NR 602 Week 8 Final Exam Solved

NR 602 Week 8 Final Exam Solved 1. Turner’s syndrome can be suspected when the patient has primary amenorrhea and Short stature and webbed neck 2. A 21-year-old woman comes into your practice seeking birth contro ...

NR 602 Week 8 Final Exam Solved 1. Turner’s syndrome can be suspected when the patient has primary amenorrhea and Short stature and webbed neck 2. A 21-year-old woman comes into your practice seeking birth control. She has only recently become sexually active and has consistently used condoms for safe sex. Your history reveals that she does not use tampons during her menses and has very little knowledge about female reproductive anatomy. Based on this information, which of the following birth control choices would be least likely to meet her needs for contraceptive management? Nuvaring 3. The most common type of invasive breast carcinoma is Infiltrating ductal 4. Measuring waist circumference is most appropriate when the client’s BMI places her in which of the following categories? Overweight 5. The American Cancer Society recommends yearly mammogram screening beginning at age:45 6. A dancer from an adult club down the street comes in for a renewal of her birth control pill prescription. She says that everything is fine. On examination, you find grayish-white vaginal discharge, greenish cervical discharge and cervical motion tenderness. All of the following differential diagnoses except? Gonorrhea, Interstitial cystitis, Bacterial vaginosis, chlamydia 7. Which of the following contraception would be best for a woman with sickle cell anemia? Progestin-only oral contraceptives 8. During a vaginal examination, you observe bulging of the anterior wall when you ask the patient to bear down. This is most likely a Cystocele 9. When examining the cervix of a 20-year-old-female, you note that most of the cervix is pink but there is a small ring of dark-red tissue surrounding the os. This is most likely? The squamocolumnar junction 10. A sexually active 18-year-old presents with postcoital spotting, dysuria, and a yellow discharge. On exam you find her cervix is erythematous and bleeds with contact. The most likely diagnosis is Chlamydia 11. A 68-year-old female had her last cervical cancer screening done at age 65 and results were normal. She has no history of abnormal screenings. She has recently started having sexual intercourse with a new male partner and asks if she should start having cervical cancer screening again. An appropriate answer would be that she: Does not need to resume either Pap tests or HPV testing 12. A 22-year-old experiences six months of amenorrhea. Laboratory test results include normal prolactin and thyroid-stimulating hormone and negative pregnancy test. The next action will to: (Answer)Administer a progestin challenge test 13. A nurse practitioner is screening a female for prescribing contraception for the first time. Which of the following conditions is an absolute contraindication to estrogen-containing contraception? Thromboembolism 14. Characteristics of polycystic ovary syndrome include: Premenarchial onset, obesity, hyperinsulinemia 15. According to USPSTF recommendations, an 80-year-old female should have: Neither a clinical breast examination nor a screening mammogram 16. A 36-year-old- is seen in your office on day 18 of her cycle for her routine annual examination. She has no complaints. Pelvic exam reveals a 9-cm- firm pelvic mass anterior to the uterus. The most likely diagnosis is: Benign cystic teratoma 17. Typical characteristics of vulvodynia include: Constant vulvar burning and discomfort 18. If you diagnose a cervical gonoccocal infection, which other infection is probably present? Chlamydia 19. HPV testing is indicated for a (n) 30-year-old-female with no history of genital warts as adjunct to routine Pap test. 20. A vaginal pH less than 4.5 is an expecting finding in a: Healthy reproductive-age woman 21. USPSTF recommendations for routine breast cancer screening include: Biennial mammograms starting at age 50 22. The new ACOG pap smear guidelines reflect a change in all of the following except: The age at which Pap smears are initiated, The frequency of Pap smear screening, The follow-up to abnormal Pap smear results, The endpoint for pap smear testing 23. A 16-year-old- woman has not yet begun menstruating but does have pubic hair. She is best described as having: Primary amenorrhea 24. Dysfunctional uterine bleeding is usually associated with Anovulation 25. A 17-year-old client presents at the clinic with the following reason for seeking care. “I have been sick for three days. I feel sick to my stomach and I have diarrhea”. Which of the following would be most appropriate to document as her reason for her visit/chief complaint? “I feel sick to my stomach and I have diarrhea” 26. First line treatment for polycystic ovary syndrome is: A combination of diet modification, weight loss, and stress management 27. A 24-year-old woman presents with complaints of nontender mass in her left breast that does not change with the menstrual cycle. On examination, you note a freely movable, 0.5 cm x 1 cm, firm, rubbery nontender mass. The most likely diagnosis is: Fibroadenoma 28. According to ACOG guidelines, which of the following physical examination and screening tests should be part of the routine well-woman visit every year for females ages 30 to 39 years? Clinical breast examination 29. In a premenopausal woman, the biggest heart attack risk factor is: Cigarette smoking 30. A 16-year-old patient comes the office because she has never had a menstrual period. She has normal breast development, scant pubic hair, and a blind vaginal pouch with no palpable uterus or ovaries. The most likely diagnosis: Androgen insensitivity/resistance syndrome 31. What is the position of the uterus when the cervix is on the anterior vaginal wall? Anteverted 32. A 26-year-old woman presents with multiple, painless, umbilicated papules on her mons pubis. The most likely diagnosis is: Molluscum contagiosum 33. A woman who is currently pregnant, has had two full-term deliveries, and had one first-trimester abortion would be considered. Gravida 4 para 2 34. Pelvic findings on examination of a 22-year-old nulliparous woman are uterus 7 cm in length and ovaries 3cmx2x1cm. These findings are consistent with: Normal size uterus and normal size ovaries. 35. A 66-year-old- woman with a history of pruritus presents with an ulceration of the vulva. The most likely diagnosis is: Vulvar carcinoma 36. Characteristic “strawberry spots” on the cervix may be seen with Trichomonas 37. A 45 year-old-female presents with complaint of lower abdominal pain with urinary urgency and frequency for the past three months. The pain is worse during sexual intercourse and relieved somewhat when she urinates. Physical exam reveals suprapubic tenderness as well as tenderness along the anterior vaginal wall and urethra. The remainder of her exam is normal. What best fits these findings? Interstitial cystitis/ painful bladder syndrome 38. Primary dysmenorrhea can best be treated with: Prostaglandin inhibitors 39. MRS. Jackson, age, 37 has been on birth control pills for approximately 15 years. She is a smoker, has a blood pressure of 110/70mmHg, and has lipid levels with normal limits. You advise that she should: Discontinue the birth control pills because of her smoking 40. The CDC recommendation for follow-up of a female treated for PID with a recommended outpatient regimen is: Re-examine patient with 72 hours after initiation of treatment 41. One of the leading causes of female infertility Stein-Leventhal syndrome is Polycystic ovary disease 42. Iris is a thirty-two-year-old married women with three children. She comes in for information on using the copper T intrauterine device (IUD) for contraception. Which of the following would be a contraindication to using this appliance? Prior ectopic pregnancy 43. A 26-year-old female has a Pap test report of ASC-US. This is her first abnormal Pap test. Recommended first steps in follow-up would include: Reflex HPV test now 44. A 22-year-old female presents with complaint of malodorous vaginal discharge and vulvar itching. On examination, a watery, yellowish-green vaginal discharge is noted along with vulvar and vaginal erythema. The most likely findings on a wet mount examination will be: Trichomonas 45. A patient taking metronidazole and cimetidine at the same time is at increased risk for: Bothersome side effects from the metronidazole 46. A 22-year-old-female has a Pap test report of HSIL. Recommended first steps in follow-up would include Colposcopy 47. The glands located posteriorly on each side of the vaginal orifice are the: Bartholin’s glands 48. The levonorgestrel-releasing IUD may be a better choice than the cooper-releasing IUD for a woman who has Dysmenorrhea 49. 58-year-old woman complaints of severe vulvar pruritus. On examination of the vulva, you note thinning of the epidermis and loss of pigmentation, as well as maculopapular lesions. You suspect the diagnosis may be: Lichensclerosus 50. A 24-year-old female presents to your office with a request for combination oral contraceptives. Her current medications include a bronchodilator for asthma. Management for this client should include advising her that: Combination oral contraceptives may potentiate the action of her bronchodilator