Actual Exam Questions and Correct Answers
A woman with a positive pregnancy test presents with abdominal pain. On examination, the NP
palpates a large, fixed, ill-defined adnexal mass. Which should you suspect?
A) Ectopic pregnancy
B) Ovarian cyst
C) Uterine fibroid
D) Endometrioma
Correct Answer: A) Ectopic pregnancy
Explanation: A positive pregnancy test with abdominal pain and a large, fixed, ill-defined
adnexal mass strongly suggests an ectopic pregnancy, a medical emergency. Ovarian cysts or
endometriomas are less likely in early pregnancy, and fibroids are typically uterine and well-
defined.
A 28-year-old musician presents with a 6-mm red, oval, nontender ulcer with an indurated base
on his penis, noticed 2 days ago, with non-tender inguinal lymphadenopathy. He has multiple
partners, inconsistent condom use, and a history of chlamydia and prostatitis. What is the most
likely diagnosis?
A) Genital herpes
B) Primary syphilis
C) Chancroid
D) Penile carcinoma
Correct Answer: B) Primary syphilis
Explanation: A painless, indurated ulcer (chancre) with non-tender lymphadenopathy is
characteristic of primary syphilis. Genital herpes causes painful vesicles, chancroid causes
painful ulcers with tender nodes, and penile carcinoma is rare and typically irregular.
Which of the following is true regarding breast self-examination?
A) It is recommended monthly for all women starting at age 18
B) It is no longer routinely recommended by major guidelines
, C) It guarantees early detection of breast cancer
D) It should only be performed by trained healthcare providers
Correct Answer: B) It is no longer routinely recommended by major guidelines
Explanation: Major guidelines (e.g., USPSTF, ACS) no longer routinely recommend breast self-
examination due to limited evidence of benefit and potential for false positives. It is not
guaranteed to detect cancer early, nor is it restricted to providers.
Which is the most effective pattern for palpating the lateral portion of the breast?
A) Circular motion starting at the nipple
B) Vertical strip pattern from axilla to bra line
C) Random palpation across the breast
D) Wedge-shaped pattern from periphery to nipple
Correct Answer: B) Vertical strip pattern from axilla to bra line
Explanation: The vertical strip pattern, covering the breast from axilla to bra line, ensures
thorough palpation of all breast tissue, including the lateral portion and tail of Spence. Other
patterns may miss areas.
A 14-year-old male presents with severe testicular pain for 2 hours. The NP suspects testicular
torsion. Which is an expected positive examination finding?
A) Positive Prehn’s sign
B) Absent cremasteric reflex
C) Normal testicular lie
D) Tender epididymis
Correct Answer: B) Absent cremasteric reflex
Explanation: Testicular torsion typically presents with an absent cremasteric reflex, severe pain,
and high-riding testis. Prehn’s sign is positive in epididymitis, testicular lie is abnormal in
torsion, and epididymal tenderness suggests epididymitis.
A 48-year-old woman presents with 1 week of heavy, itchy vaginal discharge after antibiotics for
a sinus infection. She is not sexually active, has type 2 diabetes, and hypertension. Exam shows
thick, white, curdy discharge, pH 4.1, negative KOH whiff test, and budding hyphae on wet prep.
What vaginitis is most likely?