Chapter 3 Exam Study Guide - Updated for Current Exam

Chapter 3 Exam Study Guide - Updated for Current Exam Hot flashes that occur during peri menopause are thought to be related to - answer - fluctuating estrogen level Which of the following physical exam findings in a 65 year old woman warrant further evaluation - answer - Inverted nipple Which of the following is not representative of the presentation of primary syphillis - answer - flu like symptoms A patient diagnosed with trichomoniasis is being treated with metronidazole. When teaching the patient about this medication, which of the following will the nurse practitioner include - answer - do not consume alcohol (reduce possibility of a disulfiram like reaction) The recommended time to initiate screening for cervical cancer in women is - answer - 21 years old The NP recognizes the following assessment findings as being consistent with Chalmydia (select all that apply) - answer - Vaginal discharge Cervical changes The NP is treating a 35 year old patient for primary herpes infection. The first line treatment option for primary herpes infection include A. Acyclovir 400mg TID for 7-10 days B. Valacyclovir 1g daily for 3 days C. Famciclovir 250mg BID for5 days D. No treatment needed - answer - A. Acyclovir 400mg TID 7-10 days (genital herpes) The NP examines a patient with complaints of foul smelling, frothy, copious and pale yellow to gray green vaginal discharge On exam, vulvogaginal irritation and cervical petechiae is noted. Based on this the most likely tx includes A. Fluconazole B. Metronidazole C. Clindamycin D. Azithromycin - answer - B. Metronidazole these findings are consistent with trichomoniasis, metronidazole is the first line tx of choice for protozoal infection Mary is a 36 year old women who complains of vaginal burning. The NP assess grayish white adherent vaginal discharge that had fishy odor. The discharge pH level is 5.1 and there is a positive whiff test. The treatment of choice is A. Fluconazole B. Metronidazole C. Clindamycin D. Oral doxycycline - answer - B. Metronidazole (-KOH is whiff test- bacterial vaginosis. Metronidazole is the first line tx for bacterial vaginosis) Jane is a 38 year old female who presents with non odorous thick, white, curd like vaginal discharge and vulvar itching. She is in a monogamous relationship. She was recently treated for a sinus infection. The most likely treatment includes which of the following A. Fluconazole 800mg single dose B. Metronidazole 500mg BID 7 days C. Clotrimazole cream D. Oral doxycycline - answer - Fluconazole 800mg for initial (yeast infection) A female patient is diagnosed with chlamydia. She has complaints of vaginal discharge and dysuria. Her male partner is asymptomatic. How should they be treated - answer - Doxycycline 100mg BID x7 days or azithromycin (exposed partner should be treated as well) A female patient is 31 year old. She has never had an abnormal PAP smear and has had regular screening since age 22. According to the AVS and ACOG guideline, if she has a normal PAP smear with HPV testing today, when should she have the next cervical cancer screening - answer - 5 years (HPV in 5 years, Pap smear ONLY STI can be in 3 years) A 53 year old woman who is taking HRT with conjugated estrogen, .45mg/ day with medroxyprogesterone acetate 1.5mg, has bothersome atrophic vaginitis symptoms. You would consider - answer - the addition of topical estrogen can be helpful (helps with dryness) Samantha is a 23 year old female presents with urinary burning, frequency and urgency. Urine dipsticks is positive for leukocytes and nitrates. Given that she has no medical hx and no other pertinent clinical findings, the recommended treatment of choice is - answer - Nitrofurantoin 100mg BID x 5 days (1st line tx for uncomplicated UTI) A 29 year old female patient with no medical history presented to the NP office with fever, chills and WBC casts and has been diagnosed with pyelonephritis. Which clinical finding would be consistent in this pat