NR 602 FINAL EXAM WEEK 8 POSS QUESTIONS LATEST UPDATE 2023
ACOG guidelines regarding well women exams
What is the ASCCP recommended management
... [Show More] for an ASCUS (atypical squamous cells of undetermined significance) pap result with a positive high-risk HPV 16 cotest in a 26-year-old woman without a history of abnormal pap smears?
• Colposcopy
A well-woman visit for an adolescent should include which of the following?
• A general health history focusing on reproductive and sexual health concerns (menses, gynecologic, and pregnancy related) and psychosocial (family related, peer related, emotional, and physical as well as related to abuse, drug use, and alcohol use) concerns
Physical exam, screening tests, and immunizations as indicated by the health history and gynecologic considerations for an external-only inspection of the genitalia
ACOG Pap smear guidelines
A Bethesda system Pap smear report that reads LSIL is most consistent with which classification?
• CIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as follow-up?
• Routine screening
A female patient is 35 years old. She has never had an abnormal PAP smear and has had regular screening since age
18. If she has a normal PAP smear with HPV testing today, when should she have the next cervical cancer screening?
• 5 years
A young sexually active client at the family planning clinic is advised to have a Papanicolaou (Pap) smear. She has never had a Pap smear before. What should the nurse include in the explanation of this procedure?
• The Pap smear can detect cancer of the cervix
Lab results on your 26-year-old patient show a negative Pap smear with a positive human papillomavirus (HPV) screen. Which procedure will be required next?
• Repeat Pap and HPV screen
Which of the following is not part of the criteria for an older woman to cease having any future Pap tests performed?
• Over 55 years of age
Amenorrhea (Primary and Secondary)
You are evaluating a 17-year-old Emily who presented with amenorrhea and normal secondary sex characteristics. The purpose of the progesterone challenge is to ascertain the presence of?
• Endogenous estrogen
A 17-year-old female patient presents with amenorrhea for 4 months she did experience menarche at age 15 but had not had a menstrual cycle since. On physical examination, it is noticed that she has normal secondary sexual characteristics. The nurse practitioner will consider a progesterone challenge to determine the presence of adequate
• Endogenous estrogen
A teenage patient presents with amenorrhea and moral secondary sex characteristics. A progesterone challenge is ordered. The purpose is to determine the presence of ?
• Endogenous estrogen
A 16year old girl who comes to your office with a history of secondary amenorrhea. She experienced menarche at age 10, regular cycles for 2 years. She has not menstruated now for 4 years. In your initial consideration of differential diagnoses, what is the most frequent etiology of this problem:
• Eating disorder
18yo female c/o secondary amenorrhea. On exam, there is normal secondary sex characteristics and normal genitalia. Pregnancy is ruled out. What would necessitate further eval?
• Galactorrhea
Primary amenorrhea is best described as:
• Failure to menstruation to occur by 13 yr
A nurse practitioner is caring for a woman with primary and secondary amenorrhea. The pelvic exam was normal. Which of the following may be the cause if etiology originates in the hypothalamus?
• Sheehan’s syndrome
American Cancer Society recommendations
A nurse practitioner is participating in a women’s health fair. When educating the women about risk factors for breast cancer, which of the following statements is incorrect?
• Fibrocystic breast disease
When educating women about breast cancer risk factors, which statement is incorrect?
• Fibrocystic breast disease
A woman with lobular carcinoma in situ has a relative risk of developing invasive breast cancer of
• 8.0
Androgen insensitivity/resistance syndrome
Changes in hormonal regulation during menopause result in the gradual cessation of menstruation. From which gland is Androstenedione secreted?
• Adrenals
ASCUS/HSIL results from Paper Test Report
A Pap smear result of atypical squamous cells of undetermined significance—rule out high-grade squamous intraepithelial lesion (ASCUS r/o HGSIL) will require which procedure next?
• Colposcopy
A Pap smear result of atypical squamous cells of undetermined significance (ASCUS) will require which procedure next?
• Follow up pap smear
Bartholin glands and cysts
A 25-year-old presents with a report of a very tender area just near her introitus and to the left of her perineum. Very painful sex is how she knew "something wasn't right." She showered and when washing, she felt a "pea-sized" painful lump on the left side of her "bottom." She tells you she looked at it with a mirror and it was very small, but now it is the size of a ping-pong ball and getting worse.
When you inspect her external genitalia, you are amazed at the size and appearance of the "lump."
You note what appears to be an abscess on the left medial side of the labia minora, and there is some edema extending into the perineum. Your diagnosis for this presentation is:
• Bartholin’s cyst
You explain to this young woman what this "lump" is and let her know you will be referring her to a gynecologist you consult with regularly. You explain to her the likely treatment as follows:
• A possible incision might be necessary and a catheter placed for two to four weeks to allow for drainage and appropriate healing.
A client at the women's health clinic complains of swelling of the labia and throbbing pain in the labial area after
sexual intercourse. For what condition does the nurse anticipate the client will be treated?
• Bartholinitis
25yo female c/o tender area near her introitus and to the L of her perineum. Very painful sex was first sign. Initially bump was very small, but now is ping-pong ball size. On exam, abscess is present on L medial side of labia minora and there's edema extending into perineum. What is dx?
• Bartholin’s cyst
Which of the following choices represents a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass?
• Bartholin’s cyst
A nurse practitioner instructor is reviewing the anatomy of the external genitalia. At the opening of the vagina are the Bartholin's glands. Which of the following describes the function of these glands?
• Production of alkaline secretions for sperm viability
BMI
CDC recommendations regarding STDs and PID
Cervical cancer screening
A 23-year-old women presents to your practice with a chief complaint of postcoital bleeding. Which of the following would NOT be included in the initial assessment of this patient?
• Uterine biopsy
a nurse practitioner is educating a woman who has a colposcopy ordered. Which of the following most accurately describes a colposcopy?
• A procedure that visualizes the vaginal, vulvar or cervical epithelium with magnification to identify abnormal areas that may need to be biopsied
A 33-year-old women presents to your clinic complaining of a dark brown watery vaginal discharge and postcoital bleeding. There is a strong history of multiple unprotected sexual encounters. Which of the following findings on examination would be suspicious for cervical cancer?
• A very firm, easily friable cervix
A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the client confides that her mother died of endometrial cancer 1 year ago and says that she is afraid that she will die of the same cancer. Which risk factor stated by the client after an education session on risk factors indicates that further teaching is needed?
• Late onset menarche
The frequency for cervical screening depends on the patient and her age. What is the longest recommended time interval between cervical screens for patients who are 65 years-old or younger?
• 5 years
What is the leading cause of death from a gynecologic malignancy in American women?
• Cervical cancer
Cervix/Uterus examination
A 49-year-old female patient presents with a chief complaint of dark, watery brown vaginal discharge. Part of the differential diagnosis includes that of cervical cancer. Which of the following best describes what might be visualized?
• Ulcerated firm cervix
A nurse practitioner is completing a speculum exam on a female patient. Which of the following findings world be considered a normal surface characteristic of the cervix?
• Small, yellow, raised around area on the cervix
In collection of a specimen for a PAP smear, how is the endocervical specimen collected?
• After the ectocervical specimen with a brush
Cimetidine
Condyloma acuminate
Treatment options for patients with condyloma acuminatum include:
• Imiquimod (aldera)
Which of the following best describes lesions associated with condyloma acuminatum?
• Verruciform
Treatment options for patients with condyloma acuminatum include all of the following except:
• Topical acyclovir
All of the following findings are associated with secondary stage of an infection by the organism Treponema pallidum except :
• Condyloma acuminate
Patient education for condylomata acuminata should include all the following except:
• Treatment and elimination of visible warts is a sign of cure, and transmission will not occur
Jenna was evaluated and diagnosed with condyloma acuminatum. Treatment options for Jenna will include all of
the following except:
• Topical acyclovir
Condyloma lata
Which condyloma do we see in syphilis?
• Condyloma lata-flat
Contraceptives
the cytology (Pap smear) result for a 21-year-old sexually active student whose partner uses condoms inconsistently shows a large amount of inflammation. Which of the following is the best follow-up?
• Call the patient and tell her that she needs return to the clinic for chlamydia and gonorrhea testing
A college freshman who is using oral contraceptives calls the nurse practitioner's office asking for advice. She forgot
to take her pills 2 days in a row during the second week of the pill cycle and wants to know what to do. What is the best advice?
• Take 2 pills today and two pills tomorrow, and have your partner use condoms for the rest of the pill cycle
A 17-year-old high school student is considering her birth control options. She wants to know more about Seasonale.
Which of the following statements is false?
• It is a progesterone only method of birth control and does not contain estrogen
A 35-year-old smoker is being evaluated for birth control choices. The patient has a history of pelvic inflammatory disease (PID) along with an embolic episode after her last pregnancy. Which of the following methods of birth control would you recommend?
• Condoms and the vaginal sponge (TODAY sponge)
A 20-year-old woman visiting the clinic says that she wishes to begin using depot medroxyprogesterone acetate (Depo-Provera) as a form of birth control. What important information should the nurse include when teaching the client about Depo-Provera?
• Calcium intake and exercise should be increased because of the possible loss of bone mineral density with increasing duration of use
A woman questions the nurse about the effectiveness of oral contraceptives. What most important factor about the
effectiveness of oral contraceptives should be included in the reply to this question?
• User motivation
A female client who has been sexually active for 5 years is found to have gonorrhea. The client is upset and asks the nurse, "What can I do to keep from getting another infection in the future?" Which statement by the client indicates that the teaching by the nurse was effective?
• My partner has to use a condom all the time
Contraceptives that contain estrogen-like and/or progesterone-like compounds are prepared in a variety of forms. Which contraceptives should the nurse tell clients have a hormonal component?
• Oral drugs, transdermal agents
A client seeking advice about contraception asks a nurse about how an intrauterine device (IUD) prevents pregnancy. How should the nurse respond?
• It produces a spermicidal intrauterine environment
A nurse is teaching a group of women about the side effects of different types of contraceptives. What frequent side effect associated with the use of an intrauterine device (IUD) should the nurse discuss during the teaching session?
• Excessive menstrual flow
A nurse is teaching a female client about the side effects of estrogen in an oral contraceptive. Which common side effect identified by the client indicates to the nurse that the teaching was effective?
• Nausea [Show Less]