NSG6430 Exam Questions bank

• Abnormal uterine bleeding (AUB) has multiple causes. When a woman presents and reports menstrual irregularity with amenorrhea, which is the most common cause of amenorrhea?

Ectopic pregnancy

Adenomyosis

Coagulopathy

Anovulation

• The Tanner scale of sexual maturity rating allows for accurate classification of physical pubertal maturation. During the examination of your patient, you notice that the pubic hair is increased in quantity, is darker, and is present in the typical female triangle but in a smaller quantity. Which of the following Tanner stages does this description meet?

Tanner stage I

Tanner stage II

urinary urgency and frequency in the morning and at night

pain with urination with scant bleeding

terminal dysuria

urinary urgency only

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• The most common cause of chronic pelvic pain for women in the prime of their reproductive years is

PID

Fibroids

Endometriosis

Endometritis

• A fifty-two-year-old female patient comes in for her annual well-woman examination. Her LMP was fourteen months ago without any breakthrough bleeding. She has also developed some hirsutism. You would document this as __.

secondary amenorrhea

menopause

perimenopause

polycystic ovary syndrome (PCOS)

• Polycystic ovaries predispose women to a higher incidence of:

Adrenal tumors

Ovarian cancer

Endometrial cancer

Endometriosis

• A definitive diagnosis of endometriosis cannot be made until which of these is completed?

CT scan

Transvaginal ultrasound

Exploratory laparoscopy

MRI

• After a thorough history, you note that Marie resides in a community with very high risk factors. These include poverty, violence, and lack of recreational facilities. She tells you that she

“hangs out” at a convenience store near the apartment complex she lives at with her mother.

“All the group hangs there,” she reports proudly. She shares that she has been menstruating for two years now although she has irregular cycles. She also lets you know that she has had coitus only one time and that he “pulled out.” She does not want to get pregnant, and this is why she is here today.

What is your management plan for Marie today?

• A well-woman visit for an adolescent should include which of the following?

A general health history and physical examination, including a breast examination, pelvic with Pap smear, screening tests, counseling, immunizations, risk factors, and patient concerns

A general health history focusing on reproductive and sexual health concerns (menses, gynecologic, and pregnancy related) and psychosocial (family related, peer related, emotional, and physical as well as related to abuse, drug use, and alcohol use) concerns

Physical exam, screening tests, and immunizations as indicated by the health history and gynecologic considerations for an external-only inspection of the genitalia

• A seventeen-year-old presents with an appointment for unilateral breast tenderness and swelling. Which of the following would be the most likely etiology for this problem?

Breast cancer

Mastitis

Fibrocystic breast

Fibroadenoma

• You are completing a pelvic exam on thirty-two-year-old Nancy. You detect a left adnexal mass on the bimanual exam. With an adnexal mass, the practitioner must always suspect ________

until proven otherwise.

Pelvic inflammatory disease (PID)

Malignancy

Pregnancy

Polycystic ovary disease X

• Majority of urinary tract infections do not require consultation or a referral to a specialist and are routinely treated in primary care practices. Which of the following scenarios would indicate that a consultation or referral is indicated?

The presence of secondary sexually transmitted illness

A patient with two episodes occurring in one year

Patients that remain symptomatic after three days of treatment

Patients that show urine human chorionic gonadotropin (HCG) positive

• . Long-acting progestins may be used in patients as a contraceptive method. One of the long-acting progestins is Depo-Provera. Which of the following best describes the mechanism of action of long-acting progestins in contraception?

Decrease in cervical mucus production and thinning of the circle os

Thickening of cervical mucus and suppression of gonadotropin levels

Increased gonadotropin levels and thinning of the circle os

Anovulation caused by increased gonadotropin levels

• Iris is a thirty-two-year-old married woman with three children. She comes in for information on using the copper T intrauterine device (IUD) for contraception. Which of the following would be a contraindication to using this appliance?

Prior ectopic pregnancy

• TeYou are counseling an eleven-year-old girl, Amanda, and her mother about human papillomavirus vaccine (HPV), Gardasil. Amanda is Tanner stage IV at this visit. In counseling this family, you tell them that HPV vaccine ______.

is a series of three doses, six months apart

will protect Amanda from all strains of HPV

can cause seizures in some children

is not indicated in her age group as she is not yet sexually active

• Urinary tract infections are commonly seen in primary care. A twenty-five-year-old female presents with a new onset of dysuria and suprapubic pain for the last twenty-four hours. The examination reveals only mild tenderness without any peritoneal signs on the lower abdomen. A urinalysis reveals the presence of WBCs. The urine is sent for a culture and sensitivity. In addition to Escherichia coli one might typically expect to see the presence of which bacterium?

Klebsiella

Staphylococcus aureus

Staphylococcus saprophyticus

Pseudomonas

• Which of the following conditions is not an absolute contraindication to estrogen-containing contraception?

Migraine headaches

Hypercoagulable state

Thromboembolism

History of coronary artery diseaseDefinition

• Natasha is an eleven-year-old girl brought to your office for an annual well-child visit. When discussing the onset of puberty with Natasha and her mother, you would emphasize which of the following?

Breast buds develop before pubic hair.

Breast development delayed beyond twelve years of age may be considered pathological.

The average age of menarche is nine years.

It usually takes about three and half years to go from breast buds to menarche.

• A woman is experiencing a milky white nipple discharge. Galactorrhea is usually a finding with which other diagnosis?

Fibrocystic breast disease

Mastalgia

Hyperprolactinemia

Breast cancer

• You are completing a pelvic exam on thirty-two-year-old Nancy. You detect a left adnexal mass on the bimanual exam. With an adnexal mass, the practitioner must always suspect ________

until proven otherwise.

Pelvic inflammatory disease (PID)

Malignancy

Pregnancy

Polycystic ovary disease X

A nurse practitioner is educating a patient who has just been diagnosed with polycystic ovary syndrome (PCOS). She needs to be aware that PCOS is associated with which of the following clinical manifestations?

Excessive menstrual flow

Dry, flaking skin

Obesity

Hair loss

Anticholinergic medications are a type of treatment for which type of incontinence?

Urge incontinence

sixty-five-year-old obese female with type II diabetes mellitus presents to your office with a complaint of vaginal itching and burning for two weeks. She has not been sexually active for five years. She has tried douching with an OTC cream with no relief. On physical examination, the vulva is deep red with some thick white adherent material. Which of the following conditions would be the most likely cause of her symptoms?

Herpes simplex

Lichen planus

Atrophic vaginitis

Fungal infection

One important principle of antiretroviral therapy is

Response to drug therapy is monitored by HIV RNA levels.

A thirty-two-year-old woman 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?

pap

Question 100. Question :

The World Health Organization (WHO) has determined absolute contraindications to estrogen containing contraceptives. Which of the following is not an absolute contraindication?

: History of cerebrovascular accident (CVA)

Greater than age of thirty-five years

Hypertension with vascular disease

IN Active viral hepatitis

A twenty-five-year-old patient presents with irregular bleeding after being on oral contraceptives for six months. It is important to rule out which of the following?

Chlamydial cervicitis

Uterine fibroids

Endometriosis

Anovulation

patient is completing a diary of her premenstrual syndrome (PMS) symptoms. The nurse practitioner understands that PMS occurs with greatest frequency and severity in the luteal phase

A nurse practitioner instructor is reviewing the anatomy of the external genitalia. At the opening of the vagina are the Bartholin’s glands. Which of the following describes the function of these glands?

: Hormone production for ovulation

Production of alkaline secretion for sperm viability

Development of mucous plug for pregnancy

Maintenance of vaginal pH to prevent vaginitis

Bartholin’s glands

There are several phases to the menstrual cycle. What phase begins with menses cessation and ends with ovulation?

: Ovulatory phase

Follicular phase

Proliferative phase

IN Luteal phase

The most common cause of pelvic pain can be noted as endometriosis. But you also know that the most acute causes of pelvic pain are probably

Salpingo-oophoritis (fallopian tube/ovary) secondary to PID

A nurse practitioner is participating in a sexual education class for children in middle school. Which of the following is important to review as a nonprotective factor against repeat adolescent pregnancy?

: Use of effective contraception

Participation in specialized adolescent parent program

Continued sexual relationship with the same partner

IN Continued school attendance

A teenage patient presents with amenorrhea and normal secondary sex characteristics. A progesterone challenge is ordered. The purpose is to determine the presence of ______.

: prolactin

IN luteinizing hormone (LH)

endogenous estrogen

follicle-stimulating hormone (FSH)

A nurse practitioner is reviewing the chart of a woman who has findings consistent with polycystic ovary syndrome (PCOS).The diagnostic criteria for PCOS include all of the following except:

: irregular menstrual cycles

hyperandrogenism

infertility

male pattern baldness

Breast tissue is composed of glandular, fibrous, and fatty tissue and a complex lymphatic system. Where does lymph from the medial cutaneous area of the breast flow?

: Axillary nodes

Opposite breast

Mammary nodes

Infraclavicular nodes

A thirty-three-year-old woman presents to your clinic complaining of a dark brown, watery vaginal discharge and postcoital bleeding. There is a strong history of multiple unprotected sexual encounters. Which of the following findings on examination would be suspicious for cervical cancer?

: IN Ulcerated lesion on the cervical os

A soft, pink cervix with no ulcerations

An anteverted cervix

A very firm, easily friable cervix

A fifteen-year-old patient who presents with symptoms consistent with premenstrual syndrome (PMS) is concerned that she may have ovarian cancer. Your best advice to this patient is that PMS is typically caused by which of the following?

Pituitary tumor

Polycystic ovarian disease

Genetic, psychosocial, and hormonal fluctuations

Psychosocial issues and sleep disturbance

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?

: Decrease in HDL, LDL, and triglycerides

Decrease in HDL, LDL, and increase in triglycerides

Increase in HDL with a decrease in LDL and triglycerides

Decrease in HDL with an increase in LDL and triglycerides

NSG6430 Exam Questions bank

Which of the following is an approved treatment for premenstrual dysphoric disorder (PMDD)?

: Amitriptyline (Elavil)

Spironolactone (Aldactone)

Drospirenone/ethinyl estradiol/levomefolate calcium (Beyaz)

Conjugated estrogen (Premarin)

A patient has symptoms consistent with Chlamydia. Which laboratory test would aid in the diagnosis?

: Detecting the presence of inflammatory cells on a Pap smear

IN Tissue examination using direct fluorescent antibody

Culture and sensitivity

Wet prep with potassium hydroxide (KOH) assessing for positive “whiff” test

A nurse practitioner is counseling a woman with fibrocystic changes in the breast. Which of the following is not caused by this change?

: Breast pain

An increased risk of breast cancer

Hard masses

Painless lumps

A patient is coming to the clinic for a follow-up of some diagnostic testing that she had done. When you review the chart, you find that she now has findings consistent with a diagnosis of polycystic ovary syndrome (PCOS).You recall that PCOS is characterized by which of the following?

: Menorrhagia

Infertility

Menometrorrhagia

Hypoadrogenism

A twenty-five-year-old pregnant client presents with a complaint of headaches that are confined to the base of the head as well as the upper neck and feels “tight” in nature. She denies visual changes,

photophobia, or nausea. The most likely diagnosis is which type of headache?

: Common migraine

Cluster

Muscular tension

Sinus

NSG6430 Exam Questions bank

A nurse practitioner is caring for a woman with primary and secondary amenorrhea. The pelvic exam was normal. Which of the following may be the cause if etiology originates in the hypothalamus?

: Sheehan’s syndrome

Ovarian failure

IN Thyroid dysfunction

Asherman’s syndrome

You are examining a twenty-nine-year-old female with a three day history of dysuria and urinary frequency. On examination, the patient has mild abdominal pain with palpation in the umbilical area without rebound tenderness. Her test for cerebrovascular accident (CVA) tenderness is negative. This most likely represents which of the following?

: Pyelonephritis

IN Interstitial cystitis

Ectopic pregnancy

Ascending urinary tract infection

NSG6430 Exam Questions bank

A thirty-five-year-old female presents with perimenopausal symptoms. You recall that this may begin during which age group?

: IN Forty-five to fifty years

Thirty-five to forty years

Fifty to fifty-five years

Thirty to thirty-five years

Points Received:

A woman has been prescribed Depo-Provera injections every three months for contraception. What would be the most likely side effect that she would need to be educated about?

: Abnormal uterine bleeding

Dysmenorrhea

Nausea

IN Abdominal pain

A woman has been prescribed Depo-Provera injections every three months for contraception. What

would be the most likely side effect that she would need to be educated about?

: Abnormal uterine bleeding

Dysmenorrhea

Nausea

IN Abdominal pain

A twenty-four-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 been noted on self-breast examination, and she reports it has been unchanged for the past three months. The best course of action by the nurse practitioner would be to __________.

: order a mammogram

referral for surgical excision

continue to observe the lesion and recheck in three months

IN determine other risk factors such as family history of breast cancer

Which of the following choices represents a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass?

: Syphilis

Bartholin’s cyst

Labial adhesion

Herpes simplex type 2

NSG6430 Exam Questions bank

A twenty-four-year-old female patient has been diagnosed with primary dysmenorrhea. Which of the following medications would be used as a first line to help control her symptoms?

: Antianxiety agents

Progesterone-only contraception

Oral steroids

Nonsteroidal anti-inflammatory drugsrm

Changes in hormonal regulation during menopause result in the gradual cessation of menstruation. From which gland is Androstenedione secreted?

: Anterior pituitary

Posterior pituitary

Corpus Luteum

Adrenals

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A postmenopausal woman is concerned because she is having postcoital bleeding. Which of the following would be the most likely etiology?

: Cervical cancer

Endometrial cancer

Atrophic vaginitis

Polycystic ovary syndrome (PCOS)

A fifty-five-year-old woman presents to the clinic for evaluation of a breast mass. Which of the following is not a typical presenting sign of breast cancer?

: Engorgement of one areola and nipple

Dimpling of skin over breast

Unilateral retraction and deviation of nipple

A 2 cm, rubbery, tender lesion

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?

: Endometrial biopsy

Basal body temperature

IN Hysterosalpingogram

Postcoital testing

A seventeen-year-old female patient presents with amenorrhea for four months. She did experience menarche at the age of fifteen but had not had a menstrual cycle since. On physical examination, it is noted that she has normal secondary sexual characteristics. The nurse practitioner will consider a progesterone challenge to determine the presence of adequate __.

: endogenous estrogen

prolactin

L-thyroxine

IN follicle-stimulating hormone (FSH)

A couple is presenting for a first trimester pregnancy exam. They are curious about the sex of the baby. You recall that the human embryo becomes bipotential at what week of gestation?

: IN Sixth

Tenth

Twelfth

Eighth

A sixteen-year-old girl who comes to your office with a history of secondary amenorrhea. She experienced menarche at age ten, with regular cycles for two years. She has not menstruated now for four years. In your initial consideration of differential diagnoses, what is the most frequent etiology of this problem?

: Eating disorder

Pregnancy

Anovulatory cycles

IN Stress

A forty-four-year-old woman with dysfunctional uterine bleeding (DUB) presents for treatment. Which of the following medications can be used for management of DUB?

: Ethinyl estradiol

Medroxyprogesterone

Estrogen/progesterone combination

Conjugated estrogen

NSG6430 Exam Questions bank

A twenty-five-year-old patient presents with irregular bleeding after being on oral contraceptives for six months. It is important to rule out which of the following?

: Chlamydial cervicitis

IN Uterine fibroids

Endometriosis

Anovulation

The National Osteoporosis Foundation has screening guidelines for DEXA scans. Which of the following women would be most in need of bone mineral density testing?

therapy (HRT)

A sixty-year-old postmenopausal woman receiving hormone replacement

A fifty-year-old woman who is having irregular menstrual cycles

A fifty-one-year-old woman with COPD on long-term corticosteroid therapy A forty-nine-year-old, obese Caucasian woman who smokes

A patient asks 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?

: To locate small lesions prior to surgery

As a screening test for breast cancer

To determine if a breast lesion is cystic or solid

For definitive diagnosis of breast cancer

A thirty-one-year-old female presents for contraceptive counseling following the birth of their first child. She is interested in using the diaphragm as her method of contraception. Which of the following statements is true regarding the use of this device?

: IN The device may be inserted up to twenty-four hours prior to intercourse.

The device may be left in place for up to twelve hours.

The device may be inserted at any time up to six hours prior to intercourse.

The device should be removed within one hour after intercourse.

In reviewing cancer statistics, after breast cancer, what would you find to be the most common female genital malignancy?

: Endometrial

Ovarian

Vulvovaginal

IN Cervical

A twenty-four-year-old female presents to the office with a complaint of vaginal itching in addition to thick mucoid discharge. She also has some mild urinary discomfort. A wet mount preparation using potassium hydroxide (KOH) reveals a negative whiff test and few clue cells. There were no trichomonads visualized but the WBCs were too numerous to count. Which of the following would be the most likely diagnosis in this patient?

: Bacterial vaginosis

Herpes simplex

Chlamydia

Cystitis with cervicitis

A woman is concerned that she may develop breast cancer. Which of the following is not an associated risk factor for this?

: Late menarche

Family history

Nulliparity

IN Late menopause

NSG6430 Exam Questions bank

Breast masses are a common finding in adolescents and most typically are benign. Which of the following descriptions of a breast mass most likely represents a benign finding?

: Bilateral, round, or oval firm mass

Unilateral, round mass with hard consistency

Bilateral, round, or oval for mass with dimpling of the nipple

Multiple unilateral masses with hard consistency found in the axilla

Which of the following statements best describe the difference between type I and type II bone loss in patients with osteoporosis?

: Type II bone loss involves the trabecular compartment

Type II bone loss results from loss of ovarian function

Type I bone loss involves the cortical bone

Type I bone loss results from loss of ovarian function

A thirty-two-year-old woman 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?

: IN Papanicolaou smear

Uterine biopsy

Pelvic ultrasound

CBC with diff

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?

: Herpes simplex

Trichomonas

Candidiasis

IN Chlamydia

A sixty-five-year-old obese female with type II diabetes mellitus presents to your office with a complaint of vaginal itching and burning for two weeks. She has not been sexually active for five years. She has tried douching with an OTC cream with no relief. On physical examination, the vulva is deep red with some thick white adherent material. Which of the following conditions would be the most likely cause of her symptoms?

: Herpes simplex

Lichen planus

IN Atrophic vaginitis

Fungal infection

NSG6430 Exam Questions bank

: Excessive menstrual flow

Dry, flaking skin

Obesity

Hair loss

A twenty-eight-year-old female presents with breast tenderness, fatigue, abdominal bloating, fluid retention, and irritability one week prior to the onset of her menses. The nurse practitioner suspects the patient may have premenstrual syndrome (PMS). What is the most important information to obtain from this patient to make the determination?

: Severity of symptoms

Occurrence of symptoms in the menstrual cycle

IN Frequency and number of symptoms over the past four months

Presence or absence of depression or anxiety

A woman is experiencing a milky white nipple discharge. Galactorrhea is usually a finding with which other diagnosis?

: Fibrocystic breast disease

Mastalgia

Hyperprolactinemia

Breast cancer

Natasha is an eleven-year-old girl brought to your office for an annual well-child visit. When discussing the onset of puberty with Natasha and her mother, you would emphasize which of the following?

: Breast buds develop before pubic hair.

Breast development delayed beyond twelve years of age may be considered pathological.

The average age of menarche is nine years.

It usually takes about three and half years to go from breast buds to menarche.

Which of the following conditions is not an absolute contraindication to estrogen-containing contraception?

: Migraine headaches

Hypercoagulable state

Thromboembolism

History of coronary artery disease

NSG6430 Exam Questions bank

A thirty-six-year-old type I diabetic patient is considering starting on an oral contraceptive method. She is on both insulin and oral antidiabetic agents. The patient should be informed that ____.

: oral contraception is contraindicated in diabetic patients

a common side effect is hyperglycemia

IN hypoglycemic effects may be antagonized

an increase in insulin dosing may be recommended

A twenty-five-year-old patient is on oral contraception and comes in with an elevated blood pressure after being on the medication for six months. Prior to the initiation of the medication, the patient’s blood pressure had been within normal limits. The patient should be advised that ____.

: most likely the oral contraceptive is not causing the blood pressure elevation approximately over 3% oral contraceptive users develop hypertension

IN most likely progesterone is causing blood pressure elevation blood pressure elevation results from fluid retention

A forty-one-year-old patient is currently on griseofulvin for the treatment of onychomycosis. As an advanced practice nurse, you would advise the patient that this medication has the potential for which of the following?

: Increase estrogen secretion

Decrease steroid levels

IN Increase follicle-stimulating hormone (FSH) secretion

Decrease progesterone secretion

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?

: Cesarean section will be necessary for any pregnancy and delivery.

IN Antiviral medications will be useful in treating and curing an outbreak.

The sexual partner will not contract herpes if lesions are not present.

Symptoms of the initial outbreak of the lesions are typically worse than subsequent

outbreaks.

When educating patients about the use of combination oral contraceptive medications, they should be advised that pregnancy is prevented primarily by ____________.

: cervical mucus thinning

inflammation of the endometrium

ovulation suppression

decreased fallopian tube motility

NSG6430 Exam Questions bank

Urinary tract infections are commonly seen in primary care. A twenty-five-year-old female presents with a new onset of dysuria and suprapubic pain for the last twenty-four hours. The examination reveals only mild tenderness without any peritoneal signs on the lower abdomen. A urinalysis reveals the presence of WBCs. The urine is sent for a culture and sensitivity. In addition to Escherichia coli one might typically expect to see the presence of which bacterium?

: Klebsiella

Staphylococcus aureus

Staphylococcus saprophyticus

Pseudomonas

A female patient is concerned about using combination oral contraception that includes both estrogen and progesterone. You instruct her that the medication actually will decrease risks of which of the following cancers?

: Endometrial

Breast

Cervical

IN Ovarian

Adolescence sexuality is important to understand and to discuss with your patients. Sexual behavior begins with childhood curiosity. Based upon the following characteristics, you would define your patient in which level of adolescence: low physical and mental investment in sexuality, information gathering on the topic of sexuality, prepubertal appearance and masturbation.

: Preadolescence

IN Early adolescence

Middle adolescence

Late adolescence

ORDER NOW

A woman is completing a symptom diary of her symptoms associated with premenstrual syndrome (PMS). In which of the following phases would the problems most likely appear?

: Ovulatory

Follicular

Proliferative

Late luteal

You are counseling an eleven-year-old girl, Amanda, and her mother about human papillomavirus vaccine (HPV), Gardasil. Amanda is Tanner stage IV at this visit. In counseling this family, you tell them that HPV vaccine ______.

: is a series of three doses, six months apart IN will protect Amanda from all strains of HPV

can cause seizures in some children

is not indicated in her age group as she is not yet sexually active

Gynecomastia or breast development in males is a common issue in clinical practice. Which of the following statements defines Gynecomastia most accurately?

: It is always unilateral.

Onset coincides with the start of puberty.

Illegal drug use is rarely a cause.

An endocrine workup should be instituted in all cases.

NSG6430 Exam Questions bank

A school nurse is reviewing a female student’s records regarding presence of the human papillomavirus vaccine (HPV). Which of the following statements most clearly represents the current guidelines with respect to immunization against HPV?

: The vaccine targets HPV types 19 and 21.

The HPV vaccine should be given as early as age eight.

HPV immunization should be given after initial sexual contact.

The HPV vaccine is initiated at ages eleven or twelve.

A nurse practitioner has just completed education with a female adolescent about intrauterine contraceptive devices. Which of the following statements by the patient would suggest that further education is needed?

: They are only indicated for women with stable monogamous relationships.

It is not commonly used for nulliparous women as there are better options.

IN They are contraindicated in women with a past history of pelvic inflammatory disease.

They may be used by a woman who has had a previous ectopic pregnancy.

Anna, aged twenty-five years, presents with dysmenorrhea. She states that her sister and her mother have endometriosis and she would like to be evaluated for it as well. Which if the following is consistent with a diagnosis of endometriosis?

: Frequent episodes of bacterial vaginosis

Postcoital bleeding with malodorous discharge

Infertility and dysmenorrhea

Constipation and amenorrhea

Points Received:

Long-acting progestins may be used in patients as a contraceptive method. One of the long-acting progestins is Depo-Provera. Which of the following best describes the mechanism of action of long-acting progestins in contraception?

: Decrease in cervical mucus production and thinning of the circle os Thickening of cervical mucus and suppression of gonadotropin levels

Increased gonadotropin levels and thinning of the circle os Anovulation caused by increased gonadotropin levels

The ovaries are located near the pelvic wall at the level of the anterior superior iliac spine. Which layer of the ovaries contains the lymphatics and blood vessels?

: Endometrium

Central medulla

Cuboidal epithelium

Ovarian stroma

A female child presents for a well-child exam. Her mother is concerned about changes in her daughter’s body, which indicate to you precocious puberty. Which of the following findings would be consistent with this diagnosis? NSG6430 Exam Questions bank

: Delay in any of the Tanner stages takes longer than one year between stages Breast budding occurs after the development of pubic hair

Puberty starts before eight years of age in a female The growth spurt in a female occurs after puberty is complete

fifty-one-year-old postmenopausal patient presents with renewed onset of vaginal bleeding. She had not menstruated for more than one year. Physical examination, including abdominal and pelvic examination appears grossly normal. Your initial treatment for this patient would include which of the following?

: Observe the patient and have her return of the bleeding continues

Medroxyprogesterone acetate 5 to 10 mg daily to control bleeding

Monophasic oral contraceptives for three months and then reassess

Referral to a gynecologist for consideration for endometrial biopsy

A nurse practitioner is educating a pregnant female about breast changes. Common normal physiologic changes include all of the following except:

: Development of straie

Fibrocystic changes

Nipple pigmentation

Venous engorgement

You are instructing a patient in the proper use of the diaphragm, a barrier contraceptive method. Which of the following would you include in your instructions?

: The diaphragm should be removed within two hours after intercourse.

IN The diaphragm may be inserted up to twelve hours prior to intercourse.

The diaphragm is more effective when used with spermicidal jelly.

Douching is safe immediately upon removal of the diaphragm.

When educating a patient about the rationale for obtaining a mammogram, which of the following statements is false?

: Mammography is a cost-effective method to screen for breast cancer

Mammography detects all breast cancers

IN Mammography should be accompanied by breast examination

Negative mammography should not delay biopsy of a clinically suspicious mass

TA 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?

: Small, yellow, raised around area on the cervix

Friable, bleeding tissue opening of the cervical os

IN Red patch areas with occasional white spots

Irregular, granular surface with red patcheserm

Majority of urinary tract infections do not require consultation or a referral to a specialist and are routinely treated in primary care practices. Which of the following scenarios would indicate that a consultation or referral is indicated?

: The presence of secondary sexually transmitted illness

A patient with two episodes occurring in one year

Patients that remain symptomatic after three days of treatment

IN Patients that show urine human chorionic gonadotropin (HCG) positive

NSG6430 Exam Questions bank

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 microscopic examination reveals mobile protozoa on the normal saline slide. This most likely represents _________.

: trichomonas

mucopurulent cervicitis

bacterial vaginosis

gonorrhea

A thirty-five-year-old female presents for her normal annual examination and complains of recent changes in her breasts. She reports that they feel tender and “lumpy” during certain times of the month. As a result, she does not perform self-breast examination as she had been doing in the past. Which of the following statements would offer the best advice to this patient?

: Order a mammogram to establish baseline data.

Recommend that she perform a self-breast examination every two months.

Determine the time of the month when her breasts are tender and recommend a change to her breast self-examination schedule.

Stress the importance of breast self-examination to detect unusual lumps.

A seventeen-year-old presents with an appointment for unilateral breast tenderness and swelling. Which of the following would be the most likely etiology for this problem?

: Breast cancer

Mastitis

IN Fibrocystic breast

Fibroadenoma

A fifty-two-year-old female patient comes in for her annual well-woman examination. Her LMP was fourteen months ago without any breakthrough bleeding. She has also developed some hirsutism. You would document this as __.

: secondary amenorrhea

menopause

perimenopause

polycystic ovary syndrome (PCOS)

A twenty-five-year-old patient presents with urinary frequency and urgency. These symptoms have been occurring for three days without fever. A patient with interstitial cystitis would most likely describe their symptoms as _______.

: urinary urgency and frequency in the morning and at night pain with urination with scant bleeding

IN terminal dysuria

urinary urgency only

You are completing a well visit on a fourteen-year-old female who is currently not menstruating. Primary amenorrhea is best described as ________.

: cessation of menstruation for six months failure of menstruation to occur by age fifteen

failure of menstruation to occur by age thirteen cessation of menstruation for six months after menarche

A Pap smear result of atypical squamous cells of undetermined significance (ASCUS) will require which procedure next?

: Cold knife cone (CKC)

Follow-up Pap smear

Colposcopy

Loop electro-excision procedure (LEEP)

A patient has been ordered a breast ultrasound after having a mammogram. The primary rationale for ordering this is to _____.

: screen for breast cancer

breast cancer staging

determine if a breast lesion is cystic or solid evaluate for structural abnormalities

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?

: Excessive exercise

History of maternal osteoporosis

Routine use of alcohol or caffeine

Use of opposed Estrogen use

TThe 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?

: Acetaminophen

Ibuprofen

Combination hormone replacement therapy (HRT)

Amitriptylineerm

A patient who a nurse practitioner is seeing for the first time has the past medical history of primary dysmenorrhea. She recalls that which of the following is considered as the primary etiology?

: IN Ovarian cysts

Prostaglandin production

Endometriosis

AdenomyosisTerm

Thalia is a fifteen-year-old who is referred to your women’s health practice by her school counselor. She has macromastia and has been teased and ridiculed by her classmates at school. Which of the following would be the first step in dealing with this problem?

. Encourage Thalia to wear loose clothing and a bra with strong support.

Refer Thalia to a therapist for counseling and support, including antibullying.

Meet with Thalia and her parents to discuss options, including breast reduction surgery.

Assess Thalia’s Tanner staging for breasts and date of menarche.

Which of the following characteristics is not associated with psychosocial development problems in adolescence?

Being different than others or feeling different

Late onset of pubertal sexual maturity

Sexual identity as GLBTQ

Having a disability or chronic health condition

Abby, twenty years old, presents with pelvic pain. Which of the following is not a first-line diagnostic test for evaluation of pelvic pain?

Pregnancy test

CBC with differential

CT of pelvis

Urinalysis

Mitzi, a twenty-three-year-old, is here for her well-woman checkup. She asks about douching. Which of the following statements about douching is true?

Douching is a reliable contraceptive method.

Douching may increase the risk of infection and ectopic pregnancy.

Douching effectively prevents sperm from entering the uterus.

Douching should be used after intercourse and after menses.

NSG6430 Exam Questions bank

You are meeting with twenty-two-year-old Emily to discuss birth control options. She has tried “the pill” in the past but failed to take it regularly. She is interested in depo because she only has to come in every three months for a shot. She also heard that one does not get a period on depo, and she likes the thought of that. Which of the following would be a specific consideration with depo that you would need to discuss?

Depo offers no protection from STIs.

Depo depletes skeletal mass, so it is necessary to take calcium supplements.

As with any hormonal birth control, changes in weight can occur.

Depo does not offer pregnancy protection for those who are obese.

There are several phases to the menstrual cycle. What phase begins with ovulation and ends with menstruation?

Ovulatory phase

Follicular phase

Proliferative phase

Luteal phase

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A nurse practitioner is educating a woman who has a colposcopy ordered. Which of the following most accurately describes a colposcopy?

A procedure that visualizes the vaginal, vulvar, or cervical epithelium with magnification to identify abnormal areas that may need to be biopsied

A procedure to visualize the uterine cavity through a small, fiber-optic scope introduced through the cervix

A procedure to remove a sample of endometrial tissue with a curette or an aspiration tool for

biopsy

A procedure to visualize the abdominal and pelvic cavity by fiber-optic endoscope via a subumbilical incision

A pregnant woman has been diagnosed with preeclampsia or pregnancy-induced hypertension (PIH). Which of the following statements about PIH is in?

One of the manifestations is edema of the hands and face.

The timing of PIH is usually after the twentieth week of pregnancy.

Proteinuria is a late development in PIH.

PIH is a precursor to chronic hypertension and heart disease.

A pregnant client in your practice is experiencing nausea and vomiting in her first trimester. Which of the following would you suggest to alleviate the problem?

Avoiding all carbonated beverages, including sodas and seltzer water

Eating small meals at frequent intervals, avoiding spicy or fatty foods

Avoiding eating the first thing on awakening in the morning

Taking additional iron and prenatal vitamins

A pathology report has been returned on a woman’s breast mass malignancy. The most common type of invasive breast cancer is ______

lobular

infiltrating ductal

infiltrating papillary

medullary

A woman presents to the office seeking the birth control measure that is 100% effective. When counseling a woman on effectiveness of these methods, which of the following fulfills this requirement?

Implanon

Combined oral contraceptive

Abstinence

Intrauterine device (IUD)

A thirty-three-year-old woman presents to your clinic complaining of a dark brown, watery vaginal discharge and postcoital bleeding. There is a strong history of multiple unprotected sexual encounters. She has not been immunized for human papillomavirus (HPV). Which of the following examination findings would be suspicious for cervical cancer?

Lymphadenopathy of the femoral area

A soft, pink cervix with no ulcerations

An anteverted cervix with lateral displacement

A very firm cervix with an ulcer

Which of the following choices represent a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass?

Endometrial polyp

Bartholin’s cyst

Cervical polyp

Pilonidal cyst

A young woman presents to your practice with vaginal itching and a white discharge. She denies sexual activity or douching. She has been in good health except for a recurrent strep throat. Pelvic examination reveals a tender vulvovaginal area with edema and white patches; no odor is detected. Which of the following is the most likely cause of this problem?

Bacterial vaginosis

Diabetes mellitus

Allergy to personal hygiene product

Candidiasis after antibiotic treatment

Lauren, twenty-three years old, presents to your office with a complaint of severe menstrual cramps for four months since she quit using an oral contraceptive. Your tentative diagnosis is primary dysmenorrhea. What would be the first-line treatment for this condition?

Acetaminophen

Naproxen

Ergotamine

Elavil

A twenty-one-year-old woman presents for her initial well-woman examination. She has never been sexually active and has a negative family history for gynecology problems. Personal history is negative for abuse, and she exercises regularly and eats a balanced diet. Menstrual history reveals that she experienced menarche at fourteen years of age, has a regular twenty-eight-day cycle, and denies dysmenorrhea. Which of the following would be included in her physical examination today?

Stool for occult blood

Baseline mammography

Cultures for gonorrhea and chlamydia

Pap smear

Sally, a sixty-one-year-old 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?

Smoking

History of maternal osteoporosis

Excessive use of alcohol or caffeine

Use of combined oral contraception

You are seeing a twenty-two-year-old pregnant woman for routing antepartal care. She discloses that she forgets to take her prenatal vitamins. Which of the following would not be part of your counseling and education? NSG6430 Exam Questions bank

Try putting them next to your toothbrush and taking them at night when you brush before going to bed.

Using an OTC stool softener and drinking plenty of water can help with constipation.

You can just take a regular multivitamin in place of the prenatals.

Prenatal vitamins are specially formulated to prevent anemia in you and your baby.

Which of the following is an approved treatment for premenstrual dysphoric disorder (PMDD)?

Drospirenone/ethinyl estradiol/levomefolate calcium (Beyaz)

Soybean milk (Soy)

Amitriptyline (Elavil)

Conjugated estrogen (Premarin)

Karen is concerned that she may develop breast cancer. Which of the following is not an associated risk factor?

Older age

Family history

Nulliparity

Breastfeeding

The National Osteoporosis Foundation has screening guidelines for DEXA scans. Which of the following women would be most in need of bone mineral density testing?

A fifty-four-year-old postmenopausal woman receiving hormone replacement therapy (HRT) A fifty-year-old woman who is having irregular menstrual cycles

A fifty-one-year-old woman with systemic lupus erythematosus (SLE) on long-term corticosteroid therapy

A forty-nine-year-old Caucasian woman who smokes and has an excessive alcohol intake

Lenore, fifty-five years old, comes in for evaluation of a breast mass. Which of the following is not usually linked with carcinoma of the breast?

Scaly lesions similar to eczema on one areola and nipple

Peau d’orange dimpling of skin over breast

Unilateral retraction and deviation of nipple

Well-circumscribed, rubbery, and tender lesion

Bodily image concerns can be a major problem during the adolescent years. Which of the following psychosocial developmental phases of adolescence represents a period of greatest concern over bodily image? NSG6430 Exam Questions bank

Middle adolescence

Late adolescence

Preadolescence

Early adolescence

During puberty, linear growth is determined by the amount of growth hormone (GH) and the feedback loop. Which of the following patterns describes the release of GH in patients in puberty?

Rapid secretion of GH with activity

Pulsatile release in the morning

GH release that increases at rest

Pulsatile release at the onset of slow wave sleep

The vaccine targets HPV types 19 and 21.

The HPV vaccine should be given as early as age eight.

HPV immunization should be given after initial sexual contact.

The HPV vaccine is initiated at ages eleven or twelve.

The onset and duration of puberty varies greatly from patient to patient and is also dependent upon race. Which of the following phrases can you expect to have the earlier onset of puberty in boys

African American boys

Native American boys

Caucasian boys

Hispanic boys

A diagnosis has been formulated on a patient as premenstrual syndrome (PMS). Which of the following medication regimes is the best treatment for the PMS?

Vitamin B6, Antiprostaglandins, and Diuretics

Calcium, Antidepressants, and Vitamin D

Vitamin B6, Calcium, and Acetaminophen

Evening Primrose Oil, Ginkgo Biloba, and Antidepressants

A patient who a nurse practitioner is seeing for the first time has the past medical history of primary dysmenorrhea. She recalls that which of the following is considered as the primary etiology

Ovarian cysts

Prostaglandin production

Endometriosis

Adenomyosis

4. Question :

Question 26. Question :

A twenty-one-year-old woman presents to your family planning clinic seeking emergency contraception. She had unprotected sex last night and is not currently on any contraception. Her last menstrual period was two weeks ago, and she denies recent sexual intercourse. Which of the following is not an emergency contraception modality?

Combined oral contraceptive using the Yuzpe protocol

Progesterone-only contraceptive using Plan B protocol

Mechanical agents using an intrauterine device (IUD) protocol

RU-486—mifepristone protocol

NSG6430 Exam Questions bank

A twenty-four-year-old woman in your practice has been trying to conceive. She comes in for a pregnancy test, and it is positive. LMP was five weeks ago. She is prone to migraines and has used Imitrex (sumatriptan) with good success. She asks you about what to do if she

has a migraine during pregnancy. Which of the following would be an inappropriate intervention as part of your counseling?

: Triptans are contraindicated during pregnancy.

Substitute ibuprofen at the onset of a headache; it is safe and

effective.

Migraines often occur less frequently during pregnancy due to

hormonal changes.

Nonpharmacological measures such as pressure points or lying

down in a quiet environment for a brief rest at the onset of headache

can help.

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Question 29. Question :Luz is a fifteen-year-old girl who comes to your office stating, “I have not had my period for two months now.” She experienced menarche at ten years of age, with regular cycles for the past two years. In your initial consideration of a differential diagnoses, what is the most likely etiology of this problem?

: Disordered eating

Pregnancy

Anovulatory cycles

Stress

Question 31. Question :A female patient has been diagnosed with polycystic ovary syndrome (PCOS) and weighs 250 pounds. In addition to obesity, PCOS is associated with which of the following clinical manifestations?

: Excessive menstrual flow

Dry, flaking skin

Infertility

Hair loss

Question 32. Question :A nurse practitioner is screening a female for prescribing contraceptions for the first time. Which of the following conditions is an absolute contraindication to estrogen-containing contraception?

: Migraine headaches

Hypertension

Thromboembolism

Seizure disorder

Question 43. Question :You are researching preliminary evidence-based sources about breast cancer risk factors. Which of the following would you find is not one for the disease?

: First full-term pregnancy after thirty-five years of age

Late menopause after fifty-four years of age

History of maternal breast cancer

Fibrocystic breast disease

NSG6430 Exam Questions bank

Question 45. Question :A sixty-year-old woman has presented with the chief complaint of bleeding after intercourse. Which of the following is not associated with postcoital bleeding or spotting in a postmenopausal woman?

: Cervical cancer

Endometrial cancer

Atrophic vaginitis

Polycystic ovary syndrome (PCOS)

Question 46. Question :A patient is being rechecked after having a total hysterectomy performed and is having multiple problems since. Which of the following is/are early symptom(s) of estrogen withdrawal?

: Vaginal lubrication

Chills

Sleep disturbances

Myalgias