South University NSG6430 Final Exam Latest 2020

Question 1 The nurse practitioner knows that a highly valuable assessment tool for evaluating urinary incontinence and contributing factors in daily life is:

A)           the interview

B)            a voiding diary

C)            the physical exam

D)           the patient’s response to non-pharmacologic treatments

Question 2 The nurse practitioner is counseling a 57 year-old patient with urinary incontinence. The patient desires to try non-pharmacological, non-invasive methods of treatment at this time. Which of the following should be included in the patient’s plan of care? Select all that apply.

Bladder training

Kegel exercises

Eliminate caffeine and alcohol consumption

Use of bulking agents

Question 3 The nurse practitioner is performing a bimanual exam on a new OB patient and notices that the lower portion of the patient’s uterus is soft. This is known as:

A)           Hegar’s Sign

B)            Chadwick’s Sign

C)            Nightingale’s Sign

D)           Goodell’s Sign

Question 4 Your female patient presents for vaginal discharge with an odor, and has noticed painless “bumps” on her vaginal area. Sexual history includes past male partners and her current female partner. On exam you note beefy red papules and an ulcerative lesion on her vulva, granular tissue and scarring, and inguinal adenopathy. You suspect she has:

A)           HSV-2

B)            Granuloma Inguinale

C)             Chancroid

D)           Molluscum Contagiosum

Question 5 The physical examination of any woman suspected of being abused or battered includes all of the following except:

A)           a thorough inspection for signs of injury, past and present

B)            a physical assessment just like that of any other adult female

C)            a focus on the patient’s physical appearance, not her behavior

D)           the use of body maps and diagrams to accurately portray the patient’s physical condition

Question 6 The most effective means of obtaining the history of abuse is to use a communication model that:

A)           avoids having the patient’s children present during the discussion

B)            signals someone is interested and that the woman is not alone

C)            emphasizes the belief that violence is not acceptable, no matter what the batterer might have said to the patient

D)           allows the patient to talk without interruption and with time to relate, emphasize, and repeat her full story

Question 7 Clinicians should routinely consider intimate partment violence (IPV) as a possible diagnosis for women who present with all of the following except:

A)           chronic stress-related symptoms

B)            denial of any physical health problems

C)            central nervous system (CNS) symptoms

D)           gynecologic problems, especially multiple ones

Question 8 The factors that enable women to enjoy and control their sexual and reproductive lives, including a physical and emotional state of well-being and the quality of sexual and other close relationships, make up a woman’s:

Question 8 options:

A)           sexual health

B)            gender identit

C)            gender role behaviors

D)           psychosocial orientation

Question 9 Which one of the following is not among the ways clinicians can provide a welcoming, safe environment for Lesbian, Gay, Bixsexual, or Transgender (LGBT) patients?

Question 9 options:

 

A)           Avoid the heterosexual assumption by using gender-neutral language.

 

 

B)            Explain whether and how information will be documented in the patient’s medical record.

 

 

C)            Ignore the sexual status or gender identity of all patients.

 

 

D)           Offer mainstream referrals that are culturally sensitive to SGMs.

 

 

Question 10

 

Which one of the following is the definition of the term “gender identity”?

Question 10 options:

A)           People who respond erotically to both sexes

B)            A self-label, regardless of biologic or natal sex

C)            People who are similar in age, class, and sexual status

D)           A label for behavior not usually associated with one’s natal sex

Question 11

 

Which one of the following statements about sexually transmitted infections (STIs) is false?

Question 11 options:

A)           Lesbians are at very low risk for development of STIs and vaginal infections.

B)            HIV has been identified in case studies of women who report sex only with women.

C)            Transgender women (Male to Female) have extremely high rates of HIV infection.

D)           Risky behaviors for STIs include sex during menses.

Question 12

Among the midlife health issues of women, the number one cause of mortality in the United States is:

Question 12 options:

 

A)           primary osteoporosis

B)            cardiovascular disease

C)            overweight and obesity

D)           cancer

Question 13

Lifestyle approaches to manage menopause related vasomotor symptoms include:

Question 13 options:

A)            sleeping more than 8 hours per night

B)            avoiding spicy foods, hot drinks, caffeine, and alcohol

C)            decreasing levels of physical activity

D)           more than 1,000 international units/day of vitamin E

Question 14

The standard for managing moderate to severe menopausal symptoms is:

Question 14 options:

A)           lifestyle changes, such as dieting and exercising

B)            nonhormone products, such as antidepressant medications

C)            alternative care, such as acupuncture, combined with organic herbs

D)           prescription systemic hormone products, such as estrogen and progestogen

 

Question 15

The nurse practitioner is managing an adolescent with a 4 cm functional ovarian cyst that was confirmed on a recent ultrasound. What plan of care should be anticipated for this patient?

Question 15 options:

A)           Repeat bimanual exam in 1 week

B)            Refer for surgical consult

C)            Repeat ultrasound in 2 months

D)           Stop all ovulatory inhibitor meds

Question 16

Non-pharmacologic therapy for chronic pelvic pain includes the following: Select all that apply.

Question 16 options:

A)           Vitamin B6

B)            Physical therapy

C)            Aerobic and nonaerobic exercise

D)           Antidepressants

Question 17 The nurse practitioner understands that all of the following organisms are responsible for infection of the Bartholin’s gland except::

Streptococcus faecalis

Klebsiella

Staphylococcus aureus

E. Coli

Question 18 Treatment of a large, symptomatic Bartholin’s cyst includes all of the following except:

Sitz baths

Incision and drainage

Topical corticosteroids

Antibiotics

Question 19 A 44 year-old African American female presents with complaints of menorrhagia x 15 months. Pelvic ultrasound confirms the presence of a large intramural leiomyomata. The nurse practitioner should discuss all of the following options with the patient except:

GnRH agonist therapy

Referral for surgical consult

Progestin therapy

Estrogen therapy

Question 20 The nurse practitioner is treating a patient with Elimite for scabies. The proper instructions to the patient should include:

All household contacts should be treated with Elimite regardless of symptoms.

The medication should be taken orally in one single dose and repeated in 2 weeks.

Apply only to the body area infested with scabies and repeat treatment in 5 days.

Apply to all areas of the body from the neck down, wash off after 8 to 14 hours, then repeat treatment in one week

Question 21 The nurse practitioner understands that the proper management of an asymptomatic woman with a small fibroid should include:

Start combination COC therapy.

Repeat ultrasound in 3-4 months.

Reassess in 6 to 12 months.

Refer for myomectomy.

Question 22 The nurse practitioner is teaching a patient about pediculosis. Which of the following statements by the nurse practitioner is correct?

Nits can survive in hot and humid climates up to 21 days.”

 “Adult pubic lice can survive 72 hours off their host.”

 “Pruritus is not a common manifestation.”

 “The condition is treated with Permethrin cream.”

Question 23 All of the following medications may be used for neuropathic pain management of vulvodynia, except:

Neurontin

SSRIs

Methotrexate

Tricyclics

Question 24 The nurse practitioner understands that which of the following lab tests is appropriate for the patient who presents with symptoms of dysesthetic vulvodynia?

RPR

Pap smear

Wet mount

Endometrial biopsy

Question 25 Which of the following is a common antibiotic for treatment of an infected Bartholin’s cyst?

Question 25 options:

Minocycline

Levaquin

Bactrim

Ampicillin

Question 26 The patient presents with complaints of a painful, swollen lump in her vaginal area. She reports difficulty sitting and walking due to the pain. Which of the following is a likely diagnosis for this patient?

Syphilis chancre

Lichen Planus

Genital Wart

Bartholin’s cyst

Question 27 The nurse practitioner understands that which of the following are differential diagnoses in an adult female patient with acute pelvic pain. Select all that apply:

A)           Ectopic pregnancy

B)            Appendicitis

C)            Ovarian cyst with rupture

D)           Pelvic Congestion Syndrome

Question 28 When women experience mild premenstrual symptoms, such as mild breast tenderness, abdominal bloating, and mild weight gain from water retention, this is known as:

Luteal phase deficiency

Premenstrual dysmorphic disorder

Premenstrual syndrome

Follicular phase deficiency

Question 29 A patient with intraductal papilloma will commonly present with a chief complaint of:

A palpable mass

Bloody nipple discharge

Bilateral milky discharge

Mild localized pain

Question 30 The nurse practitioner understands that the necessary screening techniques in a patient suspicious of ovarian cancer should include the following: Select all that apply.

CA-125

 Transvaginal ultrasound

 Bimanual pelvic exam

 Pap smear

Question 31 Early symptoms experienced by a woman with ovarian cancer include all of the following except:

Vague abdominal pain

 Abdominal bloating

 Fatigue

 Unexplained weight gain

Question 32

  The nurse practitioner is evaluating a patient’s risk of ovarian cancer. All of the following factors are associated with an increased risk for ovarian cancer except:

Question 32 options:

 First degree relative with ovarian cancer

 BRCA -1 and 2 mutations

 Obesity

 Oral Contraceptive Use

Question 33

  Patient education for condylomataacuminata should include all the following except:

Question 33 options:

 The cause of the condition is a virus of the HPV type

 Sexual partners should be checked and condoms used to decrease incidence of transmission

 Treatment and elimination of visible warts is a sign of cure, and transmission will not occur

 The virus does not always cause a lesion, subclinical infection may occur

Question 34 Tina is evaluated and diagnosed with Molluscum Contagiosum. The nurse practitioner understands that clinical presentation of this disease is characterized by:

Fleshy, papular skin colored lesions with indented centers that contain white curdlike material.

 Ulcerated ragged edge lesions that are painful

 Clusters of vesicles that itch and are painful to palpation

 Painless fleshy clusters of growths that resemble grapes or cauliflower

Question 35

  Sara is 72 years old and has been a widow for 12 years. She presents for her yearly well woman exam. Sara has not been sexually active since age 60. She has had regular pap screenings in her life and has had no abnormal pap tests. Sara asks if she needs a Pap test. Your response would be:

Question 35 options:

 Yes, you need a Pap test with HPV testing every 5 years.

 Yes, you should have a Pap test every 3 years.

 No, you do not need a Pap test or a pelvic exam again, unless you notice a vaginal discharge, have discomforts, or anything out of the ordinary.

 No, you do not need a Pap test, but I do recommend we do a pelvic exam to assess for abnormalities.

Question 36

  Misty presents with a painful “sores” in her perineal area, dysuria and dyspareunia. On exam she has 2 shallow ulcerated lesions on the right labia majora and one on the left. She also presents with enlarged inguinal lymph nodes. Based on these findings you suspect she has:

Question 36 options:

 HSV-2

 Genital warts

 Chancroid

 Syphilis lesions

Question 37

  Which of the following is not true for HIV infection evaluation?

Question 37 options:

 The CDC recommends HIV testing for all persons seeking evaluation for STIs.

 HIV evaluation is recommended if a patient has a history of unprotected sex with a previously incarcerated male, an uncircumcised male, or participates in anal penetration.

 If a patient is fearful they have been exposed to HIV, but denies all risk factors, it is not recommended to test for HIV.

 Aids is caused by HIV, mainly by sexual contact (anal, vaginal, or oral), contaminated blood and blood products, contaminated semen used for artificial insemination, intrauterine acquisition, and breastmilk.

Question 38

  The nurse practitioner understands that the risk factors for developing vaginal candidiasis include which of the following?

Question 38 options:

 Hypoglycemia

 A diet high in refined sugar

 Use of Vit C supplement

 A habit of consuming live culture yogurt several times a week

 

Question 39

  Cindy presents to your clinic for STI testing after realizing her current boyfriend has been seeing other women. She states she was told that one of the women has hepatitis B. Your patient education regarding hepatitis B includes all the following except:

Question 39 options:

 Hepatitis B is transmitted enterically

 Hepatitis B has an incubation period of 6 weeks to 6 months

 Hepatitis B surface antigen (HBsAG) indicates if the patient has hepatitis B infection

 Hepatitis B infection primarily affects the liver

Question 40

  Stacy has made an appointment at your clinic for c/o dysuria. During the HPI she explains, “My bottom hurts when I pee, and I have bumps there”. She has never had this before and is worried. She denies fever, although she feels “a little like I have the flu” explaining she has a headache and feels achy and tired. She denies exposure to a STI noting she and her partner have been monogamous for 6 years. On exam you notice a cluster of painful vesicles adjacent to the vaginal introitus. The most likely diagnosis is:

Question 40 options:

 Syphilis

 Genital Herpes

 Chancroid

 Chlamydia

Question 41

  You see an 18-year-old woman with a history of Chlamydia infection and a total of five lifetime partners. Based on the latest evidence-based guidelines, you recommend:

Question 41 options:

 Pap smear only

 Pap smear with HPV testing

 Pap smear and STI testing

 STI testing only

Question 42

  Karen was recently diagnosed with primary syphilis. The nurse practitioner understands that the first-line treatment option for primary syphilis include:

Question 42 options:

 Penicillin

 Ciprofloxacin

 Erythromycin

 Ceftriaxone

Question 43

  While educating Karen about the different stages of syphilis, which of the following is not representative of the presentation of secondary syphilis?

Question 43 options:

 generalized rash

 chancre

 arthralgia

 lymphadenopathy

Question 44

  Karen was recently diagnosed with primary syphilis by her primary care provider, she is very upset and inquires how long after sexual contact do syphilis symptoms typically occur. What is the correct response by the primary care provider?

Question 44 options:

 3-4 days

 1 week

 3 weeks

 6 weeks

Question 45

  Which of the following terms describe the mechanism of action of Imiquimod (Aldara) in the management of genital warts?

Question 45 options:

 keratolytic

 immune modifier

 cryogenic

 cytolytic

 

Question 46

  The nurse practitioner understands that HPV types _____ and ____are most often associated with cervical and anogenital cancer.

Question 46 options:

 1, 2, and 3

 6 and 11

 16 and 18

 22 and 24

Question 47

  Jenna was evaluated and diagnosed with condylomaacuminatum. Treatment options for Jenna will include all of the following except:

Question 47 options:

 A)          Topical acyclovir

B)            Cryotherapy

C)            Podofilox

D)           Tricholoroaceticacid .

Question 48 Which of the following is a treatment option for a 30-year-old woman with PID and a history of severe hive-form reaction when taking a penicillin or cephalosporin?

Question 48 options:

A)           Ofloxacin with metronidazole

B)            Amoxicillin with gentamicin

C)            Cefixime with vancomycin

D)           Clindamycin with azithromycin

Question 49

The nurse practitioner understands that a complication of gonoccocal and chlamydial genitourinary infection in women include which of the following:

Question 49 options:

A)           Pelvic inflammatory disease (PID)

B)            Conjunctivitis

C)            Acute pyelonephritis

D)           Prostatitis

 

Question 50

The nurse practitioner understands that women with PID typically present with all of the following except:

Question 50 options:

A)            Fever

B)             Leukopenia

C)            Cervical motion tenderness

D)           abdominal pain

Question 51 Elizabeth was evaluated and diagnosed with a primary outbreak of genital herpes in the clinic today. The treatment plan for Elizabeth will include a prescription for:

Question 51 options:

A)            Ribavirin

B)            Indinavir

C)            Valacyclovir

D)           Cyclosporine

 

Question 52 Elizabeth was recently diagnosed with genital herpes after having unprotected intercourse with a new partner. The nurse practitioner explains to Christine that the incubation period for HSV Type 2 is approximately:

Question 52 options:

A)           4 to 7 days up to 4 weeks

B)            24 hours

C)            24 days

D)           1 to 3 days up to 14 days

 

Question 53  

Kristin returns to the clinic for follow-up on STI results. The nurse practitioner informs her the Chlamydia test was positive. Which of the following agents will the nurse practitioner prescribe for treatment?

Question 53 options:

A)           Amoxicillin

B)            Metronidazole

C)            Azithromycin

D)           Tinidazole

Question 54

The nurse practitioner student is studying the CDC guidelines for treating sexually transmitted infections. Which of the following agents is recommended for Gonorrhea treatment?

Question 54 options:

A)           Ceftriaxone

B)            Doxycycline

C)            Ketoconazole

D)           Amoxicillin

Question 55

A 30-year-old woman presents without symptoms but states that her male partner has dysuria without penile discharge. Examination of the woman reveals a friable cervix with yellow discharge from the cervical os. This description is most consistent with an infection caused by: Select all that apply.

Question 55 options:

A)           Chlamydia trachomatis

B)            Neisseria gonorrhoeae

C)            Human papilloma virus (HPV)

D)           Trichomonas vaginalis

 

Question 56 Karen was diagnosed with trichomoniasis by her primary care provider and treated with:

Question 56 options:

A)           Metronidazole 500 mg po BID x 7 days

(If single-dose metronidazole treatment fails and reinfection is excluded, metronidazole 500 mg orally twice a day for 7 days should be prescribed.) this is the correct answer if first treatment doesn’t work

B)            Terconazole vaginally Q HS x 5 days

C)            Azithromycin 1 gm po x 1 dose

D)           Bactrim DS ipo Q 12 hours x 3 days

Question 57 A 24-year-old woman presents with a 1-week history of thin, greenish yellow vaginal discharge with perivaginal irritation. Physical examination findings include vaginal erythema with petechial hemorrhages on the cervix, numerous white blood cells, and motile organisms on microscopic examination. These findings most likely represent:

Question 57 options:

A)           motile sperm with irritative vaginitis

B)            trichomoniasis

C)            bacterial vaginosis

D)           condylomaacuminatum

Question 58

For patients needing topical treatment for vulvovaginitis caused by Candida albicans, the nurse practitioner will prescribe:

Question 58 options:

 A)          metronidazole gel

B)            clotrimazole cream

C)            hydrocortisone ointment

D)           clindamycin cream

 

Question 59

The nurse practitioner understands that women with bacterial vaginosis typically present with:

Question 59 options:

A)           vulvitis

B)            pruritus

C)            dysuria

D)           malodorous discharge

Question 60

The U.S. Preventative Services Task Force (USPSTF) recommends ____________ of folic acid supplement daily at least one month before conception for all women with average risk for neural tube defects.

Question 60 options:

A)           8000 mg

B)            .4 to .8 mg

C)            4 to 8 mg

D)           4000 mg

 

Question 61

The American College of Obstetrician &Gynecologists recommend that all pregnant women be offered aneuploidy screening before 20 weeks gestation. This test identifies women whose fetuses are at increased risk for which of the following? Select all that apply.

Question 61 options:

A)           Trisomy 11

B)            Trisomy 13

C)            Trisomy 18

D)           Trisomy 21

 

Question 62  

An important part of patient education for the patient with bacterial vaginosis who is receiving a prescription for oral Metronidazole is:

Question 62 options:

The patient should be treated prophylactically for a yeast infection.

The medication may cause constipation.

Avoid alcohol for 48 hours after completing medication.

The patient’s partner will need treatment also.

Question 63

  For the patient with chronic bacterial vaginosis, the nurse practitioner will prescribe:

Question 63 options:

 A)          Metronidazole 500 mg po weekly for 2 months

B)            Metronidazole 500 mg po BID x 7 days

C)            Metronidazole gel .75% vaginally BID x 5 days

D)           Metronidazole gel .75% vaginally 1-2 times a week for 4 to 6 months

 

Question 64

The nurse practitioner’s exam findings on a patient with vaginal Candidiasis is positive for all of the following except:

Question 64 options:

A)           erythematous vaginal mucosa

B)            thick, white, curd-like vaginal discharge

C)            vaginal ph of 7

D)           hyp