NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION AND ANSWERS WITH EXPLANATIONS.

NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION
AND ANSWERS WITH EXPLANATIONS.


Question 1

When palpating the cervix during the bimanual exam, cervical motion tenderness
(chandelier sign) is noted. This tenderness could be suggestive of:



A. retroversion of the uterus.
B. pelvic inflammatory disease.
C. vulvar lesions.
D. Bartholin gland infection.



Explanation:

Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal tenderness,
suggest pelvic inflammatory disease, ectopic pregnancy, or appendicitis.



Question 2

In a female diagnosed with a first-degree uterine prolapse, the cervix:



A. is located in its normal position.
B. has slipped but is well within the vagina.
C. is located in the introitus.
D. and vagina are outside the introitus.



Explanation:

Uterine prolapse occurs in progressive stages. The uterus becomes retroverted and
descends down the vaginal canal to the exterior. In first-degree prolapse, the cervix is still



NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION
AND ANSWERS WITH EXPLANATIONS.

, NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION
AND ANSWERS WITH EXPLANATIONS.
well within the vagina. In second-degree prolapse, it is at the introitus. In third-degree
prolapse (procidentia), the cervix and vagina are outside the introitus.



Question 3

Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at a high risk
for developing all of the following abnormalities except:



A. columnar epithelium covering most or all of the cervix.
B. a slit- like cervical os.
C. vaginal adenosis.
D. a circular collar or ridge of tissue between the cervix and the vagina.



Explanation:

Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at greatly
increased risk for several abnormalities: columnar epithelium that covers most or all of the
cervix vaginal adenosis, and a circular collar or ridge of tissue, of varying shapes, between
the cervix and vagina. The slit-like cervical os is a normal variation.



Question 4

A female patient presents with a profuse, yellowish, green vaginal discharge that is
malodorous. This vaginal discharge is most consistent with:



A. candidal vaginitis.
B. bacterial vaginosis.
C. Trichomonal vaginitis.
D. gonorrhea.




NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION
AND ANSWERS WITH EXPLANATIONS.

, NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION
AND ANSWERS WITH EXPLANATIONS.
Explanation:

Trichomonas vaginalis causes trichomonal vaginitis. Presenting symptoms include a
profuse, yellowish, green vaginal discharge that is malodorous. Candidal vaginitis
produces
a white and curd-like thin discharge that is rarely malodorous. With bacterial vaginosis, the
discharge can be gray or white, thin, malodorous (fishy), and not usually profuse. The
discharge associated with gonorrhea is usually thick and bloody.



Question 5

The most common causes of sexual problems in females are related to:



A. lack of sexual desire.
B. inadequate vaginal
lubrication. C. psychosocial
factors.
D. pelvic disorders.



Explanation:

The most common problems that occur during sexual activity are related to situational or
psychosocial factors. Although lack of desire, inadequate vaginal lubrication, and pelvic
disorders may all contribute to sexual problems, the most common causes are situational
and psychosocial in origin. Therefore, obtaining a comprehensive sexual history is of
utmost importance.



Question 6

Chronic pelvic pain refers to pain that does not respond to therapy and:




NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION
AND ANSWERS WITH EXPLANATIONS.

, NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION
AND ANSWERS WITH EXPLANATIONS.
A. lasts more than 3 months.
B. lasts more than 6 months.
C. lasts more than 9 months.
D. lasts more than 12 months.



Explanation:

According to the International Pelvic Pain Society, chronic pelvic pain refers to pain that
lasts more than 6 months without response to treatment.
Question 7

In female patients with dyspareunia, superficial pain is most likely related to all of the
following except:



A. local inflammation.
B. atrophic vaginitis.
C. pressure on a normal ovary.
D. inadequate lubrication.



Explanation:

In females, dyspareunia, or painful intercourse, can occur at the vaginal opening, occurring
at the start of intercourse, or when the partner is pushing deeper. It is important to
differentiate the pain to determine the etiology. Superficial pain suggests local
inflammation, atrophic vaginitis, or inadequate lubrication. Deeper pain may be from pelvic
disorders or pressure on a normal ovary.



Question 8

If urethritis or inflammation of the paraurethral glands is suspected in a female patient, the
index finger should be inserted into the vagina and:



NR 509 APEA EXAM – WOMEN’S HEALTH QUESTION
AND ANSWERS WITH EXPLANATIONS.