NUR 3065 Health Assess Exam 3 Study Guide (Review Quizzes 10-12) Questions With Answers.Quiz 10:
1. Your 20 yo male patient is ℅ growths on his penile
... [Show More] shaft. He noticed them first
about 6 weeks ago, and he thinks there are more now. Denies pain with
intercourse or urination. He has had 3 former partners and has been with his
current girlfriend for 6 months. She is on the pill so they do not use condoms.
Denies fever, weight loss, night sweats. His PMH is unremarkable. He is in
college part time and works in construction and is engaged to be married and
has no children. On exam, you see several moist papules along all sides of the
penile shaft and two on the cornea. He has been circumcised. On palpation of his
inguinal region, there is no inguinal lymphadenopathy. Which abnormality of the
penis does patient most likely have?
-Condylomata acuminata
2. A 29 yo married computer programmer is ℅ “something strange” going on in his
scrotum. Last month he felt a lump in his left testis and is still there. He has had
some aching in the left testis but denies pain with urination or intercourse.
Palpation of his scrotum is unremarkable on the right side but indicates a large
mass on the left. You attempt to place your finger through the left inguinal ring but
cannot get above the mass. What disorder of the testes is most likely the
diagnosis?
-Scrotal hernia
3. A 22 yo male presents in your clinic ℅ pain in his testicle and penis. The pain
began last night and has steadily become worse. He hurts when he urinates. He
has not attempted intercourse since the pain began. He has tried Tylenol and
Ibuprofen without improvement. Denies fevers or night sweats. He has had 4
previous sexual partners and has had a new partner for the last month. She is
using oral contraceptives and they do not use a condom. On exam, you see a
young man lying on his side, mildly ill. His temp is 100.2. There are no visible
lesions on the penis or discharge from the meatus. The scrotum appears normal.
Palpation of the testes reveals severe tenderness at the superior pole of the
normal-sized left testicle. He also has tenderness when you palpate the
structures superior to the testicle through the scrotal wall. The right testicle is
unremarkable. An examining finger is placed through each inguinal ring without
bulges notes with bearing down. Urinalysis shows WBC and bacteria. What
diagnosis of the male genitalia is most likely?
-Acute epididymitis
4. A 15 yo high school football player is in your clinic, ℅ severe testicular pain since
8am this morning. Denies sexual activity. Unable to urinate due to pain. He is
nauseated and is vomiting. He is lying on the exam table, uncomfortably shifting
his position. His BP is 150/100, pulse is 110, respirations are 24. There are no
lesions on the penis and no discharge from the meatus. The scrotal skin is tense
and red. Palpation of the left testicle causes severe pain and the patient begins
to cry. Prostate exam is normal. His cremasteric reflex is absent on the left but is
normal on the right. The urine sample by catheter is normal. You send him to the
ER, what do you think it could be?
-Torsion of the spermatic cord
5. Frank is a 24 yo man who presents with multiple vesicles and burning erosions
on the shaft of his penis and some tender inguinal adenopathy. Which of the
following is most likely?
-Herpes
6. Your 22 yo female patient ℅ severe burning with urination, fever of 101, and
aching all over. She takes oral contraceptives. She reports one new partner
within the last month. Palpation of the inguinal nodes reveals bilateral
lymphadenopathy. There are more than 10 shallow ulcers along each side of the
vulva. She is very tender at the introitus. Urine has some WBC but no RBC or
bacteria. Which disorder of the vulva is most likely?
-Genital herpes
7. Your 30 year old female patient is c/o bad-smelling vaginal discharge with mild
itching for about 3 weeks. Douching did not help. Denies painful urination or
intercourse. She noticed the smell increased after intercourse and during her
period last week. There are no lesions on the perineum. No lymphadenopathy.
On speculum examination, there is a thin gray-white discharge. The pH of the
discharge is over 4.5 and there is a fishy odor when potassium hydroxide (KOH)
is applied to the vaginal secretions on the slide. Wet prep shows epithelial cells
with stippled border (clue cells). What type of vaginitis best describes the
findings?
-Bacterial vaginosis
8. Which of the following represents metrorrhagia?
-Bleeding between periods
9. Which is a sign of benign prostatic hyperplasia?
-Nocturia
10.Which is true of prostate cancer?
-Ethnicity is risk factor
Quiz 11:
1. During the delivery of a male infant, you are there to assess the Apgar score. He
was born through an intact pelvis and had no complications during labor or
delivery. At 1 minute he is pink all over and grimaces. He is flexing his arms and
legs occasionally. He is breathing well and his heart rate is 110. At 5 minutes he
is still pink all over but now is crying vigorously, with active movement. His
respiratory effort is good and his heart rate is 130. What is his Apgar score?
-8 at 1 minute, 10 at 5 minutes
2. Which of the following conditions involves a tight prepuce which, once retracted,
cannot be returned?
-Paramorphisis
3. A mother brings her 16 month old son in for an evaluation. She is afraid he is not
meeting his developmental milestones and wants to know if he should be sent to
therapy. He was the product of an uneventful pregnancy and a spontaneous
vaginal delivery. His Apgar scores were 7 and 9. Until reaching a year old the
mother believes he has hitting his milestones appropriately. You decide to
administer the Denver Developmental Screening Test. You find that he is using a
spoon to eat with and can take off his own shoes and shirt. He can build a tower
of two cubes. His vocabulary consists of at least 10 words. He can stand alone
and stoop and recover, but he is unable to walk without holding onto someone's
hand. What type of developmental delay does he have?
-Gross motor
4. A young Hispanic mother brings in her two month old son. She is upset because
her neighbors have threatened to call the Child Protective Agency because they
think his birthmark is a bruise. Her son was the product of an uneventful
pregnancy and spontaneous vaginal delivery. On examination you see a large,
smooth-bordered bluish mark on his buttock and lower back. Otherwise his
examination is unremarkable. What form of birthmark is this likely to be?
-Mongolian spot
5. A mother brings her 15 month old daughter to your office for evaluation of a rash
and fever. She says the rash started one day and the fever developed the next
day. Her daughter has had all of her vaccinations up to ten months. The mother
sheepishly admits that she has not had time to bring her daughter in since her 10
month check up. On examination you see a mildly sick-appearing toddler with a
temp of 102. Looking at her skin you see at least 100 of a variety of papules,
vesicles, and ulcers in different stages of development. What illness prevented
by proper vaccination does this toddler have?
-Varicella
6. You are observing an infant who is able to pull to a stand, uses "mama" and
"dada" specifically, and indicates his wants by vocalization and pointing. Where
would you place this child's developmental age?
-8 months
7. Which of the following will help to optimize yield from a pediatric examination?
-Doing the examination out of order if necessary to take advantage of quiet
periods for auscultation, etc.
8. You are assessing Tanner staging of the breasts in a young woman. You notice
projection of the areola and nipple to form a secondary mound above the level of
the breast. Which Tanner stage would this be?
-IV
9. A 15 month old is brought to you for a fever of 38.6 degrees Celsius and
fussiness. The ear examination is as follows: external ear, normal appearance
and no tenderness with manipulation; canal, normal diameter without evidence of
inflammation; tympanic membrane, bulging, erythematous, and opaque. What do
you think this could be?
-Otitis media
10.An adolescent male comes to your clinic; his mother is in the waiting room. He
has come in for his annual sports physical required to play football. For his age
his physical examination is unremarkable and you complete the school form. You
take this opportunity to do some health education with him. He admits to
wondering a lot lately if he is normal. Although he is in football he really enjoys
science and computers more. He is worried that all his buddies will think he is a
geek. He is convinced he also won't get a date for the dance next week because
the girls all think he is boring, too. He denies any experimentation with tobacco or
alcohol, and he blushes when you mention sex. After hitting all the pertinent ageappropriate education points you give him his sports physical form and he
leaves.The patient's concern during the visit most resembles what developmental
stage of adolescence?
-Early adolescence (10 to 14 years old)
Quiz 12:
1. Which of the following are expected in vision as part of the normal aging process?
- Blurring of near vision
2. An 88 year old retired piano teacher comes for evaluation of fatigue. You notice that
her clothes are hanging loosely off her frame and that she had lost 15 pounds. She is
unaware of this. Her husband of 63 years died a few months ago. You ask the patient to
complete a Rapid Screen for Dietary Intake. Which of the following statements is
considered to be part of this rapid screen?
-“Without wanting to, I have lost or gained 10 pounds in the last 2 months”
3. You are asked to perform a home safety assessment for an 87 year old retired farmer
who lives by himself. Which of the following is not considered to be an increased risk for
falls?
-Bright lighting
4. Which of the following questions is part of the screening for physical disability?
-Are you able to go shopping for groceries or clothes?
5. It is summer and an 82 year old woman is brought to you from her home after seeing
her primary care doctor 2 days ago. She was started on an antibiotic at that time. Today,
she comes to the emergency room not knowing where she is or what year it is. What
could be a likely cause of this?
-Delirium
6. Blood pressure abnormalities found more commonly in Western elderly include which
of the following?
-Elevation of the systolic BP
7. Claire, 82 years old, is hospitalized for assessment since she has fallen several times
in her home. Which assessments are indicated at this time?
a. Orthostatic vital signs
b. Review of her medications
c. Assessment of gait and balance
d. All of the above
8. Mrs. Geller is somewhat quiet today. She has several bruises of different colors on
the ulnar aspects of her forearms and on her abdomen. She otherwise has no
complaints and her diabetes and HTN are well managed. Her son from out of state
accompanies her today and has recently moved in to help her. What should you
suspect?
-Elder abuse
9. A patient comes to you for the appearance of purple patches on his forearms that
have been present for several months. They remain for several weeks, then fade. He
denies a history of trauma. Which of the following is likely?
-Actinic purpura
10. For patients with a conductive hearing loss, a noisy environment might actually help.
-True [Show Less]