Nursing Final Exam Week 10 Questions with Answers, Exams of Nursing

Download Nursing Final Exam Week 10 Questions with Answers and more Exams Nursing in PDF only on Docsity! Nursing Final Exam Week 10 Questions with Answers 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? (Points : 2) African American boys Native American boys Caucasian boys Hispanic boys Question 2. 2. 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? (Points : 2) 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 Question 3. 3. Gynecomastia or breast development in males is a common issue in clinical practice. Which of the following statements defines Gynecomastia most accurately? (Points : 2) 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. Question 4. 4. A school nurse is reviewing a female student’s records regarding presence of the human papillomavirus vaccine (HPV). Which of the following statements most clearly represents the current guidelines with respect to immunization against HPV? (Points : 2) The vaccine targets HPV types 19 and 21. The HPV vaccine should be given as early as age eight. HPV immunization should be given after initial sexual contact. The HPV vaccine is initiated at ages eleven or twelve. Question 5. 5. 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? (Points : 2) 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 Question 6. 6. 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? (Points : 2) 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 Question 7. 7. 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? (Points : 2) 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 Question 8. 8. Changes in hormonal regulation during menopause result in the gradual cessation of menstruation. From which gland is Androstenedione secreted? (Points : 2) Anterior pituitary Posterior pituitary Corpus Luteum Adrenals Question 19. 19. 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? (Points : 2) Chlamydial cervicitis Uterine fibroids Endometriosis Anovulation Question 20. 20. A woman has developed acne and hirsutism while taking oral contraceptives. These changes result from . (Points : 2) increased estrogen levels decreased estrogen levels increased free androgens decreased free androgens Question 21. 21. 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? (Points : 2) Increase estrogen secretion Decrease steroid levels Increase follicle-stimulating hormone (FSH) secretion Decrease progesterone secretion Question 22. 22. 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? (Points : 2) 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. Question 23. 23. 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? (Points : 2) Endometrium Central medulla Cuboidal epithelium Ovarian stroma Question 24. 24. 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? (Points : 2) Dehydroepiandrosterone Dehydroepiandrosterone sulfate Androstenedione Estrogen Question 25. 25. 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 . (Points : 2) 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 Question 28. 28. 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? (Points : 2) Klebsiella Staphylococcus aureus Staphylococcus saprophyticus Pseudomonas Question 29. 29. 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 . (Points : 2) 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 Question 30. 30. 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? (Points : 2) Menorrhagia Infertility Menometrorrhagia Hypoadrogenism Question 31. 31. 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? (Points : 2) Excessive menstrual flow Dry, flaking skin Obesity Hair loss Question 41. 41. 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 . (Points : 2) late luteal phase midfollicular phase proliferative phase early luteal phase Question 42. 42. 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? (Points : 2) Use of effective contraception Participation in specialized adolescent parent program Continued sexual relationship with the same partner Continued school attendance Question 43. 43. 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? (Points : 2) Sheehan's syndrome Ovarian failure Thyroid dysfunction Asherman's syndrome Question 44. 44. Which of the following conditions is not an absolute contraindication to estrogen-containing contraception? (Points : 2) Migraine headaches Hypercoagulable state Thromboembolism History of coronary artery disease Question 45. 45. You are counseling an eleven-year-old girl, Amanda, and her mother about human papillomavirus vaccine (HPV), Gardasil. Amanda is Tanner stage IV at this visit. In counseling this family, you tell them that HPV vaccine . (Points : 2) 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 Question 46. 46. 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? (Points : 2) Excessive exercise History of maternal osteoporosis Routine use of alcohol or caffeine Use of opposed Estrogen use Question 47. 47. 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. (Points : 2) hypothalamus posterior pituitary ovary anterior pituitary Question 48. 48. A female patient is concerned about having irregular menstrual bleeding. Which of the following is not a common cause of this problem? (Points : 2) Endocrine disorders Stress Anovulation Anatomical abnormality Question 49. 49. 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? (Points : 2) Papanicolaou smear Uterine biopsy Pelvic ultrasound CBC with diff Question 50. 50. for three days without fever. A patient with interstitial cystitis would most likely describe their symptoms as . (Points : 2) urinary urgency and frequency in the morning and at night pain with urination with scant bleeding terminal dysuria urinary urgency only Question 51. 51. 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? (Points : 2) Uterine cancer Dysfunctional uterine bleeding (DUB) Uterine fibroid Fecal impaction Question 52. 52. Sheryl, a seventeen-year-old, complains of a vaginal discharge for the past eight to nine months. When she wipes after urinating, there is "white stuff" on the tissue. Sheryl denies urinary problems but has had some genital itching, but no odor. She also denies sexual activity. Her vaginal discharge is most likely a result of . (Points : 2) a yeast infection Hirsutism Question 60. 60. A patient has been diagnosed with interstitial cystitis. The nurse practitioner remembers that this is best defined as . (Points : 2) 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 Question 61. 61. 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? (Points : 2) 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 Question 62. 62. A patient has been ordered a breast ultrasound after having a mammogram. The primary rationale for ordering this is to . (Points : 2) screen for breast cancer breast cancer staging determine if a breast lesion is cystic or solid evaluate for structural abnormalities Question 63. 63. In reviewing cancer statistics, after breast cancer, what would you find to be the most common female genital malignancy? (Points : 2) Endometrial Ovarian Vulvovaginal Cervical Question 64. 64. 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? (Points : 2) Onset of climacteric Hypothalamus disorder Anterior pituitary disorder Premature ovarian failure Question 65. 65. 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 . (Points : 2) intraductal papilloma fibroadenoma fibrocystic breast disease lobular carcinoma Question 66. 66. 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? (Points : 2) Bacterial vaginitis Trichomonas Lactobacillus overgrowth Candidiasis Question 67. 67. 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? (Points : 2) Ulcerated lesion on the cervical os A soft, pink cervix with no ulcerations An anteverted cervix A very firm, easily friable cervix Question 68. 68. A postmenopausal female is taking hormone replacement therapy (HRT). Which of the following risk factors would not be a contraindication? (Points : 2) Abnormal vaginal bleeding Uncontrolled hypertension Chronic active hepatitis Recent deep vein thrombosis Question 69. 69. A forty-nine-year-old female patient presents with a chief complaint of dark, watery brown vaginal discharge. Part of the differential diagnosis includes that of cervical cancer. Which of the following best describes what might be visualized on physical examination in patients with cervical cancer? (Points : 2) Ulcerated firm cervix Lower abdominal pain that is vague Enlarged tender femoral lymph nodes Soft, still shaped cervix Question 70. 70. The first line treatment of severe menstrual cramps that have been occurring for four months in a patient with primary dysmenorrhea includes which of the following? (Points : 2) Acetaminophen Ibuprofen Combination hormone replacement therapy (HRT) Amitriptyline Question 71. 71. 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? (Points : 2) To locate small lesions prior to surgery luteinizing hormone (LH) endogenous estrogen follicle-stimulating hormone (FSH) Question 83. 83. 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? (Points : 2) Endometrial biopsy Basal body temperature Hysterosalpingogram Postcoital testing Question 84. 84. 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? (Points : 2) Herpes simplex Trichomonas Candidiasis Chlamydia Question 85. 85. 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? (Points : 2) Cesarean section will be necessary for any pregnancy and delivery. 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. Question 86. 86. 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? (Points : 2) 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. Question 87. 87. 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? (Points : 2) 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 Question 88. 88. 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? (Points : 2) Hormone production for ovulation Production of alkaline secretion for sperm viability Development of mucous plug for pregnancy Maintenance of vaginal pH to prevent vaginitis Question 89. 89. 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? (Points : 2) 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. Question 91. 91. 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? (Points : 2) 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. Question 92. 92. 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? (Points : 2) Urine human chorionic gonadotropin (HCG) CBC with differential CT of pelvis Pelvic ultrasound Question 93. 93. 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 . (Points : 2) order a mammogram referral for surgical excision continue to observe the lesion and recheck in three months determine other risk factors such as family history of breast cancer Question 94. 94. 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? (Points : 2) Abnormal uterine bleeding Dysmenorrhea Nausea Abdominal pain production Endometriosis Adenomyosis Question 12.12. 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? (Points : 2) Polycystic ovarian disease Pituitary tumor Genetic, psychosocial, and hormonal fluctuations Psychosocial issues and sleep disturbance Question 16.16. 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? (Points : 2) Decreasing serum steroid levels Decreased hepatic clearance Increased renal tubular absorption Increased serum steroid levels Question 18.18. 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 . (Points : 2) oral contraception is contraindicated in diabetic patients a common side effect is hyperglycemia hypoglycemic effects may be antagonized an increase in insulin dosing may be recommended Question 19.19. Changes in hormonal regulation during menopause result in the gradual cessation of menstruation. From which gland is Androstenedione secreted? (Points : 2) Anterior pituitary Posterior pituitary Corpus Luteum Adrenals Question 26.26. A nurse practitioner is educating a pregnant female about breast changes. Common normal physiologic changes include all of the following except: (Points : 2) Development of straie Colposcopy Loop electro-excision procedure (LEEP) Question 49.49. Oral contraceptive agents may contain both progesterone and estrogen. The progesterone component of the oral contraceptive produces which the following effects? (Points : 2) Decrease in luteinizing hormone (LH) Cervical mucus production Increased levels of follicle-stimulating hormone (FSH) Thinning of the cervical os Question 50.50. You are counseling an eleven-year-old girl, Amanda, and her mother about human papillomavirus vaccine (HPV), Gardasil. Amanda is Tanner stage IV at this visit. In counseling this family, you tell them that HPV vaccine . (Points : 2) 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 Question 52.52. A twenty-five-year-old female patient wishes to be tested for HIV. With respect to blood testing for HIV, you advise the patient that . (Points : 2) it is best to start with a western blot test an enzyme immunosorbent assay (EIA) confirms the diagnosis an EIA is used for screening two positive EIA tests confirms the diagnosis Question 55.55. A woman is experiencing symptoms after initial estrogen withdrawal. Which of the following would not be one of those? (Points : 2) Vaginal dryness Hot flashes Sleep disturbances Breast tenderness Question 56.56. 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? (Points : 2) Herpes simplex Lichen planus Atrophic vaginitis Fungal infection Question 58.58. Which of the following is true regarding education of a forty-two-year-old woman diagnosed with uterine myoma? (Points : 2) 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. Question 62.62. 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? (Points : 2) Sheehan's syndrome Ovarian failure Thyroid dysfunction Asherman's syndrome Question 63.63. 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 . (Points : 2) secondary cellular changes. These changes are most often associated with . (Points : 2) use of topical estrogen cream drying artifact oral contraceptive use inflammatory changes Question 97.97. 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? (Points : 2) Sloughing of the endometrium Prostaglandin release and synthesis Anovulatory cycles Excess progesterone production Question 98.98. 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? (Points : 2) Pregnancy after age of thirty-five years Late menopause after age of fifty-seven years History of maternal breast cancer Fibrocystic breast disease Question 99.99. 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? (Points : 2) Chronic anovulation Increased estradiol levels Hyperprolactinemia Weight loss Points Received: Comments: 0 of 2 Points Received: Comments: 2 of 2 A female patient is concerned about having irregular menstrual bleeding. Which of the following is not a common cause of this problem? Student Answer: Endocrine disorders Stress Anovulation Anatomical abnormality -809641662 MultipleChoic e 58 False 0 -809641662 MultipleChoic e 58 Question 2 . Question : 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? Student Answer: 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 -809641661 MultipleChoice 10 True 0 -809641661 MultipleChoice 10 Question 3 . Question : 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? Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 Points Received:2 of 2 Nulliparity Late menopause -809641658 MultipleChoic e 85 True 0 -809641658 MultipleChoic e 85 Question 6 . Question : When reviewing the risk factors for breast cancer with your patient, which of the following would not be a contributing factor? Student Answer: Early menarche High fat diet Early menopause Advanced age -809641657 MultipleChoice 117 True 0 -809641657 MultipleChoice 117 Question 7 . Question : A thirty-year-old female is about to begin oral contraception. As an advanced practice nurse, in addition to a complete history, which of the following would you include in your workup prior to the initiation of the medication? Student Answer: Breast exam, CBC, and luteinizing hormone (LH) level Blood pressure, breast exam in CBC LH level, breast exam, and blood pressure Blood pressure, breast exam may be required Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 -809641656 MultipleChoic e 35 True 0 -809641656 MultipleChoic e 35 Question 8 . Question : A nurse practitioner student is completing a review of the anatomy of the female reproductive system. She recalls that the outer portion of the cervix is comprised of epithelium tissue, but which specific type? Student Answer: Simple columnar epithelium Stratified columnar epithelium Stratified squamous epithelium Simple squamous epithelium -809641655 MultipleChoice 22 True 0 -809641655 MultipleChoice 22 Question 9 . Question : The pituitary gland is responsible for a variety of functions with respect to hormonal regulation and is composed of two lobes, the anterior and posterior sections. Which of the following list of hormones are secreted by the anterior pituitary gland? Student Answer: Growth hormone (GH) and thyroid-stimulating hormone Prolactin and T4 Follicle-stimulating hormone (FSH) and T3 Luteinizing hormone (LH) and oxytocin -809641654 MultipleChoice 24 True Comments: | ~809641654 | MultipleChoice] 24 Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 Student Answer: Syphilis Bartholin’s cyst Labial adhesion Herpes simplex type 2 -809641650 MultipleChoic e 86 True 0 -809641650 MultipleChoic e 86 Question 13 . Question : You are performing an annual well visit on a prepubescent female. Which of the following hormonal changes best describes the fluctuations during this time? Student Answer: A decrease in adrenal cortex androgens The initiation of secretion of follicle-stimulating hormone (FSH) An increase of adrenal cortex androgens between six and eight years of age Elevation of estrogen levels at eight years of age -809641649 MultipleChoice 27 True 0 -809641649 MultipleChoice 27 Question 14 . Question : A nurse practitioner is completing a social and medical history of a patient. Which of the following characteristics places her at risk for early menopause? Student Answer: Overweight (BMI 26- 29) Current smoker Early menarche Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 Points Received:2 of 2 Nulliparity -809641648 MultipleChoic e 72 True 0 -809641648 MultipleChoic e 72 Question 15 . Question : 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 . Student Answer: endogenous estrogen prolactin L-thyroxine follicle-stimulating hormone (FSH) -809641647 MultipleChoic e 108 True 0 -809641647 MultipleChoic e 108 0 -809641645 MultipleChoic e 57 Question 17 . Question : A nurse practitioner is counseling a woman with fibrocystic changes in the breast. Which of the following is not caused by this change? Student Answer: Breast pain An increased risk of breast cancer Hard masses Painless lumps Points Received: Comments: 2 of 2 -809641644 MultipleChoic e 67 True 0 -809641644 MultipleChoic e 67 Question 18 . Question : A thirty-nine-year-old female has just completed a course of Amoxicillin for the treatment of streptococcal pharyngitis. Her LMP was two weeks ago and reports that it was normal for her. On physical examination, there is some erythema of the external genitalia with a small amount of white discharge. The microscopic wet prep examination reveals few clue cells but an abundance of budding hyphae. There are no WBCs present. Considering the differential diagnoses and results of the microscopic examination, which of the following would be the most appropriate treatment? Student Answer: Metronidazole 500 mg BID for seven days OTC hydrocortisone 1% cream TID Fluconazole tablets 150 mg as a onetime dose Erythromycin 500 mg TID for ten days -809641643 MultipleChoice 122 True 0 -809641643 MultipleChoice 122 Question 19 . Question : A woman presents for her prenatal visit and has a diagnosis of preeclampsia or pregnancy-induced hypertension (PIH). The nurse practitioner is educating the patient about the diagnosis. Which of the following about PIH indicates that the nurse practitioner has made an incorrect statement? Student Answer: Symptoms include edema of the hands and face Symptoms occur during the second trimester Proteinuria is a late development in PIH PIH is a precursor to chronic hypertension and heart disease Comments: Question 22 . Question : A twenty-five-year-old patient presents with urinary frequency and Points Received: Comments: 0 of 2 Points Received: Comments: 2 of 2 urgency. These symptoms have been occurring for three days without fever. A patient with interstitial cystitis would most likely describe their symptoms as . Student Answer: urinary urgency and frequency in the morning and at night pain with urination with scant bleeding terminal dysuria urinary urgency only -809641638 MultipleChoic e 47 False 0 -809641638 MultipleChoic e 47 Question 23 . Question : 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? Student Answer: Sheehan's syndrome Ovarian failure Thyroid dysfunction Asherman's syndrome -809641637 MultipleChoice 48 True 0 -809641637 MultipleChoice 48 Question 24 . Question : The first line treatment of severe menstrual cramps that have been occurring for four months in a patient with primary dysme norrhe a include s which of the followi ng? Points Received: Comments: 2 of 2 Points Received: Comments: 0 of 2 Points Received: Comments: 2 of 2 Eighth -809641633 MultipleChoic e 25 True 0 -809641633 MultipleChoic e 25 Question 27 . Question : 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? Student Answer: Middle adolescence Late adolescence Preadolescence Early adolescence -809641632 MultipleChoice 6 False 0 -809641632 MultipleChoice 6 Question 28 . Question : A patient has been diagnosed with interstitial cystitis. The nurse practitioner remembers that this is best defined as . Student Answer: 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 09641630 MultipleChoic | 46 True e Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 0 -809641630 MultipleChoic e 46 Question 29 . Question : A postmenopausal woman is concerned because she is having postcoital bleeding. Which of the following would be the most likely etiology? Student Answer: Cervical cancer Endometrial cancer Atrophic vaginitis Polycystic ovary syndrome (PCOS) -809641629 MultipleChoice 90 True 0 -809641629 MultipleChoice 90 Question 30 . Question : 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? Student Answer: Hormone production for ovulation Production of alkaline secretion for sperm viability Development of mucous plug for pregnancy Maintenance of vaginal pH to prevent vaginitis -809641628 MultipleChoice 113 True 0 -809641628 MultipleChoice 113 Question 31 . Question : Which of the following is an approved treatment for premenstrual dysphoric disorder (PMDD)? Points Received: Comments: 2 of 2 Points Received: Comments: 0 of 2 Points Received: Comments: 2 of 2 Venous engorgement -809641624 MultipleChoic e 20 True 0 -809641624 MultipleChoic e 20 Question 34 . Question : 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 . Student Answer: order a mammogram referral for surgical excision continue to observe the lesion and recheck in three months determine other risk factors such as family history of breast cancer -809641623 MultipleChoice 135 False 0 -809641623 MultipleChoice 135 Question 35 . Question : A patient has a prescription that was written for birth control pills that now has progestin added to the estrogen therapy. What would this intervention decrease the risk of? Student Answer: Fibrocystic breast disease Amenorrhea Endometrial cancer Osteoarthritis Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 -809641622 MultipleChoic e 64 True 0 -809641622 MultipleChoic e 64 Question 36 . Question : 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? Student Answer: Papanicolaou smear Uterine biopsy Pelvic ultrasound CBC with diff -809641620 MultipleChoice 63 True 0 -809641620 MultipleChoice 63 Question 37 . Question : When educating a patient about the rationale for obtaining a mammogram, which of the following statements is false? Student Answer: 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 -809641619 MultipleChoice 103 True 0 -809641619 MultipleChoice 103 Question 38 . Question : The onset and duratio n of pubert y varies greatly from patient to patient and is also depend ent upon race. Which of the followi ng phrase s can P r o l i f e r a t i v e Points Received: Comments: 0 of 2 Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 Late luteal -809641612 MultipleChoic e 110 False 0 -809641612 MultipleChoic e 110 Question 43 . Question : 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? Student Answer: Endometrium Central medulla Cuboidal epithelium Ovarian stroma -809641611 MultipleChoice 23 True 0 -809641611 MultipleChoice 23 Question 44 . Question : 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? Student Answer: Vitamin C Folic acid Vitamin B12 Riboflavin Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 -809641610 MultipleChoic e 78 True 0 -809641610 MultipleChoic e 78 Question 45 . Question : Which of the following conditions is not an absolute contraindication to estrogen-containing contraception? Student Answer: Migraine headaches Hypercoagulable state Thromboembolism History of coronary artery disease -809641609 MultipleChoice 51 True 0 -809641609 MultipleChoice 51 Question 46 . Question : 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? Student Answer: Bacterial vaginitis Trichomonas Lactobacillus overgrowth Candidiasis -809641607 MultipleChoice 92 True A woman has been prescri bed Depo- Prover a injectio ns every three months for contrac eption. What would be the most likely side effect that Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 she would need to be educated about? Student Answer: Abnormal uterine bleeding Dysmenorrhea Nausea Abdominal pain -809641603 MultipleChoic e 128 True 0 -809641603 MultipleChoic e 128 Question 50 . Question : 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? Student Answer: 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. -809641602 MultipleChoice 52 True 0 -809641602 MultipleChoice 52 Question 51 . Question : 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? Student Answer: Urine human chorionic gonadotro pin (HCG) Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 -809641599 MultipleChoic e 62 True 0 -809641599 MultipleChoic e 62 Question 54 . Question : 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? Student Answer: Frequent episodes of bacterial vaginosis Postcoital bleeding with malodorous discharge Infertility and dysmenorrhea Constipation and amenorrhea -809641597 MultipleChoice 96 True 0 -809641597 MultipleChoice 96 Question 55 . Question : 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? Student Answer: Use of effective contraception Participation in specialized adolescent parent program Continued sexual relationship with the same partner Continued school attendance -809641596 MultipleChoice 81 True 0 -809641596 MultipleChoice 81 Comments: Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 Question 56 . Question : 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? Student Answer: Ulcerated lesion on the cervical os A soft, pink cervix with no ulcerations An anteverted cervix A very firm, easily friable cervix -809641595 MultipleChoic e 91 True 0 -809641595 MultipleChoic e 91 Question 57 . Question : 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? Student Answer: Klebsiella Staphylococcus aureus Staphylococcus saprophyticus Pseudomonas -809641594 MultipleChoice 42 True 0 -809641594 MultipleChoice 42 Points Received: Comments: 2 of 2 Points Received: Comments: 0 of 2 Question 58 . Question : 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? Student Answer: Chlamydial cervicitis Uterine fibroids Endometriosis Anovulation -809641592 MultipleChoic e 38 True 0 -809641592 MultipleChoic e 38 Question 59 . Question : In reviewing cancer statistics, after breast cancer, what would you find to be the most common female genital malignancy? Student Answer: Endometri al Ovarian Vulvovagin al Cervical -809641591 MultipleChoice 118 False 0 -809641591 MultipleChoice 118 Question 60 . Question : 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? Student Answer: Points Received: 0 of 2 Points Received: Comments: 2 of 2 Points Received:2 of 2 -809641587 MultipleChoic e 9 False 0 -809641587 MultipleChoic e 9 Question 63 . Question : 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? Student Answer: 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. -809641586 MultipleChoice 30 True 0 -809641586 MultipleChoice 30 Question 64 . Question : 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? Student Answer: Menorrhagia Infertility Menometrorrha gia Hypoadrogenis m Comments: Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 -809641584 MultipleChoic e 28 True 0 -809641584 MultipleChoic e 28 Question 65 . Question : 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? Student Answer: Ovarian cysts Prostaglandin production Endometriosis Adenomyosis -809641583 MultipleChoice 11 True 0 -809641583 MultipleChoice 11 Question 66 . Question : 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? Student Answer: 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 -809641582 MultipleChoice 14 True 0 -809641582 MultipleChoice 14 Comments: Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 instructions? Student Answer: 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. -809641578 MultipleChoic e 88 True 0 -809641578 MultipleChoic e 88 Question 70 . Question : 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? Student Answer: Cesarean section will be necessary for any pregnancy and delivery. 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. -809641577 MultipleChoice 114 True 0 -809641577 MultipleChoice 114 Question 71 . Question : Long-acting progestins used in contraception do not always contain estrogen. As a result of the lack of this hormone, there will be no Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 alteration in which of the following? Student Answer: Hepatic globulin production Serum androgen levels Blood pressure Decreased serum insulin levels -809641575 MultipleChoic e 41 True 0 -809641575 MultipleChoic e 41 Question 72 . Question : 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? Student Answer: Eating disorder Pregnancy Anovulatory cycles Stress -809641574 MultipleChoice 56 True 0 -809641574 MultipleChoice 56 Question 73 . Question : A forty-nine-year-old female patient presents with a chief complaint of dark, watery brown vaginal discharge. Part of the differential diagnosis includes that of cervical cancer. Which of the following best describes what might be visualized on physical examination in patients with cervical cancer? Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 Student Answer: Ulcerated firm cervix Lower abdominal pain that is vague Enlarged tender femoral lymph nodes Soft, still shaped cervix -809641573 MultipleChoic e 121 True 0 -809641573 MultipleChoic e 121 Question 74 . Question : A twenty-five-year-old female patient wishes to be tested for HIV. With respect to blood testing for HIV, you advise the patient that . Student Answer: it is best to start with a western blot test an enzyme immunosorbent assay (EIA) confirms the diagnosis an EIA is used for screening two positive EIA tests confirms the diagnosis -809641572 MultipleChoice 50 True 0 -809641572 MultipleChoice 50 Question 75 . Question : 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 . Student Answer: trichomonas mucopurulent cervicitis bacterial Points Received: Comments: 0 of 2 Points Received: Comments: 2 of 2 0 -809641568 MultipleChoic e 68 Question 78 . Question : 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? Student Answer: Breast cancer Mastitis Fibrocystic breast Fibroadenoma -809641566 MultipleChoice 59 False 0 -809641566 MultipleChoice 59 Question 79 . Question : 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? Student Answer: Excessive exercise History of maternal osteoporosis Routine use of alcohol or caffeine Use of opposed Estrogen use -809641565 MultipleChoice 80 True 0 -809641565 MultipleChoice 80 Question 80 . Question : A forty-year-old female presents with an abnormal menstrual cycle with menorrhagia and intermenstrual bleeding. The nurse practiti oner suspec ts the patien t may have dysfun ctional uterin e bleedi ng (DUB) Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 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? Student Answer: Onset of climacteric Hypothalamus disorder Anterior pituitary disorder Premature ovarian failure -809641564 MultipleChoic e 112 True 0 -809641564 MultipleChoic e 112 Question 81 . Question : A thirty-five-year-old female presents with perimenopausal symptoms. You recall that this may begin during which age group? Student Answer: Forty-five to fifty years Thirty-five to forty years Fifty to fifty-five years Thirty to thirty-five years -809641562 MultipleChoice 17 True 0 -809641562 MultipleChoice 17 Question 82 . Question : 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 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 Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 Points Received: 2 of 2 Patients that show urine human chorionic gonadotropin (HCG) positive -809641559 MultipleChoic e 45 True 0 -809641559 MultipleChoic e 45 Question 85 . Question : 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? Student Answer: 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 -809641558 MultipleChoice 54 True 0 -809641558 MultipleChoice 54 Question 86 . Question : 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? Student Answer: 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 Points Received: Comments: 2 of 2 Points Received: Comments: 2 of 2 -809641557 MultipleChoic e 40 True 0 -809641557 MultipleChoic e 40 Question 87 . Question : 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 . Student Answer: intraductal papilloma fibroadenoma fibrocystic breast disease lobular carcinoma -809641556 MultipleChoice 115 True 0 -809641556 MultipleChoice 115 Question 88 . Question : Oral contraceptive agents may contain both progesterone and estrogen. The progesterone component of the oral contraceptive produces which the following effects? Student Answer: Decrease in luteinizing hormone (LH) Cervical mucus production Increased levels of follicle-stimulating hormone (FSH) Thinning of the cervical os -809641555 MultipleChoice 34 True 0 -809641555 MultipleChoice 34 Comments: