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NUR251 CDU FINAL EXAM PRACTICE
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QUESTIONS AND DETAILED CORRECT
ANSWERS WITH RATIONALES | 2024 -
What is the most likely treatment plan for reoccurring endometrial cancer? Correct Answer Progesterone therapy. Endometrial cancer is the most common invasive gynaecological cancer in Australia. Surgery is the treatment of choice for primary diagnosis of endometrial cancer. Approximately 1/3 of women respond well to progesterone therapy with chemotherapy the least effective. Whilst inserting an indwelling catheter you observe blisters on a female patient's labia majora. On further assessment she states the blisters are new onset and painful. What is the most likely cause of these symptoms? Correct Answer First episode of genital herpes. Red papules appear 2-10 days after exposure to the herpes virus with the first outbreak or first episode lasting up to 12 days. The clear fluid in the papules contains virus particles and is highly infectious.
Whilst inserting an indwelling catheter you observe cauliflower shaped lesions on the shaft of a male patient's penis. What is the most likely condition causing this? Correct Answer Genital warts. Genital warts (condyloma acuminate) are caused by the human papillomavirus (HPV) which is chronic, incurable and largely asymptomatic. During a nursing assessment a female patients stated an abnormal watery vaginal discharge with an offensive 'fishy' odour. What is the most likely cause of these symptoms? Correct Answer Bacterial vaginosis. Non-specific vaginitis is the most common cause of vaginal infections in women of reproductive age and is easily treated with oral or intravaginal antibacterial agents. You are providing discharge education to a female patient diagnosed with the STI chlamydia. Which of the following statements would not be included? Correct Answer Now you have had it once you cant can't get it again. Chlamydia is asymptomatic in most women until the uterus and fallopian tubes have been invaded and delay in treatment can result in devastating long term complications with fertility. Regular screening is recommended for people who are young, sexually active and do not use condoms.
Pelvic inflammatory disease (PID) can have severe and life threatening complications. Health promotion and education is vital for prevention and good sexual health. Douching is washing or cleaning out the inside of the vagina with water or other mixtures of fluids. Douching before or after sex does not prevent STIs as it removes some of the normal bacteria in the vagina that protects from infection therefore increasing the risk. You are providing patient education for someone with herpes simplex virus II (HSV2). Which of the following statements are incorrect? Correct Answer This condition causes cervical cancer. Blisters contain the highly infectious virus and create patches of painful ulcers that can last up to six weeks. Touching these blisters and then rubbing, scratching or touching other areas can spread the infection. Abstinence is required from sexual contact from the time symptoms appear until 10days after all lesions have healed. Prevent and control of STIs are based on the principles of education, early detection, diagnosis and treatment of infected people and their sexual partners? Correct Answer True.
Sexual health assessment is essential to the prevention and control of STIs. When conducting an assessment remember to include the 5Ps - partners, prevention of pregnancy, protection from STIs, current practice and past history. Good, professional, non-judgemental communication is key in sexual health assessment. Which sexually transmitted virus causes cervical cancer? Correct Answer Human papillomavirus. Almost all cervical cancer is caused by the human papillomavirus (HPV). Current screening using pap smears is recommended for all sexually active females every 2 years. The Gardasil vaccine has been included to the National Vaccination Program which will see changes to screening in the future. What is NOT a function of the kidneys? Correct Answer Hormone production including insulin. Excretion: the removal of wastes from body fluids. Elimination: the elimination of wastes from the body. Homeostatic: regulation of the volume and solute concentration of plasma in the blood. Which of the following is a normal result from a urinary sample? Correct Answer Light - straw to amber - yellow coloured urine.
Glomerular filtration rate is the passive, nonselective process where hydrostatic pressure forces fluid and solutes from the blood into the glomerular capsule. Remember to keep in mind age related renal changes which can be as low as 60mL/min/1.73m2 for this cohort. On inserting a urinary catheter a patient voids 450mls. What is this urine output considered to be? Correct Answer Normal. In healthy adults the bladder holds about 300- 500 mls of urine. However, it can hold more than twice that amount if necessary. Normal hourly output should be above 30mls/hr. Results from a routine urinalysis show +3 ketones in the urine. What could this indicate? Correct Answer Diabetes mellitus. Presence of ketones in the urine is called ketonuria. When the body is unable to get enough glucose for energy it will use body fats. Ketones are the result of body breaking down these fats to use for energy. Normal ketones should be negative. A patient with an indwelling catheter is demonstrating signs of bacteriuria. Which of the following would be the recommended treatment plan? Correct Answer Remove the catheter and begin antibiotic therapy.
The recommended treatment for catheter associated UTI is immediate removal of IDC and 10-14 days of antibiotic therapy to eliminate infection. An elderly patient suddenly starts to act confused and disorientated. What in the most likely cause? Correct Answer UTI. The older adult may not complain of dysuria and often inflammatory and immune responses diminish with age. Foul smelling urine, incontinence and confusion are just some of the symptoms to look out for. What psychosocial impacts can incontinence have on people? Correct Answer Embarrrassment; Withdrawal; Isolation; Helplessness. Urinary incontinence can have a significant impact on an individual's quality of life and can lead to other physical and mental conditions. It is not a normal aspect of ageing. Oliguria is characterised by urine output of: Correct Answer <400mls per day. Oliguria = less than 400mls per day; Anuria = no urine output; Polyuria = greater than 2500mls per day.
A person with acute kidney injury (AKI) is prescribed frusemide. Why is this medication helpful? Correct Answer It will reduce oedema. Frusemide is a loop diuretic. In AKI the kidneys are unable to excrete adequate urine to maintain a normal extracellular fluid balance. Oedema results from fluid retention and heart failure can develop. A person who is recovering from acute renal injury is being discharged. Which of the following should the nurse include in the discharge instructions? Correct Answer Avoid alcohol. During recovery nephrons remain vulnerable to damage by nephrotoxins. Alcohol increases the nephrotoxicity of some materials so it is discouraged. The most common cause of kidney damage is: Correct Answer Blunt trauma. Injury ranges from small contusion to haematomas to fragmentation or shattering of the kidney that causes significant blood loss and urine extravasation. Tearing of renal vessels may cause rapid haemorrhage and death. A person diagnosed with only 45% of the normal glomerular filtration rate is experiencing which of the following: Correct Answer Renal insufficiency.
Renal insufficiency is the broad term describing any condition in which kidneys are unable to remove accumulated metabolites from the blood, leading to altered fluid, electrolytes and acid-base balance. A patient undergoing haemodialysis must have their vascular access site assessed for pulsation or vibration and an audible bruit? Correct Answer True. Infection & thrombus formation are the most common problems affecting the access site in haemodialysis. Always alert staff to the extremity with the vascular access so it is not used for any procedures, this can damage vessels and lead to failure of the arteriovenous fistula Stage 4 kidney disease is also known as end stage kidney disease? Correct Answer False. Stage 5 is also known as end stage kidney disease is the terminal phase of CKD, kidney replacement therapy is needed to sustain life. The postoperative instruction is to ambulate the patient gradually. You are aware the patient is feeling weak from inadequate fluid pre and intra operatively. How can you implement these instructions? Correct Answer Assist the person to move into different positions in stages. The person with fluid volume deficit is at risk of injury because of dizziness and loss of balance resulting from
potassium in your body, if they are not working properly, they will be unable to filter and remove excess potassium from the body. The patient you are providing post-operative care to has been diagnosed with fluid volume excess (hypervolaemia). Which of the following would you expect to observe? Correct Answer Distended neck veins. Excess fluid volume effects circulation. Your patient may also have a bounding pulse as well as distended neck and peripheral veins, increased central venous pressure, moist cough, peripheral oedema and ascites may develop. Males diagnosed with diabetes and coronary artery diseases are more likely to experience erectile dysfunction. Correct Answer True. To assist in maintaining an erection an O ring can be worn at the base of the penis to constrict blood flow out of the penis whilst still allowing blood flow in. What is the most common cause of scrotal swelling Correct Answer Hydrocele. Hydroceles can occur secondary to trauma, infection or a tumour. A hydrocele may be differentiated from a solid mass by trans illumination or ultrasound of the scrotum. Hydroceles are not associated with infertility.
A man presents to the emergency department concerned his erection has lasted more than 4 hours. Your nursing assessment must include; Correct Answer Use of medications or supplements for erectile dysfunction. Priapism is an involuntary, sustained, painful erection that is associated with sexual arousal. Nursing management focusses on assessment, monitoring urine output and pain control. What is the most common cause of epididymitis? Correct Answer Chlamydia, Gonorrhoea. Epididymitis is an infection or inflammation of the epididymis, the structure that lies along the posterior boarder of the testis. Early manifestation includes pain and oedema of the scrotum which can be relieved with analgesia, scrotal supports and ice packs. Epididymitis is treated with antibiotics - if the course of antibiotics is not completed what is most likely to develop? Correct Answer Orchitis. Orchitis is an acute inflammation of the testes; it is a common complication of system illness or an extension of epididymitis. What is the most common treatment for testicular cancer? Correct Answer Surgical removal of the affected testicle.
resectopscope and electrocautery inserted through the urethra. Early stage prostate cancer is often asymptomatic? Correct Answer True. Symptoms which may occur are due to metastasis of bone and can affect the genitourinary, musculoskeletal and neurological systems. You are providing nursing care to a 55 year old female patient who voices concerns about constant anxiety, inability to sleep, headaches and just not feeling like herself. What is the most likely cause of these symptoms? Correct Answer Menopause. Nursing care for women experiencing menopausal symptoms focuses on symptomatic relief and education. Menopause is the permanent cessation of menses and is a normal physiological process. A female complains about increasing premenstrual symptoms over the past few years and thinks something must be wrong. What is the most likely cause? Correct Answer Normal pattern of premenstrual syndrome (PMS). Premenstrual syndrome (PMS) is a complex group of symptoms from mood swings to breast tenderness, fatigue, irritability, food cravings and depression. Usually limited to 2-14 days and self-resolving.
The nurse is assisting a female patient with ways to reduce the severity of her monthly menstrual discomforts associated with PMS. What healthy lifestyle choices may provide symptom relief? Correct Answer Limited alcohol intake; Regular exercise; Relaxation techniques. Teaching complementary therapies and coping mechanism is helpful. Techniques for relaxation and stress management include deep abdominal breathing, medication and muscle relaxation. Alcohol and unhealthy diets should be avoided as it exacerbates the symptoms of PMS. What factors most likely contribute to a uterine prolapse into the vaginal canal? Correct Answer Multiple pregnancies. When the uterus is displaced within the pelvic cavity, it can be mild to completely prolapsed (outside the vagina) it is commonly due to weakened pelvic musculature usually attributable to stretching of the supporting ligaments and muscles during pregnancy. Which of the following is not a term for dysfunctional uterine bleeding? Correct Answer Dyspareunia. Dysfunctional uterine bleeding is any abnormal volume, duration or time of bleeding. Factors including stress,
Vaginal hysterectomy is the removal of the uterus through the vagina and leaves no visible abdominal scaring. You are providing discharge education for a woman following a laparoscopic hysterectomy. What important information will you provide to ensure a successful discharge? Correct Answer Maintain an iron rich balanced diet; Restrict physical activity for 4-6 weeks; Regular analgesia for therapeutic pain management. Sexual intercourse and anything inserted into the vagina (i.e. tampon) should be avoided until after the postoperative check-up. This precaution reduces the risk of infection. An elderly patient is being discharged with oedema to bilateral lower legs due to fluid volume excess. What discharge education will you include? Correct Answer Wear compression socks. Wearing compression garments or support hose assist with decreasing oedema. The compression action reduces the diameter of distended veins and improves blood flow. In the clinical environment they are often referred to as TED stocking. You are providing nursing care to a patient with poor verbal communication due to dementia. How can you assess if the person is dehydrated? Correct Answer Assess urine specific gravity.
Specific gravity measures the concentration of urine. When someone is dehydrated, the kidneys conserve water resulting in the increased specific gravity and osmolality of urine. A patient states they are experiencing several days of watery diarrhoea and abdominal/muscle cramping. What condition are they most at risk of? Correct Answer Hyponatraemia. These signs are very early indicators of decreasing sodium levels. As they continue to decrease the brain and nervous system are affected by cellular oedema. When sodium levels drop dangerously low convulsions or coma are likely. You perform an ECG with has peaked T waves and widened QRS complexes. What is the most likely cause? Correct Answer Hyperkalaemia. Hyperkalaemia alters the cell membrane, increasing the concentration of potassium outside the cell. Cardiac depolarisation is decreased as a result. All ECGs needs to be reviewed by a medical officer to initiate the appropriate treatment. You are providing nursing care to a patient with a history of sodium retention. During assessment you identify skipping heart beats and leg tremors. What is the most likely cause? Correct Answer Using salt alternative.
