D120 Study Guide Questions with 100%
Correct Answers
A young woman is complaining of tenderness and burning of her vulva. On exam, the
vulva is edematous and excoriated. The FNP performs a wet mount preparation of
vaginal secretions. It reveals pseudohyphae and spores. What is the diagnosis for this
patient?
vulvovaginal candidiasis;
Pseudohyphae and spores on the wet mount with potassium hydroxide are diagnostic for
candida infection.
A young woman presents with complaints of irritation in the vaginal area. This is the
first time this has occurred. On exam, the cervix is inflamed and friable. Flagellated
protozoa are seen on the wet mount. What is the most likely diagnosis?
trichomoniasis;
Flagellated protozoan confirms the diagnosis of trichomoniasis.
A 21-year-old female patient presents for her first well-woman exam. She has never
been sexually active. Her family history and past medical history are negative for any
gynecologic diseases. Her menses occur every 28 days, lasting 5 days, with a relatively
moderate flow and no significant dysmenorrhea. Her physical exam should include
which tests?
Pap smear;
The recommended age for females to begin screening pap smears is at the age of 21,
regardless of sexual activity history. STD screening is not necessary as the patient is not
sexually active. Hemoccult and mammogram are not recommended for this age group of
patient.
,A young adult patient presents with a history of vaginal itching and heavy white
discharge. The patient denies a history of sexual activity. On exam, the FNP finds a red,
edematous vulva and white patches on the vaginal walls. The discharge has no odor.
What finding would the FNP suspect in the patient's history?
recent antibiotic use;
Almost half of all vaginal infections are caused by candida. The majority of women who
develop this infection have recently taken antibiotics.
A 46-year-old female patient is being seen in the clinic by the FNP. She was last seen 2
weeks ago for an upper respiratory tract infection and was treated with amoxicillin
250mg PO TID x 10days. She completed her medication last week, but now complains
of vaginal itching and thick white discharge. She states that she has never experienced
such intense itching. She is in a mutually monogamous relationship. Her LMP was 2
weeks ago. Her partner had a vasectomy. Wet mount shows negative whiff test, rare
clue cells, positive lactobacilli, positive hyphae, positive spores, few WBCs, and no
trichomonads. She is leaving tomorrow for a week long cruise. She is not taking any
medications and has no known drug allergies. The FNP should prescribe which of the
following?
fluconazole 150mg 1 tab PO x1 dose;
Fluconazole is approved for a single-dose oral treatment of uncomplicated vulvovaginal
candidiasis. It is the most convenient treatment for this patient who will is unlikely to be
compliant with vaginal creams given the upcoming travel.
A 25-year-old patient presents with complaints of malodorous vaginal discharge, which
is white and watery. She douches with vinegar and water every 2 weeks. She uses a
diaphragm for contraception and has been sexually active with her boyfriend for two
,years, using condoms for STD prevention. Her LMP was 1 week ago, and there are no
noted changes in her normal menstrual pattern. Her wet mount shows a positive whiff
test, clue cells too numerous to count, no lactobacilli, no hyphae, no spores. What is the
diagnosis and treatment for this patient?
bacterial vaginosis: metronidazole vaginal gel 1 applicator HS x 5 days.;
Metronidazole vaginal gel is the treatment of choice for bacterial vaginosis in the non-
pregnant female. The presence of clue cells, and the associated malodorous discharge and
absence of lactobacilli are markers for the diagnosis of bacterial vaginosis.
A 41-year-old patient is seen for her 6-week postpartum exam by the FNP. She is
breastfeeding without difficulty and plans to continue for a year. She wants to begin
using contraception and plans no further pregnancies. Which of the following is not an
appropriate choice for this patient?
Combination OC;
Combination OCs are not recommended for breastfeeding mothers because of the effect of
estrogen on milk supply. Progestin only OCs, IUDs, and Depo-Provera are acceptable
methods of contraception for breastfeeding mothers.
Which two patients should have a Pap smear test performed by the FNP?
Based on USPSTF guidelines, pap smear tests should be performed on female patients aged
21 and older, regardless of sexual activity.
What finding is considered a normal surface characteristic of the cervix?
Small, yellow, raised round area on the cervix.
Red patches with occasional white spots.
, Friable, bleeding tissue at the opening of the cervical os.
Irregular granular surface with red patches.
Small, yellow, raised round area on the cervix.;
A nabothian cyst is a small, white or yellow, raised round area on the cervix and is
considered to be a normal variant.
The FNP is reviewing the lab results of a 28-year-old patient recently seen for a pap
smear. Classification is high-grade squamous intraepithelial lesion, endocervical cells
seen, and adequate smear. The FNP phones the patient and tells her which of the
following?
Your pap smear was normal. Follow up in one year or sooner if problems arise.
Your pap smear shows invasive cancer. I would like you to see a gynecologic oncologist
for treatment.
Your pap smear shows abnormal tissue that needs to be evaluated. Please schedule an
appointment for a colposcopy.
Your pap smear shows a minor abnormality. Sometimes this can signify a disease
process that is just beginning. Please schedule a follow up pap smear in 4 months.
Your pap smear shows abnormal tissue that needs to be evaluated. Please schedule an
appointment for a colposcopy.;
The pap smear is a screening test for cervical cancer and precancerous states. The diagnostic
Correct Answers
A young woman is complaining of tenderness and burning of her vulva. On exam, the
vulva is edematous and excoriated. The FNP performs a wet mount preparation of
vaginal secretions. It reveals pseudohyphae and spores. What is the diagnosis for this
patient?
vulvovaginal candidiasis;
Pseudohyphae and spores on the wet mount with potassium hydroxide are diagnostic for
candida infection.
A young woman presents with complaints of irritation in the vaginal area. This is the
first time this has occurred. On exam, the cervix is inflamed and friable. Flagellated
protozoa are seen on the wet mount. What is the most likely diagnosis?
trichomoniasis;
Flagellated protozoan confirms the diagnosis of trichomoniasis.
A 21-year-old female patient presents for her first well-woman exam. She has never
been sexually active. Her family history and past medical history are negative for any
gynecologic diseases. Her menses occur every 28 days, lasting 5 days, with a relatively
moderate flow and no significant dysmenorrhea. Her physical exam should include
which tests?
Pap smear;
The recommended age for females to begin screening pap smears is at the age of 21,
regardless of sexual activity history. STD screening is not necessary as the patient is not
sexually active. Hemoccult and mammogram are not recommended for this age group of
patient.
,A young adult patient presents with a history of vaginal itching and heavy white
discharge. The patient denies a history of sexual activity. On exam, the FNP finds a red,
edematous vulva and white patches on the vaginal walls. The discharge has no odor.
What finding would the FNP suspect in the patient's history?
recent antibiotic use;
Almost half of all vaginal infections are caused by candida. The majority of women who
develop this infection have recently taken antibiotics.
A 46-year-old female patient is being seen in the clinic by the FNP. She was last seen 2
weeks ago for an upper respiratory tract infection and was treated with amoxicillin
250mg PO TID x 10days. She completed her medication last week, but now complains
of vaginal itching and thick white discharge. She states that she has never experienced
such intense itching. She is in a mutually monogamous relationship. Her LMP was 2
weeks ago. Her partner had a vasectomy. Wet mount shows negative whiff test, rare
clue cells, positive lactobacilli, positive hyphae, positive spores, few WBCs, and no
trichomonads. She is leaving tomorrow for a week long cruise. She is not taking any
medications and has no known drug allergies. The FNP should prescribe which of the
following?
fluconazole 150mg 1 tab PO x1 dose;
Fluconazole is approved for a single-dose oral treatment of uncomplicated vulvovaginal
candidiasis. It is the most convenient treatment for this patient who will is unlikely to be
compliant with vaginal creams given the upcoming travel.
A 25-year-old patient presents with complaints of malodorous vaginal discharge, which
is white and watery. She douches with vinegar and water every 2 weeks. She uses a
diaphragm for contraception and has been sexually active with her boyfriend for two
,years, using condoms for STD prevention. Her LMP was 1 week ago, and there are no
noted changes in her normal menstrual pattern. Her wet mount shows a positive whiff
test, clue cells too numerous to count, no lactobacilli, no hyphae, no spores. What is the
diagnosis and treatment for this patient?
bacterial vaginosis: metronidazole vaginal gel 1 applicator HS x 5 days.;
Metronidazole vaginal gel is the treatment of choice for bacterial vaginosis in the non-
pregnant female. The presence of clue cells, and the associated malodorous discharge and
absence of lactobacilli are markers for the diagnosis of bacterial vaginosis.
A 41-year-old patient is seen for her 6-week postpartum exam by the FNP. She is
breastfeeding without difficulty and plans to continue for a year. She wants to begin
using contraception and plans no further pregnancies. Which of the following is not an
appropriate choice for this patient?
Combination OC;
Combination OCs are not recommended for breastfeeding mothers because of the effect of
estrogen on milk supply. Progestin only OCs, IUDs, and Depo-Provera are acceptable
methods of contraception for breastfeeding mothers.
Which two patients should have a Pap smear test performed by the FNP?
Based on USPSTF guidelines, pap smear tests should be performed on female patients aged
21 and older, regardless of sexual activity.
What finding is considered a normal surface characteristic of the cervix?
Small, yellow, raised round area on the cervix.
Red patches with occasional white spots.
, Friable, bleeding tissue at the opening of the cervical os.
Irregular granular surface with red patches.
Small, yellow, raised round area on the cervix.;
A nabothian cyst is a small, white or yellow, raised round area on the cervix and is
considered to be a normal variant.
The FNP is reviewing the lab results of a 28-year-old patient recently seen for a pap
smear. Classification is high-grade squamous intraepithelial lesion, endocervical cells
seen, and adequate smear. The FNP phones the patient and tells her which of the
following?
Your pap smear was normal. Follow up in one year or sooner if problems arise.
Your pap smear shows invasive cancer. I would like you to see a gynecologic oncologist
for treatment.
Your pap smear shows abnormal tissue that needs to be evaluated. Please schedule an
appointment for a colposcopy.
Your pap smear shows a minor abnormality. Sometimes this can signify a disease
process that is just beginning. Please schedule a follow up pap smear in 4 months.
Your pap smear shows abnormal tissue that needs to be evaluated. Please schedule an
appointment for a colposcopy.;
The pap smear is a screening test for cervical cancer and precancerous states. The diagnostic
