NR602 Chamberlain College of Nursing Clinical Analysis Final Exam Week 8 With Answers (115 Solved Questions)

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1Nr 602 wk 8 poss questionsACOG guidelines regarding well women examsWhat is the ASCCP recommended management for an ASCUS (atypical squamous cells of undeterminedsignificance) pap result with a positive high-risk HPV 16 cotest in a 26-year-old woman without a history ofabnormal pap smears?ColposcopyA well-woman visit for an adolescent should include which of the following?A general health history focusing on reproductive and sexual health concerns (menses, gynecologic,and pregnancy related) and psychosocial (family related, peer related, emotional, and physical as wellas related to abuse, drug use, and alcohol use) concernsPhysical exam, screening tests, and immunizations as indicated by the health history and gynecologicconsiderations for an external-only inspection of the genitaliaACOG Pap smear guidelinesA Bethesda system Pap smear report that reads LSIL is most consistent with which classification?CIN 1A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as follow-up?Routine screeningA female patient is 35 years old. She has never had an abnormal PAP smear and has had regular screening since age18. If she has a normal PAP smear with HPV testing today, when should she have the next cervical cancerscreening?5 yearsA young sexually active client at the family planning clinic is advised to have a Papanicolaou (Pap) smear. She hasnever had a Pap smear before. What should the nurse include in the explanation of this procedure?The Pap smear can detect cancer of the cervixLab results on your 26-year-old patient show a negative Pap smear with a positive human papillomavirus (HPV)screen. Which procedure will be required next?Repeat Pap and HPV screenWhich of the following is not part of the criteria for an older woman to cease having any future Pap tests performed?Over 55 years of ageAmenorrhea (Primary and Secondary)You are evaluating a 17-year-old Emily who presented with amenorrhea and normal secondary sex characteristics.The purpose of the progesterone challenge is to ascertain the presence of?Endogenous estrogenA 17-year-old female patient presents with amenorrhea for 4 months she did experience menarche at age 15 but hadnot had a menstrual cycle since. On physical examination, it is noticed that she has normal secondary sexualcharacteristics. The nurse practitioner will consider a progesterone challenge to determine the presence of adequateEndogenous estrogenA teenage patient presents with amenorrhea and moral secondary sex characteristics. A progesterone challenge isordered. The purpose is to determine the presence of ____________?Endogenous estrogenA 16year old girl who comes to your office with a history of secondary amenorrhea. She experienced menarche atage 10, regular cycles for 2 years. She has not menstruated now for 4 years. In your initial consideration ofdifferential diagnoses, what is the most frequent etiology of this problem:Eating disorder18yo female c/o secondary amenorrhea. On exam, there is normal secondary sex characteristics and normalgenitalia. Pregnancy is ruled out. What would necessitate further eval?GalactorrheaPrimary amenorrhea is best described as:Failure to menstruation to occur by 13 yrA nurse practitioner is caring for a woman with primary and secondary amenorrhea. The pelvic exam was normal.Which of the following may be the cause if etiology originates in the hypothalamus?Sheehan’s syndromeAmerican Cancer Society recommendationsA nurse practitioner is participating in a women’s health fair. When educating the women about risk factors forbreast cancer, which of the following statements is incorrect?

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2Nr 602 wk 8 poss questionsFibrocystic breast diseaseWhen educating women about breast cancer risk factors, which statement is incorrect?Fibrocystic breast diseaseA woman with lobular carcinoma in situ has a relative risk of developing invasive breast cancer of8.0Androgen insensitivity/resistance syndromeChanges in hormonal regulation during menopause result in the gradual cessation of menstruation. From whichgland is Androstenedione secreted?AdrenalsASCUS/HSIL results from Paper Test ReportA Pap smear result of atypical squamous cells of undetermined significance—rule out high-grade squamousintraepithelial lesion (ASCUS r/o HGSIL) will require which procedure next?ColposcopyA Pap smear result of atypical squamous cells of undetermined significance (ASCUS) will require which procedurenext?Follow up pap smearBartholin glands and cystsA 25-year-old presents with a report of a very tender area just near her introitus and to the left of herperineum. Very painful sex is how she knew "something wasn't right." She showered and when washing, she felt a"pea-sized" painful lump on the left side of her "bottom." She tells you she looked at it with a mirror and it was verysmall, but now it is the size of a ping-pong ball and getting worse.When you inspect her external genitalia, you are amazed at the size and appearance of the "lump."You note what appears to be an abscess on the left medial side of the labia minora, and there is some edemaextending into the perineum. Your diagnosis for this presentation is:Bartholin’s cystYou explain to this young woman what this "lump" is and let her know you will be referring her to a gynecologistyou consult with regularly. You explain to her the likely treatment as follows:A possible incision might be necessary and a catheter placed for two to four weeks to allowfor drainage and appropriate healing.A client at the women's health clinic complains of swelling of the labia and throbbing pain in the labial area aftersexual intercourse. For what condition does the nurse anticipate the client will be treated?Bartholinitis25yo female c/o tender area near her introitus and to the L of her perineum. Very painful sex was first sign. Initiallybump was very small, but now is ping-pong ball size. On exam, abscess is present on L medial side of labia minoraand there's edema extending into perineum. What is dx?Bartholin’s cystWhich of the following choices represents a disorder of the reproductive tract that causes pain, erythema,dyspareunia, and a perineal mass?Bartholin’s cystA nurse practitioner instructor is reviewing the anatomy of the external genitalia. At the opening of the vagina arethe Bartholin's glands. Which of the following describes the function of these glands?Production of alkaline secretions for sperm viabilityBMICDC recommendations regarding STDs and PIDCervical cancer screeningA 23-year-old women presents to your practice with a chief complaint of postcoital bleeding. Which of the followingwould NOT be included in the initial assessment of this patient?Uterine biopsya nurse practitioner is educating a woman who has a colposcopy ordered. Which of the following most accuratelydescribes a colposcopy?A procedure that visualizes the vaginal, vulvar or cervical epithelium with magnification toidentify abnormal areas that may need to be biopsied

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3Nr 602 wk 8 poss questionsA 33-year-old women presents to your clinic complaining of a dark brown watery vaginal discharge and postcoitalbleeding. There is a strong history of multiple unprotected sexual encounters. Which of the following findings onexamination would be suspicious for cervical cancer?A very firm, easily friable cervixA 23-year-old woman comes to the clinic for a Pap smear. After the examination, the client confides that her motherdied of endometrial cancer 1 year ago and says that she is afraid that she will die of the same cancer. Which riskfactor stated by the client after an education session on risk factors indicates that further teaching is needed?Late onset menarcheThe frequency for cervical screening depends on the patient and her age. What is the longest recommended timeinterval between cervical screens for patients who are 65 years-old or younger?5 yearsWhat is the leading cause of death from a gynecologic malignancy in American women?Cervical cancerCervix/Uterus examinationA 49-year-old female patient presents with a chief complaint of dark, watery brown vaginal discharge. Part of thedifferential diagnosis includes that of cervical cancer. Which of the following best describes what might bevisualized?Ulcerated firm cervixA nurse practitioner is completing a speculum exam on a female patient. Which of the following findings world beconsidered a normal surface characteristic of the cervix?Small, yellow, raised around area on the cervixIn collection of a specimen for a PAP smear, how is the endocervical specimen collected?After the ectocervical specimen with a brushCimetidineCondyloma acuminateTreatment options for patients with condyloma acuminatum include:Imiquimod (aldera)Which of the following best describes lesions associated with condyloma acuminatum?VerruciformTreatment options for patients with condyloma acuminatum include all of the following except:Topical acyclovirAll of the following findings are associated with secondary stage of an infection by the organismTreponemapallidumexcept :Condyloma acuminatePatient education for condylomata acuminata should include all the followingexcept:Treatment and elimination of visible warts is a sign of cure, and transmission will notoccurJenna was evaluated and diagnosed with condyloma acuminatum. Treatment options for Jenna will include all ofthe followingexcept:Topical acyclovirCondyloma lataWhich condyloma do we see in syphilis?Condyloma lata-flatContraceptivesthe cytology (Pap smear) result for a 21-year-old sexually active student whose partner uses condoms inconsistentlyshows a large amount of inflammation. Which of the following is the best follow-up?Call the patient and tell her that she needs return to the clinic for chlamydia and gonorrheatestingA college freshman who is using oral contraceptives calls the nurse practitioner's office asking for advice. She forgotto take her pills 2 days in a row during the second week of the pill cycle and wants to know what to do. What is thebest advice?

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