Female Reproductive and Genitourinary Systems, Exams of Nursing

Download Female Reproductive and Genitourinary Systems and more Exams Nursing in PDF only on Docsity! Female Reproductive and Genitourinary Systems C. Presence of factor V Leiden mutation ANS: Which of the following is a contraindication to estrogen/progestin-containing methods (combined oral contraception [COC], patch [Ortho Evra], or ring [NuvaRing])? A. Mother with a history of breast cancer B. Personal history of hepatitis A at age 10 years C. Presence of factor V Leiden mutation D. Cigarette smoking one pack per day in a 22-year-old QUIZ: A. Take the last pill missed immediately, even if this means taking 2 pills today ANS: A 22-year-old woman taking a 35-mcg ethinyl estradiol COC calls after forgetting to take her pills for 2 consecutive days. She is 2 weeks into the pack. You advise her to: A. Take the last pill missed immediately, even if this means taking 2 pills today B. Discard two pills and take two pills today C. Discard the rest of the pack and start a new pack with the first day of her next menses D. Continue taking one pill daily for the rest of the cycle QUIZ: D. Prementrual syndrome symptoms are often improved with use of COC ANS: When counseling a woman about COC use, you advise that: A. Long-term use of COC is discouraged because the body needs a "rest" from birth control pills from time to time B. Fertility is often delayed for many months after discontinuation of COC C. There is an increase in the rate of breast cancer after protracted use of COC D. Prementrual syndrome symptoms are often improved with use of COC QUIZ: C. Cervicitis ANS: Noncontraceptive benefits of COC use include a decrease in all of the following except: A. Iron-deficiency anemia B. Pelvic inflammatory disease (PID) C. Cervicitis D. Ovarian cancer QUIZ: C. A 32-year-old woman with adequately-controlled hypertension ANS: Which of the following women is the best candidate for progestin-only pill (POP) use? A. An 18-year-old woman who frequently forgets to take prescribed medications B. A 28-year-old woman with multiple sexual partners C. A 32-year-old woman with adequately-controlled hypertension D. A 26-year-old woman who wants to use the pill to help "regulate" her menstrual cycle QUIZ: B. Inconvenience of use ANS: The most common reasons for discontinuing oral contraception use is breakthrough bleeding and : A. Nausea/vomiting B. Inconvenience of use C. Cost D. High failure rate QUIZ: D. Vaginal diaphragm ANS: A 38-year-old nulliparous woman who smokes two and a half packs a day is in an "on-and-off" relationship. The woman presents seeking contraception. Which of the following represents the most appropriate method? A. Contraceptive ring (NuvaRing) B. COC C. Contraceptive patch (Ortho Evra) D. Vaginal diaphragm QUIZ: B. 31-year-old woman with history of naturally occurring multiple gestation pregnancy ANS: Due to an increased risk of blood clots, an alternative to the contraceptive ring (NuvaRing) or patch (Ortha Evra) is preferred in all of the following women except: A. 42-year-old nulliparous woman B. 31-year-old woman with history of naturally occurring multiple gestation pregnancy C. 28-year-old who smokes one pack per day D. 33-year-old woman with a family history of venous thrombosis QUIZ: C. After insertion, the cervix should be smoothly covered ANS: Which of the following statements is true concerning vaginal diaphragm use? A. When in place, the woman is aware that the diaphragm fits snugly against the vaginal walls B. This is a suitable form of contraception for women with recurrent urinary tract infection C. After insertion, the cervix should be smoothly covered D. The device should be removed within 2 hours of coitus to minimize the risk of infection QUIZ: B. AIDS-defining illness ANS: According to the U.S. Medical Eligibility Criteria for Contraception Use, which of the following is a clinical condition in which use of a copper-containing IUD should be approached with caution? A. Uncomplicated valvular heart disease B. AIDS-defining illness C. Hypertension D. Dysmenorrhea QUIZ: C. "Depo-Provera (medroxprogesterone acetate in a depot injection [DMPA]) use will likely not interact with your seizure medication. " ANS: Which of the following is the most appropriate response to a 27-year-old woman who is taking phenytoin (Dilantin) for the treatment of a seizure disorder and is requesting hormonal contraception? A. "A barrier method would be the preferable choice." B. " COC is the best option." A. Less than 1 year B. No more than 2 years C. As long as the woman desires this form of contraception D. As determined by her lipid response to the medication QUIZ: A. Acetaminophen ANS: Irregular bleeding associated with DMPA (Depo- Provera) can be minimized with the use of all of the following except: A. Acetaminophen B. Ibuprofen C. Naproxen sodium D. Estrogen supplements QUIZ: A. Immediately ANS: When can a woman safely conceive after discontinuing COC use? A. Immediately B. After 1 to 2 months C. After 3 to 4 months D. After 5 to 6 months QUIZ: B. Candidates include women who have difficulty remembering to take a daily pill ANS: When prescribing the contraceptive patch (Ortho Evra) or vaginal ring (NuvaRing), the NP considers that: A. These are progestin-only products B. Candidates include women who have difficulty remembering to take a daily pill C. There is significant drug interactions with both products D. Contraceptive efficacy is less than with COC QUIZ: True ANS: True/False: The use of combine oral contraception (COC) reduces menstrual volume by approximately 60%, thereby reducing the risk of iron deficiency anemia. QUIZ: False ANS: True/False: Nausea with oral contraceptive use can be minimized by taking the pill on an empty stomach. QUIZ: True ANS: True/False: Calcium and vitamin D supplementation is recommended for those taking DMPA (Depo-Provera) injections to minimize the risk of a loss in bone density. QUIZ: D. Insertion of a copper-containing IUD offers an effective form of emergency and ongoing contraception ANS: An 18-year-old woman requests emergency contraception after having unprotected vaginal intercourse approximately 18 hours ago. Today is day 12 of her normally 27- to 29- day menstrual cycle and she has no contraindications to the use of any currently available forms of emergency contraception. You advise her that: A. Emergency hormonal contraception use reduces the risk of pregnancy by approximately 33% B. All forms of emergency contraception must be used within 12 hours after unprotected intercourse C. The likelihood of conception is minimal D. Insertion of a copper-containing IUD offers an effective form of emergency and ongoing contraception QUIZ: B. Acts as an abortifacient ANS: Which of the following is likely not among the proposed mechanisms of action of all forms of oral emergency contraception? A. Inhibits ovulation B. Acts as an abortifacient C. Slows sperm transport D. Slows ovum transport QUIZ: D. None of the above ANS: A 24-year-old woman who requests emergency contraception pills wants to know the effects if pregnancy does occur. You respond that there is the risk of increased rate of: A. Spontaneous abortion B. Birth defects C. Placental abruption D. None of the above QUIZ: A. Inhibiting embryo implantation ANS: In contrast to progestin-only emergency contraception, a possible mechanism of action of ulipristal is: A. Inhibiting embryo implantation B. Impairing sperm transport C. Through spontaneous abortion D. Impairing ovum transport QUIZ: B. Ulipristal ANS: You see a 34-year-old woman who reports having unprotected sexual intercourse 4 days ago and requests emergency contraception. She has a recent history of gonorrhea that was treated successfully. This most acceptable and effective option in this clinical scenario is: A. Progestin-only emergency contraception B. Ulipristal C. Copper-containing IUD D. Nothing, as 4 days is too long for emergency contraception to be effective QUIZ: D. Ulipristal is taken in two doses 12 hours apart ANS: Which of the following statements is false? A. Progestin-only emergency contraception can be taken as one close dose or two doses B. Ulipristal is available by prescription only C. Progestin-only emergency contraception is available. OTC for women 17 years old and older D. Ulipristal is taken in two doses 12 hours apart QUIZ: C. 3 to 4 ANS: A woman who has used emergency contraception pills should be advised that if she does not have a normal menstrual period within ________ weeks, a pregnancy test should be obtained. A. 1 to 2 B. 2 to 3 C. 3 to 4 D. 4 to 5 QUIZ: B. 40 to 45 years ANS: The average onset of perimenopause is between the ages of: A. 35 to 40 years B. 40 to 45 years C. 45 to 50 years D. 50 to 55 years QUIZ: A. Menstruation ceases during perimenopause ANS: Which of the following statements regarding perimenopause is false? A. Menstruation ceases during perimenopause B. Hot flashes and flushes are common during the week before menses C. Pregnancy is still possible during perimenopause D. Ovulation becomes more erratic during perimenopause QUIZ: B. Hot flashes and night sweats occur in about 60% to 90% of women ANS: In advising a woman about menopause, the NP considers that: A. The average age at last menstrual period for a North American woman is 47 to 48 years B. hot flashes and night sweats occur in about 60% to 90% of women C. Women with surgical menopause usually have milder symptoms D. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels are suppressed QUIZ: D. A pH greater than 5.0 ANS: Findings in estrogen deficiency (atrophic) vaginitis include: A. A malodorous vaginal discharge B. An increased number of lactobacilli C. A reduced number of white blood cells D. A pH greater than 5.0 QUIZ: B. The addition of a topical estrogen can be helpful ANS: A 53-year-old woman who is taking hormone therapy (HT) with conjugated equine estrogen, 0.45 mg/d, with MPA, 1.5 mg, has bothersome atrophic vaginitis symptoms. You advise that: A. Her oral estrogen dose should be increased B. The addition of a topical estrogen can be helpful C. The MPA component should be discontinued D. Baking soda douche should be tried D. Short-term studies demonstrate that oral HT is associated with lower thromboembolic risk than transdermal forms of HT. QUIZ: C. Vitamin E ANS: Examples of phytoestrogens include all of the following except: A. Red clover B. Ginseng C. Vitamin E D. Soy products QUIZ: B. One-fourth ANS: The typical HT regimen contains ________ or less of the estrogen dose of COC. A. One-eighth B. One-fourth C. One-half D. Three-fourths QUIZ: D. Paroxetine ANS: For the woman with a history of DVT who is having significant vasomotor symptoms, which of the following can be used for symptom management? A. 17-19β-estradiol patch B. Drospirenone C. Estrone D. Paroxetine QUIZ: B. 50% ANS: Long term calcium supplementation is recommended in postmenopausal women as its use reduces the risk of fracture by approximately: A. 25% B. 50% C. 65% D. 80% QUIZ: B. Reduced risk of recurrent UTIs ANS: In postmenopausal women, a major benefit from the use of topical or local estrogen is: A. Decreased rate of breast cancer B. reduced risk of recurrent UTIs C. Reduced risk of type 2 diabetes D. Increased levels of androgens QUIZ: A. Few high-quality studies support the use of these products ANS: When reviewing the use of nutritional supplements for the management of menopausal symptoms, the NP considers that: A. Few high-quality studies support the use of these products B. The use of these products is consistently reported to be helpful C. The products can be safely used as long as blood hormone levels are carefully evaluated D. The use of these products is associated with a greater reduction in menopausal symptoms than with prescription HT QUIZ: A. Many over-the-counter progesterone creams contain sterols that the human body is unable to use ANS: Which of the following statements is true? A. Many over-the-counter progesterone creams contain sterols that the human body is unable to use B. All progesterones are easily absorbed via the skin C. Alfalfa is an example of a phytoprogesterone D. Progesterones, whether synthetic or plan-based, should not be used by a woman who has undergone a hysterectomy QUIZ: A. Younger than 25 years ANS: Chlamydial infections occur most frequently among women in which age group? A. Younger than 25 years B. 25 to 35 years C. 40 to 50 years D. Over 60 years QUIZ: A. Ovaries ANS: Common site of C. trachomatis infection in women include all of the following except: A. Ovaries B. Cervix C. Endometrium D. Urethra QUIZ: C. 7 to 14 days ANS: The incubation period for C. trachomatis is approximately: A. 24 hours B. 3 days C. 7 to 14 days D. 24 days QUIZ: D. easily irritated and prone to bleeding, especially following intercourse ANS: Which of the following include characteristics of a friable cervix? A. Presence of a dull pain, particular prior to menses B. A constant burning sensation C. Presence of multiple polyps D. Easily irritated and prone to bleeding, especially following intercourse QUIZ: B. Sexually active women 25 years of age and younger ANS: An annual screening for C. trachomatis infection is recommended for: A. All sexually active women B. Sexually active women 25 years of age and younger C. Sexually active women who have had 2 or more partners in the past 12 months D. Sexually active men 25 years of age and younger QUIZ: D. Vaginal epithelial cells with adherent bacteria ANS: Which of the following is not a normal finding in a woman during the reproductive years? A. Vaginal pH of 4.5 or less B. Lactobacillus as the predominant vaginal organism C. Thick, white vaginal secretions during the luteal phase D. Vaginal epithelial cells with adherent bacteria QUIZ: C. Stringy and clear ANS: Which of the following findings is most consistent with vaginal discharge during ovulation? A. Dry and sticky B. Milky and mucoid C. Stringy and clear D. Tenacious and odorless QUIZ: A. 1 to 5 days ANS: What is the approximate incubation period for Neisseria gonorrhoeae? A. 1 to 5 days B. 7 to 10 days C. 18 days D. 28 days QUIZ: D. Ceftriaxone injection ANS: A recommended treatment for rectal gonorrhea is: A. Oral amoxicillin B. Oral azithromycin C. Oral ciprofloxacin D. Ceftriaxone injection QUIZ: C. Hyphae ANS: Physical examination of a 19-year-old woman with a 3-day history of vaginal itch reveals moderate perineal excoriation, vaginal erythema, and a white, clumping discharge. Expected microscopic examination findings include: A. A pH greater than 6.0 B. An increased number of lactobacilli C. Hyphae D. An abundance of white blood cells QUIZ: D. Malodorous discharge ANS: Women with bacterial vaginitis typically present with: A. Vulvitis B. Pruritus C. Dysuria D. Malodorous discharge QUIZ: B. Clotrimazole cream ANS: Treatment of vulvovaginitis caused by Candida albicans includes: A. Metronidazole gel QUIZ: C. Positive virological test result and negative serological test result ANS: Diagnostic testing of a person with primary HSV-2 infection would likely show: A. Negative virological and serological test results B. Negative virological test result and positive serological test result C. Positive virological test result and negative serological test result D. Positive virological and serological test results QUIZ: C. Famciclovir ANS: Treatment options for HSV-2 genital infection include: A. Ribavirin B. Indinavir C. Famciclovir D. Cyclosporine QUIZ: D. 70% to 80% ANS: Suppressive therapy reduces the frequency of genital herpes recurrences by: A. 5% to 10% B. 20% to 25% C. 40% to 50% D. 70% to 80% QUIZ: C. Hepatitis A ANS: Recommended comprehensive STI testing includes testing for all of the following except: A. Hepatitis B B. Syphilis C. Hepatitis A D. HIV QUIZ: B. Leukopenia ANS: Women with PID typically present with all of the following except: A. Dysuria B. Leukopenia C. Cervical motion tenderness D. Abdominal pain QUIZ: C. Mucopurulent vaginal discharge ANS: A 22-year-old woman complains of pelvic pain. Physical examination reveals cervical motion tenderness and uterine tenderness. Which of the following would further support a diagnosis of PID? A. Temperature less than 100 degrees F (37.8 degrees C) B. Absence of white blood cells in vaginal fluid C. Mucopurulent vaginal discharge D. Laboratory documentation of cervical infection with E. coli QUIZ: C. C. trachomatis ANS: The most likely causative pathogen in a 23-year-old woman with PID is: A. Escherichia coli B. Enterobacteriaceae C. C. trachomatis D. Pseudomonas QUIZ: D. A tubo-ovarian abscess ANS: The presence of an adnexal mass in the woman with PID most likely indicates the presence of: A. Uterine fibroids B. An ectopic pregnancy C. Ovarian malignancy D. A tubo-ovarian abscess QUIZ: C. Elevated CrCl ANS: Expected laboratory findings for the woman with PID include all of the following except: A. Elevated ESR B. Elevated CRP C. Elevated CrCl D. Leukocytosis QUIZ: A. Tubal thickening with or without free pelvic fluid ANS: A transvaginal ultrasound in the woman with PID will likely show: A. Tubal thickening with or without free pelvic fluid B. Cervical thickening C. Endometrial thinning D. Inflammation of the ovaries QUIZ: C. Cefixime with doxycycline ANS: Which of the following is a treatment option for a 28-year-old woman with PID who has no history of medication allergy and has undergone a bilateral tubal ligation? A. Ofloxacin with metronidazole B. Gentamicin with cefpodoxime C. Cefixime with doxycycline D. Clindamycin with azithromycin QUIZ: A. Ofloxacin with metronidazole ANS: Which of the following is a treatment options for a 30-year-old woman with PID and a history of severe hive-form reaction when taking a penicillin or cephalosporin? A. Ofloxacin with metronidazole B. Amoxicillin with gentamicin C. Cefixime with vancomycin D. Clindamycin with azithromycin QUIZ: A. Verruciform ANS: Which of the following best describes lesions associated with condyloma acuminatum? A. Verruciform B. Plaque-like C. Vesicular-form D. Bullous QUIZ: A. Topical acyclovir ANS: Treatment options for patients with condyloma acuminatum include all of the following except: A. Topical acyclovir B. Cryotherapy C. Podofilox D. Trichloroacetic acid QUIZ: B. 6 and 11 ANS: Which HPV types are most likely to cause genital condyloma acuminatum? A. 1, 2, and 3 B. 6 and 11 C. 16 and 18 D. 22 and 24 QUIZ: C. 16 and 18 ANS: Which HPV types are most often associated with cervical and anogenital cancer? A. 1, 2 and 3 B. 6 and 11 C. 16 and 18 D. 22 and 24 QUIZ: C. At least 70% ANS: What percentage of anogenital and cervical cancers can be attributed to HPV infection? A. Less than 30% B. At least 50% C. At least 70% D. 95% or greater QUIZ: B. Immune modulator ANS: Which of the following terms describes the mechanism of action of imiquimod (Aldabra)? A.keratolytic B. Immune modulator C. Cryogenic D. Cytolytic QUIZ: C. 50% ANS: About ______ of patients with genital warts have spontaneous regression of the lesions? A. 10% B. 25% C. 50% D. 75% QUIZ: C. 2 to 4 weeks ANS: How long after contact do clinical manifestation of syphilis typically occur?