,Maryville NURS 620 Exam 4 | Adult-Gerontology
Health Care I (2026) Q&A
1. Which of the following is the most common cause of secondary amenorrhea in
women of reproductive age?
A) Polycystic ovary syndrome
B) Pregnancy
C) Hyperprolactinemia
D) Premature ovarian insufficiency
Correct Answer: Pregnancy
Rationale: Pregnancy is the most common cause of secondary amenorrhea and
must be excluded first in any woman of reproductive age who presents with
absent menses. Polycystic ovary syndrome is a common cause of oligomenorrhea
or amenorrhea but is less common than pregnancy overall. Hyperprolactinemia
and premature ovarian insufficiency are less common etiologies.
2. A 24-year-old female presents with dysuria, pain with intercourse, and
mucopurulent vaginal discharge. Her partner was recently treated for
nongonococcal urethritis. Which sexually transmitted infection has she most likely
been exposed to?
A) Neisseria gonorrhoeae
B) Chlamydia trachomatis
C) Trichomonas vaginalis
D) Herpes simplex virus
,Correct Answer: Chlamydia trachomatis
Rationale: Chlamydia trachomatis is the most common cause of nongonococcal
urethritis in men and typically presents in women with dysuria, dyspareunia, and
mucopurulent cervical discharge. Neisseria gonorrhoeae would more often present
with purulent discharge and more acute symptoms. Trichomonas vaginalis causes
a frothy, greenish discharge. Herpes simplex virus presents with painful vesicles
and ulcers.
3. A 20-year-old sexually active female is seen in the clinic because her partner
was diagnosed with gonorrhea. What is the treatment of choice for gonorrhea?
A) Azithromycin 1 g orally once
B) Ceftriaxone 500 mg IM once
C) Doxycycline 100 mg orally twice daily for 7 days
D) Metronidazole 500 mg orally twice daily for 7 days
Correct Answer: Ceftriaxone 500 mg IM once
Rationale: Ceftriaxone 500 mg IM as a single dose is the first-line treatment for
uncomplicated gonorrhea. Azithromycin is no longer recommended as
monotherapy due to resistance. Doxycycline is used for chlamydia co-treatment.
Metronidazole is used for trichomoniasis and bacterial vaginosis.
4. A 45-year-old woman presents with complaints of vaginal discharge. Saline wet
mount reveals clue cells. What is the most likely diagnosis?
A) Candida vaginitis
B) Trichomonal vaginitis
C) Bacterial vaginosis
, D) Atrophic vaginitis
Correct Answer: Bacterial vaginosis
Rationale: Clue cells (epithelial cells coated with bacteria) are a classic finding
on wet mount in bacterial vaginosis, along with a thin, grayish-white discharge
and a fishy odor. Candida vaginitis shows budding yeast and pseudohyphae.
Trichomonal vaginitis shows motile flagellated organisms. Atrophic vaginitis
shows decreased estrogen effect without clue cells.
5. Which of the following medications is the treatment of choice for
trichomoniasis?
A) Fluconazole 150 mg orally once
B) Metronidazole 500 mg orally twice daily for 7 days
C) Doxycycline 100 mg orally twice daily for 7 days
D) Ceftriaxone 500 mg IM once
Correct Answer: Metronidazole 500 mg orally twice daily for 7 days
Rationale: Metronidazole (Flagyl) is the treatment of choice for trichomoniasis.
A single 2 g dose is also effective, but the 7-day regimen is preferred for improved
cure rates. Fluconazole treats Candida. Doxycycline treats chlamydia. Ceftriaxone
treats gonorrhea.
6. A 36-year-old woman presents with vaginal itching, burning, and discharge.
Wet mount reveals hyphae. Which treatment would be appropriate?
A) Metronidazole 500 mg orally twice daily for 7 days
B) Fluconazole 150 mg orally once
Health Care I (2026) Q&A
1. Which of the following is the most common cause of secondary amenorrhea in
women of reproductive age?
A) Polycystic ovary syndrome
B) Pregnancy
C) Hyperprolactinemia
D) Premature ovarian insufficiency
Correct Answer: Pregnancy
Rationale: Pregnancy is the most common cause of secondary amenorrhea and
must be excluded first in any woman of reproductive age who presents with
absent menses. Polycystic ovary syndrome is a common cause of oligomenorrhea
or amenorrhea but is less common than pregnancy overall. Hyperprolactinemia
and premature ovarian insufficiency are less common etiologies.
2. A 24-year-old female presents with dysuria, pain with intercourse, and
mucopurulent vaginal discharge. Her partner was recently treated for
nongonococcal urethritis. Which sexually transmitted infection has she most likely
been exposed to?
A) Neisseria gonorrhoeae
B) Chlamydia trachomatis
C) Trichomonas vaginalis
D) Herpes simplex virus
,Correct Answer: Chlamydia trachomatis
Rationale: Chlamydia trachomatis is the most common cause of nongonococcal
urethritis in men and typically presents in women with dysuria, dyspareunia, and
mucopurulent cervical discharge. Neisseria gonorrhoeae would more often present
with purulent discharge and more acute symptoms. Trichomonas vaginalis causes
a frothy, greenish discharge. Herpes simplex virus presents with painful vesicles
and ulcers.
3. A 20-year-old sexually active female is seen in the clinic because her partner
was diagnosed with gonorrhea. What is the treatment of choice for gonorrhea?
A) Azithromycin 1 g orally once
B) Ceftriaxone 500 mg IM once
C) Doxycycline 100 mg orally twice daily for 7 days
D) Metronidazole 500 mg orally twice daily for 7 days
Correct Answer: Ceftriaxone 500 mg IM once
Rationale: Ceftriaxone 500 mg IM as a single dose is the first-line treatment for
uncomplicated gonorrhea. Azithromycin is no longer recommended as
monotherapy due to resistance. Doxycycline is used for chlamydia co-treatment.
Metronidazole is used for trichomoniasis and bacterial vaginosis.
4. A 45-year-old woman presents with complaints of vaginal discharge. Saline wet
mount reveals clue cells. What is the most likely diagnosis?
A) Candida vaginitis
B) Trichomonal vaginitis
C) Bacterial vaginosis
, D) Atrophic vaginitis
Correct Answer: Bacterial vaginosis
Rationale: Clue cells (epithelial cells coated with bacteria) are a classic finding
on wet mount in bacterial vaginosis, along with a thin, grayish-white discharge
and a fishy odor. Candida vaginitis shows budding yeast and pseudohyphae.
Trichomonal vaginitis shows motile flagellated organisms. Atrophic vaginitis
shows decreased estrogen effect without clue cells.
5. Which of the following medications is the treatment of choice for
trichomoniasis?
A) Fluconazole 150 mg orally once
B) Metronidazole 500 mg orally twice daily for 7 days
C) Doxycycline 100 mg orally twice daily for 7 days
D) Ceftriaxone 500 mg IM once
Correct Answer: Metronidazole 500 mg orally twice daily for 7 days
Rationale: Metronidazole (Flagyl) is the treatment of choice for trichomoniasis.
A single 2 g dose is also effective, but the 7-day regimen is preferred for improved
cure rates. Fluconazole treats Candida. Doxycycline treats chlamydia. Ceftriaxone
treats gonorrhea.
6. A 36-year-old woman presents with vaginal itching, burning, and discharge.
Wet mount reveals hyphae. Which treatment would be appropriate?
A) Metronidazole 500 mg orally twice daily for 7 days
B) Fluconazole 150 mg orally once
