Exam (elaborations)
NR 511 Final Test Questions and Answers Graded A+
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Exam of 16 pages for the course NR511 at NR511 (NR 511 Final Test)
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NR 511 Final TestIdentify the population most commonly affected by bacterial prostatitis - answer Acute -
Sexually active men 30 to 50 years
- Chronic bacterial prostatitis common in men older than 50 years old
- Athletes who run long distance are predisposed
- Complaints of fever, chills, LBP, malaise, arthralgia, myalgia, frequency, urgency,
dysuria, nocturia, and bladder outlet obstruction
o Chronic bacterial prostatitis- men over age 50 years of age. Symptoms often absent ,
perineal pain, lower abdomen pain, scrotal or penile pain, pain with ejaculation, dysuria,
irritative voiding
Discuss the physical exam characteristics of acute bacterial prostatitis - answerAcute
bacterial prostatitis- warm, tense, swollen , boggy and very tender prostate.
Most common pathogen Strep faecalis and staph aureus
Discuss how the Phren sign can differentiate between testicular torsion and epididymitis
- answerEpididymis characteristic is relief of discomfort with elevation of testis. Positive
Prehn's sign = pain relief.
Testicular torsion elevation of the affected testicle does NOT relieve the pain (Negative
Prehn's sign = pain is NOT relieved)
Epididymis Positive Prehn's sign = pain relief. Neg = no pain relief = testicular torsion).
Discuss common symptoms reported from a patient with BPH - answerAffects men age
40 years and older.
Obstructive symptoms include
• Decreased stream • Hesitancy
• Postvoid dribbling • Sensation of incomplete bladder emptying
• Overflow incontinence • Inability to voluntarily stop the urine stream
• Urinary retention • Straining
Irritative symptoms include
• Nocturia • Urinary frequency
• Urinary urgency • Dysuria
Urge incontinence
Erectile dysfunction should be assessed on patient taking finasteride.
,Discuss the hallmark characteristic of a varicocele - answerThe hallmark characteristic
of varicocele is the sensation that the testes feel like a "bag of worms."
Varicocele can be bilateral, but if it is unilateral it is almost always on the left side due to
the anatomy of the vasculature drainage in the testes.
Tortuous veins posterior and above testes can be seen with patient sitting upright
Venous engorgement may increase with Valsalva maneuver; resolves when patient lies
down.
Grade 1 varicocele is one that is palpable only when the patient performs the Valsalva
maneuver.
Grade 2 varicocele is palpable when the patient is standing.
Grade 3 varicocele may be assessed with light palpation and visual inspection
Identify the population most affected by testicular cancer - answerMales between the
ages of 15 and 35
Explain spinal stenosis - answerNarrowing of the spinal canal w/ compression of nerve
roots
- Congenital or acquired (age)
- Most commonly from enlarging osteophytes at the facet joints, hypertrophy of the
ligamentum flavum and protrusion/buldging of the intervertebral discs
- May produce symptoms by directly pushing on nerve or interrupting the blood supply
to nerve
Common source of chronic low back pain, seen most with aging. All older people have
some degree of this
Discuss common characteristics (subjective findings) of patients with lumbar spinal
stenosis - answer- Radicular complaints in calves, buttocks, upper thighs
- Pain w/ walking or prolonged standing
o Vascular claudication - pain stops w/ rest
o Psuedoclaudication - pain doesn't stop immediately at rest
- Short term relief by leaning forward/stooping
- Sometimes relief w/ sitting
- Pain in back/leg when sleeping on back at night
- Pain w/ walking/standing
8. Discuss common characteristics (objective findings) of patients with lumbar spinal
stenosis - answer- Muscle weakness
- Impaired proprioception
- Diminished reflexes
- Sensory changes (numbness/tingling)
, - Bowel or bladder symptoms
o Sphincter tone decreased
o Don't confuse w/ prostate problems in older men
Identify the red flags associated with back and neck complaints which warrant further
investigation - answerT-Trauma
U-Unexplained weight loss
N-Neurologic symptoms
A-Age>50
F-Fever
I-Iv Drug user
S-steroid use
H-Hx of CA (prostate, renal, breat, lung)
Define chronic pain - answer• Pain that extends beyond the expected period of healing
• Pain > 3 months in duration
• More generalized, less localized to the site of injury/initial complaint
• Referral patterns can shift in location, intensity, frequency & quality
• Pain does not change with movement, rest or time
• Usually reported as constant/continuous (less likely intermittent)
• Mood or current psychological status tends to affect/worsen c/o pain
Identify the number of joints involved in a poly-articular disorder - answerMonoarticular:
One joint
Periarticular: Two to four joints
Polyarticular: Four or more joints
Describe the four cardinal signs of joint inflammation - answer1. Erythema
2. Warmth
3. Pain
4. Swelling
DeQuervain's Tenosynovitis - answer- Inflammation involving the synovial sheaths and
tendons of the abductor pollicis longus and extensor pollicis longus, and brevis tendons
(snuff box)
- Pain at base of thumb or at the radial styloid process on abduction and extension of
the thumb or on radial side of wrist with lifting
- Generally seen in patients that perform pinch-grip activities like using hand tools,
sewing, assembly
- More often middle-aged women
DeQuervain's Tenosynovitis-Exam - answero Allen's test
o Phalen's test (negative)
o Tinel's sign (negative)
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