Page 1 of 148
MVU NURS 620 Exam 4 Gremminger Review
1. A 23-year-old sexually active female presents for her
first Pap smear. She reports menarche at age 12, first
intercourse at age 14, and approximately 12 sexual
partners since. Based on this history, which condition
requires the highest vigilance during her exam?
A. Polycystic Ovary Syndrome (PCOS)
B. Endometrial hyperplasia
C. Human Papillomavirus (HPV)
D. Bacterial Vaginosis (BV)
Answer: C. Human Papillomavirus (HPV)
Rationale: Early onset of sexual intercourse (especially <18
years) and a high number of lifetime sexual partners are
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significant risk factors for acquiring HPV. HPV is the causative
agent for cervical dysplasia and genital warts, making it the
primary concern during a Pap smear in this demographic .
2. A 20-year-old female is seen in the clinic because her
boyfriend was diagnosed with gonorrhea. She reports mild
dysuria but no discharge. What is the treatment of choice for
presumptive gonorrhea in this patient?
A. Doxycycline 100 mg BID x 7 days
B. Acyclovir 400 mg TID x 7 days
C. Ceftriaxone 500 mg IM once
D. Metronidazole 2 g PO once
Answer: C. Ceftriaxone 500 mg IM once
Rationale: Due to increasing antibiotic resistance, the CDC
recommends dual therapy for gonorrhea. The backbone is
Ceftriaxone (500mg IM for patients <150kg) . While often
co-treated with Azithromycin or Doxycycline for chlamydia,
Ceftriaxone is the specific agent for Gonorrhea.
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3. A 24-year-old female complains of dysuria, pain with
intercourse, and mucopurulent vaginal discharge. Her
boyfriend was recently treated for "nongonococcal
urethritis" (NGU). Which STI has she most likely been
exposed to?
A. HPV
B. Chlamydia trachomatis
C. Trichomonas vaginalis
D. Herpes Simplex Virus (HSV)
Answer: B. Chlamydia trachomatis
Rationale: Nongonococcal urethritis (NGU) in males is most
commonly caused by Chlamydia trachomatis. In females,
Chlamydia often presents with mucopurulent discharge, dysuria
(often mistaken for UTI), and post-coital bleeding/pain .
4. A 45-year-old woman complains of a "fishy" vaginal
discharge. On microscopic examination of the wet mount,
you identify "clue cells" (epithelial cells with stippled
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borders). What is the diagnosis?
A. Trichomoniasis
B. Candidiasis
C. Bacterial Vaginosis (BV)
D. Atrophic Vaginitis
Answer: C. Bacterial Vaginosis (BV)
Rationale: The diagnosis of BV is clinical using Amsel's criteria.
The presence of clue cells on wet mount is the most specific
criterion. Other criteria include thin, homogeneous discharge,
vaginal pH >4.5, and a positive whiff test (fishy odor with
KOH) .
5. A 26-year-old woman is diagnosed with Trichomoniasis
after visualization of motile trichomonads on wet mount.
Which medication is the treatment of choice?
A. Metronidazole (Flagyl) 2g PO once
B. Doxycycline 100mg BID x 7 days
MVU NURS 620 Exam 4 Gremminger Review
1. A 23-year-old sexually active female presents for her
first Pap smear. She reports menarche at age 12, first
intercourse at age 14, and approximately 12 sexual
partners since. Based on this history, which condition
requires the highest vigilance during her exam?
A. Polycystic Ovary Syndrome (PCOS)
B. Endometrial hyperplasia
C. Human Papillomavirus (HPV)
D. Bacterial Vaginosis (BV)
Answer: C. Human Papillomavirus (HPV)
Rationale: Early onset of sexual intercourse (especially <18
years) and a high number of lifetime sexual partners are
,Page 2 of 148
significant risk factors for acquiring HPV. HPV is the causative
agent for cervical dysplasia and genital warts, making it the
primary concern during a Pap smear in this demographic .
2. A 20-year-old female is seen in the clinic because her
boyfriend was diagnosed with gonorrhea. She reports mild
dysuria but no discharge. What is the treatment of choice for
presumptive gonorrhea in this patient?
A. Doxycycline 100 mg BID x 7 days
B. Acyclovir 400 mg TID x 7 days
C. Ceftriaxone 500 mg IM once
D. Metronidazole 2 g PO once
Answer: C. Ceftriaxone 500 mg IM once
Rationale: Due to increasing antibiotic resistance, the CDC
recommends dual therapy for gonorrhea. The backbone is
Ceftriaxone (500mg IM for patients <150kg) . While often
co-treated with Azithromycin or Doxycycline for chlamydia,
Ceftriaxone is the specific agent for Gonorrhea.
,Page 3 of 148
3. A 24-year-old female complains of dysuria, pain with
intercourse, and mucopurulent vaginal discharge. Her
boyfriend was recently treated for "nongonococcal
urethritis" (NGU). Which STI has she most likely been
exposed to?
A. HPV
B. Chlamydia trachomatis
C. Trichomonas vaginalis
D. Herpes Simplex Virus (HSV)
Answer: B. Chlamydia trachomatis
Rationale: Nongonococcal urethritis (NGU) in males is most
commonly caused by Chlamydia trachomatis. In females,
Chlamydia often presents with mucopurulent discharge, dysuria
(often mistaken for UTI), and post-coital bleeding/pain .
4. A 45-year-old woman complains of a "fishy" vaginal
discharge. On microscopic examination of the wet mount,
you identify "clue cells" (epithelial cells with stippled
, Page 4 of 148
borders). What is the diagnosis?
A. Trichomoniasis
B. Candidiasis
C. Bacterial Vaginosis (BV)
D. Atrophic Vaginitis
Answer: C. Bacterial Vaginosis (BV)
Rationale: The diagnosis of BV is clinical using Amsel's criteria.
The presence of clue cells on wet mount is the most specific
criterion. Other criteria include thin, homogeneous discharge,
vaginal pH >4.5, and a positive whiff test (fishy odor with
KOH) .
5. A 26-year-old woman is diagnosed with Trichomoniasis
after visualization of motile trichomonads on wet mount.
Which medication is the treatment of choice?
A. Metronidazole (Flagyl) 2g PO once
B. Doxycycline 100mg BID x 7 days
