NSG6430 midterm Exam; Fall 2022 100 questions & Answers.

NSG6430 midterm Exam; Fall 2022 100 questions & Answers. A thirty nine year old female has not had menses for over six months and has a negative pregnancy test. Which of the following characteristics puts her at risk for an early menopause? current smoker Sally a sixty one year old Caucasian female, presents to your practice for 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? used of combined oral contraception Suzanne, a forty six year old client reports shortened menstrual cycles for one year. The most likely diagnosis is perimenopause you are seeing a twenty two year old pregnant woman for routine antepartal care. she discloses that she forgets to take her prenatal vitamins. which of the following would not be part of your counseling and education you can just take a regular multivitamin in place of the prenatals a pathology report has been returned on a woman's breast mass malignancy. The most common type of invasive breast cancer is infiltrating ductal you are performing a pelvic exam on a forty seven year old woman when you notice a large soft bulge in the vaginal floor. the primary diagnosis is rectocele a young woman presents to your practice with vaginal itching and a white discharge. She denies sexual activity or douching. She has been in good health except for a recurrent strep throat. Pelvic examination reveals a tender vulvovaginal area with edema and white patches; no odor is detected. Which of the following is the most likely cause of this problem candidiasis after antibiotic treatment the NP is prescribing an oral contraception to Sally. she is concerned about having one that has "two hormones: as the active ingredients. You instruct her that adding progestin to estrogen therapy will decrease the risk of endometrial cancer A twenty one year old woman presents for her initial well woman examination. She has never been sexually active and has a negative family history for gynecology problems. Personal history is negative for abuse and she exercises regularly and eats a balanced diet. Menstrual history reveals that she experienced menarche at fourteen years of age, has a regular twenty eight day cycle and denies dysmenorrhea. Which of the following would be included in her physical examination today pap smear Frankie is concerned that she has an ultrasound ordered after the results of her mammogram of been reviewed by the NP. You emphasize that the primary role of a breast ultrasound is to determine if a breast lesion is cystic or solid Alicia lived i foster care for several years before being placed in a new city. she is in the tenth grade. which of te following aspects of her life protect her from risk a female teacher with whom she can talk about her problems In reviewing mammogram results with a patient, the results reveal fibrocystic changes. These finding will most likely cause breast pain Mitzi, a twenty three year old is here for her well woman checkup. She asks about douching. Which of the following statements about douching is true douching may increase the risk of infection and ectopic pregnancy Lakeisha, seventeen years old, is seeing her regular NP for a sports physical. While participating in a psychosocial screen. Lakeisha volunteers that she "hasn't had sex yet" What is the best initial response to Lakeisha's statement clarify which behaviors are included in Lakeisha's definition of having sex Thalia is a fifteen year old who is referred to your women's health practice by her school counselor. She has macromastia and has been teased and ridiculed by her classmates at school. Which of the following would be the first step in dealing with this problem Assess Thailia's Tanner staging for breasts and date of menarche A college professor is creating a lecture about the prevention and diagnosis of osteoporosis. A point that needs to be included about measures that have no impact on osteoporosis is obtaining a spinal x-ray after a suspected osteoporotic compression fracture your are starting Ella, a twenty one year old on ortho tricyclen, a combined oral contraceptive. Which of the following would not be included in your instructions and advice oral contraceptives offer protection against breast cancer for as long as you are using them 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 the diaphragm is more effective when used with spermicidal jelly A postmenopausal patient is prescribed hormonal therapy (HT) The NP recalls that HT is indicated for the management of hot flashes The NP is completing a follow up visit on a woman who was previously prescribed hormonal therapy, which she has not taken for the last month. The primary reason the patient discontinued HT is vaginal bleeding The most effective interventions available to women's healthcare providers for reducing the incidence and severity of the leading causes of death and disability in this group are lifestyle changes A female patient has been diagnosed with a urinary tract infection and is currently using birth control. Which of the following contraceptive methods is associated with an increased incidence or a urinary tract infections diaphragm A woman has just stopped birth control pills in effort to become pregnant. You recall that estrogen withdrawal reflects activity primarily from the ovary a twenty-four-year old woman in your practice has been trying to conceive. she comes in for a pregnancy test, and it is positive. LMP was 5 weeks ago. She is prone to migraines and has used Imitrex (sumatriptan) with good success. She asks you about what to do if she has a migraine during pregnancy. Which of the following would be an inappropriate intervention as part of your counseling substitute ibuprofen at the onset of a headache; it is safe and effective A NP 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 according to Neinstein all stages of adolescent psychosocial development revolve around issues with independence/dependence, body image concerns, peer group involvement, and identity development. during which stage eating disorders most likely to surface middle adolescence (14 to 16 years) A fourteen year old patient is accompanied by her mother, who is concerned about irregular and infrequent periods. Her last menstrual period was two months ago. What would be the initial test performed urine Hcg A NP is educating a high school class about sexual education. Teaching should include that protective factors against repeat adolescent pregnancy include all of the following except continue sexual relationship with the same partner Karen is concerned that she may develop breast cancer, which of the following is not associated risk factor breastfeeding Which of the following is not included in diagnostic criteria for polycystic ovary syndrome diabetes insipidus A female patient has been diagnosed with polycystic ovary syndrome and weights 250 lbs. In addition to obesity PCOS is associated with which of the following clinical manifestations infertility A NP is completing a history on a woman who has been diagnosed with primary amenorrhea. Which of the following would not be a significant past medical history for this diagnosis Stein-Leventhal syndrome Leticia, 17 years old has just been diagnosed with primary dysmenorrhea. which of the following is responsible for the pain in this condition prostaglandin release and synthesis You are completing a pelvic exam on 32 year old Nancy you detect a left adnexal mass on the bimanual exam. With an adnexal mas, the practitioner must always suspect _____ until proven otherwise malignancy Tanisha is a 22 year old woman who presents with extreme irritability and mood swings, bloating, constipation, fluid retention, and headaches. She tearfully tells you, "This happens every month in my cycle. I get like a crazy woman, lashing out at everyone, I'm afraid I'll lose my job if I can't stop this. Sometimes, it's so bad. I just want to quit living, I need help: Tanisha's symptoms are typical of what disorder premenstrual dysphoric disorder (PMDD) Lucinda, 32 years old, presents to your clinic with the complaint of missed periods for two months, nausea, breast tenderness and frequent urination. She had an intrauterine device (IUD) placed five months ago. On examination you find the following cervix positive for Chadwick's sign; IUD strings protruding from cervical os; uterus no tender, enlarged; adnexa nonetneder no masses and not cervical motion tenderness. the most probable diagnosis is pregnancy 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 NP student is researching as to why menopausal women have an increased risk of heart disease. Which of the following lipid changes occur with estrogen withdrawal in menopause decrease in HDL with an increase in LDL and triglycerides A patient is complaining of a milky nipple discharge. Galactorrhea is usually a finding with which other diagnosis hyperprolactinemia Esteli, a 22 year old, comes in for birth control counseling. She is currently engaged and wants to start birth control until after her wedding next fall. She and her fiancé would like to start a family as soon as possible, so Esteli is seeking a form of birth control that is quickly reversible. Which of the following will meet this criteria lea's shield A 21 year old woman presents to your family planning clinic seeking emergency contraception. She had unprotected sex last night and is not currently on any contraception. Her last menstrual period was two weeks ago, and she denies recent sexual intercourse which of the following is not an emergency contraception modality RU486 mifepristone protocol The NP understands that premenstrual syndrome (PMS) occurs with greatest frequency and severity in the late luteal phase A pregnant woman has been diagnosed with preeclampsia or pregnancy induced hypertension (PIH). Which of the following statements about PIH is incorrect PIH is precursor to chronic hypertension and heart disease Lauren, 23 years old, presents to your office with a complaint of severe menstrual cramps for 4 months since she quit using an oral contraceptive, Your tentative diagnosis is primary dysmenorrhea. What would be the first line treatment for this condition naproxen You are seeing 12 year old Sonya for a well-adolescent checkup. She is accompanied by her mother who agrees to having you see Sonya alone but wants to talk with you at the end. After examining Sonya and assuring her of confidentiality, you meet with her mother briefly. Sonya's mother states, " I don't know how to say this, but I am so worried that my daughter is homosexual. She spends so much time with her girlfriends, and they are the focus her entire life" From your understanding of normal adolescent stages and development, how would you respond to her concern Advise Sonya's mother that same-sex close friendships are normal at this age A prescription is being written by the NP for birth control pills. When completing patient education, which of the following would be an accurate statement about oral contraceptive use oral contraceptives do not provide protection against sexually transmitted disease STDs including human immunodeficiency virus There are several phases to the menstrual cycle. What phase begins with ovulation and ends with menstruation? luteal phase A patient is being rechecked after having a total hysterectomy performed and is having multiple problems since. Which of the following is/are early symptom(s) of estrogen withdrawal sleep disturbances Iris is a thirty-two-year-old married woman with three children. She comes in for information on using the copper T intrauterine device (IUD) for contraception. Which of the following would be a contraindication to using this appliance? heart disease Lab results on your twenty-six-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 The nurse practitioner is caring for a menopausal patient reporting vaginal dryness with intercourse. How would this best be managed? vaginal estrogen Which of the following is true regarding education of a forty-two-year-old woman diagnosed with uterine myoma? myomas usually resolve with menopause Lenore, fifty-five years old, comes in for evaluation of a breast mass. Which of the following is not usually linked with carcinoma of the breast well-circumscribed, rubbery and tender lesion A thirty-two-year-old woman presents to your practice with a complaint of postcoital bleeding. Which of the following must be included in the assessment of this patient? papanicolaou smear Sylvia is a forty-four-year-old woman with dysfunctional uterine bleeding (DUB) and is unable to use oral contraceptives. Which of the following medications can be used for management of DUB medroxyprogesterone You are counseling eleven-year-old Amanda and her mother about human papillomavirus (HPV) vaccine, Gardasil. Amanda is Tanner stage IV at this visit. In counseling this family, you tell them that HPV vaccine can cause syncope in some children You are meeting with twenty-two-year-old Emily to discuss birth control options. She has tried “the pill” in the past but failed to take it regularly. She is interested in depo because she only has to come in every three months for a shot. She also heard that one does not get a period on depo, and she likes the thought of that. Which of the following would be a specific consideration with depo that you would need to discuss depo depletes skeletal mass, so it is necessary to take calcium supplements Elizabeth, twenty-four years old, is pregnant, and you are educating her on common problems during the first trimester. Which of the following is abnormal and requires immediate attention vaginal bleeding A woman presents to the office seeking the birth control measure that is 100% effective. When counseling a woman on effectiveness of these methods, which of the following fulfills this requirement? abstinence You are interviewing a teen with suspected substance abuse. Which of the following screening tools would give you the most specific information regarding substance abuse in teens CRAFFT Nakia is a sixty-five-year-old obese female with type II diabetes mellitus. She presents to your office with a complaint of vaginal itching and burning for two weeks now. She has not been sexually active for five years since her partner died of heart failure. She has tried douching and OTC Vagisil 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? candidiasis : A twenty-five-year-old pregnant client presents with the complaint of headaches that are confined to the base of the head and upper neck; she denies visual changes, photophobia, or nausea. The most likely diagnosis is which type of headache tension Jackie is a fifteen-year-old African American female who resides in a housing plan. You realize that barriers exist in providing preventive services to adolescents that include all of the following except: availability of guidelines for preventive care During pregnancy and lactation, the nutritional needs of the woman are very specific and deficiencies can result 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 folic acid Elba, a thirty-five-year-old woman, presents with a six-month history of hypermenorrhea, backache, and pelvic pressure. On examination, you discover twelve-week-size uterus with irregular contour. Which of the following does this represent? uterine fibroid n caring for a menopausal client who has had a total hysterectomy, the nurse practitioner would include which of the following options? estrogen alone Which of the following choices represent a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass? Bartholin's cyst LaShonda, thirty-four years old, is undergoing fertility treatments to become pregnant. Her period was three weeks late and heavier than normal. She thinks that she had an early miscarriage and wants confirmation. Which of the following tests would be most accurate to do this Quantitative beta HCG subunit Abby, twenty years old, presents with pelvic pain. Which of the following is not a first-line diagnostic test for evaluation of pelvic pain? CT of pelvis A twenty-one-year-old woman comes into your practice seeking birth control. She has only recently become sexually active and has consistently used condoms for safe sex. Your history reveals that she does not use tampons during her menses and has very little knowledge about female reproductive anatomy. Based on this information, which of the following birth control choices would be least likely to meet her needs for contraceptive management? NuvaRing Malignant ovarian masses are very uncommon in young women. Which of the following information would be least helpful in the assessment, diagnosis, or management of pelvic malignancies in young women? Mutations in the breast cancer gene-1 BRCA-1 are responsible for a small percentage of ovarian cancers in women n prescribing hormone replacement therapy (HRT) for a menopausal women, which of the following does not accurately reflect current best practices for HRT? Use combination therapy only in a woman with a history of prior breast cancer. Beth, a sixty-two-year-old woman, is seen for a follow-up discussion of DEXA scan result of minus 1.5 standard deviation (SD) at the hip. Her PMH includes a recent myocardial infarction and a fractured wrist at fifty-eight years of age. Which of the following would not be an option for her? Continuous conjugated estrogen 0.625 mg and medroxyprogesterone acetate (MPA) 2.5 mg (Prempro) p.o. daily A sixty-year-old woman has presented with the chief complaint of bleeding after intercourse. Which of the following is not associated with postcoital bleeding or spotting in a postmenopausal woman? Polycystic ovary syndrome (PCOS) While participating in a woman’s health fair, a parent comes to you with the concern of her daughter participating prematurely in sex. Which of the following factors is strongly associated with early onset of unwanted sexual activity Dating a partner that is 3 years older than the teen You are evaluating seventeen-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 Nancy is an eleven-year-old presenting for an annual well-child visit. When reviewing the physiology of puberty, you recall that the initiation of puberty begins physiologically with the release of GnRH by the ____. hypothalamus Strategies to protect teenagers from risks include all of the following except _ pairing young adolescents with middle adolescents The new ACOG Pap smear guidelines reflect a change in all of the following except the follow-up to abnormal Pap smear results A woman comes to the clinic with the chief complaint of disruption of urine flow. Which of the following is not a risk factor for pelvic floor relaxation? cesarean section A woman has been diagnosed with polycystic ovary syndrome (PCOS). Management of PCOS includes all of the following except ___________. daily basal insulin to reduce blood sugar Seventeen-year-old Stella presents with the chief complaint of unilateral breast tenderness and swelling. Which of the following would be the least likely etiology for this problem? breast cancer Anna, twenty-five years old, presents with dysmenorrhea. She states that her sister and mother have endometriosis; so she would like to be evaluated for it. Which if the following is consistent with a diagnosis of endometriosis? pelvic pain and dyspareunia Which of the following characteristics is not associated with psychosocial development problems in adolescence? late onset of pubertal sexual maturity A pregnant client in your practice is experiencing nausea and vomiting in her first trimester. Which of the following would you suggest to alleviate the problem Eating small meals at frequent intervals, avoiding spicy or fatty foods Cara is in the clinic for what you have diagnosed as dysfunctional uterine bleeding (DUB). She is concerned about why this is happening to her. You recall which of the following is the most common cause of DUB? anovulation Luz is a fifteen-year-old girl who comes to your office stating, “I have not had my period for two months now.” She experienced menarche at ten years of age, with regular cycles for the past two years. In your initial consideration of a differential diagnoses, what is the most likely etiology of this problem? pregnancy A mother presents to the clinic with her female child who she is concerned about because her breasts are developing “when she is so young.” When performing the initial assessment, it is important to recall that precocious puberty is present if _________. puberty starts before eight years of age in a female A nurse practitioner is screening a female for prescribing contraceptions for the first time. Which of the following conditions is an absolute contraindication to estrogen-containing contraception? thromboembolism You are researching preliminary evidence-based sources about breast cancer risk factors. Which of the following would you find is not one for the disease? fibrocystic breast disease The National Osteoporosis Foundation has screening guidelines for DEXA scans. Which of the following women would be most in need of bone mineral density testing? A fifty-one-year-old woman with systemic lupus erythematosus (SLE) on long term corticosteroid therapy 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? The average age of menarche is twelve years. You are working in a women’s health practice and decide to incorporate brief preconception counseling into every visit. Which of the following would not be included in brief preconception counseling? medication management Sheryl, a twelve-year-old, complains of a vaginal discharge for the past eight to nine months. She tells you her underpants are frequently wet. When she wipes after urinating, there is “white stuff” on the tissue. Sheryl denies urinary problems, genital itching, or odor. She also denies sexual activity. Her menses has not yet started, but she reports that she “started to develop” her breasts a little past age ten. Her vaginal discharge is most likely a result of _______. physiologic leukorrhea 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. She has not been immunized for human papillomavirus (HPV). Which of the following examination findings would be suspicious for cervical cancer? a very frim cervix with an ulcer You are speaking to a women’s group in the community about mammography screening. What important information would you include in this presentation? Mammography should be accompanied by a clinical breast exam. During a pelvic exam on a seventy-year-old, the nurse practitioner notices the position of the cervix at the introitus. The diagnosis is most likely _____. uterine prolapse Elisabeth comes for a consultation. She has been in a committed relationship for five years now and wants to become pregnant ovulation occurs on day 14+/-2 days, before the next period There are several phases to the menstrual cycle. What phase begins with menses cessation and ends with ovulation proliferative phase