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Exam 1 Practice

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Child Bearing Child Rearing Family
netherco
Quiz by netherco, updated more than 1 year ago
netherco
Created by netherco almost 9 years ago
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Question 1

Question
All of the following are infections that affect mostly the labia and vagina except:
Answer
  • Bacterial Vaginosis
  • Candidiasis
  • Trichomonaiasis
  • Chlamydia trachomatis

Question 2

Question
Patients who are diagnosed with gonorrhea should also be treated for which of the following infections?
Answer
  • Chancroid
  • Chlamydia Trachomatis
  • Herpes genitalis
  • PID

Question 3

Question
Human papilloma virus (HPV) infection of the larynx has been associated with:
Answer
  • Laryngeal neoplasia
  • Esophageal stricture
  • Cervical cancer
  • Metaplasia of esophageal squamous cells

Question 4

Question
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?
Answer
  • Trichomonas infection
  • Bacterial vaginosis
  • Candidal infection
  • A normal finding

Question 5

Question
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?
Answer
  • 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

Question
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?
Answer
  • Chronic scabies infection
  • Lichen sclerosus
  • Chronic candidal vaginitis
  • A physiologic variant found in some older women

Question 7

Question
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?
Answer
  • Flat plate of the abdomen
  • CBC with white cell differentials
  • Urine pregnancy test
  • Pelvic ultrasound

Question 8

Question
Fitz-Hugh-Curtis Syndrome is associated with which of the following infection?
Answer
  • Syphylilis
  • Chlamydia trachomatis
  • Herpes genitalis
  • Lymphogranuloma venereum

Question 9

Question
hCG is produced by the:
Answer
  • Placenta
  • Hypothalamus
  • Anterior pituitary
  • Ovaries

Question 10

Question
The majority of serum alpha fetoprotien is produced by the:
Answer
  • Fetal liver
  • Mother's liver
  • Placenta
  • Fetal neural tube

Question 11

Question
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?
Answer
  • 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

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

Question
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:
Answer
  • Positive signs of pregnancy
  • Probable signs of pregnancy
  • Presumptive signs of pregnancy
  • Possible signs of pregnancy

Question 14

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

Question
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?
Answer
  • 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

Question
Physiologic anemia of pregnancy is due to:
Answer
  • 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

Question
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?
Answer
  • Clue cells and endometrial cells
  • Vaginal cells and cervical cells
  • Squamous epithelial cells and endocervical cells
  • Leukocytes and RBCs

Question 18

Question
What does a KOH prep help the NP diagnose?
Answer
  • Herpes zoster
  • Yeast infections
  • HSV
  • Viral infections

Question 19

Question
All of the following are reportable diseases except:
Answer
  • Lyme disease
  • Gonnorrhea
  • Nongonococcal urethritis
  • Syphilis

Question 20

Question
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?
Answer
  • Atrophic vaginitis
  • BV
  • Trichomoniasis
  • This is a normal finding

Question 21

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

Question
All of the following findings are associated with secondary stage of an infection with the organism Treponema palladium except:
Answer
  • Condyloma accumata
  • Maculopapular rash on the palms and soles
  • Lymphadenopathy
  • Condyloma lata

Question 23

Question
The following are acceptable methods of birth control for breast feeding mothers except:
Answer
  • Diaphragm with spermicidal gel
  • Micronor (Progesterone Only pill)
  • Condoms
  • Low dose oral contraceptives with at least 20 mcg of estriadol

Question 24

Question
Women with a history of PID have an increased risk for all of the following except:
Answer
  • Ectopic pregnancy
  • Scarring of the fallopian tubes
  • Infertility
  • Ovarian cysts

Question 25

Question
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?
Answer
  • Contraception
  • Pregnancy
  • School physical
  • STD evaluation and treatment

Question 26

Question
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?
Answer
  • 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

Question
Human Papilloma Virus infection in women has been associated with the development of:
Answer
  • Ectopic pregnancy
  • Infertility
  • Cervical cancer
  • PID

Question 28

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

Question
Which of the following methods is used to diagnose gonorrheal pharyngitis or proctitis?
Answer
  • Serum chlamydial titer
  • Gen-Probe
  • Thayer-Martin culture
  • Culture and sensitivity of the purulent discharge

Question 30

Question
All of the following are considered Category X drugs except:
Answer
  • Misoprostol (Cytotec)
  • Isotretinoin (Accutane)
  • Finasteride (Proscar)
  • Meperidine (Demerol)

Question 31

Question
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:
Answer
  • 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

Question
What Tanner stage is a girl at when her breasts form a secondary mound?
Answer
  • Tanner Stage II
  • Tanner Stage III
  • Tanner Stage IV
  • Tanner Stage V

Question 33

Question
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?
Answer
  • Condom and the vaginal sponge
  • Estrogen patches
  • IUD
  • Depo-Provera

Question 34

Question
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:
Answer
  • Septic arthritis
  • Reiter's sydrome
  • Chondromalacia of the patella
  • Disseminated gonorrheal infection

Question 35

Question
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:
Answer
  • Metronidazole (Flagyl)
  • Ceftriaxone sodium (Rocephin)
  • Doxycycline hyclate (Vibramycin)
  • Clotrimazole (Gyne-Lotrimin)

Question 36

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

Question
All of the following drugs interfere with the metabolism of oral contraceptives except:
Answer
  • Tetracylcine
  • Rifampin
  • Phenytoin (Dilantin)
  • Ciprofloxacin (Cipro)

Question 38

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

Question
Which of the following is not a relative contraindication for oral contraceptives pills?
Answer
  • Active Hepatitis A infection
  • Thrombosis related to an IV needle
  • Undiagnosed vaginal bleeding
  • Migraine headache without focal aura

Question 40

Question
Which of the following is the most common cause of non-gonoccocal urethritis?
Answer
  • E. coli
  • C. trachomatis
  • N. gonorrhea
  • Mycoplasma

Question 41

Question
Which of the following is considered a relative contraindication for oral contraceptive pills?
Answer
  • Undiagnosed vaginal bleeding
  • A hepatoma of the liver
  • Suspected history of TIAs
  • Depression

Question 42

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

Question
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:
Answer
  • Skene's gland cyst
  • Cystocele
  • Lymohogranuloma venereum
  • Bartholin's gland abcess

Question 44

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

Question
Which of the following is responsible for the symptom of dysmenorrhea?
Answer
  • Estrogen
  • hCG
  • Prostaglandin
  • Progesterone

Question 46

Question
Which of the following is the best method for diagnosing candidiasis in the primary care setting?
Answer
  • Wet Smear
  • Tzanack smear
  • KOH smear
  • Clinical findings only

Question 47

Question
Females with PCOS are at higher risk for:
Answer
  • Heart disease and breast cancer
  • Uterine fibroids and ovarian cancer
  • Premature menopause
  • PID

Question 48

Question
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?
Answer
  • 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

Question
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?
Answer
  • Cervical motion tenderness
  • Adnexal tenderness
  • Uterine tenderness
  • Oral temperature of more than 101

Question 50

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