Test 1 Flashcards
80
A 21 - year - old patient is seen for her annual gynecologic exam. She is currently sexually active, rarely uses condoms for sexually transmitted infection (STI) prevention, and has multiple sexual partners. She smokes one pack per day, admits to sedentary lifestyle, and eats two meals per day, most often at fast food restaurants. She has eaten one hour prior to her office visit. Her exam is negative for any abnormality. Her family history and personal medical history are negative for any major disease. There are no menstrual abnormalities; her last known menstrual period (LNMP) was one week ago. You have completed her Pap smear. You have limited lab tests or time for education that you can do at this visit. Which of the following would not be appropriate for this patient at this time? (would not be in your plan today)
A. Cultures for GC and Chlamydia
B. Lab testing: glucose, cardiac risk profile, and TSH
C. HIV titer and RPR (rapid plasma regain - for syphilis)
D. Counseling on safe sex practice and contraceptive information
B. Lab testing: glucose, cardiac risk profile, and TSH
Which of the following actions does the estrogen in the COC’s include?
A. Inhibits ovulation through the suppression of the LH surge
B. Inhibits sperm penetration by thickening cervical mucus
C. Provides most of the contraceptive effect for COC’s
D. Stabilizes the endometrium for less unscheduled bleeding
D. Stabilizes the endometrium for less unscheduled bleeding
The endometrial (uterine) cycle is often described in three phases. Select the correct phases:
A. Menstrual, follicular, and luteal
B. Menstrual, proliferative, and luteal
C. Menstrual, follicular, and secretory
D. Menstrual, proliferative, and secretory
D. Menstrual, proliferative, and secretory
Reactive cellular changes on a Pap smear are most often associated with:
A. Inflammation
B. Use of estrogen vaginal cream
C. Drying artifact
D. Use of oral contraceptives
A. Inflammation
The most common cause of dysfunctional uterine bleeding is:
A. Thyroid disorder
B. Blood dyscrasia
C. Anovulation
D. Uterine tumor
Anovulation
When evaluating a young adult with amenorrhea and normal secondary sex characteristics, the purpose of the progesterone challenge test is to determine the presence of:
A. Endogenous estrogen
B. Thyroxine
C. Prolactin
D. Adequate body fat
Endogenous estrogen
A middle-aged (40 - 50) female presents with dysfunctional uterine bleeding. A hormonal profile reveals increased FSH and LH levels. The most likely cause for these findings is:
A. Hypothalamic disorder
B. Onset of climacteric (perimenopause/menopause)
C. Premature ovarian failure
D. Anterior pituitary disorder
B. Onset of climacteric (perimenopause/menopause)
Combined oral contraceptive pills prevent pregnancy primarily by:
A. Decreasing fallopian tube motility
B. Thinning of cervical mucous
C. Suppressing ovulation
D. Causing inflammation of the endometrium
C. Suppressing ovulation
Which statement about progestin only pills is true?
A. Women who are breast-feeding should not use progestin only pills.
B.Ovulation suppression is as effective with progestin only pills as with combined oral contraceptive pills.
C. There is an increased incidence of functional ovarian cysts.
D. The risk of ectopic pregnancy is lowered for women using progestin only pills.
C. There is an increased incidence of functional ovarian cysts.
A young adult female patient is being seen at the family planning clinic by you, the nurse practitioner. The patient wants birth control pills but has heard that they are dangerous to one’s health. When asked for clarification, she lists the following: weight gain, ovarian cancer, heavy or irregular periods, and infertility. You tell her “I can see that you are concerned with your health…”
A. There are a lot of fallacies about birth control pills. They are actually felt to reduce the risk of ovarian cancers, help to regulate the bleeding, and are not associated with causing infertility. There can be a minor increase in body weight of 3 to 5 pounds”
B. “Perhaps you would be better off trying the Nexplanon implant or Depo-Provera
C. What you have heard is true. They can be dangerous to your health and many people experience these problems”
D. There are a lot of fallacies about birth control pills. While ovarian cancer and infertility are risks that are taken with the use of the birth control pill, they do not cause weight gain or bleeding changes on periods. Pap smears done every year will detect such things as ovarian cancer
There are a lot of fallacies about birth control pills. They are actually felt to reduce the risk of ovarian cancers, help to regulate the bleeding, and are not associated with causing infertility. There can be a minor increase in body weight of 3 to 5 pounds”
A patient comes in with complaints of fatigue, breast tenderness, abdominal bloating, fluid retention, irritability, and difficulty sleeping the week before the onset of menses. This has been occurring for the past four months. What is most important in establishing a diagnosis of PMS in the patient?
A. Occurrence of symptoms in last half of the menstrual cycle
B. Severity of the symptoms
C. Number and frequency of symptoms over the past four months
D. Presence or absence of anxiety or depression
A. Occurrence of symptoms in last half of the menstrual cycle
A 22 year - old female patient presents for her first well-woman exam: she is not sexually active and has never been. Her family history and past medical history (PMH) are negative for any gynecologic diseases. Her menses occur every 28 days, lasting 5 days with a relatively moderate flow, and no significant abdominal cramps. Her physical exam/visit today must include which tests?
A. Pap smear
B. Cultures for GC and chlamydia
C. Stool hemoccult
D. Baseline mammogram
A. Pap smear
During a yearly physical examination, a nurse practitioner asks a woman if she has any problems or questions about sexual function or activity. Initially, the client hesitates, but with further questioning and discussion, she states that she is unsure if she has ever experience an orgasm before. The nurse practitioner suspects
A. Vaginismus
B. Primary orgasmic dysfunction
C. Secondary orgasmic dysfunction
D. Dyspareunia
B. Primary orgasmic dysfunction
Which of the following statements by a patient indicates she needs additional information about the use of the contraceptive vaginal ring?
A. I should expect to have regular periods while using the ring”
B. “I should insert a new ring every 7 days”
C. “My partner can use a male condom while I am wearing the ring”
D. “The exact position of the ring in the vagina is not important”
B. “I should insert a new ring every 7 days”
In the ovarian cycle, what phase begins with ovulation and ends with the onset of menses?
A. Follicular phase
B. Ovulation
C. Proliferative phase
D. Luteal phase
D. Luteal phase
Wat is a cause of secondary amenorrhea?
A. Testicular feminization
B. Hypogonadotropic hypogonadism
C. Congenital absence of uterus
D. Extreme exercise
D. Extreme exercise
You, the nurse practitioner, are reviewing the lab results of a 21 - year - old patient seen recently for a Pap smear. The results are as follows: Classification - high grade squamous intraepithelial lesion (HGSIL): endocervical cells seen, adequate smear. You phone the patient and tell her which of the following?
A. Your pap smear was normal. Follow-up in one
year”.
B. “Your pap smear shows invasive cancer. I would like to refer you to a gynecologic oncologist for treatment”.
C. Your pap smear shows abnormal tissue that needs to be evaluated. Please schedule an appointment for a colposcopy
D. Your pap smear shows a minor abnormality. Sometimes this can signify a disease process that is just beginning. Please schedule another pap smear in 4 to 6 months.
C. Your pap smear shows abnormal tissue that needs to be evaluated. Please schedule an appointment for a colposcopy
The primary function of FSH is:
A. Stimulate maturation of the ovarian follicles
B. Milk secretion
C. Trigger ovaluation
D. Inhibit the release of LH from the pituitary gland
A. Stimulate maturation of the ovarian follicles
Which statement is true concerning the diaphragm?
A. May be inserted up to 24 hours prior to intercourse.
B. May be inserted up to 2 hours prior to intercourse.
C. Should be removed within one hour after intercourse.
D. May be left in place for up to 72 hour
B. May be inserted up to 2 hours prior to intercourse.
What finding could be (and usually is) considered a normal surface characteristic of the cervix?
A. Small, yellow or white, raised round area on cervix (Nabothian cysts)
B. Red patchy areas with occasional white spots
C. Friable, bleeding tissue at opening of cervical os
D. Irregular, granular surface with red patches
A. Small, yellow or white, raised round area on cervix (Nabothian cysts)
