NR 509 Final Exam Study
Guide & Test Bank | 250
Questions with Correct
Detailed Answers and
Rationales | Updated
2025/2026 | Graded A+
A 20-year-old college student presents for his annual physical
examination. He recently became sexually active and is
inquiring about the best means of preventing sexually
transmitted infections (STIs). Of the following, which would
be the most effective means of prevention?
a. Early withdrawal
b. Male condoms
c. Spermicides
d. Diaphragms
e. Cervical caps - ....ANSWER...b. Male condoms
A 21-year-old college student presents to the student health
clinic for a full physical examination. He is generally healthy;
however, he reports that he has had sexual intercourse with
multiple partners in the past couple of months. He noticed a
small lesion on the shaft of his penis a few days ago. While
performing the examination, he unwillingly achieves an
erection. How should the clinician proceed at this point?
a. Stop the examination immediately.
,b. Have him return to see another provider.
c. Explain this is a normal response and finish the
examination.
d. Tell him the examination cannot proceed until the erection
subsides.
e. Assume that he is malingering. - ....ANSWER...c. Explain
this is a normal response and finish the examination.
A 45-year-old driver's education instructor presents to the
clinic for heavy periods and pelvic pain during her menses.
She reached menarche at age 13 years and has had regular
periods except during her pregnancies. She is a G4P3013 and
does not use birth control as her husband has had a
vasectomy. She states this has been going on for about a year
but seems to be getting worse. Her last period was 1 week
ago. On bimanual exam, a large midline mass halfway to the
umbilicus is palpated. Each adnexal area is nonpalpable. Her
rectal exam is normal. Her body mass index (BMI) is 27.
What is the best explanation for her physical finding?
a. Large colonic stool
b. Ovarian mass
c. Fibroids
d. 4-Month pregnancy
e. Bartholin gland enlargement - ....ANSWER...c. Fibroids
A 32-year-old G0 woman comes for evaluation on why she
and her husband have been unable to get pregnant. Her
husband has been married before and has two other children,
ages 7 and 4 years. The patient relates she began her periods
at age 12 and has been fairly regular ever since. She began
oral contraceptive pills from when she got married until last
year, when she began to try for a pregnancy.
,Before this she had regular cycles for 10 years. She has had a
history of five prior partners. She relates she was once treated
for a severe genital infection when she was in college. Based
on this patient's history, what is the best explanation for her
infertility?
a. Prior pelvic inflammatory disease (PID)
b. Prior Bartholin gland infection
c. Prior herpes infection
d. Metabolic disorder with subsequent hormonal irregularities
leading to anovulation
e. Secondary amenorrhea - ....ANSWER...a. Prior pelvic
inflammatory disease (PID)
A 24-year-old retail clerk presents to the clinic for an annual
exam. Her last Pap was 3 years ago and was normal. She is a
G0 and is currently not sexually active although she has had
two lifetime partners. She is on oral contraceptive pills for
cycle control and has no medical problems. Based on
guidelines, the clinician proceeds to perform a Pap smear and
places the speculum. There are two layers of cells, squamous
and columnar. Where is the most important area to obtain
cells for a Pap smear?
a. Zona reticularis
b. Transformation zone
c. Squamous zone
d. Columnar zone
e. Linea nigra - ....ANSWER...b. Transformation zone
A 35-year-old grade school teacher presents for her annual
exam. Her last Pap smear was 4 years ago and normal. She is
a G1P1 with a 6-year-old child. She has had four lifetime
, partners but only one partner in the last 12 years. Otherwise
she has no complaints. A speculum exam is done followed by
a bimanual examination during which a rectovaginal mass is
palpated. Which of the following exam findings would be
most reassuring that this is not a colonic mass?
a. No cervical motion tenderness
b. No pus from the os
c. The mass dents with digital pressure
d. Both adnexa are nontender
e. The perineum has no lesions - ....ANSWER...c. The mass
dents with digital pressure
A 21-year-old college student presents for her first annual
exam. She has been sexually active for 1 year and has had two
partners. She is not aware of having had any sexually
transmitted diseases (STIs).
She is using condoms for birth control and STI prevention but
admits to not always using them regularly. Her last menses
was 2 weeks ago. On speculum exam, an unusual appearance
is noted, which is diagnosed as warts. What is the best
description for these lesions?
a. Several shallow ulcers with a red base
b. Translucent nodules
c. Raised friable or lobed lesions
d. Bright red, soft lesion arising from the cervical canal
e. Strawberry cervix (small red granular spots or petechiae) -
....ANSWER...c. Raised friable or lobed lesions
A 23-year-old female comes to the clinic to discuss her birth
control options. Although she has been sexually active since
age 16 years, she has been with one partner for the last year.
Guide & Test Bank | 250
Questions with Correct
Detailed Answers and
Rationales | Updated
2025/2026 | Graded A+
A 20-year-old college student presents for his annual physical
examination. He recently became sexually active and is
inquiring about the best means of preventing sexually
transmitted infections (STIs). Of the following, which would
be the most effective means of prevention?
a. Early withdrawal
b. Male condoms
c. Spermicides
d. Diaphragms
e. Cervical caps - ....ANSWER...b. Male condoms
A 21-year-old college student presents to the student health
clinic for a full physical examination. He is generally healthy;
however, he reports that he has had sexual intercourse with
multiple partners in the past couple of months. He noticed a
small lesion on the shaft of his penis a few days ago. While
performing the examination, he unwillingly achieves an
erection. How should the clinician proceed at this point?
a. Stop the examination immediately.
,b. Have him return to see another provider.
c. Explain this is a normal response and finish the
examination.
d. Tell him the examination cannot proceed until the erection
subsides.
e. Assume that he is malingering. - ....ANSWER...c. Explain
this is a normal response and finish the examination.
A 45-year-old driver's education instructor presents to the
clinic for heavy periods and pelvic pain during her menses.
She reached menarche at age 13 years and has had regular
periods except during her pregnancies. She is a G4P3013 and
does not use birth control as her husband has had a
vasectomy. She states this has been going on for about a year
but seems to be getting worse. Her last period was 1 week
ago. On bimanual exam, a large midline mass halfway to the
umbilicus is palpated. Each adnexal area is nonpalpable. Her
rectal exam is normal. Her body mass index (BMI) is 27.
What is the best explanation for her physical finding?
a. Large colonic stool
b. Ovarian mass
c. Fibroids
d. 4-Month pregnancy
e. Bartholin gland enlargement - ....ANSWER...c. Fibroids
A 32-year-old G0 woman comes for evaluation on why she
and her husband have been unable to get pregnant. Her
husband has been married before and has two other children,
ages 7 and 4 years. The patient relates she began her periods
at age 12 and has been fairly regular ever since. She began
oral contraceptive pills from when she got married until last
year, when she began to try for a pregnancy.
,Before this she had regular cycles for 10 years. She has had a
history of five prior partners. She relates she was once treated
for a severe genital infection when she was in college. Based
on this patient's history, what is the best explanation for her
infertility?
a. Prior pelvic inflammatory disease (PID)
b. Prior Bartholin gland infection
c. Prior herpes infection
d. Metabolic disorder with subsequent hormonal irregularities
leading to anovulation
e. Secondary amenorrhea - ....ANSWER...a. Prior pelvic
inflammatory disease (PID)
A 24-year-old retail clerk presents to the clinic for an annual
exam. Her last Pap was 3 years ago and was normal. She is a
G0 and is currently not sexually active although she has had
two lifetime partners. She is on oral contraceptive pills for
cycle control and has no medical problems. Based on
guidelines, the clinician proceeds to perform a Pap smear and
places the speculum. There are two layers of cells, squamous
and columnar. Where is the most important area to obtain
cells for a Pap smear?
a. Zona reticularis
b. Transformation zone
c. Squamous zone
d. Columnar zone
e. Linea nigra - ....ANSWER...b. Transformation zone
A 35-year-old grade school teacher presents for her annual
exam. Her last Pap smear was 4 years ago and normal. She is
a G1P1 with a 6-year-old child. She has had four lifetime
, partners but only one partner in the last 12 years. Otherwise
she has no complaints. A speculum exam is done followed by
a bimanual examination during which a rectovaginal mass is
palpated. Which of the following exam findings would be
most reassuring that this is not a colonic mass?
a. No cervical motion tenderness
b. No pus from the os
c. The mass dents with digital pressure
d. Both adnexa are nontender
e. The perineum has no lesions - ....ANSWER...c. The mass
dents with digital pressure
A 21-year-old college student presents for her first annual
exam. She has been sexually active for 1 year and has had two
partners. She is not aware of having had any sexually
transmitted diseases (STIs).
She is using condoms for birth control and STI prevention but
admits to not always using them regularly. Her last menses
was 2 weeks ago. On speculum exam, an unusual appearance
is noted, which is diagnosed as warts. What is the best
description for these lesions?
a. Several shallow ulcers with a red base
b. Translucent nodules
c. Raised friable or lobed lesions
d. Bright red, soft lesion arising from the cervical canal
e. Strawberry cervix (small red granular spots or petechiae) -
....ANSWER...c. Raised friable or lobed lesions
A 23-year-old female comes to the clinic to discuss her birth
control options. Although she has been sexually active since
age 16 years, she has been with one partner for the last year.
