Chapter 8: Reproductive System

Question 1

1. Smooth muscle relaxation and shunting of blood into the sinusoids is mediated by and results in a penile erection.
   A) norepinephrine
   B) nitroglycerine
   C) nitric oxide
   D) nicotinic acid

Answer 1

C) nitric oxide

Question 2

2. Priapism is a condition that causes ischemia as a result of:
   A) circumcision trauma.
   B) failure of detumescence.
   C) tight retracted foreskin.
   D) fibrous plaque in the penis.

Answer 2

B) failure of detumescence.

Question 3

3. Common risk factors for erectile dysfunction due to generalized penile arterial insufficiency include:
   A) cryptorchidism.
   B) cigarette smoking.
   C) testicular torsion.
   D) benign prostate hypertrophy.

Answer 3

B) cigarette smoking.

Question 4

4. Squamous cell cancer of the penis is more likely to develop in men with chronic:
   A) erectile dysfunction.
   B) herpes ulcerations.
   C) Peyronie disease.
   D) smegma accumulation.

Answer 4

D) smegma accumulation.

Question 5

5. In a hydrocele, excess fluid is present in the:
   A) epididymis.
   B) tunica vaginalis.
   C) pampiniform plexus.
   D) vas deferens ampulla.

Answer 5

B) tunica vaginalis.

Question 6

6. Testicular torsion, a serious disorder affecting young male individuals, causes:
   A) inguinal herniation.
   B) cancer of the scrotum.
   C) dartos muscle atrophy.
   D) loss of testicular perfusion.

Answer 6

D) loss of testicular perfusion.

Question 7

Men older than age 50 are at high risk for prostatic hypertrophy with complications that include:
A) hypospadias.
B) scrotal edema.
C) urine retention.
D) testicular cancer.

Answer 7

C) urine retention.

Question 8

8. The major cause of acute prostatitis is:
   A) prostate hyperplasia.
   B) acute pyelonephritis.
   C) gram negative
   D) mucous gland overgrowth.
   E) coli.

Answer 8

C) gram negative

Question 9

9. The most important factor in the evaluation and treatment of benign prostatic hypertrophy (BPH) is considered to be:
   A) frequency of erectile dysfunction.
   B) testosterone level management.
   C) prostate cancer prevention measures.
   D) subjective symptoms reported by the patient.

Answer 9

D) subjective symptoms reported by the patient.

Question 10

10 Cryptorchidism, or undescended testes, is a direct cause of:
.
A) infertility.
B) paraphimosis.
C) prostate cancer.
D) low testosterone.

Answer 10

A) infertility.

Question 11

11 Which of the following physiologic processes results from the synthesis and
. release of testosterone?
A) Protein catabolism
B) Musculoskeletal growth
C) Release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
D) Prostatic hyperplasia

Answer 11

B) Musculoskeletal growth

Question 12

12 A 41-year-old patient has undergone a vasectomy. What is the physiologic
. basis for this contraception technique?
A) Spermatogenesis is inhibited because sex hormones may no longer stimulate the Sertoli cells.
B) Spermatozoa can no longer reach the epididymis and do not survive.
C) The rete testis becomes inhospitable to sperm.
D) Sperm can no longer pass through the ductus deferens.

Answer 12

D) Sperm can no longer pass through the ductus deferens.

Question 13

13 A patient has been diagnosed with an anterior pituitary tumor, and synthesis
. and release of follicle-stimulating hormone has become deranged. What are the potential consequences of this alteration in endocrine function?
A) Dysfunction of spermatogenesis
B) Overproduction of luteinizing hormone
C) Inhibition of testosterone synthesis
D) Impaired detumescence

Answer 13

A) Dysfunction of spermatogenesis

Question 14

14 Which of the following factors constitutes the most significant risk for
. balanitis xerotica obliterans?
A) Multiple sexual partners
B) Androgen deficiency
C) Uncircumcised penis
D) Chronic prostatitis

Answer 14

C) Uncircumcised penis

Question 15

15 Which of the following disorders of the male genitourinary system creates
. the most urgent need for prompt and aggressive medical treatment?
A) Spermatocele
B) Benign prostatic hyperplasia (BPH)
C) Intravaginal testicular torsion
D) Erectile dysfunction

Answer 15

C) Intravaginal testicular torsion

Question 16

16 A 30-year-old man has been diagnosed with mumps orchitis, a disease that
. has the potential to result in:
A) hematuria.
B) hematocele.
C) sterility.
D) penile atrophy.

Answer 16

C) sterility.

Question 17

17 After seeking care due to recent history of testicular enlargement and scrotal
. pain, a 22-year-old college student has been diagnosed with testicular cancer. Which of the patients following statements indicates the need for further teaching?
A) I cant shake this feeling like Ive received a death sentence.
B) I have to admit that the prospect of losing a testicle is a bit overwhelming.
C) I really hope the cancer hasnt spread anywhere, because Ive read that its a possibility.
D) I guess theres some solace in the fact that this cancer wasnt a result of an unhealthy lifestyle.

Answer 17

A) I cant shake this feeling like Ive received a death sentence.

Question 18

18 Which of the following assessments is most likely to reveal a potential
. exacerbation in a 70-year-old patients diagnosis of benign prostatic hyperplasia (BPH)?
A) Urine testing for microalbuminuria
B) Blood test for white blood cells and differential
C) Bladder ultrasound
D) Sperm morphology testing

Answer 18

C) Bladder ultrasound

Question 19

19 Which of the following statements about screening for prostate cancer is
. most accurate?
A) Digital rectal examination detects the majority of new cases of prostate cancer.
B) A positive prostate-specific antigen (PSA) test is definitive for prostate cancer.
C) BPH and prostatitis can confound prostate screening results.
D) Digital rectal examination and PSA testing have been proven ineffective.

Answer 19

C) BPH and prostatitis can confound prostate screening results.

Question 20

20 Which of the following diagnoses is most likely to require surgical
. correction?
A) Hypospadias
B) Orchitis
C) Erectile dysfunction
D) Spermatocele

Answer 20

A) Hypospadias

Question 21

1. Acute cervicitis is an inflammation of the cervix characterized by:
   A) abscess formation.
   B) mucopurulent drainage.
   C) thick gray-white plaques.
   D) persistent pruritic vulvitis.

Answer 21

B) mucopurulent drainage.

Question 22

2. Carcinoma of the cervix is often considered to be a sexually transmitted disease associated with viral infection.
   A) Chlamydia trachomatis
   B) herpes simplex
   C) human papilloma
   D) varicella zoster

Answer 22

C) human papilloma

Question 23

3. Pelvic inflammatory disease, an inflammation of the female upper reproductive tract, is caused by:
   A) chronic endometriosis.
   B) ruptured tubal pregnancy.
   C) STD polymicrobial infection.
   D) serous luteal ovarian cysts.

Answer 23

C) STD polymicrobial infection.

Question 24

4. Endometriosis is characterized by painful hemorrhagic lesions in the pelvis and complications that include:
   A) pelvic adhesions.
   B) endometrial cancer.
   C) candidiasis vaginitis.
   D) bladder herniation.

Answer 24

A) pelvic adhesions.

Question 25

5. Leiomyomas are smooth muscle fibroid tumors that usually develop in:
   A) fibrocystic breasts.
   B) postmenopause.
   C) uterosacral ligaments.
   D) the corpus of the uterus.

Answer 25

D) the corpus of the uterus.

Question 26

6. Symptoms of difficulty in emptying the bladder, frequency, and urgency of urination are common in women with:
   A) rectocele.
   B) cystocele.
   C) endometritis.
   D) prolapsed uterus.

Answer 26

B) cystocele.

Question 27

7. Although there are no effective screening methods for ovarian cancer, and early symptoms are usually absent, there are high-risk indicators that include:
   A) nulliparity.
   B) lactation.
   C) mammary duct ectasia.
   D) oral contraceptive use.

Answer 27

A) nulliparity.

Question 28

8. Polycystic ovary syndrome (PCOS) is ovarian dysfunction caused by a combination of hormone imbalances that include levels.
   A) absent FSH
   B) insulin deficit
   C) elevated LH
   D) low androgen

Answer 28

C) elevated LH

Question 29

9. In the lactating woman, mastitis is usually the result of:
   A) intraductal papillomas.
   B) secretory cell hyperplasia.
   C) fibrocystic tissue changes.
   D) ascending bacterial infection.

Answer 29

D) ascending bacterial infection.

Question 30

10 Women are screened regularly for risk factors and manifestations of breast
. cancer. High-risk women may have a history of:
A) late menopause.
B) leiomyoma tumors.
C) STDs and vaginitis.
D) multiple pregnancies.

Answer 30

A) late menopause.

Question 31

11 Which of the following signs and symptoms is most likely to accompany a
. diagnosis of vulvodynia?
A) Vulvar pain
B) Purulent discharge
C) Urinary incontinence
D) Open lesions on the surface of the vulva

Answer 31

A) Vulvar pain

Question 32

12 A 21-year-old college student has sought care because of the vaginal
. burning, itching, and redness that have become worse in recent weeks. Which of the clinicians assessment questions is most likely to apply to a diagnosis of vaginitis?
A) Have your periods been regular in the last few months?
B) Have you ever had a sexually transmitted infection?
C) Are you using oral contraceptives?
D) Have you ever been pregnant?

Answer 32

B) Have you ever had a sexually transmitted infection?

Question 33

13 A 29-year-old patient had a Papanicolaou smear performed during her most
. recent visit to her primary care provider. This diagnostic procedure aims to identify:
A) dysplastic cervical cells.
B) human papillomavirus (HPV) antibodies.
C) cervical polyps.
D) lesions at the transformation zone.

Answer 33

A) dysplastic cervical cells.

Question 34

14 Which of the following physiologic processes is caused by estrogens?
.
A) Increased release of gonadotropin-releasing hormone (GnRH)
B) Stimulation of lactation in the postpartum period
C) Promotion of ovarian follicle growth
D) Progesterone synthesis

Answer 34

C) Promotion of ovarian follicle growth

Question 35

15 Which of the following disorders of the female genitourinary system is most
. likely to result from a disruption in normal endocrine function?
A) Ovarian cancer
B) Pelvic inflammatory disease (PID)
C) Polycystic ovary syndrome (PCOS)
D) Cervicitis

Answer 35

C) Polycystic ovary syndrome (PCOS)

Question 36

16 Which of the following complaints by middle-aged women should prompt a
. care provider to rule out the possibility of ovarian cancer?
A) Im having a lot of vaginal discharge lately and its quite foul.
B) My periods have become quite irregular since last winter.
C) I have a sharp, stabbing pain on my side for the last few days.
D) Im having a lot of indigestion and bloating, which are both new to me.

Answer 36

D) Im having a lot of indigestion and bloating, which are both new to me.

Question 37

18 Which of the following processes is a component of the pathogenesis of
. proliferative breast lesions without atypia?
A) Growth of ductile or lobular epithelial cells
B) Cystic dilation of terminal ducts
C) Increase in fibrous breast tissue
D) Fat necrosis leading to lesion formation

Answer 37

A) Growth of ductile or lobular epithelial cells

Question 38

19 Which of the following physiologic changes results in menopause?
A) Changes in anterior pituitary function that alter ovarian hormone production
B) Gradual resistance of ovarian target cells to LH and FSH stimulation
C) Cessation of ovarian function and decreased estrogen levels
D) Decreased levels of gonadotropin-releasing hormone (GnRH)

Answer 38

C) Cessation of ovarian function and decreased estrogen levels

Question 39

20 A 59-year-old woman with a recent diagnosis of breast cancer has begun a
. course of hormone therapy. What is the goal of this pharmacologic treatment?
A) Blocking the effects of progesterone on tumor growth
B) Increasing serum hormone levels to promote tumor cell lysis
C) Blocking the entry of malignant cells into the axillary lymph nodes
D) Blocking receptors on the surface of malignant cells

Answer 39

D) Blocking receptors on the surface of malignant cells

Question 40

What is a leiomyoma

Answer 40

uterine fibroid: firm, rubbery growth of smooth myometrium muscle
grow during menstural years, shrink with menopause
asymptomatic (usually)
increases risk for spontaneous abortion or preterm labor
- constipation
- pelvic pain
- heavy menstruation
- painful intercourse

treat with monitoring, hormone therapy, oral contraceptives (with caution, may increase growth), nsaids, surgery

Question 41

What is endometriosis?

Answer 41

growth of endometrial tissue outside the uterus
- dysmenorrhea
- pain during sex
- infertility
- uterus/cervix immobility
- adrenal mass

treat w/ hormone, nsaids, surgical repair

Question 42

Which of the following is a main risk factor for endometriosis?
A. Nulliparity
B. High BMI
C. STI
D. Late onset menstruation

Answer 42

A. Nulliparity

Question 43

A patient presents with chest pain, shortness of breath, fever, scrotal pain and swelling, and penile discharge. What is a likely diagnosis?
Myocardial infarction
Testicular tortion
Gonorrhea
syphilis

Answer 43

gonorrhea - gonorrhea may be asymptomatic, but can result in penile discharge. Left untreated, it can lead spread causing epididymitis (scrotal pain and swelling), or even endocarditis (chest pain, shortness of breath).

Question 44

True or False: When chancres are no longer present, the syphilis infection is no longer active and the patient is not contagious.

Answer 44

False - he bacteria may go dormant, resulting in resolution of symptoms, but the bacteria is still present and thus the patient is still contagious.

Question 45

Facts about endometrial cancer

Answer 45

cancer of the uterus, arises from the lining (endometrium)
- early signs = abnormal, painless bleeding d/t erosion of endometrium
- late signs = non bloody discharge, pain, mass

detection w/ pap smear, biopsy, US

Question 46

Facts about ovarian cancer

Answer 46

• cancer in the ovary (95% from epithelial cells; 5% from germ cells or connective tissues)
• genetic predisposition (BRCA1 & BRCA 2 defect), nulliparity, excessive extrogen, obesity
• early sign = abdominal distention, urinary frequency, felling full, GI disturbance
• late = pain, malaise, menstrual changes

not detectable w/ pap smear
CA-125 protein
ultrasound
biopsy

Question 47

Nitrous oxide is reduced during an erection T/F

Answer 47

F - increased to vasodilate

Question 48

Peak instance of testicular torsion

Answer 48

1st year
age 12-18

Question 49

A patient has herpes simplex 2 viral infection (HSV-2). The APRN recognizes that which of the following should be included in teaching the patient?

The virus causes “cold sores” of the lips.
Treatment is focused on relieving symptoms.
The virus may be cured with antibiotics.
The virus when active may not be contracted during intercourse

Answer 49

Treatment is focused on relieving symptoms.

Question 50

True or False:

HSV-2 can only be transmitted if there are active lesions.

Answer 50

false

Question 51

A 24-year-old woman presents to the clinic complaining of painful menses. She
states that for the last several years, she has had cramping pain in the days
preceding her menses as well as during her menses. In addition, she notes
bloating and weight gain in the week before her menses, with swelling of her
hands and feet. She experiences irritability and severe mood swings during that
time, such that she cries easily and for no reason seems to become enraged at
her family or boyfriend. On a review of systems, she denies urinary symptoms,
vaginal discharge, and gastrointestinal symptoms. She has no significant medical
history. She has never been pregnant

Answer 51

Patients with dysmenorrhea have an excessive production of prostaglandin F 2α , which
stimulates myometrial contractions of the uterus. Excessive contractions of the myometrium
cause ischemia of the uterine muscle, thereby stimulating uterine pain fibers

The first step in treating patients with premenstrual syndrome is to encourage
lifestyle changes such as more sleep, exercise, improved diet, and
discontinuation or decreased use of tobacco, alcohol, and caffeine.
* Pharmacologic therapy with selective serotonin reuptake inhibitors (SSRIs) has
proven beneficial in addition to behavioral modification.
* Additionally, pain may be treated with monthly pharmacotherapy with
prostaglandin synthesis inhibitors such as NSAIDs.

Question 52

23 year old female patient states she has not gotten her period for 5 months and is not currently pregnant. She explains
that she has always gotten very regular menstrual cycles but they have stopped since starting her new, high-stress job.
What is the diagnosis?
A) Amenorrhea
B) Premenstrual syndrome
C) Endometriosis
D) Dysmenorrhea

Answer 52

A) Amenorrhea

Question 53

A male patient is complaining of fever, chills, testicular tenderness and edema, and bloody semen. He states that elevating
his scrotum relieves the pain. What is the diagnosis?
A) Testicular torsion
B) BPH
C) Epididymitis
D) Chlamydia

Answer 53

C) Epididymitis

Question 54

During the menstrual cycle, the luteal/secretory phase is about _____ days in
length, and is dominated by the hormone _______.
a. 14-21 days; estrogen
b. 10 days; estrogen
c. 14 days; progesterone
d. 25-28 days; progesterone

Answer 54

c. 14 days; progesterone

Question 55

Scenario 1: A 13-year-old girl is having episodes of amenorrhea and infrequent menses. Her menarche was at the age of 12, she denies being sexually active, and the urine pregnancy test is negative.

Answer 55

Abnormal uterine bleeding can be seen in the initial 1–2 years after menarche. During this time, missed menses, infrequent menses, and even episodes of heavy menstrual bleeding can occur and are not necessarily a reflection of an abnormality. This abnormal pattern is commonly due to an immature hypothalamic–pituitary–ovarian axis. These patterns are generally anovulatory; however, the transition to ovulatory, regular menses is not known and pregnancy can occur.

Question 56

Scenario 2: A 60-year-old woman who has been in menopause for 5 years is having episodes of menstrual bleeding for the past 2 months. She said sometimes it is just spotting but, at times, she has worn a small sanitary pad. She is overweight and says despite her efforts, she struggles to lose weight.

Possible causes?

Answer 56

Any bleeding after menopause (i.e., 1 year without a menstrual cycle) is considered abnormal. The causes often include endometrial polyps and malignant disorders (uterine cancer). Hormone replacement therapy can also cause postmenopausal bleeding. The exact cause of uterine cancer is unknown, but unopposed estrogen may be a major actor in development. There is an excess of endogenous estrogen due to obesity.

Question 57

Scenario 3: A 21-year-old woman is having episodes of amenorrhea and infrequent menses. Her menarche was at the age of 14 and her menses have sometimes been regular. She is overweight and says despite her efforts to lose weight, she does not do so. She is generally very healthy otherwise, and the only medication she is taking is doxycycline for acne, which she feels is getting worse. She said her mother’s menstrual pattern was the same and that her mother told her she had trouble getting pregnant (the patient is an only child). She is sexually active, her partner uses condoms consistently, and her urine pregnancy test is negative.

Answer 57

One consideration in this case is a diagnosis of polycystic ovarian syndrome (PCOS), which is considered one of the most common endocrine disorders in women. In PCOS, the dysfunctional ovarian theca cells are overly sensitive to luteinizing hormone (LH) and oversecrete androgens. The excessive androgens also affect the granulosa cells as they normally rely on theca cell coordination to release progesterone and continue preovulatory follicle development. The excess androgens cause the growth of a lot of small follicles. Increased LH causes premature luteinization of the follicle (the one that would have been dominant), and the follicle does not

Question 58

A 15-year-old presents to the emergency department complaining of sudden onset of right-sided scrotal and groin pain. He states the pain is constant and extreme. He says it started about 2 hours ago during basketball practice at school, but he denies any trauma to the scrotum. He is worried that he has a sexually transmitted infection as he just started having sexual intercourse with his girlfriend and he did not use condoms. He says he feels nauseated and thinks he is going to vomit. He said he noticed this same pain once before, but it went away within a few seconds and he did not tell anyone.

• Vital signs: temperature 98.9°F; pulse 100 beats/minute; respirations 20 breaths/minute; blood pressure 120/70 mmHg
• Physical examination reveals a healthy-appearing adolescent who is anxious and grimacing. The patient has edema and erythema of his right scrotum. His scrotum is tender, and the patient only tolerated superficial palpation.

1. The most likely diagnosis based on his history and physical examination is:
   a. Epididymitis
   b. Testicular torsion

Answer 58

Answer: b

Rationale: Testicular torsion is the most likely diagnosis because he is 15 years old and the pain started during exercise (playing basketball). The pain came on suddenly, and he has scrotal swelling and systemic symptoms such as nausea. Epididymitis would most likely present with signs of infection such as fever, chills, and myalgia.

Question 59

Erythema and edema of the scrotum are only present with epididymitis.
a. True
b. False

Answer 59

Answer: b
Rationale: Erythema and edema can occur with both epidymytis and testicular torsion.

Question 60

Which of the following clinical manifestations are consistent with epididymitis, and which are consistent with testicular torsion?
a. Positive Prehn sign
b. Negative cremasteric reflex
c. Testis elevated on affected side
d. Fever

Answer 60

1. Testicular torsion: b and c

The cremasteric reflex is a protective reflex in males that involves the contraction of the cremaster muscle in the scrotum, which raises the testicles:

2. Epididymitis: a and d
   P ositive Prehn’s sign
   Pain is relieved when the scrotum is elevated, which is associated with epididymitis. Epididymitis is usually caused by a bacterial infection of the epididymis and can be treated with antibiotics.
   Negative Prehn’s sign
   Pain worsens when the scrotum is elevated, which is associated with testicular torsion. Testicular torsion is a medical emergency that requires immediate diagnosis and treatment because the spermatic cord rotates and cuts off blood supply

Question 61

Discuss the treatment plans for testicular torsion and for epididymitis

Answer 61

Surgery will be required to treat testicular torsion and should be performed within 6 hours to prevent testicular necrosis. Manual manipulation by rotating the testicle gently away from the midline may be used to untwist the testes, but surgery will be required to secure the testicle (orchiopexy) and prevent recurrence.

Treatment strategies for epididymitis center on eliminating the infection and decreasing discomfort. These interventions include the following measures:

• Antibiotic therapy
• Analgesics (especially NSAIDs)
• Bed rest
• Scrotal support (wearing briefs instead of boxers) and elevation (on a rolled towel)
• Cold application
• Screening and treatment of sexual partners

Question 62

A 40-year-old woman comes in complaining of an increased thin whitish vaginal discharge that started about 5 days ago. She said it is so much that she needs to wear a small sanitary pad. She also noted that she had a funny odor after having sexual intercourse, and she says the odor continues despite her attempts to control it with douching.

Physical examination reveals a thin white discharge around the vaginal wall with no erythema. Examination of the discharge includes a positive KOH whiff test and a vaginal pH >4.5. Vaginal microscopy reveals clue cells.

1. What is a likely cause of the vaginal discharge?
   a. Trichomoniasis
   b. Bacterial vaginosis
   c. Vulvovaginal candidiasis

Answer 62

Answer: b

Rationale: Manifestations include increased vaginal discharge that is off-white/gray, thin, and of an unpleasant fishy odor that worsens after sexual intercourse or menses. Clue cells and a positive KOH whiff test and a pH >4.5 are consistent with bacterial vaginosis.

Question 63

Which of the clinical manifestations confirms the diagnosis of bacterial vaginosis?
a. The thin white discharge
b. Malodorous discharge
c. Presence of clue cells on a saline wet mount slide

Answer 63

Answer: All options are correct.

Rationale: Diagnosis is made based on a history, physical examination, and the presence of at least three of the Amsel criteria: (1) characteristic vaginal discharge, (2) elevated pH, (3) clue cells, and (4) fishy odor.

Question 64

What is the cause of this vaginal discharge disorder (BV)?
a. An alteration in the vaginal flora
b. Overgrowth of yeast due to antibiotic use
c. A sexually transmitted organism, T. pallidum

Answer 64

Answer: a

Rationale: Bacterial vaginosis (BV) is a common cause of vaginal discharge. BV occurs as result of a reduction in vaginal flora (e.g., Lactobacillus) and an increase in a variety of bacterial species and anaerobes (e.g., Gardnerella vaginalis).

Question 65

4. Which of these is the primary treatment of this vaginal discharge disorder (BV)?
   a. Fluconazole
   b. Metronidazole
   c. Clindamycin

Answer 65

Answer: b or c

Rationale: Metronidazole and clindamycin are recommended treatments for BV. Fluconazole is used for vulvovaginal candidiasis.

Question 66

T/F hypospadias is a medical emergency?

Answer 66

f, but may need surgical treatment

Question 67

which of the following is most likely to require surgical intervention?
testicular torsion
hydrocele
priapism
phimosis

Answer 67

testicular torsion

Question 68

The APRN is seeing a patient in the clinic who is requesting sexually transmitted infection testing. The patient reports to the clinician that a few months ago he had unprotected sex with a male who has tested positive for syphilis. The patient reports that he has been feeling tired and feverish. Upon examination the APRN notes enlarged lymph nodes in the patient’s neck and groin as well as a rash on the patient’s trunk. Based on the history and symptoms the patient is most likely in what stage of syphilis?
A. Primary Syphilis
B. Secondary Syphilis
C. Latent Syphilis
D. Congenital Syphilis

Answer 68

B. Secondary Syphilis

Question 69

A patient presents to the clinic with a history and symptoms consistent with mastitis. The APRN knows all of the following are true about mastitis except:
A. Breastfeeding is not safe during treatment and should be discontinued until treatment has concluded
B. There may be purulent nipple discharge present
C. Mastitis is most caused by a staphylococcal or streptococcal bacteria
D. Flu-like symptoms may be present

Answer 69

A. Breastfeeding is not safe during treatment and should be discontinued until treatment has concluded

Question 70

These benign growths caused by HPV are most commonly harmless and asymptomatic and may be removed for aesthetic purposes. They may appear as?
A. Raised
B. Flat
C. Flesh colored
D. Pink
E. All of the above

Answer 70

E

Question 71

In polycystic ovary syndrome ovarian theca cells are dysfunctional and are overly sensitive to LH and oversecrete:
A. Calcitonin
B. Adrenaline
C. Androgens
D. TSH

Answer 71

C. Androgens

Question 72

The most common pathogen causing prostatitis is gram-negative:
A. Human papillomavirus
B. Trichomonas vaginalis
C. Escherichia coli
D. N. gonorrhoeae

Answer 72

C. Escherichia coli

Question 73

most common type of testicular cancer

Answer 73

germ cell tumors
hard, painless, palpable mass

Question 74

risk factors for breast cancer

Answer 74

early menarche, late menopause, nulliparity, pregnancy after 30, chest wall radiation, exogenous estrogen

genetic predisposition (BRCA 1 and 2)

Question 75

most common type of breast cancer

Answer 75

adenocarcinomas (glandular tissue cancer)

or originate in the epithelial lining of the duct system

Question 76

most common type of invasive breast cancer

Answer 76

infliltrating ductal carcinoma

Question 77

effect of LH on male reproductive system

Answer 77

stimulates leydig cells to produce/secrete testosterone

Question 78

effect of FSH on male reproductive system

Answer 78

stimulate sertoli cells to promote spermatogenesis

Question 79

effect of inhibin on male reproductive system

Answer 79

inhibits fsh = reduction in sperm

Question 80

what is the production steps of testosterone

Answer 80

cholesterol -> DHEA -> androstenediol -> testosterone

Question 81

estrogen synthesis

Answer 81

cholesterol -> DHEA -> androstenediol -> estrone -> estradiol

Question 82

effect of FSH on female reproductive

Answer 82

follicles develop, increases estrogen

Question 83

which hormone increases after ovulation

Answer 83

progesterone

Question 84

effect of hcg (human chorionoc gonadotropin)

Answer 84

During pregnancy, hCG is produced by the placenta to support the growing embryo and thicken the uterine lining. HCG levels increase after conception and continue to rise until about 10 weeks into the pregnancy.