NR 509 ADVANCED PHYSICAL ASSESMENT
FINAL EXAM STUDY QUESTIONS AND
ANSWERS LATEST UPDATED CHAMBERLAIN
UNIVERSITY
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1. Multiple processes must take place in order for a male to sustain an erection. Various
cues stimulate sympathetic outflow from higher brain centers to the T11–L2 levels of the
spinal cord and parasympathetic outflow from S2 to S4 reflex arcs. Local vasodilatation
within the penis erectile tissue results from increased levels of which of the following?
Ans: Nitric oxide (NO) and cyclic guanosine monophosphate (cGMP)
2. The human papillomavirus (HPV) can cause genital warts in males and females as well as
cervical cancer in females. Vaccination against HPV is available and should be offered to
males between what ages?
Ans: 9–21 years
3. A 32-year-old male complains of a painless, cystic mass just above his left testicle. During
the physical examination, a strong flashlight is placed behind the scrotum through the
area in question and transillumination is noted. What is the most likely diagnosis?
Ans: Spermatocele
4. A 25-year-old graduate student presents to the clinic complaining of scrotal pain, which
has been increasing over the past 2 days. He is sexually active and has had unprotected
intercourse with multiple partners in the past couple of weeks. On examination, some
mild to moderate swelling of the scrotum on the right and tenderness with palpation of
the right testicle are notes. What is the most likely diagnosis?
Ans: Acute epididymitis
5. A 32-year-old elementary teacher requests a workup for infertility. He and his wife have
been trying to conceive for the last 2 years. He reports that his wife has been evaluated
and does not appear to have any infertility issues. The overall examination does not
reveal any significant abnormalities. He is of average height and weight and has normal
secondary sex characteristics of the genitalia. Of the following, which would be most
likely be abnormal and causing male infertility?
, lOMoAR cPSD| 42147428
Ans: Follicle-stimulating hormone (FSH)
6. While performing a physical examination on male patients, it is possible to palpate
multiple structures in relation to the inguinal canal and related hernias. Which of the
following is not palpable during an external examination of the abdominal wall or
inguinal region?
Ans: Internal inguinal ring
7. 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?
Ans: Male condoms
8. 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?
Ans: Fibroids
9. 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?
Ans : Prior pelvic inflammatory disease (PID)
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