Page 1 of 119
“NR509 FINAL EXAM CHAMBERLAIN “ NEWEST
UPDATED EXAM 2025 – 2026 SOLVED QUESTIONS &
ANSWERS VERIFIED 100% GRADED A+ (LATEST
VERSION)
NR509 Final Exam Chamberlain
A 32-year-old G0 woman comes for evaluation on why she and her husband
have been unable to get pregnant. Her husband has been married before and
has two other children, ages 7 and 4 years. The patient relates she began her
periods at age 12 and has been fairly regular ever since. She began oral
contraceptive pills from when she got married until last year, when she began
to try for a pregnancy. Before this she had regular cycles for 10 years. She has
had a history of five prior partners. She relates she was once treated for a
severe genital infection when she was in college. Based on this patient's
history, what is the best explanation for her infertility?
a. Prior pelvic inflammatory disease (PID)
b. Prior Bartholin gland infection
c. Prior herpes infection
d. Metabolic disorder with subsequent hormonal irregularities leading to
anovulation
e. Secondary amenorrhea
a. Prior pelvic inflammatory disease (PID)
Rationale: PID is a genital infection caused by gonorrhea, chlamydia, and other
organisms. If not treated early enough it can lead to tubal pregnancies or infertility.
, Page 2 of 119
A 24-year-old retail clerk presents to the clinic for an annual exam. Her last
Pap was 3 years ago and was normal. She is a G0 and is currently not sexually
active although she has had two lifetime partners. She is on oral contraceptive
pills for cycle control and has no medical problems. Based on guidelines, the
clinician proceeds to perform a Pap smear and places the speculum. There are
two layers of cells, squamous and columnar. Where is the most important area
to obtain cells for a Pap smear?
a. Zona reticularis
b. Transformation zone
c. Squamous zone
d. Columnar zone
e. Linea nigra
b. Transformation zone
Rationale: The transformation zone is where cancerous cells are most likely to
develop and is thus the most important area to sample in a Pap test.
A 35-year-old grade school teacher presents for her annual exam. Her last Pap
smear was 4 years ago and normal. She is a G1P1 with a 6-year-old child. She
has had four lifetime partners but only one partner in the last 12 years.
Otherwise she has no complaints. A speculum exam is done followed by a
bimanual examination during which a rectovaginal mass is palpated. Which of
the following exam findings would be most reassuring that this is not a colonic
mass?
a. No cervical motion tenderness
b. No pus from the os
c. The mass dents with digital pressure
d. Both adnexa are nontender
e. The perineum has no lesions
c. The mass dents with digital pressure
Rationale: Stool in the rectum simulates a rectovaginal mass. Unlike a malignant
mass it is dented by digital pressure reassuring the examiner. A rectovaginal exam
will confirm the distinction. No cervical motion tenderness is incorrect. This reassures
, Page 3 of 119
the examiner that there is no pelvic inflammatory disease (PID), ectopic pregnancy,
or appendicitis.
A 21-year-old college student presents for her first annual exam. She has been
sexually active for 1 year and has had two partners. She is not aware of having
had any sexually transmitted diseases (STIs). She is using condoms for birth
control and STI prevention but admits to not always using them regularly. Her
last menses was 2 weeks ago. On speculum exam, an unusual appearance is
noted, which is diagnosed as warts. What is the best description for these
lesions?
a. Several shallow ulcers with a red base
b. Translucent nodules
c. Raised friable or lobed lesions
d. Bright red, soft lesion arising from the cervical canal
e. Strawberry cervix (small red granular spots or petechiae)
c. Raised friable or lobed lesions
Rationale: Warts or condylomata are raised lesions that are often lobed in
appearance. With addition of acetic acid, they will often turn white
A 23-year-old female comes to the clinic to discuss her birth control options.
Although she has been sexually active since age 16 years, she has been with
one partner for the last year. She has decided to discontinue condoms and
would like a different birth control option. She has not had a pelvic exam for 2
years. She had a normal Pap smear that year and negative sexually
transmitted infection (STI) testing. Her last menstrual period was 2 days ago.
She states that she is still spotting. She also states that she last had sex with
her boyfriend 1 week ago, so the clinician elects to postpone her speculum
exam. What is the best explanation for the decision to postpone her exam?
a. She is on her menses.
b. She has only one current partner and does not need STI testing.
c. She had a normal Pap smear within the last 3 years.
d. She should not be sexually active.
e. She has been using condoms.
a. She is on her menses.
Rationale: For best results with either a Pap smear or STI testing it is best to not
, Page 4 of 119
have the patient menstruating. On conventional Pap smears, blood masks the
cytology. For STI testing, the vaginal sample results are not always valid. Some
practices do use urine STI testing but this is not yet universally available.
An 18-year-old high school senior presents to the clinic complaining of a
vaginal discharge. She states that it is thick and yellow and that she has had
some recent pelvic pain. She is sexually active and is not using any type of
birth control or sexually transmitted infection (STI) prevention. She denies any
burning with urination, nausea, vomiting, or diarrhea. She has had some fever
and chills with a temperature up to 101.5ºF. Her last menstrual period was last
week. After a physical exam, she is diagnosed with pelvic inflammatory
disease (PID). Visualization of purulent discharge in which of the following
areas would best support a diagnosis of PID?
a. Cervical os
b. Posterior fornix
c. Anterior fornix
d. Skene gland opening
e. Bartholin gland opening
a. Cervical os
Rationale: An infection in the uterus, tubes, and ovaries would drain through the
cervix and out of the os
A 27-year-old G0 bus driver presents to the clinic complaining of an itchy
vaginal discharge for the last week. She reached menarche at age 12 years,
became sexually active at age 18 years, and has had a total of five sexual
partners. She has been with her current partner for 1 month. She is on oral
contraceptive pills and does not use condoms as she is allergic to latex. Her
last menstrual period was 3 weeks ago. She is not having any pelvic pain,
fever, nausea, or vomiting. Her vitals are normal with a body mass index of 22.
The clinician places the metal medium Graves speculum in the vagina but
cannot find the cervix. What is the best next maneuver to visualize the cervix?
a. Replace the speculum with a larger one (large Graves).
b. Withdraw the speculum and do a bimanual exam to find the cervix.
c. Withdraw the speculum slightly and reposition it on a different slope.
d. Replace the speculum with a plastic one wi
“NR509 FINAL EXAM CHAMBERLAIN “ NEWEST
UPDATED EXAM 2025 – 2026 SOLVED QUESTIONS &
ANSWERS VERIFIED 100% GRADED A+ (LATEST
VERSION)
NR509 Final Exam Chamberlain
A 32-year-old G0 woman comes for evaluation on why she and her husband
have been unable to get pregnant. Her husband has been married before and
has two other children, ages 7 and 4 years. The patient relates she began her
periods at age 12 and has been fairly regular ever since. She began oral
contraceptive pills from when she got married until last year, when she began
to try for a pregnancy. Before this she had regular cycles for 10 years. She has
had a history of five prior partners. She relates she was once treated for a
severe genital infection when she was in college. Based on this patient's
history, what is the best explanation for her infertility?
a. Prior pelvic inflammatory disease (PID)
b. Prior Bartholin gland infection
c. Prior herpes infection
d. Metabolic disorder with subsequent hormonal irregularities leading to
anovulation
e. Secondary amenorrhea
a. Prior pelvic inflammatory disease (PID)
Rationale: PID is a genital infection caused by gonorrhea, chlamydia, and other
organisms. If not treated early enough it can lead to tubal pregnancies or infertility.
, Page 2 of 119
A 24-year-old retail clerk presents to the clinic for an annual exam. Her last
Pap was 3 years ago and was normal. She is a G0 and is currently not sexually
active although she has had two lifetime partners. She is on oral contraceptive
pills for cycle control and has no medical problems. Based on guidelines, the
clinician proceeds to perform a Pap smear and places the speculum. There are
two layers of cells, squamous and columnar. Where is the most important area
to obtain cells for a Pap smear?
a. Zona reticularis
b. Transformation zone
c. Squamous zone
d. Columnar zone
e. Linea nigra
b. Transformation zone
Rationale: The transformation zone is where cancerous cells are most likely to
develop and is thus the most important area to sample in a Pap test.
A 35-year-old grade school teacher presents for her annual exam. Her last Pap
smear was 4 years ago and normal. She is a G1P1 with a 6-year-old child. She
has had four lifetime partners but only one partner in the last 12 years.
Otherwise she has no complaints. A speculum exam is done followed by a
bimanual examination during which a rectovaginal mass is palpated. Which of
the following exam findings would be most reassuring that this is not a colonic
mass?
a. No cervical motion tenderness
b. No pus from the os
c. The mass dents with digital pressure
d. Both adnexa are nontender
e. The perineum has no lesions
c. The mass dents with digital pressure
Rationale: Stool in the rectum simulates a rectovaginal mass. Unlike a malignant
mass it is dented by digital pressure reassuring the examiner. A rectovaginal exam
will confirm the distinction. No cervical motion tenderness is incorrect. This reassures
, Page 3 of 119
the examiner that there is no pelvic inflammatory disease (PID), ectopic pregnancy,
or appendicitis.
A 21-year-old college student presents for her first annual exam. She has been
sexually active for 1 year and has had two partners. She is not aware of having
had any sexually transmitted diseases (STIs). She is using condoms for birth
control and STI prevention but admits to not always using them regularly. Her
last menses was 2 weeks ago. On speculum exam, an unusual appearance is
noted, which is diagnosed as warts. What is the best description for these
lesions?
a. Several shallow ulcers with a red base
b. Translucent nodules
c. Raised friable or lobed lesions
d. Bright red, soft lesion arising from the cervical canal
e. Strawberry cervix (small red granular spots or petechiae)
c. Raised friable or lobed lesions
Rationale: Warts or condylomata are raised lesions that are often lobed in
appearance. With addition of acetic acid, they will often turn white
A 23-year-old female comes to the clinic to discuss her birth control options.
Although she has been sexually active since age 16 years, she has been with
one partner for the last year. She has decided to discontinue condoms and
would like a different birth control option. She has not had a pelvic exam for 2
years. She had a normal Pap smear that year and negative sexually
transmitted infection (STI) testing. Her last menstrual period was 2 days ago.
She states that she is still spotting. She also states that she last had sex with
her boyfriend 1 week ago, so the clinician elects to postpone her speculum
exam. What is the best explanation for the decision to postpone her exam?
a. She is on her menses.
b. She has only one current partner and does not need STI testing.
c. She had a normal Pap smear within the last 3 years.
d. She should not be sexually active.
e. She has been using condoms.
a. She is on her menses.
Rationale: For best results with either a Pap smear or STI testing it is best to not
, Page 4 of 119
have the patient menstruating. On conventional Pap smears, blood masks the
cytology. For STI testing, the vaginal sample results are not always valid. Some
practices do use urine STI testing but this is not yet universally available.
An 18-year-old high school senior presents to the clinic complaining of a
vaginal discharge. She states that it is thick and yellow and that she has had
some recent pelvic pain. She is sexually active and is not using any type of
birth control or sexually transmitted infection (STI) prevention. She denies any
burning with urination, nausea, vomiting, or diarrhea. She has had some fever
and chills with a temperature up to 101.5ºF. Her last menstrual period was last
week. After a physical exam, she is diagnosed with pelvic inflammatory
disease (PID). Visualization of purulent discharge in which of the following
areas would best support a diagnosis of PID?
a. Cervical os
b. Posterior fornix
c. Anterior fornix
d. Skene gland opening
e. Bartholin gland opening
a. Cervical os
Rationale: An infection in the uterus, tubes, and ovaries would drain through the
cervix and out of the os
A 27-year-old G0 bus driver presents to the clinic complaining of an itchy
vaginal discharge for the last week. She reached menarche at age 12 years,
became sexually active at age 18 years, and has had a total of five sexual
partners. She has been with her current partner for 1 month. She is on oral
contraceptive pills and does not use condoms as she is allergic to latex. Her
last menstrual period was 3 weeks ago. She is not having any pelvic pain,
fever, nausea, or vomiting. Her vitals are normal with a body mass index of 22.
The clinician places the metal medium Graves speculum in the vagina but
cannot find the cervix. What is the best next maneuver to visualize the cervix?
a. Replace the speculum with a larger one (large Graves).
b. Withdraw the speculum and do a bimanual exam to find the cervix.
c. Withdraw the speculum slightly and reposition it on a different slope.
d. Replace the speculum with a plastic one wi
