NUR 5120 Exam 1 Questions with 100% accurate solutions+ rationales 2026

nonmaleficience

do no harm

benefience

do good and promote wellness

autonomy

accept the choices of the patient

confidentiality

prevent disclosure of personal information

informed consent

educating patient on risks, benefit, and alternatives of procedure or intervention

truth telling

Providing enough honest information so that a patient can make an informed decision about his or her health care.

justice

treat all patients equally

subjective

anything the patient tells you

-symptoms

-ex) sore throat

objective

anything you can assess

-signs

-detected on physical exam/ measureable

-ex) fever

chief complaint

main reason why patient is there

-in the words of patient

HPI

story behind chief complaint

-chronological events

-patient's thoughts and feelings

-told in patient's own words

ROS

subjective information

-pertinent positives and negatives

pertinent positives

-symptoms that the patient has related to suspected disease

-ex) answered yes to having sore throat

pertinent negatives

s/sx you would expect to find with suspected disease that patient does NOT have

-ex) answered NO to having diarrhea

Assessment

your physical exam

-objective

-NOT ROS

consensual reaction (eye exam)

constriction of the pupil in one eye when light is shone in the other eye

PERRLA

pupils equal, round, reactive to light and accommodation

accomodation of the eye

the eye's ability to change the shape of its lense to focus on objects at different distances

-allows etes to adjust focus on near or distant objects

covergece

coordinated inward movement of the eyes when focusing on near objects

ABCDE of melanoma

Asymmetry: one half unlike other half

Border: ragged, notched, blurred

Color: more than 2 colors

Diameter: >6mm

Evolving characteristics: changing rapidly in size, sx, or morphology

skin with hypothyroidism

dry

eczema

-erythema

-scaling

-dry skin

-intense itching

whisper test

-go behind patient and whisper sentence

-tests for acuity and hearing loss

scotoma

spots in the visual field

rhinorrhea

runny nose

pityriasis rosea

-Christmas tree pattern

-oval lesions on the trunk in older children

tinea versicolor

-fungal rash

-hypo/hyper pigmented or tan round/oval macules

-causes discolored patches

psoriasis

plaquey, silvery

-lesions from plaque

-affect scalp, extensor surfaces of elbows, knees, umbilicus, and glueteal cleft

what to include in medical hx

-past surgery

-medical hx (hypertension)

-medications

-hospitalizations

-changes in family hx

stage 1 pressure ulcer

intact skin with localized area of nonblanchable erythema

stage 2 pressure ulcer

partial thickness loss of skin with exposed dermis

-ulcer, blister, abrasion

stage 3 pressure ulcer

full thickness skin loss

-adipose tissue is visible

-granulation tissue and rolled wound edges often present

stage 4 pressure ulcer

full thickness skin and tissue loss

-exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone

-can have tunneling

unstageable pressure ulcer

full thickness skin and tissue loss

-extent of tissue damage within the ulcer cannot be confirmed because it is obscured by slough or eschar

slough

yellow or white dead tissue

eschar

black or brown crusty tissue

deep tissue pressure injury

persistent nonblanchable deep red, maroon, or purple discoloration

alopecia areata

-hair shedding at the root

-sudden onset of clearly demarcated, usually localized, round or oval patches of hair loss

-leaves smooth skin without hair

-no visible scaling or erythema

tinea capitis

hair breaks along the shaft

-ringworm

-round scaling patches or alopecia

-may have black dots of broken hairs

impetigo

infection d/t bacteria

-appears bulbous or crusty and yellowed with some pus

-honey crusted, yellow

hives

urticaria

-described as a wheal

-lasts <24h

-circumscribed, raised lesion consisting of dermal edema

-comes and goes

-itchy

-changes shape

actinic keratosis

rough, scaly, crusty patches of skin

-flattened papule covered by dry scale

-d/t sun damage

-precursor to squamous cell carcinoma

-pink, red, or brown in discoloration

seborrheic keratosis

greasy, velvety scaling

-non melanocytic lesion (cannot use ABCDE)

-benign

-verrucous texture (wart-like)

-appears like a "stuck on" or flattened ball of wax

-may crumble and bleed if picked

-can be darkly pigmented

basal cell carcinoma

oval, pink, pearly papule

-most common cancer in the world

-pink patch that does not leave

-pink lesions that leave a depressed center with firm elevated border

-caused by UV exposure

squamous cell carcinoma

firm REDDISH appearing lesion

-often emerging in sun exposed areas

-feels rough or keratonic

-crusty, scaly, ulcerated

-can metastasize

Vertigo

sensation as if the room is spinning

1) positional

2) meunière disease

3) central vertigo

-usually problem of the inner ear (CN VIII - vestibular)

-accompanied by nystagmus and ataxia

positional vertigo

sudden onset when rolling onto affected side or tilting head up

-may have n/v and nystagmus

meunière disease

-disorder or inner ear channel

-sudden onset

-hours to days

-sensorineural hearing loss

-tinnitus

-feel pressure/fullness in affected ear

-hearing loss and nystagmus

central vertigo

-brain stem deficits present: dysarthria, ataxia, crossed motor/sensory deficits

causes of unilateral loss of vision

-vitreous hemorrhage (diabetes or trauma)

-macular degeneration

-retinal detachment

-retinal vein occlusion

-central renal artery occlusion

cataract

blurred vision

macular degeneration

central vision lost

glaucoma

increased intraocular pressure

-tunnel vision

PTSD

caused by a trigger of something traumatic

-re-experiencing trauma (nightmares or flashbacks)

-persistent negative alterations in arousal and activity

-avoidance or trauma-related stimuli

-hyperarousal: increased startle response, difficulty sleeping, irritability

GAD

generalized anxiety disorder

-can be genetic

-excessive worry and rumination over 4 week period

-comorbid with substance use and mood disorders

-can experience chest pain and hyperventilation

most common cause of oropharyngeal cancer

HPV

neuropathic pain

trauma directly to peripheral or CNS

-electric shock like, stabbing, burning, pins and needles

-CNS or spinal cord involvement from stroke or trauma

psychosomatic pain

pain caused or exacerbated by psychological factors such as stress, anxiety, depression, trauma

somatic pain

pain originating from musculoskeletal system (bones, muscles, joints)

-arthritis

-fractures, injuries

visceral pain

pain originating from internal organs

-heart, lungs, bladder

nociceptive pain

dull, pressing, pulling, throbbing, spasmodic, colicky

-activation of pain receptors in response to tissue damage or inflammation

-linked to damage to skin, musculoskeletal system, or viscera

-sensory nervous system is intact

-ex) arthritis, burn, cut, headache

idiopathic pain

no identifiable etiology

contact dermatitis

exposure to allergen like poison ivy

-linear lesions

seborrheic dermatitis

redness and scaling

-red, scaly, greasy patches of skin

-forehead and central face

-improve with moisturizer and mild topical steroids

atopic dermatitis

eczema

-crusted patches

-goes with asthma and food allergies

-erythema, scaling, dry skin, intense itching

nummular dermatitis

Chronic dermatitis in which there are inflamed, coin-shaped, crusted and scaling pruritic lesions.

rhus dermatitis

Delayed type IV allergic reaction to Poision Ivy, Oak, and Sumac

incontinence associated dermatitis

moisture-associated skin breakdown caused by prolonged contact of the skin with urine or feces

intertriginous dermatitis

inflammation of skin where two surfaces rub such as groin, beneath breasts, and underarm area

candida diaper dermatitis

bright red rash (beefy red plaques) with satellite lesions along the edges

-involve intertriginous folds

snellen chart:

first # indicates distance of the patient from the chart

-second # is distance at which the patient can read the line of the letters

-larger the second number, the worse the vision

-test one eye at a time

-patient is always positioned 20 ft from chart

chalazion

clogged duct

-gland is swollen

-more generalized than stye

-treat with warm compress

-not painful

-usually points inside the lid rather than on the lid margin like a stye

-can caused blurry vision

hordeolum

stye

-infection of eyelashes typically

-painful

-can have purulence (abx)

-abscess on eye

-inner or outer margin of eyelid

-normally from staph aureus

-red and tender to touch

blepharitis

inflammation of eyelid

-appears red, swollen, burning

-flakes or oily particles wrapped at base of eyelashes

-warm compress, abx, eye drops

xanthelasma

fatty deposits on eye from high cholesterol

-slightly raised, yellow, well-circumscribed cholesterol filled placques

-along nasal portions of one or both eyelids

-common in hyperlipidemia and biliary cirrhosis

otitis media

inflammation of middle ear

-tenderness behind ear

-can have purulent effusion with bacterial infection

-can cause conductive hearing loss

-can cause ruptured tympanic membrane

otitis externa

swimmers ear

-fluid stuck in canal and causes pain to canal

-movement or auricle and tragus is often only painful in this and not in otitis media

cholesteatoma

-fatty tissue inside ear drum

-rare

-mostly seen with perforation of tympanic membrane (growth behind it)

-smelly discharge

rediculopathy

disease of the nerve roots

-pinched nerve (spinal column compressed)

-pain, numbness/tingling, weakness

-herniated discs, spinal stenosis, tumors, trauma

-sharp shooting pain

schizophrenic affective disorder

combination of schizophrenia and a mood disorder (BPD, depression)

-persistent combination of psychotic sx (hallucinations, delusions) and mood sx (depression, mania, hypomania)

affect

observable mood of a person expressed through facial expression

-does not always match mood

mood

sustained emotion of the state

-how they feel

-does not always match affect

schizophrenia

thought/psychotic disorder

-grooming/personal hygiene may be deteriorated

-flat affect

-hallucinations vs illusions

hallucinations

false sensory perceptions occurring without any external stimulus

-ex) hearing a voice that isn't there

-no stimulus

illusions

misinterpretations of real external stimuli

-ex) mistaking a shadow for a person

-ex) mistaking car honk for voice

-misread stimulus

blocking (schizophrenia)

person's thought process and speech is suddenly and abruptly interrupted, leaving them unable to continue the sentence or thought

clanging (schizophrenia)

speech with choice of words based on sound rather than meaning

-ex) rhyming

derailment (schizophrenia)

tangential speech with shifting topics that are loosely connected or unrelated

-pt unaware of lack of association

echocholalia (schizophrenia)

repetition of words and phrases

incoherence (schizophrenia)

incomprehensible and illogical speech

-flight of ideas may produce this

neologisms

invented or distorted words

preservation

persistent repetition of words or ideas

ophthalmological emergency

something that needs to be noticed immediately

-changes in vision acuity

-any vision change (blurry, loss of vision, scotomas, flashing lights)

-eye pain, redness, tearing

-diplopia

otoscopic exam: what to look for

patency of ear canal

how to perform exam with otoscope

-straighten right ear canal --> UP and BACK away from head

-hold otoscope with right hand, brace fingers of right hand against pt face

-switch hands when examining left ear

dysthymic disorder

persistent depressive disorder

-characterized by depressive/ irritable mood lasting for at least 2 year with at least 2 depressive symptoms

mania

elation and euphoria

-accelerated and louder speech with this

-2 types: BPD and MDD

BPD

bipolar disorder

-depressive episodes and manic/hypomanic episodes

-increase in reckless behavior, expansive movement, euphoria, grandiosity, less sleep

hypomania

elevated mood, energy, and activity that is less severe than mania but can still cause impairment

-less severe form of mania

-seen in BPD

MDD

major depressive disorder

-can experience depression and mania/hypomania during a single mood episode

-can feel manic and energized but upset and hopeless at same time

-period of significant and persistent low moods

-must have 5 sx for most of the day for everyday for 2 weeks

-zung scale