exam 4

Question 1

Subjective data gathering of breast history

Answer 1

pain, lump, and discharge, rash, swelling, trauma, history of breast disease, surgery or radiation, medications, patient-centered care, perform breast self-examination/last mammogram, tenderness, lump, or swelling, rash, make sure to ask questions about any pain or swelling, tenderness, sore, burning sensation?

Question 2

Patient teaching about self-breast exam—what information would you teach the patient?

Answer 2

lie down, press the 3 middle fingers, in a circular motion and use 3 levels of pressure, follow and up and down motion, sit up and examine underarm with arm slightly raised, note any surface changes or lumps and if there are any discharge coming from the nipple

Question 3

Abnormal findings during inspection of breast during exam

Answer 3

dimpling, nipple retraction, edema (Peau d’Orange), fixation, deviation in nipple pointing, benign (“Fibrocystic”) Breast Disease, cancer, fibroadenoma, differentiating breast lumps, age, shape, consistency, and demarcation, number, mobility, and tenderness, skin retraction, pattern of growth, and risk to health

Question 4

Internal structures of the breast

Answer 4

glandular tissue, fibrous tissue, adipose tissue

Question 5

Factors that increase relative risk for invasive breast cancer in women
end of 18

Answer 5

-BRCA 1 and BRCA 2 genes
-Breast cancer survival rates have increased greatly in recent years
-Ethnic and racial considerations:
-Mortality rate is 40% higher for Black women
-Worse prognosis with later stage diagnosis
-Lifestyle risk factors

Question 6

Procedure to perform the Phalen’s test

Answer 6

having the patient hold both wrists in complete and forced flexion (pushing the dorsal surfaces of both hands together) for 30-60 seconds, help diagnose carpel tunnel

Question 7

Procedure to perform plantar flexion

Answer 7

the downward movement of the foot away from the body, which occurs when the ankle is bent

Question 8

Crepitation

Answer 8

dry crackling sound or sensation due to grating of the ends of the damaged bone

Question 9

Positions/movements for normal range of motion of the ankle

Answer 9

limited to flexion (dorsiflexion) and
extension (plantar flexion) in one plane, eversion and inversion

Question 10

Lordosis
Kyphosis
Osteoporosis

Answer 10

lordosis: inward or concave curvature of the lumbar spine
kyphosis: an abnormal rounding of the upper back that causes a person to appear hunched over or to slouch
osteoporosis:a bone disease that weakens bones, making them more likely to break, degenerative

Question 11

Abduction/adduction

Answer 11

abduction: moving a body part away from an axis or the median line
adduction: moving body part toward the center or toward the median line

Question 12

ligaments

Answer 12

fibrous bands from one bone to another bone that strengthen the joint and prevent unwanted movement

Question 13

supination

Answer 13

turning forearm so that palm is up

Question 14

Passive range of motion

Answer 14

having to help them do the range of motion, external force

Question 15

Common exam findings along with symptoms of patients with rheumatoid arthritis

Answer 15

inflammatory, joint pain, stiffness, swelling

Question 16

Common symptoms of osteoarthritis

Answer 16

degenerative, pain when using the joint, limit joint movement, pain, swelling

Question 17

Swan-neck and boutonniere deformity
end of 23

Answer 17

swan-neck: knuckle is bent back
boutonniere: ulnar deformity, wrist is outward

Question 18

Know all 12 cranial nerves by name, roman numeral and functions

Answer 18

I: olfactory: sensory
II: optic: sensory
III: oculomotor: motor
IV: trochlear: motor
V: trigeminal: sensory and motor
VI: abducens: motor
VII: facial: sensory and motor
VIII: acoustic: sensory
IX: glossopharyngeal: sensory and motor
X: vagus: sensory and motor
XI: spinal: motor
XII: hypoglossal: motor
“some say marry money but my boyfriend says beautiful babies matter more.”

Question 19

Documentation of findings of normal and abnormal patellar reflexes

Answer 19

A normal patellar reflex is documented as a brisk, quick extension of the knee with a single, moderate movement when the patellar tendon is tapped, typically graded as a “2+” on a reflex scale; an abnormal patellar reflex could be absent (0), diminished (1+), exaggerated or hyperactive (3+, 4+), or accompanied by clonus (rhythmic oscillations) which indicates a neurological issue, and should be noted with the specific findings on each side of the body.

Question 20

Procedure to check for presence of Babinski reflex

Answer 20

firmly stroke the sole of the foot with a blunt object like a tongue depressor, moving from the heel towards the base of the big toe; a positive

Question 21

Glasgow coma scale—purpose of use in clinical setting

Answer 21

to objectively assess and monitor a patient’s level of consciousness, particularly after a head injury, by evaluating their eye opening, verbal response, and motor response

Question 22

Symptoms exhibited for a patient with injury to the Broca’s area of the frontal lobe

Answer 22

difficulty forming complete sentences, struggling to articulate words clearly, omitting grammatical elements like “and” or “the,” and generally having trouble expressing themselves verbally despite understanding what they want to say

Question 22

Testing the function of cranial nerve XI:
Testing the function of cranial nerve XII:

Answer 22

XI(acceessory): shurg shoulders and apply resistence
XII(hypoglossal):place tongue depressor on tongue to intiate gag reflex and watch tonils come to the center and watch uvula rise

Question 23

physical exam findings associated with deficit of cranial nerve VII

Answer 23

unable to form smile, drooping of face

Question 24

List the some of the specific mediating function of the frontal, parietal, occipital and temporal lobes of the brain

Answer 24

frontal lobe: decision making,motor control, emotions,personality expression parietal:touch,taste, spacial awarness occipital:visual stimuli, recognizing faces and objects temporal: memory formation,language comprehnesion and emotional recognition

Question 25

Procedure to perform the graphesthesia test

Answer 25

ask the patient to close their eyes, then use a blunt object like a pen or applicator stick to trace a number or letter on the palm of their hand, and have them identify what you drew

Question 26

parathesia

Answer 26

numbness, tingling,itching or skin crawling

Question 27

Functions of the cerebellum

Answer 27

processes motor coordination and muscle tone of voluntary movements

Question 28

sterognosis

Answer 28

ability to recognize objects by feeling their form, size, and weight while the eyes are closed

Question 29

Positive Babinski test findings in an adult

Answer 29

Babinski reflex is indicated when the big toe flexes upwards and the other toes fan out, which is considered normal in infants but abnormal in adults and older children,

Question 30

Testing sensory function of cranial nerve V

Answer 30

have patient close their eyes and rub a cotton swab on the face and have patient tell you when they feel it

Question 31

Functions of the cerebral cortex

Answer 31

governing thought, memory, easoning, sensation, voluntary movement

Question 32

Exam findings associated with a positive Romberg sign/test

Answer 32

increased body sway, foot movement in the direction of a potential fall, or even falling when eyes are closed while standing with feet together.

Question 33

2 parts of the nervous system end of 24

Answer 33

central nervous system and peripheral nervous system

Question 34

Teaching testicular self-exam

Answer 34

do exam after warm bath or shower, roll each testicle between thumb and pointer fingers and feel for any bumbs or lumps or unusual features

Question 35

Expected normal findings of palpating the testes

Answer 35

should feel oval and firm (not hard) , should feel smooth with no bumbs, should have no pain

Question 36

Hypospadias

Answer 36

a congenital condition that occurs when the urethra doesn't develop properly in a male fetus

Question 37

Signs and symptoms of HSV-2 (herpes) related to STI

Answer 37

Blisters or sores on the genitals, rectum, or mouth Painful sores that may take a week or more to heal Flu-like symptoms like fever, body aches, or swollen glands Unusual or smelly genital discharge Burning when peeing Bleeding between periods Itching, tingling, or burning feeling in the vaginal or anal area Pain in the legs, buttocks, or vaginal area A feeling of pressure in the area below the stomach

Question 38

Patient teaching for prevention of STIs

Answer 38

WEAR CONDOMS

Question 39

Structures of the male genitalia end of 25

Answer 39

penis, scrotum, testes, epididymis, vas deferens, prostate, and seminal vesicles.

Question 40

Abnormal findings of prostate palpation that be suggestive of cancer end f 26

Answer 40

Bumps or hard areas in the prostate gland An asymmetrical boggy mass in the prostate gland,Difficulty urinating Weak or interrupted urine flow Frequent urination, especially at night Pain or burning during urination Blood in the urine or semen Pain when ejaculating Erectile dysfunction Pain or stiffness in the lower back, pelvis, hips, or upper thighs

Question 40

Common symptoms of benign prostatic hypertrophy

Answer 40

Frequent or urgent need to pee, also called urination. Peeing more often at night. Trouble starting to pee. Weak urine stream, or a stream that stops and starts. Dribbling at the end of urination. Not being able to fully empty the bladder.

Question 40

Positioning patient for rectal exam

Answer 40

The patient lies on the left side with the buttocks near the edge of the examining table or bedside with the right knee and hip in slight flexion.

Question 41

General recommended guidelines for pap smear screening

Answer 41

start recieving pap smear at age 21 to 29 every 3 years

Question 42

Physiologic causes of stress incontinence

Answer 42

eakening of the pelvic floor muscles

Question 43

Signs and symptoms of HSV-2 (herpes) related to STI

Answer 43

Blisters or sores on the genitals, rectum, or mouth Painful sores that may take a week or more to heal Flu-like symptoms like fever, body aches, or swollen glands Unusual or smelly genital discharge Burning when peeing Bleeding between periods Itching, tingling, or burning feeling in the vaginal or anal area Pain in the legs, buttocks, or vaginal area

Question 44

Menorrhagia

Answer 44

a menstrual period that is abnormally heavy or prolonged

Question 45

Common symptoms related to menopause

Answer 45

hot flashes, trouble sleeping, mood changes, night sweats

Question 46

Use of oral contraceptives—what would you want to include in obtaining information/health history regarding a woman who wishes to begin use of oral contraceptives

Answer 46

number of partners, practices, any preference, how often, past STI tests