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NR 509 Advanced Physical Assessment Final Exam Review: Weeks 5-8, Exams of Nursing

Hampton University (HU)Nursing

A comprehensive review of key concepts and topics covered in weeks 5-8 of the nr 509 advanced physical assessment course. It includes detailed information on breast exams, lactation, breast cancer, abdominal exams, gastrointestinal disorders, and pelvic exams. Organized into a question-and-answer format, making it easy to review and understand the material. It is a valuable resource for students preparing for their final exam.

Typology: Exams

2024/2025

Available from 04/03/2025

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NR 509 / NR509 Advanced Physical Assessment
Final Exam Week 5 to 8 Review
1.
Breast Exam
Answer
5-7 days after the first day of menstruation
-Inspect for symmetry, contours, and retractions
-Palpitation with patient supine with arm above head
-Palpate in ladder pattern, circular motion for each location
2.
Lactation
Answer
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Partial preview of the text

Download NR 509 Advanced Physical Assessment Final Exam Review: Weeks 5-8 and more Exams Nursing in PDF only on Docsity!

NR 509 / NR509 Advanced Physical Assessment

Final Exam Week 5 to 8 Review

  1. Breast Exam Answer 5-7 days after the first day of menstruation -Inspect for symmetry, contours, and retractions -Palpitation with patient supine with arm above head -Palpate in ladder pattern, circular motion for each location
  2. Lactation Answer

Physiological secretion with pregnancy, lactation, chest wall stimula- tion, sleep and stress.

  1. Montgomery glands:

sebaceous glands that secrete a protective lipid substance during lactation

  1. Galactorrhea : Answer a milky discharge from the nipple unrelated to normal breast feeding
  2. Mammary souffle: Answer (^) "puff of air" heard during pregnancy and lactation (venous hum)
  3. Breast Cancer Answer Redness -Peau d'orange: thickening and prominent pores -Flattening instead of normal convexity -Asymmetry -Change in nipple direction -Paget disease: rash, scaling, ulceration of nipple and areola
  4. Breast cancer risk factors Answer Increasing age -First degree family member

11. GERD

Answer Rising retrosternal burning pain or discomfort -Aggravated by certain foods (alcohol, chocolate, citrus, coffee. onions, peppermint)

and positional changes (supine or bending forward) -Coughing after eating or laying down

  1. Risk factor for Barretts's esophagus: Answer (^) Esophageal cancer

13. PUD:

Common causes: H.Pylori and NSAIDs Pain after meals (2-3 hr delay for duodenal) GERD Hematemesis Melena Treat with PPI, H2RA, antacids

  1. Appendicitis: McBurney's point: tenderness on direct palpation Rovsing: rebound tenderness when palpating LLQ Psoas: raise thigh (flexion), contracts psoas muscle Obturator: flex the right thigh at the hip, bend knee, rotate leg internally, contracts obturator muscle Rectal exam: right side rectal tenderness Pelvic exam: palpable appendix through the pelvis May also presents with leukocytosis, high fever, nausea, vomiting, bowel changes
  2. Diverticulitis:

Diverticulosis: benign form (pockets only) LLQ pain,

Answer

Answer

Answer

-Diagnosis of exclusion, intermittent pain for at least 12 weeks over a year, relief with defecation, changes in stool frequency and consistency -Commonly associated with food intolerances

  1. IBD (inflammatory bowel disease)

Mucous in stool -Bloating -Pain with defecation -Chronic diarrhea -Hematochezia -Anal fissures-Crohn's -Colonoscopy shows skip lesion or cobblestoning (Crohn), continuous inflammation (UC) -Strong family link

  1. Colon Cancer

Changes in stool -Palpable mass (late stage) -Pencil-thin stools -Hematochezia -(+) Cologuard/fecal tests=colonoscopy

  1. Risk factors for colon cancer

African American -Men

-Elderly -IBD -Family history -Inactivity -Low fiber diet -Obesity -Alcohol -Cigarette smoking

  1. Rectal Exam Answer Side lying (preferred for elderly, obese) -Standing bent forward -Bear down to get past external sphincter -Asses glove for bleeding, discharge, or fecal matter -Masses: Moveable-fecal matter Immovable-prostate nodule, hemorrhoid, or fecal matter -Rectal lesion, fissures, modules, skin tags
  2. Prostate Cancer risk factors Answer Higher risk at age 40, increases rapidly after age 50 -African American higher incidence and mortality -Agent orange -High fat diet

Answer

Answer

Answer

Patient standing

  1. If fingers can go above the mass it is likely

A hydrocele

  1. Cryptorchidism: undescended testicles
  2. Occluded follicles / epidermoid cyst: dome-shaped white or yellow lesions
  3. Testicular torsion: Tender, painful, scrotal swelling
  4. Hydrocele: Fluid filled lesion, transilluminates
  5. Varicocele: Varicose vein of spermatic cord, thick rope-like texture
  6. Testicular Cancer

Painless nodule -Peak incidence 15-34 years old -Palpable inguinal lymph nodes -Self testicular exam after warm shower

  1. Pelvic Exam

Always have a chaperone -External examination -Don't use lubricant, especially near the end of speculum -30 degree downward angle -PAP smear -Bimanual exam

  1. Chlamydia: White discharge in men, yellow in women

Answer

  1. Gonorrhea: Yellow in men and women
  2. Syphilis: Primary chancre, secondary flat top lesions in women
  3. Genital wart: Severely raise, can be erythematous
  4. Herpes: Smaller lesion, can be normal pigmentation, erythematous, crusted
  5. Pubic lice: severe excoriation