NSG 6430 Final Exam (2018): South University
Question 1 (2.5 points)
The nurse practitioner knows that a highly valuable assessment tool for evaluating urinary incontinence and contributing factors in daily life is:
Question 1 options:
A) the interview
B) a voiding diary
C) the physical exam
D) the patient's response to non-pharmacologic treatments
Question 2 (2.5 points)
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.
Question 2 options:
A. Bladder training
B. Kegel exercises
C. Eliminate caffeine and alcohol consumption
D. Use of bulking agents
Question 3 (2.5 points)
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:
Question 3 options:
A) Hegar's Sign
B) Chadwick's Sign
C) Nightingale's Sign
D) Goodell's Sign
Question 4 (2.5 points)
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:
Question 4 options:
B) Granuloma Inguinale
D) Molluscum Contagiosum
Question 5 (2.5 points)
The physical examination of any woman suspected of being abused or battered includes all of the following except:
Question 5 options:
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 (2.5 points)
The most effective means of obtaining the history of abuse is to use a communication model that:
Question 6 options:
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 (2.5 points)
Clinicians should routinely consider intimate partment violence (IPV) as a possible diagnosis for women who present with all of the following except:
Question 7 options:
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 (2.5 points)
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 (2.5 points)
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 (2.5 points)
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 (2.5 points)
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 (2.5 points)
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
Question 13 (2.5 points)
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 (2.5 points)
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 (2.5 points)
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 (2.5 points)
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
Question 17 (2.5 points)
The nurse practitioner understands that all of the following organisms are responsible for infection of the Bartholin's gland except:
Question 17 options:
Question 18 (2.5 points)
Treatment of a large, symptomatic Bartholin's cyst includes all of the following except:
Question 18 options:
Incision and drainage
Question 19 (2.5 points)
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:
Question 19 options:
GnRH agonist therapy
Referral for surgical consult
Question 20 (2.5 points)
The nurse practitioner is treating a patient with Elimite for scabies. The proper instructions to the patient should include:
Question 20 options:
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 (2.5 points)
The nurse practitioner understands that the proper management of an asymptomatic woman with a small fibroid should include:
Question 21 options:
Start combination COC therapy.
Repeat ultrasound in 3-4 months.
Reassess in 6 to 12 months.
Refer for myomectomy.
Question 22 (2.5 points)
The nurse practitioner is teaching a patient about pediculosis. Which of the following statements by the nurse practitioner is correct?
Question 22 options:
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 (2.5 points)
All of the following medications may be used for neuropathic pain management of vulvodynia, except:
Question 23 options:
Question 24 (2.5 points)
The nurse practitioner understands that which of the following lab tests is appropriate for the patient who presents with symptoms of dysesthetic vulvodynia?
Question 24 options:
Question 25 (2.5 points)
Which of the following is a common antibiotic for treatment of an infected Bartholin's cyst?
Question 25 options:
Question 26 (2.5 points)
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?
Question 26 options:
Question 27 (2.5 points)
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:
Question 27 options:
A) Ectopic pregnancy
C) Ovarian cyst with rupture
D) Pelvic Congestion Syndrome
Question 28 (2.5 points)
When women experience mild premenstrual symptoms, such as mild breast tenderness, abdominal bloating, and mild weight gain from water retention, this is known as:
Question 28 options:
Luteal phase deficiency
Premenstrual dysmorphic disorder
Follicular phase deficiency
Question 29 (2.5 points)
A patient with intraductal papilloma will commonly present with a chief complaint of:
Question 29 options:
A palpable mass
Bloody nipple discharge
Bilateral milky discharge
Mild localized pain
Question 30 (2.5 points)
The nurse practitioner understands that the necessary screening techniques in a patient suspicious of ovarian cancer should include the following: Select all that apply.
Question 30 options:
Bimanual pelvic exam
Question 31 (2.5 points)
Early symptoms experienced by a woman with ovarian cancer include all of the following except:
Question 31 options:
Vague abdominal pain
Unexplained weight gain
Question 32 (2.5 points)
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
Oral Contraceptive Use
Question 33 (2.5 points)
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 (2.5 points)
Tina is evaluated and diagnosed with Molluscum Contagiosum. The nurse practitioner understands that clinical presentation of this disease is characterized by:
Question 34 options:
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 (2.5 points)
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 (2.5 points)
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:
Question 37 (2.5 points)
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 (2.5 points)
The nurse practitioner understands that the risk factors for developing vaginal candidiasis include which of the following?
Question 38 options:
A diet high in refined sugar
Use of Vit C supplement
A habit of consuming live culture yogurt several times a week
Question 39 (2.5 points)
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 (2.5 points)
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:
Question 41 (2.5 points)
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