Guide 2023 NR602 Final Exam Nursing Study

Guide 2023 NR602 Final Exam Nursing Study ASCCP recommended management for an ASCUS pap result with high risk hpv 16 cotest in 26 year old no abnormal paps - CORRECT ANSWER-colposcopy What is included in the well women of an adolescent? - CORRECT ANSWER-health history menses gynecologic and pregnancy issues psychosocial abuse drugs alcohol use physical exam screening tests immunizations When does ACOG pap smear start - CORRECT ANSWER-21 years old done every three years ACOG pap for over 30 yrs old - CORRECT ANSWER-every five years with HPV test completed ACOG when can you stop pap smear - CORRECT ANSWER-can stop at 65 if negative history for 10 years or if they had a hysterectomy with no history of cervical cancer Bethesda pap smear report reads LSIL is what classification? - CORRECT ANSWER-CIN 1 A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as follow-up? - CORRECT ANSWER-routine screening a female patient is 35 years old. she has never had an abnormal PAP smear has 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? - CORRECT ANSWER-5 years A young sexually active is having her first pap smear what would you explain? - CORRECT ANSWER-pap smear detects cervical cancer 26 year old pap smear shows negative and positive HPV what do you do? - CORRECT ANSWER-repeat HPV and pap what is not part of criteria for older women to cease pap smears? - CORRECT ANSWER-over 55 year old no menarche in a 15 year old with no medical problems and Tanner stage 1 with a uterus - CORRECT ANSWER-primary amenorrhea No menses for at least 6 months - CORRECT ANSWER-secondary amenorrhea female athlete triad - CORRECT ANSWER-disordered eating, amenorrhea, osteoporosis labs for female athlete triad - CORRECT ANSWER-HCG serum prolactin serum TSH,FSH, LH if amenorhea lasts longer than 6 months do what? - CORRECT ANSWER-bone density test treatment plan for female athlete triad - CORRECT ANSWER-increase caloric intake, decrease exercise prescribe ca and vit d 1200/1500 daily and vitamin e 400 iu daily complications of female athlete triad - CORRECT ANSWER-osteopenia/osteoporosis (stress fracture) myocardial atrophy, arrhythmia, hypotension, brady hypoglycemia, dehydration, electrolytes lanugo, telogen effluvium hair loss zerosis dry skin, infertility, low body mass, cachexia, respiratory failure purpose of progesterone challenge - CORRECT ANSWER-endogenous estrogen primary and secondary amenorrhea originates in hypothalamus - CORRECT ANSWER-sheehans syndrome symptoms of breast cancer ( early) - CORRECT ANSWER-None Non-painful mass (occasionally pain) Eczematous nipple (Paget's) Serosanguinous (bloody) nipple discharge late symptoms of breast cancer - CORRECT ANSWER-skin or nipple retraction axilary lymhadenpathy breast enlargement redness, edema, brawny induration peau d' orange pain fixation of the mass to the skin or chest wall very late findings of breast cancer - CORRECT ANSWER-ulceration supraclavicular lymphadenopathy edema of the arm, bone, lung, liver, brain or other distant metstases Follow up for breast cancer patients - CORRECT ANSWER-1. Bilateral mammogram 6 months after complete radiation post-lumpectomy; Mammogram yearly after 2. Contralateral mammogram annually post-mastectomy (entire breast + pectoralis major fascia) PE every 3-6 months for 3 years then annually fibrocystic breast disease - CORRECT ANSWER-the presence of single or multiple benign cysts in the breasts signs and symptoms of fibrocystic breast disease - CORRECT ANSWER-occurs 2 weeks before the onset of mensus and worst right before the menstrual cycle. resolves after menses starts often in women in their 30's. breast lumps are rubbery and mobile to touch Tx for fibrocystic breast disease - CORRECT ANSWER-Once a benign diagnosis or normal findings have been established by biopsy or on clinical or imaging findings, simple reassurance will provide many patients with adequate relief. For those patients who still seek treatment, symptomatic relief by avoiding trauma and by wearing a bra with adequate support can be very helpful. The role of caffeine consumption in the development and treatment of fibrocystic change has never been proven; however, many patients report relief of symptoms after abstinence from coffee, tea, and chocolate. Similarly, observational studies have suggested that low-fat diets can provide some relief. The data regarding the utility of vitamin E supplementation and evening primrose oil are controversial. Mild analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to relieve breast pain. For more symptomatic women, danazol and tamoxifen have been found to be effective, although their significant side effects have limited their acceptability and utility. Fibroadenoma - CORRECT ANSWER-benign breast lesion 15-40 yrs old risk factors for fibroadenoma - CORRECT ANSWER-multiple fibroadenomas associated with rate cancer syndromes like mafficci syndrome, Cowden syndrome, carney complex early ETOH consumption findings with fibroadenoma - CORRECT ANSWER-painless, firm or rubbery mass with well defined borders, freely mobile, changes with size may occur with pregnany or menstrual cycle, lesions under 5 cm, considered to be giant fibrodenomas no nipple discharge Dx of fibroadenoma - CORRECT ANSWER-mammo, us to differentiate fluid filled to solid mass, fine needle aspiration biopsy, open biopsy Intraductal papilloma - CORRECT ANSWER-benign tumor within the ductal system of the breast, one of the heterogeneous group of lesions encompassed by the term benign breast disease seen in females 30-50 risk factors for intraductal papilloma - CORRECT ANSWER-multiple papilloma's which increases the risk for breast cancer dx studies for intraductal papilloma - CORRECT ANSWER-mammo, us mri, galactography, fine needle or core biopsy a pap smear result of atypical squamous cells of undetermined significance rule out high grade squamous intraepithelial lesions will require which procedure next? - CORRECT ANSWER-colposcopy pap smear is ASCUS what is next? - CORRECT ANSWER-follow up pap smear Bartholin's glands obstruction symptoms - CORRECT ANSWER-pain, tenderness, dyspareunia, walking with adducted thighs assessment findings of Bartholin's glands obstruction - CORRECT ANSWER-firm labia mass or cyst, erythema, induration, edema of treatment for bartholins gland obstruction - CORRECT ANSWER-warm baths Augmentin for e coli and strep staph or MRSA clindamycin re assess in 7-10 days drainage of the infected cyst through marsupialization or WORD catheter BMI below 18.5 - CORRECT ANSWER-underweight BMI 18.5-24.9 - CORRECT ANSWER-normal BMI 25-29.9 - CORRECT ANSWER-overweight BMI 30 - CORRECT ANSWER-obese annual screening for chlamydia and gonorrhea at increased risk - CORRECT ANSWER-every 3-6 months annual screening for pharyngeal gonorrhea throat at increased risk - CORRECT ANSWER-every 3-6 months annual testing for HIV, syphilis and HBsAG - CORRECT ANSWER-test frequently screen pregnant woman at first prenatal visit for - CORRECT ANSWER-HIV, chlamydia, syphilis, hepatitis B testing for pregnant women after chlamydia and gonorrhea treatment - CORRECT ANSWER-within 3-4 weeks after tx retest for chlamydia and gonorrhea (not for cure) - CORRECT ANSWER-3 months PID tx - CORRECT ANSWER-Rocephin 250 IM plus Doxy bid x 14 days with or without flagyl x 14 days PID symptoms - CORRECT ANSWER-pelvic lower ab pain and one of the following cervical motion tenderness, uterine or adnexa tenderness testing for PID - CORRECT ANSWER-endometrial bx, transvag US, laprascopy cervix disorders - CORRECT ANSWER-fusion of mullerian ducts to form cervix and corpus uteri Cervical agenesis - CORRECT ANSWER-an absent uterine cervix with a normal uterine corpus and normal vagina rx of cervical agenesis - CORRECT ANSWER-suppression of menstruation with continuous combined estrogen progesterone pills may improve the pain related complaints. dx of cervical agenesis - CORRECT ANSWER-ultrasonography, MRI, laparoscopy Incomplete Mullerian Fusion - CORRECT ANSWER-complete failure of fusion of the Mullerian ducts results in duplication of preproduction structures. Failure of Resorption - CORRECT ANSWER-complete spectate uterus Diethylstilbestrol (DES) - CORRECT ANSWER-cervical abnormalities and are at increased risk for infertility laceration of the cervix - CORRECT ANSWER-cervical cerclage, precipitous labor, vacuum extraction, nulliparity and episiotomy are associated with increased risk for clinically significant lacerations perforation of the cervix - CORRECT ANSWER-may occur during sounding of the cervix, cervical dilation, dilation of cervix, insertions of radioactive sources or conization of the cervix or during self inducted abortion with sharp objects ulceration of the cervix - CORRECT ANSWER-from pressure necrosis from vaginal pessary. or from uterine prolapse when the cervix protrudes through the vaginal introitus cervical stenosis - CORRECT ANSWER-narrowing or obstruction of the cervical canal caused by an acquired condition Pyometra - CORRECT ANSWER-infection of the uterus Dx of pyometra - CORRECT ANSWER-biopsy to rule out endometrial carcinoma tx of pyometra - CORRECT ANSWER-1) OHE w/ *pre-surgical stabilization is paramount* 2) anti-biotic therapy for 2 weeks post-op annular detachment - CORRECT ANSWER-extremely rare devitalized and torn uterus and expelled during labor complications of cervical injuries - CORRECT ANSWER-hemorrhage hypovolemic shock Mongolian spots - CORRECT ANSWER-areas of deep bluish-gray pigmentation most commonly on the sacral aspect of a newborn lead poisoning - CORRECT ANSWER-test at 12 months of age cystic fibrosis - CORRECT ANSWER-A genetic disorder that is present at birth and affects both the respiratory and digestive systems. Traumatic Brain Injury (TBI) - CORRECT ANSWER-A traumatic insult to the brain capable of producing physical, intellectual, emotional, social, and vocational changes. sickle cell anemia - CORRECT ANSWER-a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape iron deficiency anemia - CORRECT ANSWER-anemia caused by inadequate iron intake Anemia of prematurity - CORRECT ANSWER--MC anemia in premature, low birth weight infant -low RBC production and short RBC lifespan -normocytic normochromic anemia -*retic low* (v hemolytic, sickle cell - retic high) -normal WBC, plt count -normal total bili (v hemolytic) -tx: iron supplemnts, blood transfusion Thalassemia - CORRECT ANSWER-inherited defect in ability to produce hemoglobin, leading to hypochromia otitis media - CORRECT ANSWER-inflammation of the middle ear Tourrette Syndrome - CORRECT ANSWER-involuntary, spasmodic, twitching movements; uncontrollable vocal sounds; and inappropriate words cerebral palsy - CORRECT ANSWER-paralysis caused by damage to the area of the brain responsible for movement Pediatric UTI - CORRECT ANSWER--bowel or bladder dysfunction: withholding maneuvers, incontinence, constipation -vesicoureteral reflux -tx with 3rd generation cephalosporin: cefixime, cefdinir, ceftibuten for 3-5 days if afebrile and 10 days if febrile -if febrile refer to urology renal bladder ultrasound (RBUS) for all infants 2-24 months with first febrile UTI ADHD - CORRECT ANSWER-a psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity dyslexia - CORRECT ANSWER-impairment of the ability to read odd - CORRECT ANSWER-oppositional defiant disorder bipolar disorder - CORRECT ANSWER-A mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania. Depression - CORRECT ANSWER-A prolonged feeling of helplessness, hopelessness, and sadness Pinworms - CORRECT ANSWER-- Come out of the anus at night to lay their eggs, Shower in the AM and underwear should be changed at this time with the child standing. - The child doesn't need to stay out of school, good hand hygiene contains the spread of pinworms. - Pinworm paddle lab test - Wash bed linens in hot soapy water. congenital heart defects - CORRECT ANSWER-structural abnormalities caused by the failure of the heart to develop normally before birth Kawasaki disease - CORRECT ANSWE