarettes5
4a54day,54drinks54less54than54six54beers54a54week,54and54denies54using54any54illegal54dr
ugs.54His54mother54has54high54blood54pressure54and54arthritis54and54his54father54died54o
f54lung54cancer54in54his54sixties.54On54examination,54his54blood54pressure54is54130/8054
and54his54pulse54is5480.54His54cardiac,54lung,54and54abdominal54examinations54are54nor
mal.54He54has54no54inguinal54hernia,54but54on54his54digital54rectal54examination54you54p
alpate54a54soft,54smooth,54and54nontender54pedunculated54mass54on54the54posterior54w
all54of54the54rectum.54What54anal,54rectal,54or54prostate54disorder54best54fits54his54prese
ntation?54-54CORRECT54ANSWER54-54Rectal54polyp
A5415-year-
old54high54school54football54player54is54brought54to54your54office54by54his54mother.54He54
is54complaining54of54severe54testicular54pain54since54exactly548:0054this54morning.54He54
denies54any54sexual54activity54and54states54that54he54hurts54so54bad54he54can't54even54u
rinate.54He54is54nauseated54and54is54throwing54up.54He54denies54any54recent54illness54or
54fever.54His54past54medical54history54is54unremarkable.54He54denies54any54tobacco,54al
cohol,54or54drug54use.54His54parents54are54both54in54good54health.54On54examination,54y
ou54see54a54young54teenager54lying54on54the54bed54with54an54emesis54basin.54He54is54v
ery54uncomfortable54and54keeps54shifting54his54position.54His54blood54pressure54is54150/
100,54his54pulse54is54110,54and54his54respirations54are5424.54On54visualization54of54the54p
enis,54he54is54circumcised54and54there54are54no54lesions54and54no54discharge54from54th
e54meatus.
His54scrotal54skin54is54tense54and54red.54Palpation54of54the54left54testicle54causes54se
vere54pain54and54the54patient54begins54to54cry.54His54prostate54examination54is54unre
markable.54His54-54CORRECT54ANSWER54-Torsion54of54the54spermatic54cord
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when 54 you 54 examine 54 them. 54 What 54 should 54 you 54 do? 54 - 54 CORRECT 54 ANSWER 54 -

Ask 54 how 54 she 54 acquired 54 them.

A 5458 - year-

old 54 man 54 comes 54 to 54 your 54 office 54 complaining 54 of 54 bilateral 54 back 54 pain 54 that 54 now 54 a

wakens 54 him 54 at 54 night. 54 This 54 has 54 been 54 steadily 54 increasing 54 for 54 the 54 past 54254 mont

hs. 54 Which 54 one 54 of 54 the 54 following 54 is 54 the 54 most 54 reassuring 54 in 54 this 54 patient 54 with 54 b

ack 54 pain? 54 - 54 CORRECT 54 ANSWER 54 - Pain 54 that 54 is 54 bilateral

The 54 Phalen's 54 test 54 is 54 used 54 to 54 evaluate: 54 - 54 CORRECT 54 ANSWER 54 -

inflammation 54 of 54 the 54 median 54 nerve

Which 54 of 54 the 54 following 54 would 54 lead 54 you 54 to 54 suspect 54 a 54 hydrocele 54 versus 54 other 54

causes 54 of 54 scrotal 54 swelling? 54 - 54 CORRECT 54 ANSWER 54 -

A 54 positive 54 transillumination 54 test

You 54 are 54 examining 54 a 54 newborn 54 and 54 note 54 that 54 the 54 right 54 testicle 54 is 54 not 54 in 54 the 5

4 scrotum. 54 What 54 should 54 you 54 do 54 next? 54 - 54 CORRECT 54 ANSWER 54 -

Attempt 54 to 54 bring 54 down 54 the 54 testis 54 from 54 the 54 inguinal 54 canal

A 5450 - year-

old 54 truck 54 driver 54 comes 54 to 54 your 54 clinic 54 for 54 a 54 work 54 physical. 54 He 54 has 54 had 54 no 54

upper 54 respiratory, 54 cardiac, 54 pulmonary, 54 gastrointestinal, 54 urinary, 54 or 54 musculoskelet

al 54 system 54 complaints. 54 His 54 past 54 medical 54 history 54 is 54 significant 54 for 54 mild 54 arthritis 5

4 and 54 prior 54 knee5 4 surgery 54 in 54 college. 54 He 54 is 54 married 54 and 54 just 54 changed 54 jobs, 54

working 54 for 54 a 54 different 54 trucking 54 company. 54 He 54 smokes 54 one 54 pack 54 of 54 cigarettes 5

4 a 54 day, 54 drinks 54 less 54 than 54 six 54 beers 54 a 54 week, 54 and 54 denies 54 using 54 any 54 illegal 54 dr

ugs. 54 His 54 mother 54 has 54 high 54 blood 54 pressure 54 and 54 arthritis 54 and 54 his 54 father 54 died 54 o

f 54 lung 54 cancer 54 in 54 his 54 sixties. 54 On 54 examination, 54 his 54 blood 54 pressure 54 is 54 130/80 54

and 54 his 54 pulse 54 is 54 80. 54 His 54 cardiac, 54 lung, 54 and 54 abdominal 54 examinations 54 are 54 nor

mal. 54 He 54 has 54 no 54 inguinal 54 hernia, 54 but 54 on 54 his 54 digital 54 rectal 54 examination 54 you 54 p

alpate 54 a 54 soft, 54 smooth, 54 and 54 nontender 54 pedunculated 54 mass 54 on 54 the 54 posterior 54 w

all 54 of 54 the 54 rectum. 54 What 54 anal, 54 rectal, 54 or 54 prostate 54 disorder 54 best 54 fits 54 his 54 prese

ntation? 54 - 54 CORRECT 54 ANSWER 54 - 54 Rectal 54 polyp

A 5415 - year-

old 54 high 54 school 54 football 54 player 54 is 54 brought 54 to 54 your 54 office 54 by 54 his 54 mother. 54 He 54

is 54 complaining 54 of 54 severe 54 testicular 54 pain 54 since 54 exactly 54 8:00 54 this 54 morning. 54 He 54

denies 54 any 54 sexual 54 activity 54 and 54 states 54 that 54 he 54 hurts 54 so 54 bad 54 he 54 can't 54 even 54 u

rinate. 54 He 54 is 54 nauseated 54 and 54 is 54 throwing 54 up. 54 He 54 denies 54 any 54 recent 54 illness 54 or

54 fever. 54 His 54 past 54 medical 54 history 54 is 54 unremarkable. 54 He 54 denies 54 any 54 tobacco, 54 al

cohol, 54 or 54 drug 54 use. 54 His 54 parents 54 are 54 both 54 in 54 good 54 health. 54 On 54 examination, 54 y

ou 54 see 54 a 54 young 54 teenager 54 lying 54 on 54 the 54 bed 54 with 54 an 54 emesis 54 basin. 54 He 54 is 54 v

ery 54 uncomfortable 54 and 54 keeps 54 shifting 54 his 54 position. 54 His 54 blood 54 pressure 54 is 54 150/

100, 54 his 54 pulse 54 is 54 110, 54 and 54 his 54 respirations 54 are 54 24. 54 On 54 visualization 54 of 54 the 54 p

enis, 54 he 54 is 54 circumcised 54 and 54 there 54 are 54 no 54 lesions 54 and 54 no 54 discharge 54 from 54 th

e 54 meatus.

His 54 scrotal 54 skin 54 is 54 tense 54 and 54 red. 54 Palpation 54 of 54 the 54 left 54 testicle 54 causes 54 se

vere 54 pain 54 and 54 the 54 patient 54 begins 54 to 54 cry. 54 His 54 prostate 54 examination 54 is 54 unre

markable. 54 His 54 - 54 CORRECT 54 ANSWER 54 - Torsion 54 of 54 the 54 spermatic 54 cord

Which 54 is 54 true 54 of 54 prostate 54 cancer? 54 - 54 CORRECT 54 ANSWER 54 - Ethnicity 54 is 54 a 54 risk 54 factor.

Imbalance 54 of 54 hormones 54 of 54 puberty

Which 54 of 54 the 54 following 54 represents 54 metrorrhagia? 54 - 54 CORRECT 54 ANSWER 54 -

Bleeding 54 between 54 periods

A 5476 - year-

old 54 retired 54 farmer 54 comes 54 to 54 your 54 office 54 complaining 54 of 54 abdominal 54 pain, 54 consti

pation, 54 and 54 a 54 low-

grade 54 fever 54 for 54 about 54 three 54 days. 54 He 54 denies 54 any 54 nausea, 54 vomiting, 54 or 54 diarrh

ea. 54 The 54 only 54 unusual 54 thing 54 he 54 remembers 54 eating 54 is 54 two 54 bags 54 of 54 popcorn 54 at

54 the 54 movies 54 with 54 his 54 grandson, 54 three 54 days 54 before 54 his 54 symptoms 54 began. 54 He 5

4 denies 54 any 54 other 54 recent 54 illnesses. 54 His 54 past 54 medical 54 history 54 is 54 significant 54 for 5

4 coronary 54 artery 54 disease 54 and 54 high 54 blood 54 pressure. 54 He 54 has 54 been 54 married 54 for 5

4 over 54 fifty 54 years. 54 He 54 denies 54 any 54 tobacco, 54 alcohol, 54 or 54 drug 54 use. 54 His 54 mother 54

died 54 of 54 colon 54 cancer 54 and 54 his 54 father 54 had 54 a 54 stroke. 54 On 54 examination, 54 he 54 appe

ars 54 his 54 stated 54 age 54 and 54 is 54 in 54 no 54 acute 54 distress. 54 His 54 temperature 54 is 54 100.9 54 de

grees 54 and 54 his 54 other 54 vital 54 signs 54 are 54 unremarkable. 54 His 54 head, 54 cardiac, 54 a

What 54 does 54 a 54 KOH 54 (potassium 54 hydroxide) 54 prep 54 help 54 the 54 nurse 54 practitioner 54 dia

gnose? 54 - 54 CORRECT 54 ANSWER 54 - Yeast 54 infections

Abby 54 is 54 a 54 newly 54 married 54 woman 54 who 54 is 54 unable 54 to 54 have 54 intercourse 54 becaus

e 54 of 54 vaginismus. 54 Which 54 of 54 the 54 following 54 is 54 true? 54 - 54 CORRECT 54 ANSWER 54 -

Psychosocial 54 reasons 54 may 54 cause 54 this 54 condition.

A 5430 - year-old 54 man 54 notices 54 a 54 firm, 542 -

cm 54 mass 54 under 54 his 54 areola. 54 He 54 has 54 no 54 other 54 symptoms 54 and 54 no 54 diagnosis 54 of

54 breast 54 cancer 54 in 54 his 54 first-

degree 54 relatives. 54 What 54 is 54 the 54 most 54 likely 54 diagnosis? 54 - 54 CORRECT 54 ANSWER 54 -

Breast 54 tissue

Which 54 of 54 the 54 following 54 is 54 true 54 regarding 54 breast 54 self-examination? 54 - 54 CORRECT 54 ANSWER

- A 54 high 54 proportion 54 of 54 breast 54 masses 54 are 54 detected 54 by 54 breast 54 self-examination.

A 5423 - year-

old 54 computer 54 programmer 54 comes 54 to 54 your 54 office 54 for 54 an 54 annual 54 examination. 54 S

he 54 has 54 recently 54 become 54 sexually 54 active 54 and 54 wants 54 to 54 be 54 placed 54 on 54 birth 54 c

ontrol. 54 Her 54 only 54 complaint 54 is 54 that 54 the 54 skin 54 in 54 her 54 armpits 54 has 54 become 54 darke

r. 54 She 54 states 54 it 54 looks 54 like 54 dirt, 54 and 54 she 54 scrubs 54 her 54 skin 54 nightly 54 with 54 soap 54

and 54 water 54 but 54 the 54 color 54 stays. 54 Her 54 past 54 medical 54 symptoms 54 consist 54 of 54 acne 54

and 54 mild 54 obesity. 54 Her 54 periods 54 have 54 been 54 irregular 54 for 54354 years. 54 Her 54 mother 54

has 54 type 54254 diabetes, 54 and 54 her 54 father 54 has 54 high 54 blood 54 pressure. 54 The 54 patient 54 d

enies 54 using 54 tobacco 54 but 54 has 54 four 54 to 54 five 54 drinks 54 on 54 Friday 54 and 54 Saturday 54 nig

hts. 54 She 54 denies 54 any 54 illegal 54 drug 54 use. 54 On 54 examination, 54 you 54 see 54 a 54 mildly 54 ob

ese 54 female 54 who 54 is 54 breathing 54 comfortably. 54 Her 54 vital 54 signs 54 are 54 unremarkable. 54

Looking 54 under 54 her 54 axilla, 54 you 54 see 54 dark, 54 velvet-

like 54 skin. 54 Her 54 annual 54 examination 54 is 54 otherwise 54 unremarkable. 54 What 54 disorder 54 o

f 54 the 54 breast 54 or 54 axilla 54 is 54 she 54 most 54 likely 54 to 54 have? 54 - 54 CORRECT 54 ANSWER 54 -

54 Acanthosis 54 nigricans

Which 54 of 54 the 54 following 54 is 54 true 54 of 54 women 54 who 54 have 54 had 54 a 54 unilateral 54 mastect

omy? 54 - 54 CORRECT 54 ANSWER 54 -

They 54 should 54 be 54 examined 54 carefully 54 along 54 the 54 surgical 54 scar 54 for 54 masses.

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