NSG 6430 MedU Questions
NSG 6430 MedU Questions
Case 1 – Self-Assessment
Question
A 34-year-old woman who has no past medical problems nor is currently taking any medications comes into your office because she noticed a tender lump in her left breast starting approximately one month ago. She is worried because she has an aunt who had breast cancer that was BRCA positive. Her periods have been regular since they started at the age of 12 and occur every 32 days. She is currently menstruating. She has three children aged 12, 9, and 4. On exam, her BMI is 32 and her other vital signs are stable. On breast exam, you note a mobile rubbery mass of approximately 1 x 1cm and with regular borders that is tender to palpation. You appreciate no axillary adenopathy. The rest of her physical exam is unremarkable. Of the information provided, which of the following places this patient at increased risk for breast cancer?
Single Choice Answer:
A Age
B Weight
C Parity history
D Family history of cancer
E Age of menarche
Question
A 64-year-old woman who is overweight with well-controlled hypertension comes to your office complaining of a lump in her breast that she noticed while showering. She denies any pain, tenderness, or skin changes. A pertinent review of systems is negative. Menarche began at the age of 10. Her first child was born when she was 29 and she had her second and last child at the age of 33. She experienced menopause at the age of 44. Her mother died of colon cancer when she was 65 and her father passed away from metastatic prostate cancer at the age of 70. She has no history of tobacco use ever and occasionally drinks a glass of wine with dinner. Her BMI is 34. Which of the information provided thus far puts the patient at decreased risk for breast cancer?
Single Choice Answer:
A Age
B Weight
C Age at first birth
D Age at menarche
E Age at menopause
Question
A 63-year old woman comes into your office for her annual preventive exam. She has hypertension and type 2 diabetes. She is not sexually active and experienced menopause at the age of 52. Her blood pressure is 125/83 and her physical exam otherwise is within normal limits. You recommend influenza and zoster vaccination. Her last colonoscopy was 8 years ago and her last mammogram one year ago was normal. She has never had an abnormal Pap smear. At the age of 45 she had a total hysterectomy for fibroids. You tell her she does not require a Pap smear today because:
Single Choice Answer:
A She has never had an abnormal Pap smear
B She is not sexually active
C She had a total hysterectomy for fibroids
D She is 63 years old
E She experienced menopause more than 10 years ago
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Question
A 47-year-old woman comes into your office for a health care maintenance exam. She has hypertension and type 2 diabetes. She is not sexually active and has not yet experienced menopause. There is no family history of cancer. Her blood pressure is 118/78, her BMI is 34 and the remainder of her physical exam is within normal limits. Her vaccinations are up-to-date, she has a PAP smear today and will have labs drawn. According to USPSTF, which of the following is the best recommendation to give her concerning mammography? NSG 6430 MedU Questions
Single Choice Answer:
A Should have started at age 40 and every year thereafter
B Should have started at age 40 and every 2 years thereafter
C Start at age 50 and every year thereafter
D Start at age 50 and every 2 years thereafter
E Screening mammography is not recommended at this time
Question
A 27-year-old woman comes into your office because she heard from her friend about a vaccination against cervical cancer and would like one. She has no medical problems and has had a Mirena IUD for three years. She has an allergy to latex and penicillin. She began having sex at the age of 18 and is currently sexually active with one partner. She occasionally uses condoms. She smokes half a pack of cigarettes per day. Her mother had endometrial cancer several years ago and had a total hysterectomy. Why is the patient not a good candidate for the Gardasil vaccination?
Single Choice Answer:
A Age
B Sexual activity
C Mirena IUD
D Allergy to penicillin
E Family history of endometrial cancer
F Tobacco use
Case 12 – Self-Assessment
Question
A 33-year-old G0P0 female presents to your clinic for her first prenatal visit. Her home pregnancy test was positive, she has been experiencing mild nausea for two weeks. Her last normal menstrual period was six weeks ago. Her initial prenatal visit should include:
Single Choice Answer:
A Quad screen
B Abdominal ultrasound
C Complete metabolic panel
D Complete blood count
Question
A 32-year-old female presents at your office for a preconception health visit. She is a G2P2, both deliveries were vaginal. Her first child was born with a neural tube defect. According to the USPSTF, what doseage of folate should this patient take daily before she gets pregnant?
Single Choice Answer:
A 1 mg
B 4 mg
C 400 mcg
D 800 mcg
Question
A 24-year-old African American G1P0 at 14 weeks presents with vaginal bleeding and abdominal cramping. On examination her vital signs are: blood pressure 120/75 mmHg, pulse rate 74/minute, temperature 98.4 degrees F taken orally, respiratory rate 18/minute, and oxygen saturation 99% on room air. On pelvic examination, there is a small amount of blood in the vagina, the cervical os is open, and there is no cervical or adnexal tenderness noted. On pelvic ultrasound, an intrauterine gestational sac with a yolk sac is seen. What is her diagnosis?
Single Choice Answer:
A Complete abortion
B Threatened abortion
C Missed abortion
D Inevitable abortion
Question
A 25-year-old caucasian female presents with vaginal bleeding and cramping. Her last normal menstrual period was six weeks ago. The patient’s vital signs are stable. On speculum exam of the vagina, there is no bleeding from the cervix. A quantitative beta-human chorionic gonadotropin (beta-hCG) level is 1492 mIU/ml. The patient is sent home and told to return to in 48 hours. Her beta-hCG on the return visit is 3000 mIU/ml. What is the appropriate next step in the management of this patient?
Single Choice Answer:
A Surgery for ectopic pregnancy
B Methotrexate for ectopic pregnancy
C Ultrasound to confirm intrauterine pregnancy
D Dilation and currettage
Question
A 23-year-old heterosexual Caucasian G0P0 female presents to your office with abdominal pain, fever and vaginal discharge. The discharge has an abnormal odor. She denies new or multiple sex partners. On pelvic exam, there is cervical motion tenderness and adnexal pain during the bimanual exam. A cervical culture is positive for chlamydia trachomatis. What risk factor for chlamyida infection is present in this patient?
Single Choice Answer:
A Sexual orientation
B Ethnicity
C Age