NURS 620 Adult Gerontology Health Care 1
Exam 4 Prep Test
250 Questions with Correct Answers
and Detailed Rationales
Latest Exam 4 | Graded A+
1. Characteristics of polycystic ovarian syndrome include:
A. Hirsutism, thinness, hypoinsulinemia
B. Menopause onset, vitiligo, hyperinsulinemia
C. Alopecia, thinness, abdominal cramping
D. Premenarcheal onset, obesity, hyperinsulinemia
Correct Answer: D
Rationale: Polycystic ovarian syndrome (PCOS) is characterized by hyperandrogenism
(hirsutism, acne, alopecia), ovulatory dysfunction (oligomenorrhea or amenorrhea), and
polycystic ovaries on ultrasound. It is commonly associated with obesity and
hyperinsulinemia/insulin resistance, which are key pathophysiological features. The
condition typically presents post-menarche, not premenarcheal. Thinness and
hypoinsulinemia are not characteristic; in fact, the metabolic syndrome components make
obesity and hyperinsulinemia more common findings. PCOS is the most common cause of
anovulatory infertility.
2. A treatment used to improve the chance of pregnancy in an infertile woman who has
minimal or mild endometriosis is:
A. A laparoscopic resection or ablation of the lesions
B. Dilation or curettage
C. The use of gonadotropin-releasing hormone analogs
SCHOLARSOURCE 1
,D. The use of birth control pills for 3 months followed by an abrupt stop
Correct Answer: A
Rationale: Laparoscopic resection or ablation of endometriotic lesions (operative
laparoscopy) is the first-line surgical treatment for infertility associated with minimal to
mild endometriosis. Studies have shown that surgical treatment of minimal and mild
endometriosis increases pregnancy rates compared to diagnostic laparoscopy alone. GnRH
analogs are used to suppress endometriosis but do not improve pregnancy rates and delay
conception. Birth control pills are used for symptom management, not fertility
enhancement. Dilation and curettage has no role in treating endometriosis-associated
infertility.
3. An occurrence of genital herpes is:
A. Cured with acyclovir (Zovirax)
B. Best managed with trichloroacetic acid, 80%-90%, applied directly to the lesion
C. Expected to be completely resolved within 21 days (for the primary lesion)
D. Not a factor in continuing with intercourse
Correct Answer: C
Rationale: Primary genital herpes lesions typically completely resolve within 21 days, even
without treatment. Acyclovir and other antiviral medications shorten the duration of
symptoms and viral shedding but do not cure the infection (the virus remains latent in
nerve ganglia). Trichloroacetic acid is used for genital warts (HPV), not herpes lesions.
Genital herpes is a significant factor in sexual activity; patients should avoid intercourse
during active outbreaks and use condoms consistently between outbreaks to reduce
transmission risk.
SCHOLARSOURCE 2
,4. A 17-year-old female asks to start Depo-Provera injections as her method of birth
control. She discloses she has had four sexual partners in the past year. Her last menstrual
period was 12 days ago, and she had unprotected sex 3 days ago. The appropriate
management for this patient would be to:
A. Administer the injection today
B. Advise her to use another method for now and return with her next menses
C. Give the injection after a negative pregnancy test and tell her to use a condom for the
next 7 days
D. Give her injection and tell her to use a barrier method for 7 days
Correct Answer: B
Rationale: Depo-Provera should ideally be initiated within the first 5 days of the menstrual
cycle to ensure immediate contraceptive coverage. Since this patient had unprotected
intercourse 3 days ago and is now on day 12 of her cycle, she may already be pregnant or at
risk for pregnancy. Administering Depo-Provera today would not provide emergency
contraception. She should be advised to use another method for now (such as condoms)
and return for the injection with her next menses, at which time a pregnancy test should be
performed. Emergency contraception (Plan B or ella) should be offered if within the
appropriate time frame (72 hours for Plan B, 120 hours for ella).
5. Beth is breastfeeding her 3-month-old infant with no supplementation. She says she has
heard she cannot get pregnant during this time. What do you tell her:
A. "It's highly likely that you may become pregnant, so you should use another method of
birth control"
B. "Yes, you are safe as long as you breastfeed"
C. "For the first 6 months, if you breastfeed and have very little supplementation, your
chances are less than 2% that you will get pregnant"
D. "You're more at risk for getting pregnant now because of your fluctuating hormone
levels"
Correct Answer: C
SCHOLARSOURCE 3
, Rationale: The lactational amenorrhea method (LAM) is an effective form of contraception
when specific criteria are met. For LAM to be effective, the woman must be exclusively
breastfeeding (or nearly exclusively), the infant must be less than 6 months old, and the
mother must be amenorrheic. When these conditions are met, the pregnancy rate is less
than 2%, which is comparable to hormonal contraceptives. Option A overstates the risk
when criteria are met. Option B is incorrect because it suggests absolute safety without
conditions. Option D is incorrect as breastfeeding typically suppresses ovulation through
elevated prolactin levels.
6. Mrs. Williams would like to schedule an appointment to bring her 18-year-old daughter
in for her first gynecological exam and Pap smear. The most appropriate reply would
include:
A. "I would be happy to see your daughter and complete her gynecological exam and Pap
smear"
B. "Your daughter does not need a gynecological exam and Pap at this time"
C. "Your daughter only needs a gynecological exam and Pap smear when she becomes
sexually active"
D. "I would be happy to see your daughter and complete her gynecological exam, however,
she does not need a Pap smear until the age of 21"
Correct Answer: D
Rationale: Current American College of Obstetricians and Gynecologists (ACOG) and U.S.
Preventive Services Task Force (USPSTF) guidelines recommend that cervical cancer
screening (Pap smear) begin at age 21, regardless of sexual history. However, a
gynecological exam can be performed earlier if there are specific concerns or if the patient
desires contraception. Option A is incorrect because a Pap smear is not indicated at age 18.
Option B is incorrect because the daughter may benefit from a gynecological exam for other
reasons. Option C is incorrect because screening is recommended at age 21 regardless of
sexual activity.
7. Candidiasis is more common in:
SCHOLARSOURCE 4
Exam 4 Prep Test
250 Questions with Correct Answers
and Detailed Rationales
Latest Exam 4 | Graded A+
1. Characteristics of polycystic ovarian syndrome include:
A. Hirsutism, thinness, hypoinsulinemia
B. Menopause onset, vitiligo, hyperinsulinemia
C. Alopecia, thinness, abdominal cramping
D. Premenarcheal onset, obesity, hyperinsulinemia
Correct Answer: D
Rationale: Polycystic ovarian syndrome (PCOS) is characterized by hyperandrogenism
(hirsutism, acne, alopecia), ovulatory dysfunction (oligomenorrhea or amenorrhea), and
polycystic ovaries on ultrasound. It is commonly associated with obesity and
hyperinsulinemia/insulin resistance, which are key pathophysiological features. The
condition typically presents post-menarche, not premenarcheal. Thinness and
hypoinsulinemia are not characteristic; in fact, the metabolic syndrome components make
obesity and hyperinsulinemia more common findings. PCOS is the most common cause of
anovulatory infertility.
2. A treatment used to improve the chance of pregnancy in an infertile woman who has
minimal or mild endometriosis is:
A. A laparoscopic resection or ablation of the lesions
B. Dilation or curettage
C. The use of gonadotropin-releasing hormone analogs
SCHOLARSOURCE 1
,D. The use of birth control pills for 3 months followed by an abrupt stop
Correct Answer: A
Rationale: Laparoscopic resection or ablation of endometriotic lesions (operative
laparoscopy) is the first-line surgical treatment for infertility associated with minimal to
mild endometriosis. Studies have shown that surgical treatment of minimal and mild
endometriosis increases pregnancy rates compared to diagnostic laparoscopy alone. GnRH
analogs are used to suppress endometriosis but do not improve pregnancy rates and delay
conception. Birth control pills are used for symptom management, not fertility
enhancement. Dilation and curettage has no role in treating endometriosis-associated
infertility.
3. An occurrence of genital herpes is:
A. Cured with acyclovir (Zovirax)
B. Best managed with trichloroacetic acid, 80%-90%, applied directly to the lesion
C. Expected to be completely resolved within 21 days (for the primary lesion)
D. Not a factor in continuing with intercourse
Correct Answer: C
Rationale: Primary genital herpes lesions typically completely resolve within 21 days, even
without treatment. Acyclovir and other antiviral medications shorten the duration of
symptoms and viral shedding but do not cure the infection (the virus remains latent in
nerve ganglia). Trichloroacetic acid is used for genital warts (HPV), not herpes lesions.
Genital herpes is a significant factor in sexual activity; patients should avoid intercourse
during active outbreaks and use condoms consistently between outbreaks to reduce
transmission risk.
SCHOLARSOURCE 2
,4. A 17-year-old female asks to start Depo-Provera injections as her method of birth
control. She discloses she has had four sexual partners in the past year. Her last menstrual
period was 12 days ago, and she had unprotected sex 3 days ago. The appropriate
management for this patient would be to:
A. Administer the injection today
B. Advise her to use another method for now and return with her next menses
C. Give the injection after a negative pregnancy test and tell her to use a condom for the
next 7 days
D. Give her injection and tell her to use a barrier method for 7 days
Correct Answer: B
Rationale: Depo-Provera should ideally be initiated within the first 5 days of the menstrual
cycle to ensure immediate contraceptive coverage. Since this patient had unprotected
intercourse 3 days ago and is now on day 12 of her cycle, she may already be pregnant or at
risk for pregnancy. Administering Depo-Provera today would not provide emergency
contraception. She should be advised to use another method for now (such as condoms)
and return for the injection with her next menses, at which time a pregnancy test should be
performed. Emergency contraception (Plan B or ella) should be offered if within the
appropriate time frame (72 hours for Plan B, 120 hours for ella).
5. Beth is breastfeeding her 3-month-old infant with no supplementation. She says she has
heard she cannot get pregnant during this time. What do you tell her:
A. "It's highly likely that you may become pregnant, so you should use another method of
birth control"
B. "Yes, you are safe as long as you breastfeed"
C. "For the first 6 months, if you breastfeed and have very little supplementation, your
chances are less than 2% that you will get pregnant"
D. "You're more at risk for getting pregnant now because of your fluctuating hormone
levels"
Correct Answer: C
SCHOLARSOURCE 3
, Rationale: The lactational amenorrhea method (LAM) is an effective form of contraception
when specific criteria are met. For LAM to be effective, the woman must be exclusively
breastfeeding (or nearly exclusively), the infant must be less than 6 months old, and the
mother must be amenorrheic. When these conditions are met, the pregnancy rate is less
than 2%, which is comparable to hormonal contraceptives. Option A overstates the risk
when criteria are met. Option B is incorrect because it suggests absolute safety without
conditions. Option D is incorrect as breastfeeding typically suppresses ovulation through
elevated prolactin levels.
6. Mrs. Williams would like to schedule an appointment to bring her 18-year-old daughter
in for her first gynecological exam and Pap smear. The most appropriate reply would
include:
A. "I would be happy to see your daughter and complete her gynecological exam and Pap
smear"
B. "Your daughter does not need a gynecological exam and Pap at this time"
C. "Your daughter only needs a gynecological exam and Pap smear when she becomes
sexually active"
D. "I would be happy to see your daughter and complete her gynecological exam, however,
she does not need a Pap smear until the age of 21"
Correct Answer: D
Rationale: Current American College of Obstetricians and Gynecologists (ACOG) and U.S.
Preventive Services Task Force (USPSTF) guidelines recommend that cervical cancer
screening (Pap smear) begin at age 21, regardless of sexual history. However, a
gynecological exam can be performed earlier if there are specific concerns or if the patient
desires contraception. Option A is incorrect because a Pap smear is not indicated at age 18.
Option B is incorrect because the daughter may benefit from a gynecological exam for other
reasons. Option C is incorrect because screening is recommended at age 21 regardless of
sexual activity.
7. Candidiasis is more common in:
SCHOLARSOURCE 4
