NR 602 Possible Assignment Questions

NR 602 Possible Assignment Questions

NR 602 Possible Assignment Questions

1. Bartholin’s cyst

A nurse practitioner instructor is reviewing the anatomy of the external genitalia. At the opening of the vagina are the Bartholin’s glands. Which of the following describes the function of these glands?

• Production of alkaline secretion for sperm viability

Which of the following choices represents a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass?

• Bartholin’s cyst

You explain to this young woman what this “lump” is and let her know you will be referring her to a gynecologist you consult with regularly. You explain to her the likely treatment as follows:

• A possible incision might be necessary and a catheter (WORD) placed for two to four weeks to allow for drainage and appropriate healing.

Which of the following choices represent a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass?

• Bartholin’s cyst

A 25-year-old presents with a report of a very tender area just near her introitus and to the left of her perineum. 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 very small, 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 edema extending into the perineum. Your diagnosis for this presentation is:

• Bartholin’s cyst

Treatment of a large, symptomatic Bartholin’s cyst includes all of the following except:

• Topical corticosteroids

 

Which of the following is a common antibiotic for treatment of an infected Bartholin’s cyst?

• Bactrim

The patient presents with complaints of a painful, swollen lump in her vaginal area. She reports difficulty sitting and walking due to the pain. Which of the following is a likely diagnosis for this patient?

• Bartholin cyst

2. Breast Cancer

17- year-old Stella presents with a chief complain of unilateral breast tenderness and swelling. Which of the following would be the least likely etiology for this problem?

• Breast cancer

A nurse practitioner is counseling a woman with fibrocystic changes in the breast. Which of the following is not caused by this change?

• An increased risk of breast cancer

A 55-year-old woman presents to the clinic for evaluation of a breast mass. Which of the following is not a typical presenting sign of breast cancer?

• A 2 cm, rubbery, tender lesion

A pathology report has been returned on a woman’s breast mass malignancy. The most common type of invasive breast cancer is ______

• Infiltrating ductal

Karen is concerned that she may develop breast cancer. Which of the following is not an associated risk factor?

• Breast feeding

A female patient is concerned about using combination oral contraception that includes both estrogen and progesterone. You instruct her that the medication actually will decrease risks of which of the following cancers?

• Breast

You are starting Ella, a 21-year-old, on Ortho Tri-Cyclen, a combined oral contraceptive. Which of the following would not be included in your instructions and advice?

• Oral contraceptives offer protection against breast cancer for as long as you are using them.

When reviewing the risk factors for breast cancer with your patient, which of the following would not be a contributing factor?

• Early menopause

A 55-year-old postmenopausal female patient presents with pain in the upper outer quadrant of her left breast for over one month now. The best course of action would be to _______.

A woman is concerned that she may develop breast cancer and is discussing her concerns with the nurse practitioner. Which of the following is not an associated risk factor for this?

NR 602 Possible Assignment Questions

• Late menarche

What factor is considered high risk for breast cancer?

• genetic mutation in BRCA-1 and BRCA-2 genes

3. Breast Disorders

You are researching preliminary evidence-based sources about breast cancer risk factors. Which of the following would you find is not one for the disease?

• Fibrocystic breast disease

A woman is experiencing a milky white nipple discharge. Galactorrhea is usually a finding with which other diagnosis?

• Hyperprolactinemia

Lenore, 55years old, comes in for evaluation of a breast mass. Which of the following is not usually linked with carcinoma of the breast?

• Well-circumscribed, rubbery and tender lesion

A nurse practitioner is educating a pregnant female about breast changes. Common normal physiologic changes include all of the following except:

• Fibrocystic changes

Breast tissue is composed of glandular, fibrous, and fatty tissue and a complex lymphatic system. Where does lymph from the medial cutaneous area of the breast flow?

• Opposite breast

A 21year-old female presents to the practice with the chief complaint of a breast mass. Considering the differential diagnoses, the most common cause of the mass in this age group is ____.

• Fibroadenoma

A 35- year-old female presents for her normal annual examination and complains of recent changes in her breasts. She reports that they feel tender and “lumpy” during certain times of the month. As a result, she does not perform self-breast examination as she had been doing in the past. Which of the following statements would offer the best advice to this patient?

• Determine the time of the month when her breasts are tender and recommend a change to her breast self-examination schedule.

A nurse practitioner is participating in a women’s health fair. When educating the women about risk factors for breast cancer, which of the following statements is incorrect?

NR 602 Possible Assignment Questions

• Fibrocystic breast disease

An 18-year-old patient presents with secondary amenorrhea. On physical exam, there is normal secondary sex characteristics in addition to the appearance of normal genitalia. Pregnancy has been ruled out through urine human chorionic gonadotropin (HCG). Which of the following signs or symptoms would necessitate further evaluation in this patient?

• Galactorrhea

Breast masses are a common finding in adolescents and most typically are benign. Which of the following descriptions of a breast mass most likely represents a benign finding?

• Bilateral, round or oval firm mass

A 17-year-old presents with an appointment for unilateral breast tenderness and swelling. Which of the following would be the most likely etiology for this problem?

• Mastitis

When women experience mild premenstrual symptoms, such as mild breast tenderness, abdominal bloating, and mild weight gain from water retention, this is known as:

• Premenstrual syndrome

4. Cervical Cancer

A patient has a prescription that was written for birth control pills that now has progestin added to the estrogen therapy. What would this intervention decrease the risk of?

• Endometrial cancer

In reviewing cancer statistics, after breast cancer, what would you find to be the most common female genital malignancy?

• Endometrial cancer

A 15-year-old patient who presents with symptoms consistent with premenstrual syndrome (PMS) is concerned that she may have ovarian cancer. Your best advice to this patient is that PMS is typically caused by which of the following?

• Genetic, psychosocial and hormonal fluctuations

A 33- -year-old woman presents to your clinic complaining of a dark brown, watery vaginal discharge and postcoital bleeding. There is a strong history of multiple unprotected sexual encounters. She has not been immunized for human papillomavirus (HPV). Which of the following examination findings would be suspicious for cervical cancer?

• A very firm cervix with an ulcer

The nurse practitioner is prescribing an oral contraception to Sally. She is concerned about having one that has “two hormones” as the active ingredients. You instruct her that adding progestin to estrogen therapy will decrease the risk of ___________.

• ENDOMETERIAL CANCER

The nurse practitioner understands that HPV types _____ and ____are most often associated with cervical and anogenital cancer.

• 16 and 18

Based on the latest ACOG guidelines, the nurse practitioner understands that the recommended time to initiate screening for cervical cancer in women is:

• At age 21 years

A 69 y/o woman presented w/abnormal vaginal bleeding and has now been dx with endometrial cancer. She returns to you because she doesn’t understand how this could happen when her pap smear was normal 6 months ago. What is your best response?

• Pap smears are not useful in determining uterine cancer in most cases

Current USPSTF guidelines assigns an “A” recommendation to screening for cervical cancer for all of the following except:

• 65 y/o with hx of previous cytologically normal screens who is not at increased risk for cervical cancer

The nurse practitioner understands that the necessary screening techniques in a patient suspicious of ovarian cancer should include the following: Select all that apply.

NR 602 Possible Assignment Questions

• CA-125 AND TRANSVAGINAL ULTRASOUND

5. Cervix disorders

The most common cause of chronic pelvic pain for women is the prime of their reproductive years is?

• Endometriosis

You are completing a pelvic exam on 32-year-old Nancy. You detect a left adnexal mass on the bimanual exam. With an adnexal mass, the practitioner must always suspect ________ until proven otherwise.

• Malignancy

Malignant ovarian masses are very uncommon in young women. Which of the following information would be least helpful in the assessment, diagnosis, or management of pelvic malignancies in young women?

• Mutations in the breast cancer gene-1 (BRCA-1) are responsible for a small percentage of ovarian cancers in women.

A 25- year-old patient presents with irregular bleeding after being on oral contraceptives for six months. It is important to rule out which of the following?

• Chlamydial cervicitis

A nurse practitioner is completing a speculum exam on a female patient. Which of the following findings would be considered a normal surface characteristic of the cervix?

• Small, yellow, raised around area on the cervix

Anna, aged 25- years, presents with dysmenorrhea. She states that her sister and her mother have endometriosis and she would like to be evaluated for it as well. Which if the following is consistent with a diagnosis of endometriosis?

• Infertility and dysmenorrhea

Which of the following is true regarding education of a forty-two-year-old woman diagnosed with uterine myoma?

• Myomas will decrease with the withdrawal of estrogen

The nurse practitioner is examining a twenty-nine-year-old female with a three day history of dysuria and urinary frequency. On examination, the patient is positive for suprapubic tenderness and negative for costovertebral angle (CVA) tenderness. This most likely represents which of the following?

• Cystitis

6. Mammogram and Breast Ultrasound

A 24y  female presents to the practice with a painless 2 cm, lobular mass in the right breast that is freely mobile and firm. This has been noted on self-breast examination, and she reports it has been unchanged for the past three months. The best course of action by the nurse practitioner would be to __________.

• Order a mammogram

During a community education program, a nurse practitioner is discussing the usefulness of mammography in the screening and detection of breast cancer. Which of the following statements is accurate?

• All women over 40 years of age should have a mammogram on an annual basis

A patient has been ordered a breast ultrasound after having a mammogram. The primary rationale for ordering this is to _____.

• Determine if a breast lesion is cystic or solid

When educating a patient about the rationale for obtaining a mammogram, which of the following statements is false

• Mammography detects all breast cancers

Frankie is concerned that she has an ultrasound ordered after the results of her mammogram of been reviewed by the nurse practitioner. You emphasize that the primary role of a breast ultrasound is to _____.

• Determine if a breast lesion is cystic or solid

A 55-year-old postmenopausal female patient presents with pain in the upper outer quadrant of her left breast for over one month now. The best course of action would be to _______.

• Perform a breast examination and order a mammogram

Which of these women does not need to receive mammogram screening?

• 34 y/o dx with fibrocystic breast disease

NR 602 Possible Assignment Questions

7. Pelvic Inflammatory Disease

The most common cause of pelvic pain can be noted as endometriosis. But you also know that the most acute causes of pelvic pain are probably

• Salpingo-oophoritis ( fallopian tube/ovary) secondary to PID

Primary dysmeorrhea can be caused by endometriosis, tumors, ovarian cysts, or PID.

• False

The nurse practitioner understands that a complication of gonococcal and chlamydial genitourinary infection in women include which of the following:

• Pelvic inflammatory disease (PID)

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8. Pelvic Pain

Anna, twenty-five years old, presents with dysmenorrhea. She states that her sister and mother have endometriosis; so she would like to be evaluated for it. Which if the following is consistent with a diagnosis of endometriosis?

• Pelvic pain and dyspareunia

 

Abby, 20 years old, presents with pelvic pain. Which of the following is not a first-line diagnostic test for evaluation of pelvic pain?

• CT OF PELVIS

The most common cause of chronic pelvic pain for a women in the prime of their reproductive years is?

• Endometriosis

The nurse practitioner understands that which of the following are differential diagnoses in an adult female patient with acute pelvic pain. Select all that apply:

• Ectopic pregnancy, appendicitis, ovarian cyst with rupture

 

The nurse practitioner is managing an adolescent with a 4 cm functional ovarian cyst that was confirmed on a recent ultrasound. What plan of care should be anticipated for this patient?

• Repeat ultrasound in 2 months

leading cause of pelvic pain caused by urinary system

• interstitial cystitis

Pelvic pain in adolescents is almost always

• gynecologic in origin

Non-pharmacologic therapy for chronic pelvic pain includes the following: Select all that apply.

• PHYSICAL THEARAPY AND AEROBIC AND NONAEROBIC EXERCISE

NR 602 Possible Assignment Questions

9. Polycystic Ovary Syndrome (PCOS)

A female patient has been diagnosed with polycystic ovary syndrome (PCOS) and weighs 250 pounds. In addition to obesity, PCOS is associated with which of the following clinical manifestations?

• Infertility

A 60-year-old  woman has presented with the chief complaint of bleeding after intercourse. Which of the following is not associated with postcoital bleeding or spotting in a postmenopausal woman?

• Polycystic ovary syndrome (PCOS)

Polycystic ovaries predispose women to a higher incidence of:

• Endocervical cancer

A nurse practitioner is reviewing the chart of a woman who has findings consistent with polycystic ovary syndrome (PCOS).The diagnostic criteria for PCOS include all of the following except:

• Male pattern baldness

A patient is coming to the clinic for a follow-up of some diagnostic testing that she had done. When you review the chart, you find that she now has findings consistent with a diagnosis of polycystic ovary syndrome (PCOS).You recall that PCOS is characterized by which of the following?

• Infertility

A nurse practitioner is reviewing the signs of polycystic ovary syndrome (PCOS) for a differential diagnosis for a female patient. Which of the following would be a positive finding?

• Chronic anovulation

A nurse practitioner is educating a patient who has just been diagnosed with polycystic ovary syndrome (PCOS). She needs to be aware that PCOS is associated with which of the following clinical manifestations?

• Obesity

A woman has been diagnosed with polycystic ovary syndrome (PCOS). Management of PCOS includes all of the following except ___________.

• Daily basal insulin to reduce blood sugar

Which of the following is not a biochemical feature of PCOS?

• Markedly elevated serum total testosterone levels

Polycystic ovarian syndrome exhibits all of the following symptoms, which one is the most accurate?

• hirsutism, alopecia, acne, virilization, menstrual irregularity and infertility, polycystic ovaries, obesity, insulin resistance adn metabolic syndrome

10. Uterine Fibroid

A 35-year-old women presents with 6-month history of hypermenorrhea, backache and pelvic pressure. On examination you discover a 12-week size uterus with irregular contour. Which of the following does this represent?

• Uterine fibroid

A middle-aged woman, in the climateric stage of her life, presents with pelvic pain. What is the least likely cause of her pain?

• Uterine fibroids

What is most freq symptom of uterine fibroids?

• Increased bleeding at menses

Other names for uterine fibroids

• myomas or leiomyomatas-benign growth that arise from the smooth muscle of the uterus; often asymptomatic

The nurse practitioner understands that the proper management of an asymptomatic woman with a small fibroid should include:

• Reassess in 6 to 12 months