NURS 602 FINAL EXAM STUDY GUIDE WITH RATIONALES
1. A 16yearold sexually active female has a fever, bilateral lower abdominal pain, and
malaise. A speculum and bimanual exam reveals adnexal tenderness. The urinalysis is
normal and cervical cultures are pending. What medications will the primary care pediatric
nurse practitioner prescribe for this patient?
Answer PID : she is Sexually active Adnexal Tenderness and negative for UTI. Ceftriaxone,
doxycycline, and metronidazole
Rationale : This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg
BID for 14 days plus with or without Metronidazole 500 mg PO bid for 14 days.
2. 4. A sexually active adolescent female tests positive for N. gonorrhea and Chlamydia.
She tells the primary care pediatric nurse practitioner that she wants to be treated today
since she is moving out of town the next day. What will the nurse practitioner order? What
is the treatment for her
Answer Ceftriaxone 250 mg IM and azithromycin 1 g PO one time each
Rationale : Remember the G in Gonorrhea for or Ceftriaxone and Chlamydia you can give
either Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is moving
she are giving this combination.
, NURS 602 FINAL EXAM STUDY GUIDE WITH RATIONALES
3. A 14yearold female has menometrorrhagia with moderate increase in menstrual flow
and irregular periods. Her hemoglobin is 13.1 g/dL. How will this be managed?
Answer Iron supplementation and prostaglandin inhibitors
Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is 11.9
: 15. It is better to give Iron because of the bleeding and for pain relief Prostaglandins
such as Ibuprofen.
4. An adolescent female has heavy periods that are also irregular. The physical exam is
normal. A complete blood count reveals a hemoglobin of 8.9 g/dL.
What test will the primary care pediatric nurse practitioner order next?
Answer Coagulation studies
Rationale : The normal Hemoglobin range is 11.9: 13.1 and she is outside the range. We
need to look for reasons of this.
5. An adolescent female has periods every 30 days that are consistently heavy and last
from 5 to 8 days. What is her diagnosis?
Answer Menorrhagia
Rationale : The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8
days. She is consistent with when her periods start so it won't be menometrorrhagia
because that is irregular periods.
, NURS 602 FINAL EXAM STUDY GUIDE WITH RATIONALES
6. A 16yearold female has not had a menstrual period yet and is concerned. She denies
sexual activity. An exam reveals an adult sexual maturity rating. Which laboratory test will
the primary care pediatric nurse practitioner order initially?
Answer Pregnancy Test
Rationale : All people lie and the number one reason for Amenorrhea is pregnancy. After
I rule out that then I can look at other things such as nutrition, is she an athlete and is it
Primary Amenorrhea which is failure to have a period for 3 years or crest development or
by age 15. or Secondary Anemia which is no menstrual periods for 3 months or absent of
period for 6 months for those on irregular periods.
7. A 16yearold female reports breast tenderness and a "lump." The primary care
pediatric nurse practitioner palpates a small fluid filled mass in her right breast.
Answer Order an Ultra Sound of Breast
Rationale : First thing you always do is order an ultra sound first to determine reason.
Most girls this age do not have breast cancer.
, NURS 602 FINAL EXAM STUDY GUIDE WITH RATIONALES
8. A 15yearold n female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she isn't sure she
wants to keep the baby. What will the nurse practitioner do first?
Answer Determine the state mandated reporting laws.
Rationale : Each state has different laws on reporting to parents about STIs and
Pregnancy.
9. A 17yearold sexually active female who began having periods at age 14 reports
having moderate to severe dull lower abdominal pain associated predominantly with
periods but that occurs at other times as well. The history reveals a recent onset of these
symptoms. A pregnancy test is negative. Which course of action is most important?
Answer Perform a full diagnostic workup to evaluate potential causes.
Rationale : This is not normal and needs more workup to determine the reason for it. She
is sexually active so this raises more concerns for other things that might be going on
such as PID or an STI
1. A 16yearold sexually active female has a fever, bilateral lower abdominal pain, and
malaise. A speculum and bimanual exam reveals adnexal tenderness. The urinalysis is
normal and cervical cultures are pending. What medications will the primary care pediatric
nurse practitioner prescribe for this patient?
Answer PID : she is Sexually active Adnexal Tenderness and negative for UTI. Ceftriaxone,
doxycycline, and metronidazole
Rationale : This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg
BID for 14 days plus with or without Metronidazole 500 mg PO bid for 14 days.
2. 4. A sexually active adolescent female tests positive for N. gonorrhea and Chlamydia.
She tells the primary care pediatric nurse practitioner that she wants to be treated today
since she is moving out of town the next day. What will the nurse practitioner order? What
is the treatment for her
Answer Ceftriaxone 250 mg IM and azithromycin 1 g PO one time each
Rationale : Remember the G in Gonorrhea for or Ceftriaxone and Chlamydia you can give
either Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is moving
she are giving this combination.
, NURS 602 FINAL EXAM STUDY GUIDE WITH RATIONALES
3. A 14yearold female has menometrorrhagia with moderate increase in menstrual flow
and irregular periods. Her hemoglobin is 13.1 g/dL. How will this be managed?
Answer Iron supplementation and prostaglandin inhibitors
Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is 11.9
: 15. It is better to give Iron because of the bleeding and for pain relief Prostaglandins
such as Ibuprofen.
4. An adolescent female has heavy periods that are also irregular. The physical exam is
normal. A complete blood count reveals a hemoglobin of 8.9 g/dL.
What test will the primary care pediatric nurse practitioner order next?
Answer Coagulation studies
Rationale : The normal Hemoglobin range is 11.9: 13.1 and she is outside the range. We
need to look for reasons of this.
5. An adolescent female has periods every 30 days that are consistently heavy and last
from 5 to 8 days. What is her diagnosis?
Answer Menorrhagia
Rationale : The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8
days. She is consistent with when her periods start so it won't be menometrorrhagia
because that is irregular periods.
, NURS 602 FINAL EXAM STUDY GUIDE WITH RATIONALES
6. A 16yearold female has not had a menstrual period yet and is concerned. She denies
sexual activity. An exam reveals an adult sexual maturity rating. Which laboratory test will
the primary care pediatric nurse practitioner order initially?
Answer Pregnancy Test
Rationale : All people lie and the number one reason for Amenorrhea is pregnancy. After
I rule out that then I can look at other things such as nutrition, is she an athlete and is it
Primary Amenorrhea which is failure to have a period for 3 years or crest development or
by age 15. or Secondary Anemia which is no menstrual periods for 3 months or absent of
period for 6 months for those on irregular periods.
7. A 16yearold female reports breast tenderness and a "lump." The primary care
pediatric nurse practitioner palpates a small fluid filled mass in her right breast.
Answer Order an Ultra Sound of Breast
Rationale : First thing you always do is order an ultra sound first to determine reason.
Most girls this age do not have breast cancer.
, NURS 602 FINAL EXAM STUDY GUIDE WITH RATIONALES
8. A 15yearold n female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she isn't sure she
wants to keep the baby. What will the nurse practitioner do first?
Answer Determine the state mandated reporting laws.
Rationale : Each state has different laws on reporting to parents about STIs and
Pregnancy.
9. A 17yearold sexually active female who began having periods at age 14 reports
having moderate to severe dull lower abdominal pain associated predominantly with
periods but that occurs at other times as well. The history reveals a recent onset of these
symptoms. A pregnancy test is negative. Which course of action is most important?
Answer Perform a full diagnostic workup to evaluate potential causes.
Rationale : This is not normal and needs more workup to determine the reason for it. She
is sexually active so this raises more concerns for other things that might be going on
such as PID or an STI
