NR602gFinalgExam:gEssentialgQuestiongBankgwithgIn-
DepthgAnswersgandgLatestgUpdatesg2024
• Abnormalguterinegbleedingg(AUB)ghasgmultiplegcauses.gWhengagwomangpresentsgan
dgreportsgmenstrualgirregularitygwithgamenorrhea,gwhichgisgthegmostgcommongcause
gofgamenorrhea?
Ectopicgpregnanc
ygAdenomyosi
sgCoagulopath
ygAnovulation
• ThegTannergscalegofgsexualgmaturitygratinggallowsgforgaccurategclassificationgofgphysica
lgpubertalgmaturation.gDuringgthegexaminationgofgyourgpatient,gyougnoticegthatgthegpubic
ghairgisgincreasedgingquantity,gisgdarker,gandgisgpresentgingthegtypicalgfemalegtrianglegbut
gingagsmallergquantity.gWhichgofgthegfollowinggTannergstagesgdoesgthisgdescriptiongmeet
?
TannergstagegIgTann
ergstagegIIgTannergs
tagegIIIgTannergstag
egIV
• Agtwenty-five-year-
oldgpatientgpresentsgwithgurinarygfrequencygandgurgency.gThesegsymptomsghavegbe
engoccurringgforgthreegdaysgwithoutgfever.gAgpatientgwithginterstitialgcystitisgwouldgmo
stglikelygdescribegtheirgsymptomsgas .
urinarygurgencygandgfrequencygingthegmorninggandgatgnight
gpaingwithgurinationgwithgscantgbleeding
terminalgdysuriagurin
arygurgencygonly
• Thegmostgcommongcausegofgchronicgpelvicgpaingforgwomengingthegprimegofgthe
irgreproductivegyearsgis
,NR602gFinalgExam:gEssentialgQuestiongBankgwithgIn-
DepthgAnswersgandgLatestgUpdatesg2024
PID
Fibroids
CORRECTg EndometriosisgEndometrit
is
• Agfifty-two-year-oldgfemalegpatientgcomesgingforghergannualgwell-
womangexamination.gHergLMPgwasgfourteengmonthsgagogwithoutganygbreakthroughgbleeding.
gSheghasgalsogdevelopedgsomeghirsutism.gYougwouldgdocumentgthisgasgg g .
secondarygamenorrheagme
nopausegperimenopaus
e
polycysticgovarygsyndromeg(PCOS)
• Polycysticgovariesgpredisposegwomengtogaghighergincidencegof:
AdrenalgtumorsgOvari
angcancergEndometr
ialgcancergEndometri
osis
• Agdefinitivegdiagnosisgofgendometriosisgcannotgbegmadeguntilgwhichgofgthesegisgcompleted?
CTgscan
Transvaginalgultrasound
gExploratoryglaparoscop
ygMRI
Aftergagthoroughghistory,gyougnotegthatgMariegresidesgingagcommunitygwithgveryghighgriskgfacto
rs.gThesegincludegpoverty,gviolence,gandglackgofgrecreationalgfacilities.gShegtellsgyougthatgsheg“h
angsgout”gatgagconveniencegstoregneargthegapartmentgcomplexgsheglivesgatgwithghergmother.
,NR602gFinalgExam:gEssentialgQuestiongBankgwithgIn-
DepthgAnswersgandgLatestgUpdatesg2024
“Allgtheggroupghangsgthere,”gshegreportsgproudly.gShegsharesgthatgsheghasgbeengmenstruatinggf
orgtwogyearsgnowgalthoughgsheghasgirregulargcycles.gShegalsogletsgyougknowgthatgsheghasghadgc
oitusgonlygonegtimegandgthatgheg“pulledgout.”gShegdoesgnotgwantgtoggetgpregnant,gandgthisgisg
whygshegisgheregtoday.
WhatgisgyourgmanagementgplangforgMariegtoday?
StudentgAnswer:g CORRECTg Yougwillgassessgallgpredisposinggfactorsgthatgleadgtogpremaritalgsexgandgthegnegativegconseq
uences,gtellgMariegtogbegcareful,gandgprescribegbirth-controlgpills.
CORRECTgOnegbygone,gyougwillgplangtogcarefullygaddressgthegrisksg(redgflags)gingMarie’sghistory.gYourggoalgwillgbegtogcl
arifygandgaddressgmisconceptions,gasgwellgasgsharegvaluablegsexgeducationgingagsensitive,gnonjudgmentalgway.gYougwillgletg
hergknowgyougareghergadvocategandgaregverygprotectivegofgherghealth.gWithoutgpreaching,gyougwantghergtogbegawaregofgt
hegnegativegpossibilitiesgofgpremarital,gunprotectedgsexualgactivities.gYougwillgalsogsharegagcleargunderstandinggofgthegriskgo
fgSTIsgwithgMarie.
CORRECTgAftergprocessinggallgofgtheghistorygMarieghasgshared,gyougwillgwritegagreferralgforgpsychiatricgevaluationgand
gtellghergshegneedsgongoinggcounselinggforghergbehaviorgatgsuchgagyounggagegandgsheglikelygneedsgtoglearngtogcopegwithi
nghergenvironmentg(homegandgcommunity).
CORRECTgYourggoalgisgtogincludeghealthygsexual-
healthgdecisiongmaking,gincludinggdecisionsgregardinggabstinence,gbirth-
gcontrolgefficacygandgchoice,gandgcondomguse.gDependinggongthegneed,gyougmaygincludegagreferralgtogangeffectivegprog
ramgforgteensg(forgexample,gagprogramgthatgdealsgwithgSTIgpreventiongandgorgagfamily-
basedginterventiongprogramgifgavailable).
• Agwell-womangvisitgforgangadolescentgshouldgincludegwhichgofgthegfollowing?
Aggeneralghealthghistorygandgphysicalgexamination,gincludinggagbreastgexamination,gpelvicgwithgPapgsmear,gscreeningg
tests,gcounseling,gimmunizations,griskgfactors,gandgpatientgconcerns
Aggeneralghealthghistorygfocusinggongreproductivegandgsexualghealthgconcernsg(menses,ggynecologic,gandgpregn
ancygrelated)gandgpsychosocialg(familygrelated,gpeergrelated,gemotional,gandgphysicalgasgwellgasgrelatedgtogabuse,gdr
ugguse,gandgalcoholguse)gconcerns
Physicalgexam,gscreeninggtests,gandgimmunizationsgasgindicatedgbygtheghealthghistorygandggynecologicgconsidera
tionsgforgangexternal-onlyginspectiongofgtheggenitalia
CORRECTg Bothgbgandgc
• Agseventeen-year-
oldgpresentsgwithgangappointmentgforgunilateralgbreastgtendernessgandgswelling.gWhichg
ofgthegfollowinggwouldgbegthegmostglikelygetiologygforgthisgproblem?
, NR602gFinalgExam:gEssentialgQuestiongBankgwithgIn-
DepthgAnswersgandgLatestgUpdatesg2024
BreastgcancergMasti
tisgFibrocysticgbre
astgFibroadenom
a
• Yougaregcompletinggagpelvicgexamgongthirty-two-year-
oldgNancy.gYougdetectgagleftgadnexalgmassgongthegbimanualgexam.gWithgangadnexalgmass,gtheg
practitionergmustgalwaysgsuspectg
untilgprovengotherwise.
g
Pelvicginflammatorygdiseaseg(PID)
Malignancy
Pregnancy
PolycysticgovarygdiseasegX
• Majoritygofgurinarygtractginfectionsgdognotgrequiregconsultationgorgagreferralgtogagspecialistgan
dgaregroutinelygtreatedgingprimarygcaregpractices.gWhichgofgthegfollowinggscenariosgwouldgindic
ategthatgagconsultationgorgreferralgisgindicated?
Thegpresencegofgsecondarygsexuallygtransmittedgillnes
sgAgpatientgwithgtwogepisodesgoccurringgingonegy
ear
PatientsgthatgremaingsymptomaticgaftergthreegdaysgofgtreatmentgPati
entsgthatgshowgurineghumangchorionicggonadotroping(HCG)gpositive
• .gLong-
actinggprogestinsgmaygbegusedgingpatientsgasgagcontraceptivegmethod.gOnegofgtheglong-
gactinggprogestinsgisgDepo-
Provera.gWhichgofgthegfollowinggbestgdescribesgthegmechanismgofgactiongofglong-
actinggprogestinsgingcontraception?
DecreasegingcervicalgmucusgproductiongandgthinninggofgthegcirclegosgT
hickeninggofgcervicalgmucusgandgsuppressiongofggonadotropinglevelsg
IncreasedggonadotropinglevelsgandgthinninggofgthegcirclegosgAnovula
tiongcausedgbygincreasedggonadotropinglevels
DepthgAnswersgandgLatestgUpdatesg2024
• Abnormalguterinegbleedingg(AUB)ghasgmultiplegcauses.gWhengagwomangpresentsgan
dgreportsgmenstrualgirregularitygwithgamenorrhea,gwhichgisgthegmostgcommongcause
gofgamenorrhea?
Ectopicgpregnanc
ygAdenomyosi
sgCoagulopath
ygAnovulation
• ThegTannergscalegofgsexualgmaturitygratinggallowsgforgaccurategclassificationgofgphysica
lgpubertalgmaturation.gDuringgthegexaminationgofgyourgpatient,gyougnoticegthatgthegpubic
ghairgisgincreasedgingquantity,gisgdarker,gandgisgpresentgingthegtypicalgfemalegtrianglegbut
gingagsmallergquantity.gWhichgofgthegfollowinggTannergstagesgdoesgthisgdescriptiongmeet
?
TannergstagegIgTann
ergstagegIIgTannergs
tagegIIIgTannergstag
egIV
• Agtwenty-five-year-
oldgpatientgpresentsgwithgurinarygfrequencygandgurgency.gThesegsymptomsghavegbe
engoccurringgforgthreegdaysgwithoutgfever.gAgpatientgwithginterstitialgcystitisgwouldgmo
stglikelygdescribegtheirgsymptomsgas .
urinarygurgencygandgfrequencygingthegmorninggandgatgnight
gpaingwithgurinationgwithgscantgbleeding
terminalgdysuriagurin
arygurgencygonly
• Thegmostgcommongcausegofgchronicgpelvicgpaingforgwomengingthegprimegofgthe
irgreproductivegyearsgis
,NR602gFinalgExam:gEssentialgQuestiongBankgwithgIn-
DepthgAnswersgandgLatestgUpdatesg2024
PID
Fibroids
CORRECTg EndometriosisgEndometrit
is
• Agfifty-two-year-oldgfemalegpatientgcomesgingforghergannualgwell-
womangexamination.gHergLMPgwasgfourteengmonthsgagogwithoutganygbreakthroughgbleeding.
gSheghasgalsogdevelopedgsomeghirsutism.gYougwouldgdocumentgthisgasgg g .
secondarygamenorrheagme
nopausegperimenopaus
e
polycysticgovarygsyndromeg(PCOS)
• Polycysticgovariesgpredisposegwomengtogaghighergincidencegof:
AdrenalgtumorsgOvari
angcancergEndometr
ialgcancergEndometri
osis
• Agdefinitivegdiagnosisgofgendometriosisgcannotgbegmadeguntilgwhichgofgthesegisgcompleted?
CTgscan
Transvaginalgultrasound
gExploratoryglaparoscop
ygMRI
Aftergagthoroughghistory,gyougnotegthatgMariegresidesgingagcommunitygwithgveryghighgriskgfacto
rs.gThesegincludegpoverty,gviolence,gandglackgofgrecreationalgfacilities.gShegtellsgyougthatgsheg“h
angsgout”gatgagconveniencegstoregneargthegapartmentgcomplexgsheglivesgatgwithghergmother.
,NR602gFinalgExam:gEssentialgQuestiongBankgwithgIn-
DepthgAnswersgandgLatestgUpdatesg2024
“Allgtheggroupghangsgthere,”gshegreportsgproudly.gShegsharesgthatgsheghasgbeengmenstruatinggf
orgtwogyearsgnowgalthoughgsheghasgirregulargcycles.gShegalsogletsgyougknowgthatgsheghasghadgc
oitusgonlygonegtimegandgthatgheg“pulledgout.”gShegdoesgnotgwantgtoggetgpregnant,gandgthisgisg
whygshegisgheregtoday.
WhatgisgyourgmanagementgplangforgMariegtoday?
StudentgAnswer:g CORRECTg Yougwillgassessgallgpredisposinggfactorsgthatgleadgtogpremaritalgsexgandgthegnegativegconseq
uences,gtellgMariegtogbegcareful,gandgprescribegbirth-controlgpills.
CORRECTgOnegbygone,gyougwillgplangtogcarefullygaddressgthegrisksg(redgflags)gingMarie’sghistory.gYourggoalgwillgbegtogcl
arifygandgaddressgmisconceptions,gasgwellgasgsharegvaluablegsexgeducationgingagsensitive,gnonjudgmentalgway.gYougwillgletg
hergknowgyougareghergadvocategandgaregverygprotectivegofgherghealth.gWithoutgpreaching,gyougwantghergtogbegawaregofgt
hegnegativegpossibilitiesgofgpremarital,gunprotectedgsexualgactivities.gYougwillgalsogsharegagcleargunderstandinggofgthegriskgo
fgSTIsgwithgMarie.
CORRECTgAftergprocessinggallgofgtheghistorygMarieghasgshared,gyougwillgwritegagreferralgforgpsychiatricgevaluationgand
gtellghergshegneedsgongoinggcounselinggforghergbehaviorgatgsuchgagyounggagegandgsheglikelygneedsgtoglearngtogcopegwithi
nghergenvironmentg(homegandgcommunity).
CORRECTgYourggoalgisgtogincludeghealthygsexual-
healthgdecisiongmaking,gincludinggdecisionsgregardinggabstinence,gbirth-
gcontrolgefficacygandgchoice,gandgcondomguse.gDependinggongthegneed,gyougmaygincludegagreferralgtogangeffectivegprog
ramgforgteensg(forgexample,gagprogramgthatgdealsgwithgSTIgpreventiongandgorgagfamily-
basedginterventiongprogramgifgavailable).
• Agwell-womangvisitgforgangadolescentgshouldgincludegwhichgofgthegfollowing?
Aggeneralghealthghistorygandgphysicalgexamination,gincludinggagbreastgexamination,gpelvicgwithgPapgsmear,gscreeningg
tests,gcounseling,gimmunizations,griskgfactors,gandgpatientgconcerns
Aggeneralghealthghistorygfocusinggongreproductivegandgsexualghealthgconcernsg(menses,ggynecologic,gandgpregn
ancygrelated)gandgpsychosocialg(familygrelated,gpeergrelated,gemotional,gandgphysicalgasgwellgasgrelatedgtogabuse,gdr
ugguse,gandgalcoholguse)gconcerns
Physicalgexam,gscreeninggtests,gandgimmunizationsgasgindicatedgbygtheghealthghistorygandggynecologicgconsidera
tionsgforgangexternal-onlyginspectiongofgtheggenitalia
CORRECTg Bothgbgandgc
• Agseventeen-year-
oldgpresentsgwithgangappointmentgforgunilateralgbreastgtendernessgandgswelling.gWhichg
ofgthegfollowinggwouldgbegthegmostglikelygetiologygforgthisgproblem?
, NR602gFinalgExam:gEssentialgQuestiongBankgwithgIn-
DepthgAnswersgandgLatestgUpdatesg2024
BreastgcancergMasti
tisgFibrocysticgbre
astgFibroadenom
a
• Yougaregcompletinggagpelvicgexamgongthirty-two-year-
oldgNancy.gYougdetectgagleftgadnexalgmassgongthegbimanualgexam.gWithgangadnexalgmass,gtheg
practitionergmustgalwaysgsuspectg
untilgprovengotherwise.
g
Pelvicginflammatorygdiseaseg(PID)
Malignancy
Pregnancy
PolycysticgovarygdiseasegX
• Majoritygofgurinarygtractginfectionsgdognotgrequiregconsultationgorgagreferralgtogagspecialistgan
dgaregroutinelygtreatedgingprimarygcaregpractices.gWhichgofgthegfollowinggscenariosgwouldgindic
ategthatgagconsultationgorgreferralgisgindicated?
Thegpresencegofgsecondarygsexuallygtransmittedgillnes
sgAgpatientgwithgtwogepisodesgoccurringgingonegy
ear
PatientsgthatgremaingsymptomaticgaftergthreegdaysgofgtreatmentgPati
entsgthatgshowgurineghumangchorionicggonadotroping(HCG)gpositive
• .gLong-
actinggprogestinsgmaygbegusedgingpatientsgasgagcontraceptivegmethod.gOnegofgtheglong-
gactinggprogestinsgisgDepo-
Provera.gWhichgofgthegfollowinggbestgdescribesgthegmechanismgofgactiongofglong-
actinggprogestinsgingcontraception?
DecreasegingcervicalgmucusgproductiongandgthinninggofgthegcirclegosgT
hickeninggofgcervicalgmucusgandgsuppressiongofggonadotropinglevelsg
IncreasedggonadotropinglevelsgandgthinninggofgthegcirclegosgAnovula
tiongcausedgbygincreasedggonadotropinglevels
