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MARYVILLE NURS 620 EXAM 4
QUESTIONS AND ANSWERS
1. 23-year-old, sexually active female who presents for her first pap smear.
Her history includes no pregnancies. Her first intercourse was at age 14 and has had at least 10 sexual partners if not 12 partners since. Which conditions do you want to be alert for during her exam? ANS HPV
2. 20-year-old, sexually active female seen in the clinic because her boyfriend
was diagnosed with gonorrhea. What is the treatment of choice for gonor- rhea? ANS ceftriaxone
3. A 24-year-old female with complaints of dysuria, pain with sex, and mucop-
urulent vaginal discharge. Her boyfriend was recently treated for nongono- coccal urethritis. What STIs has she most likely been exposed to? ANS Chlamydia
4. 45-year-old women with complaints of vaginal discharge. You identify clue
cells on the vaginal smear. What diagnosis? ANS BV
5. Which of the following medications is the treatment of choice for Trich?
ANS -
Flagyl
6. A 26-year-old woman presents with complaints of irregular vaginal bleed-
ing. Which of the following tests should be the first priority. ANS pregnancy test
7. A 36-year-old woman with complaints of vaginal itching, burning, and
discharge. On the wet mount, you notice hyphae. Which treatment would be appropriate? ANS fluconazole
8. 21-year-old woman requesting birth control pills. Which of the following
tests would be essential before prescribing any oral contraceptives? ANS HCG
9. A 40-year-old woman who sees you yearly for exams. She is single and not
in a monogamous relationship. She smokes occasional and drinks 2 beers a day. Her BMI is 25. She is requesting birth control. Which is appropriate for her? ANS IUD
10. What is the most common cause of secondary amenorrhea?
ANS Pregnancy
11. A 22-year-old woman diagnosed with PMS. Which of the following lifestyle
changes to minimize symptoms? ANS getting regular exercise
12. A 25-year-old woman complaining of painful menstruation. Which pelvic
pathology is the most common cause of dysmenorrhea? ANS endometriosis
13. A male patient comes in with complaints of painful penile lesions. Small
fluid-filled vesicles that are painful to the touch. Which treatment would you give?
15. When providing education to a woman about the use of Plan B, the NP
knows to tell the patient that the latest it can be used after intercourse and be effective is? ANS 72 hours
16. Male patient presents with painful lesions on the penis. They are small
fluid-filled vesicles clustered to the shaft of his penis. What is the diagno- sis? ANS Herpes
17. Which medication would the NP prescribe for a patient diagnosed with
primary syphilis who has no known drug allergies? ANS penicillin G
18. What age should a woman receive her first pap smear regardless of
sexual activity? ANS 21
19. A 24-year-old female comes in with complaints of dysuria, pain with sex,
and mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What medication would you treat her with? ANS - azithromycin
20. A 45-year-old woman with complaints of vaginal discharge. On the wet
mount, you notice clue cells. What medications would you use to treat this patient? ANS flagyl
21. A 36-year-old woman with vaginal itching, burning, and discharge. On the
wet mount, you notice hyphae. Based on clinical symptoms and findings what diagnosis do you suspect? ANS candida
22. A 25-year-old female with complaints of no menstrual cycle for 6 months.
What test would be appropriate to order? ANS prolactin
23. Which of the following is contraindicated to estrogen-containing contra-
ceptive methods ANS factor 5 Leiden mutation
24. You are counseling a patient on oral combination contraceptive treat-
ment. She wants to know what to do if she misses a pill. ANS take last missed pill along with today's pill
25. In providing contraceptive counseling to a patient on Dilantin for a
seizure disorder. Which contraceptive would you recommend? ANS Depo provera
26. Which of the following is a common side effect reported after one year
use of depo? ANS weight gain
27. With a hormonal IUD, which of the following is commonly reported by
patients? ANS reduction in menstrual flow
36. A woman presents to discuss contraceptive options. She is breast feed-
ing on demand. She wishes to continue. What is the most appropriate con- traceptive for her to use? ANS progesterone only oral contraceptive
37. What are some of the consequences of chlamydia/gonorrhea?
ANS PID, infer- tility, ectopic pregnancy
38. Most common STI reported in the U.S.
ANS Chlamydia
39. A patient is being treated with Metronidazole for Bacterial Vaginosis,
why should you counsel them to avoid alcohol? ANS Mixing the two can cause, headache, nausea/vomiting, chest pain, and or hypertension.
40. Most common cause of vaginal odor and discharge?
ANS BV
41. What does Protozoa on a vaginal smear mean?
ANS Trichomoniasis
42. What does clue cells on a vaginal smear mean?
ANS BV
43. What does hyphae on a vaginal smear mean?
ANS candida yeast
44. At what age should a woman have her first pap regardless of sexual activity
and how ofter there after? ANS 21; 21-29 Q 3 yrs; e 30 2 neg paps then Q 5 yrs; stop @ e 65 with e 3 neg in row & no abnorm in 10 yrs or after hyst NOT due to cancer
45. A KOH wet mount is to detect the presents of what?
ANS candida
46. How is atrophic vaginitis treated?
ANS 1) Topical estrogen in cream
2) estrogen Suppository or ring
3) PO estrogen
4) Treat any concomitant infection
47. S/S of genital herpes
ANS fever, chills, malaise, dysuria, multiple, painful vesicular lesions
48. What are the stages of syphilis infection?
ANS primary ANS classic chancre (pain- less); Secondary ANS Maculopapular rash palms and soles; Tertiary ANS neurologic and cardiac manifestations
49. What is the treatment for syphilis?
ANS Penicillin G ; if allergic to penicillin, doxycycline or tetracycline
50. Menopause is seen most often between what ages?
ANS 48-
51. 5 contraindications of using estrogen OCP
