NR 509 /NR509 FINAL EXAM NEWEST 2024 TEST BANK AND STUDY GUIDE COMPLETE 250 QUESTIONS AND CORRECT DETAILED ASNWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

NR 509 /NR509 FINAL EXAM NEWEST
2024 TEST BANK AND STUDY GUIDE
COMPLETE 250 QUESTIONS AND
CORRECT DETAILED ASNWERS WITH
RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
A 20-year-old college student presents for his annual physical
examination. He recently became sexually active and is
inquiring about the best means of preventing sexually
transmitted infections (STIs). Of the following, which would
be the most effective means of prevention?
a. Early withdrawal
b. Male condoms
c. Spermicides
d. Diaphragms
e. Cervical caps - ....ANSWER...b. Male condoms
A 21-year-old college student presents to the student health
clinic for a full physical examination. He is generally healthy;
however, he reports that he has had sexual intercourse with
multiple partners in the past couple of months. He noticed a
small lesion on the shaft of his penis a few days ago. While
performing the examination, he unwillingly achieves an
erection. How should the clinician proceed at this point?
a. Stop the examination immediately.
b. Have him return to see another provider.
c. Explain this is a normal response and finish the
examination.
d. Tell him the examination cannot proceed until the erection
subsides.
e. Assume that he is malingering. - ....ANSWER...c. Explain
this is a normal response and finish the examination.
A 45-year-old driver's education instructor presents to the
clinic for heavy periods and pelvic pain during her menses.
She reached menarche at age 13 years and has had regular
periods except during her pregnancies. She is a G4P3013 and
does not use birth control as her husband has had a
vasectomy. She states this has been going on for about a year
but seems to be getting worse. Her last period was 1 week
ago. On bimanual exam, a large midline mass halfway to the
umbilicus is palpated. Each adnexal area is nonpalpable. Her
rectal exam is normal. Her body mass index (BMI) is 27.
What is the best explanation for her physical finding?
a. Large colonic stool
b. Ovarian mass
c. Fibroids
d. 4-Month pregnancy
e. Bartholin gland enlargement - ....ANSWER...c. Fibroids
A 32-year-old G0 woman comes for evaluation on why she
and her husband have been unable to get pregnant. Her
husband has been married before and has two other children,
ages 7 and 4 years. The patient relates she began her periods
at age 12 and has been fairly regular ever since. She began
oral contraceptive pills from when she got married until last
year, when she began to try for a pregnancy.
Before this she had regular cycles for 10 years. She has had a
history of five prior partners. She relates she was once treated
for a severe genital infection when she was in college. Based
on this patient's history, what is the best explanation for her
infertility?
a. Prior pelvic inflammatory disease (PID)
b. Prior Bartholin gland infection
c. Prior herpes infection
d. Metabolic disorder with subsequent hormonal irregularities
leading to anovulation
e. Secondary amenorrhea - ....ANSWER...a. Prior pelvic
inflammatory disease (PID)
A 24-year-old retail clerk presents to the clinic for an annual
exam. Her last Pap was 3 years ago and was normal. She is a
G0 and is currently not sexually active although she has had
two lifetime partners. She is on oral contraceptive pills for
cycle control and has no medical problems. Based on
guidelines, the clinician proceeds to perform a Pap smear and
places the speculum. There are two layers of cells, squamous
and columnar. Where is the most important area to obtain
cells for a Pap smear?
a. Zona reticularis
b. Transformation zone
c. Squamous zone
d. Columnar zone
e. Linea nigra - ....ANSWER...b. Transformation zone
A 35-year-old grade school teacher presents for her annual
exam. Her last Pap smear was 4 years ago and normal. She is
a G1P1 with a 6-year-old child. She has had four lifetime
partners but only one partner in the last 12 years. Otherwise
she has no complaints. A speculum exam is done followed by
a bimanual examination during which a rectovaginal mass is
palpated. Which of the following exam findings would be
most reassuring that this is not a colonic mass?
a. No cervical motion tenderness
b. No pus from the os
c. The mass dents with digital pressure
d. Both adnexa are nontender
e. The perineum has no lesions - ....ANSWER...c. The mass
dents with digital pressure
A 21-year-old college student presents for her first annual
exam. She has been sexually active for 1 year and has had two
partners. She is not aware of having had any sexually
transmitted diseases (STIs).
She is using condoms for birth control and STI prevention but
admits to not always using them regularly. Her last menses
was 2 weeks ago. On speculum exam, an unusual appearance
is noted, which is diagnosed as warts. What is the best
description for these lesions?
a. Several shallow ulcers with a red base
b. Translucent nodules
c. Raised friable or lobed lesions
d. Bright red, soft lesion arising from the cervical canal
e. Strawberry cervix (small red granular spots or petechiae) -
....ANSWER...c. Raised friable or lobed lesions
A 23-year-old female comes to the clinic to discuss her birth
control options. Although she has been sexually active since
age 16 years, she has been with one partner for the last year.
She has decided to discontinue condoms and would like a
different birth control option. She has not had a pelvic exam
for 2 years. She had a normal Pap smear that year and
negative sexually transmitted infection (STI) testing. Her last
menstrual period was 2 days ago. She states that she is still
spotting. She also states that she last had sex with her
boyfriend 1 week ago, so the clinician elects to postpone her
speculum exam. What is the best explanation for the decision
to postpone her exam?
a. She is on her menses.
b. She has only one current partner and does not need STI
testing
c. She had a normal Pap smear within the last 3 years.
d. She should not be sexually active.
e. She has been using condoms. - ....ANSWER...a. She is on
her menses.
An 18-year-old high school senior presents to the clinic
complaining of a vaginal discharge. She states that it is thick
and yellow and that she has had some recent pelvic pain. She
is sexually active and is not using any type of birth control or
sexually transmitted infection (STI) prevention. She denies
any burning with urination, nausea, vomiting, or diarrhea. She
has had some fever and chills with a temperature up to
101.5ºF. Her last menstrual period was last week. After a
physical exam, she is diagnosed with pelvic inflammatory
disease (PID). Visualization of purulent discharge in which of
the following areas would best support a diagnosis of PID?
a. Cervical os
b. Posterior fornix
c. Anterior fornix
d. Skene gland opening
e. Bartholin gland opening - ....ANSWER...a. Cervical os
A 27-year-old G0 bus driver presents to the clinic
complaining of an itchy vaginal discharge for the last week.
She reached menarche at age 12 years, became sexually active
at age 18 years, and has had a total of five sexual partners.
She has been with her current partner for 1 month. She is on
oral contraceptive pills and does not use condoms as she is
allergic to latex. Her last menstrual period was 3 weeks ago.
She is not having any pelvic pain, fever, nausea, or vomiting.
Her vitals are normal with a body mass index of 22. The
clinician places the metal medium Graves speculum in the
vagina but cannot find the cervix. What is the best next
maneuver to visualize the cervix?
a. Replace the speculum with a larger one (large Graves).
b. Withdraw the speculum and do a bimanual exam to find the
cervix.
c. Withdraw the speculum slightly and reposition it on a
different slope
d. Replace the speculum with a plastic one wi -
....ANSWER...c. Withdraw the speculum slightly and
reposition it on a different slope
A 63-year-old office worker comes to the clinic for her
women's health exam. Her last Pap smear was 5 years ago and
was normal. She is married and has been with the same sexual
partner for the last 35 years. After performing the majority of
the exam, the clinician decides to do a speculum exam to
collect cytology for Pap smear. What is the correct position to
have the patient in for her speculum exam?
a. Sitting
b. Supine
c. Prone
d. Trendelenburg
e. Lithotomy - ....ANSWER...e. Lithotomy
A 68-year-old retired patient presents to the clinic
complaining about feeling like something is falling out of her
vagina. She is a G6P6007 and had all her children vaginally,
even the twins. She went through menopause at age 55 years,
and, for the last few months, she has felt this falling sensation.
On exam, an anterior bulge in the vaginal wall is apparent
when she bears down. Weakness in which muscle would best
account for the anterior bulge in the vaginal wall?
a. Levatori ani
b. Anal sphincter
c. Pubis symphysis
d. Ischiocavernosus muscle
e. Bulbocavernosus muscle - ....ANSWER...a. Levatori ani
A 49-year-old male nurse experiences fecal incontinence after
a motor vehicle accident that left him paralyzed below the
waist. He asks his rehabilitation physician about the control of
this function in a person without his injuries. Which of the
following is true regarding the muscle control of the anal
sphincter?
a. The internal anal sphincter is under voluntary control,
whereas the external anal sphincter is under involuntary
control.
b. The internal anal sphincter is under involuntary control,
whereas the external anal sphincter is under voluntary control.
c. Both internal and external anal sphincter are under
voluntary control.
d. Both internal and external anal sphincter are under
involuntary control.
e. Control of the anal sphincters is variable between
individuals. - ....ANSWER...b. The internal anal sphincter is
under involuntary control, whereas the external anal sphincter
is under voluntary control.