NURS 684 PRIMARY CARE WOMEN'S HEALTH FINAL EXAM VERIFIED EXAM WITH ANSWERS

NURS 684 PRIMARY CARE WOMEN'S HEALTH FINAL EXAM VERIFIED EXAM WITH ANSWERS “A 22-year-old woman presents with c/o a non-tender mass in her left breast that does not change with her menstrual cycle. On examination, you note a freely movable, 0.5 cm x 1 cm firm, rubbery non-tender mass. The most likely diagnosis is: - CORRECT ANSWER Fibroadenoma" "In a review of vaccinations at an initial prenatal visit at 12 weeks gestation the patient tells you she had the Tdap vaccination with her last pregnancy which was 2 years ago. You would advise her she needs a: - CORRECT ANSWER Tdap vaccination in her third trimester" "The screening test for group B streptococcus requires that a specimen be obtained from the: - CORRECT ANSWER Vaginal introitus and rectum" "Routine gestational diabetes screening is recommended at: - CORRECT ANSWER Between 24 and 28 weeks gestation" "In the PLISSIT model, explaining the possible effect of an illness on sexual functioning is considered: - CORRECT ANSWER Limited information" "The terms gender identity and sexual orientation have similar meanings. - CORRECT ANSWER False" "Which of the following statements about women who have sex with women (WSW) is correct? - CORRECT ANSWER WSW tend to obtain routine gynecologic care less frequently than women who are heterosexual." "Which of the following is part of the diagnostic criteria for female sexual interest/arousal disorder? - CORRECT ANSWER Causes marked distress or interpersonal difficulty" "Erectile dysfunction has been linked to which of the following components of metabolic syndrome? - CORRECT ANSWER Abdominal obesity Hypertension Hyperlipidemia All of the above" "Specific gynecologic cancer screening recommendations have been established based on gender identity. - CORRECT ANSWER False" "Known teratogens include all of the following EXCEPT: - CORRECT ANSWER Insulin" "A woman with hypertension that has been well controlled with an angiotensin converting enzyme inhibitor (ACEI) and who is otherwise healthy is interested in becoming pregnant in the near future. Appropriate information would include: - CORRECT ANSWER She will need to switch to another antihypertensive medication prior to becoming pregnant." "You are seeing a 29-year-old female for an annual well woman visit who is considering a pregnancy in the next year. She had a preterm birth 2 years ago and wants to know what she can do to prevent this from happening again. Appropriate information would include: - CORRECT ANSWER She should discuss with her OB/GYN provider the potential benefit of treatment with progesterone with this next pregnancy." "A mother brings her infant into the office for a well-baby visit at 3 months of age. You ask how she is doing and she tells you she has been having difficulty sleeping with frequent nightmares and having panic attacks for no reason. Her affect at this visit is normal except for expressing worry about her symptoms and she appears to be bonding well with the baby. The baby is doing well now although he had to be resuscitated and then transported to a NICU at another hospital immediately after birth because he was preterm and low-birth-weight. You suspect possible: - CORRECT ANSWER Post-traumatic stress disorder" "Noncontraceptive benefits of combination oral contraceptives include all of the following EXCEPT: - CORRECT ANSWER Decrease in cervical cancer" "Symptoms of epididymitis include all of the following EXCEPT: - CORRECT ANSWER Sudden onset of severe pain" "According to U.S. Medical Eligibility Criteria for Contraceptive Use you should refrain from providing combination oral contraceptives to a woman in which of the following situations: - CORRECT ANSWER Breastfeeding and less than one month postpartum" "A woman who has been on Depo Provera IM for 9 months presents for her injection. It has been 16 weeks since her last injection. The last time she had sex was 7 days ago. Appropriate management would be: - CORRECT ANSWER Perform a sensitive urine pregnancy test and give the injection if the test is negative" "CDC recommendations for follow up of a female treated for PID with ceftriaxone 250 mg IM and doxycycline 100 mg orally bid for 14 days is: - CORRECT ANSWER See patient again within 72 hours after initiation of treatment" "A 20-year-old sexually active female comes to the clinic for contraception. She has had 1 male sex partner. She has never had a pelvic exam or any sexually transmitted infection testing. She has no symptoms of any infection. According to current nationally accepted guidelines which of the following tests should she have at this visit for routine screening purposes? - CORRECT ANSWER Chlamydia, gonorrhea, and HIV" "During a pregnancy the uterus is palpable at, or just above, the symphysis pubis at __ weeks gestation: - CORRECT ANSWER 12" "A 14 your old is receiving the HPV vaccines. What is the appropriate vaccination schedule? - CORRECT ANSWER HPV will be in 2 series; 2nd dose will be 6 to 12 months after initial shot" "T/F? The Depo shot decreases your risk for endometrial cancer - CORRECT ANSWER TRUE" "The ACS and ACOG agree that.... - CORRECT ANSWER Everyone needs a mammogram at 40 years old" "Breast cancer is the most common cancer in American women, affecting _____________ women. - CORRECT ANSWER 1 in every 8" "When performing the mammogram of a postmenopausal woman, you note that there is very dense breast tissue. What is the most appropriate course of action? - CORRECT ANSWER Do further testing" "What is the most appropriate birth control for a patient who takes phenytoin? - CORRECT ANSWER Depo shot" "When beginning combined oral contraceptive (COC) pills, what is an important teaching point? - CORRECT ANSWER Use back up method (BUM) for 7 days on 1st pack" "What is important teaching to include about condom use? - CORRECT ANSWER Hold at base when removing from penis" "T/F? It is important that female condoms use non-latex material - CORRECT ANSWER TRUE" "T/F? The position of the Nuva ring is very important and should be emphasized to the patient - CORRECT ANSWER FALSE" "T/F? If a patient is obese Plan B is not as effective - CORRECT ANSWER TRUE" "T/F? When using the sponge, it is important to note that it is not as effective if the woman has been pregnant before - CORRECT ANSWER TRUE" "If a woman becomes pregnant while using an IUD, what is the next step? - CORRECT ANSWER Removal if strings visible" "T/F? The use of BC in postmenopausal women is pregnancy prevention - CORRECT ANSWER FALSE- do not prescribe them IUD" "What is an expected characteristic of cervical mucus? - CORRECT ANSWER Thin and stretchy with ovulation" "What type of BC is not appropriate for a 46-year-old woman who smokes? - CORRECT ANSWER Nuva Ring" "T/F? Insertion of either IUD at or after 4 weeks postpartum can be used without restrictions - CORRECT ANSWER TRUE" "A breastfeeding mother of an infant is using lactation as BC. What is important education to give her? - CORRECT ANSWER Need another type at 6 months old" "When considering offering HIV testing to clients, the nurse should keep which of the following in mind? A. Offer it all women who are being tested for STI's B. the testing is completely voluntary C. specific signed consent for testing should be required D. opt out HIV screening is recommended E. antigen only tests are encouragedComprehensive Final - CORRECT ANSWER A. Offer it all women who are being tested for STI's B. the testing is completely voluntary D. opt out HIV screening is recommended" "Mindy is a 35-year-old client with a family history of coronary heart disease and a body mass index (BMI) of 31. How often should Mindy have a lipid profile assessment performed? A. Every year B. Every 5 years C. Every 7 years D. Every 10 years - CORRECT ANSWER B. Every 5 years" "The nurse is reviewing contraception options for Olivia, a 37- year old client who gave birth 3 weeks ago. Olivia is interested in trying a combined oral contraceptives but it not sure whether it would be safe for her. Which of the following would be contraindications for Olivia beginning COCs now, given her situation? A. Breast feeding B. Smoking C. History of irregular menses D. family history of ovarian cancer E. Current breast cancer - CORRECT ANSWER A. Breastfeeding B. Smoking E. Current Breast Cancer" "The prenatal clinician is working in an ambulatory public health setting. For which of the following might the provider order expedited partner therapy? - CORRECT ANSWER Chlamydia" "A woman at 35 weeks gestation reports pain during the active straight leg test. What is this indicative of? - CORRECT ANSWER Symphysis seperation" "Which of the following is true regarding chronic htn w/ super imposed preeclampsia? - CORRECT ANSWER ACOG recommends labor and birth at 37 weeks gestation?" "A woman at 32 weeks gestation reports sensations of uncomfortable jumpy and itching leg for the last 2 weeks, usually during the night. Which test is essential to obtain? - CORRECT ANSWER serum ferritin" "Which of the following is true regarding Beta HCG in the first trimester? - CORRECT ANSWER It doubles every 2-3 weeks until approximately 10 weeks?" "Noninvasive prenatal testing is offered to? - CORRECT ANSWER " "Prenatal care had its origins in screening for? - CORRECT ANSWER Preeclampsia" "Systemic 1st generation antihistamines such as diphenhydramine and chlorpheniramine incur what risk when used during pregnancy? - CORRECT ANSWER ?" "What is the typical onset for the nausea and vomiting of pregnancy? - CORRECT ANSWER 5-9 weeks" "Zoe is a 37-year-old client in her 3rd trimester with twins. What complications should hte nurse assess for Zoe because she is carrying twins? - CORRECT ANSWER " "Potential causes for galactorrhea include all of the following EXCEPT: - CORRECT ANSWER Heavy tobacco use" "A 50-year-old woman presents with complaint of a burning sensation behind both nipples and a spontaneous greenish brown nipple discharge. On examination you note bilateral multiduct sticky green nipple discharge with no masses or breast skin changes. The most likely diagnosis is: - CORRECT ANSWER Mammary duct ectasia" "Differential diagnoses for a woman who presents with red moist patches or one or both breasts include eczema and Paget's disease of the nipple. Findings that fit with Paget's disease of the nipple include which of the following: - CORRECT ANSWER Nipple always involved, itching common" "Rapid onset of diffuse erythema of the breast with fine dimpling (peau d'orange) of the skin is indicative of: - CORRECT ANSWER Inflammatory breast cancer" "A 54-year-old woman has a mammogram that is negative but shows that she has dense breasts. Appropriate information for this woman would include: - CORRECT ANSWER Additional surveillance may be recommended depending on other breast cancer risk factors." "Each offspring of an individual found to carry a BRCA mutation has a 50% chance of inheriting the same mutation. - CORRECT ANSWER True" "Expected findings during examination of the pregnant woman who is 10 weeks gestation would include: - CORRECT ANSWER Softening of the cervix" "Folic acid supplementation prior to conception has been shown to decrease the incidence of: - CORRECT ANSWER Neural tube defects" "Advise for the postpartum woman who had gestational diabetes should include: - CORRECT ANSWER She should have regular screening for type 2 diabetes" "A client presents with complaint of increased vaginal discharge with bad odor and itching. On examination a yellow, frothy discharge is noted. Findings on further evaluation of the vaginal discharge will likely include - CORRECT ANSWER Motile trichomonads" "A 22-year-old female has a pap test report of ASC-H. The H indicates "cannot rule out HSIL" Recommended first steps in follow-up would include: - CORRECT ANSWER Colposcopy" "A post-menopausal woman has a Pap test report of HSIL. Recommended initial management is: - CORRECT ANSWER Colposcopy" "Which of the following would be an expected finding with adenomyosis? - CORRECT ANSWER Boggy, tender, enlarged uterus" "Which of the following conditions places a woman at increased risk for endometrial cancer? - CORRECT ANSWER Polycystic ovarian syndrome" "Of the following, which would be the best choice for a 55-year-old menopausal woman without a uterus who is having severe hot flashes and dyspareunia related to vulvovaginal atrophy? She has no contraindications to any of these medications. - CORRECT ANSWER Transdermal estrogen patch" "A 20 year old female presents at the clinic with concern that she had spotting several days in her current pill cycle. She has been on the same combination oral contraceptives for two years without any problems. She states she has not missed any pills and her last period was normal. Appropriate initial management would include: - CORRECT ANSWER Discuss her recent sexual history and do a test for Chlamydia if indicated" "Potential disadvantages of the progestin only implant (Nexplanon) include: - CORRECT ANSWER May cause irregular bleeding of spotting" "Which of the following best describes the typical lesion(s) seen with genital herpes? - CORRECT ANSWER Multiple vesicles and shallow ulcers" "Which of the following statements is correct? - CORRECT ANSWER Women with interpregnancy intervals (IPIs) of less than 18 months are more likely to have premature and/or low birth weight infants than those with IPIs greater than 18 months." "Which of the following statements concerning raloxifine (Evista) is correct? - CORRECT ANSWER It is approved for both prevention and treatment of osteoporosis." "A breastfeeding woman who had an uncomplicated full term vaginal delivery is in the office today for her six weeks postpartum checkup. Expected physical examination findings would include: - CORRECT ANSWER Decreased vaginal rugation" "Which of the following statements concerning HPV vaccination is correct? - CORRECT ANSWER It is safe to administer it at the same visit as other recommended vaccines." "An 18-year-old female presents with genital warts. Appropriate tests to consider include: - CORRECT ANSWER HIV test" "The most variable phase in the ovarian cycle in terms of days it lasts is the: - CORRECT ANSWER Follicular phase" "Which of the following statements by a client indicates that she needs additional instructions on use of the contraceptive vaginal ring? - CORRECT ANSWER I should insert a new ring every seven days." "A common side effect of oral tolterodine (Detrol) for treatment of urge incontinence is: - CORRECT ANSWER Dry Mouth" "A 25-year-old female who is planning for a first pregnancy asks if there are any tests for infections she should have before she gets pregnant. Appropriate advice would include that she should consider testing for: - CORRECT ANSWER HIV infection" "Risk factors for ovarian cancer include: - CORRECT ANSWER Nulliparity" "Which of the following could be a sign or symptom of either PID or an ectopic pregnancy in a sexually active, reproductive age woman? - CORRECT ANSWER Cervical motion tenderness Spotting Pelvic mass All of the above" "Increased production of __________________ is associated with primary dysmenorrhea. - CORRECT ANSWER Prostaglandin" "The results of bone densitometry test on a 65 year-old-woman is a T-score of - 2.0. This indicates she has: - CORRECT ANSWER Bone loss that is at the level for a diagnosis of osteopenia" "A woman who was late starting a new pack of her combination oral contraceptives (COCs) and had unprotected sex is given ulipristal acetate (Ella) for emergency contraception. She should be advised to: - CORRECT ANSWER Abstain from sex or use a barrier method for five days and then restart COCs" "Which of the following components of the PLISSIT model would best describe instructing a couple on the use of water-based lubrication for dyspareunia caused by vaginal dryness? - CORRECT ANSWER Limited information" "Initial management for a 30-year-old woman whose brother had breast cancer should be: - CORRECT ANSWER Refer her for genetic counseling and possible genetic testing" "A 66-year-old female presents with complaint of vulvar itching for the past 3 months. On exam you note thickened vulvar tissue with a raised area of darker pigmentation. Initial management should include: - CORRECT ANSWER Biopsy of the vulvar tissue" "In almost all cases preconception wellness results in good health for women, irrespective of pregnancy intentions. - CORRECT ANSWER True" "The recommended treatment for trichomoniasis is: - CORRECT ANSWER Oral metronidazole" "A 26-year-old woman presents with multiple, painless, umbilicated papules on her mons pubis. The most likely diagnosis is: - CORRECT ANSWER Molluscum contagiosum" "A 45-year-old female presents with complaint of lower abdominal pain with urinary frequency and urgency for the past three months. The pain is worse during sexual intercourse and relieved somewhat when she urinates. Physical exam reveals suprapubic tenderness as well as tenderness along the anterior wall of the vagina and urethra. The remainder of her exam is normal. What diagnosis fits best with these findings? - CORRECT ANSWER Interstitial cystitis/painful bladder syndrome" A 21-year-old patient receives a positive LSIL. What is the most appropriate course of action? - CORRECT ANSWER Repeat pap in 1 year" "Your 28-year-old patient is positive for HSIL. What is the most appropriate course of action? - CORRECT ANSWER Colposcopy" "T/F? Genitals warts are a lifelong disease. - CORRECT ANSWER TRUE" "A patient with a hx of vulvar cancer is reporting itching in the vulvar area. What is the most appropriate course of action? - CORRECT ANSWER Biopsy" "T/F? Once someone has genital warts, they are no longer eligible for the HPV vaccine - CORRECT ANSWER FALSE" "Genital warts increase the risk for which type of cancer? - CORRECT ANSWER Cervical" "S/S of ovarian cancer - CORRECT ANSWER USu asymptomatic, or symptoms are vague -Abd pain -bloating -pelvic pain -frequency -constipation -abnormal discharge/bleeding" "T/F? Copper IUD thins endometrial lining and cervical mucus - CORRECT ANSWER TRUE" "T/F? A patient with PID receiving tx must have their IUD removed immediately - CORRECT ANSWER FALSE-can keep in unless s/s do not improve" "T/F? The longer a patient has had a vasectomy, the more difficult it is the reverse. - CORRECT ANSWER TRUE" "A patient has missed their progestin-only pill (POP) for three hours. What is appropriate education to give them? - CORRECT ANSWER Use back-up method" "A patient is having spotting during their active pills. What is important to rule out? - CORRECT ANSWER Chlamydia" "A patient with a BMI of 28 would like the Depo shot for her contraceptive use. What is important to tell her? - CORRECT ANSWER Depo shot decreases risk of endometrial cancer" "T/F? When doing a pap, it is important to insert the brush so that the bristles are fully in the os - CORRECT ANSWER TRUE" "Which patient is a category 2 classification for COC? - CORRECT ANSWER Healthy 40-year-old" "T/F? COC pills decrease the risk for ovarian cancer - CORRECT ANSWER TRUE" "When discussing IUD type it is important to note: - CORRECT ANSWER How heavy their menstrual bleeding is" "T/F? Nexplanon may cause irregular or prolonged bleeding - CORRECT ANSWER True" "A patient has had unprotected sex and wants to use emergency contraception. What is important education? - CORRECT ANSWER Effective sooner rather than alter, should be within five days ("other than Friday night")" "Important for copper IUD vs LNG IUD? - CORRECT ANSWER LNG has more favorable SEs, can have heavy bleeding with copper" "Important things to remember when starting a patient on the Depo shot - CORRECT ANSWER Start when patient is on period, take BP" "T/F? 30% of US pregnancies are unplanned - CORRECT ANSWER FALSE-50%" "A 28-year-old has atypical squamous cells (ASC-H) found on their pap. What is the most appropriate course of action? - CORRECT ANSWER Send for colposcopy" "T/F? COC decreases risk for cervical cancer. - CORRECT ANSWER FALSE- ALL but" "T/F? HPV increases risk for vulvar cancer - CORRECT ANSWER TRUE" Which of the following are risk factors associated with hypothyroidism? -tumor of thyroid -age 60 + -male gender -family hx -surgical removal of thyroid - CORRECT ANSWER -tumor of thyroid -age 60+ -surgical removal of thyroid" "Risk factors the nurse is instructing a client on risk factors associated with being infected with HIV. Which of the following should the nurse mention? SATA A. Being male B. lesions being present within the vagina C. being pregnant D. having sex during menstruation E. douching - CORRECT ANSWER B. lesions being present within the vagina C. being pregnant D. having sex during menstruation E. douching" "Carol is a client who is being assessed for risk for anal HPV infection. Which of the following are factors that would increase Carol's risk for having anal HPV? SATA A. Presence of cervical HPV B. CD4 count of 50 C. History of anal intercourse D. Lesbian sexual orientation E. Smoking - CORRECT ANSWER A. Presence of cervical HPV B. CD4 count of 50 C. History of anal intercourse E. Smoking" "Prenatal care had its origins in screening for symptoms of? - CORRECT ANSWER Preeclampsia" "A 33 year old pregnant woman at 14 weeks gestation is her for her first prenatal visit. When discussing genetic screening options id is most appropriate to offer? - CORRECT ANSWER Quad Screen" "Polyhydraminos is NOT associated with? - CORRECT ANSWER ?" "Management of the fetus w/ suspected macrosomia includes? - CORRECT ANSWER Elective C section and early indection of labor" "Suppressive antibiotic therapy is recommended for recurring UTIs in pregnant women under what conditions? - CORRECT ANSWER UTI w/ a hx of preterm labor and birth?"