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NR 509 Final Exam Answers and Questions, Exams of Nursing

Brunel University LondonNursing

The answers and questions from a practical exam for a healthcare course, covering various medical conditions and diagnoses.

Typology: Exams

2023/2024

Available from 03/19/2024

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NR 509 Final test
practical exam with
answers
1. A 6-year-old female presents to the clinic with sore throat. The point of care test
for Group A Streptococcal infection is positive. Which of the following indicates
the expected lymphadenopathy presentation in this case? - Correct answer
Bilateral, tender, mobile anterior cervical lymphadenopathy
2. Which of the following changes are expected in vision as part of the normal aging
process? - Correct answer Blurring of near vision
3. Identify the anatomical structure in this image between both of the examiner's
hands and fingertips. - Correct answer Cricoid cartilage
4. A 19-year-old African-American female presents to the clinic with moderate to
severe right lower quadrant abdominal pain for the last 2 days. She has been
experiencing nausea and vomiting but unsure if she has had fever. Which of the
following is a possible differential diagnosis? - Correct answer Appendicitis
5. A 15-day old infant girl is brought to the outpatient clinic by her mother on a
Monday morning. The mother is concerned about a rash that seems to have
appeared suddenly after she and her infant daughter spent the previous
weekend in Florida visiting family. The time of year is August and the house did
not have air conditioning. The infant is afebrile, eating and drinking well, and
does not appear to be in distress. You note scattered vesicles on an
erythematous base involving the infant's face and trunk. Based on the history and
physical examination findings, what is the likely diagnosis? - Correct answer
Erythema Toxicum
6. A 48-year-old high school librarian comes to your clinic, complaining of 1 week of
heavy discharge causing severe itching. She is not presently sexually active and
has had no burning with urination. The symptoms started several days after her
last period. She just finished a course of antibiotics for a sinus infection. Her past
medical history consists of type 2 diabetes and high blood pressure. She is
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Download NR 509 Final Exam Answers and Questions and more Exams Nursing in PDF only on Docsity!

NR 509 Final test

practical exam with

answers

  1. A 6-year-old female presents to the clinic with sore throat. The point of care test for Group A Streptococcal infection is positive. Which of the following indicates the expected lymphadenopathy presentation in this case? - Correct answer Bilateral, tender, mobile anterior cervical lymphadenopathy
  2. Which of the following changes are expected in vision as part of the normal aging process? - Correct answer Blurring of near vision
  3. Identify the anatomical structure in this image between both of the examiner's hands and fingertips. - Correct answer Cricoid cartilage
  4. A 19-year-old African-American female presents to the clinic with moderate to severe right lower quadrant abdominal pain for the last 2 days. She has been experiencing nausea and vomiting but unsure if she has had fever. Which of the following is a possible differential diagnosis? - Correct answer Appendicitis
  5. A 15-day old infant girl is brought to the outpatient clinic by her mother on a Monday morning. The mother is concerned about a rash that seems to have appeared suddenly after she and her infant daughter spent the previous weekend in Florida visiting family. The time of year is August and the house did not have air conditioning. The infant is afebrile, eating and drinking well, and does not appear to be in distress. You note scattered vesicles on an erythematous base involving the infant's face and trunk. Based on the history and physical examination findings, what is the likely diagnosis? - Correct answer Erythema Toxicum
  6. A 48-year-old high school librarian comes to your clinic, complaining of 1 week of heavy discharge causing severe itching. She is not presently sexually active and has had no burning with urination. The symptoms started several days after her last period. She just finished a course of antibiotics for a sinus infection. Her past medical history consists of type 2 diabetes and high blood pressure. She is

widowed and has three children. She denies tobacco, alcohol, or drug use. Her mother has high blood pressure and her father died of diabetes complications. On examination you see a healthy appearing woman. Her blood pressure is 130/80 and her pulse is 70. Her head, eyes, ears, nose, throat, cardiac, lung, and abdominal examinations are unremarkable. Palpation of the inguinal lymph nodes is unremarkable. On visualization of the vulva, a thick, white, curdy discharge is seen at the introitus. On speculum examination ther - Correct answer Candida vaginitis

  1. A 32-year-old female presents with a complaint of a singular breast mass. The nurse practitioner collects a thorough history and physical examination of the client's breast and related systems. Based on the characteristics of a soft, round, mobile, and tender mass, as well at the client's age, select the most likely cause of the breast mass. - Correct answer Cyst
  2. A 16-year-old female presents with the complaint of acne as represented in this image. When documenting the assessment findings, what is the morphology of the predominant skin lesions? - Correct answer Papules and pustules
  3. You are observing an infant born at 42-weeks gestation 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? - Correct answer 8 months
  4. Which of the following vaccinations are safe during pregnancy? - Correct answer Hep B
  5. A 50- year-old Caucasian male presents to the clinic with left leg pain that increases with rest and a feeling of warmth in the calf area. During your physical examination, you note erythema and increased warm involving the left posterior lower leg as well as a palpable cord. What diagnosis do you suspect? - Correct answer Thrombophlebitis
  6. Upon physical examination of an 11-month-old infant, you note the skin findings represented in this image. What is your initial assessment? - Correct answer Atopic dermatitis
  7. Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which has been occurring for 2 days. He does note a dark, granular substance resembling the coffee left in the filter after brewing. What do you suspect? - Correct answer Bleeding from a peptic ulcer
  8. A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned that he may have peripheral vascular
  1. A pregnant woman is concerned by the recent onset of mid-line abdominal swelling. It is soft and non-tender. What does this represent? - Correct answer Diastasis recti
  2. A 60-year-old African-American male presents to the office with nail changes. He denies pain or history of injury, trauma, or chronic, systemic, inflammatory disease. What is the most likely etiology for the nail changes in this image? - Correct answer Onychomycosis
  3. Jim is a 47-year-old man who is having difficulties with sexual function. He is recently separated from his wife of 20 years. He notes that he has early morning erections but otherwise cannot function. Which of the following is the most likely cause for his problem? - Correct answer Psychological issues
  4. Dawn is a 55-year-old woman who comes in today for her yearly wellness examination. You carefully perform the rectal examination in the lithotomy position and feel an irregular mass against the bowel wall which is firm and immobile. Which of the following is most likely? - Correct answer Colon Cancer
  5. A 29-year-old woman comes to your office. As you take the history, you notice that she is speaking very quickly, and jumping from topic to topic so rapidly that you have trouble following her. You are able to find some connections between ideas, but it is difficult. How would you document this thought process in your notes? - Correct answer Flight of ideas
  6. Which of the following booster immunizations is recommended in the older adult population? - Correct answer Tetanus
  7. A 26-year-old sports store manager comes to your clinic, complaining of severe right sided abdominal pain for 12 hours. He began having a stomachache yesterday, with a decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea and vomiting but no constipation or diarrhea. His last bowel movement was last night and was normal. He has had no fever or chills. He denies any recent illnesses or injuries. His past medical history is unremarkable. He is engaged. He denies any tobacco or drug use and drinks four to six beers per week. His mother has breast cancer and his father has coronary artery disease. On examination he appears ill and is lying on his right side. His temperature is 100.4 and his heart rate is 110. His bowel sounds are decreased and he has rebound and involuntary guarding, one third of the way between the anterior superior iliac spine and the umbilicus in the r - Correct answer Acute appendicitis
  8. A 32-year-old white female comes to your clinic, complaining of overwhelming sadness. She says for the past 2 months she has had crying episodes, difficulty sleeping, and problems with overeating. She says she used to go out with her friends from work but now she just wants to go home and be by herself. She also

thinks that her work productivity has been dropping because she just is too tired to care or concentrate. She denies any feelings of guilt or any suicidal ideation. She states that she has never felt this way in the past. She denies any recent illness or injuries. Her past medical history consists of an appendectomy when she was a teenager; otherwise, she has been healthy. She is single and works as a clerk in a medical office. She denies tobacco, alcohol, or illegal drug use. Her mother has high blood pressure and her father has had a history of mental illness. On examination you see a woman appearing her st - Correct answer Major depressive episode

  1. Which of the following represents age-related changes in the lungs? - Correct answer Decrease in chest wall compliance
  2. Delayed puberty is suspected in boys who have no signs of pubertal development by what age? - Correct answer 14
  3. In obtaining a history, you note that a patient uses the word "largely" repeatedly, to the point of being a distraction to your task. Which word best describes this speech pattern? - Correct answer Perseveration
  4. A daycare worker presents to your office with jaundice. She denies IV drug use, blood transfusion, and travel and has not been sexually active for the past 10 months. Which type of hepatitis is most likely? - Correct answer Hep A
  5. You are beginning the examination of the skin on a 25-year-old teacher. You have previously elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You strongly suspect that she has hypothyroidism. What is the expected moisture and texture of the skin of a patient with hypothyroidism? - Correct answer Dry and rough
  6. A 33-year-old construction worker comes for evaluation and treatment of acute onset of low back pain. He notes that the pain is an aching located in the lumbosacral area. It has been present intermittently for several years; there is no known trauma or injury. He points to the left lower back. The pain does not radiate and there is no numbness or tingling in the legs or incontinence. He was moving furniture for a friend over the weekend. On physical examination, you note muscle spasm, with normal deep tendon reflexes and muscle strength. What is the most likely cause of this patient's low back pain? - Correct answer Mechanical low back pain
  7. A 40-year-old mother of two presents to your office for consultation. She is interested in knowing what her relative risks are for developing breast cancer. She is concerned because her sister had unilateral breast cancer 6 years ago at age 38. The patient reports on her history that she began having periods at age 11 and has been fairly regular ever since, except during her two pregnancies. Her first child arrived when she was 26 and her second at age 28. Otherwise she
  1. A 50-year-old truck driver comes to your clinic for a work physical. He has had no upper respiratory, cardiac, pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. His past medical history is significant for mild arthritis and prior knee surgery in college. He is married and just changed jobs, working for a different trucking company. He smokes one pack of cigarettes a day, drinks less than six beers a week, and denies using any illegal drugs. His mother has high blood pressure and arthritis and his father died of lung cancer in his 60s. On examination, his blood pressure is 130/80 and his pulse is 80. His cardiac, lung, and abdominal examinations are normal. He has no inguinal hernia, but on his digital rectal examination you palpate a soft, smooth, non- tender pedunculated mass on the posterior wall of the rectum. What anal, rectal, or prostate disorder best fits his presentation? - Correct answer Rectal polyp
  2. Which of the following represents metrorrhagia? - Correct answer bleeding between periods
  3. Which is true of a third heart sound (S3)? - Correct answer It is caused by rapid deceleration of blood against the ventricular wall.
  4. 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 hypertension are well managed. Her son from out of state accompanies her today and has recently moved in to help her. What should you suspect? - Correct answer Elder Abuse
  5. A 26-year-old stewardess comes in for a third trimester prenatal visit. She has had prenatal care since her sixth week of pregnancy. She has no complaints today and her prenatal course has been unremarkable. Today her blood pressure and weight gain are appropriate and her urine is unremarkable. You measure the patient's uterus in centimeters by placing one end of the tape over the uterine fundus. From what inferior anatomic position should the beginning of the tape be placed? - Correct answer Pubic Symphysis
  6. A 22-year-old unemployed roofer presents to your clinic, complaining of pain in his testicle and penis. He states the pain began last night and has steadily become worse. He states it hurts when he urinates and he has not attempted intercourse since the pain began. He has tried Tylenol and ibuprofen without improvement. He denies any fever or night sweats. His past medical history is unremarkable. He has had four previous sexual partners and has had a new partner for the last month. She is on oral contraceptives so he has not used condoms. His parents are both in good health. On examination you see a young man lying on his side. He appears mildly ill. His temperature is 100.2 and his blood pressure, respirations, and pulse are normal. On visualization of the penis he is circumcised, with no lesions or discharge from the meatus. Visualization of the scrotal skin appears unremarkable. Palpation of the testes shows seve - Correct answer Acute epididymitis
  1. Where is the point of maximal impulse (PMI) normally located? - Correct answer In the left 5th intercostal space, 7 to 9 cm lateral to the sternum
  2. Identify the macula on this image representing the structures of the left fundus. - Correct answer A
  3. Lucille is in her 24th week. You notice a new onset of high blood pressure readings. Today's value is 168/96. Her urine is normal. What do you suspect? - Correct answer Gestational hypertension
  4. Which of the following is true regarding breast self-examination? - Correct answer A high proportion of breast masses are detected by breast self- examination
  5. A woman has a positive pregnancy test and comes to you with abdominal pain. On physical examination, you palpate a large, fixed, and ill-defined adnexal mass. Which of the following should you suspect? - Correct answer Ectopic pregnancy
  6. A 20-year-old part-time college student comes to your clinic, complaining of growths on his penile shaft. They have been there for about 6 weeks and haven't gone away. In fact, he thinks there may be more now. He denies any pain with intercourse or urination. He has had three former partners and has been with his current girlfriend for 6 months. He says that because she is on the pill they don't use condoms. He denies any fever, weight loss, or night sweats. His past medical history is unremarkable. In addition to college, he works part-time for his father in construction. He is engaged to be married and has no children. His father is healthy and his mother has hypothyroidism. On examination the young man appears healthy. His vital signs are unremarkable. On visualization of his penis you see several moist papules along all sides of his penile shaft and even two on the corona. He has been circumcised. On palpation of - Correct answer Condylomata acuminata
  7. Which of the following positive physical examination finding supports peritonitis?
    • Correct answer Pressing down onto the abdomen firmly and slowly and withdrawing the hand quickly produces pain
  8. You are assessing Tanner staging of the breast 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? - Correct answer 2
  9. Monique is a 33-year-old administrative assistant who has had intermittent lower abdominal pain approximately one week a month for the past year. It is not related to her menses. She notes relief with defecation, and a change in form

one of the following characteristics is typical of the carotid pulse? - Correct answer Palpable

  1. A 30-year-old Hispanic male presents to the clinic with complaint of a painless, rubbery, bump on his right lower eyelid which appeared several days ago approximately the size of a small bead. He reports that the bump became much larger although he denies manipulating the lesion. He denies changes in his vision, fever, chills, or feeling otherwise ill. What is your assessment? - Correct answer Chalazion
  2. A 68-year-old mechanic presents to the emergency room for shortness of breath. You are concerned about a cardiac cause and measure his jugular venous pressure (JVP). It is elevated. Which one of the following conditions is NOT a potential cause of elevated JVP? - Correct answer Constrictive pericarditis
  3. Mrs. LaFarge is a 60-year-old who presents with urinary incontinence. She is unable to get to the bathroom quickly enough when she senses the need to urinate. She has normal mobility. Which of the following is most likely? - Correct answer Urge incontinence
  4. A 60-year-old coach comes to your clinic, complaining of difficulty starting to urinate for the last several months. He believes the problem is steadily getting worse. When asked he says he has a very weak stream and it feels like it takes 10 minutes to empty his bladder. He also has the urge to go to the bathroom more often than he used to. He denies any blood or sediment in his urine and any pain with urination. He has had no fever, weight gain, weight loss, or night sweats. His medical history includes type diabetes and high blood pressure treated with medications. He does not smoke but drinks a six pack of beer weekly. He has been married for 35 years. His mother died of a myocardial infarction in her 70s and his father is currently in his 80s with high blood pressure and arthritis. On examination you see a mildly obese male who is alert and cooperative. His blood pressure is 130/70 with a heart rate of 80. He is - Correct answer Benign prostatic hyperplasia (BPH)
  5. You are examining a newborn and note that the right testicle is not in the scrotum. What should you do next? - Correct answer Attempt to bring down the testis from the inguinal canal