APEA 3P Exam Prep- Women's
Health Questions with Correct
Answers and Explanations
Three .of .the .following .interventions .are .appropriately .used .to .prevent .osteoporosis .after
.menopause. .Which .one .is .NOT?
Avoidance .of .corticosteroids
Performance .of .weight-bearing .activities .for .40 .mins .at .least .5 .days/week .Estrogen
.replacement .therapy
Adequate .calcium .& .vitamin .D .intake .C.
Prevention .of .osteoporosis .may .be .optimized .by .elimination .of .risk .factors .and .engaging
.in .interventions .that .maximize .bone .density. .Good .nutrition .from .infancy .throughout
.adulthood .is .a .major .component .of .good .bone .health. .Others .include .engaging .in .weight-
bearing .exercises, .adequate .intake .of .calcium .and .vitamin .D, .smoking .cessation, .limiting
.alcohol .consumption .to .moderate .amounts, .and .avoidance .when .possible .of .medications
.that .may .decrease .bone .density .(corticosteroids, .anticonvulsants). .Osteoporosis .occurs .at
.accelerated .rates .in .women .who .are .post-menopausal. .The .lack .of .estrogen .can .produce
.rapid .bone .loss .due .to .bone .resorption. .Estrogen .replacement .is .not .used .to .prevent .or
.treat .osteoporosis.
A .patient .who .is .scheduled .for .pelvic .exam .with .PAP .smear .should .be .advised .to .avoid
.douching, .sexual .intercourse, .and .tampon .use .before .her .exam. .For .how .long .should .she
.be .advised .to .avoid .these .activities .for .optimal .evaluation?
24 .hours
48 .hours
36 .hours
1 .week
.B.
,The .general .recommendation .is .to .avoid .these .activities .and .any .vaginal .medication .for
.48 .hours .prior .to .the .PAP .smear. .Douching .and .tampon .use .can .remove .superficial .cells,
.which .are .the .ones .collected .and .used .as .representative .samples .on .PAP .smear. .Sexual
.intercourse .should .be .avoided .because .there .can .be .specimen .contamination .by .the
.male .partner. .With .vaginal .medications .or .creams, .either .can .serve .as .a .barrier .to
.epithelial .cell .sampling.
When .collecting .cervical .cells .for .a .PAP .smear, .when .are .the .endocervical .cells .typically
.collected?
After .the .ectocervical .specimen .with .a .broom .After
.the .ectocervical .specimen .with .a .brush .Before
.the .ectocervical .specimen .with .a .broom .Before
.the .ectocervical .specimen .with .a .brush .B.
Ectocervical .specimens .are .collected .first .to .minimize .any .bleeding .that .can .occur .when
.the .endocervical .cells .are .sampled. .The .brush .is .considered .a .superior .tool .for .the
.collection .of .endocervical .specimens .because .it .produces .the .highest .yield .of .endocervical
.cells, .and .thus, .is .a .good .reflection .of .the .health .of .the .cervix.
Alternatively, .a .cervical .broom .can .be .used .to .collect .endocervical .cells .and .ectocervical
.cells .simultaneously. .It .is .rotated .for .5 .turns .before .the .samples .are .placed .on .the .slide.
.This .may .be .used .in .pregnant .women.
A .16-year-old .female .is .diagnosed .with .primary .dysmenorrhea. .She .has .taken .over- .the-
.counter .ibuprofen .in .800-mg .increments .every .8 .hours .during .menses .for .the .past .3
.months, .with .minimal .relief .of .symptoms. .What .intervention .will .provide .greatest .relief
.of .dysmenorrhea .symptoms?
Flurbiprofen .during .menses
.Combined .oral .contraceptives
Daily .multivitamin .with .B12 .supplementation .30
.minutes .of .regular .exercise .daily
B.
NSAIDs .and .hormonal .contraceptives .represent .the .mainstay .of .pharmacologic .treatment
.for .dysmenorrhea. .NSAIDs .produce .an .80-86% .response .rate .when .used .for
.dysmenorrhea. .The .general .recommendation .is .that .when .one .agent .(NSAIDs .or
.hormonal .contraceptives) .does .not .produce .relief .of .symptoms, .the .other .agent
, should .be .tried. .Hence, .the .best .choice .is .oral .contraceptives. .Both .agents .should .be
.considered .for .women .who .are .symptomatic .with .one .agent .only.
A .22-year-old .female .states .that .she .has .multiple .sexual .partners .and .inconsistently .uses
.barrier .protection. .Which .form .of .birth .control .should .the .nurse .practitioner .avoid
.prescribing .in .this .patient?
Intrauterine .device
.Progestin-only .pill
.Diaphragm
Oral .contraceptives
.A.
Multiple .sexual .partners .place .the .patient .at .increased .risk .for .infection .with .sexually
.transmitted .diseases. .The .patient .is .at .very .high .risk .of .developing .pelvic .inflammatory
.disease .(PID) .when .there .is .an .implanted .foreign .body. .An .example .of .this .is .an
.intrauterine .device .(IUD). .The .risk .is .also .increased .with .a .diaphragm, .but, .because .it .is
.not .implanted .for .long .periods .at .a .time, .the .risk .of .PID .is .less .than .with .an .IUD.
The .first .step .in .evaluating .a .breast .lump .is:
history .and .physical .exam.
.mammogram.
ultrasound. .Incorrect
.MRI.
A.
Although .most .patients .will .need .further .work-up .of .a .breast .mass, .historical .information
.is .critically .important .in .directing .the .health .care .provider .to .the .next .step. .Historical
.information .that .should .be .ascertained .is .the .location .of .the .lump, .how .and .when .it .was
.first .noticed, .whether .there .is .nipple .discharge, .and .whether .it .changes .in .size .related .to
.menses. .Other .historical .information .is .the .patient’s .personal .and .family .history .of .breast
.cancer .and/or .history .of .breast .biopsies.
A .patient .who .takes .oral .contraceptive .pills .is .at .increased .risk .of:
.gallbladder .disease.
depression.
Health Questions with Correct
Answers and Explanations
Three .of .the .following .interventions .are .appropriately .used .to .prevent .osteoporosis .after
.menopause. .Which .one .is .NOT?
Avoidance .of .corticosteroids
Performance .of .weight-bearing .activities .for .40 .mins .at .least .5 .days/week .Estrogen
.replacement .therapy
Adequate .calcium .& .vitamin .D .intake .C.
Prevention .of .osteoporosis .may .be .optimized .by .elimination .of .risk .factors .and .engaging
.in .interventions .that .maximize .bone .density. .Good .nutrition .from .infancy .throughout
.adulthood .is .a .major .component .of .good .bone .health. .Others .include .engaging .in .weight-
bearing .exercises, .adequate .intake .of .calcium .and .vitamin .D, .smoking .cessation, .limiting
.alcohol .consumption .to .moderate .amounts, .and .avoidance .when .possible .of .medications
.that .may .decrease .bone .density .(corticosteroids, .anticonvulsants). .Osteoporosis .occurs .at
.accelerated .rates .in .women .who .are .post-menopausal. .The .lack .of .estrogen .can .produce
.rapid .bone .loss .due .to .bone .resorption. .Estrogen .replacement .is .not .used .to .prevent .or
.treat .osteoporosis.
A .patient .who .is .scheduled .for .pelvic .exam .with .PAP .smear .should .be .advised .to .avoid
.douching, .sexual .intercourse, .and .tampon .use .before .her .exam. .For .how .long .should .she
.be .advised .to .avoid .these .activities .for .optimal .evaluation?
24 .hours
48 .hours
36 .hours
1 .week
.B.
,The .general .recommendation .is .to .avoid .these .activities .and .any .vaginal .medication .for
.48 .hours .prior .to .the .PAP .smear. .Douching .and .tampon .use .can .remove .superficial .cells,
.which .are .the .ones .collected .and .used .as .representative .samples .on .PAP .smear. .Sexual
.intercourse .should .be .avoided .because .there .can .be .specimen .contamination .by .the
.male .partner. .With .vaginal .medications .or .creams, .either .can .serve .as .a .barrier .to
.epithelial .cell .sampling.
When .collecting .cervical .cells .for .a .PAP .smear, .when .are .the .endocervical .cells .typically
.collected?
After .the .ectocervical .specimen .with .a .broom .After
.the .ectocervical .specimen .with .a .brush .Before
.the .ectocervical .specimen .with .a .broom .Before
.the .ectocervical .specimen .with .a .brush .B.
Ectocervical .specimens .are .collected .first .to .minimize .any .bleeding .that .can .occur .when
.the .endocervical .cells .are .sampled. .The .brush .is .considered .a .superior .tool .for .the
.collection .of .endocervical .specimens .because .it .produces .the .highest .yield .of .endocervical
.cells, .and .thus, .is .a .good .reflection .of .the .health .of .the .cervix.
Alternatively, .a .cervical .broom .can .be .used .to .collect .endocervical .cells .and .ectocervical
.cells .simultaneously. .It .is .rotated .for .5 .turns .before .the .samples .are .placed .on .the .slide.
.This .may .be .used .in .pregnant .women.
A .16-year-old .female .is .diagnosed .with .primary .dysmenorrhea. .She .has .taken .over- .the-
.counter .ibuprofen .in .800-mg .increments .every .8 .hours .during .menses .for .the .past .3
.months, .with .minimal .relief .of .symptoms. .What .intervention .will .provide .greatest .relief
.of .dysmenorrhea .symptoms?
Flurbiprofen .during .menses
.Combined .oral .contraceptives
Daily .multivitamin .with .B12 .supplementation .30
.minutes .of .regular .exercise .daily
B.
NSAIDs .and .hormonal .contraceptives .represent .the .mainstay .of .pharmacologic .treatment
.for .dysmenorrhea. .NSAIDs .produce .an .80-86% .response .rate .when .used .for
.dysmenorrhea. .The .general .recommendation .is .that .when .one .agent .(NSAIDs .or
.hormonal .contraceptives) .does .not .produce .relief .of .symptoms, .the .other .agent
, should .be .tried. .Hence, .the .best .choice .is .oral .contraceptives. .Both .agents .should .be
.considered .for .women .who .are .symptomatic .with .one .agent .only.
A .22-year-old .female .states .that .she .has .multiple .sexual .partners .and .inconsistently .uses
.barrier .protection. .Which .form .of .birth .control .should .the .nurse .practitioner .avoid
.prescribing .in .this .patient?
Intrauterine .device
.Progestin-only .pill
.Diaphragm
Oral .contraceptives
.A.
Multiple .sexual .partners .place .the .patient .at .increased .risk .for .infection .with .sexually
.transmitted .diseases. .The .patient .is .at .very .high .risk .of .developing .pelvic .inflammatory
.disease .(PID) .when .there .is .an .implanted .foreign .body. .An .example .of .this .is .an
.intrauterine .device .(IUD). .The .risk .is .also .increased .with .a .diaphragm, .but, .because .it .is
.not .implanted .for .long .periods .at .a .time, .the .risk .of .PID .is .less .than .with .an .IUD.
The .first .step .in .evaluating .a .breast .lump .is:
history .and .physical .exam.
.mammogram.
ultrasound. .Incorrect
.MRI.
A.
Although .most .patients .will .need .further .work-up .of .a .breast .mass, .historical .information
.is .critically .important .in .directing .the .health .care .provider .to .the .next .step. .Historical
.information .that .should .be .ascertained .is .the .location .of .the .lump, .how .and .when .it .was
.first .noticed, .whether .there .is .nipple .discharge, .and .whether .it .changes .in .size .related .to
.menses. .Other .historical .information .is .the .patient’s .personal .and .family .history .of .breast
.cancer .and/or .history .of .breast .biopsies.
A .patient .who .takes .oral .contraceptive .pills .is .at .increased .risk .of:
.gallbladder .disease.
depression.
