NR 602 FINAL EXAM/NR 602 WEEK 8 FINAL EXAM 2023 ACTUAL EXAM
COMPLETE 50 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
ASCCP recommended management for an ASCUS pap result with high risk hpv 16
cotest in 26 year old no abnormal paps - ANSWER: colposcopy
What is included in the well women of an adolescent? - ANSWER: health history
menses
gynecologic and pregnancy issues
psychosocial
abuse drugs alcohol use
physical exam
screening tests
immunizations
When does ACOG pap smear start - ANSWER: 21 years old done every three years
ACOG pap for over 30 yrs old - ANSWER: every five years with HPV test completed
ACOG when can you stop pap smear - ANSWER: can stop at 65 if negative history for
10 years or if they had a hysterectomy with no history of cervical cancer
Bethesda pap smear report reads LSIL is what classification? - ANSWER: CIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should
have what as follow-up? - ANSWER: routine screening
a female patient is 35 years old. she has never had an abnormal PAP smear has
regular screening since age 18. If she has a normal PAP smear with HPV testing
today, when should she have the next cervical cancer screening? - ANSWER: 5 years
A young sexually active is having her first pap smear what would you explain? -
ANSWER: pap smear detects cervical cancer
26 year old pap smear shows negative and positive HPV what do you do? - ANSWER:
repeat HPV and pap
what is not part of criteria for older women to cease pap smears? - ANSWER: over 55
year old
no menarche in a 15 year old with no medical problems and Tanner stage 1 with a
uterus - ANSWER: primary amenorrhea
No menses for at least 6 months - ANSWER: secondary amenorrhea
,female athlete triad - ANSWER: disordered eating, amenorrhea, osteoporosis
labs for female athlete triad - ANSWER: HCG
serum prolactin
serum TSH,FSH, LH
if amenorhea lasts longer than 6 months do what? - ANSWER: bone density test
treatment plan for female athlete triad - ANSWER: increase caloric intake, decrease
exercise
prescribe ca and vit d 1200/1500 daily and vitamin e 400 iu daily
complications of female athlete triad - ANSWER: osteopenia/osteoporosis (stress
fracture)
myocardial atrophy, arrhythmia, hypotension, brady
hypoglycemia, dehydration, electrolytes
lanugo, telogen effluvium hair loss zerosis dry skin, infertility, low body mass,
cachexia, respiratory failure
purpose of progesterone challenge - ANSWER: endogenous estrogen
primary and secondary amenorrhea originates in hypothalamus - ANSWER: sheehans
syndrome
symptoms of breast cancer ( early) - ANSWER: None
Non-painful mass (occasionally pain)
Eczematous nipple (Paget's)
Serosanguinous (bloody) nipple discharge
late symptoms of breast cancer - ANSWER: skin or nipple retraction
axilary lymhadenpathy
breast enlargement
redness, edema, brawny induration
peau d' orange
pain
fixation of the mass to the skin or chest wall
very late findings of breast cancer - ANSWER: ulceration
supraclavicular lymphadenopathy
edema of the arm, bone, lung, liver, brain or other distant metstases
Follow up for breast cancer patients - ANSWER: 1. Bilateral mammogram 6 months
after complete radiation post-lumpectomy; Mammogram yearly after
2. Contralateral mammogram annually post-mastectomy (entire breast + pectoralis
major fascia)
PE every 3-6 months for 3 years then annually
, fibrocystic breast disease - ANSWER: the presence of single or multiple benign cysts
in the breasts
signs and symptoms of fibrocystic breast disease - ANSWER: occurs 2 weeks before
the onset of mensus and worst right before the menstrual cycle. resolves after
menses starts often in women in their 30's. breast lumps are rubbery and mobile to
touch
Tx for fibrocystic breast disease - ANSWER: Once a benign diagnosis or normal
findings have been established by biopsy or on clinical or imaging findings, simple
reassurance will provide many patients with adequate relief.
For those patients who still seek treatment, symptomatic relief by avoiding trauma
and by wearing a bra with adequate support can be very helpful. The role of caffeine
consumption in the development and treatment of fibrocystic change has never
been proven; however, many patients report relief of symptoms after abstinence
from coffee, tea, and chocolate. Similarly, observational studies have suggested that
low-fat diets can provide some relief. The data regarding the utility of vitamin E
supplementation and evening primrose oil are controversial. Mild analgesics such as
acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to
relieve breast pain. For more symptomatic women, danazol and tamoxifen have
been found to be effective, although their significant side effects have limited their
acceptability and utility.
Fibroadenoma - ANSWER: benign breast lesion 15-40 yrs old
risk factors for fibroadenoma - ANSWER: multiple fibroadenomas associated with
rate cancer syndromes like mafficci syndrome, Cowden syndrome, carney complex
early ETOH consumption
findings with fibroadenoma - ANSWER: painless, firm or rubbery mass with well
defined borders, freely mobile, changes with size may occur with pregnany or
menstrual cycle, lesions under 5 cm, considered to be giant fibrodenomas no nipple
discharge
Dx of fibroadenoma - ANSWER: mammo, us to differentiate fluid filled to solid mass,
fine needle aspiration biopsy, open biopsy
Intraductal papilloma - ANSWER: benign tumor within the ductal system of the
breast, one of the heterogeneous group of lesions encompassed by the term benign
breast disease seen in females 30-50
risk factors for intraductal papilloma - ANSWER: multiple papilloma's which increases
the risk for breast cancer
COMPLETE 50 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
ASCCP recommended management for an ASCUS pap result with high risk hpv 16
cotest in 26 year old no abnormal paps - ANSWER: colposcopy
What is included in the well women of an adolescent? - ANSWER: health history
menses
gynecologic and pregnancy issues
psychosocial
abuse drugs alcohol use
physical exam
screening tests
immunizations
When does ACOG pap smear start - ANSWER: 21 years old done every three years
ACOG pap for over 30 yrs old - ANSWER: every five years with HPV test completed
ACOG when can you stop pap smear - ANSWER: can stop at 65 if negative history for
10 years or if they had a hysterectomy with no history of cervical cancer
Bethesda pap smear report reads LSIL is what classification? - ANSWER: CIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should
have what as follow-up? - ANSWER: routine screening
a female patient is 35 years old. she has never had an abnormal PAP smear has
regular screening since age 18. If she has a normal PAP smear with HPV testing
today, when should she have the next cervical cancer screening? - ANSWER: 5 years
A young sexually active is having her first pap smear what would you explain? -
ANSWER: pap smear detects cervical cancer
26 year old pap smear shows negative and positive HPV what do you do? - ANSWER:
repeat HPV and pap
what is not part of criteria for older women to cease pap smears? - ANSWER: over 55
year old
no menarche in a 15 year old with no medical problems and Tanner stage 1 with a
uterus - ANSWER: primary amenorrhea
No menses for at least 6 months - ANSWER: secondary amenorrhea
,female athlete triad - ANSWER: disordered eating, amenorrhea, osteoporosis
labs for female athlete triad - ANSWER: HCG
serum prolactin
serum TSH,FSH, LH
if amenorhea lasts longer than 6 months do what? - ANSWER: bone density test
treatment plan for female athlete triad - ANSWER: increase caloric intake, decrease
exercise
prescribe ca and vit d 1200/1500 daily and vitamin e 400 iu daily
complications of female athlete triad - ANSWER: osteopenia/osteoporosis (stress
fracture)
myocardial atrophy, arrhythmia, hypotension, brady
hypoglycemia, dehydration, electrolytes
lanugo, telogen effluvium hair loss zerosis dry skin, infertility, low body mass,
cachexia, respiratory failure
purpose of progesterone challenge - ANSWER: endogenous estrogen
primary and secondary amenorrhea originates in hypothalamus - ANSWER: sheehans
syndrome
symptoms of breast cancer ( early) - ANSWER: None
Non-painful mass (occasionally pain)
Eczematous nipple (Paget's)
Serosanguinous (bloody) nipple discharge
late symptoms of breast cancer - ANSWER: skin or nipple retraction
axilary lymhadenpathy
breast enlargement
redness, edema, brawny induration
peau d' orange
pain
fixation of the mass to the skin or chest wall
very late findings of breast cancer - ANSWER: ulceration
supraclavicular lymphadenopathy
edema of the arm, bone, lung, liver, brain or other distant metstases
Follow up for breast cancer patients - ANSWER: 1. Bilateral mammogram 6 months
after complete radiation post-lumpectomy; Mammogram yearly after
2. Contralateral mammogram annually post-mastectomy (entire breast + pectoralis
major fascia)
PE every 3-6 months for 3 years then annually
, fibrocystic breast disease - ANSWER: the presence of single or multiple benign cysts
in the breasts
signs and symptoms of fibrocystic breast disease - ANSWER: occurs 2 weeks before
the onset of mensus and worst right before the menstrual cycle. resolves after
menses starts often in women in their 30's. breast lumps are rubbery and mobile to
touch
Tx for fibrocystic breast disease - ANSWER: Once a benign diagnosis or normal
findings have been established by biopsy or on clinical or imaging findings, simple
reassurance will provide many patients with adequate relief.
For those patients who still seek treatment, symptomatic relief by avoiding trauma
and by wearing a bra with adequate support can be very helpful. The role of caffeine
consumption in the development and treatment of fibrocystic change has never
been proven; however, many patients report relief of symptoms after abstinence
from coffee, tea, and chocolate. Similarly, observational studies have suggested that
low-fat diets can provide some relief. The data regarding the utility of vitamin E
supplementation and evening primrose oil are controversial. Mild analgesics such as
acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to
relieve breast pain. For more symptomatic women, danazol and tamoxifen have
been found to be effective, although their significant side effects have limited their
acceptability and utility.
Fibroadenoma - ANSWER: benign breast lesion 15-40 yrs old
risk factors for fibroadenoma - ANSWER: multiple fibroadenomas associated with
rate cancer syndromes like mafficci syndrome, Cowden syndrome, carney complex
early ETOH consumption
findings with fibroadenoma - ANSWER: painless, firm or rubbery mass with well
defined borders, freely mobile, changes with size may occur with pregnany or
menstrual cycle, lesions under 5 cm, considered to be giant fibrodenomas no nipple
discharge
Dx of fibroadenoma - ANSWER: mammo, us to differentiate fluid filled to solid mass,
fine needle aspiration biopsy, open biopsy
Intraductal papilloma - ANSWER: benign tumor within the ductal system of the
breast, one of the heterogeneous group of lesions encompassed by the term benign
breast disease seen in females 30-50
risk factors for intraductal papilloma - ANSWER: multiple papilloma's which increases
the risk for breast cancer
