NURS 5432 Exam 4 V3 | NURS 5432 Family
I (FNP 1) | Actual Q&A with Rationale
(NURS5432 Exam 4) | The University of
Texas at Arlington
1. A 24-year-old female presents with a thin, grayish-white vaginal discharge and a fishy odor
that is more noticeable after intercourse. Microscopic examination of the discharge reveals
epithelial cells with blurred margins covered in bacteria. Which of the following is the most
likely diagnosis?
A. Trichomoniasis
B. Vulvovaginal Candidiasis
C. Bacterial Vaginosis
D. Chlamydia Trachomatis
Answer: C
Rationale: Bacterial Vaginosis is characterized by a thin, homogeneous discharge and the
presence of clue cells on a wet mount. The fishy odor is typically caused by the release of
amines when the discharge is mixed with potassium hydroxide or semen. This condition
results from a shift in vaginal flora where Lactobacillus is replaced by anaerobic bacteria
like Gardnerella vaginalis.
,2. Which diagnostic finding is considered the gold standard for confirming a diagnosis of
endometriosis?
A. Transvaginal Ultrasound
B. Serum CA-125 Level
C. Pelvic Magnetic Resonance Imaging (MRI)
D. Laparoscopy with biopsy
Answer: D
Rationale: While imaging can suggest the presence of endometriosis, direct visualization
via laparoscopy is the only definitive way to diagnose the condition. Biopsy of suspicious
lesions during the procedure provides histological confirmation of endometrial tissue
outside the uterus. This invasive approach is generally reserved for patients with severe
symptoms or those who fail conservative medical management.
3. A 55-year-old male patient presents with complaints of urinary frequency, nocturia, and a
weak urinary stream. Digital rectal examination reveals a smooth, firm, non-tender,
symmetrically enlarged prostate. Which of the following is the most appropriate initial
medication for this patient?
A. Finasteride
B. Tamsulosin
C. Ciprofloxacin
D. Tadalafil
,Answer: B
Rationale: Tamsulosin is an alpha-1 blocker that provides rapid relief of lower urinary tract
symptoms associated with Benign Prostatic Hyperplasia by relaxing smooth muscle in the
prostate and bladder neck. Unlike 5-alpha reductase inhibitors like finasteride, alpha-
blockers do not shrink the prostate but offer faster symptom improvement. Patients should
be monitored for side effects such as orthostatic hypotension and retrograde ejaculation.
4. According to current guidelines, at what age should routine screening for cervical cancer
begin for an immunocompetent female?
A. At the onset of sexual activity
B. Age 18
C. Age 21
D. Age 25
Answer: C
Rationale: Current consensus guidelines recommend starting cervical cancer screening at
age 21 regardless of the age of sexual debut. Screening before this age is discouraged
because adolescent cervical changes often resolve spontaneously and can lead to
unnecessary procedures. For women aged 21 to 29, cytology alone every three years is the
preferred screening method.
, 5. A 32-year-old pregnant female at 28 weeks gestation is found to be Rh-negative. Her
indirect Coombs test is negative. What is the next appropriate step in her prenatal care?
A. Administer Rho(D) immune globulin (RhoGAM) now
B. Wait until delivery to assess fetal blood type
C. Repeat the Coombs test in 4 weeks
D. Administer Rho(D) immune globulin only if she experiences trauma
Answer: A
Rationale: Rho(D) immune globulin is routinely administered to Rh-negative, unsensitized
women at 28 weeks of gestation to prevent isoimmunization. This medication works by
clearing any fetal Rh-positive red blood cells from the maternal circulation before the
mother can mount an immune response. A second dose is typically required within 72
hours of delivery if the infant is confirmed to be Rh-positive.
6. Which of the following is a classic clinical finding in a 4-week-old infant with hypertrophic
pyloric stenosis?
A. Currant jelly stools
B. Bile-stained emesis
C. Projectile, non-bilious vomiting
D. Sausage-shaped mass in the left lower quadrant
Answer: C
I (FNP 1) | Actual Q&A with Rationale
(NURS5432 Exam 4) | The University of
Texas at Arlington
1. A 24-year-old female presents with a thin, grayish-white vaginal discharge and a fishy odor
that is more noticeable after intercourse. Microscopic examination of the discharge reveals
epithelial cells with blurred margins covered in bacteria. Which of the following is the most
likely diagnosis?
A. Trichomoniasis
B. Vulvovaginal Candidiasis
C. Bacterial Vaginosis
D. Chlamydia Trachomatis
Answer: C
Rationale: Bacterial Vaginosis is characterized by a thin, homogeneous discharge and the
presence of clue cells on a wet mount. The fishy odor is typically caused by the release of
amines when the discharge is mixed with potassium hydroxide or semen. This condition
results from a shift in vaginal flora where Lactobacillus is replaced by anaerobic bacteria
like Gardnerella vaginalis.
,2. Which diagnostic finding is considered the gold standard for confirming a diagnosis of
endometriosis?
A. Transvaginal Ultrasound
B. Serum CA-125 Level
C. Pelvic Magnetic Resonance Imaging (MRI)
D. Laparoscopy with biopsy
Answer: D
Rationale: While imaging can suggest the presence of endometriosis, direct visualization
via laparoscopy is the only definitive way to diagnose the condition. Biopsy of suspicious
lesions during the procedure provides histological confirmation of endometrial tissue
outside the uterus. This invasive approach is generally reserved for patients with severe
symptoms or those who fail conservative medical management.
3. A 55-year-old male patient presents with complaints of urinary frequency, nocturia, and a
weak urinary stream. Digital rectal examination reveals a smooth, firm, non-tender,
symmetrically enlarged prostate. Which of the following is the most appropriate initial
medication for this patient?
A. Finasteride
B. Tamsulosin
C. Ciprofloxacin
D. Tadalafil
,Answer: B
Rationale: Tamsulosin is an alpha-1 blocker that provides rapid relief of lower urinary tract
symptoms associated with Benign Prostatic Hyperplasia by relaxing smooth muscle in the
prostate and bladder neck. Unlike 5-alpha reductase inhibitors like finasteride, alpha-
blockers do not shrink the prostate but offer faster symptom improvement. Patients should
be monitored for side effects such as orthostatic hypotension and retrograde ejaculation.
4. According to current guidelines, at what age should routine screening for cervical cancer
begin for an immunocompetent female?
A. At the onset of sexual activity
B. Age 18
C. Age 21
D. Age 25
Answer: C
Rationale: Current consensus guidelines recommend starting cervical cancer screening at
age 21 regardless of the age of sexual debut. Screening before this age is discouraged
because adolescent cervical changes often resolve spontaneously and can lead to
unnecessary procedures. For women aged 21 to 29, cytology alone every three years is the
preferred screening method.
, 5. A 32-year-old pregnant female at 28 weeks gestation is found to be Rh-negative. Her
indirect Coombs test is negative. What is the next appropriate step in her prenatal care?
A. Administer Rho(D) immune globulin (RhoGAM) now
B. Wait until delivery to assess fetal blood type
C. Repeat the Coombs test in 4 weeks
D. Administer Rho(D) immune globulin only if she experiences trauma
Answer: A
Rationale: Rho(D) immune globulin is routinely administered to Rh-negative, unsensitized
women at 28 weeks of gestation to prevent isoimmunization. This medication works by
clearing any fetal Rh-positive red blood cells from the maternal circulation before the
mother can mount an immune response. A second dose is typically required within 72
hours of delivery if the infant is confirmed to be Rh-positive.
6. Which of the following is a classic clinical finding in a 4-week-old infant with hypertrophic
pyloric stenosis?
A. Currant jelly stools
B. Bile-stained emesis
C. Projectile, non-bilious vomiting
D. Sausage-shaped mass in the left lower quadrant
Answer: C
