(Solved & Graded distinction level) NSG6430 midterm Exam; 2022.

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NSG6430 midterm Exam; 2022. 1. A thirty-nine-year-old female has not had menses for over six months and has a negative pregnancy test. Which of the following characteristics puts her at risk for an... early menopause? 2. Sally a sixty-one-year-old Caucasian female, presents to your practice for well-woman examination. She remarks that she feels like she is shrinking over the past year, despite keeping active and incorporating sources of calcium in her diet. Which of the following is not a risk factor for osteoporosis? 3. Suzanne, a forty-six-year-old client reports shortened menstrual cycles for one year. The most likely diagnosis is 4. you are seeing a twenty-two-year-old pregnant woman for routine antepartal care. she discloses that she forgets to take her prenatal vitamins. which of the following would not be part of your counseling and education 5. a pathology report has been returned on a woman's breast mass malignancy. The most common type of invasive breast cancer is 6. you are performing a pelvic exam on a forty seven year old woman when you notice a large soft bulge in the vaginal floor. the primary diagnosis is 7. a young woman presents to your practice with vaginal itching and a white discharge. She denies sexual activity or douching. She has been in good health except for a recurrent strep throat. Pelvic examination reveals a tender vulvovaginal area with edema and white patches; no odor is detected. Which of the following is the most likely cause of this problem 8. the NP 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 9. A twenty one year old woman presents for her initial well woman examination. She has never been sexually active and has a negative family history for gynecology problems. Personal history is negative for abuse and she exercises regularly and eats a balanced diet. Menstrual history reveals that she experienced menarche at fourteen years of age, has a regular twenty eight day cycle and denies dysmenorrhea. Which of the following would be included in her physical examination today 10. Frankie is concerned that she has an ultrasound ordered after the results of her mammogram of been reviewed by the NP. You emphasize that the primary role of a breast ultrasound is to 11. Alicia lived i foster care for several years before being placed in a new city. she is in the tenth grade. which of te following aspects of her life protect her from risk 12. In reviewing mammogram results with a patient, the results reveal fibrocystic changes. These finding will most likely cause 13. Mitzi, a twenty three year old is here for her well woman checkup. She asks about douching. Which of the following statements about douching is true 14. Lakeisha, seventeen years old, is seeing her regular NP for a sports physical. While participating in a psychosocial screen. Lakeisha volunteers that she "hasn't had sex yet" What is the best initial response to Lakeisha's statement 15. Thalia is a fifteen year old who is referred to your women's health practice by her school counselor. She has macromastia and has been teased and ridiculed by her classmates at school. Which of the following would be the first step in dealing with this problem 16. A college professor is creating a lecture about the prevention and diagnosis of osteoporosis. A point that needs to be included about measures that have no impact on osteoporosis is 17. your are starting Ella, a twenty one year old on ortho tricyclen, a combined oral contraceptive. Which of the following would not be included in your instructions and advice 18. you are instructing a patient in the proper use of the diaphragm, a barrier contraceptive method. Which of the following would you include in your instructions - 19. A postmenopausal patient is prescribed hormonal therapy (HT) The NP recalls that HT is indicated for the management of 20. The NP is completing a follow up visit on a woman who was previously prescribed hormonal therapy, which she has not taken for the last month. The primary reason the patient discontinued HT is 21. The most effective interventions available to women's healthcare providers for reducing the incidence and severity of the leading causes of death and disability in this group are 22. A female patient has been diagnosed with a urinary tract infection and is currently using birth control. Which of the following contraceptive methods is associated with an increased incidence or a urinary tract infections 23. A woman has just stopped birth control pills in effort to become pregnant. You recall that estrogen withdrawal reflects activity primarily from the 24. a twenty-four-year old woman in your practice has been trying to conceive. she comes in for a pregnancy test, and it is positive. LMP was 5 weeks ago. She is prone to migraines and has used Imitrex (sumatriptan) with good success. She asks you about what to do if she has a migraine during pregnancy. Which of the following would be an inappropriate intervention as part of your counseling 25. A NP is educating a woman who has a colposcopy ordered. Which of the following most accurately describes a colposcopy 26. according to Neinstein all stages of adolescent psychosocial development revolve around issues with independence/dependence, body image concerns, peer group involvement, and identity development. during which stage eating disorders most likely to surface 27. A fourteen year old patient is accompanied by her mother, who is concerned about irregular and infrequent periods. Her last menstrual period was two months ago. What would be the initial test performed 28. A NP is educating a high school class about sexual education. Teaching should include that protective factors against repeat adolescent pregnancy include all of the following except 29. Karen is concerned that she may develop breast cancer, which of the following is not associated risk factor 30. Which of the following is not included in diagnostic criteria for polycystic ovary syndrome 31. A female patient has been diagnosed with polycystic ovary syndrome and weights 250 lbs. In addition to obesity PCOS is associated with which of the following clinical manifestations 32. A NP is completing a history on a woman who has been diagnosed with primary amenorrhea. Which of the following would not be a significant past medical history for this diagnosis 33. Leticia, 17 years old has just been diagnosed with primary dysmenorrhea. which of the following is responsible for the pain in this condition 34. You are completing a pelvic exam on 32 year old Nancy you detect a left adnexal mass on the bimanual exam. With an adnexal mas, the practitioner must always suspect _____ until proven otherwise 35. Tanisha is a 22 year old woman who presents with extreme irritability and mood swings, bloating, constipation, fluid retention, and headaches. She tearfully tells you, "This happens every month in my cycle. I get like a crazy woman, lashing out at everyone, I'm afraid I'll lose my job if I can't stop this. Sometimes, it's so bad. I just want to quit living, I need help: Tanisha's symptoms are typical of what disorder 36. Lucinda, 32 years old, presents to your clinic with the complaint of missed periods for two months, nausea, breast tenderness and frequent urination. She had an intrauterine device (IUD) placed five months ago. On examination you find the following cervix positive for Chadwick's sign; IUD strings protruding from cervical os; uterus no tender, enlarged; adnexa nonetneder no masses and not cervical motion tenderness. the most probable diagnosis is - pregnancy 37. a pap smear result of atypical squamous cells of undetermined significance rule out high-grade squamous intraepithelial lesion (ASCUS r/o HGSIL) will require which procedure next 38. A NP student is researching as to why menopausal women have an increased risk of heart disease. Which of the following lipid changes occur with estrogen withdrawal in menopause 39. A patient is complaining of a milky nipple discharge. Galactorrhea is usually a finding with which other diagnosis 40. Esteli, a 22 year old, comes in for birth control counseling. She is currently engaged and wants to start birth control until after her wedding next fall. She and her fiancé would like to start a family as soon as possible, so Esteli is seeking a form of birth control that is quickly reversible. Which of the following will meet this criteria 41. A 21 year old woman presents to your family planning clinic seeking emergency contraception. She had unprotected sex last night and is not currently on any contraception. Her last menstrual period was two weeks ago, and she denies recent sexual intercourse which of the following is not an emergency contraception modality 42. The NP understands that premenstrual syndrome (PMS) occurs with greatest frequency and severity in the 43. A pregnant woman has been diagnosed with preeclampsia or pregnancy induced hypertension (PIH). Which of the following statements about PIH is incorrect 44. Lauren, 23 years old, presents to your office with a complaint of severe menstrual cramps for 4 months since she quit using an oral contraceptive, Your tentative diagnosis is primary dysmenorrhea. What would be the first line treatment for this condition 45. You are seeing 12 year old Sonya for a well-adolescent checkup. She is accompanied by her mother who agrees to having you see Sonya alone but wants to talk with you at the end. After examining Sonya and assuring her of confidentiality, you meet with her mother briefly. Sonya's mother states, " I don't know how to say this, but I am so worried that my daughter is homosexual. She spends so much time with her girlfriends, and they are the focus her entire life" From your understanding of normal adolescent stages and development, how would you respond to her concern 46. A prescription is being written by the NP for birth control pills. When completing patient education, which of the following would be an accurate statement about oral contraceptive use 47. There are several phases to the menstrual cycle. What phase begins with ovulation and ends with menstruation? 48. A patient is being rechecked after having a total hysterectomy performed and is having multiple problems since. Which of the following is/are early symptom(s) of estrogen withdrawal 49. Iris is a thirty-two-year-old married woman with three children. She comes in for information on using the copper T intrauterine device (IUD) for contraception. Which of the following would be a contraindication to using this appliance? 50. Lab results on your twenty-six-year-old patient show a negative Pap smear with a positive human papillomavirus (HPV) screen. Which procedure will be required next? 51. The nurse practitioner is caring for a menopausal patient reporting vaginal dryness with intercourse. How would this best be managed? 52. Which of the following is true regarding education of a forty-two-year-old woman diagnosed with uterine myoma? 53. Lenore, fifty-five years old, comes in for evaluation of a breast mass. Which of the following is not usually linked with carcinoma of the breast 54. A thirty-two-year-old woman presents to your practice with a complaint of postcoital bleeding. Which of the following must be included in the assessment of this patient? 55. Sylvia is a forty-four-year-old woman with dysfunctional uterine bleeding (DUB) and is unable to use oral contraceptives. Which of the following medications can be used for management of DUB 56. You are counseling eleven-year-old Amanda and her mother about human papillomavirus (HPV) vaccine, Gardasil. Amanda is Tanner stage IV at this visit. In counseling this family, you tell them that HPV vaccine 57. You are meeting with twenty-two-year-old Emily to discuss birth control options. She has tried "the pill" in the past but failed to take it regularly. She is interested in depo because she only has to come in every three months for a shot. She also heard that one does not get a period on depo, and she likes the thought of that. Which of the following would be a specific consideration with depo that you would need to discuss 58. Elizabeth, twenty-four years old, is pregnant, and you are educating her on common problems during the first trimester. Which of the following is abnormal and requires immediate attention 59. A woman presents to the office seeking the birth control measure that is 100% effective. When counseling a woman on effectiveness of these methods, which of the following fulfills this requirement? 60. You are interviewing a teen with suspected substance abuse. Which of the following screening tools would give you the most specific information regarding substance abuse in teens 61. Nakia is a sixty-five-year-old obese female with type II diabetes mellitus. She presents to your office with a complaint of vaginal itching and burning for two weeks now. She has not been sexually active for five years since her partner died of heart failure. She has tried douching and OTC Vagisil cream with no relief. On physical examination, the vulva is deep red with some thick white adherent material. Which of the following conditions would be the most likely cause of her symptoms? 62. : A twenty-five-year-old pregnant client presents with the complaint of headaches that are confined to the base of the head and upper neck; she denies visual changes, photophobia, or nausea. The most likely diagnosis is which type of headache 63. Jackie is a fifteen-year-old African American female who resides in a housing plan. You realize that barriers exist in providing preventive services to adolescents that include all of the following except: 64. During pregnancy and lactation, the nutritional needs of the woman are very specific and deficiencies can result in harm to the woman or her baby. Neural tube defects are one of the most common birth defects. Deficiency of which nutrient is responsible for these conditions 65. Elba, a thirty-five-year-old woman, presents with a six-month history of hypermenorrhea, backache, and pelvic pressure. On examination, you discover twelve-week-size uterus with irregular contour. Which of the following does this represent? 66. n caring for a menopausal client who has had a total hysterectomy, the nurse practitioner would include which of the following options? 67. Which of the following choices represent a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass? 68. LaShonda, thirty-four years old, is undergoing fertility treatments to become pregnant. Her period was three weeks late and heavier than normal. She thinks that she had an early miscarriage and wants confirmation. Which of the following tests would be most accurate to do this 69. Abby, twenty years old, presents with pelvic pain. Which of the following is not a first-line diagnostic test for evaluation of pelvic pain? 70. A twenty-one-year-old woman comes into your practice seeking birth control. She has only recently become sexually active and has consistently used condoms for safe sex. Your history reveals that she does not use tampons during her menses and has very little knowledge about female reproductive anatomy. Based on this information, which of the following birth control choices would be least likely to meet her needs for contraceptive management? 71. 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? 72. n prescribing hormone replacement therapy (HRT) for a menopausal women, which of the following does not accurately reflect current best practices for HRT? 73. Beth, a sixty-two-year-old woman, is seen for a follow-up discussion of DEXA scan result of minus 1.5 standard deviation (SD) at the hip. Her PMH includes a recent myocardial infarction and a fractured wrist at fifty-eight years of age. Which of the following would not be an option for her? 74. A sixty-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? 75. While participating in a woman's health fair, a parent comes to you with the concern of her daughter participating prematurely in sex. Which of the following factors is strongly associated with early onset of unwanted sexual activity 76. You are evaluating seventeen-year-old Emily who presented with amenorrhea and normal secondary sex characteristics. The purpose of the progesterone challenge is to ascertain the presence of __________. 77. Nancy is an eleven-year-old presenting for an annual well-child visit. When reviewing the physiology of puberty, you recall that the initiation of puberty begins physiologically with the release of GnRH by the ____. - 78. Strategies to protect teenagers from risks include all of the following except _ - 79. The new ACOG Pap smear guidelines reflect a change in all of the following except - 80. A woman comes to the clinic with the chief complaint of disruption of urine flow. Which of the following is not a risk factor for pelvic floor relaxation? 81. A woman has been diagnosed with polycystic ovary syndrome (PCOS). Management of PCOS includes all of the following except ___________. 82. Seventeen-year-old Stella presents with the chief complaint of unilateral breast tenderness and swelling. Which of the following would be the least likely etiology for this problem? 83. 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? 84. Which of the following characteristics is not associated with psychosocial development problems in adolescence? 85. A pregnant client in your practice is experiencing nausea and vomiting in her first trimester. Which of the following would you suggest to alleviate the problem 86. Cara is in the clinic for what you have diagnosed as dysfunctional uterine bleeding (DUB). She is concerned about why this is happening to her. You recall which of the following is the most common cause of DUB? 87. Luz is a fifteen-year-old girl who comes to your office stating, "I have not had my period for two months now." She experienced menarche at ten years of age, with regular cycles for the past two years. In your initial consideration of a differential diagnoses, what is the most likely etiology of this problem? 88. A mother presents to the clinic with her female child who she is concerned about because her breasts are developing "when she is so young." When performing the initial assessment, it is important to recall that precocious puberty is present if _________. 89. A nurse practitioner is screening a female for prescribing contraceptions for the first time. Which of the following conditions is an absolute contraindication to estrogen-containing contraception? 90. 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? 91. The National Osteoporosis Foundation has screening guidelines for DEXA scans. Which of the following women would be most in need of bone mineral density testing? 92. Natasha is an eleven-year-old girl brought to your office for an annual well child visit. When discussing the onset of puberty with Natasha and her mother, you would emphasize which of the following? 93. You are working in a women's health practice and decide to incorporate brief preconception counseling into every visit. Which of the following would not be included in brief preconception counseling? 94. Sheryl, a twelve-year-old, complains of a vaginal discharge for the past eight to nine months. She tells you her underpants are frequently wet. When she wipes after urinating, there is "white stuff" on the tissue. Sheryl denies urinary problems, genital itching, or odor. She also denies sexual activity. Her menses has not yet started, but she reports that she "started to develop" her breasts a little past age ten. Her vaginal discharge is most likely a result of _______. 95. A thirty-three-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? 96. You are speaking to a women's group in the community about mammography screening. What important information would you include in this presentation? - 97. During a pelvic exam on a seventy-year-old, the nurse practitioner notices the position of the cervix at the introitus. The diagnosis is most likely _____. 98. Elisabeth comes for a consultation. She has been in a committed relationship for five years now and wants to become pregnant [Show More]

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