NUR 6130 Exam 3 V3 | NUR 6130
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 3) | William
Paterson University
1. An 18-year-old female presents for her first gynecological exam and asks about cervical
cancer screening. Based on current ACOG and USPSTF guidelines, what is the most
appropriate recommendation?
A. Initiate Pap smear screening now as she is sexually active.
B. Screen with HPV co-testing starting at age 21.
C. Perform a Pap smear every 5 years starting at age 18.
D. Delay cervical cancer screening until the age of 21 regardless of sexual activity.
Answer: D
Rationale: Current clinical guidelines recommend that cervical cancer screening begin at
age 21, regardless of the age of sexual debut. This recommendation aims to prevent
unnecessary procedures on the adolescent cervix, which often undergoes transient HPV
infections that resolve spontaneously. Evidence shows that screening before 21 does not
lead to a decrease in cancer incidence but increases the risk of over-treatment of benign
lesions.
,2. A 52-year-old woman complains of hot flashes, night sweats, and vaginal dryness. She has
an intact uterus. Which hormone therapy regimen is most appropriate for her symptoms?
A. Estrogen-only therapy (ET).
B. High-dose oral contraceptives.
C. Testosterone supplementation.
D. Combined estrogen and progestogen therapy (EPT).
Answer: D
Rationale: For women with an intact uterus, systemic estrogen must be paired with a
progestogen to prevent endometrial hyperplasia and the subsequent risk of endometrial
cancer. Estrogen-only therapy is reserved specifically for women who have undergone a
hysterectomy. This combination treatment effectively manages vasomotor symptoms while
protecting the integrity of the uterine lining.
3. A mother brings in her 4-year-old son with a ‘barking’ cough and inspiratory stridor that
worsens at night. Which diagnosis is most likely?
A. Laryngotracheobronchitis (Croup)
B. Bacterial Tracheitis
C. Epiglottitis
D. Foreign body aspiration
Answer: A
,Rationale: Laryngotracheobronchitis, commonly known as Croup, is characterized by the
classic barking cough and inspiratory stridor due to upper airway inflammation. It typically
follows a viral prodrome and is most prevalent in children aged 6 months to 3 years.
Management often involves a single dose of dexamethasone to reduce subglottic edema
and improve respiratory effort.
4. Which of the following is considered the ‘gold standard’ for diagnosing Polycystic Ovary
Syndrome (PCOS) according to the Rotterdam criteria?
A. Elevated serum cortisol and weight gain.
B. A single finding of an enlarged ovary during a pelvic exam.
C. Elevated prolactin levels and bilateral galactorrhea.
D. Presence of at least two: oligo-ovulation/anovulation, clinical/biochemical
hyperandrogenism, and polycystic ovaries on ultrasound.
Answer: D
Rationale: The Rotterdam criteria require the presence of at least two out of the three
specified conditions for a PCOS diagnosis. These conditions include ovulatory dysfunction,
signs of androgen excess, and characteristic ovarian morphology on imaging. Using this
standardized approach ensures that other endocrine disorders, such as congenital adrenal
hyperplasia, are ruled out before confirming PCOS.
, 5. A 28-year-old pregnant patient at 36 weeks gestation presents with a blood pressure of
155/95 mmHg and 2+ proteinuria. What is the most likely diagnosis?
A. Gestational Hypertension
B. Preeclampsia
C. Chronic Hypertension
D. Eclampsia
Answer: B
Rationale: Preeclampsia is defined by the new onset of hypertension (BP >140/90) and
proteinuria after 20 weeks of gestation in a previously normotensive woman. It is a
multisystem disorder that requires close monitoring of both the mother and the fetus for
signs of progression to severe features. If the patient were to experience seizures, the
diagnosis would then shift to eclampsia.
6. When assessing a 12-month-old child during a well-visit, which developmental milestone
should the child have typically achieved?
A. Walking alone or with one hand held.
B. Speaking in 3-word sentences.
C. Copying a circle with a crayon.
D. Hopping on one foot.
Answer: A
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 3) | William
Paterson University
1. An 18-year-old female presents for her first gynecological exam and asks about cervical
cancer screening. Based on current ACOG and USPSTF guidelines, what is the most
appropriate recommendation?
A. Initiate Pap smear screening now as she is sexually active.
B. Screen with HPV co-testing starting at age 21.
C. Perform a Pap smear every 5 years starting at age 18.
D. Delay cervical cancer screening until the age of 21 regardless of sexual activity.
Answer: D
Rationale: Current clinical guidelines recommend that cervical cancer screening begin at
age 21, regardless of the age of sexual debut. This recommendation aims to prevent
unnecessary procedures on the adolescent cervix, which often undergoes transient HPV
infections that resolve spontaneously. Evidence shows that screening before 21 does not
lead to a decrease in cancer incidence but increases the risk of over-treatment of benign
lesions.
,2. A 52-year-old woman complains of hot flashes, night sweats, and vaginal dryness. She has
an intact uterus. Which hormone therapy regimen is most appropriate for her symptoms?
A. Estrogen-only therapy (ET).
B. High-dose oral contraceptives.
C. Testosterone supplementation.
D. Combined estrogen and progestogen therapy (EPT).
Answer: D
Rationale: For women with an intact uterus, systemic estrogen must be paired with a
progestogen to prevent endometrial hyperplasia and the subsequent risk of endometrial
cancer. Estrogen-only therapy is reserved specifically for women who have undergone a
hysterectomy. This combination treatment effectively manages vasomotor symptoms while
protecting the integrity of the uterine lining.
3. A mother brings in her 4-year-old son with a ‘barking’ cough and inspiratory stridor that
worsens at night. Which diagnosis is most likely?
A. Laryngotracheobronchitis (Croup)
B. Bacterial Tracheitis
C. Epiglottitis
D. Foreign body aspiration
Answer: A
,Rationale: Laryngotracheobronchitis, commonly known as Croup, is characterized by the
classic barking cough and inspiratory stridor due to upper airway inflammation. It typically
follows a viral prodrome and is most prevalent in children aged 6 months to 3 years.
Management often involves a single dose of dexamethasone to reduce subglottic edema
and improve respiratory effort.
4. Which of the following is considered the ‘gold standard’ for diagnosing Polycystic Ovary
Syndrome (PCOS) according to the Rotterdam criteria?
A. Elevated serum cortisol and weight gain.
B. A single finding of an enlarged ovary during a pelvic exam.
C. Elevated prolactin levels and bilateral galactorrhea.
D. Presence of at least two: oligo-ovulation/anovulation, clinical/biochemical
hyperandrogenism, and polycystic ovaries on ultrasound.
Answer: D
Rationale: The Rotterdam criteria require the presence of at least two out of the three
specified conditions for a PCOS diagnosis. These conditions include ovulatory dysfunction,
signs of androgen excess, and characteristic ovarian morphology on imaging. Using this
standardized approach ensures that other endocrine disorders, such as congenital adrenal
hyperplasia, are ruled out before confirming PCOS.
, 5. A 28-year-old pregnant patient at 36 weeks gestation presents with a blood pressure of
155/95 mmHg and 2+ proteinuria. What is the most likely diagnosis?
A. Gestational Hypertension
B. Preeclampsia
C. Chronic Hypertension
D. Eclampsia
Answer: B
Rationale: Preeclampsia is defined by the new onset of hypertension (BP >140/90) and
proteinuria after 20 weeks of gestation in a previously normotensive woman. It is a
multisystem disorder that requires close monitoring of both the mother and the fetus for
signs of progression to severe features. If the patient were to experience seizures, the
diagnosis would then shift to eclampsia.
6. When assessing a 12-month-old child during a well-visit, which developmental milestone
should the child have typically achieved?
A. Walking alone or with one hand held.
B. Speaking in 3-word sentences.
C. Copying a circle with a crayon.
D. Hopping on one foot.
Answer: A
