NR 509 Final Exam/91 Questions with
Verified Answers
Know that in a 47-year-old man ED is usually ___________ rather than
testosterone - -psychologic
-Erectile dysfunction may be from psychogenic causes, especially if - -early
morning erection is preserved.
it may also reflect decreased testosterone, decreased blood flow in the
hypogastric arterial system, impaired neural innervation, and diabetes
-When performing a breast exam, know what abnormal masses should do
when the arm - -may be fixed to skin or underlying tissues (may cause
dimpling of skin or retraction when arms are lifted over head or hands are
pressed against hips)
-Fibroadenoma and cysts mobility - -very mobile/mobile
-Know that a high proportion of breast masses are noted during ________ - -
BSE
-Breast stage 1 - -preadolescent- elevation of nipple only
-Breast stage 2 - -breast bud stage- elevation of breast and nipple as a
small mound; enlargement of areolar diameter
-breast stage 3 - -further enlargement of elevation of breast and areola,
with no separation of their contours
-breast stage 4 - -projection of areola and nipple to form a secondary
mound above the level of breast
-breast stage 5 - -mature stage- projection of nipple only; areola has
receded to general contour of the breast (although in some individuals the
areola continues to form a secondary mound)
-Know where pain is located with pancreatitis: acute - -epigastric, may
radiation straight to the back of other areas of the abdomen; 20% with
severe sequelae of organ failure
-Know where pain is located with pancreatitis: chronic - -epigastric,
radiating to back
, -Know how hepatitis A is transmitted - -Transmitted through fecal-oral
route. Fecal shedding followed by poor handwashing contaminates water and
foods leading to infection of household and sexual contacts
-Stress incontinence - -the urethral sphincter is weakened so that transient
increases in intra-abdominal pressure raise the bladder pressure to levels
that exceed urethral resistance. Causes include childbirth and surgery,
postmenopausal atrophy of the mucosa, and urethral infection. May follow
prostate surgery in men.
-urge incontinence - -detrusor contractions are stronger than normal and
overcome the normal urethral resistance. The bladder is typically small.
Mechanisms: Decreased cortical inhibition of detrusor contractions from
stroke, brain tumor, dementia, and lesions of the spinal cord above sacral
level. Also hyperexcitability of sensory pathways ie: bladder infections,
tumors, and fecal impaction. Deconditioning of voiding reflexes ie: frequent
voluntary voiding at low bladder volumes.
-overflow incontinence - -detrusor contractions are insufficient to overcome
urethral resistance, causing urinary retention. The bladder is typically flaccid
and large, even after an effort to void. Mechanisms: obstruction of the
bladder outlet ie: BPH or tumor. Weakness of the detrusor muscle associated
with peripheral nerve disease at S2-4 level. Impaired bladder sensation that
interrupts the reflex arc ie: diabetic neuropathy.
-functional incontinence - -the patient is functionally able to reach the toilet
in time because of impaired health or environmental conditions. Mechanism:
problems in mobility resulting from weakness, arthritis, poor vision, or other
conditions. Also environmental factors such as an unfamiliar setting, distant
bathroom facilities, bed rails, or physical restraints.
-Incontinence secondary to medications - -drugs may contribute to any type
of incontinence listed. Ex: sedatives, tranquilizers, anticholinergics,
sympathetic blockers, and potent diuretics
-Know where lymph nodes should be with strep - -· Strep throat
àstreptococcal pharyngitis, bacterial infection that may cause a sore,
scratchy throat
· Common childhood infection has a classic presentation of erythema of the
posterior pharynx and palatal petechiae
· Enlarged swollen cervical lymph nodes -> superficial cervical lymph nodes
Superficial cervical -> superficial to the sternocleidomastoid
-What vaccines are safe during pregnancy - -tdap, flu, Pneumococcal,
meningococcal, Hepatitis B, rho gam
*NOT MMR, polio, or varicella