WOMEN'S HEALTH EXAM PRACTICE QUESTIONS
WITH VERIFIED ACCURATE ANSWERS
VAGINITIS DIAGNOSIS AND TREATMENT
Organism Discharge Odor Microscopy pH Treatment
Bacterial vaginosis Thin, gray, homogeneous Fishy with positive "whif test" Clue cells
>4.5 Metronidazole 500 mg BID × 7 days or clindamycin 300 mg BID × 7 days or topical
metronidazole 1 applicatorful intravaginally daily × 5 days (lower success rate)
Candida Adherent, white, "cottage cheese" like Neutral Pseudohyphae but only 65-85%
sensitive <4.5 Fluconazole oral, topical clotrimazole, miconazole, etc.
Trichomonas Copious yellow, gray, green, foamy. Friable "strawberry" cervix
Malodorous Trichomonads >4.5
Metronidazole 2 g PO once (recommended), or 500 mg
BID × 7 days (alternative)
HELPFUL TIP:
The most recent evidence points to insulin resistance as the underlying cause of PCOS,
and these patients may have acanthosis nigricans. Insulin resistance can be quantified
by calculating the ratio of fasting glucose to insulin. A ratio of less than 4.5 indicates
insulin resistance. Insulin resistance stimulates ovarian androgen production, which
leads to anovulation.
HELPFUL TIP:
As with other STIs, a patient with Trichomonas should have her partner tested and
treated (or just treated depending whether or not this is allowable under your state law).
HELPFUL TIP:
While it makes sense that single-dose azithromycin would work better in treating
Chlamydial cervicitis because of compliance issues, the cure rate is the same whether
azithromycin or the doxycycline is used. There is about a 3% failure rate with
azithromycin which isn't seen with doxycycline.
HELPFUL TIP:
For hirsutism associated with PCOS, Question 1:
A 16-year-old female presents with her mother. They don't look happy. Her mother
says, "She needs a Pap smear because she's been having sex with a couple of boys—
in my house, I will have you know—for a year!" The patient rolls her eyes.
Consistent with published guidelines, you recommend:
A
,Pap smear
B
Gonorrhea and chlamydia testing
C
Pap smear and gonorrhea and chlamydia testing
D
Return for a Pap after sexually active for 3 years (age 18 for this patient)
E
A chastity belt
Explanation:
The correct answer is "B." It is now recommended to delay cervical cancer screening
until age 21, even if the woman has been sexually active. The reasoning: although
adolescent females are frequently infected with HPV, they also easily clear these
infections, with 95% of lesions spontaneously regressing. Exceptions to this rule include
patients who are immunocompromised (e.g., organ transplant, HIV infection). For -
Answers -
A 25-year-old woman comes to the clinic complaining of increased vaginal discharge,
milky gray in color with a "fishy" odor that both she and her husband have noticed. A
wet smear is performed and the presence of "clue cells" confirmed. Which type of
infection does the nurse suspect?
1
Candidiasis
2
Trichomoniasis
3
Bacterial vaginosis
4
Group B Streptococcus - Answers - -Bacterial vaginosis
Signs of bacterial vaginosis include a milky gray vaginal discharge that has a
characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV.
Candidiasis is a yeast infection caused by the organism Candida albicans. The most
common symptom of a yeast infection is vulvar and vaginal pruritus. Vaginal discharge
in a candidal infection is thick, white, and lumpy. A woman with a trichomoniasis
infection may present with a frothy yellowish-green vaginal discharge. Vulvar irritation,
pruritus, and dyspareunia are usually present. Group B Streptococcus may be
considered part of the normal vaginal flora in a woman who is not pregnant, and no
treatment is necessary.
,A 20-year-old woman visiting the clinic says that she wishes to begin using depot
medroxyprogesterone acetate (Depo-Provera) as a form of birth control. What important
information should the nurse include when teaching the client about Depo-Provera?
1
Depo-Provera offers protection against the herpes simplex virus.
2
To continue the contraceptive effects the client will need to return for another injection in
6 months.
3
Women using Depo-Provera may lose more blood each month with their periods, so it is
important to add iron-rich foods to the diet to help prevent anemia.
4
Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use - Answers - -Calcium intake and exercise
should be increased because of possible loss of bone mineral density with increasing
duration of use
Loss of bone mineral density is a significant side effect of Depo-Provera, and increased
calcium intake and exercise should be encouraged. Depo-Provera should be
administered every 11 to 13 weeks; 6 months is too long before the next dose.
Menstrual periods usually lighten or disappear over time. Depo-Provera confers no
protection against herpes simplex virus.
A 24-year-old woman wants to use her basal body temperature (BBT) in natural family
planning but is unsure when to take her temperature. The nurse informs her that an
accurate BBT is best taken:
1
Each night right before bed
2
On the first day of her next menstrual cycle
3
Each morning prior to getting out of bed or increasing her activity
4
At bedtime beginning on day 14 of her menstrual cycle and continuing until her next
period - Answers - -Each morning prior to getting out of bed or increasing her activity
The most accurate BBT is taken before a woman gets out of bed and begins any type of
activity that could increase the body's temperature even slightly. BBT should be charted
daily on a calendar to permit interpretation of temperature fluctuations. A BBT taken in
the evening may be increased after a day of activity. Daily assessment and recording of
BBT during the first half of the menstrual cycle is also crucial, because a woman's BBT
is lower then than during the second half of her cycle. The BBT temperature may rise
slightly with ovulation.
A 37-year-old woman is admitted to the unit with severe menorrhagia. During
assessment the nurse learns that she has a history of fibroids, menorrhagia, pelvic pain,
, and depression. The client has been undergoing hormone therapy in hopes of easing
the symptoms and reducing the size of the fibroids, without success. The lab reports
hemoglobin and hematocrit readings of 6.8 and 20.2, respectively. The client begins to
sob and cries, "I don't know what to do—the doctor is recommending a hysterectomy,
but I haven't had children yet!" What is the best response by the nurse?
1
"There are so many orphans looking for a mother."
2
"This must be so difficult for you. Children are really important to you?"
3
"You really have no choice but to follow the recommendation; the doctor is right."
4
"Believe me when I tell you that kids are so difficult to raise—you're better off without
them." - Answers - -"This must be so difficult for you. Children are really important to
you?"
Validating the client's feelings and including an open-ended question will encourage
further expression. Previous problems and health conditions could later be included in
the conversation to help the client make the best decision. Adoption is certainly an
option for this person, but this is not what she needs to hear at this time. This statement
also closes down communication. The client does have a choice, and telling her that
she does not could close down communication and cause anger and defensiveness.
Telling the client that she's better off without children is not what the client needs to
hear, especially when she is facing an operation that could end her chance of giving
birth to children.
A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the
client confides that her mother died of endometrial cancer 1 year ago and says that she
is afraid that she will die of the same cancer. Which risk factor stated by the client after
an education session on risk factors indicates that further teaching is needed?
1
Obesity
2
High-fat diet
3
Hypertension
4
Late-onset menarche - Answers - -Late-onset menarche
Early-onset, not late-onset, menarche is a risk factor for endometrial cancer. A high-fat
diet, hypertension, and obesity are all risk factors
A 32-year-old woman is admitted to the unit with a history of fibroids and menorrhagia.
Which findings does the nurse expect to encounter during assessment of the client?
Select all that apply.
1
WITH VERIFIED ACCURATE ANSWERS
VAGINITIS DIAGNOSIS AND TREATMENT
Organism Discharge Odor Microscopy pH Treatment
Bacterial vaginosis Thin, gray, homogeneous Fishy with positive "whif test" Clue cells
>4.5 Metronidazole 500 mg BID × 7 days or clindamycin 300 mg BID × 7 days or topical
metronidazole 1 applicatorful intravaginally daily × 5 days (lower success rate)
Candida Adherent, white, "cottage cheese" like Neutral Pseudohyphae but only 65-85%
sensitive <4.5 Fluconazole oral, topical clotrimazole, miconazole, etc.
Trichomonas Copious yellow, gray, green, foamy. Friable "strawberry" cervix
Malodorous Trichomonads >4.5
Metronidazole 2 g PO once (recommended), or 500 mg
BID × 7 days (alternative)
HELPFUL TIP:
The most recent evidence points to insulin resistance as the underlying cause of PCOS,
and these patients may have acanthosis nigricans. Insulin resistance can be quantified
by calculating the ratio of fasting glucose to insulin. A ratio of less than 4.5 indicates
insulin resistance. Insulin resistance stimulates ovarian androgen production, which
leads to anovulation.
HELPFUL TIP:
As with other STIs, a patient with Trichomonas should have her partner tested and
treated (or just treated depending whether or not this is allowable under your state law).
HELPFUL TIP:
While it makes sense that single-dose azithromycin would work better in treating
Chlamydial cervicitis because of compliance issues, the cure rate is the same whether
azithromycin or the doxycycline is used. There is about a 3% failure rate with
azithromycin which isn't seen with doxycycline.
HELPFUL TIP:
For hirsutism associated with PCOS, Question 1:
A 16-year-old female presents with her mother. They don't look happy. Her mother
says, "She needs a Pap smear because she's been having sex with a couple of boys—
in my house, I will have you know—for a year!" The patient rolls her eyes.
Consistent with published guidelines, you recommend:
A
,Pap smear
B
Gonorrhea and chlamydia testing
C
Pap smear and gonorrhea and chlamydia testing
D
Return for a Pap after sexually active for 3 years (age 18 for this patient)
E
A chastity belt
Explanation:
The correct answer is "B." It is now recommended to delay cervical cancer screening
until age 21, even if the woman has been sexually active. The reasoning: although
adolescent females are frequently infected with HPV, they also easily clear these
infections, with 95% of lesions spontaneously regressing. Exceptions to this rule include
patients who are immunocompromised (e.g., organ transplant, HIV infection). For -
Answers -
A 25-year-old woman comes to the clinic complaining of increased vaginal discharge,
milky gray in color with a "fishy" odor that both she and her husband have noticed. A
wet smear is performed and the presence of "clue cells" confirmed. Which type of
infection does the nurse suspect?
1
Candidiasis
2
Trichomoniasis
3
Bacterial vaginosis
4
Group B Streptococcus - Answers - -Bacterial vaginosis
Signs of bacterial vaginosis include a milky gray vaginal discharge that has a
characteristic fishy odor. "Clue cells" noted on wet smear are indicative of BV.
Candidiasis is a yeast infection caused by the organism Candida albicans. The most
common symptom of a yeast infection is vulvar and vaginal pruritus. Vaginal discharge
in a candidal infection is thick, white, and lumpy. A woman with a trichomoniasis
infection may present with a frothy yellowish-green vaginal discharge. Vulvar irritation,
pruritus, and dyspareunia are usually present. Group B Streptococcus may be
considered part of the normal vaginal flora in a woman who is not pregnant, and no
treatment is necessary.
,A 20-year-old woman visiting the clinic says that she wishes to begin using depot
medroxyprogesterone acetate (Depo-Provera) as a form of birth control. What important
information should the nurse include when teaching the client about Depo-Provera?
1
Depo-Provera offers protection against the herpes simplex virus.
2
To continue the contraceptive effects the client will need to return for another injection in
6 months.
3
Women using Depo-Provera may lose more blood each month with their periods, so it is
important to add iron-rich foods to the diet to help prevent anemia.
4
Calcium intake and exercise should be increased because of possible loss of bone
mineral density with increasing duration of use - Answers - -Calcium intake and exercise
should be increased because of possible loss of bone mineral density with increasing
duration of use
Loss of bone mineral density is a significant side effect of Depo-Provera, and increased
calcium intake and exercise should be encouraged. Depo-Provera should be
administered every 11 to 13 weeks; 6 months is too long before the next dose.
Menstrual periods usually lighten or disappear over time. Depo-Provera confers no
protection against herpes simplex virus.
A 24-year-old woman wants to use her basal body temperature (BBT) in natural family
planning but is unsure when to take her temperature. The nurse informs her that an
accurate BBT is best taken:
1
Each night right before bed
2
On the first day of her next menstrual cycle
3
Each morning prior to getting out of bed or increasing her activity
4
At bedtime beginning on day 14 of her menstrual cycle and continuing until her next
period - Answers - -Each morning prior to getting out of bed or increasing her activity
The most accurate BBT is taken before a woman gets out of bed and begins any type of
activity that could increase the body's temperature even slightly. BBT should be charted
daily on a calendar to permit interpretation of temperature fluctuations. A BBT taken in
the evening may be increased after a day of activity. Daily assessment and recording of
BBT during the first half of the menstrual cycle is also crucial, because a woman's BBT
is lower then than during the second half of her cycle. The BBT temperature may rise
slightly with ovulation.
A 37-year-old woman is admitted to the unit with severe menorrhagia. During
assessment the nurse learns that she has a history of fibroids, menorrhagia, pelvic pain,
, and depression. The client has been undergoing hormone therapy in hopes of easing
the symptoms and reducing the size of the fibroids, without success. The lab reports
hemoglobin and hematocrit readings of 6.8 and 20.2, respectively. The client begins to
sob and cries, "I don't know what to do—the doctor is recommending a hysterectomy,
but I haven't had children yet!" What is the best response by the nurse?
1
"There are so many orphans looking for a mother."
2
"This must be so difficult for you. Children are really important to you?"
3
"You really have no choice but to follow the recommendation; the doctor is right."
4
"Believe me when I tell you that kids are so difficult to raise—you're better off without
them." - Answers - -"This must be so difficult for you. Children are really important to
you?"
Validating the client's feelings and including an open-ended question will encourage
further expression. Previous problems and health conditions could later be included in
the conversation to help the client make the best decision. Adoption is certainly an
option for this person, but this is not what she needs to hear at this time. This statement
also closes down communication. The client does have a choice, and telling her that
she does not could close down communication and cause anger and defensiveness.
Telling the client that she's better off without children is not what the client needs to
hear, especially when she is facing an operation that could end her chance of giving
birth to children.
A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the
client confides that her mother died of endometrial cancer 1 year ago and says that she
is afraid that she will die of the same cancer. Which risk factor stated by the client after
an education session on risk factors indicates that further teaching is needed?
1
Obesity
2
High-fat diet
3
Hypertension
4
Late-onset menarche - Answers - -Late-onset menarche
Early-onset, not late-onset, menarche is a risk factor for endometrial cancer. A high-fat
diet, hypertension, and obesity are all risk factors
A 32-year-old woman is admitted to the unit with a history of fibroids and menorrhagia.
Which findings does the nurse expect to encounter during assessment of the client?
Select all that apply.
1
