Download NR 509 Midterm Exam Questions and Answers (2025) and more Exams Nursing in PDF only on Docsity!
Cause of saddle numbness and urinary retention - Correct Answers ✅Cauda equina syndrome Presentation of retinal detachment - Correct Answers ✅If sudden visual loss is unilateral and painless, Obtunded - Correct Answers ✅patient opens the eyes and looks at you but responds slowly and is somewhat confused. Alertness and interest in the environment are decreased. Cranial nerve for lateral gaze - Correct Answers ✅CN6: Abducens Adult Illnesses - Correct Answers ✅Medical: Illnesses such as diabetes, hypertension, hepatitis, asthma, and human immunodeficiency virus (HIV); hospitalizations; number and gender of sexual partners; and risk- taking sexual practices ■ Surgical: Dates, indications, and types of operations ■ Obstetric/Gynecologic: Obstetric history, menstrual history, methods of contraception, and sexual function ■ Psychiatric: Illness and time frame, diagnoses, hospitalizations, and treatments Present Illness - Correct Answers ✅chronologic description of the problems prompting the patient's visit, including the onset of the
problem, the setting in which it developed, its manifestations, and any treatments to date.Each problem/symptom needs: (1) location; (2) quality; (3) quantity or severity; (4) timing, including onset, duration, and frequency; (5) the setting in which it occurs; (6) factors that have aggravated -meds, allergies, tobacco use, ETOH and drug use Absence of red reflex - Correct Answers ✅an opacity of the lens (cataract) or, possibly, the vitreous (or even an artificial eye). Less commonly, a detached retina or, in children, a retinoblastoma may obscure this reflex. S/S of seasonal allergies - Correct Answers ✅Itching, watery eyes, sneezing, ear congestion, postnasal drainage Presentation of optic neuritis - Correct Answers ✅Enlarged blind spot, vision loss in 1 eye, loss of color vision, hole in center of vision, trouble seeing to the side, eye pain pityriasis rosea - Correct Answers ✅Multiple round to oval scaling violaceous plaques on abdomen and back Acromion - Correct Answers ✅tip of shoulder
- Empowering the pt s/s of degenerative pain - Correct Answers ✅-Slowly progressive, with temporary exacerbations after periods of overuse -usually insidious
- flexion and deviation deformities How otosclerosis presents with Weber and Rinne test - Correct Answers ✅- Weber: Sound lateralizes to impaired ear. Room noise not well heard, so detection of vibrations improves
- Rinne: BC longer than or equal to AC. While air conduction through the external or middle ear is impaired, vibrations through bone bypass the problem to reach the cochlea. Cherry angiomas - Correct Answers ✅Benign Interpreting visual acuity test - Correct Answers ✅Vision of 20/ means that at 20 feet the patient can read print that a person with normal vision could read at 200 feet. The larger the second number, the worse the vision. "20/40 corrected" means the patient could read the 20/40 line with glasses (a correction). Sequence of the interview - Correct Answers ✅Preparation. Then, Greeting the patient and establishing rapport. Establishing the agenda
for the interview. Inviting the patient's story. Exploring the patient's perspective. Identifying and responding to emotional cues. Expand-ing and clarifying the patient's story. Generating and testing diagnostic hypotheses. Sharing the treatment plan. Closing the interview and the visit. Taking time for self-reflection. Patient consent - Correct Answers ✅you need consent to carry out a visit with someone in the room with them. Health History - Correct Answers ✅● Identifying data and source of the history; reliability ● Chief complaint(s) ● Present illness ● Past history ● Family history ● Personal and social history ● Review of systems Rotator cuff injury - Correct Answers ✅Atrophy of the supraspinatus and infraspinatus with increased prominence of scapular spine can appear within 2 to 3 weeks of a rotator cuff tear; infraspinatus atrophy has a positive likelihood ratio (LR) of 2 for rotator cuff disease. prioritizing patient complaints - Correct Answers ✅Problem list
- Most active and serious problems first
- then, problems that need future observation and attention
sources of joint pain - Correct Answers ✅-If age <60 years, consider repetitive strain or overuse syndromes like tendinitis or bursitis, crystalline arthritis (gout; crystalline pyrophosphate deposition disease [CPPD]) (males), rheumatoid arthritis (RA), psoriatic arthritis and reactive (Reiter) arthritis (in inflammatory bowel disease [IBD]), and infectious arthritis from gonorrhea, Lyme disease, or viral or bacterial infections.
- If age >60 years, look for OA, gout and pseudogout, polymyalgia rheumatica (PMR), osteoporotic fracture, and septic bacterial arthritis.
- congenital, inflammatory or infectious, immunologic, neoplastic, metabolic, nutritional, degenerative, vascular, traumatic, and toxic? CN 1-6 - Correct Answers ✅1) Olfactory- smell 2)Optic- visual acuity with eye chart & pupil response 3)Oculomotor- conjugate gaze with EOM 4)Trochlear- conjugate gaze with EOM
- Trigeminal- palpate masseter & touch face and have pt identify where
- Abducens- Conjugate gaze with EOM CN 7-12 - Correct Answers ✅7)Facial- Blow cheeks out, smile, frown, pucker lips 8)Vestibulocochlear (Acoustic)- Whisper test
- Glossopharyngeal- Gag reflex
10)Vagus- say "ahhh". soft palate and uvula rise symmetrically
- Accessory- shrug shoulders
- Hypoglossal- Stick out tongue and move left to right epistaxis causes - Correct Answers ✅nosebleed
- cause: trauma, inflammation, drying and crusting of the mucosa, tumors and foreign bodies Vesicular lung sounds - Correct Answers ✅soft and low pitched. They are heard throughout inspiration, continue without pause through expiration, and then fade away about one third of the way through expiration. Bronchovesicular sounds - Correct Answers ✅with inspiratory and expiratory sounds about equal in length, at times separated by a silent interval. Detecting differences in pitch and intensity is often easier during expiration. Bronchial - Correct Answers ✅or louder, harsher and higher in pitch, with a short silence be-tween inspiratory and expiratory sounds. Expiratory sounds last longer than inspiratory sounds. tracheal sounds - Correct Answers ✅Loud, harsh sounds heard over the trachea in the neck
● Freckles (inherited brown macules) ● Ultraviolet radiation from heavy sun exposure, sunlamps, or tanning booths ● Light eye or skin color, especially skin that freckles or burns easily ● Severe blistering sunburns in childhood ●Immunosuppression from human immunodeficiency virus (HIV) or from chemotherapy ● Personal history of nonmelanoma skin cancer Symptoms of a SAH - Correct Answers ✅Headache with severe and sudden onset -thunderclap headache reaching maximal intensity over several minutes Headache warning signs - Correct Answers ✅Progressively frequent or severe over a 3-month period ● Sudden onset like a "thunderclap" or "the worst headache of my life" ● New onset after age 50 years ● Aggravated or relieved by change in position ● Precipitated by Valsalva maneuver or exertion ● Associated symptoms of fever, night sweats, or weight loss ● Presence of cancer, HIV infection, or pregnancy
● Recent head trauma ● Change in pattern from past headaches ● Lack of a similar headache in the past ● Associated papilledema, neck stiffness, or focal neurologic deficits Making a pelvic exam more comfortable - Correct Answers ✅Obtains permission; selects chaperone Explains each step of the examination in advance Drapes the patient from mid-abdomen to knees; depresses the drape between the knees to provide eye contact with patient Avoids unexpected or sudden movements Chooses a speculum that is the correct size Warms the speculum with tap water Monitors the comfort of the examination by watching the patient's face Uses excellent but gentle technique, especially when inserting the speculum if one patient comes from another country - Correct Answers ✅You still need to be selective in who you screen for malaria Signs of increased ICP - Correct Answers ✅Papilledema ( pink, hyperemic, loss of venous pulsations, disc more visible, disc swollen with blurred margins, physiologic cup not visible)
signs of asthma - Correct Answers ✅wheezes absent breath sounds & abnormal retraction (severe asthma) hyperresonance Acanthosis nigricans - Correct Answers ✅deeply pigmented, velvety axillary skin in the axilla -associated with diabetes, obesity, PCOS, and rarely malignant paraneoplastic disorders Labs for vitiligo - Correct Answers ✅thyroid (hyperthyroidism) interpreter in the room - Correct Answers ✅you have eye contact with patient. Speak to pt. have interpreter sit close to the patient, or even behind you, so you don't have to turn your head back and forth constitutional ROS - Correct Answers ✅fatigue, weakness, fever, chills, night sweats, weight changes, pain Dim response of olfactory nerve in elderly - Correct Answers ✅Normal finding C-section should be listed under surgeries - Correct Answers ✅
psoriasis presentation - Correct Answers ✅-Scattered erythematous round drop-like, flat-topped well-circumscribed scaling papules and plaques on trunk (guttate psoriasis) -Scattered erythematous to bright pink well-circumscribed flat-topped plaques on extensor knees and elbows, with overlying silvery scale; plaque psoriasis vasovagal syncope - Correct Answers ✅-neurocardiogenic (also called neutrally mediated vasodepressor syncope or vasovagal syncope) and of cardiac origin from arrhythmias in only ∼20% of cases Angina pectoris - Correct Answers ✅Consider this as a differential diagnosis for chest pain subconjunctival hemorrhage - Correct Answers ✅-no pain -vision not affected
- no eye discharge -pupil not affected -clear cornea
- benign, spontaneous, doesn't need treatment. Sternocleidomastoid lymph nodes - Correct Answers ✅Considered posterior cervical
Glaucoma - Correct Answers ✅Increased cup-to-disc ratio Bulging discs - Correct Answers ✅Vertebral bodies of the spin associated with bulging disc are cartilaginous
