NSG 6330 Final Study Guide

A patient has been diagnosed with interstitial cystitis. The nurse practitioner remembers that this is best defined as _____. the recurrence of lower urinary tract infections with bacterium A noninfectious disorder of the urinary bladder histologic changes of the urinary bladder lining an acute, inflammatory urinary bladder disorder

A noninfectious disorder of the urinary bladder

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 2 cm, rubbery, tender lesion

Alicia lived in foster care for several years before being placed in a new city. She is in tenth grade. Which of the following aspects of her life protect her from risk? Her recent move to a new city and school Occasional alcohol use while at parties Friendships with two teen girls who have "been around the foster care system" A female teacher with whom she can talk about her problems

A female teacher with whom she can talk about her problems

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

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

Myomas

A myoma, commonly known as a fibroid, is a benign (noncancerous) tumor that develops in or around the uterus.

You explain to this young woman what this "lump" is and let her know you will be referring her to a gynecologist you consult with regularly. You explain to her the likely treatment as follows: She will need to take sitz baths three times per day and a broad-spectrum antibiotic. This is likely a fatty tumor and will need to be surgically removed. A possible incision might be necessary and a catheter placed for two to four weeks to allow for drainage and appropriate healing. This is a folliculitis that has become infected and needs a needle aspiration and broad-spectrum antibiotic treatment.

A possible incision might be necessary and a catheter placed for two to four weeks to allow for drainage and appropriate healing.

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

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

A very firm cervix with an ulcer

The HIV is positive, and the chest X-ray reflects bilateral infiltrates. The radiologist telephones you with a diagnosis of pneumonia. Further evaluation and report are sent to you with a diagnosis of pneumocystis pneumonia. What stage is this HIV presentation? Acute HIV infection Early-stage infection AIDS Symptomatic but likely to begin a latency period

AIDS

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

African American boys

Treatment for stress incontinence can include: Student Answer: Pelvic muscle exercises/kegel floor exercises Biofeedback Weight loss if obese All of the above

All of the above

Drug interactions are an important consideration when helping a patient decide the appropriate contraceptive method. Anticonvulsant medications may interfere with oral contraception by what mechanism? Decreasing serum steroid levels Decreased hepatic clearance Increased renal tubular absorption Increased serum steroid levels

Decreasing serum steroid levels

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)

Abstinence

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

Adrenals

You are seeing twelve-year-old Sonya for a well-adolescent checkup. She is accompanied by her mother who agrees to having you see Sonya alone but wants to talk with you at the end. After examining Sonya and assuring her of confidentiality, you meet with her mother briefly. Sonya's mother states, "I don't know how to say this, but I am so worried that my daughter is homosexual. She spends so much time with her girlfriends, and they are the focus of her entire life." From your understanding of normal adolescent stages and development, how would you respond to her concern? Advise Sonya's mother that same-sex close friendships are normal at this age. Offer to refer Sonya's mother to a counselor who is experienced with gay teens. Caution the mother that you can't disclose any information that Sonya has told you. Explain that Sonya is old enough to decide her own sexual identity and to "let go."

Advise Sonya's mother that same-sex close friendships are normal at this age.

During a community education program, a nurse practitioner is discussing the usefulness of mammography in the screening and detection of breast cancer. Which of the following statements is accurate? A mammogram should be done if there is any breast pain or nipple retraction. All women over forty years of age should have a mammogram on an annual basis. A mammography should be done annually for all women of child-bearing age. Mammograms should be performed annually after the initial pregnancy, especially if the woman does not breast-feed.

All women over forty years of age should have a mammogram on an annual basis.

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

An increased risk of breast cancer

A female patient is concerned about having irregular menstrual bleeding. Which of the following is not a common cause of this problem? Endocrine disorders Stress Anovulation Anatomical abnormality

Anovulation

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

Anovulation

Cara is in the clinic for what you have diagnosed as dysfunctional uterine bleeding (DUB). She is concerned about why this is happening to her. You recall which of the following is the most common cause of DUB? Endocrine disorders Stress Anovulation Anatomical abnormality

Anovulation

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 tenderness is negative. This most likely represents which of the following? Pyelonephritis Interstitial cystitis Ectopic pregnancy Ascending urinary tract infection

Ascending urinary tract infection

Jackie is a fifteen-year-old African American female who resides in a housing plan. You realize that barriers exist in providing preventive services to adolescents that include all of the following except: Reluctance of adolescents to seek care Concept that adolescents are "healthy" and don't need services Concerns about lack of confidentiality Availability of guidelines for preventive care

Availability of guidelines for preventive care

A twenty-five-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: Lipoma Dermoid cyst Bartholin's cyst Skene's duct cyst

Bartholin's cyst

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

Bartholin's cyst

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 Hysterosalpingogram Postcoital testing

Basal body temperature

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

Bilateral, round, or oval firm mass

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 Both b and c

Both b and c

A woman is experiencing symptoms after initial estrogen withdrawal. Which of the following would not be one of those? Vaginal dryness Hot flashes Sleep disturbances Breast tenderness

Breast tenderness

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

Late onset of pubertal sexual maturity

A myriad of influencing factors can affect adolescent women in a positive or negative way. As an advanced practice nurse, you will need to be cognizant of such influences and address them from a health promotion/prevention lens. Today, Marie, a sixteen-year-old woman, arrives for a well-woman visit, hoping to begin birth control since "all her friends are using it." 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? (Select those that apply.) You will assess all predisposing factors that lead to premarital sex and the negative consequences, tell Marie to be careful, and prescribe birth-control pills. One by one, you will plan to carefully address the risks (red flags) in Marie's history. Your goal will be to clarify and address misconceptions, as well as share valuable sex education in a sensitive, nonjudgmental way. You will let her know you are her advocate and are very protective of her health. Without preaching, you want her to be aware of the negative possibilities of premarital, unprotected sexual activities. You will also share a clear understanding of the risk of STIs with Marie. After processing all of the history Marie has shared, you will write a referral for psychiatric evaluation and tell her she needs ongoing counseling for her behavior at such a young age and she likely needs to learn to cope within her environment (home and community). Your goal is to include healthy sexual-health decision making, including decisions regarding abstinence, birth-control efficacy and choice, and condom use. Depending on the need, you may include a referral to an effective program for teens (for example, a program that deals with STI prevention and or a family-based intervention program if available).

CORRECT You will assess all predisposing factors that lead to premarital sex and the negative consequences, tell Marie to be careful, and prescribe birth-control pills. CORRECT One by one, you will plan to carefully address the risks (red flags) in Marie's history. Your goal will be to clarify and address misconceptions, as well as share valuable sex education in a sensitive, nonjudgmental way. You will let her know you are her advocate and are very protective of her health. Without preaching, you want her to be aware of the negative possibilities of premarital, unprotected sexual activities. You will also share a clear understanding of the risk of STIs with Marie. CORRECT After processing all of the history Marie has shared, you will write a referral for psychiatric evaluation and tell her she needs ongoing counseling for her behavior at such a young age and she likely needs to learn to cope within her environment (home and community).

You are interviewing a teen with suspected substance abuse. Which of the following screening tools would give you the most specific information regarding substance abuse in teens? GAPS CAGE CRAFFT HEADSS

CRAFFT

What does CRAFFT stand for

CRAFFT stands for the key words of the 6 items in the second section of the assessment - Car, Relax, Alone, Forget, Friends, Trouble.

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

CT of pelvis

Pelvic pain is a common complaint in young women. Which of the following is not a first-line diagnostic test for evaluation of pelvic pain? Urine human chorionic gonadotropin (HCG) CBC with differential CT of pelvis Pelvic ultrasound

CT of pelvis

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 Chlamydia

Candidiasis

A woman presents to your practice with vaginal itching and a white discharge. She has been in good health except for recent treatment for strep throat. Pelvic examination reveals a tender vulvovaginal area with edema and nonmalodorous white patches. Which of the following is the most likely cause of this problem? Bacterial vaginitis Trichomonas Lactobacillus overgrowth Candidiasis

Candidiasis

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

Central medulla

A woman comes to the clinic with the chief complaint of disruption of urine flow. Which of the following is not a risk factor for pelvic floor relaxation? Obesity Menopause Vaginal delivery Cesarean section

Cesarean section

Question : 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

Chlamydia

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

Chlamydial cervicitis

A nurse practitioner is reviewing the signs of polycystic ovary syndrome (PCOS) for a differential diagnosis for a female patient. Which of the following would be a positive finding? Chronic anovulation Increased estradiol levels Hyperprolactinemia Weight loss

Chronic anovulation

Lakeisha, seventeen years old, is seeing her regular nurse practitioner for a sports physical. While participating in a psychosocial screen, Lakeisha volunteers that she "hasn't had sex yet." What is the best initial response to Lakeisha's statement? Congratulate her for abstaining and move on to another topic. Clarify which behaviors are included in Lakeisha's definition of "having sex." Demonstrate condom use and give Lakeisha some condoms for future partners. Encourage Lakeisha to be screened for STIs.

Clarify which behaviors are included in Lakeisha's definition of "having sex."

Lakeisha, seventeen years old, is seeing her regular nurse practitioner for a sports physical. While participating in a psychosocial screen, Lakeisha volunteers that she "hasn't had sex yet." What is the best initial response to Lakeisha's statement? (Points : 2) Congratulate her for abstaining and move on to another topic. Clarify which behaviors are included in Lakeisha's definition of "having sex." Demonstrate condom use and give Lakeisha some condoms for future partners. Encourage Lakeisha to be screened for STIs.

Clarify which behaviors are included in Lakeisha's definition of "having sex."

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? Cold knife cone (CKC) Follow-up Pap smear Colposcopy Loop electro-excision procedure (LEEP)

Colposcopy

A nurse practitioner is educating a high school class about sexual education. Teaching should include that protective factors against repeat adolescent pregnancy include all of the following except: Use of effective contraception Participation in specialized adolescent parent program Continued sexual relationship with the same partner Continued school attendance

Continued sexual relationship with the same partner

Beth, a sixty-two-year-old woman, is seen for a follow-up discussion of DEXA scan result of minus 1.5 standard deviation (SD) at the hip. Her PMH includes a recent myocardial infarction and a fractured wrist at fifty-eight years of age. Which of the following would not be an option for her? Continuous conjugated estrogen 0.625 mg and medroxyprogesterone acetate (MPA) 2.5 mg (Prempro) p.o. daily Counseling on smoking cessation and alcohol consumption Ibandronate (Boniva) 150 mg p.o. once monthly in the a.m. Encouraging weight-bearing exercises and increased calcium intake

Continuous conjugated estrogen 0.625 mg and medroxyprogesterone acetate (MPA) 2.5 mg (Prempro) p.o. daily

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 Tissue examination using direct fluorescent antibody Culture and sensitivity Wet prep with potassium hydroxide (KOH) assessing for positive "whiff" test

Culture and sensitivity

While participating in a woman's health fair, a parent comes to you with the concern of her daughter participating prematurely in sex. Which of the following factors is strongly associated with early onset of unwanted sexual activity? Dating a partner that is >3 years older than the teen Planning on attending college in the near future Poor academic performance in school Presence of strong religious convictions

Dating a partner that is >3 years older than the teen

A nurse practitioner student is researching as to why menopausal women have an increased risk of heart disease. Which of the following lipid changes occur with estrogen withdrawal in menopause? (Points : 2) Increase in HDL, LDL, and triglycerides Decrease in HDL, LDL, and triglycerides Increase in HDL with a decrease in LDL and triglycerides Decrease in HDL with an increase in LDL and triglycerides

Decrease in HDL with an increase in LDL and triglycerides

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

Decrease in HDL with an increase in LDL and triglycerides

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 Increase follicle-stimulating hormone (FSH) secretion Decrease progesterone secretion

Decrease steroid levels

A nurse practitioner is teaching an undergraduate pathophysiology class about changes associated with puberty. Which of the following is an inaccurate point that should not be included? A decrease in the sensitivity of the hypothalamus An elevation of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) Decreasing estrogen levels and a reduction in gonadotropin-releasing hormone (GnRH) Nocturnal secretion of pulsatile LH

Decreasing estrogen levels and a reduction in gonadotropin-releasing hormone (GnRH)

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.

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

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.

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

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.

Douching may increase the risk of infection and ectopic pregnancy.

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)

Drospirenone/ethinyl estradiol/levomefolate calcium (Beyaz)

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? Middle adolescence Late adolescence Preadolescence Early adolescence

Early adolescence

When reviewing the risk factors for breast cancer with your patient, which of the following would not be a contributing factor? Early menarche High fat diet Early menopause Advanced age

Early menopause

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 Stress

Eating disorder

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

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

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? Sixth Tenth Twelfth Eighth

Eighth

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

Endometrial

Polycystic ovaries predispose women to a higher incidence of: Adrenal tumors Ovarian cancer Endometrial cancer Endometriosis

Endometrial cancer

The most common cause of chronic pelvic pain for women in the prime of their reproductive years is: PID Fibroids Endometriosis Endometritis

Endometriosis

Malignant ovarian masses are very uncommon in young women. Which of the following information would be least helpful in the assessment, diagnosis, or management of pelvic malignancies in young women? Malignant germ cell tumors are the most common ovarian tumors in young women. Mutations in the breast cancer gene-1 (BRCA-1) are responsible for a small percentage of ovarian cancers in women. Oral contraceptives are effective in minimizing the risks of functional ovarian masses. The most common metastatic ovarian lesions in young women are lymphomas and leukemias.

Mutations in the breast cancer gene-1 (BRCA-1) are responsible for a small percentage of ovarian cancers in women.

The initiation of puberty develops in various phases and is determined by a complex set of hormonal changes. During the prepubertal phase, hormones are secreted into the circulation from the adrenal cortex. Which of the following hormones is not considered an adrenal female androgen? Dehydroepiandrosterone Dehydroepiandrosterone sulfate Androstenedione Estrogen

Estrogen

In caring for a menopausal client who has had a total hysterectomy, the nurse practitioner would include which of the following options? Estrogen alone Estrogen and progestin Progestin and testosterone Testosterone alone

Estrogen alone

Question : HIV risk factors are all of these except: Unprotected sex or trauma with sexual activity or multiple partners IV drug use, including shared syringes Exchange of saliva

Exchange of saliva

A definitive diagnosis of endometriosis cannot be made until which of these is completed? CT scan Transvaginal ultrasound Exploratory laparoscopy MRI

Exploratory laparoscopy

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? Pregnancy after age of thirty-five years Late menopause after age of fifty-seven years History of maternal breast cancer Fibrocystic breast disease Fibrocystic breast disease

Fibrocystic breast disease

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

Fibrocystic changes

During pregnancy and lactation, the nutritional needs of the woman are increased with deficiencies resulting in harm to the woman or her baby. Neural tube defects are one of the most common birth defects. Deficiency of which nutrient is responsible for these conditions? Vitamin C Folic acid Vitamin B12 Riboflavin

Folic acid

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

Follicular phase

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)

Follow-up Pap smear

An eighteen-year-old patient presents with secondary amenorrhea. On physical exam, there is normal secondary sex characteristics in addition to the appearance of normal genitalia. Pregnancy has been ruled out through urine human chorionic gonadotropin (HCG). Which of the following signs or symptoms would necessitate further evaluation in this patient? Elevated blood cholesterol levels Androgen deficiency Galactorrhea Hirsutism

Galactorrhea

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? Polycystic ovarian disease Pituitary tumor Genetic, psychosocial, and hormonal fluctuations Psychosocial issues and sleep disturbance

Genetic, psychosocial, and hormonal fluctuations

Which of the following is true regarding education of a forty-two-year-old woman diagnosed with uterine myoma? Myomas usually resolve with menopause. Myomas will become larger with the withdrawal of estrogen. Hysterectomy is the treatment of choice. Myomas are never responsible for uterine bleeding.

Myomas usually resolve with menopause.

Which of the following is true regarding education of a forty-two-year-old woman diagnosed with uterine myoma? Myomas usually does not resolve with menopause. Myomas will decrease with the withdrawal of estrogen. Hysterectomy is the treatment of choice. Myomas are never responsible for uterine bleeding.

Myomas will decrease with the withdrawal of estrogen.

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 Active viral hepatitis

Greater than age of thirty-five years

Whether you order diagnostic testing or refer the patient to an HIV-specific facility, laboratory confirmation for documentation for appropriate care rendered. The test confirming HIV infection is _____________. HIV-1/2 Ag/Ab combination immunoassay enzyme-linked immunosorbent HIV RNA CD4+ lymphocyte count quantitative plasma HIV RNA

HIV-1/2 Ag/Ab combination immunoassay

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? Nulliparity Heart disease Prior ectopic pregnancy History of multiple births

Heart disease

Long-acting progestins used in contraception do not always contain estrogen. As a result of the lack of this hormone, there will be no alteration in which of the following? Hepatic globulin production Serum androgen levels Blood pressure Decreased serum insulin levels

Hepatic globulin production

Adolescence is a period of time where patients undergo significant biological, psychological, and emotional growth. Which of the following characteristics describe the psychosocial development of middle adolescence? Middle school years between ages ten and thirteen Late elementary school from ages eight to nine High school years from ages fourteen to seventeen Ages seventeen to twenty-one and posthigh school years

High school years from ages fourteen to seventeen

A patient is complaining of a milky nipple discharge. Galactorrhea is usually a finding with which other diagnosis? Cancer Mastalgia Hyperprolactinemia Fibroma

Hyperprolactinemia

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

Hyperprolactinemia

Bartholin's Cyst

If a Bartholin duct gets blocked, fluid builds up in the gland. The blocked gland is called a Bartholin gland cyst

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

Infertility

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

Infertility and dysmenorrhea

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

Late luteal

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

Malignancy

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 Mammography should be accompanied by breast examination Negative mammography should not delay biopsy of a clinically suspicious mass

Mammography detects all breast cancers

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

Mastitis

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

Medroxyprogesterone

Your fifteen-year-old patient has been diagnosed with secondary amenorrhea. The urine human chorionic gonadotropin (HCG) is negative and Prolactin levels are within normal limits. The physical examination reveals growth of breast tissue and Tanner stage III. Which of the following medication regimes would be most appropriate? Oral estrogen 1.25 mg daily for three weeks Medroxyprogesterone acetate 5 mg every other day for one month Medrol 16 mg dose pack Medroxyprogesterone acetate 5 mg daily for five to ten days

Medroxyprogesterone acetate 5 mg daily for five to ten days

A patient has been diagnosed with trichomoniasis. Which of the following single dose medications would be the best option? Azithromycin 1 g Clindamycin 300 mg Ofloxacin 500 mg Metronidazole 2 g

Metronidazole 2 g

Which of the following conditions is not an absolute contraindication to estrogen-containing contraception? Migraine headaches Hypercoagulable state Thromboembolism History of coronary artery disease

Migraine headaches

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

Muscular tension

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

Naproxen

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 drugs

Nonsteroidal anti-inflammatory drugs

A twenty-one-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? Combined oral contraceptive (COC) pill Depo-Provera Ortho Evra patch NuvaRing

NuvaRing

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

Obesity

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 Frequency and number of symptoms over the past four months Presence or absence of depression or anxiety

Occurrence of symptoms in the menstrual cycle

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.

Onset coincides with the start of puberty

A forty-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 Hypothalamus disorder Anterior pituitary disorder Premature ovarian failure

Onset of climacteric

A prescription is being written by the nurse practitioner for birth control pills. When completing patient education, which of the following would be an accurate statement about oral contraceptive use? It is unnecessary to double up on missed pills for combined oral contraception. Oral contraceptives do not provide protection against sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Most women will not notice a change in their periods once they go on the pill. The pill provides added protection against cervical and uterine cancer.

Oral contraceptives do not provide protection against sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV).

You are starting Ella, a twenty-one-year-old, on Ortho Tri-Cyclen, a combined oral contraceptive. Which of the following would not be included in your instructions and advice? Try to take the pill at the same time every day. If you miss one day, double up the next day. You need to use backup protection consistently for the first month to avoid pregnancy. Breakthrough bleeding may occur in the first few cycles. Please do not stop taking the pill due to this. If you are uncomfortable with this, come in for a follow-up appointment to discuss other options. Oral contraceptives offer protection against breast cancer for as long as you are using them.

Oral contraceptives offer protection against breast cancer for as long as you are using them.

When prescribing a combined oral contraceptive for a young patient, which of the following would not be included in your discharge instructions? If you miss one day, double up the next day. You need to use backup protection consistently for the first month to avoid pregnancy. Breakthrough bleeding may occur in the first few cycles. Oral contraceptives offer protection against cervical cancer.

Oral contraceptives offer protection against cervical cancer.

Elisabeth comes for a consultation. She has been in a committed relationship for five years now and wants to become pregnant. She is seeking information on the menstrual cycle and her "fertile period." Her cycle is twenty-eight days and regular. She and her partner have used condoms consistently to avoid pregnancy. Which of the following would be most valuable to her initially The viability period for sperm is twenty-four hours. Ovulation occurs on day 14 +/- 2 days, before the next period. Taking her temperature daily will tell her when she is fertile. Cervical mucus evaluation can be used to determine fertility.

Ovulation occurs on day 14 +/- 2 days, before the next period.

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

Pap smear

Anna, twenty-five years old, presents with dysmenorrhea. She states that her sister and mother have endometriosis; so she would like to be evaluated for it. Which if the following is consistent with a diagnosis of endometriosis? Erythema and edema of the vulva Postcoital bleeding with malodorous discharge Pelvic pain and dyspareunia Frequent diarrhea and amenorrhea

Pelvic pain and dyspareunia

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

Production of alkaline secretion for sperm viability

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

Prostaglandin production

A nurse practitioner is teaching an undergraduate course in woman's health. A student asks about the etiology of the pain that occurs with primary dysmenorrhea. Which of the following responses is correct? Sloughing of the endometrium Prostaglandin release and synthesis Anovulatory cycles Excess progesterone production

Prostaglandin release and synthesis

A twenty-seven-year old comes in to see you for a consultation. She has been in a committed relationship for five years now and wants to become pregnant. She is seeking information on the menstrual cycle and her "fertile period." Her cycle is every twenty-eight days and is regular; she and her partner have used condoms consistently to avoid pregnancy. Which of the following would be most valuable to her initially? The viability period for sperm is twelve hours Ovulation occurs on day 7 +/- 2 days Taking her temperature at midcycle will tell her when she is fertile Cervical mucus evaluation can be used to determine fertility

Taking her temperature at midcycle will tell her when she is fertile

You are at the office and a thirty-year-old woman presents with an abrupt onset of pain when attempting to urinate. She is also complaining of frequency and urgency and thinks she may have seen some blood as well.You take her history and she tells you she had sex three days ago with her long-term significant other, but she realized she left her diaphragm in until today when these symptoms occurred. Her BP is unremarkable, pulse is 90, temperature is 99, no costovertebral angle tenderness (CVAT), and is experiencing slight suprapubic discomfort. You review her urine dip and you note 2+ blood, +nitrates, +leukocyte esterase. You send the urine for a microscopic and culture and sensitivity but your management plan is: Pending the culture and sensitivities, you will treat accordingly. Advise her to drink cranberry juice and you will give her a pain medication. Provide broad spectrum antibiotic while waiting for culture and sensitivity lab to return for specific microbe. Refer to a urologist.

Provide broad spectrum antibiotic while waiting for culture and sensitivity lab to return for specific microbe.

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? 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

Puberty starts before eight years of age in a female

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

Pulsatile release at the onset of slow wave sleep

A 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

Referral to a gynecologist for consideration for endometrial biopsy

Lab results on your twenty-six-year-old patient show a negative Pap smear with a positive human papillomavirus (HPV) screen. Which procedure will be required next? Repeat Pap and HPV screen Colposcopy Cold knife cone (CKC) Loop electro-excision procedure (LEEP)

Repeat Pap and HPV screen

Treatment, although not curative, is critical for the best outcome possible. One important principle of antiretroviral therapy is: Therapy should be started when symptoms first appear. Monotherapy is recommended. Response to drug therapy is monitored by HIV RNA levels. Response to drug therapy is monitored with CD4+ counts.

Response to drug therapy is monitored by HIV RNA levels.

Women often tend to reschedule a well-woman visit, but they don't do so often with a problem such as pelvic pain. This symptom can present as an acute, or chronic, insult. When a woman presents with pelvic pain, the term can encompass many possibilities. Differentiating acute from chronic assists with narrowing down the possibilities but nonetheless can originate from more than one system as a referred pain or discomfort. The focus here will be of reproductive/pelvic origin. As you know, 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 Gynecologic malignancy Adhesions Myomata uteri

Salpingo-oophoritis (fallopian tube/ovary)

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 Thyroid dysfunction Asherman's syndrome

Sheehan's syndrome

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? Small, yellow, raised around area on the cervix Friable, bleeding tissue opening of the cervical os Red patch areas with occasional white spots Irregular, granular surface with red patches

Small, yellow, raised around area on the cervix

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

Staphylococcus saprophyticus

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? Breast milk production Stimulation of ovarian follicles Maturation of ovarian follicles Luteinizing hormone (LH) inhibition

Stimulation of ovarian follicles

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 Tanner stage III Tanner stage IV

Tanner stage III

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? Pubic hair develops before breast buds. Breast development delayed beyond twelve years of age may be considered pathological. The average age of menarche is twelve years. It usually takes about three-and-half years to go from breast buds to menarche.

The average age of menarche is twelve years.

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? (Points : 2) Pubic hair develops before breast buds. Breast development delayed beyond twelve years of age may be considered pathological. The average age of menarche is twelve years. It usually takes about three-and-half years to go from breast buds to menarche.

The average age of menarche is twelve years.

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? 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.

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

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. 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.

The diaphragm is more effective when used with spermicidal jelly.

When discussing contraception with a patient, which of the following statements is true regarding progestin-only therapy? There is an decreased risk of ectopic pregnancy. There is an increased risk in the development of functional ovarian cysts. Ovulation suppression is equal to combined oral contraceptive methods. Women that are breast-feeding should not use progestin-only treatment.

There is an increased risk in the development of functional ovarian cysts.

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

Use of opposed Estrogen use

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. 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.

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

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

Thickening of cervical mucus and suppression of gonadotropin levels

A thirty-five-year-old female presents with perimenopausal symptoms. You recall that this may begin during which age group? Forty-five to fifty years Thirty-five to forty years Fifty to fifty-five years Thirty to thirty-five years

Thirty-five to forty years

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

To determine if a breast lesion is cystic or solid

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

Type I bone loss results from loss of ovarian function

A postmenopausal female is taking hormone replacement therapy (HRT). Which of the following risk factors would not be a contraindication? Abnormal vaginal bleeding Uncontrolled hypertension Chronic active hepatitis Recent deep vein thrombosis

Uncontrolled hypertension

Anticholinergic medications are a type of treatment for which type of incontinence? Urge incontinence Stress incontinence Vulvodynia Vestibulitis

Urge incontinence

A fourteen-year-old patient is accompanied by her mother, who is concerned about irregular and infrequent periods. Her last menstrual period was two months ago. What would be the initial test performed? Urine HCG Serum beta HCG Hemoglobin and hematocrit Chlamydia culture

Urine HCG

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 represent? Uterine cancer Dysfunctional uterine bleeding (DUB) Uterine fibroid Fecal impaction

Uterine fibroid

Elizabeth, twenty-four years old, is pregnant, and you are educating her on common problems during the first trimester. Which of the following is abnormal and requires immediate attention? Nausea and vomiting (aka "morning sickness") Fatigue and tiredness Back ache in the lumbar area Vaginal bleeding

Vaginal bleeding

A woman is experiencing urinary symptoms. Which of the following is a risk factor in her pelvic floor relaxation? Thin stature Perimenopause Vaginal delivery Cesarean section

Vaginal delivery

How is HIV transmitted

Vertical transmission from a mother to her baby, blood transfusion, or exchange of any blood products

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

Vitamin B6, Antiprostaglandins, and Diuretics

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

Well-circumscribed, rubbery, and tender lesion

An adolescent female patient is considering starting contraception. She reports that she has asthma that is well controlled on inhaled corticosteroids. You would advise this patient that ____. the use of oral contraceptives is contraindicated in patients with asthma injectable methods of contraception are best for patients with asthma all methods of contraception may be used by patients with asthma the use of hormone patches is indicated for patients with asthma

all methods of contraception may be used by patients with asthma

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

approximately over 3% oral contraceptive users develop hypertension

A woman has been diagnosed with polycystic ovary syndrome (PCOS). Management of PCOS includes all of the following except ___________. oral contraceptives to establish a regular menstrual cycle a planned program of regular exercise consult with dietician for weight management daily basal insulin to reduce blood sugar

daily basal insulin to reduce blood sugar

Frankie is concerned that she has an ultrasound ordered after the results of her mammogram of been reviewed by the nurse practitioner. You emphasize that the primary role of a breast ultrasound is to _____. screen for breast cancer definitively diagnose breast cancer determine if a breast lesion is cystic or solid locate small lesions before surgery

determine if a breast lesion is cystic or solid

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 __. CORRECT endogenous estrogen prolactin L-thyroxine follicle-stimulating hormone (FSH)

endogenous estrogen

The nurse practitioner is prescribing an oral contraception to Sally. She is concerned about having one that has "two hormones" as the active ingredients. You instruct her that adding progestin to estrogen therapy will decrease the risk of ___________. breast cancer withdrawal bleeding endometrial cancer osteoporosis

endometrial cancer

Sheehan's syndrome

postpartum hypopituitarism or postpartum pituitary gland necrosis, is hypopituitarism (decreased functioning of the pituitary gland), caused by ischemic necrosis due to blood loss and hypovolemic shock during and after childbirth.

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

failure of menstruation to occur by age fifteen

anovulation

failure to release an egg or ovulate

A twenty-one-year-old female presents to the practice with the chief complaint of a breast mass. Considering the differential diagnoses, the most common cause of the mass in this age group is ____. intraductal papilloma fibroadenoma fibrocystic breast disease lobular carcinoma

fibroadenoma

Nancy is an eleven-year-old presenting for an annual well-child visit. When reviewing the physiology of puberty, you recall that the initiation of puberty begins physiologically with the release of GnRH by the ____. (Points : 2) hypothalamus adrenal gland ovaries pituitary gland

hypothalamus

A woman has developed acne and hirsutism while taking oral contraceptives. These changes result from _____. increased estrogen levels decreased estrogen levels increased free androgens decreased free androgens

increased free androgens

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

infiltrating ductal

A 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 ____. late luteal phase midfollicular phase proliferative phase early luteal phase

late luteal phase

The nurse practitioner understands that premenstrual syndrome (PMS) occurs with greatest frequency and severity in the ___________. late luteal phase follicular phase proliferative phase ovulatory phase

late luteal phase

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

male pattern baldness

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)

menopause

Maria, fifty-two years old, comes in for her annual well-woman examination. LMP was fourteen months ago. You would document this as ____________. secondary amenorrhea menopause perimenopause primary ovarian failure

menopause

A college professor is creating a lecture about the prevention and diagnosis of osteoporosis. A point that needs to be included about measures that have no impact on osteoporosis is _____________. educating young women about importance of calcium and nutrition in attaining peak bone mass educating women of all ages to the importance of regular weight-bearing exercise obtaining a DEXA scan on postmenopausal women to assess for osteopenia obtaining a spinal X-ray after a suspected osteoporotic compression fracture

obtaining a spinal X-ray after a suspected osteoporotic compression fracture

A nurse practitioner is caring for a woman who is post-op from a total hysterectomy. It is important to recall that estrogen withdrawal reflects hormonal activity primarily from the ______. hypothalamus posterior pituitary ovary anterior pituitary

ovary

A woman has just stopped birth control pills in efforts to become pregnant. You recall that estrogen withdrawal reflects activity primarily from the _________. hypothalamus uterus ovary pituitary

ovary

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

ovulation suppression

Strategies to protect teenagers from risks include all of the following except _________. involving them in community activities for a worthy cause encouraging them to participate in teambuilding sports pairing young adolescents with middle adolescents involving them in school-related activities

pairing young adolescents with middle adolescents

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 _______. reassure the patient that pain is often not a presenting symptom of breast cancer teach the patient breast self-examination order laboratory studies as most likely this is secondary to a hormonal fluctuation perform a breast examination and order a mammogram

perform a breast examination and order a mammogram

Suzanne, a forty-six-year-old client, reports shortened menstrual cycles for one year. The most likely diagnosis is __________. anovulatory bleeding menopause perimenopause breakthrough bleeding

perimenopause

The twenty-eight-year-old female is interested in the use of an intrauterine device (IUD) as a method of birth control. The nurse practitioner would advise the patient that the action of the IUD _______. blocks the transportation of sperm through the cervical os has a similar action to that of spermicide prevents the implantation of a fertilized ovum decreases transit time of the ovum into the uterus

prevents the implantation of a fertilized ovum

A twenty-one-year-old patient presents with symptoms of lower urinary tract infection, including dysuria, frequency, and urgency. The urinalysis reveals the presence of leukocytes but is negative for nitrates. This most likely represents ______. vaginitis specimen contamination sexually transmitted disease interstitial cystitis

specimen contamination

The diagnosis of stress incontinence can be confirmed by __________. your suspected etiology the woman's symptom history to date urodynamic evaluation pelvic muscle evaluation

the woman's symptom history to date

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

trichomonas

During a pelvic exam on a seventy-year-old, the nurse practitioner notices the position of the cervix at the introitus. The diagnosis is most likely _____. cystocele rectocele urethral prolapse uterine prolapse

uterine prolapse

The nurse practitioner is completing a follow-up visit on a woman who was previously prescribed hormonal therapy (HT), which she has not taken for the last month. The primary reason the patient discontinued HT is _________. weight gain vaginal bleeding breast tenderness mood changes

vaginal bleeding

Anovulation

when the ovaries do not release an oocyte during a menstrual cycle. Therefore, ovulation does not take place. However, a woman who does not ovulate at each menstrual cycle is not necessarily going through menopause. Chronic anovulation is a common cause of infertility.