Women-s Health Actual Exam Questions with 100% Verified Answers

Women-s Health Actual Exam Questions with 100% Verified Answers 1. A 30-year-old female presents with lower abdominal pain. The nurse practitioner immediately considers an ectopic pregnancy as the cause. Which factor listed below does NOT increase her risk of an ectopic? A) Prior history of ectopic pregnancy B) IUD use C) History of PID D) Age - ANSWER Age 2. A patient asks the NP's advice about an herb to help with her hot flashes. The NP knows these: A) are safe to use in all patients B) may be contraindicated in patients with history of breast cancer C) substances have a mild estrogenic effect and will halt hot flashes D) help prevent osteoporosis - ANSWER may be contraindicated in patients with history of breast cancer 3. A patient who is 35 years old has identified a small, discrete mass in one breast. How should this be evaluated? - ANSWER Order a mammogram and ultrasound to assess the mass 4. Clinical evaluation of a breast mass begins with a good history of the mass and a physical exam of the breasts, lymph nodes, neck, and chest wall. While asking about whether the mass changes with menses is a good question in history, a mammogram should be the first radiographic assessment in females with breast complaints who are over age 30. This patient is 35 years old. An ultrasound is used for evaluation of a focal abnormality in a breast, especially if it has been identified on a mammogram. In this patient, both are prudent since there is a discrete, palpable mass. Re-assessing the mass 3-10 days after next menses may be appropriate for a female younger than age 30 depending on her history and physical exam. A diagnosis of osteoporosis can be made when: - ANSWER bone mineral density is 2.5 standard deviations below the mean 5. Osteoporosis can be diagnosed with a bone mineral density test (BMD). The technique used is a dual energy x-ray absorptiometry (DXA). This is the most common clinical tool used to diagnose osteoporosis. Osteoporosis can also be diagnosed when there is a fragility fracture. This can be identified on x-ray. In an absence of trauma, a fragility fracture may indicate osteoporosis, multiple myeloma or other diseases. BMD that is 2.5 or more standard deviations below the young adult mean (or T-score of -2.5 or less) constitutes a diagnosis of osteoporosis. The recommended time to initiate screening for cervical cancer in women is: - ANSWER at the age of 21 years 6. Prior to 2009, the recommendation for cervical cancer screening was by age 18 years or 3 years after first sexual intercourse. American Cancer Society (ACS) and American College of Obstetricians and Gynecologists (ACOG) have updated this. The current recommendation for cervical screening is age 21 years. Cervical cancer is considered extremely rare in patients younger than 21 years. A 16 year-old female is diagnosed with primary dysmenorrhea. She has taken over the counter ibuprofen in 800 mg increments every 8 hours during menses for the past 3 months with minimal relief of symptoms. What intervention will provide greatest relief of dysmenorrhea symptoms? - ANSWER Combined oral contraceptives 7. A 17 year-old presents with complaints of dysmenorrhea. What finding below suggests that this is secondary dysmenorrhea? - ANSWER Dysmenorrhea is not limited to menses 8. Primary dysmenorrhea has been attributed to prolonged uterine contractions that cause ischemia to the myometrium. Some females with secondary dysmenorrhea may have a normal pelvic exam, but they tend to have an enlarged irregularly shaped uterus or tender uterus on exam. Most secondary dysmenorrhea is due to endometriosis. On physical exam, patients with secondary dysmenorrhea can have displacement of the cervix, cervical stenosis, adnexal enlargement, or nodular and/or tender uterosacral ligaments. A patient who takes oral contraceptive pills is at increased risk of: - ANSWER gallbladder disease 9. One of the major components of gallstones is estrogen. A patient with underlying gallbladder disease should not receive oral contraceptives (OC) since they will increase estrogen exposure and theoretically, formation of gallstones. Depression, hypothyroidism and varicose veins do not increase the risk of gallbladder disease. What recommendation should be made to a 70 year-old female regarding mammograms? - ANSWER She should have them annually as long as she has a reasonable life expectancy 10. Ovarian cancer may present as an adnexal mass, pelvic or abdominal symptoms and a variety of others. Postmenopausal bleeding (PMB) is a very uncommon presentation of ovarian cancer, but can present this way. In women with PMB, other causes of uterine pathology should be evaluated before considering ovarian pathology. In early menopause, the most common etiology is atrophy of the endometrium or vaginal mucosa. This patient is postmenopausal for approximately 2 years. Other common causes of PMB are polyps, fibroids, and endometrial hyperplasia. After a vaginal exam, a patient received a prescription for metronidazole. What was her likely diagnosis? - ANSWER Trichomonas 11. Trichomonas can be treated with metronidazole orally. This is usually effective and is generally well tolerated as long as the patient avoids alcohol. Alcohol in the presence of metronidazole can produce a disulfiram reaction. Another medication used to treat trichomonas is tinidazole. The exact mechanism of tinidazole is unknown, but is an antiprotozoal. A patient asks the NP's advice about an herb to help with her hot flashes. The NP knows these: - ANSWER may be contraindicated in patients with history of breast cancer 12. The herb that the patient is asking about is probably black cohosh, Actaea racemosa. It is a phytoestrogen. This means that it provides estrogen from a plant source. If estrogen is contraindicated in a patient, then it does not matter whether it comes from plants or is produced synthetically. There is a potential safety concern in using black cohosh in women with breast cancer or who are at high risk of breast cancer because of the estrogenic effects that are possible on the breasts. A 28 year-old female presents with a slightly tender 1.5 cm lump in her right breast. She noticed it two days ago. She has no associated lymphadenopathy and there is no nipple discharge. How should she be managed? - ANSWER Re examination after her next menses