Final Exam: NRNP 6531 / NRNP6531 Advanced Primary
Care of Adults | Highly Rated Questions and Answers with |
2023/ 2024 Update
If cervical stenosis is met when performing IUD insertions, which of the following should be
used to overcome resistance?
12 - 15 cm
3 - 6 cm
9 - 12 cm
6 - 9 cm
Answer: 6 - 9 cm
A 45 year old diabetic female presents with c/o vaginal itching and discharge that began after
douching post-menstruation approximately one week ago. Upon exam, you find thick, white
discharge with a curd-like consistency and erythema generally in the vuvlvogavinal region.
Under a wet mount you see the following below (budding, branching hyphae). Which of the
following is an appropriate treatment for this patient?
No treatment needed
Rocephin (Ceftriaxone) 250mg IM x 1 and Azithromycin 1 g PO x 1
Diflucan (Fluconazole) 150mg PO x 1
Flagyl (Metronidazole) 500mg PO BID x 7 days
Answer: Diflucan (Fluconazole) 150mg PO x 1
What is included in your treatment plan for #4?
Flagyl (Metronidazole) 2g PO x 1 of patient only and no report to the county
Rocephin (Ceftriaxone) 250mg IM with partner treatment and report to the county
Flagyl (Metronidazole) 2g PO x 1 with partner treatment and report to the county
Rocephin (Ceftriaxone) 250mg IM of patient only and no report to the county
, Answer: Flagyl (Metronidazole) 2g PO x 1 with partner treatment and report to
the county
Syphilis may present as:
Discharge
Painful lesions
Dysuria
A rash
Answer: A rash
Secondary syphilis can present as a rash, more commonly on the
palms of the hands or soles of the feet. Lesions are usually painless. It usually does not produce
significant dysuria or discharge.
A 19-year-old student who is on prescription combined oral contraceptive pills is being seen for
lower GI pain. The nurse practitioner has obtained a Pap smear and is about to perform the
bimanual exam. She gently remove the plastic speculum from the vagina. While the NP is
performing the bimanual vaginal exam, the patient complaints of slight discomfort during
palpation of the ovaries. Which with the following is a true statement?
The fallopian tubes and ovaries are not sensitive to light or deep palpation
The ovaries are sensitive to deep palpation but they should not be painful.
The uterus and ovaries are not important organs of reproduction
The uterus and ovaries are both sensitive to any Palpation
Answer: The ovaries are sensitive to deep palpation but they should not be
painful.
Unilateral adnexal pain accompanied by cervical motion tenderness and purulent endocervical
discharge suggestive of PID
When seen on a wet mount like the following, clue cells would indicate the treatment by which
of the following?
Flagyl (Metronidazole) 500mg PO BID x 7 days
Diflucan (Fluconazole) 150mg PO x 1
,Rocephin (Ceftriaxone) 250mg IM x 1 and Azithromycin 1 g PO x 1
No treatment needed
Answer: Flagyl (Metronidazole) 500mg PO BID x 7 days
A 54-year-old female presents with small to moderate amount of vaginal bleeding of recent
onset. She has been postmenopausal for approximately 2 years. With diagnosis is least likely?
Endometrial carcinoma
Ovarian cancer
Endometrial hyperplasia
Uterine polyps
Answer: Ovarian cancer
Ovarian cancer may present as an adnexal mass, pelvic or abdominal symptoms and a variety of
others. Postmenopausal bleeding is an uncommon presentation of ovarian cancer, but can present
this way. Other pathologies are usually evaluated before considering ovarian pathology.
Clue cells are found in patients who have:
Pneumonia
Leukemia
Epidermal fungal infections
Bacterial vaginosis
Answer: Bacterial vaginosis
Clue cells are hallmark sign of bacterial vaginosis and can be seen in a microscopic exam.
A 40 year old female patient returns to your clinic to review her pap smear results from the
previous week. You tell her the test is abnormal with "atypical squamous cells of undetermined
significance and HPV positive". What is the
appropriate next step of the following?
Repeat cytology immediately
Repeat cytology in 1 year
, Perform or refer out for colposcopy
Repeat cytology in 2-4 months
Answer: Perform or refer out for colposcopy
A 65 year old female presents with c/o vaginal soreness and dysuria that has been intermittent for
several years. She notes the pain is worse after intercourse with her husband of 30 years, with
whom is in an monogamous relationship. She denies vaginal discharge and has not had a pap
smear since her total hysterectomy ten years ago. She currently only takes a multivitamin. Your
wet mount reveals few lactobacilli and increased parabasal cells. What is your likely diagnosis?
Trichomonas vaginalis
Vaginal candidiasis
Atrophic vulvovaginitis
Bacterial Vaginosis
Answer: Atrophic vulvovaginitis
An initial pharmacological approach to the patient was diagnosed with primary dysmenorrhea
could be:
NSAIDs prior to the onset of menses
NSAIDs at the time symptoms begin or onset of menses
Combination of acetaminophen and NSAIDs
Acetaminophen
Answer: NSAIDs at the time symptoms begin or onset of menses
Pain associated with dysmenorrhea is likely due to prostaglandins. NSAIDs are prostaglandin
synthesis inhibitors. They are usually started at the onset of menses or onset of symptoms and
continued for 2-3 days depending on symptom pattern. There is no demonstrated increase in
efficacy when acetaminophen is added or given alone.
A 26-year-old female patient has been diagnosed with gonorrhea. However should she be
managed?
Ceftriaxone and azithromycin
Care of Adults | Highly Rated Questions and Answers with |
2023/ 2024 Update
If cervical stenosis is met when performing IUD insertions, which of the following should be
used to overcome resistance?
12 - 15 cm
3 - 6 cm
9 - 12 cm
6 - 9 cm
Answer: 6 - 9 cm
A 45 year old diabetic female presents with c/o vaginal itching and discharge that began after
douching post-menstruation approximately one week ago. Upon exam, you find thick, white
discharge with a curd-like consistency and erythema generally in the vuvlvogavinal region.
Under a wet mount you see the following below (budding, branching hyphae). Which of the
following is an appropriate treatment for this patient?
No treatment needed
Rocephin (Ceftriaxone) 250mg IM x 1 and Azithromycin 1 g PO x 1
Diflucan (Fluconazole) 150mg PO x 1
Flagyl (Metronidazole) 500mg PO BID x 7 days
Answer: Diflucan (Fluconazole) 150mg PO x 1
What is included in your treatment plan for #4?
Flagyl (Metronidazole) 2g PO x 1 of patient only and no report to the county
Rocephin (Ceftriaxone) 250mg IM with partner treatment and report to the county
Flagyl (Metronidazole) 2g PO x 1 with partner treatment and report to the county
Rocephin (Ceftriaxone) 250mg IM of patient only and no report to the county
, Answer: Flagyl (Metronidazole) 2g PO x 1 with partner treatment and report to
the county
Syphilis may present as:
Discharge
Painful lesions
Dysuria
A rash
Answer: A rash
Secondary syphilis can present as a rash, more commonly on the
palms of the hands or soles of the feet. Lesions are usually painless. It usually does not produce
significant dysuria or discharge.
A 19-year-old student who is on prescription combined oral contraceptive pills is being seen for
lower GI pain. The nurse practitioner has obtained a Pap smear and is about to perform the
bimanual exam. She gently remove the plastic speculum from the vagina. While the NP is
performing the bimanual vaginal exam, the patient complaints of slight discomfort during
palpation of the ovaries. Which with the following is a true statement?
The fallopian tubes and ovaries are not sensitive to light or deep palpation
The ovaries are sensitive to deep palpation but they should not be painful.
The uterus and ovaries are not important organs of reproduction
The uterus and ovaries are both sensitive to any Palpation
Answer: The ovaries are sensitive to deep palpation but they should not be
painful.
Unilateral adnexal pain accompanied by cervical motion tenderness and purulent endocervical
discharge suggestive of PID
When seen on a wet mount like the following, clue cells would indicate the treatment by which
of the following?
Flagyl (Metronidazole) 500mg PO BID x 7 days
Diflucan (Fluconazole) 150mg PO x 1
,Rocephin (Ceftriaxone) 250mg IM x 1 and Azithromycin 1 g PO x 1
No treatment needed
Answer: Flagyl (Metronidazole) 500mg PO BID x 7 days
A 54-year-old female presents with small to moderate amount of vaginal bleeding of recent
onset. She has been postmenopausal for approximately 2 years. With diagnosis is least likely?
Endometrial carcinoma
Ovarian cancer
Endometrial hyperplasia
Uterine polyps
Answer: Ovarian cancer
Ovarian cancer may present as an adnexal mass, pelvic or abdominal symptoms and a variety of
others. Postmenopausal bleeding is an uncommon presentation of ovarian cancer, but can present
this way. Other pathologies are usually evaluated before considering ovarian pathology.
Clue cells are found in patients who have:
Pneumonia
Leukemia
Epidermal fungal infections
Bacterial vaginosis
Answer: Bacterial vaginosis
Clue cells are hallmark sign of bacterial vaginosis and can be seen in a microscopic exam.
A 40 year old female patient returns to your clinic to review her pap smear results from the
previous week. You tell her the test is abnormal with "atypical squamous cells of undetermined
significance and HPV positive". What is the
appropriate next step of the following?
Repeat cytology immediately
Repeat cytology in 1 year
, Perform or refer out for colposcopy
Repeat cytology in 2-4 months
Answer: Perform or refer out for colposcopy
A 65 year old female presents with c/o vaginal soreness and dysuria that has been intermittent for
several years. She notes the pain is worse after intercourse with her husband of 30 years, with
whom is in an monogamous relationship. She denies vaginal discharge and has not had a pap
smear since her total hysterectomy ten years ago. She currently only takes a multivitamin. Your
wet mount reveals few lactobacilli and increased parabasal cells. What is your likely diagnosis?
Trichomonas vaginalis
Vaginal candidiasis
Atrophic vulvovaginitis
Bacterial Vaginosis
Answer: Atrophic vulvovaginitis
An initial pharmacological approach to the patient was diagnosed with primary dysmenorrhea
could be:
NSAIDs prior to the onset of menses
NSAIDs at the time symptoms begin or onset of menses
Combination of acetaminophen and NSAIDs
Acetaminophen
Answer: NSAIDs at the time symptoms begin or onset of menses
Pain associated with dysmenorrhea is likely due to prostaglandins. NSAIDs are prostaglandin
synthesis inhibitors. They are usually started at the onset of menses or onset of symptoms and
continued for 2-3 days depending on symptom pattern. There is no demonstrated increase in
efficacy when acetaminophen is added or given alone.
A 26-year-old female patient has been diagnosed with gonorrhea. However should she be
managed?
Ceftriaxone and azithromycin
