Download Exams 1,2 & Final :NU665B/ NU 665B (NEW 2025/ 2026 Updates BUNDLE) 100% Correct- Regis and more Exams Nursing in PDF only on Docsity!
Exam l 1: l NU665B/ l NU l 665 B l (NEW l 2025/ l
2026 l Update) l Primary l Care l of l Family l II l
Guide| l Questions l & l Answers| l Grade l A| l
100% l Correct l (Verified l Solutions)- l Regis
QUESTION
stagingl andl gradingl ofl GYNl cancer Answer: stagingl 1 - 4:l refersl tol extentl andl locationl ofl spreadl ofl tumorl (lymphl nodel involvementl etc) stagel 1:earlyl form stagel 2:l localized stagel 3:earlyl locallyl advanced stagel 4:l mets grading:l degreel ofl differentiationl ofl celll typel (gradel 3 l higherl maligantl potential)
QUESTION
uterinel cancerl symptomsl andl screening Answer: symptoms:l bleedingl betweenl periods,l anyl postmenopausall bleeding,l pelvicl pain,l dysmenorrhea averagel age:l 61 nol screeningl testl (AGCl onl pap)
QUESTION
riskl factors Answer: obesity hormonel therapy:l exogenousl estrogenl withoutl oppositionl byl progestin tamoxifen-ERTl antagonist/agonist
PCOSl (chronicl anovulation) earlyl menarche,l lastl menopause nullipartiy estrogenl secretingl tumorl (germl cell,l functionall ovarianl tumor) HNPCCl (l hereditaryl non-polyposisl colorectall cancerl akal lynchl syndrome)-l redl flagl ifl cal beforel 50
QUESTION
linkl betweenl obesityl andl CA Answer: weightl sizel shouldl bel morel morel thanl 1/2l heighl inl inches women/menl 3/1l ratio excessivel viscerall fatl coorelatesl withl metabolicl syndrome,cardiovascularl disease,l insulinl resistance,l DM,l increasel inl LDLl cholesterol,l fattyl liverl andl somel cancerl (endometriall highesy,l breast,l ovarian,l colon,l lung)
QUESTION
clinicall presentationl forl uterinel CA Answer: abnormall uterinel bleeding-l occursl inl 90%l ofl cases postmenopausall bleeding-l evenl onel dropl ofl bloodl warrantsl al workl up amountl ofl bleedingl doesl notl coorelatel withl CAl risk,l probablyl increasesl withl numberl ofl yearsl beyondl menopausel postmenopausall bleeding=l endometriall biopsyl and/orl transvaginall USl tol evaluatel endometriall lining-l shouldl alsol dol al dxl pap prel andl peril menopausall womenl withl abnormall bleedingl shouldl alsol bel workedl up,l espl withl anotherl riskl factor incidentall findingl onl imaging
QUESTION
papl smearl findingsl withl endometriall CA Answer: atypicall glandularl cells:l significantl markerl forl al premaligantl orl malignantl lesionl ofl thel endocervixl orl endometriuml (10-40%l ofl cases)
QUESTION
ovarianl CA Answer: 20%l ofl newlyl discoveredl pelvicl massesl arel maligantl 1%l ofl newl cancerl inl thel lifetime
QUESTION
endotheliall ovarianl CA Answer: mostl common 'gas'l likel 'tingling'l pain,l abdominall bloating,l weightl loss,l typicallyl nonl tenderl andl nol masses,l urinaryl frequncy onlyl 25%l ofl womenl havel GYNl s/s medianl agel ofl dx-l 56 l yo nol raciall disparityl inl dx factorsl thatl canl delayl dx:l omissionl ofl al pelvicl examl atl firstl visit,l havingl al multitidel ofl s/s,l notl initallyl recievingl anl US,l CTl orl cal 125 l test,l youngerl age manyl womenl havel al GIl workupl withl colonscopyl priorl tol referra;,l whenl coloscopyl isl negativel oftenl al CTl scanl isl obtained
QUESTION
pathophysiologyl withl ovarianl CA Answer: theory-l repeatedl ovulaionl leadsl tol continuedl minorl trumal tol thel ovarianl epithelium,l leadingl tol inflammationl andl possiblel malignantl trasnformationl (higherl probabilityl ofl spontaneousl mutuations theory-l persistentl exposurel tol highl levelsl ofl gonadatropinsl andl estrogenl leadl tol epitheliuml profilerationl andl possiblel malignantl transformation 5 - 10%l ofl epitheliall ovarianl carcinomal resultsl froml inheritedl predispostionl (BRCA)
QUESTION
riskl factorsl forl ovarianl CA
Answer: familyl hx-l anyl owmenl withl al personall hxl ofl epitheliall ovarianl carcinomal shouldl bel offeredl geneticl counseling nulliparity,l earlyl menarche,l latel menopause obesity talcl powderl (asbestos)
QUESTION
s/sl ofl ovarianl CA Answer: abdominall bloatingl (mostl common)l ,l earlyl satiety,l indigestion,l abdominall pain,l nausea/l GIl disturbancel (secondl mostl common)l ,l urinaryl frequencyl orl retention,l weightl loss,l backl pain, acutel symptomsl duel tol torsionl orl rupturel arel rare
QUESTION
Physicall examl withl ovarianl CA Answer: possiblel PE:l decreasedl breathl sounds abdominall exam:l mayl havel mass,l tender,l ascities pelvicl exam:l rectrovaginall examl tol detectl presencel ofl solid,l fixed,l irregularl pelvicl mass US,l CXR,l abdominall CTl ofl abdomenl andl pelvisl withl contrast
QUESTION
ascitisl withl ovarianl CA Answer: lookl forl grossl asymmetryl acrossl thel abdomen,l protrusionl atl flank percussion:l percussl forl thel upperl andl lowerl marginal ofl thel liver,l changesl relatedl tol thel fluidl shifts,l dullnessl overl areasl ofl fluid palpationl ofl fluidl shifts
QUESTION
Adnexall masses Answer: indicationl forl referrall tol GYNl onc,l needl surgicall explorationl
5cml overl 6 - 8 l weeksl withl nol regression solidl ovarianl lesion papillaryl vegitationl onl cystl wall 10cml diameter ascities/l pleurall effusions palpablel massl onl premenarcall orl postmenarchall woman torsionl orl rupturel suspected h/ol breastl orl ovarianl CAl inl firstl degreel relativel forl considerationl ofl geneticl testing/l prophylacticl surgery
QUESTION
CAl 125 Answer: dependsl onl labl butl normallyl < veryl nonl specificl test,l elevatedl inl thel settingl ofl anyl inflammation commonlyl elevatedl inl gyn:
- PID,l benignl ovarianl neosplasm,l endometrisos,l functionall ovarianl cyst,l menstruation,l fibroid,l ovarianl hyperstimulation elevatedl inl nonl gyn:l hepatitis,l pancreatitis,l cirrhosis,l colitis,l CHF,l diverticultis,l non- maligantl ascitis,l PNA,l lupus,l renall disease,l postl opl etc
QUESTION
screeningl forl ovarianl CA Answer: nol evidencel tol showl CAl 125 l +/-l TVUSl canl bel usedl effectivelyl tol reducel morbidityl andl mortality
- sceeningl isl costly
- leadsl tol unnesearyl surgicall proceudresl withl morel morbities highl riskl managment
- geneticl counselingl BRCAl 1 l orl 2
- ifl positivel thenl TVUSl andl CAl 125 l ql 6 - 12 l monthsl agesl 25 - 25
- orall contraceptivesl ifl notl contral (reducel risk)
- prophylacticl oophorectoyl afterl childbearingl (<40l yo)
QUESTION
ovarianl cancerl awareness Answer: promotingl geneticl testingl inl atl riskl populations encoruagingl 'opportunisticl salphingectomy',l removingl fallopianl tubesl sol toxinsl cantl travell up evaluatel s/sl forl promptl dxl *pelvicl examl TVU,l CAl 125 opportunisticl oophorectomy
QUESTION
opportunisticl salpingectomy Answer: removall ofl fallopianl tubesl forl primaryl preventionl ofl peritoneal/ovarian/fallopianl tubel cancerl inl womenl atl anl otherwisel lowl riskl forl CAl undergoingl pelvicl surgeryl forl anotherl indicationl recentl findingsl showl thatl prophylacticl salpingectomyl performedl atl thel timel ofl hysterectomyl orl inl placel ofl al sterilzationl procedurel doesl notl increasel thel riskl ofl complications,l suchl asl hospitall readmit,l bloodl tranfusionsl orl lengthl ofl stay. 6 l minl longerl thanl tuball ligationl andl 10mll greaterl EBL performedl BSl ratherl thanl BTLl forl womenl desiringl permanentl sterilzationl canl theoreticallyl derceasel thel incidencel ofl ovarianl cancerl byl morel thanl 50%l amongl womenl withl littlel orl nol increasedl surgicall risk
QUESTION
fallopianl tubel cancer Answer: similarl tol ovarianl cancerl (elevationl inl CAl 125,l similarl tx,l increasedl inl womenl withl BCRAl mutations) presentation:l serosengeinousl orl copiousl wateryl vaginall discharge***,l pelvicl painl (colickyl orl dulll r/tl distentionl orl peristalsisl ofl tube),l pelvicl massl seenl onl imaging
QUESTION
riskl factorsl forl Vaginall andl vulvarl cancer Answer: increasedl age,l hxl ofl gynl maligancies,l atypicall cellsl ofl thel vagina,l HPV,l ***DES.l exposurel (syntheticl estrogen,l ptsl inl thel 50s),l multiplel sexl partners,l earlyl agel atl firstl intercourse,l smoking,l immunosuppression vaginall cancerl hasl thel asmel riskl factorsl asl cervicall neoplasia:l multiplel lifetimel sexuall partners,l earlyl agel atl firstl intercourse,l andl beingl al currentl smoker
QUESTION
symptomsl relatedl tol vaginall andl vulvarl cancer Answer: vaginall bleeding-l postcoital,l postmenopausal,l wateryl vaginall discharge,l lumpl orl massl inl thel vagina,l constipation,l pelvicl pain asl manyl asl 20%l ofl womenl asl asymptomaticl atl timel ofl sxl mayl bel detectedl asl resultl ofl cytologicl screeningl forl cervicall CAl orl mayl bel incidentall findingl ofl al vaginall massl onl pelvicl exam
QUESTION
dxl ofl vaginall andl vulvarl cancer Answer: papl andl pelvicl exam
- lesionl mayl bel missedl onl initall examl ifl itl isl smalll andl situatedl inl thel lowerl 2/3rdsl ofl thel vaginal colopscopy,l biopsy CTl scans,l PETl scans
QUESTION
txl ofl vaginall andl vulvarl cancer Answer: surgery-l excisionl (usel skinl graftl forl repair),l vaginectomyl andl lymphl nodesl withl repairl graft,l radicall hysterectomy,l lymphl nodel dissection
laser
QUESTION
vulvarl cancer Answer: leastl commonl ofl alll gynl maligancies HPVl isl associatedl withl thel majorityl ofl vulvarl squamousl celll carcinomasl al synchronousl secondaryl malignacy,l mostl commonlyl cervicall neoplasia,l isl foundl inl upl tol 22%l ofl patientsl withl al vulvarl pregnancy **itchingl isl commonl complaint ***vulvarl lichenl sclerosusl isl associatedl withl anl increasedl riskl ofl vulvarl cancerl effectsl thel epidermall layerl ofl thel vulvarl tissuel andl canl includel thel labial majora,l clitosi,l fourchette,l glands
QUESTION
celll typesl withl vaginall CA Answer: squamousl cell-l 85%,l unifocal,l growsl withl locall extensionl andl spreadsl vial lymphl nodes-l canl affectl thel vagina,l urethral andl rectum melanoma-l 10%l youngerl population,l highl ratel ofl met,l rare
- commonl lesionsl arel melanocyticl nevusl orl angioketatoma basall cell,l adenoca,l sarcoma,l paget's:5%l slowl growing,l elderlyl populationl lesionsl thatl lookl similarl tol vulvarl carcinoma:l epidermall inclusionl cyst,l condylomal acuminatal (genitall warts),l disordersl ofl bartholinl gland,l acronchordons,l seborrheicl keratoses,l hidradenomas
- ifl onel ofl thesel disorderl doesn'tl respondl tol tx,l biopsyl shouldl bel performed
QUESTION
s/sl ofl vaginall CA Answer: lumpl orl ulceration,l itchingl orl irritation,l locall bleedingl andl discharge,l dysuria,l dyspareunia,l darkl discolorationl (melanoma),l bartholin'sl gladl (adenocarcinoma)
***3rdl mostl commonl cancerl inl womenl worldwide,l 85%l happenl inl low-l middlel incomel countries
QUESTION
riskl factorsl forl cervicall CA Answer: HPVl infection-l unvaccinated multiplel partners l sexl atl anl earlyl age immunocompromised cigarettel smoking lowl socioeconomicl status
QUESTION
cervicall CAl S/S Answer: bleedingl betweenl periods,l bleedingl afterl sex,l postmenopausall bleeding,l vaginall dischargel (watery,l mucoid,l purulentl orl malodorous),l urinaryl frequency,l constipation,l pelvicl pain earlyl stage:l nol s/s commonl mets-l extral pelvicl lymphl nodes,l lungs,l liverl andl bones
QUESTION
cervicall changesl withl CA Answer: normall - >l LSILl - >l HSILl - >l cervicall CA
QUESTION
Papl recommendations Answer:
21l =l nol screening 21 - 29=l cytologyl alonel everyl 3 l yrs
30 - 65=l cyctologyl alonel everyl 3 l yrs,l cotestingl everyl 5 l orl primaryl hpvl testingl everyl 5
65=l nol screeningl afterl adequatel negativel priorl screeningl results hysterectomyl withl removall ofl cervix=l nol screeningl inl individualsl whol dol notl havel hxl ofl highl gradel cergicall precancerousl lesionsl orl cervicall CA
QUESTION
selfl screeningl forl HPV Answer: USTPSTFl foundl nol differencel inl accuracy selfl collectionl canl helpl promotel higherl screeningl inl womenl whol arel eitherl underl screenedl orl neverl beenl screened
QUESTION
HPVl vaccinationl schedule Answer: canl bel startedl agel 9,l recommendedl 11 - 12 l (2l doses) catchl upl 13 - 26 sharedl clinicall decisionl makingl 27 - 45 aboutl 85%l ofl peoplel getl HPVl atl somel line
QUESTION
txl ofl cervicall CA Answer: surgery:l whenl limitedl tol cervixl andl uterus,l earlyl stagel disease radiation:l locall advancedl diseasel andl surgeryl isl notl anl option,l internall orl externall beaml 5 l daysl al weekl forl 5 l daysl f/u:l PEl everyl 6 l monthsl forl 2 l yrs,l 6 - 12 l monthsl forl 5 l years,l pelvic,l chestl andl abdominall examl forl lymphl nodesl s/sl ofl cervicall cancerl recurrncel include:l vaginall bleedingl orl discharge,l abdominopelvicl pan,l urinaryl s/sl changel inl bowell habits 5 l yearl surivcall stagel 1 l ratel isl 91%,l tagel ivl isl 17%
Answer: Individualsl withl Disabilitiesl Educationl Actl (IDEA)l specificl agenciesl providel earlyl interventionl servicesl beforel entryl intol preschooll orl kindergarten
QUESTION
ASDl screening Answer: Thel Americanl Academyl ofl Pediatricsl andl thel Centersl forl Diseasel Controll andl Preventionl recommendedl ASDl specificl screeningl forl alll childrenl atl 18 l andl 24 l monthl ofl agel becausel thesel arel criticall timesl forl earlyl sociall andl languagel development,l andl earlierl interventionl isl morel effectivel forl ASD
QUESTION
DSMl levelsl forl ASD Answer: levell 1:l 'requiringl support',l noticablel imapairmentl withoutl suport;l difficultyl initiatingl sociall interactions,l atypicall orl unsuccessfull responsesl tol sociall overtures;l decreasedl interestl inl sociall interactyions;l failurel tol generatel responsesl orl topicsl appropriatel tol thel context,l unsuccessfull orl oddl attemptsl tol makel friends levell 2:l 'requiringl substantiall support',l markedl deficitsl inl communication,l impairmentsl apparentl evenl withl supports,l limitedl initationl ofl sociall interactions,l reduced/abnormall responsel tol sociall overtures levell 3:l 'requiringl substantiall support',l severel impairementsl inl functioning;l veryl limitedl initiationl ofl sociall interactions,l minimall responsel tol sociall overturesl froml other
QUESTION
commonl comorbiditiesl withl ASD Answer: medicall disorders:l seizures,l potentiall geneticl disorders,l leadl poisonigl inl childrenl withl PICA developmentl andl mentall healthl comorbidites:l hyperactivity,l anxiety,l depression,l behaviorall regulationl sleepl problems:l latel onset,l frequentl waking,l restlessness
GI:l constipation,l restrictedl diet dleaysl ofl acquistionl ofl selfl helpl skills
QUESTION
clinicall presentationl ofl ASD Answer: presentationl inl firstl twol yearsl ofl lifel parentsl report:
- speech/languagel delays
- failurel tol makel eyel contact
- limitedl interestl inl socializing
QUESTION
delayedl speech/languagel timel points Answer: nol babblingl byl 9 l monthsl lackl ofl orientationl tol namel byl agel 12 l months lackl ofl pointingl orl gesturingl tol indicatel inetesetl (pointingl tol airplanel flyingl over)l byl agel 14 l months nol singlel wordsl byl 16 l months lackl ofl pretendl /symbolicl playl (feedingl al doll)l byl agel 18 l monthsl nol spontaneous,l meaningfull (nonl repetaitvel orl echolaicl twol wordl phrasesl byl 24 l months)
QUESTION
M-CHAT
Answer: alll childrenl shouldl bel screenedl forl autisml atl agel 18 l monthsl evenl ifl theyl showl nol signsl ofl developmentall delay;l accoridngl tol AAPl guidlines M-CHATl simplel screeningl tool-l 20 l itemsl yes/nol forl parents
QUESTION
osteol stats
Answer: repeatl ifl onl tx,l 1 - 2 l yrs BMD-l correlatesl withl bonel strengthl andl isl anl excellentl predictorl ofl fracturel risk DEXA-l duall energyl xrayl mostl widlyl used,l 15 l minl test,l 1/10thl standardl radiation
- measuresl hip,l spinel wrist,l mostl commonl areasl tol fracture
QUESTION
BMDl results Answer: tl scorel <l orl =l - 2.5l isl osteo tl scorel betwenl - 1 l andl - 2.5l isl lowl bonel mass/l osteopenia tl scorel - 1 l orl higherl isl normal performl BMDl 1 - 2 l yearsl afterl initiationl andl everyl 2 l yrsl after
QUESTION
FRAX
Answer: fracturel riskl assessment estimatesl thel 10 l yearl probabilityl ofl hipl fracturel andl majorl osteol fracturel forl untxl ptsl btwl 40 l andl 90 riskl factors:l age,l smoking,l familyl hx,l gluc,l arthritis,l femorall neckl bonel densityl calibratedl basedl onl datal froml country
QUESTION
osteol txl supplementsl andl lifestyle Answer: calciuml (citratel absorbsl betterl onl emptyl stomach)
- premenopause/men:l 1000mgl daily
- postl menopause-l 1200mg/daily vitl D
- premenopause:l 600 - 800IU/day
- postmenopause:l 800 - 1000IU/day exercise:l 30 l minl dailyl xl 3 l weekly,l weightl bearing
QUESTION
whol needsl medicationl forl osteo? Answer: postmenopausall womenl withl al hxl ofl fragilityl fracturel orl withl osteoporosisl basedl uponl bonel minerall densityl (BMD)l measurmentl (Tl scorel <-2.5) peoplel withl osteopenial (tl - 1.0l andl - 2.5)l andl anl estimatedl 10 l yearl riskl (FRAXl score)l ofl hipl orl osteoporosisl fracturel >3l orl >20% orall bisphonatesl shouldl alwaysl bel consideredl asl firstl linel therapyl (antireabsortive)
QUESTION
antireabsortivel tx Answer: slowsl bonel lossl thatl occursl inl thel breakdownl partl ofl thel remodelingl cycle,l butl stilll makesl newl bone usedl forl preventionl andl tx bonel densityl mayl increase goal-l preventl bonel lossl andl lowerl riskl ofl breakingl bone
QUESTION
typesl ofl antireabsortives Answer: bisphosphonates alendronate-l fosamax
- shownl tol increasel BMDl andl decreasel riskl ofl spine,l hipl andl otherl brokenl bonesl byl 50%l overl 2 - 4 l yrs
- dosel 5mgl QDl orl 35mgl qwkl forl osteopenia,l 10mgQDl orl 70mgqwkl forl osteoporosis ****takel firstl thingl inl thel aml onl anl emptyl stomachl withl 6 - 8ozl ofl waterl atl leastl 30 l minutesl beforel eatingl orl drinking,l NEEDl TOl STAYl UPRIGHTl TOl PREVENTl EROSIVEl ESOPHAGITIS ibandonate-boniva
- decreasel spinel fracturesl byl 50%l oveel 3 l yrs
- 150mgl monthlyl injectionsl orl quarterlyl injections
- samel orall instructionsl
