NRNP 6552 ADVANCED NURSE PRACTICE IN REPRODUCTIVE
HEALTH CARE
WEEK 4 FOCUSED SOAP NOTE: STI INVESTIGATION CASE STUDY TEST BANK
2026-2027 UPDATE EXAM TEST BANK • ADVANCED CLINICAL PRACTICE
Exam Blueprint Overview: This test bank is a comprehensive, student-friendly clinical study guide fully
grounded in the official course materials of NRNP 6552: Advanced Nurse Practice in Reproductive Health
Care. It covers the Week 4 episodic focused SOAP note and STI investigation case study of S.L., a
24-year-old female presenting with postcoital bleeding, pharyngeal symptoms, and low-grade fever. The
questions evaluate subjective history-taking, objective physical examinations, diagnostic testing modalities
(NAAT, wet prep, pH), pharmacological treatments, and critical patient education (including the classic
disulfiram-like drug interaction of alcohol with metronidazole and tinidazole).
1. S.L., a 24-year-old female, presents to the clinic with postcoital bleeding of six weeks' duration, a
sore throat of three weeks' duration, and a low-grade fever for one to two days. Which aspect of S.L.'s
presentation is classified as a chief complaint?
A. Physical examination finding of bilateral anterior cervical adenopathy
B. Postcoital bleeding, sore throat, and fever as reported by the patient
C. Friable cervix with slight yellow frothy vaginal discharge
D. Patient's age of 24 and history of smoking half a pack of cigarettes daily
ANSWER ■: B — Postcoital bleeding, sore throat, and fever as reported by the patient
Explanation: Subjective chief complaints represent the primary reason(s) the patient sought medical care,
reported in their own words or summarized directly from their subjective reporting. Here, S.L. specifically reports
postcoital bleeding for six weeks, a sore throat for three weeks, and a fever for one to two days. Option A
describes physical exam findings which are objective data. Option C also represents objective clinical
observations made during the pelvic examination. Option D represents demographic and social history, not the
chief complaints that prompted the clinical visit.
NRNP 6552 Advanced Reproductive Health Care - Official Course Companion Page 1
, 2. In collecting S.L.'s History of Present Illness (HPI), the clinician documents that her pain is rated a
6/10 on the visual analog scale, and she utilizes over-the-counter (OTC) Tylenol as a relieving factor.
This information represents which elements of the 'HPI' framework?
A. Location and Onset
B. Character and Associated Signs
C. Severity and Exacerbating/Relieving Factors
D. Timing and Radiation
ANSWER ■: C — Severity and Exacerbating/Relieving Factors
Explanation: A comprehensive HPI utilizes a standardized format (such as OLDCARTS) to describe the
patient's symptoms. S.L.'s pain scale rating of 6/10 represents 'Severity,' and her use of OTC Tylenol to manage
the pain represents 'Relieving Factors.' Location would refer to the vaginal and throat areas, onset refers to 3-6
weeks, character refers to 'sore,' and timing refers to 'after sex.' Radiation is not applicable in this description.
3. S.L.'s social history is remarkable for cigarette smoking (half a pack per day since age 14), alcohol
consumption (6 to 8 hard liquor drinks daily on weekends), and marijuana use. According to clinical
guidelines, which of these substances is most strongly recognized as an established co-factor that
increases the risk of acquiring cervical infections and neoplasia?
A. Daily marijuana smoking
B. Moderate physical jogging 3-4 times a week
C. Cigarette smoking (tobacco use)
D. Binge weekend alcohol consumption
ANSWER ■: C — Cigarette smoking (tobacco use)
Explanation: Cigarette smoking is a well-established behavioral co-factor that compromises localized cervical
immunity, rendering the cervix more susceptible to persistent sexually transmitted infections (like HPV) and
subsequent neoplastic changes. S.L. has smoked half a pack per day since age 14, placing her at elevated risk.
While heavy weekend alcohol consumption and marijuana use are significant health behaviors requiring
counseling, tobacco use has a direct, biochemically proven synergistic effect on cervical epithelial vulnerability.
4. During the physical examination of S.L., the clinician documents 'anterior cervical adenopathy
bilaterally.' In which section of the SOAP note does this finding belong, and what type of data does it
represent?
A. Subjective (S), representing patient-reported symptoms
B. Objective (O), representing clinician-observed physical data
C. Assessment (A), representing differential diagnoses
D. Plan (P), representing ordered laboratory evaluations
ANSWER ■: B — Objective (O), representing clinician-observed physical data
Explanation: Anterior cervical adenopathy bilaterally is an objective physical finding obtained via clinician
palpation during the head, ears, eyes, nose, and throat (HEENT) and neck examination. All physical examination
findings, including vital signs and structural examinations, are documented in the Objective (O) section.
Subjective data are reported by the patient (e.g., her report of a sore throat). Assessment represents the clinical
diagnoses, and Plan represents the diagnostic/therapeutic actions.
NRNP 6552 Advanced Reproductive Health Care - Official Course Companion Page 2
, 5. S.L. reports a sore throat for three weeks. On objective exam, the clinician notes 'erythematous
pharynx and tonsils' along with 'bilateral anterior cervical adenopathy.' Given her active sexual history
and reproductive age, which sexually transmitted pathogens must be highly suspected as etiologies for
both her pharyngeal and urogenital presentations?
A. Trichomonas vaginalis and Gardnerella vaginalis
B. Neisseria gonorrhoeae and Chlamydia trachomatis
C. Haemophilus ducreyi and Herpes simplex virus type 1
D. Human papillomavirus types 6 and 11
ANSWER ■: B — Neisseria gonorrhoeae and Chlamydia trachomatis
Explanation: Neisseria gonorrhoeae and Chlamydia trachomatis are bacterial pathogens capable of infecting
both columnar and transitional epithelial tissues across multiple mucosal sites, including the urogenital tract
(causing friable cervix and discharge) and the pharynx (transmitted via receptive oral intercourse). S.L. presents
with both pharyngeal erythema/adenopathy and cervical friability/discharge, highlighting the need to test both
sites. Trichomonas vaginalis is primarily a urogenital parasite and rarely infects the pharynx. HPV 6 and 11
cause genital warts (perineum intact in S.L.).
6. A clinician performs a breast examination on S.L. and documents 'fibrocystic changes bilaterally,
without masses, dimpling, redness, or discharge.' Which of the following is correct regarding this
physical exam finding?
A. It represents an acute infectious process requiring immediate antibiotic therapy
B. It represents a benign, common structural breast variant that is not considered a pathological mass
C. It is an objective indicator of systemic lymphatic obstruction
D. It is a subjective symptom reported by S.L. during the review of systems
ANSWER ■: B — It represents a benign, common structural breast variant that is not considered a
pathological mass
Explanation: Bilateral fibrocystic breast changes are a very common, benign structural variation characterized
by glandular nodularity. The documentation specifies 'without masses, dimpling, redness, or discharge,'
confirming the absence of acute pathology (such as mastitis or malignancy). It is an objective finding
documented by the clinician during the physical exam, not a subjective symptom, and does not require
immediate antibiotic or surgical intervention.
NRNP 6552 Advanced Reproductive Health Care - Official Course Companion Page 3
HEALTH CARE
WEEK 4 FOCUSED SOAP NOTE: STI INVESTIGATION CASE STUDY TEST BANK
2026-2027 UPDATE EXAM TEST BANK • ADVANCED CLINICAL PRACTICE
Exam Blueprint Overview: This test bank is a comprehensive, student-friendly clinical study guide fully
grounded in the official course materials of NRNP 6552: Advanced Nurse Practice in Reproductive Health
Care. It covers the Week 4 episodic focused SOAP note and STI investigation case study of S.L., a
24-year-old female presenting with postcoital bleeding, pharyngeal symptoms, and low-grade fever. The
questions evaluate subjective history-taking, objective physical examinations, diagnostic testing modalities
(NAAT, wet prep, pH), pharmacological treatments, and critical patient education (including the classic
disulfiram-like drug interaction of alcohol with metronidazole and tinidazole).
1. S.L., a 24-year-old female, presents to the clinic with postcoital bleeding of six weeks' duration, a
sore throat of three weeks' duration, and a low-grade fever for one to two days. Which aspect of S.L.'s
presentation is classified as a chief complaint?
A. Physical examination finding of bilateral anterior cervical adenopathy
B. Postcoital bleeding, sore throat, and fever as reported by the patient
C. Friable cervix with slight yellow frothy vaginal discharge
D. Patient's age of 24 and history of smoking half a pack of cigarettes daily
ANSWER ■: B — Postcoital bleeding, sore throat, and fever as reported by the patient
Explanation: Subjective chief complaints represent the primary reason(s) the patient sought medical care,
reported in their own words or summarized directly from their subjective reporting. Here, S.L. specifically reports
postcoital bleeding for six weeks, a sore throat for three weeks, and a fever for one to two days. Option A
describes physical exam findings which are objective data. Option C also represents objective clinical
observations made during the pelvic examination. Option D represents demographic and social history, not the
chief complaints that prompted the clinical visit.
NRNP 6552 Advanced Reproductive Health Care - Official Course Companion Page 1
, 2. In collecting S.L.'s History of Present Illness (HPI), the clinician documents that her pain is rated a
6/10 on the visual analog scale, and she utilizes over-the-counter (OTC) Tylenol as a relieving factor.
This information represents which elements of the 'HPI' framework?
A. Location and Onset
B. Character and Associated Signs
C. Severity and Exacerbating/Relieving Factors
D. Timing and Radiation
ANSWER ■: C — Severity and Exacerbating/Relieving Factors
Explanation: A comprehensive HPI utilizes a standardized format (such as OLDCARTS) to describe the
patient's symptoms. S.L.'s pain scale rating of 6/10 represents 'Severity,' and her use of OTC Tylenol to manage
the pain represents 'Relieving Factors.' Location would refer to the vaginal and throat areas, onset refers to 3-6
weeks, character refers to 'sore,' and timing refers to 'after sex.' Radiation is not applicable in this description.
3. S.L.'s social history is remarkable for cigarette smoking (half a pack per day since age 14), alcohol
consumption (6 to 8 hard liquor drinks daily on weekends), and marijuana use. According to clinical
guidelines, which of these substances is most strongly recognized as an established co-factor that
increases the risk of acquiring cervical infections and neoplasia?
A. Daily marijuana smoking
B. Moderate physical jogging 3-4 times a week
C. Cigarette smoking (tobacco use)
D. Binge weekend alcohol consumption
ANSWER ■: C — Cigarette smoking (tobacco use)
Explanation: Cigarette smoking is a well-established behavioral co-factor that compromises localized cervical
immunity, rendering the cervix more susceptible to persistent sexually transmitted infections (like HPV) and
subsequent neoplastic changes. S.L. has smoked half a pack per day since age 14, placing her at elevated risk.
While heavy weekend alcohol consumption and marijuana use are significant health behaviors requiring
counseling, tobacco use has a direct, biochemically proven synergistic effect on cervical epithelial vulnerability.
4. During the physical examination of S.L., the clinician documents 'anterior cervical adenopathy
bilaterally.' In which section of the SOAP note does this finding belong, and what type of data does it
represent?
A. Subjective (S), representing patient-reported symptoms
B. Objective (O), representing clinician-observed physical data
C. Assessment (A), representing differential diagnoses
D. Plan (P), representing ordered laboratory evaluations
ANSWER ■: B — Objective (O), representing clinician-observed physical data
Explanation: Anterior cervical adenopathy bilaterally is an objective physical finding obtained via clinician
palpation during the head, ears, eyes, nose, and throat (HEENT) and neck examination. All physical examination
findings, including vital signs and structural examinations, are documented in the Objective (O) section.
Subjective data are reported by the patient (e.g., her report of a sore throat). Assessment represents the clinical
diagnoses, and Plan represents the diagnostic/therapeutic actions.
NRNP 6552 Advanced Reproductive Health Care - Official Course Companion Page 2
, 5. S.L. reports a sore throat for three weeks. On objective exam, the clinician notes 'erythematous
pharynx and tonsils' along with 'bilateral anterior cervical adenopathy.' Given her active sexual history
and reproductive age, which sexually transmitted pathogens must be highly suspected as etiologies for
both her pharyngeal and urogenital presentations?
A. Trichomonas vaginalis and Gardnerella vaginalis
B. Neisseria gonorrhoeae and Chlamydia trachomatis
C. Haemophilus ducreyi and Herpes simplex virus type 1
D. Human papillomavirus types 6 and 11
ANSWER ■: B — Neisseria gonorrhoeae and Chlamydia trachomatis
Explanation: Neisseria gonorrhoeae and Chlamydia trachomatis are bacterial pathogens capable of infecting
both columnar and transitional epithelial tissues across multiple mucosal sites, including the urogenital tract
(causing friable cervix and discharge) and the pharynx (transmitted via receptive oral intercourse). S.L. presents
with both pharyngeal erythema/adenopathy and cervical friability/discharge, highlighting the need to test both
sites. Trichomonas vaginalis is primarily a urogenital parasite and rarely infects the pharynx. HPV 6 and 11
cause genital warts (perineum intact in S.L.).
6. A clinician performs a breast examination on S.L. and documents 'fibrocystic changes bilaterally,
without masses, dimpling, redness, or discharge.' Which of the following is correct regarding this
physical exam finding?
A. It represents an acute infectious process requiring immediate antibiotic therapy
B. It represents a benign, common structural breast variant that is not considered a pathological mass
C. It is an objective indicator of systemic lymphatic obstruction
D. It is a subjective symptom reported by S.L. during the review of systems
ANSWER ■: B — It represents a benign, common structural breast variant that is not considered a
pathological mass
Explanation: Bilateral fibrocystic breast changes are a very common, benign structural variation characterized
by glandular nodularity. The documentation specifies 'without masses, dimpling, redness, or discharge,'
confirming the absence of acute pathology (such as mastitis or malignancy). It is an objective finding
documented by the clinician during the physical exam, not a subjective symptom, and does not require
immediate antibiotic or surgical intervention.
NRNP 6552 Advanced Reproductive Health Care - Official Course Companion Page 3
