NR 509 Final Exam Latest 2023 - 2024

NR 509 Final Exam (Latest 2023 - 2024) New Full Questions and Answers ( Included ) 100% Correct

• Suspicious breast mass: -A mobile mass that becomes fixed when the arm relaxes is attached to

the ribs and intercostal muscles; if fixed when the hand is pressed against the hip, it is attached to the pectoral fascia.-Hard irregular poorly circumscribed nodules, fixed to the skin or underlying tissues, strongly suggest cancer

2. Risk for Breast cancer: --*Age*

-family history of breast/ovarian CA

• inherited genetic mutations,

-personal history of breast cancer

• high levels of endogenous hormones
• breast tissue density
• proliferative lesions with atypia on breast biopsy, - duration of unopposed estrogenexposure related to

early menarche -age of first full-term pregnancy

• late menopause.
• breastfeeding for less than 1 year,
• postmenopausal obesity

-cigarette smoking, alcohol ingestion,

• physical inactivity, and type of contraception.

3. Characteristics of a breast cyst: Soft to firm, round, mobile, often tender.

• The best way to examine the lateral portion of the breast: -Have pt roll ontothe opposite hip

-place her hand on her forehead.

• keep shoulders pressed against the bed

-palpate in the axilla, moving in a straight line down to the bra line, then move the fingers medially and palpate in a vertical strip up the chest to the clavicle. Continuein vertical overlapping strips until you reach the nipple

• Bacterial Vaginosis (BV): -Caused by overgrowth of anaerobic bacteria (oftenfrom sex)
• Discharge: Gray or white, thin, homogenous, malodorous, coats the vaginal walls,usually not profuse,

may be minimal

• Fishy/musty genital odor

-Normal vulva and vaginal mucosa -Scan saline wet mount for clue cells (epithelial cells with stippled borders); sniff forfishy odor after applying KOH ("whiff test"); test the vaginal secretions for pH > 4.5 1 / 2

• Candidal Vaginitis: -Cause: Candida albicans, a yeast (normal overgrowth ofvaginal flora); many

factors predispose, including antibiotic therapy -Discharge: white and curdy, may be thin but usually thick, not as profuse astrichomonal infection, not malodorous

• vaginal soreness, pruritus, pain on urination, dyspareunia (painful intercourse)

-The vulva and surrounding skin are inflamed and sometimes swollen to a variableextent; the vaginal mucosa is reddened, with white tenacious patches of discharge;the mucosa may bleed when these patches are scraped off; in mild cases, the mucosa looks normal -Scan potassium hydroxide (KOH) preparation for the branching hyphae of Candida

• TrichomonalVaginitis: -Trichomonas vaginalis, a protozoan; often but not alwaysacquired sexually
• Discharge:Yellowish green or gray, possibly frothy; often profuse and pooled in thevaginal fornix; may

be malodorous -Pruritus (though not usually as severe as with Candida infection); pain on urination (from skin inflammation or possibly urethritis); dyspare-unia -Vestibule and labia minora may be erythematous; the vaginal mucosa may be diffusely reddened, with small red granular spots or petechiae in the posterior fornix;in mild cases, the mucosa looks normal

• Scan saline wet mount for trichomonads

• Syphillis: This ulcerated papule with an indurated edge usually appears after 3 to 6 weeks of

incubating infection from the spirochete Treponema pallidum. These lesions may resemble a carcinoma or crusted cold sore. Similar primary lesions arecommon in the pharynx, anus, and vagina but may escape detection since they arepainless, nonsuppurative, and usually heal spontaneously in 3 to 6 weeks.Wear gloves during palpation since these chancres are infectious.

• s/s of epididymitis: Acute: swollen, and notably tender, making it difficult todistinguish from

the testis. The scrotum may be reddened and the vas deferensinflamed.Chronic: firm enlargement of the epididymis, which is sometimes tender, with thick-ening or beading of the vas deferens.

• Genital Warts (Condylomata Acuminata): -Single or multiple papules or plaques of variable shapes;

may be round, acuminate (pointed), or thin and slender.May be raised, flat, or cauliflower-like (verrucous).-Causative organism: HPV, usually subtypes 6, 11; carcinogenic subtypes rare, approximately 5-10% of all anogenital warts. Incubation: weeks to months; infectedcontact may have no visible warts.-Can arise on penis, scrotum, groin, thighs, anus; usually asymptomatic, occasion-ally cause itching and pain.-May disappear without treatment.

• Risk for prostate CA: Age, ethnicity, and family history are the strongest riskfactors for prostate

cancer.

12. s/s prostatitis: -fever

-frequency, urgency, dysuria, incomplete voiding,

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