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

• 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

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

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

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

Te

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

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

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

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

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

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

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 fal

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