Maryville NURS 620 Exam 4
Questions and answers latest
2025&2027
Course
NURS 620
1. A 23-year-old sexually active woman presents for her first Pap test. Which infection should
the nurse practitioner be particularly alert for based on her sexual history?
A. Candida
B. HPV
C. Trichomoniasis
D. Bacterial vaginosis
Answer: B. HPV
Rationale: Persistent infection with high-risk human papillomavirus is strongly associated with
cervical dysplasia and cervical cancer. Sexual history can increase the likelihood of HPV
exposure.
2. A 20-year-old woman presents after her sexual partner was diagnosed with gonorrhea.
Which medication is currently recommended as first-line treatment for uncomplicated
gonorrhea?
A. Acyclovir
B. Metronidazole
C. Ceftriaxone
D. Fluconazole
Answer: C. Ceftriaxone
Rationale: Ceftriaxone is the recommended first-line antimicrobial for uncomplicated
gonorrhea. Treatment should also consider possible concomitant chlamydial infection when
chlamydia has not been excluded.
3. A woman reports dysuria, dyspareunia, and mucopurulent cervical discharge. Her partner
was recently treated for nongonococcal urethritis. Which infection is most likely?
A. Chlamydia
B. Candida
C. Herpes simplex virus
D. Syphilis
,Answer: A. Chlamydia
Rationale: Chlamydia commonly produces cervicitis with mucopurulent discharge, dysuria, and
sometimes dyspareunia. It may also be asymptomatic.
4. A vaginal wet mount demonstrates clue cells. Which diagnosis is most likely?
A. Vulvovaginal candidiasis
B. Bacterial vaginosis
C. Trichomoniasis
D. Genital herpes
Answer: B. Bacterial vaginosis
Rationale: Clue cells are vaginal epithelial cells coated with bacteria and are characteristic of
bacterial vaginosis. BV is also associated with a thin discharge and elevated vaginal pH.
5. A patient has a vaginal discharge with a fishy odor that becomes more noticeable after
adding potassium hydroxide. What does this finding suggest?
A. Bacterial vaginosis
B. Genital herpes
C. Candidiasis
D. Syphilis
Answer: A. Bacterial vaginosis
Rationale: A positive whiff test occurs when an amine odor is released after KOH is added to
vaginal secretions, supporting the diagnosis of bacterial vaginosis.
6. A vaginal wet mount reveals motile, flagellated organisms. Which diagnosis should the
clinician make?
A. Candida vaginitis
B. Bacterial vaginosis
C. Trichomoniasis
D. Atrophic vaginitis
Answer: C. Trichomoniasis
Rationale: Motile trichomonads on microscopy are characteristic of Trichomonas vaginalis, a
sexually transmitted protozoal infection.
7. Which medication class is used to treat trichomoniasis?
,A. Nitroimidazoles
B. Macrolides
C. Penicillins
D. Antivirals
Answer: A. Nitroimidazoles
Rationale: Metronidazole or tinidazole is used to treat trichomoniasis. Sexual partners should
also be treated to prevent reinfection.
8. A woman presents with intense vulvar itching and a thick, white, non-odorous vaginal
discharge. Which diagnosis is most likely?
A. Trichomoniasis
B. Bacterial vaginosis
C. Vulvovaginal candidiasis
D. Gonorrhea
Answer: C. Vulvovaginal candidiasis
Rationale: Candida commonly causes intense pruritus, vulvar irritation, and a thick white
discharge. Vaginal pH is typically normal.
9. Which finding is most characteristic of genital herpes?
A. Painless chancre
B. Painful grouped vesicles
C. Clue cells
D. Frothy green discharge
Answer: B. Painful grouped vesicles
Rationale: Genital herpes classically produces painful grouped vesicles that can rupture into
shallow ulcers. Systemic symptoms may occur during the initial outbreak.
10. A patient has a painless genital ulcer followed several weeks later by a diffuse rash
involving the palms and soles. Which infection is most likely?
A. Chlamydia
B. Gonorrhea
C. Syphilis
D. Herpes simplex
Answer: C. Syphilis
, Rationale: Primary syphilis classically causes a painless chancre. Secondary syphilis can cause a
generalized rash, including the palms and soles.
11. What is the preferred treatment for primary, secondary, or early latent syphilis in a
nonpregnant adult?
A. Ceftriaxone
B. Benzathine penicillin G
C. Acyclovir
D. Metronidazole
Answer: B. Benzathine penicillin G
Rationale: Benzathine penicillin G is the standard treatment for early syphilis.
12. A patient with pelvic pain, fever, cervical motion tenderness, and vaginal discharge is
suspected of having pelvic inflammatory disease. Why is prompt treatment important?
A. PID always causes immediate infertility
B. Untreated PID can result in infertility and ectopic pregnancy
C. PID is always self-limited
D. PID only affects the cervix
Answer: B. Untreated PID can result in infertility and ectopic pregnancy
Rationale: PID can cause inflammation and scarring of the upper reproductive tract, increasing
the risk of infertility, chronic pelvic pain, tubo-ovarian abscess, and ectopic pregnancy.
13. Which finding is most suggestive of pelvic inflammatory disease?
A. Cervical motion tenderness
B. Painless vulvar ulcer
C. Thick white discharge without inflammation
D. Breast tenderness
Answer: A. Cervical motion tenderness
Rationale: Pelvic or lower abdominal pain combined with cervical motion, uterine, or adnexal
tenderness is highly concerning for PID in an appropriate clinical context.
14. A 42-year-old woman reports hot flashes and six months of amenorrhea. Which hormonal
pattern would be expected as ovarian function declines?
A. Increased FSH and LH
B. Decreased FSH and LH
Questions and answers latest
2025&2027
Course
NURS 620
1. A 23-year-old sexually active woman presents for her first Pap test. Which infection should
the nurse practitioner be particularly alert for based on her sexual history?
A. Candida
B. HPV
C. Trichomoniasis
D. Bacterial vaginosis
Answer: B. HPV
Rationale: Persistent infection with high-risk human papillomavirus is strongly associated with
cervical dysplasia and cervical cancer. Sexual history can increase the likelihood of HPV
exposure.
2. A 20-year-old woman presents after her sexual partner was diagnosed with gonorrhea.
Which medication is currently recommended as first-line treatment for uncomplicated
gonorrhea?
A. Acyclovir
B. Metronidazole
C. Ceftriaxone
D. Fluconazole
Answer: C. Ceftriaxone
Rationale: Ceftriaxone is the recommended first-line antimicrobial for uncomplicated
gonorrhea. Treatment should also consider possible concomitant chlamydial infection when
chlamydia has not been excluded.
3. A woman reports dysuria, dyspareunia, and mucopurulent cervical discharge. Her partner
was recently treated for nongonococcal urethritis. Which infection is most likely?
A. Chlamydia
B. Candida
C. Herpes simplex virus
D. Syphilis
,Answer: A. Chlamydia
Rationale: Chlamydia commonly produces cervicitis with mucopurulent discharge, dysuria, and
sometimes dyspareunia. It may also be asymptomatic.
4. A vaginal wet mount demonstrates clue cells. Which diagnosis is most likely?
A. Vulvovaginal candidiasis
B. Bacterial vaginosis
C. Trichomoniasis
D. Genital herpes
Answer: B. Bacterial vaginosis
Rationale: Clue cells are vaginal epithelial cells coated with bacteria and are characteristic of
bacterial vaginosis. BV is also associated with a thin discharge and elevated vaginal pH.
5. A patient has a vaginal discharge with a fishy odor that becomes more noticeable after
adding potassium hydroxide. What does this finding suggest?
A. Bacterial vaginosis
B. Genital herpes
C. Candidiasis
D. Syphilis
Answer: A. Bacterial vaginosis
Rationale: A positive whiff test occurs when an amine odor is released after KOH is added to
vaginal secretions, supporting the diagnosis of bacterial vaginosis.
6. A vaginal wet mount reveals motile, flagellated organisms. Which diagnosis should the
clinician make?
A. Candida vaginitis
B. Bacterial vaginosis
C. Trichomoniasis
D. Atrophic vaginitis
Answer: C. Trichomoniasis
Rationale: Motile trichomonads on microscopy are characteristic of Trichomonas vaginalis, a
sexually transmitted protozoal infection.
7. Which medication class is used to treat trichomoniasis?
,A. Nitroimidazoles
B. Macrolides
C. Penicillins
D. Antivirals
Answer: A. Nitroimidazoles
Rationale: Metronidazole or tinidazole is used to treat trichomoniasis. Sexual partners should
also be treated to prevent reinfection.
8. A woman presents with intense vulvar itching and a thick, white, non-odorous vaginal
discharge. Which diagnosis is most likely?
A. Trichomoniasis
B. Bacterial vaginosis
C. Vulvovaginal candidiasis
D. Gonorrhea
Answer: C. Vulvovaginal candidiasis
Rationale: Candida commonly causes intense pruritus, vulvar irritation, and a thick white
discharge. Vaginal pH is typically normal.
9. Which finding is most characteristic of genital herpes?
A. Painless chancre
B. Painful grouped vesicles
C. Clue cells
D. Frothy green discharge
Answer: B. Painful grouped vesicles
Rationale: Genital herpes classically produces painful grouped vesicles that can rupture into
shallow ulcers. Systemic symptoms may occur during the initial outbreak.
10. A patient has a painless genital ulcer followed several weeks later by a diffuse rash
involving the palms and soles. Which infection is most likely?
A. Chlamydia
B. Gonorrhea
C. Syphilis
D. Herpes simplex
Answer: C. Syphilis
, Rationale: Primary syphilis classically causes a painless chancre. Secondary syphilis can cause a
generalized rash, including the palms and soles.
11. What is the preferred treatment for primary, secondary, or early latent syphilis in a
nonpregnant adult?
A. Ceftriaxone
B. Benzathine penicillin G
C. Acyclovir
D. Metronidazole
Answer: B. Benzathine penicillin G
Rationale: Benzathine penicillin G is the standard treatment for early syphilis.
12. A patient with pelvic pain, fever, cervical motion tenderness, and vaginal discharge is
suspected of having pelvic inflammatory disease. Why is prompt treatment important?
A. PID always causes immediate infertility
B. Untreated PID can result in infertility and ectopic pregnancy
C. PID is always self-limited
D. PID only affects the cervix
Answer: B. Untreated PID can result in infertility and ectopic pregnancy
Rationale: PID can cause inflammation and scarring of the upper reproductive tract, increasing
the risk of infertility, chronic pelvic pain, tubo-ovarian abscess, and ectopic pregnancy.
13. Which finding is most suggestive of pelvic inflammatory disease?
A. Cervical motion tenderness
B. Painless vulvar ulcer
C. Thick white discharge without inflammation
D. Breast tenderness
Answer: A. Cervical motion tenderness
Rationale: Pelvic or lower abdominal pain combined with cervical motion, uterine, or adnexal
tenderness is highly concerning for PID in an appropriate clinical context.
14. A 42-year-old woman reports hot flashes and six months of amenorrhea. Which hormonal
pattern would be expected as ovarian function declines?
A. Increased FSH and LH
B. Decreased FSH and LH
