Final Exam: NR 509 / NR509 (Latest 2023/
2024 Update) Advanced Physical Assessment
Exam Review | Weeks 5-8 Covered| Questions
and Verified Answers- Cha... [Show More] mberlain
QUESTION
A 66-year-old female museum curator presents for a routine annual ex- amination. On
examination, a notably enlarged supraclavicular lymph node is appreciated on the right side. The
lymph node is nontender and feels firm
and rubbery. She denies any localized or systemic symptoms such as breast lumps, fevers, or
night sweats. She has been taking conjugated estrogen tablets for 9 years since menopause,
though she has not taken progestin
compounds since she had a hysterectomy for heavy bleeding at age 45 years. Which of the
following is true about this presentation of lymphadenopathy?
a. Breast cancer always presents with axillary lymphadenopathy because the lymphatics of the
breast uniformly drain into the axilla.
b. Supraclavicular nodes are generally considered benign and require no further evaluation or
follow-up.
c. Supraclavicular nodes are found along the anterior edge of the trapezius muscle in the neck.
d. Firm, rubbery lymph nodes are generally considered to be benign.
e. Metastatic breast cancer cells may spread directly into the infraclavicular and then
supraclavicular nodes without first causing notable changes in the axillary nodes.
Answer:
: e. Metastatic breast cancer cells may spread directly into the infraclavicular and then
supraclavicular nodes without first causing notable changes in the axillary nodes.
QUESTION
A 24-year-old graphic designer presents to clinic with a concern for a breast mass. A rubbery,
mobile, nontender mass is palpated in the right breast as described by the patient, which is
consistent with a firbroadenoma. In describing the location of the mass, the examiner notes that it
is 3 cm proximal to and 3 cm to the left of the nipple. Which of the following would be the most
appropriate way to report this finding?
a. "Rubbery, mobile, nontender mass located in right breast, in the 10
Answer:
: 30 position from the nipple"
b. "Rubbery, mobile, nontender mass located in right breast, in the lower outer quadrant"
c. "Rubbery, mobile, nontender mass located in right breast, in the upper inner quadrant"
d. "Rubbery, mobile, nontender mass located in the left breast, upper outer quadrant"
e. "Rubbery, mobile, nontender mass located in right breast, in the 1
Answer:
: 30 position from the nipple"
Answer:
: a. "Rubbery, mobile, nontender mass located in right breast, in the 10:30 position from the
nipple"
QUESTION
A 54-year-old female dietician presents for a routine annual examination. On review of systems,
she reports that she has had many breast findings over several years, including one biopsy with
normal pathology. She feels that her breasts have become far less lumpy since she underwent
menopause 3 years ago. Which of the following is true regarding changes in the breasts with
menopause?
a. Transformation of breasts to primarily fatty tissue with menopause decreas- es the sensitivity
and specificity of mammograms.
b. Estrogen in hormone replacement therapy (HRT) has no effect on breast density after
menopause.
c. Glandular tissue of the breast atrophies with menopause, primarily due to decrease in the
number of lobules.
d. Breast density has no genetic component and is entirely due to estrogen dose from endogenous
and exogenous sources over the lifetime.
e. Mammography performs most poorly in the menopausal and post- menopausal age group and
should be limited for that reason.
Answer:
: c. Glandular tissue of the breast atrophies with menopause, primarily due to decrease in the
number of lobules.
QUESTION
A 67-year-old electronics technician with a history of hypertension and type 2 diabetes presents
for his yearly physical examination and complains of progressively worsening erectile
dysfunction (ED). While counseling him, the clinician mentions that multiple processes must
take place to achieve
an erection. Which of the following structures would be most affected by vascular deficiencies
related to his preexisting medical conditions and is likely contributing to his symptoms?
a. Corpora cavernosa b. Ejaculatory duct
c. Epididymis
d. Seminal vesicle
e. Vas deferens
Answer:
: a. Corpora cavernosa
QUESTION
A 29-year-old graduate student states that he is able to achieve an erec- tion and ejaculate during
sexual intercourse; however, he does not experience any pleasurable sensation of orgasm. He is
otherwise healthy and is not on any medications. What is the most likely cause of his problem?
a. Androgen insufficiency b. Endocrine dysfunction c. Peyronie disease
d. Psychogenic
e. Sexually transmitted infection (STI)
Answer:
: d. Psychogenic
QUESTION
Multiple processes must take place in order for a male to sustain an erec- tion. Various cues
stimulate sympathetic outflow from higher brain centers to
the T11-L2 levels of the spinal cord and parasympathetic outflow from S2 to S4 reflex arcs.
Local vasodilatation within the penis erectile tissue results from increased levels of which of the
following?
a. Follicle-stimulating hormone (FSH)
b. Gonadotropin-releasing hormone (GRH)
c. Luteinizing hormone (LH)
d. Nitric oxide (NO) and cyclic guanosine monophosphate (cGMP)
e. Testosterone
Answer:
: d. Nitric oxide (NO) and cyclic guanosine monophosphate (cGMP)
QUESTION
The human papillomavirus (HPV) can cause genital warts in males and females as well as
cervical cancer in females. Vaccination against HPV is available and should be offered to males
between what ages?
a. 6-9 months b. 1-3 years [Show Less]
