ACOG guidelines regarding well women exams
What is the ASCCP recommended management for an ASCUS (atypical squamous cells of undetermined significance) pap result with a positive high-risk HPV 16 cotest in a 26-year-old
...
ACOG guidelines regarding well women exams
What is the ASCCP recommended management for an ASCUS (atypical squamous cells of undetermined significance) pap result with a positive high-risk HPV 16 cotest in a 26-year-old woman without a history of abnormal pap smears?
ACOG Pap smear guidelines
A Bethesda system Pap smear report that reads LSIL is most consistent with which classification?
A female patient is 35 years old. She has never had an abnormal PAP smear and has had regular screening since age
If she has a normal PAP smear with HPV testing today, when should she have the next cervical cancer
screening?
Lab results on your 26-year-old patient show a negative Pap smear with a positive human papillomavirus (HPV)
screen. Which procedure will be required next?
Amenorrhea (Primary and Secondary)
You are evaluating a 17-year-old Emily who presented with amenorrhea and normal secondary sex characteristics.
The purpose of the progesterone challenge is to ascertain the presence of?
A 16year old girl who comes to your office with a history of secondary amenorrhea. She experienced menarche at
age 10, regular cycles for 2 years. She has not menstruated now for 4 years. In your initial consideration of
differential diagnoses, what is the most frequent etiology of this problem:
• Eating disorder
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?
Androgen insensitivity/resistance syndrome
Changes in hormonal regulation during menopause result in the gradual cessation of menstruation. From which
gland is Androstenedione secreted?
• Adrenals
A Pap smear result of atypical squamous cells of undetermined significance—rule out high-grade squamous
intraepithelial lesion (ASCUS r/o HGSIL) will require which procedure next?
A 25-year-old presents with a report of a very tender area just near her introitus and to the left of her perineum. Very painful sex is how she knew "something wasn't right." She showered and when washing, she felt a "pea-sized" painful lump on the left side of her "bottom." She tells you she looked at it with a mirror and it was very small, but now it is the size of a ping-pong ball and getting worse.
When you inspect her external genitalia, you are amazed at the size and appearance of the "lump."
You note what appears to be an abscess on the left medial side of the labia minora, and there is some edema extending into the perineum. Your diagnosis for this presentation is:
BMI
CDC recommendations regarding STDs and PID
Cervical cancer screening
A 23-year-old women presents to your practice with a chief complaint of postcoital bleeding. Which of the following would NOT be included in the initial assessment of this patient?
A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the client confides that her mother
died of endometrial cancer 1 year ago and says that she is afraid that she will die of the same cancer. Which risk
factor stated by the client after an education session on risk factors indicates that further teaching is needed?
The frequency for cervical screening depends on the patient and her age. What is the longest recommended time
interval between cervical screens for patients who are 65 years-old or younger?
• 5 years
Cervix/Uterus examination
A 49-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?
In collection of a specimen for a PAP smear, how is the endocervical specimen collected?
Condyloma acuminate
Treatment options for patients with condyloma acuminatum include:
Treatment options for patients with condyloma acuminatum include all of the following except:
• Topical acyclovir
Patient education for condylomata acuminata should include all the following except:
Jenna was evaluated and diagnosed with condyloma acuminatum. Treatment options for Jenna will include all of
the following except:
Condyloma lata
Which condyloma do we see in syphilis?
Contraceptives
the cytology (Pap smear) result for a 21-year-old sexually active student whose partner uses condoms inconsistently
shows a large amount of inflammation. Which of the following is the best follow-up?
A 35-year-old smoker is being evaluated for birth control choices. The patient has a history of pelvic inflammatory
disease (PID) along with an embolic episode after her last pregnancy. Which of the following methods of birth
control would you recommend?
• Condoms and the vaginal sponge (TODAY sponge)
A nurse is teaching a group of women about the side effects of different types of contraceptives. What frequent side
effect associated with the use of an intrauterine device (IUD) should the nurse discuss during the teaching session?
• Excessive menstrual flow
Which form of birth control presents the highest risk to a female patient if she is exposed to a sexually transmitted
disease (STD)?
A 21-year-old woman comes into your practice seeking birth control. She has only recently become sexually active and has consistently used condoms for safe sex. Your history reveals that she does not use tampons during her menses and has very little knowledge about female reproductive anatomy. Based on this information, which of the following birth control choices would be least likely to meet her needs for contraceptive management?
Cystocele is best defined as
• Descent or prolapse of the bladder
While a speculum is retracting the posterior vaginal wall, a 51-year-old patient is asked to strain down. There is a
bulge from the anterior vaginal wall. This is most likely
• Cystocele
The situation where the bladder forces the anterior vaginal wall down and out is termed
• Cystocele
Which of the following is an effect of estrogen deficiency on paravaginal tissue?
• Cystocele
A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history,
which of the following would the nurse expect to find?
• Stress incontinence with feeling low abdominal pressure
Dysmenorrhea
Which of the following substances is responsible for the symptoms of dysmenorrhea?
A 40-year-old female presents with an abnormal menstrual cycle with menorrhagia and intermenstrual bleeding. The
nurse practitioner suspects the patient may have dysfunctional uterine bleeding (DUB) and orders tests for follicle
stimulating hormone (FSH) and luteinizing hormone (LH) levels. Both of these lab values are elevated. What is the
most likely cause of DUB in this patient?
• Onset of climacteric
Sylvia is 44-year-old women with dysfunctional uterine bleeding (DUB) and is unable to use oral contraceptives.
Which of the following medications can be used for management of DUB?
Which is not a common cause of irregular menstrual bleeding?
A 16-year-old female is diagnosed with primary dysmenorrhea. She has taken over the counter ibuprofen in 800 mg
increments every 8 hours during menses for the past 3 months with minimal relief of symptoms. What intervention
will provide greatest relief of dysmenorrhea symptoms?
A woman visits the clinic because she has dysmenorrhea. What goal should the nurse identify for this client?
Gravida/Para
Interstitial cystitis/ Painful bladder syndrome
After treatment for a bladder infection, a client asks whether there is anything she can do to prevent cystitis in the
future. What is the best response by the nurse?
Lichen sclerosus
A 65-year-old female presents for a health maintenance examination. She complains of a vulvar itching due to what
she calls "recurrent yeast infections," and her symptoms have worsened over the last few months. She is sexually
active with her husband and has experienced dyspareunia with penetration lately. She always uses a water-based
lubricant with intercourse. On examination, you find complete loss of the borders of the labia minora, constriction of
the vaginal outlet, and several thin white plaques (like parchment paper) on the vulva. There is no other skin or
mucosal involvement.
A 65-year-old patient is diagnosed with lichen sclerosus. The woman asks the nurse what this really means. What is
the nurse's best response?
Lichen simplex chronicus
The appearance of lichen simplex chronicus is best described as
Mammogram
A patient ask why she needs a breast ultrasound when she already has had a mammogram. Which of the following
would be the best response of the use?
A 55-year-old female patient presents with pain in the upper outer quadrant of her left breast for over 1month now.
The best course of action would be to .
A 24-year-old female presents to the practice with a painless 2 cm, lobular mass in the right breast that is freely
mobile and firm. This has noted on self-breast examination, and she reports it has been unchanged for the past 3
months. The best course of action by the nurse practitioner would be to .
When educating a patient about the rationale for obtaining a mammogram, which of the following statements is
false?
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