NR 602 Final Study Set
A 16yearold sexually active female has a fever, bilateral lower abdominal
pain,and malaise. A speculum and bimanual exam reveals adnexal tenderness.
The urinalysis is normal and cervical cultures are pending. What medications will the primary care
pediatric nurse practitioner prescribe for this patient? - ANS PID- she is Sexually active+Adnexal
Tenderness and negative for UTI.
Ceftriaxone, doxycycline, and metronidazole
Rational- This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg BID for 14 days
plus with or without Metronidazole 500 mg PO bid for 14 days.
4. A sexually active adolescent female tests positive for N. gonorrhea
and Chalmydia. She tells the primary care pediatric nurse practitioner that she
wants to be treated today since she is moving out of town the next day. What will the nurse practitioner
order?What is the treatment for her - ANS Ceftriaxone 250 mg IM and azithromycin 1 g PO one time
each
Rational- Remember the G in Gonorehea for or Ceftriaxone and Chlamydia you can give either
Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is moving she are giving this
combination.
A 14yearold female has menometrorrhagia with moderate increase in menstrual flow and irregular
periods. Her hemoglobin is 13.1 g/dL. How will this be managed? - ANS Iron supplementation and
prostaglandin inhibitors
Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is 11.9-15. It is better
to give Iron because of the bleeding and for pain reliefe Prostoglandins such as Ibuprofen.
,An adolescent female has heavy periods that are also irregular. The physical exam is normal. A complete
blood count reveals a hemoglobin of 8.9 g/dL. What test will the primary care pediatric nurse
practitioner order next? - ANS Coagulation studies
Rational-The normal Hemoglobin range is 11.9-13.1 and she is outside the range. We need to look for
reasons of this.
An adolescent female has periods every 30 days that are consistently
heavy and last from 5 to 8 days. What is her diagnosis? - ANS Menorrhagia-
Rationale- The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8 days. She is
consistant with when her periods start so it won't be menometrorrhagia because that is irregular
periods.
A 16yearold female has not had a menstrual period yet and is concerned. She
denies sexual activity. An exam reveals an adult sexual maturity rating.
Which laboratory test will the primary care pediatric nurse practitioner order initially? - ANS Pregnancy
Test
Rationale- All people lie and the number one reason for Ammenorrhea is pregnancy. After I rule out that
then I can look at other things such as nutrition, is she an athlete and is it Primary Amenorrhea which is
failure to have a period for 3 years or creast development or by age 15. or Secondary Anemia which is
no menstrual periods for 3 months or absent of period for 6 months for those on irregular periods.
A 16yearold female reports breast tenderness and a "lump." The primary care pediatric nurse
practitioner palpates a small fluidfilled mass in her right breast. - ANS Order an Ultra Sound of Breast
Rationale- First thing you always do is order an ultra sound first to determine reason. Most girls this age
do not have breast cancer.
, A 15yearold n female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she isn't sure she wants to
keep the baby. What will the nurse practitioner do first? - ANS Determine the state mandated reporting
laws.
Rationale- Each state has different laws on reporting to parents about STIs and Pregnancy.
A 17yearold sexually active female who began having periods at age 14 reports having moderate to
severe dull lower abdominal pain associated
predominantly with periods but that occurs at other times as well. The history reveals a recent onset of
these symptoms. A pregnancy test is negative. Which course of action is most important? - ANS Perform
a full diagnostic workup to evaluate potential causes.
Rationale- This is not normal and needs more workup to determine the reason for it. She is sexually
active so this raises more concerns for other things that might be going on such as PID or an STI
A 16yearold female reports dull, achy cramping pa in in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
The adolescent is not sexually active. What is the treatment for this condition? - ANS Prostaglandin
inhibitor analgesics and a heating pad
Rationale -This is signs of normal period and the 1st line treatment is Prostoglandin and heating pad.
A schoolage female has had vulvovaginitis for 2 months. All cultures and tests .are negative, but the
symptoms persist after treatment with both topical antibiotics and oral amoxicillin. What is the next
course of action to treat this condition? - ANS Estrogen cream at bedtime for 2 to 3 weeks
A 4yearold female who has had two urinary tract infections has persistent dysuria and genital redness.
The physical exam reveals a thin, flat membrane from the posterior fourchette almost to the clitoris.
Which treatment is indicated? - ANS Use of estrogencontaining cream
A 16yearold sexually active female has a fever, bilateral lower abdominal
pain,and malaise. A speculum and bimanual exam reveals adnexal tenderness.
The urinalysis is normal and cervical cultures are pending. What medications will the primary care
pediatric nurse practitioner prescribe for this patient? - ANS PID- she is Sexually active+Adnexal
Tenderness and negative for UTI.
Ceftriaxone, doxycycline, and metronidazole
Rational- This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg BID for 14 days
plus with or without Metronidazole 500 mg PO bid for 14 days.
4. A sexually active adolescent female tests positive for N. gonorrhea
and Chalmydia. She tells the primary care pediatric nurse practitioner that she
wants to be treated today since she is moving out of town the next day. What will the nurse practitioner
order?What is the treatment for her - ANS Ceftriaxone 250 mg IM and azithromycin 1 g PO one time
each
Rational- Remember the G in Gonorehea for or Ceftriaxone and Chlamydia you can give either
Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is moving she are giving this
combination.
A 14yearold female has menometrorrhagia with moderate increase in menstrual flow and irregular
periods. Her hemoglobin is 13.1 g/dL. How will this be managed? - ANS Iron supplementation and
prostaglandin inhibitors
Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is 11.9-15. It is better
to give Iron because of the bleeding and for pain reliefe Prostoglandins such as Ibuprofen.
,An adolescent female has heavy periods that are also irregular. The physical exam is normal. A complete
blood count reveals a hemoglobin of 8.9 g/dL. What test will the primary care pediatric nurse
practitioner order next? - ANS Coagulation studies
Rational-The normal Hemoglobin range is 11.9-13.1 and she is outside the range. We need to look for
reasons of this.
An adolescent female has periods every 30 days that are consistently
heavy and last from 5 to 8 days. What is her diagnosis? - ANS Menorrhagia-
Rationale- The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8 days. She is
consistant with when her periods start so it won't be menometrorrhagia because that is irregular
periods.
A 16yearold female has not had a menstrual period yet and is concerned. She
denies sexual activity. An exam reveals an adult sexual maturity rating.
Which laboratory test will the primary care pediatric nurse practitioner order initially? - ANS Pregnancy
Test
Rationale- All people lie and the number one reason for Ammenorrhea is pregnancy. After I rule out that
then I can look at other things such as nutrition, is she an athlete and is it Primary Amenorrhea which is
failure to have a period for 3 years or creast development or by age 15. or Secondary Anemia which is
no menstrual periods for 3 months or absent of period for 6 months for those on irregular periods.
A 16yearold female reports breast tenderness and a "lump." The primary care pediatric nurse
practitioner palpates a small fluidfilled mass in her right breast. - ANS Order an Ultra Sound of Breast
Rationale- First thing you always do is order an ultra sound first to determine reason. Most girls this age
do not have breast cancer.
, A 15yearold n female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she isn't sure she wants to
keep the baby. What will the nurse practitioner do first? - ANS Determine the state mandated reporting
laws.
Rationale- Each state has different laws on reporting to parents about STIs and Pregnancy.
A 17yearold sexually active female who began having periods at age 14 reports having moderate to
severe dull lower abdominal pain associated
predominantly with periods but that occurs at other times as well. The history reveals a recent onset of
these symptoms. A pregnancy test is negative. Which course of action is most important? - ANS Perform
a full diagnostic workup to evaluate potential causes.
Rationale- This is not normal and needs more workup to determine the reason for it. She is sexually
active so this raises more concerns for other things that might be going on such as PID or an STI
A 16yearold female reports dull, achy cramping pa in in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
The adolescent is not sexually active. What is the treatment for this condition? - ANS Prostaglandin
inhibitor analgesics and a heating pad
Rationale -This is signs of normal period and the 1st line treatment is Prostoglandin and heating pad.
A schoolage female has had vulvovaginitis for 2 months. All cultures and tests .are negative, but the
symptoms persist after treatment with both topical antibiotics and oral amoxicillin. What is the next
course of action to treat this condition? - ANS Estrogen cream at bedtime for 2 to 3 weeks
A 4yearold female who has had two urinary tract infections has persistent dysuria and genital redness.
The physical exam reveals a thin, flat membrane from the posterior fourchette almost to the clitoris.
Which treatment is indicated? - ANS Use of estrogencontaining cream
