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NSG6430 Final Exam.
Question 1 The nurse practitioner is performing a bimanual exam on a new OB patient and notices that the lower portion of the patient’s uterus is soft. This is known as: : A) Hegar's Sign B) Chadwick's Sign C) Nightingale's Sign D) Goodell's Sign Question 2 Your female patient presents for vaginal discharge with an odor, and has noticed painless “bumps” on her vaginal area. Sexual history includes past male partners and her current female partner. On exam you note beefy red papules and an ulcerative lesion on her vulva, granular tissue and scarring, and inguinal adenopathy. You suspect she has: A) HSV-2 B) Granuloma Inguinale C) Chancroid D) Molluscum Contagiosum Question 3 The nurse practitioner knows that a highly valuable assessment tool for evaluating urinary incontinence and contributing factors in daily life is: A) the interview B) a voiding diary C) the physical exam D) the patient's response to non-pharmacologic treatments Question 4 The nurse practitioner is counseling a 57 year-old patient with urinary incontinence. The patient desires to try non- pharmacological, non-invasive methods of treatment at this time.
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Which of the following should be included in the patient's plan of care? Select all that apply. A. Bladder training B. Kegel exercises C. Eliminate caffeine and alcohol consumption D. Use of bulking agents Question 5 The physical examination of any woman suspected of being abused or battered includes all of the following except: A) a thorough inspection for signs of injury, past and present B) a physical assessment just like that of any other adult female C) a focus on the patient's physical appearance, not her behavior D) the use of body maps and diagrams to accurately portray the patient's physical condition Question 6 The most effective means of obtaining the history of abuse is to use a communication model that: A) avoids having the patient's children present during the discussion B) signals someone is interested and that the woman is not alone C) emphasizes the belief that violence is not acceptable, no matter what the batterer might have said to the patient D) allows the patient to talk without interruption and with time to relate, emphasize, and repeat her full story Question 7 Clinicians should routinely consider intimate partner violence (IPV) as a possible diagnosis for women who present with all of the following except: A) chronic stress-related symptoms B) denial of any physical health problems C) central nervous system (CNS) symptoms D) gynecologic problems, especially multiple ones
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infection. D) Risky behaviors for STIs include sex during menses.
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Question 12 Among the midlife health issues of women, the number one cause of mortality in the United States is: A) primary osteoporosis B) cardiovascular disease C) overweight and obesity D) cancer Question 13 Lifestyle approaches to manage menopause related vasomotor symptoms include: A) sleeping more than 8 hours per night B) avoiding spicy foods, hot drinks, caffeine, and alcohol C) decreasing levels of physical activity D) more than 1,000 international units/day of vitamin E Question 14 The standard for managing moderate to severe menopausal symptoms is: A) lifestyle changes, such as dieting and exercising B) nonhormone products, such as antidepressant medications C) alternative care, such as acupuncture, combined with organic herbs D) prescription systemic hormone products, such as estrogen and progestogen Question 15 The nurse practitioner is managing an adolescent with a 4 cm functional ovarian cyst that was confirmed on a recent ultrasound. What plan of care should be anticipated for this patient? A) Repeat bimanual exam in 1 week B) Refer for surgical consult C) Repeat ultrasound in 2 months D) Stop all ovulatory inhibitor meds
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A) Vitamin B6 B) Physical therapy C) Aerobic and nonaerobic exercise D) Antidepressants Question 17 The nurse practitioner understands that all of the following organisms are responsible for infection of the Bartholin's gland except: A) Streptococcus faecalis B) Klebsiella C) Staphylococcus aureus D) E. Coli Question 18 Treatment of a large, symptomatic Bartholin's cyst includes all of the following except: A) Sitz baths B) Incision and drainage C) Topical corticosteroids D) Antibiotics Question 19 A 44 year-old African American female presents with complaints of menorrhagia x 15 months. Pelvic ultrasound confirms the presence of a large intramural leiomyomata. The nurse practitioner should discuss all of the following options with the patient except: A) GnRH agonist therapy B) Referral for surgical consult C) Progestin therapy D) Estrogen therapy Question 20 The nurse practitioner is treating a patient with Elimite for scabies. The proper instructions to the patient should include: A) All household contacts should be treated with Elimite regardless of symptoms. B) The medication should be taken orally in one single dose and repeated in 2 weeks.
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C) Apply only to the body area infested with scabies and repeat treatment in 5 days. D) Apply to all areas of the body from the neck down, wash off after 8 to 14 hours, then repeat treatment in one week
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Question 26 (2.5 points) The patient presents with complaints of a painful, swollen lump in her vaginal area. She reports difficulty sitting and walking due to the pain. Which of the following is a likely diagnosis for this patient? Question 26 options: Syphilis chancre Lichen Planus Genital Wart Bartholin's cyst Question 27 (2.5 points) The nurse practitioner understands that which of the following are differential diagnoses in an adult female patient with acute pelvic pain. Select all that apply: Question 27 options: A) Ectopic pregnancy B) Appendicitis C) Ovarian cyst with rupture D) Pelvic Congestion Syndrome Question 28 (2.5 points) When women experience mild premenstrual symptoms, such as mild breast tenderness, abdominal bloating, and mild weight gain from water retention, this is known as: Question 28 options: Luteal phase deficiency Premenstrual dysmorphic disorder Premenstrual syndrome Follicular phase deficiency Question 29 (2.5 points) A patient with intraductal papilloma will commonly present with a chief complaint of: Question 29 options: A palpable mass Bloody nipple discharge Bilateral milky discharge Mild localized pain Question 30 (2.5 points) The nurse practitioner understands that the necessary screening techniques in a patient
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suspicious of ovarian cancer should include the following: Select all that apply.
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characterized by: Question 34 options: Fleshy, papular skin colored lesions with indented centers that contain white curdlike material. Ulcerated ragged edge lesions that are painful Clusters of vesicles that itch and
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are painful to palpation Painless fleshy clusters of growths that resemble grapes or cauliflower Question 35 (2.5 points) Sara is 72 years old and has been a widow for 12 years. She presents for her yearly well woman exam. Sara has not been sexually active since age 60. She has had regular pap screenings in her life and has had no abnormal pap tests. Sara asks if she needs a Pap test. Your response would be: Question 35 options: Yes, you need a Pap test with HPV testing every 5 years. Yes, you should have a Pap test every 3 years. No, you do not need a Pap test or a pelvic exam again, unless you notice a vaginal discharge, have discomforts, or anything out of the ordinary. No, you do not need a Pap test, but I do recommend we do a pelvic exam to assess for abnormalities. Question 36 (2.5 points) Misty presents with a painful “sores” in her perineal area, dysuria and dyspareunia. On exam she has 2 shallow ulcerated lesions on the right labia majora and one on the left. She also presents with enlarged inguinal lymph nodes. Based on these findings you suspect she has: Question 36 options: HSV-2 Genital warts Chancroid Syphilis lesions Question 37 (2.5 points) Which of the following is not true for HIV infection evaluation? Question 37 o ptions: The CDC recommends HIV testing for all persons seeking evaluation for STIs. HIV evaluation is recommended if a patient has a history of unprotected sex with a previously incarcerated male, an uncircumcised male,
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contaminated blood and blood products, contaminated semen used for artificial insemination, intrauterine acquisition, and breastmilk. Question 38 (2.5 points) The nurse practitioner understands that the risk factors for developing vaginal candidiasis include which of the following? Question 38 options: Hypoglycemia A diet high in refined sugar Use of Vit C supplement A habit of consuming live culture yogurt several times a week Question 39 (2.5 points) Cindy presents to your clinic for STI testing after realizing her current boyfriend has been seeing other women. She states she was told that one of the women has hepatitis B. Your patient education regarding hepatitis B includes all the following except: Question 39 options: Hepatitis B is transmitted enterically Hepatitis B has an incubation period of 6 weeks to 6 months Hepatitis B surface antigen (HBsAG) indicates if the patient has hepatitis B infection Hepatitis B infection primarily affects the liver Question 40 (2.5 points) Stacy has made an appointment at your clinic for c/o dysuria. During the HPI she explains, “My bottom hurts when I pee, and I have bumps there”. She has never had this before and is worried. She denies fever, although she feels “a little like I have the flu” explaining she has a headache and feels achy and tired. She denies exposure to a STI noting she and her partner have been monogamous for 6 years. On exam you notice a cluster of
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painful vesicles adjacent to the vaginal introitus. The most likely diagnosis is: Question 40 options: Syphilis Genital Herpes Chancroid Chlamydia
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Question 45 (2.5 points) Which of the following terms describe the mechanism of action of Imiquimod (Aldara) in the management of genital warts? Question 45 options: keratolytic immune modifier cryogenic cytolytic Question 46 (2.5 points) The nurse practitioner understands that HPV types and are most often associated with cervical and anogenital cancer. Question 46 options: 1, 2, and 3 6 and 11 16 and 18 22 and 24 Question 47 (2.5 points) Jenna was evaluated and diagnosed with condylomaacuminatum. Treatment options for Jenna will include all of the following except: Question 47 options: A) Topical acyclovir B) Cryotherapy C) Podofilox D) Tricholoroaceticacid. Question 48 (2.5 points) Which of the following is a treatment option for a 30-year-old woman with PID and a history of severe hive-form reaction when taking a penicillin or cephalosporin? Question 48 options: A) Ofloxacin with metronidazole B) Amoxicillin with gentamicin C) Cefixime with vancomycin D) Clindamycin with azithromycin
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Question 49 (2.5 points) The nurse practitioner understands that a complication of gonoccocal and chlamydial genitourinary infection in women include which of the following: Question 49 options: A) Pelvic inflammatory disease (PID) B) Conjunctivitis C) Acute pyelonephritis D) Prostatitis Question 50 (2.5 points) The nurse practitioner understands that women with PID typically present with all of the following except: Question 50 options: A) Fever B) Leukopenia C) Cervical motion tenderness D) abdominal pain Question 51 (2.5 points) Elizabeth was evaluated and diagnosed with a primary outbreak of genital herpes in the clinic today. The treatment plan for Elizabeth will include a prescription for: Question 51 options: A) Ribavirin B) Indinavir C) Valacyclovir D) Cyclosporine Question 52 (2.5 points) Elizabeth was recently diagnosed with genital herpes after having unprotected intercourse with a new partner. The nurse practitioner explains to Christine that the incubation period for HSV Type 2 is approximately:
