NR-602 Primary Care of the

Childbearing & Childrearing Family

Practicum

Midterm Exam Questions & Answers

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A Bethesda System Pap smear report that reads LSIL is most consistent with whichclassification

CIN 1

A single Pap smear reading of ASCUS in a patient negative for HPV infection shouldhave what as

follow-up?

Routine screening

A female patient is 35 years old. She has never had an abnormal Pap smear and has had regular

screening since age 18. Ifshe has a normal Pap smear with HPV testing today, when should she

have thenext cervical cancer screening 5 years

Lab results on your 26-year-old patient show a negative Pap smear with a positive HPVscreen.

Which procedure will be required next

Repeat Pap and HPV screen

9yo female has completed course of amox for strep throat. LMP was 2wks ago, says it was

normal. On exam, there's erythema of extern. genitalia w/small amount of white discharge.

Micro wet prep reveals few clue cells, but many budding hyphae. No WBCs.Which one would be

the most appropriate treatment?

a. Metronidazole 500mg BID x7 days

b. OTC hydrocortisone 1% cream TID

c.Fluconazole tabs 150mg x1 dose

d. Erythromycin 500mg TID x10 days

Woman c/o vaginal itching, white discharge. She is in good health except for recent abx for

strep throat. Pelvic reveals tender vulvovaginal area w/edema and nonmalodorous white

patches. Which isthe most likely cause?

a. Bacterial vaginosis

b. Trichomonas

c. Lactobacillus overgrowth

d. Candidiasis

18yo female c/o secondary amenorrhea. On exam, there is normal secondary sex characteristics

andnormal genitalia. Pregnancy is ruled out. What would necessitate further eval?

a. Elevated blood cholesterol levels

b. Androgen deficiency

c. Galactorrhea

d. Hirsutism

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Primary amenorrhea is best described as:

a. Cessation of menstruation x6mo

b. Failure of menstruation to occur by

17ho

c. Failure of menstruation to occur by

13yo

25yo female c/o vaginal irritation and discharge. On exam, cervix is easily friable and

erythematous. No adnexal tenderness. Wet prep reveals mobile protozoa on NS slide. This

most likely represents:

a. Trichomonas

Treatment options for condyloma acuminatum include:

a. Imiquimod (Aldera)

49yo female c/o dark, watery brown vaginal discharge. Which best describes what might be seen

onphysical exam in pt's with cervical cancer?

a. Ulcerated firm cervix

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22yo female c/o pelvic pain. Exam reveals cervical motion and uterine tenderness. Which

supports PIDdx?

a. Temp <100F

b. Absence of WBCs in vag

fluid

c. Mucopurulent vag

discharge

When a patin is diagnosed with PMS, which intervention would be recommended tohelp

alleviate the symptoms?

B. Eating a diet low in simple sugars and high in proteins.

(Decrease caffeine, take diuretics but continue to consume fluids, regular exercise, and

analgesics).

is the condition in which functional endometrial tissue is found in ectopic sites

outside the uterus.

Endometriosis

is the condition in which endometrial glands and stoma are found within the

myometrium, interspersed between the smooth muscle fibers.

Adenomyosis

Uterine are benign neoplasms of smooth muscle origin.

Leiomyomas

are firm, rubbery, sharply defined round masses in breast tissue.

Fibroadenomas

Endometriosis is the condition where endometrial tissue is found growing outside of theuterus

in the pelvic cavity. What are risk factors for endometriosis?

D. Periods longer than 7 days and increased menstrual pain.

An 18 yr old woman presents at the clinic complaining new-onset breakthrough bleeding,

even though she is on contraceptive. What contraceptive use, along with newonset-onset

breakthrough bleeding, has been associated with pelvic inflammatory disease?

B. Depo-Provera

A woman with lobular carcinoma in situ has a relative risk of developing invasive breastcancer of

8.0

Pap smear results of atypical squamous cells of undetermined significance requirewhich

procedure next

Follow-up Pap smear

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A 23-year-old woman comes to the clinic for a Pap smear. After the examination, the client

confides that her mother had died of endometrial cancer one year ago and says that she is

afraid that she would die of the same cancer. Which risk factor stated by theclient after an

education session on wrist factors indicate that brother teaching is needed

Late onset menarche

The frequency for cervical screening depends on the patient and her age. What is thelongest

recommended time interval between cervical screens for patients who are 65 years old or

younger

Five years

Jenna was evaluated and diagnosed with condyloma acuminatum. Treatment optionsfor Jenna

will include all of the following except

Topical acyclovir

I can roll over grasp a rattly, and reach for things and have begun feeding myself fingerfoods, but

i can't wave bye-bye yet. How old am I?

6 months

I can walk well on tiptoes, my speech is 50% understandable, I know six body parts, butcan't

balance on one foot for 2 seconds. I am:

2 1/2 years old

Most children can independently dress themselves by age

4 years

A 35-year-old smoker is being evaluated for birth control choices. Patient has a history of

pelvic inflammatory disease along with an embolic episode after her last pregnancy.Which of

the following methods of birth control would you recommend?

Condoms and the vaginal sponge

A 20-year-old woman visiting the clinic says that she wishes to begin using Depot

Medroxyprogesterone acetate (Depo-Provera) as a form of birth control what important

information said the nurse include when teaching the client about Depo-Provera Calcium

intake and exercise should be increased because of the possible loss of bonemineral density

with increasing duration of use

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A client seeking advice about contraception asked the nurse about how an Intrauterinedevice

prevent pregnancy how should the nurse respond

It produces a spermicidal intrauterine environment

A nurse is teaching a group of women about the side effects of different types of contraceptives.

What frequent side effect associated with the use of an IUD should thenurse discussed during the

teaching session

Excessive menstrual flow

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A nurse is teaching a female client about the side effects of estrogen in an oral contraceptive.

Which common side effect identified by the client indicates to the nurseat the teaching was

effective

Nausea

A nurse is canceling a female client with type one diabetes to request a contraceptive

information. What contraceptive method should the nurse recommend

Diaphragm with spermicide

The client asked the nurse about the use of an IUD for contraception. What informationshould

the nurse include in the response

Explosion of the device, occasional dyspareunia, risk for perforation of the uterus

Sylvia is 44-year-old woman with dysfunctional uterine bleeding and is an able to use oral

contraceptives. Which of the following medications can be use for management ofDUB

Medroxyprogesterone

Which is not a common cause of irregular menstrual bleeding

Anovulation

a na, 25-year-old, presents with dysmenorrhea. She states that her sister and mother have

endometriosis, so she would like to be evaluated for it. Which of the following is consistent

with a diagnosis of endometriosis

Pelvic pain and dyspareunia

A 16-year-old female is diagnosed with primary dysmenorrhea. She has taken over thecounter

ibuprofen 800 mg increments every eight hours during mentors for the past three months

with minimal relief of symptoms. What intervention will provide greatest relief of

dysmenorrhea symptoms

Combined oral contraceptives

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