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NR 509 APEA EXAM – WOMEN’S HEALTH
NR 509 APEA EXAM – WOMEN’S HEALTH Question: When palpating the cervix during the bimanual exam, cervical motion tenderness (chandelier sign) is not... [Show More] ed. This tenderness could be suggestive of: retroversion of the uterus.pelvic inflammatory disease. Correctvulvar lesions. IncorrectBartholin gland infection. Explanation: Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal tenderness, suggest pelvic inflammatory disease, ectopic pregnancy, or appendicitis. Question: In a female diagnosed with a first-degree uterine prolapse, the cervix: is located in its normal position. has slipped but is well within the vagina. Correctis located in the introitus.and vagina are outside the introitus. Explanation: Uterine prolapse occurs in progressive stages. The uterus becomes retroverted and descends down the vaginal canal to the exterior. In first-degree prolapse, the cervix is still well within the vagina. In second-degree prolapse, it is at the introitus. In third-degree prolapse (procidentia), the cervix and vagina are outside the introitus. Question: Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at a high risk for developing all of the following abnormalities except: columnar epithelium covering most or all of the cervix.a slit- like cervical os. Correctvaginal adenosis.a circular collar or ridge of tissue between the cervix and the vagina. Explanation: Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at greatly increased risk for several abnormalities: columnar epithelium that covers most or all of the cervix vaginal adenosis, and a circular collar or ridge of tissue, of varying shapes, between the cervix and vagina. The slit-like cervical os is a normal variation. Question: A female patient presents with a profuse, yellowish, green vaginal discharge that is malodorous. This vaginal discharge is most consistent with: candidal vaginitis.bacterial vaginosis.Trichomonal vaginitis. Correctgonorrhea. Explanation: Trichomonas vaginalis causes trichomonal vaginitis. Presenting symptoms include a profuse, yellowish, green vaginal discharge that is malodorous. Candidal vaginitis produces a white and curd-like thin discharge that is rarely malodorous. With bacterial vaginosis, the discharge can be gray or white, thin, malodorous (fishy), and not usually profuse. The discharge associated with gonorrhea is usually thick and bloody. Question: The most common causes of sexual problems in females are related to: lack of sexual desire.inadequate vaginal lubrication. Incorrectpsychosocial factors. Correctpelvic disorders. Explanation: The most common problems that occur during sexual activity are related to situational or psychosocial factors. Although lack of desire, inadequate vaginal lubrication, and pelvic disorders may all contribute to sexual problems, the most common causes are situational and psychosocial in origin. Therefore, obtaining a comprehensive sexual history is of utmost importance. Question: Chronic pelvic pain refers to pain that does not respond to therapy and: lasts more than 3 months. Incorrectlasts more than 6 months. Correctlasts more than 9 months.lasts more than 12 months. Explanation: According to the International Pelvic Pain Society, chronic pelvic pain refers to pain that lasts more than 6 months without response to treatment. Question: In female patients with dyspareunia, superficial pain is most likely related to all of the following except: local inflammation.atrophic vaginitis. Incorrectpressure on a normal ovary. Correctinadequate lubrication. Explanation: In females, dyspareunia, or painful intercourse, can occur at the vaginal opening, occurring at the start of intercourse, or when the partner is pushing deeper. It is important to differentiate the pain to determine the etiology. Superficial pain suggests local inflammation, atrophic vaginitis, or inadequate lubrication. Deeper pain may be from pelvic disorders or pressure on a normal ovary. Question: If urethritis or inflammation of the paraurethral glands is suspected in a female patient, the index finger should be inserted into the vagina and: milk the urethra gently from the outside inward.milk the urethra gently from the inside outward. Correctmassage the urethral meatus with the other hand.massage the pelvic floor muscles in a clockwise fashion. Explanation: If urethritis or inflammation of the paraurethral glands is suspected, the examiner should insert the index finger into the vagina and milk the urethra gently from inside outward. Note any discharge from or about the urethral meatus. If present, it should be cultured. Question: Upon examination of the vagina, a swollen red ring is noted around the urethral opening. This finding is most consistent with a: prolapse of the urethral mucosa. Correcturethral caruncle. Incorrectcystocele.cystourethrocele. Explanation: A prolapsed urethral mucosa forms a swollen red ring around the urethral meatus. A urethral caruncle is a small, red, benign tumor visible at the posterior part of the urethral meatus. It usually occurs in postmenopausal women. A cystocele is a bulge of the upper two-thirds of the anterior vaginal wall and the bladder above it. It results from weakened supporting tissues. When the entire anterior vaginal wall, together with the bladder and urethra, is involved in the bulge, a cystourethrocele is present. Question: When performing a bimanual vaginal exam, a solid, nodular-like lesion is palpated over the right ovary. This finding is most consistent with: ovarian cancer.an ovarian tumor. Correcta right tubal pregnancy.a tubo-ovarian abscess. Explanation: Ovarian tumors appear solid and often nodular upon palpation. Ovarian cancer is relatively rare and usually presents at an advanced stage with symptoms of pelvic pain, increased abdominal size, and urinary tract symptoms. An ovarian cyst tends to be smooth and compressible and if uncomplicated, nontender. A right tubal pregnancy does not typically present with an ovarian lesion. A tubo-ovarian abscess is difficult to palpate and typically presents with severe pain and purulent vaginal discharge. Question: Indications for performing a rectovaginal exam include all of the following except to: palpate a retroverted uterus.assess pelvic pathology.assess an inguinal hernia. Correctscreen for colorectal cancer in women over 50. Explanation: The rectovaginal examination has three primary purposes: to palpate a retroverted uterus, the uterosacral ligaments, cul-de-sac, and adnexa; to screen for colorectal cancer in women 50 years or older; and to assess for pelvic pathology. It is not indicated for assessing or palpating inguinal hernias. Question: Examination of a female patient's right breast reveals a retraction of the nipple and areola. This finding is consistent with: breast cancer. Correctmastitis.Paget's disease of the breast.fibrocystic breast disease. Explanation: Retraction of the nipple and areola are suggestive of an underlying tumor. Mastitis is an inflammation of the breast tissue. Paget's disease is an uncommon form of breast cancer that starts with a scaly, eczema-like lesion that may weep, crust, or erode. Fibrocystic breast disease findings include lumps, thickening and swelling in the breast tissue, and becomes prominent immediately before onset of menses. Question: To assess pelvic floor muscle strength during the bimanual vaginal exam, have the patient squeeze around the inserted fingers for as long as possible. To consider full strength, snug compression should last for: 1 seconds.2 seconds.3 seconds. Correctat lease 5 seconds. Incorrect Explanation: To assess pelvic floor muscle strength during the bimanual vaginal exam, have the patient squeeze around the inserted fingers for as long as possible. To consider full strength, snug compression should last for 3 or more seconds. [Show Less]
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NR 509 APEA EXAM – UROLOGY
NR 509 APEA EXAM – UROLOGY Question: In men, painful urination without frequency or urgency suggests: cystitis.Incorrect urethritis:Correct c... [Show More] onstipation. acute prostatitis. Explanation: In men, painful urination without frequency or urgency suggests urethritis. Cystitis presents with frequency and urgency. Constipation usually does not present with urinary tract symptoms. Acute prostatitis presents with frequency, urgency, and dysuria. Question: A 65-year-old woman complains that when she feels the urge to urinate, she has to go immediately or else she urinates "on herself". She has become homebound because she wants to stay close to the bathroom. This condition is termed: functional incontinence. overflow incontinence. urge incontinence:correct stress incontinence. Explanation: In urge incontinence, (overactive bladder), urgency is followed by immediate involuntary leakage due to uncontrolled detrusor contractions that overcome urethral resistance. Following an urge to void, there is an involuntary loss of urine since the patient cannot get to the toilet quickly enough. Overflow incontinence is associated with a neurological or anatomical obstruction from pelvic organs or the prostate which limits bladder emptying and causes an overdistended bladder. Stress incontinence is commonly seen in women and arises from decreased intraurethral pressure. This condition is generally noted when a patient coughs, sneezes, or laughs. Functional incontinence usually arises from cognitive impairment, musculoskeletal problems, or immobility. Question: Symptoms of proctitis may include all of the following except: left-sided abdominal pain. rectal pain. suprapubic pain:Correct tenesmus. Explanation: Proctitis is inflammation of the lining of the rectum leading to rectal pain, bleeding, and a continuous sensation to defecate (tenesmus). Additional symptoms may also include left-sided abdominal pain, diarrhea, pain with bowel movements, and a feeling of fullness in the rectum. Suprapubic pain is not generally associated with proctitis. Question: A 40 year old male complains of right flank pain. His temperature is 102° F. These symptoms may be characteristic of: renal calculi. acute pyelonephritis:Correct urethritis. prostatitis. Explanation: Kidney pain in the flank area and groin that is accompanied by fever and chills is consistent with acute pyelonephritis. Renal or ureteral colic usually presents with a sudden onset of pain in the flank area, abdomen, or groin. Chills and fever do not generally accompany urinary calculi. In men, painful urination without frequency or urgency suggests urethritis. Acute prostatitis presents with frequency, urgency, and dysuria. Question: A useful mnemonic for elucidating causes of incontinence in the older adult is: STOOL. DIAPERS: Correct DRIP. URINE. Explanation: For elucidating causes of incontinence, two mnemonics may be helpful: DIAPERS, (Delirium, Infection, Atrophic urethritis/vaginitis, Pharmaceuticals, Excess urine output from conditions like hyperglycemia or heart failure, Restricted mobility, and Stool impaction) and DDRRIIPP (Delirium, Drug side effects, Retention of feces, Restricted mobility, Infection of urine, Inflammation, Polyuria, and Psychogenic). Home My Results Saved Exams FAQ Logout PATIENT ASSESSMENT [Show Less]
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NR 509 APEA EXAM – RANDOM PAPERS
NR 509 APEA EXAM – RANDOM PAPERS Question: A transient ischemic attack is: a transient episode of neurologic dysfunction by focal brain, spinal c... [Show More] ord, or retinal ischemia, without acute infarction. Correctan infarction of the central nervous system tissue that may be silent or symptomatic.the abrupt onset of motor or sensory deficits. Incorrectfocal or asymmetric weaknesses caused by central and peripheral nerve damage. Explanation: TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.” Ischemic stroke is “an infarction of central nervous system tissue” that may be symptomatic or silent. The other terms are not related to the new definitions. Question: A patient is asked to visually follow a finger through the cardinal fields of gaze. Which cranial nerves are being assessed? III, IVIII, IV, VI CorrectV, VI, VII Explanation: Visually following a finger through the cardinal fields of gaze is one way to assess the oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves. CN I is the olfactory nerve and assesses smell. CN II is the optic nerve and assesses visual acuity. CN V is the trigeminal nerve and assesses both sensory and motor functions. Question: Uncontrolled electrical activity in the brain, which may produce minor physical signs, thought disturbances, or disturbed motor activity is: dystonia.bradykinesia.tremor.seizure. Correct Explanation: A seizure is an uncontrolled electrical activity in the brain which may produce minor physical signs, thought disturbances, or disturbed motor activity, or a combination of symptoms. Dystonia is a neurological disorder that causes involuntary muscle spasms and twisting of the limbs. Bradykinesia is the term used to describe the impaired ability to adjust to one's body position. This symptom is noted in patients who have Parkinson's disease. A rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups is a tremor. Question: When evaluating the sensory system, testing the posterior columns tract would include assessing sensations of: position and vibration. Correctpain and temperature.deep touch. Incorrectdiscriminative sensations. Explanation: When evaluating the sensory system, testing the spinothalamic tracts would include assessing sensations of pain and temperature. Assessing position and vibration evaluate the posterior columns. Light touch assesses both the spinothalamic and posterior column tracts. To assess discriminative sensation, both the spinothalamic and posterior columns tracts as well as the cortex would be assessed. Question: Physical exam of a well two-week-old infant reveals a little dimple with a small amount of hair just above the sacral area. This could be: an unusual finding but within normal limits. Incorrecthirsutism.Arnold -Chiari malformation. spina bifida occulta. Correct Explanation: There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and myelomeningocele. Occulta is the mildest and most common form in which one or more vertebrae are malformed. The name “occulta,” which means “hidden,” indicates that a layer of skin covers the malformation, or opening in the vertebrae. This form of spina bifida, present in 10-20 percent of the general population, rarely causes disability or symptoms. Closed neural tube defects are often recognized early in life due to an abnormal tuft or clump of hair or a small dimple or birthmark on the skin at the site of the spinal malformation. Meningocele and myelomeningocele generally involve a fluid-filled sac—visible on the back—protruding from the spinal canal. In meningocele, the sac may be covered by a thin layer of skin. In most cases of myelomeningocele, there is no layer of skin covering the sac and an area of abnormally developed spinal cord tissue is usually exposed. Hirsutism is an excessive amount of hair on the body usually caused by a hormonal imbalance. An Arnold-Chiari malformation is a cyst-like formation in the fourth ventricle, cerebellum or brainstem. Question: A female patient complains of weakness in her arm when combing her hair. This finding could be suggestive of which type of weakness pattern? Proximal CorrectDistal IncorrectSymmetricAsymmetric Explanation: To identify proximal weakness, ask about difficulty with movements such as combing hair, reaching up to a shelf, getting up out of a chair, or climbing a high step. Question: What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains? DeliriumCognitive impairmentParkinson's diseaseAlzheimer's disease Correct Explanation: Alzheimer's disease is a geriatric condition in which normal alertness is present but progressive global deterioration of cognition occurs in multiple domains, including short-term memory, but with sparing of memory for remote events, subtle language errors, visuospatial perceptual difficulties, and changes in executive function, or the ability to perform sequential tasks such as instrumental activities of daily living (IADLs). Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment and confused thinking. Cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Parkinson's disease is a progressive disorder of the nervous system that affects movement. Question: When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates position sense? Motor systemCerebellar systemVestibular system IncorrectSensory system Correct Explanation: Coordination of muscle movement requires that four areas of the nervous system function in an integrated way: motor system for muscle strength, cerebellar system for rhythmic movements and steady posture, vestibular system for balance and coordinating eye, head, and body movements, and sensory system for position sense. Question: A band of skin innervated by the sensory root of a single spinal nerve is termed a: peripheral nerve field.dermatome. Correctsynapseasterixis. Explanation: A band of skin innervated by the sensory root of a single spinal or dorsal nerve root is termed a dermatome. A peripheral nerve field refers to an area of the skin innervated by a single nerve and is described as cutaneous nerve distribution. A synapse is a structure that permits a neuron to pass an electrical or chemical signal to another cell. Asterixis refers to an abnormal tremor consisting of involuntary jerking movements, especially in the hands, frequently occurring with impending hepatic coma and other forms of metabolic encephalopathy. This is also known as flapping tremor. Question: An 8-month-old with a significant head lag would suggest the need for: exercises that strengthen the neck muscles.a follow-up visit in 2 months.a neurological evaluation. Correctan orthopedic referral. Explanation: A baby typically should be able to control the neck muscles by around 4 months of age, so that when pulling from a lying to a sitting position the head should remain in line with the torso and not flop back. Delays in reaching this developmental milestone have been observed in premature babies and in those with cerebral palsy; all others should be referred to a pediatric neurologist for further evaluation. The other choices do not address the issue or the cause. Early interventions result in better outcomes. Question: Hyperalgesia refers to: decreased sensitivity to pain.increased sensitivity to pain. Correctabsence of pain sensation.absence of touch sensation. Explanation: Analgesia refers to absence of pain sensation; hypalgesia to decreased sensitivity to pain; hyperalgesia to increased sensitivity; and anesthesia to absence of touch sensation. Question: Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals are consistent with: facial tics. Correctdystonic movements.athetoid movements.oral-facial dyskinesias. Incorrect Explanation: Facial tics are brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals. Examples include repetitive winking, grimacing, and shoulder shrugging. Dystonic movements are similar to athetoid movements, but often involve larger portions of the body, including the trunk. Grotesque, twisted postures may result. Athetoid movements are slower and more twisting and writhing than choreiform movements, and have a larger amplitude. They most commonly involve the face and the distal extremities. Oral–facial dyskinesias are rhythmic, repetitive, bizarre movements that chiefly involve the face, mouth, jaw, and tongue: grimacing, pursing of the lips, protrusions of the tongue, opening and closing of the mouth, and deviations of the jaw. These are involuntary movements. Question: W [Show Less]
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NR 509 APEA EXAM – PREGNANCY
NR 509 APEA EXAM – PREGNANCY Question: What is the standard instrument used to auscultate fetal heart tones? StethoscopeDoppler CorrectPre-nat... [Show More] al monitorUltrasound Explanation: The Doppler fetal rate monitor is the standard instrument used for this measurement, and can detect the fetal rate (FHR) as early as 10 weeks gestation. Question: During pregnancy, what sound may be auscultated at the second or third intercostal space at the sternal border due to increased blood flow through the vessels? Diastolic murmur IncorrectSystolic murmurVenous hum CorrectBruit Explanation: A venous hum, or continuous mammary souffle that occurs during pregnancy is due to increased blood flow through normal vessels. The mammary souffle is commonly heard during late pregnancy or lactation. It is heard loudest in the second or third intercostal space at the sternal border, and is typically both systolic and diastolic, though only the systolic component may be audible. Question: If regular uterine contractions occur prior to 37 weeks gestation, this could be: a normal finding. Incorrectpreterm labor. Correctpreeclampsia.supine hypotensive syndrome. Explanation: Before 37 weeks, regular uterine contractions with or without pain and bleeding are abnormal, suggesting preterm labor. Question: Weight gain should be monitored during pregnancy. For a pregnant woman whose BMI is 18.5 - 24.9, the total weight gain should be: 11-20 pounds.15-25 pounds.25-35 pounds Correct28-40 pounds. Explanation: Weight gain should be closely monitored during pregnancy, as both excessive and inadequate weight gain are associated with poor birth outcomes. The pregnant woman who has a BMI of <18.5, should gain 28 - 40 pounds; BMI 18.5-24.9 should gain 25 - 35 pounds; BMI 25-29.9 should gain 15 - 25 pounds; and the obese pregnant woman should gain 11 - 20 pounds. Question: During pregnancy, a palpable softening of the cervical isthmus is noted. This finding is: Hegar's sign. CorrectChadwick's sign.striae gravidarum.linea nigra. Explanation: Hegar’s sign is the palpable softening of the cervical isthmus, the portion of the uterus that narrows into the cervix. Increased vascularity throughout the pelvis during pregnancy gives the vagina a bluish color, known as Chadwick’s sign. As the skin over the abdomen stretches to accommodate the fetus, purplish striae gravidarum (“stretch marks”) may appear. Linea nigra is a brownish black pigmented vertical stripe along the midline skin of the abdomen. Question: As tension on the abdominal wall increases with advancing pregnancy, the rectus abdominis muscles may separate at the midline of the abdomen. This finding is termed: striae gravidarum.linea nigra.adnexae.diastasis recti. Correct Explanation: As tension on the abdominal wall increases with advancing pregnancy, the rectus abdominis muscles may separate at the midline: this is diastasis recti. If diastasis is severe, especially in multiparous women, only a layer of skin, fascia, and peritoneum may cover the anterior uterine wall, and fetal parts may be palpable through this muscular gap. Question: Facial edema in a pregnant woman after 20 weeks gestation, could be: a normal finding.suggestive of preeclampsia. Correctrenal failure. Incorrectheart failure. Explanation: Facial edema in a pregnant woman after 20 gestational weeks may reflect preeclampsia and should be investigated. Question: Weight gain should be monitored during pregnancy. For a pregnant woman whose BMI is < 18.5, the total weight gain should be: 11-20 pounds.15-25 pounds.25-35 pounds28-40 pounds. Correct Explanation: Weight gain should be closely monitored during pregnancy, as both excessive and inadequate weight gain are associated with poor birth outcomes. The pregnant woman who has a BMI of <18.5, should gain 28 - 40 pounds; BMI 18.5-24.9 should gain 25 - 35 pounds; BMI 25-29.9 should gain 15 - 25 pounds; and the obese pregnant woman should gain 11 - 20 pounds. Question: Murmurs audible during pregnancy may suggest: preeclampsia.hypertension. Incorrectanemia. Correctpulmonary embolus. Explanation: Murmurs audible during pregnancy may suggest anemia. However, benign systolic murmurs can be heard in pregnant women after the first trimester. Question: What is the importance of prenatal care? Determines gestational age Estimates expected date of deliveryOptimizes health and minimizes risk for mother and fetus CorrectObtain family history Explanation: Prenatal care focuses on optimizing health and minimizing risk for the mother and fetus. Goals of the initial prenatal visit are to confirm the pregnancy, assess the health of the mother and risks of complications, and counsel the mother about expectations for the pregnancy. Question: During pregnancy, which hormone promotes endometrial growth that supports the early embryo? Progesterone IncorrectHuman chorionic gonadotropin (HCG)Estrogen CorrectHuman placental lactogen Explanation: Estrogen promotes endometrial growth that supports the early embryo. This hormone appears to stimulate prolactin output in the anterior lobe of the pituitary gland, which readies breast tissue for lactation. Estrogen also contributes to the hypercoagulable state that puts pregnant women at higher ris [Show Less]
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NR 509 APEA EXAM – ORTHO
NR 509 APEA EXAM – ORTHO Question: A tool for assessing risk factors for osteoporotic fractures is the: DEXA. FRAX:Correct BRCA1. HAARM:Incorr... [Show More] ect Explanation: The FRAX calculator generates fracture risk based on age, body mass index, parental fracture history, use of glucocorticoids, presence of rheumatoid arthritis or secondary osteoporosis, and tobacco and alcohol use. It has been validated for black, Hispanic, and Asian women in the USA and has calculators that are country and continent specific. Duel energy x-ray absorptiometry, DEXA, is the optimal standard for measuring bone density. BRAC1 is a gene that can mutate and increase the risk of breast cancer. HAARM is the melanoma risk model. Question: Anserine bursitis arises from: excessive running:Correct excessive kneeling:Incorrect arthritis. trauma Explanation: Anserine bursitis arises from excessive running, valgus knee deformity, fibromyalgias, and osteoarthritis. Prepatellar bursitis (“housemaid’s knee”) arises from excessive kneeling. A popliteal or “baker’s” cyst arises from distention of the gastrocnemius semimembranous bursa from underlying arthritis or trauma. Question: When examining the knee, which of the following symptoms could be indicative of a positive Adduction (Varus) Stress Test? Pain in the lateral joint line: Correct Pain in the medial joint line:Incorrect Pain in the anterior joint line A click along the medial joint line. Explanation: The Adduction (or Varus) Stress Test is a maneuver that evaluates the function of the lateral collateral ligament. To perform this test, the knee is held in 30 degrees of flexion. With one hand on the medial side of the knee and one hand on the ankle, an adduction force is gently applied. If pain is noted in the lateral joint line, this could be indicative of a lateral collateral ligament tear. When tenderness extends more to the proximal or distal joint line, the collateral ligament may be the cause of pain instead of the meniscus. Question: When assessing the knee, the examiner instructs the patient to straighten his knee. This motion would assess knee: flexion.extension:Correct internal rotation. external rotation. Explanation: Having the patient straighten his leg assesses extension of the knee. The examiner instructs the patient to bend his knee. This maneuver assesses knee flexion. Internal rotation of the knee could be elicited by having the patient swing his lower leg toward the midline while sitting. Instructing the patient to swing his leg away from his midline while sitting assesses external rotation of the knee. Question: When performing an examination of a tender left finger on an adult, the surrounding tissue reveals warmth, edema, and redness. This finding could be suggestive of: carcinoma. muscular atrophy. Synovitis:Incorrect gouty arthritis:Correct Explanation: Redness, warmth, and edema over a tender joint suggest septic or gouty arthritis infection, or possibly rheumatoid arthritis. Question: An example of a fibrous joint would be the: vertebral bodies of the spine. Skull:Correct Shoulder:Incorrect pubic symphysis of the pelvis. Explanation: The skull is an example of the fibrous joint. Examples of synovial joints include the shoulder, knee, hip, wrist, distal radioulnar, elbow, and carpals. Vertebral bodies of the spine and the pubic symphysis of the pelvis are examples of cartilaginous joints. Question: To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the: lateral joint line of the knee. on either side of the patella. upper edge of the tibial plateau:Correct top of the patella. Explanation: To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the upper edge of the tibial plateau. The lateral meniscus is palpated on the lateral joint line by placing the patient's knee in slight flexion. To palpate the tibiofemoral joint, face the patient's knee and place the thumbs in the soft-tissue depressions on either side of the patellar tendon. Question: A patient complains of a sharp burning pain in the neck and right arm with associated paresthesias and weakness. These symptoms may be associated with: mechanical neck pain. mechanical neck pain with whiplash. cervical radiculopathy:Correct cervical myelopathy. Explanation: With cervical radiculopathy, nerve root compression is the etiology. Symptoms may include sharp burning or tingling pain in the neck and one arm with associated paresthesias. Mechanical neck pain is described as aching pain in the cervical paraspinal muscles and ligaments with associated muscle spasm and stiffness and tightness in the upper back and shoulder, lasting up to 6 weeks. In patients with mechanical neck pain with whiplash, the paracervical pain and stiffness begins the day after injury and may be accompanied by occipital headaches, dizziness, and malaise. In cervical myelopathy, cervical cord compression, the neck pain is associated with bilateral weakness and paresthesias in both upper and lower extremities. Question: A patient complains of lateral hip pain while pointing near the trochanter. This type of pain could be suggestive of: Sciatica: Incorrect radicular pain. polyarticular arthritis. Bursitis:Correct Explanation: Lateral hip pain near the greater trochanter suggests trochanteric bursitis. Sciatica symptoms usually include a shooting pain below the knee, commonly in the lateral leg or posterior calf and accompanied by low back pain. Radicular pain refers to pain that radiates along the dermatome of a nerve due to inflammation or irritation of a nerve root, as with sciatica pain. Polyarticular arthritis refers to arthritis involving several joints. Question: The muscle of the scapulohumeral group that crosses the glenohumeral joint posteriorly and inserts on the greater tubercle is known as the: infraspinatus muscle: Correct pectoralis major. subscapularis muscle: Incorrect [Show Less]
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NR 509 APEA EXAM – NEUROLOGY
NR 509 APEA EXAM – NEUROLOGY Question 1: Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with: a myoclonic seizure. Cor... [Show More] rect an absent seizure. a myoclonic atonic seizure. a focal seizure with impairment of consciousness. Explanation: A patient experiencing a myoclonic seizure manifests sudden, brief, rapid jerks, involving the trunk or limbs. A sudden brief lapse of consciousness with momentary blinking, staring, or movements of the lips and hands but no falling is consistent with an absent seizure. During a myoclonic atonic seizure, the patient experiences a sudden loss of consciousness with falling but no movements. Injury may occur. Focal seizures with impairment of consciousness the person appears confused. Automatisms include automatic motor behaviors such as chewing, smacking the lips, walking about, and unbuttoning clothes. Question 2: Which of the following neurological assessment findings indicate the need for further evaluation? Lifting one foot and then the other when the infant is held upright with the feet touching a solid surface Fanning and hyperextension of the toes when the sole is stroked upward from the heel Grasping a finger placed in the neonate's palm Weak and ineffective sucking movements Correct Explanation: Weak and ineffective sucking movements would indicate the need for further evaluation since any weak, absent, asymmetrical or fine jumping movements would suggest neurological system disorders. The other choices represent common reflexes found in the normal newborn: Babinski, grasping, and stepping. Question 3: An example of proximal weakness is: the right shoulder. Correct the right hand. both arms. Incorrect on the right side of the face. Explanation: There are 4 different patterns of weakness: Proximal, distal, symmetric, and asymmetric. An example of proximal weakness is weakness in the shoulder or hip girdle. Distal weakness occurs in the hands or feet. Symmetric weakness occurs in the same areas on both sides of the body. An asymmetric weakness occurs in a portion of the face or extremity - a form of focal weakness. Question: A female patient complains of weakness in her hand when opening a jar. This finding could be suggestive of which type of weakness pattern? ProximalDistal CorrectSymmetricAsymmetric Explanation: To identify distal weakness, ask about hand movements when opening a jar, can or using scissors or a screwdriver. Another example is a problems like tripping when walking. Question: A patient presents with an altered level of consciousness. He/she is considered in a stuporous state if he/she: appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep.arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily lapses into an unresponsive state. Correctremains unarousable with eyes closed. There is no evident response to inner need or external stimuli.opens the eyes and looks at the examiner, but responds slowly and is somewhat confused. Explanation: A stuporous patient arouses from sleep after exposure to painful stimuli, verbal responses are slow, and lapses into an unresponsive state. A lethargic patient appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep. An obtunded patient opens the eyes and looks at the examiner, but responds slowly and is somewhat confused. A comatose patient remains unarousable with eyes closed. There is no evident response to inner need or external stimuli. Question: One way to assess cerebellar function would be to have the patient: hop on one foot. Correctread out loud. Incorrectshrug the shoulders.discriminate between light and sharp pain. Explanation: The cerebellar function tests are used to monitor the patient's sense of equilibrium, which includes the patient's gait (walk), ability to stand upright with eyes closed (Romberg test), touch finger to nose, and move the heel to opposite knee while lying down. Other examples also include: hopping on one foot, walking heel-to-toe, and touching the examiner's finger and the examinees' nose. Reading out loud tests visual acuity; shrugging shoulders assesses the spinal accessory nerve and discriminating pain between light and sharp assesses the sensory system. Question: Hypesthesia refers to: absence of touch sensation.decreased sensitivity to touch. Correctincreased sensitivity to touch. Incorrectabsence of pain sensation. Explanation: Anesthesia is absence of touch sensation; hypesthesia is decreased sensitivity to touch; hyperesthesia is increased sensitivity to touch; and analgesia refers to absence of pain sensation. Question: When conducting a neurologic exam, which one of the following assessments is not considered part of the mental status assessment? Level of alertnessCranial Nerve II (CNII) CorrectAppropriateness of responsesOrientation to time Explanation: When conducting a neurologic exam, mental status assessment should include evaluation of the level of alertness, appropriateness of responses, and orientation to person, place, and time. Assessing cranial nerve II would be part of the cranial nerve assessment. Question: A mother reports to the nurse practitioner that her teenager might be taking drugs because earlier today the teenager had a mild seizure and now has an unstable gait and is beginning to complain of shortness of breath. These symptoms might be consistent with a possible overdose of: barbiturates.amphetamines. Correctmarijuana.opioids. Explanation: Amphetamines are central nervous system (CNS) stimulants. The teenager could exhibit signs of ataxia, respiratory distress, seizures, coma, myocardial infarction, death if he/she consumed this substance. Impaired memory, judgment, and attention, slurred speech, drowsiness, and irritability are suggestive of central nervous system depressants (CNS). Barbiturates, alcohol and benzodiazepines fall in this class. Opioids may cause euphoria, drowsiness, constricted pupils and some of the same symptoms as CNS depressants. Marijuana intoxication would present with relaxation, euphoria, detachment, talkativeness, slowed perception of time, and possible anxiety or paranoia. Question: An ischemic stroke is: a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia, without acute infarction. Incorrectan infarction of the central nervous system tissue that may be silent or symptomatic. Correctthe abrupt onset of motor or sensory deficits.focal or asymmetric weaknesses caused by central and peripheral nerve damage. Explanation: Ischemic stroke is “an infarction of central nervous system tissue” that may be symptomatic or silent. TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.” The other terms are not related to the new definitions. Question: By placing the patient in the supine position, the nurse practitioner raises the patient's relaxed and straightened leg while flexing the leg at the hip, then dorsiflexes the foot. This maneuver is known as: Kernig's sign.the straight-leg raise. Correctthe plantar response.the ankle reflex. Explanation: By placing the patient in the supine position, the nurse practitioner raises the patient's relaxed and straightened leg while flexing the leg at the hip, then dorsiflexes the foot. This maneuver is known as the straight leg raise and is used to evaluate sciatica. It is positive if there is pain down the back of the leg below the knee. Ipsilateral calf wasting and weak ankle dorsiflexion may be present. Question: The level of consciousness that refers to the patient that appears drowsy but can open his eyes, respond to questions, then fall back to sleep is known as: obtundation.alertness.lethargy. Correctstupor. Explanation: Lethargy refers to the patient that appears drowsy but can open his eyes, respond to questions, then fall back to sleep. An obtunded patient opens his eyes, looks at the person speaking to him but responds slowly and appears confused. The level of consciousness that refers to the ability of the patient to respond fully and appropriately to stimuli is known as alertness. A stuporous patient arouses from sleep only after painful stimuli. Question: When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates a steady posture? Motor systemCerebellar system CorrectVestibular systemSensory system Explanation: Coordination of muscle movement requires that four areas of the nervous system function in an integrated way: motor system for muscle strength, cerebellar system for rhythmic movements and steady posture, vestibular system for balance and coordinating eye, head, and body movements, and sensory system for position sense. Question: An older adult presenting with signs of undernourishment, slowed motor performance, and loss of muscle mass or weakness suggests: depression.frailty. CorrectParkinson's disease.Alzheimer's disease. Explanation: Undernutrition, slowed motor performance, loss of muscle mass, or weakness suggests frailty. Question: Postural tremors appear when the affected part is: at rest.moving voluntarily. Incorrectis actively maintaining a posture. Correctgetting closer to its target. Explanation: Tremors are rhythmic oscillatory movements. Postural tremors appear when the affected part is actively maintaining a posture. Examples include the fine rapid tremor of hyperthyroidism, the tremors of anxiety and fatigue, and benign essential tremor. The other choices are not consistent with postural tremors. Question: A discriminative sensation that describes the ability to identify an object by feeling it is: [Show Less]
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NR 509 APEA EXAM – HEENT
NR 509 APEA EXAM – HEENT Question: The function of the auditory ossicles is to: transmit the light reflex to the light cone.transform sound vibrati... [Show More] ons into mechanical waves for the inner ear. Correctto capture sound waves from the external ear for transmission into the middle ear.to separate the inner ear from the middle ear. Explanation: The function of the auditory ossicles is to transform sound vibrations into mechanical waves for the inner ear Question: A 35-year-old patient complains of vertigo accompanied by nausea and vomiting. Examination reveals bilateral diplopia and an unsteady gait. These symptoms could be suggestive of: an arrhythmia.a neurological condition. Correctan inner ear infection. Incorrectorthostatic hypotension. Explanation: Vertigo symptoms associated with neurologic conditions include: ataxia, diplopia, and dysarthria. Symptoms associated with cardiovascular conditions and vertigo include arrhythmias, orthostatic hypotension, vasovagal stimulation, lightheadedness, weakness, or presyncope. Question: A 60-year-old was concerned about a yellowish colored lesion above her right eyelid. Findings revealed a slightly raised yellowish, well circumscribed plaque along the nasal area of her right eyelid. This finding is most consistent with: a pinguecula.a chalazion.episcleritis.xanthelasma. Correct Explanation: Slightly raised, yellowish, well-circumscribed plaques appearing along the nasal area of one or both eyelids are consistent with lipid disorders and called xanthelasma. Pinguecula refer to harmless, yellowish, triangular nodules in the bulbar conjunctiva on either side of the iris. A chalazion is a nontender nodule usually on the underside of the eyelid. Episcleritis is an ocular inflammation of the episcleral vessels. Question: Assessment of a patient's visual acuity resulted in 20/200 using the Snellen eye chart. This means that: at 200 feet the patient can read printed information that a person with normal vision could read at 20 feet.at 20 feet the patient can read printed information that a person with normal vision could read at 200 feet. Correctthe patient has normal visual acuity.the patient may not be able to read so he should be tested with the picture or "E" eye charts. Explanation: Visual acuity that is corrected to 20/200 constitutes legal blindness. The larger the number under 20, the worse the visual acuity. If this is a new finding, the patient needs ophthalmologic evaluation. Question: Findings following assessment of a person's left eye gaze include impaired movements when attempting to look upward, downward, or inward. This condition is most consistent with: a conjugate gaze.left cranial nerve III (oculomotor) paralysis Correctcranial nerve IV (trochlear) paralysis.cranial nerve VI (abducens) paralysis. Explanation: With a left cranial nerve III paralysis, upward, downward, or inward movements are impaired. In conjugate or normal gaze, the normal movement of the two eyes appears simultaneously in the same direction to bring something into view. With a left cranial nerve VI paralysis, a person's gaze would include eyes conjugate when looking to the right, esotropia (one or both eyes turn inward) appears in the left eye when looking straight ahead, and esotropia is maximum in the left eye when looking to the left. The left eye is unable to look down when turned inward in a left cranial nerve IV paralysis. Question: Findings following assessment of a person's eye gaze include both eyes moving in the same direction simultaneously. This condition is most consistent with: a conjugate gaze. Correctleft cranial nerve III (oculomotor) paralysis cranial nerve IV (trochlear) paralysis.cranial nerve VI (abducens) paralysis. Explanation: In conjugate or normal gaze, the normal movement of the two eyes appears simultaneously in the same direction to bring something into view. With a left cranial nerve VI paralysis, a person's gaze would include eyes conjugate when looking to the right, esotropia (one or both eyes turn inward) in the left eye when looking straight ahead, and esotropia is maximum in the left eye when looking to the left. With a left cranial nerve III paralysis, upward, downward, or inward movements are impaired. The left eye is unable to look down when turned inward in a left cranial nerve IV paralysis. Question: A patient was diagnosed as being farsighted. The term for this condition is: hyperopia. Correctmyopia.strabismus.astigmatism. Explanation: Myopia, nearsightedness, occurs when light rays focus anterior to the retina. Hyperopia, farsightedness, occurs when light rays focus posterior to the retina. Strabismus, heterotropia, is a condition in which the eyes are not properly aligned with each other. In astigmatism, light rays do not focus correctly on the retina. This causes blurriness. Question: A buildup of excess fluid around the periphery of the eye orbits is known as: episcleritis.pinguecula.ptosis.periorbital edema. Correct [Show Less]
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NR 509 APEA EXAM – CARDIO
NR 509 APEA EXAM – CARDIO Question 1: The lymphatic ducts drain into the: arterial system. venous system. Correct arteriovenous system. capilla... [Show More] ry bed. Incorrect Explanation: The lymphatic ducts drain into the venous system. Question 2: While auscultating the patient's heart, a medium, soft murmur is audible. It is pansystolic and heard loudest at the apex with radiation to the left axilla. These findings are consistent with: tricuspid regurgitation.mitral regurgitation. Correcta ventricular septal defect.an innocent murmur. Incorrect Explanation: Mitral regurgitation produces a pansystolic, harsh murmur heard loudest at the apex with radiation toward the left axilla. The intensity of the murmur can be soft or if there is an atrial thrill, it can be loud. With tricuspid regurgitation, the murmur is audible loudest at the left sternal border with radiation to the right sternal border, xiphoid area, or to the left midclavicular line. It produces a blowing sound and is pansystolic. The murmur of an uncomplicated ventricular septal defect has a high pitch and is usually heard throughout systole. An innocent murmur is heard loudest at mid systole near the second to fourth intercostal spaces between the left sternal border and the apex. It usually decreases or disappears when sitting. Question 3: Which of the following group of symptoms would be suggestive of an infant experiencing a congenital heart defect associated with a decreased pulmonary blood flow pattern? Tissue perfusion greater than 3 seconds, bluish colored skin, and poor feeding Correct Abnormal heart sounds, capillary refill less than 2 seconds, and oxygen saturation less than 95% Capillary refill less than 2 seconds, tissue perfusion less than 3 seconds, and oxygen saturation greater than 95% Poor feeding, audible heart murmur, and oxygen saturation greater than 95% Explanation: Infants with defects resulting from decreased pulmonary blood flow have cyanosis because of desaturated blood entering systemic circulation and/or because of the inability to get blood to the lungs. Tetralogy of Fallot (TOF), pulmonary atresia and tricuspid atresia all fall in this category and are considered cyanotic defects. Due to the ventricular septal defect in TOF, the absence of the tricuspid valve or pulmonary valve in tricuspid and pulmonary atresia, one should hear abnormal heart sounds either due to the murmur in TOF or single heart sounds of S1 or S2 in pulmonary atresia or tricuspid atresia. Usually these infants have activity intolerance and therefore, experience failure to thrive because of their inability to consume enough formula to gain weight appropriately. Capillary refill is usually prolonged due to poor oxygenation and poor perfusion secondary to the defect as well as the O2 sats being lower than normal, sometimes even in the 80% range. Question 4: Right atrial pressure can be determined by: palpating the carotid pulse. Incorrect identifying the pulsations of the right jugular vein. Correct analyzing the arterial blood gases. assessing for dependent edema. Explanation: Jugular venous pressure reflects pressure in the right atrium and is best assessed from pulsations in the right internal jugular vein. This is an indicator of cardiac function and right heart hemodynamics. Palpating the carotid artery denotes arterial pressure; analyzing blood gases reflects the status of the arterial blood. Assessing for dependent edema is a reflection of heart failure and poor venous return and not atrial pressure. Question 5: When assessing the heart rate of a healthy 13-month-old child, which one of the following sites is the most appropriate for this child? Apical pulse at the 5th intercostal space right midclavicular line Apical pulse between the 3rd and 4th intercostal space in the left midclavicular line Correct Apical pulse to the right of the midclavicular line in the 3rd intercostal space Apical pulse in the 5th intercostal space left midclavicular line Incorrect Explanation: The apical pulse in a 13-month-old is auscultated for a full minute between the 3rd and 4th intercostal space to the left of the midclavicular line. The only time one would auscultate the right midclavicular line would be if the child had situs inversus or dextrocardia. Question 6: The infraorbital or maxillary, buccinator, and supramandibular lymph nodes drain lymphatic fluid from the: palpebral conjunctiva and the skin adjacent to the ear within the temporal region. eyelids, the conjunctiva, and the skin and mucous membrane of the nose and cheek. Correct mouth, throat, and face. Incorrect posterior part of the temporoparietal region. Explanation: The facial lymph nodes (infraorbital or maxillary, buccinator, and supramandibular) drain lymphatic fluid from the eyelids, the conjunctiva, and the skin and mucous membranes of the nose and cheek. Tonsillar, submandibular, and submental nodes (anterior and superficial cervical lymph nodes) drain lymphatic fluid from portions of the mouth, throat, and face. The preauricular nodes drain lymphatic fluid from the palpebral conjunctiva as well as the skin adjacent to the ear within the temporal region. The posterior auricular lymph nodes drain lymphatic fluid from the posterior part of the temporoparietal region. Question 7: The external iliac lymph nodes drain lymphatic fluid from the following areas except the: urinary bladder. prostate. uterus. gluteal region. Correct Explanation: The external iliac lymph nodes receive lymphatic fluid from the umbilicus, urinary bladder, prostate or uterus, and the upper vagina. The internal iliac lymph nodes receive lymphatic fluid from all pelvic viscera, deep part of the perineum, and the gluteal region. Question 8: The amplitude of the pulse in a patient in cardiogenic shock would most likely appear: bounding. thready. Correct normal. as a bruit. Explanation: The amplitude of the pulse correlates with pulse pressure. Small, thready, or weak pulses occur in patients in cardiogenic shock. Bounding pulses are seen in patients in aortic insufficiency. A bruit is not typically associated with pulse amplitude. It is associated with stenosis or turbulent arterial blood flow. Usually the presence of a bruit requires further investigation and is not in itself diagnostic. Question 9: When auscultating the heart for aortic insufficiency, ask the patient to: lie supine and inhale. exhale while standing. turn to the left side and breath deeply. sit up, lean forward, and exhale. Correct Explanation: To bring the left ventricular outflow tract closer to the chest wall to listen for aortic insufficiency, ask the patient to sit up, lean forward, and exhale. Question 10: The horizontal superficial inguinal lymph nodes are located in the anterior thigh below the inguinal ligament and drain lymphatic fluid from all of these areas except: [Show Less]
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NR 509 APEA EXAM – WOMENS HEALTH
Question: 1 When palpating the cervix during the bimanual exam, cervical motion tenderness (chandelier sign) is noted. This tenderness could be suggestive... [Show More] of: a) retroversion of the uterus. b) pelvic inflammatory disease. Correct c) vulvar lesions. Incorrect d) Bartholin gland infection. Explanation: Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal tenderness, suggest pelvic inflammatory disease, ectopic pregnancy, or appendicitis. Question: 2 In a female diagnosed with a first-degree uterine prolapse, the cervix: a) is located in its normal position. b) has slipped but is well within the vagina. Correct c) is located in the introitus. d) and vagina are outside the introitus. Explanation: Uterine prolapse occurs in progressive stages. The uterus becomes retroverted and descends down the vaginal canal to the exterior. In first-degree prolapse, the cervix is still well within the vagina. In second-degree prolapse, it is at the introitus. In third-degree prolapse (procidentia), the cervix and vagina are outside the introitus. Question: 3 Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at a high risk for developing all of the following abnormalities except: a) columnar epithelium covering most or all of the cervix. b) a slit- like cervical os. Correct c) vaginal adenosis. d) a circular collar or ridge of tissue between the cervix and the vagina. Explanation: Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at greatly increased risk for several abnormalities: columnar epithelium that covers most or all of the cervix vaginal adenosis, and a circular collar or ridge of tissue, of varying shapes, between the cervix and vagina. The slit-like cervical os is a normal variation. Question: 4 A female patient presents with a profuse, yellowish, green vaginal discharge that is malodorous. This vaginal discharge is most consistent with: a) candidal vaginitis. b) bacterial vaginosis. c) Trichomonal vaginitis. Correct d) gonorrhea. Explanation: Trichomonas vaginalis causes trichomonal vaginitis. Presenting symptoms include a profuse, yellowish, green vaginal discharge that is malodorous. Candidal vaginitis produces a white and curd-like thin discharge that is rarely malodorous. With bacterial vaginosis, the discharge can be gray or white, thin, malodorous (fishy), and not usually profuse. The discharge associated with gonorrhea is usually thick and bloody. Question: 5 The most common causes of sexual problems in females are related to: a) lack of sexual desire. b) inadequate vaginal lubrication. Incorrect c) psychosocial factors. Correct d) pelvic disorders. Explanation: The most common problems that occur during sexual activity are related to situational or psychosocial factors. Although lack of desire, inadequate vaginal lubrication, and pelvic disorders may all contribute to sexual problems, the most common causes are situational and psychosocial in origin. Therefore, obtaining a comprehensive sexual history is of utmost importance. Question: 6 Chronic pelvic pain refers to pain that does not respond to therapy and: a) lasts more than 3 months. Incorrect b) lasts more than 6 months. Correct c) lasts more than 9 months. d) lasts more than 12 months. Explanation: According to the International Pelvic Pain Society, chronic pelvic pain refers to pain that lasts more than 6 months without response to treatment. Question: 7 In female patients with dyspareunia, superficial pain is most likely related to all of the following except: a) local inflammation. b) atrophic vaginitis. Incorrect c) pressure on a normal ovary. Correct d) inadequate lubrication. Explanation: In females, dyspareunia, or painful intercourse, can occur at the vaginal opening, occurring at the start of intercourse, or when the partner is pushing deeper. It is important to differentiate the pain to determine the etiology. Superficial pain suggests local inflammation, atrophic vaginitis, or inadequate lubrication. Deeper pain may be from pelvic disorders or pressure on a normal ovary. Question: 8 If urethritis or inflammation of the paraurethral glands is suspected in a female patient, the index finger should be inserted into the vagina and: a) milk the urethra gently from the outside inward. b) milk the urethra gently from the inside outward. Correct c) massage the urethral meatus with the other hand. d) massage the pelvic floor muscles in a clockwise fashion. Explanation: If urethritis or inflammation of the paraurethral glands is suspected, the examiner should insert the index finger into the vagina and milk the urethra gently from inside outward. Note any discharge from or about the urethral meatus. If present, it should be cultured. Question: 9 Upon examination of the vagina, a swollen red ring is noted around the urethral opening. This finding is most consistent with a: a) prolapse of the urethral mucosa. Correct b) urethral caruncle. Incorrect [Show Less]
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NR 509 APEA Test Urology
Question: NR509 APEA Test Urology 1. In men, painful urination without frequency or urgency suggests: a) cystitis.Incorrect urethritis:Correct co... [Show More] nstipation. b) acute prostatitis. . Question: 2. A 65-year-old woman complains that when she feels the urge to urinate, she has to go immediately or else she urinates "on herself". She has become homebound because she wants to stay close to the bathroom. This condition is termed: a) functional incontinence. b) overflow incontinence. c) urge incontinence:correct d) stress incontinence. Question: 3. Symptoms of proctitis may include all of the following except: a) left-sided abdominal pain. b) rectal pain. c) suprapubic pain:Correct d) tenesmus. Question: 4. A 40 year old male complains of right flank pain. His temperature is 102° F. These symptoms may be characteristic of: renal calculi. acute pyelonephritis:Correct urethritis. prostatitis. Question: 5. A useful mnemonic for elucidating causes of incontinence in the older adult is: a) STOOL. b) DIAPERS: Correct c) DRIP. d) URINE. Question: 6. Which condition usually coexists with epididymitis? Varicocele of the spermatic cord Spermatocele of the epididymis :Incorrect Torsion of the spermatic cord Chlamydia infection: Correct 7. Which of the following substances is found in the urine of a child suspected of having post streptococcal glomerulonephritis? Blood and protein :Correct Bacteria and ketones Glucose and white blood cells Casts and mucous threads Question: 8. A whitish sebaceous secretion that collects between the glans penis and foreskin or in the vulva is known as: candida. Smegma:Correct leukorrhea. [Show Less]
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