WGU D120 ACTUAL QUESTIONS AND
ANSWERS EXAMPREP STUDY GUIDE
◉ A young woman presents with complaints of irritation in the
vaginal area. This is the first time this has occurred. On exam, the
cervix is inflamed and friable. Flagellated protozoa are seen on the
wet mount. What is the most likely diagnosis?
Answer: trichomoniasis;
Flagellated protozoan confirms the diagnosis of trichomoniasis.
◉ A 21-year-old female patient presents for her first well-woman
exam. She has never been sexually active. Her family history and
past medical history are negative for any gynecologic diseases.
Her menses occur every 28 days, lasting 5 days, with a relatively
moderate flow and no significant dysmenorrhea. Her physical
exam should include which tests?
Answer: Pap smear;
The recommended age for females to begin screening pap smears
is at the age of 21, regardless of sexual activity history. STD
screening is not necessary as the patient is not sexually active.
Hemoccult and mammogram are not recommended for this age
group of patient.
◉ A young adult patient presents with a history of vaginal itching
and heavy white discharge. The patient denies a history of sexual
activity. On exam, the FNP finds a red, edematous vulva and white
,patches on the vaginal walls. The discharge has no odor. What
finding would the FNP suspect in the patient's history?
Answer: recent antibiotic use;
Almost half of all vaginal infections are caused by candida. The
majority of women who develop this infection have recently taken
antibiotics.
◉ A 46-year-old female patient is being seen in the clinic by the
FNP. She was last seen 2 weeks ago for an upper respiratory tract
infection and was treated with amoxicillin 250mg PO TID x
10days. She completed her medication last week, but now
complains of vaginal itching and thick white discharge. She states
that she has never experienced such intense itching. She is in a
mutually monogamous relationship. Her LMP was 2 weeks ago.
Her partner had a vasectomy. Wet mount shows negative whiff
test, rare clue cells, positive lactobacilli, positive hyphae, positive
spores, few WBCs, and no trichomonads. She is leaving tomorrow
for a week long cruise. She is not taking any medications and has
no known drug allergies. The FNP should prescribe which of the
following?
Answer: fluconazole 150mg 1 tab PO x1 dose;
Fluconazole is approved for a single-dose oral treatment of
uncomplicated vulvovaginal candidiasis. It is the most convenient
treatment for this patient who will is unlikely to be compliant
with vaginal creams given the upcoming travel.
◉ A 25-year-old patient presents with complaints of malodorous
vaginal discharge, which is white and watery. She douches with
vinegar and water every 2 weeks. She uses a diaphragm for
,contraception and has been sexually active with her boyfriend for
two years, using condoms for STD prevention. Her LMP was 1
week ago, and there are no noted changes in her normal
menstrual pattern. Her wet mount shows a positive whiff test,
clue cells too numerous to count, no lactobacilli, no hyphae, no
spores. What is the diagnosis and treatment for this patient?
Answer: bacterial vaginosis: metronidazole vaginal gel 1
applicator HS x 5 days.;
Metronidazole vaginal gel is the treatment of choice for bacterial
vaginosis in the non-pregnant female. The presence of clue cells,
and the associated malodorous discharge and absence of
lactobacilli are markers for the diagnosis of bacterial vaginosis.
◉ A 41-year-old patient is seen for her 6-week postpartum exam
by the FNP. She is breastfeeding without difficulty and plans to
continue for a year. She wants to begin using contraception and
plans no further pregnancies. Which of the following is not an
appropriate choice for this patient?
Answer: Combination OC;
Combination OCs are not recommended for breastfeeding
mothers because of the effect of estrogen on milk supply.
Progestin only OCs, IUDs, and Depo-Provera are acceptable
methods of contraception for breastfeeding mothers.
◉ Which two patients should have a Pap smear test performed by
the FNP?
, Answer: Based on USPSTF guidelines, pap smear tests should be
performed on female patients aged 21 and older, regardless of
sexual activity.
◉ What finding is considered a normal surface characteristic of
the cervix?
Answer: Small, yellow, raised round area on the cervix.;
A nabothian cyst is a small, white or yellow, raised round area on
the cervix and is considered to be a normal variant.
◉ The FNP is reviewing the lab results of a 28-year-old patient
recently seen for a pap smear. Classification is high-grade
squamous intraepithelial lesion, endocervical cells seen, and
adequate smear. The FNP phones the patient and tells her which
of the following?
Answer: Your pap smear shows abnormal tissue that needs to be
evaluated. Please schedule an appointment for a colposcopy.;
The pap smear is a screening test for cervical cancer and
precancerous states. The diagnostic test needed to confirm the
diagnosis of a high-grade lesion is a colposcopy with guided
biopsies.
◉ The FNP is reviewing the lab results of a 61-year-old patient
recently seen for a pap smear. Results are: atrophic changes, scent
endocervical cells, and adequate smear. She has been treated for
breast cancer with mastectomy and tamoxifen. She has never
received hormone replacement therapy. What is appropriate for
the FNP to tell the patient?
ANSWERS EXAMPREP STUDY GUIDE
◉ A young woman presents with complaints of irritation in the
vaginal area. This is the first time this has occurred. On exam, the
cervix is inflamed and friable. Flagellated protozoa are seen on the
wet mount. What is the most likely diagnosis?
Answer: trichomoniasis;
Flagellated protozoan confirms the diagnosis of trichomoniasis.
◉ A 21-year-old female patient presents for her first well-woman
exam. She has never been sexually active. Her family history and
past medical history are negative for any gynecologic diseases.
Her menses occur every 28 days, lasting 5 days, with a relatively
moderate flow and no significant dysmenorrhea. Her physical
exam should include which tests?
Answer: Pap smear;
The recommended age for females to begin screening pap smears
is at the age of 21, regardless of sexual activity history. STD
screening is not necessary as the patient is not sexually active.
Hemoccult and mammogram are not recommended for this age
group of patient.
◉ A young adult patient presents with a history of vaginal itching
and heavy white discharge. The patient denies a history of sexual
activity. On exam, the FNP finds a red, edematous vulva and white
,patches on the vaginal walls. The discharge has no odor. What
finding would the FNP suspect in the patient's history?
Answer: recent antibiotic use;
Almost half of all vaginal infections are caused by candida. The
majority of women who develop this infection have recently taken
antibiotics.
◉ A 46-year-old female patient is being seen in the clinic by the
FNP. She was last seen 2 weeks ago for an upper respiratory tract
infection and was treated with amoxicillin 250mg PO TID x
10days. She completed her medication last week, but now
complains of vaginal itching and thick white discharge. She states
that she has never experienced such intense itching. She is in a
mutually monogamous relationship. Her LMP was 2 weeks ago.
Her partner had a vasectomy. Wet mount shows negative whiff
test, rare clue cells, positive lactobacilli, positive hyphae, positive
spores, few WBCs, and no trichomonads. She is leaving tomorrow
for a week long cruise. She is not taking any medications and has
no known drug allergies. The FNP should prescribe which of the
following?
Answer: fluconazole 150mg 1 tab PO x1 dose;
Fluconazole is approved for a single-dose oral treatment of
uncomplicated vulvovaginal candidiasis. It is the most convenient
treatment for this patient who will is unlikely to be compliant
with vaginal creams given the upcoming travel.
◉ A 25-year-old patient presents with complaints of malodorous
vaginal discharge, which is white and watery. She douches with
vinegar and water every 2 weeks. She uses a diaphragm for
,contraception and has been sexually active with her boyfriend for
two years, using condoms for STD prevention. Her LMP was 1
week ago, and there are no noted changes in her normal
menstrual pattern. Her wet mount shows a positive whiff test,
clue cells too numerous to count, no lactobacilli, no hyphae, no
spores. What is the diagnosis and treatment for this patient?
Answer: bacterial vaginosis: metronidazole vaginal gel 1
applicator HS x 5 days.;
Metronidazole vaginal gel is the treatment of choice for bacterial
vaginosis in the non-pregnant female. The presence of clue cells,
and the associated malodorous discharge and absence of
lactobacilli are markers for the diagnosis of bacterial vaginosis.
◉ A 41-year-old patient is seen for her 6-week postpartum exam
by the FNP. She is breastfeeding without difficulty and plans to
continue for a year. She wants to begin using contraception and
plans no further pregnancies. Which of the following is not an
appropriate choice for this patient?
Answer: Combination OC;
Combination OCs are not recommended for breastfeeding
mothers because of the effect of estrogen on milk supply.
Progestin only OCs, IUDs, and Depo-Provera are acceptable
methods of contraception for breastfeeding mothers.
◉ Which two patients should have a Pap smear test performed by
the FNP?
, Answer: Based on USPSTF guidelines, pap smear tests should be
performed on female patients aged 21 and older, regardless of
sexual activity.
◉ What finding is considered a normal surface characteristic of
the cervix?
Answer: Small, yellow, raised round area on the cervix.;
A nabothian cyst is a small, white or yellow, raised round area on
the cervix and is considered to be a normal variant.
◉ The FNP is reviewing the lab results of a 28-year-old patient
recently seen for a pap smear. Classification is high-grade
squamous intraepithelial lesion, endocervical cells seen, and
adequate smear. The FNP phones the patient and tells her which
of the following?
Answer: Your pap smear shows abnormal tissue that needs to be
evaluated. Please schedule an appointment for a colposcopy.;
The pap smear is a screening test for cervical cancer and
precancerous states. The diagnostic test needed to confirm the
diagnosis of a high-grade lesion is a colposcopy with guided
biopsies.
◉ The FNP is reviewing the lab results of a 61-year-old patient
recently seen for a pap smear. Results are: atrophic changes, scent
endocervical cells, and adequate smear. She has been treated for
breast cancer with mastectomy and tamoxifen. She has never
received hormone replacement therapy. What is appropriate for
the FNP to tell the patient?
