Download NURS 5220 Exam 2 (Module 21- 26) with verified answers and more Exams Nursing in PDF only on Docsity!
NURS |! 5220 |! Exam |! 2 |! (Module |! 21- |! 26) |!
with |! verified |! answers
Mr. |! Tucker |! is |! a |! 56-year-old |! patient |! who |! presents |! to |! your |! office |! with |! a |! complaint |! of |! rectal |! pain. |! On |! examination |! you |! are |! palpating |! the |! lateral |! and |! posterior |! rectal |! walls. |! What |! should |! you |! expect |! to |! feel? A. |! A |! smooth, |! even, |! and |! uninterrupted |! surface |! B. |! Small |! nodules |! from |! internal |! hemorrhoids C. |! Tissue |! folds |! from |! the |! valves |! of |! Houston D. |! Bulging |! from |! the |! bladder |! wall |! - |! Correct |! answer |! ✔A: |! CorrectThe |! walls |! should |! feel |! smooth, |! even, |! and |! uninterrupted. Mr. |! Yates |! is |! a |! 62-year-old |! patient |! who |! presents |! with |! a |! chief |! complaint |! of |! rectal |! pain. |! The |! examiner |! will |! focus |! the |! history |! and |! examination |! on |! which |! known |! fact? A. |! Rectal |! pain |! is |! almost |! always |! accompanied |! by |! an |! infection. B. |! Rectal |! pain |! is |! almost |! always |! an |! indication |! of |! local |! disease. |! C. |! A |! complaint |! of |! rectal |! pain |! is |! usually |! associated |! with |! a |! serious |! systemic |! process. D. |! One |! of |! the |! most |! common |! causes |! of |! rectal |! pain |! is |! prostatic |! enlargement. |!
- |! Correct |! answer |! ✔B: |! CorrectRectal |! pain |! is |! almost |! always |! indicative |! of |! a |! local |! disease.
Mr. |! Bower |! is |! a |! 78-year-old |! patient |! who |! is |! unable |! to |! assume |! a |! standing |! position |! for |! a |! routine |! rectal |! examination. |! Which |! is |! the |! best |! alternative |! position? A. |! Lithotomy |! position B. |! Left |! lateral |! position |! with |! the |! knees |! flexed |! C. |! Knee-chest |! position D. |! Prone |! position |! - |! Correct |! answer |! ✔B: |! CorrectThe |! rectal |! examination |! can |! be |! performed |! with |! the |! patient |! in |! any |! of |! these |! positions: |! knee-chest; |! left |! lateral |! with |! hips |! and |! knees |! flexed; |! lithotomy, |! or |! standing |! with |! the |! hips |! flexed |! and |! the |! upper |! body |! supported |! by |! the |! examining |! table. A |! pregnant |! woman |! presents |! to |! the |! emergency |! department |! with |! the |! complaint |! of |! dark |! stools. |! She |! tells |! the |! examiner, |! "I |! read |! in |! a |! magazine |! that |! this |! is |! a |! sign |! of |! bleeding." |! Which |! question |! by |! the |! examiner |! is |! most |! applicable |! for |! this |! situation? A. |! "Where |! did |! you |! read |! that |! information?" B. |! "Have |! you |! been |! giving |! yourself |! enemas?" C. |! "How |! much |! fruit |! and |! vegetable |! intake |! have |! you |! had |! in |! the |! last |! few |! days?" D. |! "Are |! you |! taking |! prenatal |! vitamins?" |! - |! Correct |! answer |! ✔D: |! CorrectDuring |! pregnancy, |! the |! stool |! color |! may |! be |! dark |! green |! or |! black |! if |! the |! woman |! is |! taking |! iron |! supplements.
D. |! It |! feels |! like |! a |! pencil |! eraser |! - |! Correct |! answer |! ✔D: |!. |! CorrectThe |! gland |! should |! feel |! like |! a |! pencil |! eraser—firm, |! smooth, |! and |! slightly |! movable—and |! it |! should |! be |! nontender. What |! is |! the |! best |! method |! of |! verifying |! anal |! patency |! in |! a |! newborn? A. |! Inserting |! a |! lubricated |! thermometer |! through |! the |! anus |! and |! into |! the |! rectum B. |! Inserting |! the |! fifth |! digit |! through |! the |! anus |! and |! into |! the |! rectum C. |! Checking |! for |! the |! passage |! of |! meconium |! in |! the |! first |! 24 |! to |! 48 |! hours |! after |! birth D. |! Inspecting |! the |! anus |! for |! an |! anal |! opening |! - |! Correct |! answer |! ✔C: |! CorrectIf |! there |! is |! no |! passage |! of |! stool |! in |! 24 |! hours |! in |! a |! newborn, |! suspect |! rectal |! atresia, |! Hirschsprung |! disease |! (congenital |! megacolon), |! or |! cystic |! fibrosis. Mr. |! Santos |! is |! a |! 67-year-old |! patient |! who |! presents |! to |! your |! office. |! On |! examination, |! you |! palpate |! his |! prostate, |! noting |! that |! it |! is |! hard |! and |! irregular. |! The |! median |! sulcus |! is |! not |! palpable. |! These |! findings |! are |! consistent |! with: A. |! prostate |! cancer. |! B. |! benign |! prostate |! hypertrophy. C. |! prostatitis.
D. |! a |! rectal |! mass. |! - |! Correct |! answer |! ✔A: |! CorrectWith |! cancer |! of |! the |! prostate, |! a |! hard, |! irregular |! nodule |! may |! be |! palpable |! on |! prostate |! examination. Mr. |! Mills, |! a |! 38-year-old |! patient, |! presents |! with |! severe |! rectal |! pain |! and |! fever. |! Which |! condition |! might |! be |! the |! cause |! of |! the |! symptoms? A. |! An |! imperforate |! anus B. |! A |! perianal |! abscess |! C. |! Benign |! prostatic |! hypertrophy D. |! An |! anorectal |! fistula |! - |! Correct |! answer |! ✔B: |! CorrectPerianal |! abscess |! is |! an |! infection |! of |! the |! soft |! tissues |! surrounding |! the |! anal |! canal, |! with |! formation |! of |! a |! discrete |! abscess |! cavity. |! Symptoms |! include |! tenderness, |! fever, |! and |! pain |! on |! defecation |! or |! with |! sitting |! or |! walking. "Boggy, |! enlarged, |! and |! tender" |! on |! rectal |! examination |! is |! descriptive |! of |! which |! condition? A. |! Prostatitis |! B. |! Anorectal |! abscess C. |! Prostatic |! carcinoma D. |! Rectal |! polyp |! - |! Correct |! answer |! ✔A: |! CorrectSeminal |! vesicles |! are |! often |! involved |! in |! prostatitis |! and |! may |! be |! dilated |! and |! tender |! on |! palpation; |! however, |! the |! prostate |! may |! feel |! boggy, |! enlarged, |! and |! tender |! or |! have |! palpable |! areas |! of |! fibrosis |! that |! simulate |! neoplasm.
D. |! storage |! of |! feces. |! - |! Correct |! answer |! ✔D: |! CorrectAbove |! the |! anorectal |! junction, |! the |! rectum |! dilates |! and |! turns |! posteriorly |! into |! the |! hollow |! of |! the |! coccyx |! and |! sacrum, |! forming |! the |! rectal |! ampulla, |! which |! stores |! flatus |! and |! feces. Hemorrhoids |! are: A. |! ulcerations |! of |! the |! anal |! ring. B. |! varicose |! veins |! in |! the |! anal |! region. |! C. |! inflammatory |! lesions |! of |! the |! anal |! region. D. |! precursors |! to |! rectal |! polyps. |! - |! Correct |! answer |! ✔B: |! CorrectExternal |! hemorrhoids |! are |! varicose |! veins |! that |! originate |! below |! the |! anorectal |! line |! and |! are |! covered |! by |! anal |! skin. |! Internal |! hemorrhoids |! are |! varicose |! veins |! that |! originate |! above |! the |! anorectal |! junction |! and |! are |! covered |! by |! rectal |! mucosa. Mrs. |! Jackman |! brings |! her |! 6-year-old |! daughter |! in |! for |! an |! office |! visit. |! While |! examining |! the |! perineum, |! you |! observe |! hemorrhoids. |! This |! finding |! suggests: A. |! sexual |! abuse. B. |! chronic |! constipation. C. |! a |! diet |! high |! in |! fibrous |! foods. D. |! an |! underlying |! problem |! such |! as |! portal |! hypertension. |! - |! Correct |! answer |! ✔D; |! CorrectHemorrhoids |! are |! rare |! in |! children, |! and |! their |! presence |! suggests |! a |! serious |! underlying |! problem |! such |! as |! portal |! hypertension.
When |! examining |! the |! prostate, |! you |! feel |! fluctuant |! softness. |! This |! finding |! indicates: A. |! prostatic |! abscess. B. |! posterior |! rectal |! wall |! neoplasm. C. |! prostatic |! hypertrophy. D. |! rectal |! prolapse. |! - |! Correct |! answer |! ✔A: |! CorrectA |! prostatic |! abscess |! is |! felt |! as |! a |! fluctuant |! mass |! in |! the |! prostate. A |! patient |! tells |! the |! examiner |! that |! she |! has |! liquid |! stools |! containing |! small |! flecks |! of |! blood |! stained |! mucous. |! Stools |! of |! this |! type |! result |! from: A. |! amebiasis. |! B. |! excessive |! fiber |! intake. C. |! excessive |! dietary |! beef. D. |! insufficient |! fluid |! intake. |! - |! Correct |! answer |! ✔A: |! CorrectSmall |! flecks |! of |! blood-stained |! mucus |! in |! liquid |! feces |! are |! indicative |! of |! amebiasis. Which |! examination |! finding |! in |! the |! child |! is |! a |! clue |! to |! the |! diagnosis |! of |! Hirschsprung |! disease? A. |! Passing |! of |! frequent, |! loose |! stools |! in |! the |! absence |! of |! other |! symptoms B. |! A |! consistently |! empty |! rectum |! with |! a |! history |! of |! constipation |! C. |! Itching |! and |! irritation |! around |! the |! anus
C. |! estimation |! of |! the |! depth |! of |! the |! sulcus. D. |! protrusion |! of |! the |! prostate |! into |! the |! rectum. |! - |! Correct |! answer |! ✔D: |! CorrectProstate |! enlargement |! is |! classified |! by |! the |! amount |! of |! protrusion |! into |! the |! rectum During |! a |! rectal |! examination, |! you |! find |! shelf |! lesions |! when |! you |! palpate |! the |! anterior |! rectal |! wall. |! What |! is |! the |! significance |! of |! this |! finding? A. |! A |! sexually |! transmitted |! infection |! exists. B. |! Peritoneal |! metastases |! are |! present. |! C. |! Houston |! valves |! have |! fibrosed. D. |! Fecal |! matter |! has |! been |! retained. |! - |! Correct |! answer |! ✔B: |! CorrectBecause |! the |! anterior |! rectal |! wall |! is |! in |! contact |! with |! the |! peritoneum, |! you |! may |! be |! able |! to |! detect |! the |! tenderness |! of |! peritoneal |! inflammation |! and |! the |! nodularity |! of |! peritoneal |! metastases. |! The |! nodules, |! called |! shelf |! lesions, |! are |! palpable |! just |! above |! the |! prostate |! in |! men |! and |! in |! the |! cul-de-sac |! of |! women. What |! information |! do |! you |! give |! the |! parents |! of |! an |! infant |! on |! whom |! you |! have |! done |! a |! rectal |! examination? A. |! Large |! amounts |! of |! mucus |! may |! appear |! in |! the |! stool |! for |! a |! day |! or |! two. B. |! Some |! bleeding |! and |! rectal |! prolapse |! may |! be |! seen |! right |! after |! the |! examination. C. |! Stool |! is |! likely |! to |! be |! black |! for |! 48 |! hours.
D. |! Crankiness |! and |! lack |! of |! interest |! in |! sucking |! may |! occur |! for |! 12 |! to |! 24 |! hours. |! - |! Correct |! answer |! ✔B: |! CorrectSome |! health |! care |! providers |! are |! reluctant |! to |! use |! the |! index |! finger |! because |! of |! its |! size, |! choosing |! instead |! the |! fifth |! finger; |! however, |! even |! with |! the |! smallest |! of |! adult |! fingers, |! some |! bleeding |! and |! transient |! prolapse |! of |! the |! rectum |! often |! occur |! right |! after |! examination. The |! absence |! of |! meconium |! stool |! passage |! in |! an |! infant |! may |! be |! indicative |! of: A. |! a |! pilonidal |! cyst. B. |! a |! perianal |! abscess. C. |! benign |! prostatic |! hypertrophy. D. |! an |! imperforate |! anus. |! - |! Correct |! answer |! ✔D: |! CorrectImperforate |! anus |! is |! a |! condition |! that |! is |! usually |! diagnosed |! on |! rectal |! examination |! of |! the |! newborn |! and |! is |! confirmed |! by |! lack |! of |! passage |! of |! stool |! within |! the |! first |! 48 |! hours |! of |! life. |! Radiographic |! confirmation |! may |! be |! necessary. Mr. |! Custer |! is |! a |! 56-year-old |! patient |! who |! presents |! to |! your |! office. |! On |! examination, |! you |! note |! a |! smooth |! and |! firm |! protrusion |! into |! the |! rectum. |! Which |! condition |! can |! present |! as |! as |! a |! smooth, |! firm |! 4-cm |! protrusion |! into |! the |! rectum? A. |! Anorectal |! fistula B. |! Imperforate |! anus C. |! Benign |! prostatic |! hypertrophy D. |! Prostatitis |! - |! Correct |! answer |! ✔C: |! CorrectWith |! benign |! prostatic |! hypertrophy, |! the |! prostate |! feels |! smooth, |! rubbery, |! symmetric, |! and |! enlarged.
C. |! 3- |! to |! 6-day-old |! infant. D. |! formula-fed |! infant. |! - |! Correct |! answer |! ✔C: |! CorrectStools |! of |! infants |! 3 |! to |! 6 |! days |! old |! are |! transitional: |! thin, |! slimy, |! and |! brown |! to |! green. Which |! statement |! applies |! to |! screening |! for |! sexually |! transmitted |! infections |! (STIs) |! in |! men |! who |! have |! sex |! with |! men? A. |! Screening |! for |! common |! STIs |! should |! be |! done |! every |! 6 |! months |! if |! the |! man |! is |! sexually |! active. B. |! Regular |! screening |! should |! be |! done |! for |! human |! papillomavirus |! (HPV) |! infection. C. |! HIV |! screening |! should |! be |! done |! if |! HIV |! serologic |! testing |! is |! positive |! or |! if |! the |! patient |! has |! not |! been |! tested |! within |! past |! year. D. |! Screening |! for |! gonorrheal |! pharyngeal |! infection |! should |! be |! done |! if |! the |! man |! has |! had |! receptive |! oral |! intercourse |! with |! a |! condom |! - |! Correct |! answer |! ✔D: |!. |! CorrectTest |! for |! the |! following |! infection |! in |! men |! who |! have |! had |! receptive |! oral |! intercourse |! during |! the |! preceding |! year |! regardless |! of |! history |! of |! condom |! use |! during |! exposure: |! urethral |! infection |! and |! rectal |! infection |! with |! Neiserria |! gonorrhoeae |! and |! Chlamydia |! trachomatis; |! pharyngeal |! infection |! with |! N. |! gonorrhoeae. On |! rectal |! examination, |! you |! note |! a |! lax |! anal |! sphincter. |! This |! is |! an |! indication |! of |! which |! problem?
A. |! Meckel |! diverticulum B. |! Volvulus C. |! Polyps D. |! Neurologic |! deficit |! - |! Correct |! answer |! ✔D: |! CorrectA |! lax |! sphincter |! may |! indicate |! neurologic |! deficit |! or |! sexual |! abuse. ou |! are |! teaching |! a |! parent |! how |! to |! check |! for |! pinworms. |! When |! is |! the |! best |! time |! to |! have |! the |! parent |! assess |! the |! child? A. |! Right |! after |! the |! child |! wakes |! up B. |! While |! the |! child |! is |! sleeping |! C. |! Early |! afternoon D. |! Right |! before |! the |! child |! goes |! to |! bed |! - |! Correct |! answer |! ✔B: |! CorrectThe |! best |! time |! to |! visualize |! pinworms |! in |! children |! is |! after |! they |! fall |! asleep. A |! patient |! presents |! to |! your |! clinic |! with |! rectal |! pain. |! On |! examination, |! you |! note |! a |! tender, |! swollen |! mass |! in |! the |! superficial |! subcutaneous |! tissue |! just |! adjacent |! to |! the |! anus. |! Of |! what |! is |! this |! an |! indication? A. |! Pilonidal |! cyst B. |! Enlarged |! prostate C. |! Perianal |! abcess |! D. |! Hemorrhoids |! - |! Correct |! answer |! ✔C: |! CorrectPerianal |! abscess |! presents |! as |! a |! tender, |! swollen, |! fluctuant |! mass |! in |! the |! superficial |! subcutaneous |! tissue |! just |! adjacent |! to |! the |! anus.
noting |! whether |! it |! is |! thin |! and |! well |! formed, |! as |! expected, |! or |! whether |! it |! is |! split, |! possibly |! indicating |! a |! bifid |! defect. For |! what |! are |! you |! testing |! when |! you |! hold |! an |! infant |! in |! vertical |! suspension |! with |! your |! hands |! under |! the |! axillae? A. |! Fracture |! of |! the |! clavicle B. |! Degree |! of |! muscle |! tone C. |! General |! muscle |! strength |! D. |! Hip |! dislocation |! - |! Correct |! answer |! ✔C: |! CorrectGeneral |! muscle |! strength |! is |! evaluated |! by |! holding |! the |! infant |! in |! vertical |! suspension |! with |! your |! hands |! under |! the |! axillae. |! Adequate |! shoulder |! muscle |! strength |! is |! present |! if |! the |! infant |! maintains |! the |! upright |! position. |! If |! the |! infant |! begins |! to |! slip |! through |! your |! fingers, |! proximal |! muscle |! weakness |! is |! present. With |! an |! infant |! lying |! supine |! on |! the |! examining |! table, |! both |! knees |! flexed, |! feet |! flat |! on |! table, |! and |! femurs |! aligned, |! you |! note |! that |! one |! knee |! is |! higher |! than |! the |! other. |! Which |! would |! be |! a |! correct |! documentation |! of |! this |! finding? A. |! Negative |! Neer |! test B. |! Positive |! Allis |! sign |! C. |! Negative |! Gower |! sign D. |! Positive |! McMurray |! test |! - |! Correct |! answer |! ✔B: |! CorrectThe |! test |! for |! the |! Allis |! sign |! is |! used |! to |! detect |! hip |! dislocation |! or |! a |! shortened |! femur. |! When |! one |! knee |! appears |! lower |! than |! the |! other, |! the |! Allis |! sign |! is |! positive.
Which |! of |! the |! following |! questions |! asked |! by |! the |! examiner |! would |! be |! most |! helpful |! in |! understanding |! a |! patient |! complaining |! of |! acute |! back |! pain? A. |! "What |! medications |! do |! you |! currently |! take?" B. |! "Was |! there |! any |! activity |! or |! injury |! that |! occurred |! before |! the |! onset |! of |! the |! pain?" C. |! "Were |! you |! born |! with |! any |! congenital |! deformities |! of |! the |! spine?" D. |! "Have |! you |! recently |! lost |! weight?" |! - |! Correct |! answer |! ✔B: |! CorrectWhen |! a |! patient |! presents |! with |! a |! complaint |! of |! back |! pain, |! it |! is |! important |! to |! ask |! about |! any |! associated |! event, |! such |! as |! trauma, |! lifting |! of |! heavy |! weights, |! long- distance |! driving, |! sports |! activities, |! change |! in |! posture, |! or |! deformity. Mr. |! McKnight, |! a |! 72-year-old |! patient, |! presents |! to |! your |! office |! for |! a |! routine |! office |! visit. |! Which |! finding |! on |! examination |! would |! be |! considered |! normal? A. |! Meningocele B. |! Myelomeningocele C. |! Kyphosis |! D. |! Scoliosis |! - |! Correct |! answer |! ✔C; |! CorrectKyphosis |! may |! be |! observed |! in |! aging |! adults. Which |! item |! from |! a |! patient's |! history |! indicates |! an |! increased |! risk |! of |! osteomyelitis? A. |! Difficult |! to |! control |! gout B. |! Rheumatoid |! arthritis
Which |! factor |! can |! cause |! excessive |! hyperextension |! of |! the |! knee |! with |! weight |! bearing? A. |! Parrot |! beak |! tear |! of |! the |! medial |! meniscus B. |! Weakness |! of |! the |! quadriceps C. |! Displacement |! of |! the |! patells D. |! Presence |! of |! a |! Baker |! cyst |! - |! Correct |! answer |! ✔B: |! CorrectExcessive |! hyperextension |! of |! the |! knee |! with |! weight |! bearing |! (genu |! recurvatum) |! may |! indicate |! weakness |! of |! the |! quadriceps |! muscles. When |! assessing |! for |! carpal |! tunnel |! syndrome, |! which |! structure |! is |! responsible |! for |! producing |! the |! Tinel |! sign? A. |! Dorsal |! aspect |! of |! the |! wrist B. |! Volar |! carpal |! ligament C. |! Radial |! artery D. |! Median |! nerve |! - |! Correct |! answer |! ✔D: |! CorrectTinel |! sign |! is |! tested |! by |! striking |! the |! patient's |! wrist |! with |! your |! index |! or |! middle |! finger |! where |! the |! median |! nerve |! passes |! under |! the |! flexor |! retinaculum |! and |! volar |! carpal |! ligament. |! A |! tingling |! sensation |! radiating |! from |! the |! wrist |! to |! the |! hand |! in |! the |! distribution |! of |! the |! median |! nerve |! is |! a |! positive |! Tinel |! sign |! and |! is |! suggestive |! of |! carpal |! tunnel |! syndrome. Which |! group |! is |! susceptible |! to |! subluxation |! of |! the |! head |! of |! the |! radius? A. |! Infants/toddlers
B. |! Adolescents C. |! Pregnant |! women D. |! Older |! adults |! - |! Correct |! answer |! ✔A: |! CorrectThis |! injury |! is |! common |! in |! children |! 1 |! to |! 4 |! years |! of |! age. What |! are |! you |! testing |! when |! you |! ask |! a |! patient |! to |! extend |! the |! head |! against |! the |! pressure |! of |! your |! hand? A. |! Cervical |! spine |! alignment B. |! Passive |! range |! of |! motion C. |! Temporalis |! muscle |! strength D. |! Sternocleidomastoid |! muscle |! strength |! - |! Correct |! answer |! ✔D: |! Correct Evaluate |! range |! of |! motion |! in |! the |! cervical |! spine |! by |! asking |! the |! patient |! to |! perform |! the |! following |! movements |! (see |! Fig. |! 22.28):
- |! Bend |! the |! head |! forward, |! chin |! to |! the |! chest. |! Expect |! flexion |! of |! 45 |! degrees.• |! Bend |! the |! head |! backward, |! chin |! toward |! the |! ceiling. |! Expect |! extension |! of |! 45 |! degrees.• |! Bend |! the |! head |! to |! each |! side, |! ear |! to |! each |! shoulder. |! Expect |! lateral |! bending |! of |! 40 |! degrees.• |! Turn |! the |! head |! to |! each |! side, |! chin |! to |! shoulder. |! Expect |! rotation |! of |! 70 |! degrees. The |! strength |! of |! the |! sternocleidomastoid |! and |! trapezius |! muscles |! is |! evaluated |! with |! the |! patient |! maintaining |! each |! of |! these |! positions |! while |! you |! apply |! opposing |! force. |! With |! rotation, |! cranial |! nerve |! XI |! is |! simultaneously |! tested. Mrs. |! Bower |! is |! a |! 38-year-old |! patient |! who |! presents |! to |! your |! office |! with |! complaints |! of |! pain |! and |! a |! clicking |! noise |! with |! jaw |! movement. |! The |! pain |! extends |! into |! the |! face. |! These |! symptoms |! are |! suggestive |! of |! which |! condition?
