CHAMBERLAIN COLLEGE OF NURSING - NR 602 FINAL WEEK 8
ACOG GUIDELINES REGARDING WELL WOMEN EXAMS
What is the ASCCP recommended management for an ASCUS (atypical squamous cells of undetermined significance) pap result with
a positive high-risk HPV 16 cotest in a 26-year-old woman without a history of abnormal pap smears?
Colposcopy
A well-woman visit for an adolescent should include which of the following?
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
ACOG Pap smear guidelines
A Bethesda system Pap smear report that reads LSIL is most consistent with which classification?
CIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as follow-up?
Routine screening
A female patient is 35 years old. She has never had an abnormal PAP smear and has had regular screening since age 18. If she has a
normal PAP smear with HPV testing today, when should she have the next cervical cancer screening?
5 years
A young sexually active client at the family planning clinic is advised to have a Papanicolaou (Pap) smear. She has never had a Pap
smear before. What should the nurse include in the explanation of this procedure?
The Pap smear can detect cancer of the cervix
Lab results on your 26-year-old patient show a negative Pap smear with a positive human papillomavirus (HPV) screen. Which
procedure will be required next?
Repeat Pap and HPV screen
Which of the following is not part of the criteria for an older woman to cease having any future Pap tests performed?
Over 55 years of age
Amenorrhea (Primary and Secondary)
You are evaluating a 17-year-old Emily who presented with amenorrhea and normal secondary sex characteristics. The purpose of the
progesterone challenge is to ascertain the presence of?
Endogenous estrogen
A 17-year-old female patient presents with amenorrhea for 4 months she did experience menarche at age 15 but had not had a
menstrual cycle since. On physical examination, it is noticed that she has normal secondary sexual characteristics. The nurse
practitioner will consider a progesterone challenge to determine the presence of adequate
Endogenous estrogen
A teenage patient presents with amenorrhea and moral secondary sex characteristics. A progesterone challenge is ordered. The
purpose is to determine the presence of ____________?
Endogenous estrogen
A 16year old girl who comes to your office with a history of secondary amenorrhea. She experienced menarche at age 10, regular
cycles for 2 years. She has not menstruated now for 4 years. In your initial consideration of differential diagnoses, what is the most
frequent etiology of this problem:
Eating disorder
18yo female c/o secondary amenorrhea. On exam, there is normal secondary sex characteristics and normal genitalia. Pregnancy is
ruled out. What would necessitate further eval?
Galactorrhea
Primary amenorrhea is best described as:
Failure to menstruation to occur by 13 yr
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
American Cancer Society recommendations
, 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?
Fibrocystic breast disease
When educating women about breast cancer risk factors, which statement is incorrect?
Fibrocystic breast disease
A woman with lobular carcinoma in situ has a relative risk of developing invasive breast cancer of
8.0
Androgen insensitivity/resistance syndrome
Changes in hormonal regulation during menopause result in the gradual cessation of menstruation. From which gland is
Androstenedione secreted?
Adrenals
ASCUS/HSIL results from Paper Test Report
A Pap smear result of atypical squamous cells of undetermined significance—rule out high-grade squamous intraepithelial lesion
(ASCUS r/o HGSIL) will require which procedure next?
Colposcopy
A Pap smear result of atypical squamous cells of undetermined significance (ASCUS) will require which procedure next?
Follow up pap smear
Bartholin glands and cysts
A 25-year-old presents with a report of a very tender area just near her introitus and to the left of her perineum. Very painful
sex is how she knew "something wasn't right." She showered and when washing, she felt a "pea-sized" painful lump on the left side of
her "bottom." She tells you she looked at it with a mirror and it was very small, but now it is the size of a ping-pong ball and getting
worse.
When you inspect her external genitalia, you are amazed at the size and appearance of the "lump."
You note what appears to be an abscess on the left medial side of the labia minora, and there is some edema extending into the
perineum. Your diagnosis for this presentation is:
Bartholin’s cyst
You explain to this young woman what this "lump" is and let her know you will be referring her to a gynecologist you consult with
regularly. You explain to her the likely treatment as follows:
A possible incision might be necessary and a catheter placed for two to four weeks to allow for drainage and
appropriate healing.
A client at the women's health clinic complains of swelling of the labia and throbbing pain in the labial area after sexual intercourse.
For what condition does the nurse anticipate the client will be treated?
Bartholinitis
25yo female c/o tender area near her introitus and to the L of her perineum. Very painful sex was first sign. Initially bump was very
small, but now is ping-pong ball size. On exam, abscess is present on L medial side of labia minora and there's edema extending into
perineum. What is dx?
Bartholin’s cyst
Which of the following choices represents a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal
mass?
Bartholin’s cyst
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?
Production of alkaline secretions for sperm viability
BMI
CDC recommendations regarding STDs and PID
Cervical cancer screening
A 23-year-old women 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?
Uterine biopsy
a nurse practitioner is educating a woman who has a colposcopy ordered. Which of the following most accurately describes a
colposcopy?
A procedure that visualizes the vaginal, vulvar or cervical epithelium with magnification to identify abnormal
areas that may need to be biopsied
A 33-year-old women 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?
ACOG GUIDELINES REGARDING WELL WOMEN EXAMS
What is the ASCCP recommended management for an ASCUS (atypical squamous cells of undetermined significance) pap result with
a positive high-risk HPV 16 cotest in a 26-year-old woman without a history of abnormal pap smears?
Colposcopy
A well-woman visit for an adolescent should include which of the following?
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
ACOG Pap smear guidelines
A Bethesda system Pap smear report that reads LSIL is most consistent with which classification?
CIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as follow-up?
Routine screening
A female patient is 35 years old. She has never had an abnormal PAP smear and has had regular screening since age 18. If she has a
normal PAP smear with HPV testing today, when should she have the next cervical cancer screening?
5 years
A young sexually active client at the family planning clinic is advised to have a Papanicolaou (Pap) smear. She has never had a Pap
smear before. What should the nurse include in the explanation of this procedure?
The Pap smear can detect cancer of the cervix
Lab results on your 26-year-old patient show a negative Pap smear with a positive human papillomavirus (HPV) screen. Which
procedure will be required next?
Repeat Pap and HPV screen
Which of the following is not part of the criteria for an older woman to cease having any future Pap tests performed?
Over 55 years of age
Amenorrhea (Primary and Secondary)
You are evaluating a 17-year-old Emily who presented with amenorrhea and normal secondary sex characteristics. The purpose of the
progesterone challenge is to ascertain the presence of?
Endogenous estrogen
A 17-year-old female patient presents with amenorrhea for 4 months she did experience menarche at age 15 but had not had a
menstrual cycle since. On physical examination, it is noticed that she has normal secondary sexual characteristics. The nurse
practitioner will consider a progesterone challenge to determine the presence of adequate
Endogenous estrogen
A teenage patient presents with amenorrhea and moral secondary sex characteristics. A progesterone challenge is ordered. The
purpose is to determine the presence of ____________?
Endogenous estrogen
A 16year old girl who comes to your office with a history of secondary amenorrhea. She experienced menarche at age 10, regular
cycles for 2 years. She has not menstruated now for 4 years. In your initial consideration of differential diagnoses, what is the most
frequent etiology of this problem:
Eating disorder
18yo female c/o secondary amenorrhea. On exam, there is normal secondary sex characteristics and normal genitalia. Pregnancy is
ruled out. What would necessitate further eval?
Galactorrhea
Primary amenorrhea is best described as:
Failure to menstruation to occur by 13 yr
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
American Cancer Society recommendations
, 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?
Fibrocystic breast disease
When educating women about breast cancer risk factors, which statement is incorrect?
Fibrocystic breast disease
A woman with lobular carcinoma in situ has a relative risk of developing invasive breast cancer of
8.0
Androgen insensitivity/resistance syndrome
Changes in hormonal regulation during menopause result in the gradual cessation of menstruation. From which gland is
Androstenedione secreted?
Adrenals
ASCUS/HSIL results from Paper Test Report
A Pap smear result of atypical squamous cells of undetermined significance—rule out high-grade squamous intraepithelial lesion
(ASCUS r/o HGSIL) will require which procedure next?
Colposcopy
A Pap smear result of atypical squamous cells of undetermined significance (ASCUS) will require which procedure next?
Follow up pap smear
Bartholin glands and cysts
A 25-year-old presents with a report of a very tender area just near her introitus and to the left of her perineum. Very painful
sex is how she knew "something wasn't right." She showered and when washing, she felt a "pea-sized" painful lump on the left side of
her "bottom." She tells you she looked at it with a mirror and it was very small, but now it is the size of a ping-pong ball and getting
worse.
When you inspect her external genitalia, you are amazed at the size and appearance of the "lump."
You note what appears to be an abscess on the left medial side of the labia minora, and there is some edema extending into the
perineum. Your diagnosis for this presentation is:
Bartholin’s cyst
You explain to this young woman what this "lump" is and let her know you will be referring her to a gynecologist you consult with
regularly. You explain to her the likely treatment as follows:
A possible incision might be necessary and a catheter placed for two to four weeks to allow for drainage and
appropriate healing.
A client at the women's health clinic complains of swelling of the labia and throbbing pain in the labial area after sexual intercourse.
For what condition does the nurse anticipate the client will be treated?
Bartholinitis
25yo female c/o tender area near her introitus and to the L of her perineum. Very painful sex was first sign. Initially bump was very
small, but now is ping-pong ball size. On exam, abscess is present on L medial side of labia minora and there's edema extending into
perineum. What is dx?
Bartholin’s cyst
Which of the following choices represents a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal
mass?
Bartholin’s cyst
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?
Production of alkaline secretions for sperm viability
BMI
CDC recommendations regarding STDs and PID
Cervical cancer screening
A 23-year-old women 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?
Uterine biopsy
a nurse practitioner is educating a woman who has a colposcopy ordered. Which of the following most accurately describes a
colposcopy?
A procedure that visualizes the vaginal, vulvar or cervical epithelium with magnification to identify abnormal
areas that may need to be biopsied
A 33-year-old women 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?
