Walden NURS6551 Midterm Exam

How can liver and renal diseases result in abnormal uterine
bleeding (AUB)?

a. They cause an imbalance in platelet
aggregation.

b. They result in an inability to
adequately clear estrogen from the body.

c. They cause thyroid dysfunction,
which leads to bleeding abnormalities.

d. They result in elevated prolactin
levels, which lead to bleeding abnormalities.

What is now thought to be the most important causative agent
in cervical cancer?

a. PCOS

b. Vulvar cancer

c. Herpes simplex

d. HPV

An initial or primary genital herpes infection
characteristically lasts about:

a. 1 week

b. 3 weeks

c. 1 month

d. 6 weeks

Which contraceptive methods have inherent failure rates?

a. None

b. Some

c. All

d. All except sterilization

Why do adolescents have the highest risk of developing
pelvic inflammatory disease (PID)?

a. They have the highest risk for
bacterial vaginosis.

b. They are the least at risk for
developing other STIs.

c. They are the most sexually active.

d. They have decreased immunity to
infectious organisms.

Exercise-induced amenorrhea is probably due to the
combination of low body fat and decreased secretion of:

a. Estrogen

b. Prolactin

c. Progesterone

d. GnRH

What can result from an imbalance in the vaginal flora?

a. Herpes simplex virus

b. Human papillomavirus

c. Chlamydia

d. Bacterial vaginosis

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

What is the most common STI in the United States?

a. Gonorrhea

b. Chlamydia

c. Syphilis

d. Herpes simplex virus

Progestin-only pills (POPs):

a. Have no possible side effects

b. Suppress ovulation as reliably as
COCs

c. May be taken earlier or later than
prescribed

d. In combination with lactation are
nearly 100% effective

According to the World Health Organization (WHO), the
presence of a disease state:

a. Necessitates prompt medical
attention

b. Excludes a person from being
considered healthy

c. Does not exclude a person from
being considered healthy

d. Classifies a person as in poor
health

Which of the following might be a sign of hyperandrogenism?

a. Irritable bowel syndrome

b. Decreased sebum secretion in the
skin

c. Decreased muscle mass

d. Acne associated with menstrual
dysfunction

Surgical abortion represents an option for women who desire
termination of pregnancy beyond:

a. 8 weeks’ gestation

b. 12 weeks’ gestation

c. 4 weeks’ gestation

d. 15 weeks’ gestation

How can weight loss specifically control symptoms of
polycystic ovary syndrome (PCOS)?

a. It decreases SHBG.

b. It increases insulin resistance.

c. It decreases androgen levels.

d. It increases estrogen levels.

Why is acknowledging the oppression of women more difficult
within Western societies?

a. The multiplicity of minority groups
complicates the issue.

b. The availability of health care
makes acknowledgment more difficult.

c. The diversity of the news media
clouds the issue.

d. Affluence and increased
opportunities mask oppression.

How does vaginosis differ from vaginitis?

a. It must be treated with
metronidazole.

b. The discharge does not contain white
blood cells.

c. The discharge does not have an
odor.

d. It causes itching and/or burning.

What area of injury prevention is a focus of the USPSTF’s
guidelines for counseling all healthy, asymptomatic women?

a. Motor vehicle accidents

b. Falls

c. Domestic violence

d. All of the above

What approach does Healthy People 2020 use to achieve its
goals and objectives?

a. Social determinants of health

b. Evidence-based determinants of
health

c. Quality-of-life determinants of
health

d. Longevity promotion determinants of
health

Approximately what percentage of women with bacterial
vaginosis are asymptomatic?

a. 25%

b. 40%

c. 75%

d. 50%

The genetic counselor has a significant role in the care of
women because BRCA1 and BRCA2 genetic mutations account for 5 to 10 percent of
all _______ cancer cases.

a. Breast

b. Ovarian

c. Uterine

d. Pancreatic

Which organism causes 90% of vulvovaginal candidiasis
episodes in women?

a. Candida tropicalis

b. Candida albicans

c. Candida glabrata

d. Candida krusei

What term refers to the period from about 7 to 10 days
before menstrual flow begins until the first or second day of menstrual flow?

a. Amenorrhea

b. Premenstrual

c. Dysmenorrhea

d. Perimenstrual

The ParaGard IUD is impregnated with copper and is effective
for:

a. 15 years

b. 3 years

c. 5 years

d. 10 years

What is the danger of giving estrogen replacement therapy
(ERT) to menopausal women with an intact uterus?

a. A higher risk of heart disease

b. An increased likelihood of blood
clots

c. An increased likelihood of
osteoporosis

d. A higher risk of endometrial cancer

Although barrier contraception methods are less effective in
preventing pregnancy than more modern methods, interest in them is on the rise
because they:

a. Can help protect against STIs,
including HIV

b. Are coitus dependent and require planning

c. Are nonallergenic and male
controlled

d. Involve the use of hormones

A risk factor that could lead to endometrial cancer is:

a. Early menopause

b. Late menopause

c. High blood pressure

d. Cervical cancer

Of the two intrauterine contraceptive devices currently
available in the United States only one provides a local delivery of protestin.
It is the:

a. Combined contraceptive patch (Ortho
Evra)

b. Copper IUD (T380A, ParaGard)

c. LNG-IUS (Mirena)

d. Dalkon Shield

Approximately what percentage of vulvar cancers occur in
women older than the age of 50?

a. 50%

b. 70%

c. 85%

d. 60%

What is the best definition of abnormal uterine bleeding
(AUB)?

a. Uterine bleeding for which no pelvic
pathology is found

b. Uterine bleeding that is irregular
during a woman’s menstrual cycle

c. Uterine bleeding that is irregular
in amount or frequency

d. Uterine bleeding that is related to
systemic conditions

The most common benign breast masses are:

a. Galactoceles

b. Hamartomas

c. Fibroadenomas and cysts

d. Lipomas and phyllodes tumors

Which cancer has the highest mortality rate of all
gynecological cancers?

a. Vulvar cancer

b. Endometrial cancer

c. Cervical cancer

d. Ovarian cancer

Vulvovaginal candidiasis accounts for what percentage of all
vaginal infections?

A. 10–15%

B. 20–25%

C. 50–55%

D. 60–65%

Which type of counseling results in a statistically
significant reduction in STIs?

a. Abstinence-only education

b. Counseling delivered in multiple
individual or group sessions totaling more than 3 hours

c. Remote counseling via Internet or
phone

d. Brief, individual sessions in the
primary care setting

Which of the following is an ethical issue that is specifically
associated with pre-implantation testing with ART?

a. Ownership of frozen embryos after
the couple has divorced

b. A surrogate deciding she does not
want to relinquish the infant

c. Genetic engineering and the ability
to reject embryos affected by inherited disorders

d. The implantation of multiple
embryos, which can create high risk for the embryos and the woman

What symptom is present in 80 to 90 percent of women with
cervical cancer?

a. Abnormal vaginal bleeding

b. Abnormal vaginal discharge

c. Pelvic pain

d. Ectopic pregnancy

If a patient has not reported a sexual assault to law
enforcement, all of the following clinician actions are important except:

a. Asking if reporting is something she
wants to consider

b. Discussing any fears or concerns
that she may have about reporting

c. Explaining that only some forced
sexual contacts are reportable crimes

d. Telling her that women who report do
better psychologically than those who do not

What test should be ordered for a woman who is experiencing
abnormal uterine bleeding (AUB) as well as headaches and peripheral vision
changes?

a. Thyroid-stimulating hormone test

b. Nucleic acid amplification test

c. Complete blood count

d. Prolactin level test

What had been a significant problem in medical research well
into the 1990s?

a. The focus on randomized clinical
trials over epidemiological investigations

b. The lack of representation of women
in research trials

c. The lack of research related to
gynecology

d. The focus on randomized clinical
trials over observational research

What is the definitive diagnostic technique for vulvar
dermatoses?

a. Pap test

b. Biopsy

c. Colposcopy

d. Physical exam

Where in the breast do most malignancies develop?

a. Upper inner quadrant

b. Upper outer quadrant

c. Lower outer quadrant

d. Lower inner quadrant

Approximately how many Americans will contract one or more
sexually transmitted infections during their lifetime?

a. 50%

b. 25%

c. 40%

d. 60%

In the GTPAL system for recording pregnancy history, the “T”
stands for:

a. Term births

b. Terminal pregnancies

c. Total number of pregnancies

d. Type of birth (spontaneous,
assisted, or cesarean)

Both very young and elderly sexual assault victims:

a. Are addressed in most state
mandatory reporting laws

b. never has any difficulty describing
the incident and related symptoms

c. Require the same equipment for
proper examination that others do

d. Have fewer injuries than victims of
other age groups

What is one of the side effects of hormonal contraceptives?

a. Reduction in ovarian cancer risk

b. Increased menstrual blood loss

c. Increased risk of endometrial
cancer

d. Heavier menstrual flow

Tubal sterilization for women who have completed their
families is highly effective, but there are disadvantages such as:

a. Women are less likely to use condoms
or return for health services.

b. There is a decreased risk of ovarian
cancer and pelvic inflammatory disease.

c. There is a high likelihood of complications
and side effects.

d. The surgery is not covered by
insurance.

What is the current (2006) recommendation by the CDC
regarding HIV testing?

a. Test all patients who report risk
behaviors associated with HIV.

b. Test all patients unless they
explicitly decline to be tested.

c. Test all patients.

d. Test only those patients who ask to
be tested.

What is generally the cause of Bartholin’s cyst?

a. Complications from gonorrhea

b. Cystic fluid in Bartholin’s gland
becomes infected

c. A fungal infection in Bartholin’s
gland

d. Obstruction of a duct in Bartholin’s
gland

Which of the following factors associated with increased
risk for developing osteoporosis appears to be the best predictor of risk?

a. Smoking

b. Low body weight

c. Sedentary lifestyle

d. Family history

What is the definition of primary amenorrhea?

a. The cessation of menses for an
interval of 6 months

b. The failure to begin menses by age
14

c. The cessation of menses due to
outflow tract obstruction

d. The failure to begin menses by age
16

In respect to an evidentiary examination:

a. The patient may not withhold consent
if the clinician is a mandated reporter.

b. The clinician is required to
strictly follow local agency protocols, no others.

c. The time frame within which it must
take place depends on local standards.

d. Maintaining the chain of custody of
all evidence collected is recommended, not required.

QUESTION 1

1. Which of
the following is a diagnostic label that is listed in the Diagnostic and Statistical
Manual IV-TR?

2. 3. a. 4. Premenstrual dysphoric disorder

5. 6. b. 7. Premenstrual magnification

8. 9. c. 10. Dysmenorrhea

11. 12. d. 13. Premenstrual syndrome

1. About
half of all pregnancies in the United States are unintended and occur most
frequently in women who:

2. 3. a. 4. Are married or divorced

5. 6. b. 7. Have finished high school

8. 9. c. 10. Are between the ages of 18 and 24

11. 12. d. 13. Are members of the majority group

What is one factor that can reduce the risk for the
development of ovarian cancer?

a. Multiple pregnancies

b. Transvaginal ultrasounds

c. Identification of recurrence

d. Weight loss

What percentage of toxic shock syndrome cases are related to
menses?

a. 50%

b. 25%

c. 75%

d. 90%

Tubal sterilization for women who have completed their
families is highly effective, but there are disadvantages such as:

a. Women are less likely to use condoms
or return for health services.

b. There is a decreased risk of ovarian
cancer and pelvic inflammatory disease.

c. There is a high likelihood of
complications and side effects.

d. The surgery is not covered by
insurance.

Women who report experiencing the most severe symptoms of
PMS tend to be: In their late 40s

1. 2. a. 3. In their late 40s

4. 5. b. 6. In their early 20s

7. 8. c. 9. In their late teens

10. 11. d. 12. In their late 30s

What is the definition of primary amenorrhea?

a. The cessation of menses for an
interval of 6 months

b. The failure to begin menses by age
14

c. The cessation of menses due to
outflow tract obstruction

d. The failure to begin menses by age
16

How many stages does the Tanner scale use to stage sexual
maturity?

a. 3 stages

b. 5 stages

c. 6 stages

d. 8 stages

Which contraceptive methods have inherent failure rates?

1. 2. a. 3. None

4. 5. b. 6. Some

7. 8. c. 9. All

10. 11. d. 12. All except sterilization

What is the most common type of menstrual dysfunction
related to hyperandrogenism?

a. Painful menstruation

b. Absence of menses

c. Irregular bleeding

d. Early menopause

Combined oral contraceptives (COCs) are among the most
extensively studied medications available. Which one of the following
statements about their use has been found to be true?

a. Broad-spectrum antibiotics may
enhance their efficacy.

b. They do not increase the risk of
venous thromboembolism.

c. They decrease the relative risk of
ovarian and endometrial cancers.

d. Among possible side effects are
acne, hirsuitism, and benign breast conditions.

Many patients experiencing intimate partner violence (IPV)
meet the criteria for diagnosing PTSD. Those criteria include all of the
following except:

1. 2. a. 3. Experiencing a traumatic event

4. 5. b. 6. Reexperiencing the traumatic event

7. 8. c. 9. Numbness and avoidance

10. 11. d. 12. Hypovigilance

Which of the following is an ethical issue that is
specifically associated with pre-implantation testing with ART?

1. 2. a. 3. Ownership of frozen embryos after
the couple has divorced

4. 5. b. 6. A surrogate deciding she does not
want to relinquish the infant

7. 8. c. 9. Genetic engineering and the ability
to reject embryos affected by inherited disorders

10. 11. d. 12. The implantation of multiple embryos,
which can create high risk for the embryos and the woman

The ________ is probably the most widely used intimate
partner violence (IPV) screen.

a. Three-question AAS (McFarlane et
al., 1992)

b. Campbell’s Danger Assessment (2003)

c. Sheridan’s HARASS Instrument

d. Helton’s nine-question AAS

What is the term for the absence of menses for 3 to 6 months
in a woman who has previously menstruated and is not pregnant, breastfeeding,
or menopausal?

1. 2. a. 3. Primary amenorrhea

4. 5. b. 6. Initial dysmenorrhea

7. 8. c. 9. Secondary amenorrhea

10. 11. d. 12. Primary dysmenorrhea

Among women age 55 years and older:

a. Macromastia is the most common cause
of breast masses.

b. Breast masses are presumed malignant
until proven otherwise.

c. Most breast masses decrease in size
over time and many resolve completely.

d. Diagnostic imaging of a breast mass
and tissue sampling should be deferred.

Both very young and elderly sexual assault victims:

1. 2. a. 3. Are addressed in most state
mandatory reporting laws

4. 5. b. 6. never has any difficulty describing
the incident and related symptoms

7. 8. c. 9. Require the same equipment for
proper examination that others do

10. 11. d. 12. Have fewer injuries than victims of
other age groups

What is the major source of normal vaginal secretions?

a. Bartholin’s glands

b. Apocrine glands

c. Sebaceous glands

d. Cervical mucosa

Which one of the following statements about intimate partner
violence (IPV) is false?

1. 2. a. 3. It refers to an escalating pattern
of abuse.

4. 5. b. 6. It includes emotional abuse, such as
disregarding what a woman wants.

7. 8. c. 9. It includes using physical force to
make a woman engage in a sexual act against her will.

10. 11. d. 12. It refers to a current or former
spouse or dating partner of the opposite sex, not someone of the same sex.

How is being overweight defined on the BMI table?

a. 18–29.9

b. 20–29.9

c. 25–29.9

d. 30 or greater

What has contributed to the decreased incidence of hepatitis
B over the past 20 years?

1. 2. a. 3. The decrease in PID

4. 5. b. 6. The HBV vaccination

7. 8. c. 9. The increase in condom use

10. 11. d. 12. More precise screening methods

Which are the most common forms of hepatitis seen in women’s
health practices?

a. A and B

b. A and D

c. B, C, and D

d. B and C

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:

1. 2. a. 3. Sexual health

4. 5. b. 6. Gender identity

7. 8. c. 9. Gender role behaviors

10. 11. d. 12. Psychosocial orientation

What test should be ordered for a woman who is experiencing
abnormal uterine bleeding (AUB) as well as headaches and peripheral vision
changes?

a. Thyroid-stimulating hormone test

b. Nucleic acid amplification test

c. Complete blood count

d. Prolactin level test

Surgical abortion represents an option for women who desire
termination of pregnancy beyond:

1. 2. a. 3. 8 weeks’ gestation

4. 5. b. 6. 12 weeks’ gestation

7. 8. c. 9. 4 weeks’ gestation

10. 11. d. 12. 15 weeks’ gestation

What population of women should be screened for signs and
symptoms of thyroid dysfunction?

1. 2. a. 3. All women

4. 5. b. 6. Older women

7. 8. c. 9. Older women, smokers, and women with
diabetes

10. 11. d. 12. Older women, postpartum women, and
women with Down syndrome

All of the following diagnostic testing and procedures are
now infrequently performed in clinical practice except:

1. 2. a. 3. Hysterosalpingogram

4. 5. b. 6. Sperm penetration assay

7. 8. c. 9. The postcoital test (PCT)

10. 11. d. 12. Endometrial biopsy (EMB)

The most common site for endometrial implants found in other
parts of the body is:

1. 2. a. 3. The appendix

4. 5. b. 6. The uterus

7. 8. c. 9. The ovaries

10. 11. d. 12. The fallopian tubes

Women who have had toxic shock syndrome should be instructed
not to use tampons or:

a. Barrier contraception methods

b. Hormonal contraception methods

c. Intravaginal antibiotic cream

d. Oral antibiotics

Cyclic mastalgia:

a. More likely causes unilateral,
localized pain that is sharp or burning in nature

b. Has an increased risk of occurrence
in women whose diets are low in fat

c. Occurs most frequently in women who
are 18 to 30 years old

d. Is caused by hormonal changes
associated with menstruation

The incidence of uterine fibroids:

1. 2. a. 3. Increases with age

4. 5. b. 6. Decreases with age

7. 8. c. 9. Is often caused by early menopause

10. 11. d. 12. Is related to the age of first menses

Patients presenting for STI treatment should be screened for
HIV:

a. At each visit

b. At the end of treatment

c. At the beginning of treatment

d. Each year

1. What
screening recommendation is similar across all groups for colorectal cancer?

2. 3. a. 4. Screening women age 76 to 85 based
on risk factors

5. 6. b. 7. Screening only for those women at
increased risk

8. 9. c. 10. Screening for all women starting at
age 50

11. 12. d. 13. Against routine screening in adults
age 76 and over

Approximately what percentage of vulvar cancers occur in
women older than the age of 50?

a. 50%

b. 70%

c. 85%

d. 60%

Signs of endometrial or cervical cancer may present abnormal
uterine bleeding, often as heavy, prolonged bleeding or:

1. 2. a. 3. Menometrorrhagia

4. 5. b. 6. Amenorrhea

7. 8. c. 9. Oligomenorrhea

10. 11. d. 12. Polymenorrhea

In the GTPAL system for recording pregnancy history, the “T”
stands for:

a. Term births

b. Terminal pregnancies

c. Total number of pregnancies

d. Type of birth (spontaneous,
assisted, or cesarean)

What is now thought to be the most important causative agent
in cervical cancer?

a. PCOS

b. Vulvar cancer

c. Herpes simplex

d. HPV

The most common sites of metastatic spread of invasive
breast cancer include all of the following except:

1. 2. a. 3. Bones

4. 5. b. 6. Lungs

7. 8. c. 9. Pituitary

10. 11. d. 12. Lymph nodes

Who should be screened regularly for STIs?

a. Women who have more than one sexual
partner

b. Women over the age of 21

c. Women who are sexually active

d. Women over the age of 15

What is a common vasomotor symptom of menopause?

1. 2. a. 3. Blood clots

4. 5. b. 6. Night sweats

7. 8. c. 9. Osteoporosis

10. 11. d. 12. Hysterectomy

What is the best definition of abnormal uterine bleeding
(AUB)?

a. Uterine bleeding for which no pelvic
pathology is found

b. Uterine bleeding that is irregular
during a woman’s menstrual cycle

c. Uterine bleeding that is irregular
in amount or frequency

d. Uterine bleeding that is related to
systemic conditions

What should be the clinician’s first objective after
learning the chief reason the woman desires care?

a. To give the reason or problem a
structural and chronological framework

b. To probe for any additional concerns
missed

c. To take a family history related to
the presenting concern

d. To gain insight into the woman’s
cultural and social influences

No risk factors other than age are identifiable in ______ of
women with breast cancer.

a. 100%

b. 85%

c. 60%

d. 24%

The highest prevalence of human papillomavirus (HPV) is
found among women ages:

a. 18–20

b. 20–24

c. 25–30

d. 30–35

Although barrier contraception methods are less effective in
preventing pregnancy than more modern methods, interest in them is on the rise
because they:

a. Can help protect against STIs,
including HIV

b. Are coitus dependent and require
planning

c. Are nonallergenic and male
controlled

d. Involve the use of hormones