FNP Womens Health Exam Flashcards
The progestin component of hormone therapy is given to:
Counteract the negative lipid-effects of estrogen
Minimize endometrial hyperplasia
Help with vaginal atrophy symptoms
Prolong ovarian activity
Minimize endometrial hyperplasia
Postmenopausal hormone therapy can result in:
A reduction in the rate of cardiovascular disease
An increase in the rate of rheumatoid arthritis
A reduction in the frequency and severity of vasomotor symptoms
A disturbance in sleep patterns
A reduction in the frequency and severity of vasomotor symptoms
A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?
“It is probably just a cyst because that is the most common breast mass.”
“We will order a mammogram and ultrasound to help establish a diagnosis.”
“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
“Because your lump is painful, it is most likely not cancer.”
“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?
Pregnancy test
Pelvic ultrasound
Endometrial biopsy
Pregnancy test
A 58-year-old woman, who had a total abdominal hysterectomy at the age of 45, is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
Conjugated estrogen, 0.625 mg/day oral
Estradiol, 7.5 mcg/24 hr. vaginal ring
Medroxyprogesterone, 10 mg/day oral
Conjugated estrogen, 0.3 mg + medroxyprogesterone 1.5 mg/day oral
Estradiol, 7.5 mcg/24 hr. vaginal ring
Polycystic ovary syndrome can result in:
Infertility
Increased risk of uterine (endometrial) cancer
Hirsutism
All of the above
All of the above
Most breast cancer cases are in women with a family history of breast cancer.
True
False
False
A 65-year-old female asks if she can stop her pap exams. She heard that you can stop having screenings at age 65. You review her chart and see that she had CIN2 5 years ago. You respond:
Yes, you are 65 so you can stop pap screenings now.
No, you should continue pap screenings until the age of 70.
No, you should continue to have routine screening for at least 20 years after the CIN2 was diagnosed.
If you have a complete hysterectomy you could stop screenings.
No, you should continue to have routine screening for at least 20 years after the CIN2 was diagnosed.
Increased FSH levels and lower estrogen levels are associated with which of the following?
Decreased bone turnover
Hot flashes
Lower levels of interleukins
Chest pain
Hot flashes
When educating midlife women on health promotion, all the following should be recommended EXCEPT:
To maintain a BMI between 18.5 and 24.9
Limit alcohol consumption to no more than one drink per day
To obtain depression screening
To maintain waist circumference less than 37 inches
To maintain waist circumference less than 37 inches
How much Vitamin D is recommended for a 55-year-old woman?
200 IU/day
400 IU/day
600 IU/day
600 IU/day
It is recommended that older women (age 65 and older) be screened for falls at which of the following intervals?
Every 3 months
Every 6 months
Yearly
Every 2 years
Yearly
According to the American College of Obstetricians, the most common medications associated with female sexual dysfunction are which of the following?
SSRI’s
SNRI’s
Ace inhibitors
Statins
SSRI’s
Which of the following statements is FALSE regarding vaginal cancer?
They are rare
The most common form is squamous cell carcinoma
They are associated with HPV infections
Basal cell carcinoma is the most common form
Basal cell carcinoma is the most common form
Which of the following statements is TRUE regarding vulvar lichen sclerosis?
It often causes pruritus
It causes the vulvar epithelium to become pale
It is associated with autoimmune disorders
All the above is true
All the above is true
Chronic heavy menstrual bleeding (HMB), formerly termed menorrhagia is the most common complaint of abnormal uterine bleeding (AUB):
True
False
True
A 45-year-old woman presents with abnormal uterine bleeding. You discuss your recommendation for endometrial sampling to rule out endometrial hyperplasia and carcinoma. What is the most common cause of endometrial cancer?
Human papilloma virus
Unopposed estrogen
HNPPC
Past use of fertility medications
Unopposed estrogen
According to the American College of Obstetrics and Gynecology, which of the following statements is incorrect regarding breast cancer screenings?
Begin discussing annual or biannual mammography starting at age 40 and older
Begin offering clinical breast exams to patients ages 20-39 every 1-3 years and then annual starting at age 40.
All women should be informed to perform monthly self-breast exams.
Self-breast examinations are not recommended for screening in the general population.
All women should be informed to perform monthly self-breast exams.
A 30-year-old develops menorrhagia and iron deficiency anemia. She also reports increased pelvic pressure and dysmenorrhea. You palpate a large, mobile pelvic mass at the midline on pelvic exam and suspect a uterine leiomyoma. Which of the following is the initial test to confirm this diagnosis?
Pelvic ultrasound
Pelvic MRI
Pelvic CT
Hysteroscopy
Pelvic ultrasound
Hormone replacement therapy (HRT) increases risk of which of the following?
Osteoporosis
Vasomotor symptoms
Stroke
Thyroid cancer
Stroke
A 25-year-old female presents for her well woman visit. Her last pap was at age 22; normal results. She is sexually active with three partners within the last year. She should have the following:
Pap smear, Pelvic exam, STI screening
A 23-year-old woman returns after an abnormal pap smear result. Her results show low-grade squamous intraepithelial lesion (LSIL) with a positive human papillomavirus (HPV) test. She has had 3 male sexual partners in her life and has been in an exclusive relationship with the same man for the last three years. She denies consistent use of barrier protection during intercourse. Her periods are regular. She denies menorrhagia, vaginal discharge, abnormal bleeding, dysuria, or past history of sexually transmitted infection. She had her first pap smear two years ago with her regular doctor in another state; she is uncertain of the result. What is the appropriate step in management of this patient?
Obtain past medical records of previous pap smear results and repeat pap in 12 months
The preferred colorectal cancer screening test is a colonoscopy and should be recommended starting at what age?
50 (age 45 for African American women)
According to the American Congress of Obstetricians and Gynecologists, bone mineral density screening should routinely begin at what age? (Risk factors may warrant earlier screening)
65
Bone density should be screened in postmenopausal women < 65 years with high risk factors. All of the following are high risk factors except:
Hypertension
According to the American College of Obstetricians and Gynecologists, mammogram screenings should start at what age?
40
If a woman has never had CIN 2 or higher, and she has had three consecutive negative cytology results within the past 10 years, with the last cytology being within the past five years, at what age can cervical cytology be discontinued?
65
The human papillomavirus vaccine series is recommended for boys and girls age 9-26 years, with the target age of vaccination of:
11-12
BRCA 1 and BRCA 2 genetic mutations are associated with:
Breast
A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?
Ceftriaxone and Azithromycin
Ceftriaxone and Cefixime
Acyclovir
Metronidazole and Azithromycin
Ceftriaxone and Azithromycin
A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?
Trichomoniasis
Bacterial vaginosis
HPV
Herpes simplex virus
Bacterial vaginosis
Oral contraceptive pills can cause endometrial cancer.
True or False
False
A 40-year-old woman is seen for her yearly examination. She is single and in a monogamous relationship, no history of STIs. Her social history includes smoking cigarettes “occasionally” and drinking about two beers a day. Her body mass index (BMI) is 25. She is requesting birth control. Which of the following methods would be best for this patient?
Intrauterine device
Oral contraceptive
Etonogestrel/ethinyl estradiol vaginal ring
Vaginal contraceptive sponge
Intrauterine device
A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate?
Fluconazole
Estrogen vaginal cream
Metronidazole
Doxycycline
Fluconazole
Which of the following is likely NOT among the proposed mechanisms of action of all form of oral emergency contraception?
Inhibits ovulation
Slows sperm transport
Slows ovum transport
Acts as an abortifacient
Acts as an abortifacient
A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive?
Blood pressure measurement
Complete blood cell count
Thyroid-stimulating hormone
Urine dip for protein
Blood pressure measurement
According to the U.S. Medical Eligibility Criteria for Contraceptive Use, all of the following are category 1 or category 2 for taking combined oral contraceptives EXCEPT?
A 22-year-old woman who smokes 1 ppd
A 29-year-old woman with history of PID
A 32-year-old woman with history of migraine with aura
A 30-year-old woman breastfeeding a 6 month old infant
A 32-year-old woman with history of migraine with aura
A woman with frequent vaginal candidiasis asks you what she can do to prevent this from reoccurring. You are correct when you tell her all of the following EXCEPT:
Avoid soaps with fragrance
Wear polyester underwear
Do not douche
Avoid intercourse until end of treatment
Wear polyester underwear
Which of the following agents is most active against Trichomoniasis:
Ceftriaxone
Diflucan
Doxycycline
Metronidazole
Metronidazole
During an office visit with an 18-year-old client named Kimberly, the nurse asks whether she is using any form of birth control. Kimberly responds that she is currently breastfeeding her 6-month-old, so she doesn’t need to be on birth control. The nurse recognizes that Kimberly is relying on which type contraception?
Abstinence
Tubal ligation
Symptothermal
Lactational amenorrhea
Lactational amenorrhea
April is a 24-year-old client who has recently become sexually active with multiple partners. She knows she has been taking too many risks in her sexual encounters and would like to begin using contraception. She is also concerned about acquiring a sexually transmitted infection. Which method of contraception should the nurse recommend to April?
Male condoms and etonogestrel implant (Nexplanon) Injectable depot medroxyprogesterone acetate (DMPA) Female condoms and progestin-only contraceptive pills Intrauterine device (IUD)
Male condoms and etonogestrel implant (Nexplanon)
While performing a pelvic exam, the nurse encounters genital warts in the vagina. Which sexually transmitted disease (STD) should the nurse suspect most in this client?
Genital herpes simplex virus
Human papillomavirus (HPV)
Hepatitis B
HIV
Human papillomavirus (HPV)