Exam 1 Practice

Question 1 of 50

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All of the following are infections that affect mostly the labia and vagina except:

Select one of the following:

  • Bacterial Vaginosis

  • Candidiasis

  • Trichomonaiasis

  • Chlamydia trachomatis

Question 2 of 50

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Patients who are diagnosed with gonorrhea should also be treated for which of the following infections?

Select one of the following:

  • Chancroid

  • Chlamydia Trachomatis

  • Herpes genitalis

  • PID

Question 3 of 50

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Human papilloma virus (HPV) infection of the larynx has been associated with:

Select one of the following:

  • Laryngeal neoplasia

  • Esophageal stricture

  • Cervical cancer

  • Metaplasia of esophageal squamous cells

Question 4 of 50

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A 30 year old female who is sexually active complains of a large amount of milk-like vaginal discharge for several weeks. A microscopy slide reveals a large amount of squamous epithelial cells that have blurred margins. Veery few white blood cells are seen. The vaginal pH is 6.0. What is the most likely?

Select one of the following:

  • Trichomonas infection

  • Bacterial vaginosis

  • Candidal infection

  • A normal finding

Question 5 of 50

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The pap smear results on a 20 year old sexually active student who uses condoms inconsistently shows a large amount of inflammation. Which of the following is the best follow-up action?

Select one of the following:

  • The NP needs to do cervical cultures to verify the presence of gonorrhea

  • Prescribed metronidazole vaginal cream for the patient over the phone

  • Call the patient and tell her she needs a repeat pap smear in 6 months

  • Advise the patient to use a Betadine douche at bedtime x3 days

Question 6 of 50

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While performing a pap smear on a post-menopausal patient, several areas of flat white skin lesions that are irregularly shaped are found on the patient's labia . The patient reports that the lesions are extremely itchy and have been present for several years without much change. Which condition is best described?

Select one of the following:

  • Chronic scabies infection

  • Lichen sclerosus

  • Chronic candidal vaginitis

  • A physiologic variant found in some older women

Question 7 of 50

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A sexually active woman is complaing of amenorrhea and vaginal spotting. On exam, her left adnexa is tender and cervical motion tenderness is positive. Which of the following tests should the NP initially order?

Select one of the following:

  • Flat plate of the abdomen

  • CBC with white cell differentials

  • Urine pregnancy test

  • Pelvic ultrasound

Question 8 of 50

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Fitz-Hugh-Curtis Syndrome is associated with which of the following infection?

Select one of the following:

  • Syphylilis

  • Chlamydia trachomatis

  • Herpes genitalis

  • Lymphogranuloma venereum

Question 9 of 50

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hCG is produced by the:

Select one of the following:

  • Placenta

  • Hypothalamus

  • Anterior pituitary

  • Ovaries

Question 10 of 50

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The majority of serum alpha fetoprotien is produced by the:

Select one of the following:

  • Fetal liver

  • Mother's liver

  • Placenta

  • Fetal neural tube

Question 11 of 50

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A college student has recently been informed that he has an HPV infection on the shaft of his penis. Which of the following may reveal subclinical lesions on the penile shaft?

Select one of the following:

  • Perform a KOH exam

  • Scrape off some of the affected skin and send it for culture and sesnitivity

  • Apply acetic acid to the penile shaft and look for acetowhite changes

  • Order serum herpes virus titer

Question 12 of 50

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The ELISA and Western Blot tests are both used to test HIV. Which of the following statements is correct?

Select one of the following:

  • It is a test ot detect viral RNA

  • A positive ELISA screening does not mean the a person has HIV infection

  • It is a test to detect viruses

  • It is a diagnostic test of the AIDS virus

Question 13 of 50

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A 25 year old woman's LMP was 6 weeks ago. She is complaining of nausea with vomiting in the morning and fatigue. Her breasts feel bloaated. The NP suspects that she is pregnant. Her symptoms would be considered:

Select one of the following:

  • Positive signs of pregnancy

  • Probable signs of pregnancy

  • Presumptive signs of pregnancy

  • Possible signs of pregnancy

Question 14 of 50

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Which of the following should you expect to find on a wet mount slide of a patient diagnosed with bacterial vaginosis?

Select one of the following:

  • Tzanck cells

  • A large amount of leukocyte and epithelial cells

  • A large amount of bacteria coating the squamous cells and very few leukocytes

  • Epithelial cells and a small amount of blood

Question 15 of 50

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A 14 year old teen is worried that she has not started to menstruate like most of her friends. During the gynecological examination, the NP tells her mother, who is in the room with the patient, that her daughter is starting Tanner Stage II. What are the physical exam findings?

Select one of the following:

  • Breast buds and some straight pubic hair

  • Fully developed breasts and curly pubic hair

  • Breast tissue with the areola on a separate mound with curly pubic hair

  • No breast tissue and no pubic hair

Question 16 of 50

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Physiologic anemia of pregnancy is due to:

Select one of the following:

  • An increase in the CO at the end of the second trimester

  • A physiologic decrease in the production of RBCs in pregnant women

  • An increase of up to 50% of the plasma volume in pregnant women

  • An increase in the need for dietary iron in pregnancy

Question 17 of 50

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You are reviewing a pap smear report on a 25 year old female. Which of the following cells should be on a pap smear to be classified as a satisfactory specimen?

Select one of the following:

  • Clue cells and endometrial cells

  • Vaginal cells and cervical cells

  • Squamous epithelial cells and endocervical cells

  • Leukocytes and RBCs

Question 18 of 50

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What does a KOH prep help the NP diagnose?

Select one of the following:

  • Herpes zoster

  • Yeast infections

  • HSV

  • Viral infections

Question 19 of 50

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All of the following are reportable diseases except:

Select one of the following:

  • Lyme disease

  • Gonnorrhea

  • Nongonococcal urethritis

  • Syphilis

Question 20 of 50

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A woman is being evaluated by the NP for complaints of dyspareunia. A microscopy slide reveals a large number of atrophic squamous epithelial cells. The vaginal pH is 4.0. There are very few leukocytes and no RBCs seen on the wet smear. Which of the following is the most likely?

Select one of the following:

  • Atrophic vaginitis

  • BV

  • Trichomoniasis

  • This is a normal finding

Question 21 of 50

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The following conditions are absolute contraindications for the use of OCPs except:

Select one of the following:

  • Hepatomas

  • History of emboli that resolved with heparin therapy 15 years ago

  • A family history of migraine with aura

  • A history of gall bladder disease during pregnancy

Question 22 of 50

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All of the following findings are associated with secondary stage of an infection with the organism Treponema palladium except:

Select one of the following:

  • Condyloma accumata

  • Maculopapular rash on the palms and soles

  • Lymphadenopathy

  • Condyloma lata

Question 23 of 50

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The following are acceptable methods of birth control for breast feeding mothers except:

Select one of the following:

  • Diaphragm with spermicidal gel

  • Micronor (Progesterone Only pill)

  • Condoms

  • Low dose oral contraceptives with at least 20 mcg of estriadol

Question 24 of 50

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Women with a history of PID have an increased risk for all of the following except:

Select one of the following:

  • Ectopic pregnancy

  • Scarring of the fallopian tubes

  • Infertility

  • Ovarian cysts

Question 25 of 50

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In most states, patients younger than 18 years may consent to health care without parental or legal guardian consent except for which of the following?

Select one of the following:

  • Contraception

  • Pregnancy

  • School physical

  • STD evaluation and treatment

Question 26 of 50

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The pap smear result for a 20 year old sexually active college student who uses condoms inconsistently reveals a large number of white blood cells and blood along with inflammatory changes. During the speculum exam, the NP who examined the patient noticed that the patients cervix bled very easily (friable) and a small amount of purulent discharge was present on the cervical surface. No cervical motion tenderness was noted during the bimanual exam. What is the next step in the management of this patient?

Select one of the following:

  • The NP needs to do cervical cultures to verify gonorrhea

  • Prescribe metronidazole cream for the patient over the phone

  • Call the patient and tell her she needs a repeat pap smear in 6 months

  • Advise her to use a Betadine douche at bedtime for 3x days

Question 27 of 50

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Human Papilloma Virus infection in women has been associated with the development of:

Select one of the following:

  • Ectopic pregnancy

  • Infertility

  • Cervical cancer

  • PID

Question 28 of 50

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When Molloscum Contagiosum is found on the genital area of children, which of the following is the best explanation?

Select one of the following:

  • It should raise suspicion of child sexual abuse

  • It should not be considered a STD

  • It is caused by atypical bacteria

  • It is caused by the pox virus and will resolve on its own

Question 29 of 50

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Which of the following methods is used to diagnose gonorrheal pharyngitis or proctitis?

Select one of the following:

  • Serum chlamydial titer

  • Gen-Probe

  • Thayer-Martin culture

  • Culture and sensitivity of the purulent discharge

Question 30 of 50

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All of the following are considered Category X drugs except:

Select one of the following:

  • Misoprostol (Cytotec)

  • Isotretinoin (Accutane)

  • Finasteride (Proscar)

  • Meperidine (Demerol)

Question 31 of 50

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An 18 year old waitress is diagnosed with PID. the cervical Gen-Probe result is positive for Neisseria gonorrhoeae and negative for chlamydia trachomatis. All of the following statements are true regarding the management for this patient except:

Select one of the following:

  • This patient should be treated for chlamydia even though the Gen-Probe for chlamydia is negative

  • Ceftriaxone 250 mg IM and doxycylcine 100 mg BID x14 days are appropriate treatment for this patient

  • Advise the patient to return to the clinic for a repeat pelvic exam in 48 hours

  • Repeat the Gen-Probe test for chlamydia trachomatis to ensure that the previous test was not false-negative result

Question 32 of 50

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What Tanner stage is a girl at when her breasts form a secondary mound?

Select one of the following:

  • Tanner Stage II

  • Tanner Stage III

  • Tanner Stage IV

  • Tanner Stage V

Question 33 of 50

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A 35 year old smoker is being evaluated for birth control choices. The patient has a history of PID along with embolic epidosde after her last pregnancy, Which of the following birth control methods are appropriate for this patient?

Select one of the following:

  • Condom and the vaginal sponge

  • Estrogen patches

  • IUD

  • Depo-Provera

Question 34 of 50

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A 21 year old woman complains of left-sided pelvic pain accompanied by dyspareunia. During the gynecological exam, the NP notices green cervical discharge. The patient mentions new onset of a painful and swollen left knee and denies a history of trauma. This best describes:

Select one of the following:

  • Septic arthritis

  • Reiter's sydrome

  • Chondromalacia of the patella

  • Disseminated gonorrheal infection

Question 35 of 50

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A 25 year old woman complains of dysuria, severe vaginal pruritus, and a malodorous vaginal discharge. Pelvic examination reveals a strawberry-colored cervix and frothy yellow discharge. Microscopic exam of the discharge reveals mobile organisms that have flagella. The correct pharmacological therapy for this condition is:

Select one of the following:

  • Metronidazole (Flagyl)

  • Ceftriaxone sodium (Rocephin)

  • Doxycycline hyclate (Vibramycin)

  • Clotrimazole (Gyne-Lotrimin)

Question 36 of 50

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Metronidazole (Flagyl) produces the disulfiram (Antabuse) effect when combined with alcoholic beverages or medicine. You should educate the patient to avoid:

Select one of the following:

  • Alcoholic drinks while she is taking the medication

  • Alcoholic drinks 1 day before, during, and a few days after therapy.

  • Alcoholic drinks after she takes the medicine

  • There is no need to avoid any food or drink

Question 37 of 50

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All of the following drugs interfere with the metabolism of oral contraceptives except:

Select one of the following:

  • Tetracylcine

  • Rifampin

  • Phenytoin (Dilantin)

  • Ciprofloxacin (Cipro)

Question 38 of 50

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Which of the following is a CDC-recommended treatment for a case of uncomplicated gonorrheal and chlamydial infection?

Select one of the following:

  • Metronidazole (Flagyl) 250 mg PO TID for 7 days

  • Valacyclovir (Valtrex) 500 mg PO BID for 10 days

  • Azythromycin 1 g orally PO OR Doxycylcine 100 mg PO BID for 7 days

  • 1 dose of PO Fluconazole (Diflucan) 150 mg

Question 39 of 50

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Which of the following is not a relative contraindication for oral contraceptives pills?

Select one of the following:

  • Active Hepatitis A infection

  • Thrombosis related to an IV needle

  • Undiagnosed vaginal bleeding

  • Migraine headache without focal aura

Question 40 of 50

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Which of the following is the most common cause of non-gonoccocal urethritis?

Select one of the following:

  • E. coli

  • C. trachomatis

  • N. gonorrhea

  • Mycoplasma

Question 41 of 50

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Which of the following is considered a relative contraindication for oral contraceptive pills?

Select one of the following:

  • Undiagnosed vaginal bleeding

  • A hepatoma of the liver

  • Suspected history of TIAs

  • Depression

Question 42 of 50

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All of the following are true statements regarding oral contraceptives except:

Select one of the following:

  • The actual failure rate of oral contraceptives is 3%

  • Desogesterol belongs to the progesterone family of drugs

  • The newer low-dose birth control pills do not require back-up method during the first two weeks of use

  • Oral contraceptives are contraindicated in women who are 35 years old or older and smoke

Question 43 of 50

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You are performing a pelvic exam on a 25 year old sexually active woman . You palpate a tender and warm cystic mass on the lower edge of the left labia majora, which is red. The most likely diagnosis is:

Select one of the following:

  • Skene's gland cyst

  • Cystocele

  • Lymohogranuloma venereum

  • Bartholin's gland abcess

Question 44 of 50

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A patient diagnosed with BV should be advised that her sexual partner be treated with:

Select one of the following:

  • Ceftriaxone (Rocephin)250 mg IM with doxycylcine 100 mg BID for 14 days

  • Metronidazole (Flagyl) 500 mg PO BID for 7 days and 1 dose of azithromycin (Zithromax)

  • Her partner does not need treatment

  • Clotrimazole cream (Lotrimin) on his penis BID for 1-2 weeks

Question 45 of 50

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Which of the following is responsible for the symptom of dysmenorrhea?

Select one of the following:

  • Estrogen

  • hCG

  • Prostaglandin

  • Progesterone

Question 46 of 50

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Which of the following is the best method for diagnosing candidiasis in the primary care setting?

Select one of the following:

  • Wet Smear

  • Tzanack smear

  • KOH smear

  • Clinical findings only

Question 47 of 50

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Females with PCOS are at higher risk for:

Select one of the following:

  • Heart disease and breast cancer

  • Uterine fibroids and ovarian cancer

  • Premature menopause

  • PID

Question 48 of 50

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A college student who is OCPs forgets to take her pills two days in a row during the second week of her pill cycle and wants to know that to do. What is the best advice?

Select one of the following:

  • Start a new pack of pill and dispose of the old one

  • Take 2 pills today and 2 pills the next day; use condoms for the rest of the cycle

  • Stop taking the pills right away and start a new pill cycle in two weeks.

  • Take 1 pill now and 2 pills the next day and use condoms

Question 49 of 50

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All of the following clinical findings are classifies as major criteria that are necessary to diagnose PID. Which of the following is classified as a minor criterion?

Select one of the following:

  • Cervical motion tenderness

  • Adnexal tenderness

  • Uterine tenderness

  • Oral temperature of more than 101

Question 50 of 50

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All of the following are true statements about the HPV vaccine Gardisil except:

Select one of the following:

  • The CDC recommends the first dose at age 11-12 years

  • The CDC does not recommend the vaccine for males

  • The vaccine is not complete until a total of 3 doses have been administered

  • The minimum age the vaccine can be given is 9 years

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Exam 1 Practice

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