NSG6430 final Exam Questions and Answers

The nurse practitioner knows that a highly valuable assessment tool for evaluating urinary incontinence and contributing factors in daily life is: - ANSWER A voiding dairy The nurse practitioner is counseling a 57-yea ...

The nurse practitioner knows that a highly valuable assessment tool for evaluating urinary incontinence and contributing factors in daily life is: - ANSWER A voiding dairy 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. Which of the following should be included in the patient's plan of care? (Select all) - ANSWER Bladder training Kegel exercises Eliminate caffeine and alcohol consumption 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: - ANSWER Hegar's sign 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 parter. 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: - ANSWER Granuloma inguinale The physical examination of any woman suspected of being abused or battered includes all of the following except - ANSWER A focus on the patient's physical appearance, not her behavior the most effective means of obtaining the history of abuse is to use a communication model that - ANSWER Allows the patient to talk without interruption and with time to relate, emphasize, and repeat her full story Clinicians should routinely consider intimate parter violence (IPV) as a possible diagnosis for women who present with all of the following except: - ANSWER Denial of any physical health problems The factors that enable women to enjoy and control their sexual and reproductive lives, including a physical and emotional state of well-being and the quality of sexual and other close relationships, make up a a woman's - ANSWER Sexual health Which one of the following is not among the ways clinicians can provide a welcoming, safe environment for lesbian, gay, bisexual or transgender (LGBT) - ANSWER Ignore the sexual status or gender identity of all patiets Which one of the following is the definition of the term "gender identity" - ANSWER A self-label, regardless of biological or natural sex Which one of the following statements about sexually transmitted infections (STIs) is false - ANSWER Lesbians are at very low risk for development of STIs and vaginal infections Among the midlife health issues of women, the number one cause of mortality in the United States is - ANSWER Cardiovascular disease Lifestyle approaches to manage menopause related vasomotor symptoms include - ANSWER Avoiding spicy foods, hot drinks, caffeine, and alcohol The standard for managing moderate to severe menopausal symptoms is - ANSWER Prescription systemic hormone products, such as estrogen and progesterone 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 fo the patient? - ANSWER Repeat ultrasound in 2 months Non-pharmacological therapy for chronic pelvic pain includes the following: select all that apply - ANSWER Physical therapy Aerobic and no aerobic exercise The nurse practitioner understands that all of the following organisms are responsible for infection of the Bartholin's gland except - ANSWER Klebsiella Treatment of a large, symptomatic Bartholin's cyst includes all of the following except - ANSWER Topical corticosteroids A 44 year-old African American female presents with complaints of menorrhagia x15 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 - ANSWER Estrogen therapy The nurse practitioner is treating a patient with elimite for scabies. the proper instructions to the patient should include - ANSWER Apply to all areas of the body from the neck down, wash off after 8 to 14 hours, then repeat treatment 1 week The nurse practitioner understands that the proper management of an asymptomatic woman with a small fibroid should include - ANSWER Reassess in 6 to 12 months The nurse practitioner is teaching a patient about pediculosis. Which of the following statements by the nurse practitioner is correct - ANSWER The condition is treated with permethrin cream All of the following medications may be used for neuropathic pain management of vulvodynai except - ANSWER Methotrexate The nurse practitioner understands that which of the following lab test is appropriate for the patient who presents with symptoms of dysesthetic vulvodynia - ANSWER Wet mount Which of the following is a common antibiotic for the treatment of an infected Bartholin's cyst - ANSWER Bactrium The patient presents with complaints of a painful, swollen lump in her vaginal area. She's reports difficulty sitting and walking due to the pain. Which of the following is a likely diagnosis for this patient - ANSWER Bartholin's cyst 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 - ANSWER Ectopic pregnancy Appendicitis Ovarian cyst with rupture When women experience mild premenstrual symptoms, such as mild breast tenderness, abdominal bloating, and mild weight gain form water retention, this is known as - ANSWER Premenstrual syndrome A patient with introduction papilloma will commonly present with a chief complaint of - ANSWER Bloody nipple discharge The nurse practitioner understands that the necessary screening techniques in a patient with suspicious of ovarian cancer should include the following; Select all that apply - ANSWER CA 125 Transnational ultrasound Early symptoms experienced by a woman with ovarian cancer include all of the following except: - ANSWER Unexplained weight gain The nurse practitioner is evaluating a patient's risk of ovarian cancer. All of the following factors are associated with an increased risk for ovarian cancer except: - ANSWER Oral contraceptive use Patient education for condylomata acuminata should include all of the following except - ANSWER Treatment and elimination of visible warts is a sign of cure, and transmission will not occur Tina is evaluated and diagnosed with molluscum contagious. The nurse practitioner understands that clinical presentation of this disease is characterized by - ANSWER Fleshy, popular skin colored lesions with indented centers that contain white cordlike material 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 a regular pap screenings in her life and has had no abnormal Pap tests. Sara asks if she needs a pap test - ANSWER No, you do not need a Pap test, but I do recommend we do a pelvic exam to assess for abnormalities Misty presents with painful "sores" in her perineal area, dysuria and dyspareunia. On exam she has 2 shallow ulcerated lesions on the right labia majors and one on the left. she also presents with enlarged inguinal lymph nodes. Based on these findings you suspect she has: - ANSWER Chancroid Which of the following is not true for HIV infection evaluation - ANSWER If a patient is fearful they have been exposed to HIV, but denies all risk factors, it is not recommended to test for The nurse practitioner understands that the risk factors for developing vaginal candidiasis include which of the following - ANSWER A diet high in refined sugar 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 Hep B includes all the following except - ANSWER Hepatitis B is transmitted enterically 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 a bumps there." She has never had this before and she 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 painful vehicle adjacent to the vagnial intro it's. the most likely diagnosis is - ANSWER Genital herpes You see an 18- year old woman with a history of chlamydia infection and a total of five lifetime partners. based on the latest evidence-based guidelines, you recommend - ANSWER STI testing only Karen was recently diagnosed with primary syphilis. The nurse practitioner understands that the first-line treatment option for primary syphilis include: - ANSWER Penicillin While educating Karen about the different stages of syphilis, which of the following is not representative of the presentation of secondary syphilis? - ANSWER chancre Karen was recently diagnosed with primary syphilis by her primary care provider, she is very upset and inquires how long after sexual contact do syphilis symptoms typically occur. What is the correct response by the primary care provider? - ANSWER 3 weeks Which of the following terms describe the mechanism of action of Imiquimod (Aldara) in the management of genital warts? - ANSWER immune modifier The nurse practitioner understands that HPV types _____ and ____are most often associated with cervical and anogenital cancer. - ANSWER 16 and 18 Jenna was evaluated and diagnosed with condyloma acuminatum. Treatment options for Jenna will include all of the following except: - ANSWER topical acyclovir Which of the following is a treatment option for a 30-yearold woman with PID and a history of severe hive-form reaction when taking a penicillin or cephalosporin? - ANSWER clindamycin with azithromycin The nurse practitioner understands that a complication of gonoccocal and chlamydial genitourinary infection in women include which of the following: - ANSWER Pelvic Inflammatory Disease (PID) The nurse practitioner understands that women with PID typically present with all of the following except: - ANSWER leukopenia 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: - ANSWER Valacyclovir 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: - ANSWER 4 to 7 days up to 4 weeks Kristin returns to the clinic for follow-up on STI results. The nurse practitioner informs her the Chlamydia test was positive. Which of the following agents will the nurse practitioner prescribe for treatment? - ANSWER Azithromycin The nurse practitioner student is studying the CDC guidelines for treating sexually transmitted infections. Which of the following agents is recommended for Gonorrhea treatment? - ANSWER Cefriaxone A 30-year-old woman presents without symptoms but states that her male partner has dysuria without penile discharge. Examination of the woman reveals a friable cervix with yellow discharge from the cervical os. This description is most consistent with an infection caused by: Select all that apply. - ANSWER chlamydia trachomatis Neisseria gonorrhoeae Trichomonas vaginalis Karen was diagnosed with trichomoniasis by her primary care provider and treated with: - ANSWER Metronidazole 500 mg po BID x 7 days (If single-dose metronidazole treatment fails and reinfection is excluded, metronidazole 500 mg orally twice a day days should be prescribed.) this is the correct answer if first treatment doesn't work A 24-year-old woman presents with a 1-week history of thin, greenish yellow vaginal discharge with perivaginal irritation. Physical examination findings include vaginal erythema with petechial hemorrhages on the cervix, numerous white blood cells, and motile organisms on microscopic examination. These findings most likely represent: - ANSWER trichomoniasis For patients needing topical treatment for vulvovaginitis caused by Candida albicans, the nurse practitioner will prescribe: - ANSWER clotrimazole cream The nurse practitioner understands that women with bacterial vaginosis typically present with: - ANSWER malodorous discharge The U.S. Preventative Services Task Force (USPSTF) recommends ____________ of folic acid supplement daily at least one month before conception for all women with average risk for neural tube defects. - ANSWER .4 tp .8 mg The American College of Obstetrician &Gynecologists recommend that all pregnant women be offered aneuploidy screening before 20 weeks gestation. This test identifies women whose fetuses are at increased risk for which of the following? Select all that apply. - ANSWER Trisomy 13 Trisomy 18 Trisomy 21 An important part of patient education for the patient with bacterial vaginosis who is receiving a prescription for oral Metronidazole is: - ANSWER Avoid alcohol for 48 hours after completing medication For the patient with chronic bacterial vaginosis, the nurse practitioner will prescribe: - ANSWER Metronidazole gel .75% vaginally 1-2 times a week for 4 to 6 months The nurse practitioner's exam findings on a patient with vaginal Candidiasis is positive for all of the following except: - ANSWER vaginal ph of 7 A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2017. Using Nageles Rule, what is the client's expected date of birth (EDB)? - ANSWER November 21, 2017 Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process? - ANSWER Fundus below the symphysis pubis and nonpalpable The nurse practitioner understands that the hormone, __________, remains elevated in breastfeeding women in the postpartum period. - ANSWER Prolactin The nurse practitioner is recommending daily Calcium supplementation of ___________ to her female patients that are older than 50 years of age. - ANSWER 1200 mg Osteoporosis is diagnosed when the patient's bone density is more than ______ standard deviation(s) below the average bone mass for women younger than 35 years old. - ANSWER 2.5 Based on the latest ACOG guidelines, the nurse practitioner understands that the recommended time to initiate screening for cervical cancer in women is: - ANSWER at age 21 years The nurse practitioner understands the following lifestyle approaches may be used to prevent osteoporosis after menopause: Select all that apply. - ANSWER Limit alcohol intake Performance of regular weight-bearing activities Adequate calcium &vitamin D intake What is the primary role of a nurse practitioner in the research process? - ANSWER Collecting data for other researchers Whether you order diagnostic testing or refer the patient to an HIV-specific facility, laboratory confirmation is rendered. The test confirming HIV infection is _____________. - ANSWER Western Blot assay The nurse practitioner is examining a twenty-nine-yearold female with a three day history of dysuria and urinary frequency. On examination, the patient is positive for suprapubic tenderness and negative for costovertebral angle (CVA) tenderness. This most likely represents which of the following? - ANSWER Cystitis A patient has been diagnosed with trichomoniasis. Which of the following single dose medications would be the best option? - ANSWER Metronidazole 2 g When educating patients about the use of combination oral contraceptive medications, they should be advised that pregnancy is prevented primarily by ____________. - ANSWER ovulation suppression A twenty-four-year-old female presents to the office with a complaint of a "yucky" vaginal discharge. On exam, a milky vaginal discharge is noted. A wet mount preparation reveals a positive whiff test and 75% clue cells. There were no trichomonads or WBCs visualized. Which of the following would be the most likely diagnosis in this patient? - ANSWER bacterial vaginosis A fifty-five-year-old postmenopausal female patient presents with pain in the upper outer quadrant of her left breast for over one month now. The best course of action would be to _______. - ANSWER perform a breast examination and order a mammogram A thirty-nine-year-old female has just completed a course of Amoxicillin for the treatment of streptococcal pharyngitis. Her LMP was two weeks ago and reports that it was normal for her. On physical examination, there is some erythema of the external genitalia with a small amount of white discharge. The microscopic wet prep examination reveals few clue cells but an abundance of budding hyphae. There are no WBCs present. Considering the differential diagnoses and results of the microscopic examination, which of the following would be the most appropriate treatment? - ANSWER Fluconazole 150 mg tablet as a onetime dose A forty-nine-year-old female patient presents with a chief complaint of dark, watery brown vaginal discharge. Part of the differential diagnosis includes that of cervical cancer. Which of the following best describes what might be visualized on physical examination in patients with cervical cancer? - ANSWER Ulcerated firm cervix A twenty-five-year-old female presents with vaginal irritation and discharge. On examination, the cervix is easily friable and erythematous. There is no adnexal tenderness. The wet prep (wet mount) microscopic examination reveals mobile protozoa on the normal saline slide. This most likely represents _________. - ANSWER trichomoniasis A twenty-two-year-old female presents with an initial onset of herpes simplex on the external genitalia. During the patient education, which of the following statements is most important to include? - ANSWER Symptoms of the initial outbreak of the lesions are typically worse than subsequent outbreaks Follicle-stimulating hormone (FSH) is released from the anterior pituitary gland and is responsible for which of the following normal physiologic response of the female menstrual cycle? - ANSWER Stimulation of ovarian follicles A thirty-two-year-old patient comes in for a workup of infertility. During the history, the nurse practitioner suspects that the patient may be experiencing anovulatory cycles. In order to confirm ovulation, which of the following tests would be most appropriate to order? - ANSWER Basal body temperature A nurse practitioner is performing a wet mount with potassium hydroxide (KOH) to assist with a diagnosis in a woman experiencing vaginal discharge. Which of the following would this confirm? - ANSWER Candidiasis A nurse practitioner is completing a speculum exam on a female patient. Which of the following findings would be considered a normal surface characteristic of the cervix? - ANSWER Irregular, granular surface with red patches There are several phases to the menstrual cycle. What phase begins with menses cessation and ends with ovulation? - ANSWER Proliferative phase A nurse practitioner is participating in a women's health fair. When educating the women about risk factors for breast cancer, which of the following statements is incorrect? - ANSWER Fibrocystic breast disease The first line treatment of severe menstrual cramps that have been occurring for four months in a patient with primary dysmenorrhea includes which of the following - ANSWER Ibuprofen Which of the following choices represents a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass? - ANSWER Bartholin's cyst A woman is concerned that she may develop breast cancer and is discussing her concerns with the nurse practitioner. Which of the following is not an associated risk factor for this? - ANSWER Late menarche A sixty-one-year-old thin, Caucasian female presents to your practice for a well-woman examination. She remarks that she feels like she is shrinking over the past year, despite keeping active and incorporating sources of calcium in her diet. Which of the following is not a risk factor for osteoporosis? - ANSWER excessive exercise A thirty-five-year-old woman, presents with a six-month history of hypermenorrhea, backache, and pelvic pressure. On examination, you discover a twelve-week size uterus with irregular contour. Which of the following does this most likely represent? - ANSWER Uterine fibroid It is known that a woman who is menopausal has an increased risk of heart disease. Which of the following lipid changes occur with estrogen withdrawal in menopause? - ANSWER Decrease in HDL with an increase in LDL and triglycerides Which of the following is true regarding education of a forty-two-year-old woman diagnosed with a uterine myoma? - ANSWER Myomas will decrease with the withdrawal of estrogen. Sheryl, a seventeen-year-old, complains of a vaginal discharge for the past month. When she wipes after urinating, there is "white stuff" on