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Women's Health Questions and Answers: A Comprehensive Guide for Medical Professionals, Exams of Nursing

Fitchburg State University (FSU)Nursing

A series of questions and answers related to women's health, covering topics such as vaginal exams, vulvovaginal inflammation, breast tumors, menopause, and prenatal care. It is a valuable resource for medical professionals seeking to enhance their knowledge and understanding of common women's health issues.

Typology: Exams

2023/2024

Available from 10/29/2024

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Women's Health Questions & Answers
2023
You are about to conduct a complete vaginal exam and obtain a cervical cytology
specimen. For which of these should you use the bifid end of the Ayre spatula?
A. Vaginal pool
B. Cervical scrape
C. Endocervical specimen
D. Acetic acid wash - ANS-B. Also called a cervical brush
Which form of vulvovaginal inflammation is most characterized by fishy, foul smelling
vaginal odor?
A. Candidiasis
B. Bacterial vaginosis
C. Chlamydia
D. Trichomoniasis - ANS-B. Bacterial vaginosis - the key to answering this question is
realizing that it is asking most characterized
On vaginal exam of a 23 year old African American female you note vaginal erythema,
malodorous, frothy yellowish, green discharge. The patient c/o pruritis and dyspareunia.
The nurse practitioner would order therapy based on what diagnosis?
A. Bacterial Vaginosis
B. Candidiasis
C. Gonorrhea
D. Trichomonas - ANS-D. Trichomonas: Frothy with yellow green discharge and a fishy
odor
Which of these best depicts the site of most breast tumors in women?
A. Lower outer quadrant
B. Tail of spence
C. Upper outer corner
D. Axilla - ANS-C. Upper outer corner
A 72 year old patient presents for her annual physical exam. She states thatshe has
never had an abnormal pap smear or mammogram and adds, "I really don't want to do
all that stuff anymore unless you think it is really necessary". You note in her chart that
indeed, she has always had a normal pap smear and mammogram. Thus based on the
latest national guidelines what would you order for this visit?
A. Pap Smear
B. Mammogram
C. Both
D. Neither - ANS-B. Mammogram. Current national guidelines recommend a Pap smear
until age 65 if normal and mammograms until 75 unless abnormal.
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Women's Health Questions & Answers

You are about to conduct a complete vaginal exam and obtain a cervical cytology specimen. For which of these should you use the bifid end of the Ayre spatula? A. Vaginal pool B. Cervical scrape C. Endocervical specimen D. Acetic acid wash - ANS-B. Also called a cervical brush Which form of vulvovaginal inflammation is most characterized by fishy, foul smelling vaginal odor? A. Candidiasis B. Bacterial vaginosis C. Chlamydia D. Trichomoniasis - ANS-B. Bacterial vaginosis - the key to answering this question is realizing that it is asking most characterized On vaginal exam of a 23 year old African American female you note vaginal erythema, malodorous, frothy yellowish, green discharge. The patient c/o pruritis and dyspareunia. The nurse practitioner would order therapy based on what diagnosis? A. Bacterial Vaginosis B. Candidiasis C. Gonorrhea D. Trichomonas - ANS-D. Trichomonas: Frothy with yellow green discharge and a fishy odor Which of these best depicts the site of most breast tumors in women? A. Lower outer quadrant B. Tail of spence C. Upper outer corner D. Axilla - ANS-C. Upper outer corner A 72 year old patient presents for her annual physical exam. She states thatshe has never had an abnormal pap smear or mammogram and adds, "I really don't want to do all that stuff anymore unless you think it is really necessary". You note in her chart that indeed, she has always had a normal pap smear and mammogram. Thus based on the latest national guidelines what would you order for this visit? A. Pap Smear B. Mammogram C. Both D. Neither - ANS-B. Mammogram. Current national guidelines recommend a Pap smear until age 65 if normal and mammograms until 75 unless abnormal.

An older woman complains to the nurse practitioner that she has leakage of urine when she sneezes or laughs. The patient thinks that it is getting worse. Which of the following would be an appropriate initial intervention? A. Educate the patient about kegal exercises B. Recommend that she limit her fluid intake to less than 1 liter daily C. Refer the patient to a urologist for a cystoscopy D. Advise the patient that shew ill be given medicine to help her with bladder control - ANS-A. Stress and urge incontinence are caused by the relaxation / loss of tone and ligaments of the pelvic floor that support the bladder, uterus, urethra, lower bowel, and vagina. Kegal exercises are pelvic floor strengthening exercises performed by repeated contracting, holding, and relaxing of the pubococcygeus muscle. Human papilloma virus (HPV) of the larynx has also been associated with: A. Laryngeal cancer B. Esophageal stricture C. Cervical cancer D. Metaplasia of the squamous cells - ANS-A. Laryngeal cancer A 48 year old woman is told by her physician that she is starting menopause. All of the following are possible findings in premenopausal women except: A. Hot flashes that may interfere with sleep B. Irregular menstrual periods C. Severe Vaginal atrophic changes D. Cyclic mood swings - ANS-C. A 22 year old sexually active woman is complaining of amenorrhea and vaginal spotting. On examination, her left adnexa is tender and cervical motion tenderness is positive. Which test should the nurse practitioner initially order? A. Flat plate of the abdomen B. CBC with diff C. Pregnancy test D. Pelvic ultrasound - ANS-C. Pregnancy test: Her positive physical findings of left adnexal tenderness and cervical motion tenderness and spotting suggest ectopic pregnancy rather than pelvic inflammatory disease. Amenorrhea should always be treated as pregnancy until proven otherwise. Folic acid supplementation is recommended for women who are planning to become pregnant in order to: A. Prevent renal agenesis B. Prevent anencephaly C. Prevent kidney defects D. Prevent heart defects - ANS-B. Ancephaly is a neural tube defect where ther is an absence of a major portion of the brain, skull, and scalp during embryonic development. Spina Bifida is the other neural tube defect folic acid prevents against. Females with polycystic ovary disease are at higher risk of:

During a breast exam of a 30 year old nulliparous female, the nurse practitioner palpates several rubbery mobile areas of breast tissue. There are no skin changes and no nipple discharge. The patient is expecting to menstruate in the next five days. Which of the following interventions is best? A. Refer to a gynecologist B. Tell her to return in one week after her period so her breasts can be rechecked C. Advise the patient to return in 6 months so that you can recheck her breasts D. Schedule the patient for a mammogram - ANS-B. Which of the following would you expect to find on a wet mount slide of a patient diagnosed with bacterial vaginosis? A. Tzanck cells B. A large number of leukocytes and epithelial cells C. A large number of squamous epithelial cells whose surfaces and edges are coated with large numbers of bacteria along with a few leukocytes D. Epithelial cells and a small amount of blood - ANS-C - These are clue cells A teenage girl complains that she has never had a period. On examination, the nurse practitioner notes that she is at Tanner Stage II. What are the physical examination findings during this stage. A. Breast buds and some straight pubic hair B. Fully developed breasts and curly pubic hair C. Breast tissue with the areola on a separate mound with curly pubic hair D. No breast tissue and no pubic hair - ANS-A. Tanner stage II: is noted for breast and papilla elevated as a small mound and areola diameter increased. Tanner II pubic hair for females is sparse, lightly pigmented straight hair along the medial border of the labia. You are checking a 67 year old female's breasts during an annual gynecological examination. The left nipple and surrounding areolar skin are scaly and reddeded, The patient denies pain and pruritis. She has noticed this scaliness on her left nipple for many months. Her dermatologist gave her a topical steroid that she used on the rash twice a day for a month. The patient never went back for the follow-up. She still has the rash and wants an evaluation. The nurse practitioner suspects Paget's disease of the breast. Which of the following is the best treatment plan for this patient? A. Prescribe another potent topical steroid and tell the patient to use it twice a day for four weeks. B. Order a mammogram and refer the patient to a breast surgeon. C. Advise the patient to stop using soap on both breasts when she bathes as this causes drying of the skin of her aerola and nipples. D. Order a sonogram and a fine needle biopsy of the breast. - ANS-B - Paget's disease of the breast is a rare cancer involving the skin of the nipple, and usually the areola. Paget's disease of the breast may be misdiagnosed at first because its early symptoms are similar to those caused by some benign skin conditions. Most people with Paget's disease of the breast also have one or more tumors inside the same breast either ductal carcinoma in situ or invasive breast cancer.

You are reviewing a Pap smear report on a 25 year old female. Which of the following cells should be on a Pap smear to be classified as a satisfactory specimen? A. Clue cells and endometrial cells B. Vaginal cells and cervical cells C. Squamous epithelial cells and endocervical cells D. Leukocytes and red blood cells - ANS-C- A optimal Pap smear sample contains sufficient mature and metaplastic squamous cells to indicate adequate sampling from the transformation zone and sufficient endocervical cells sampled, and to provide a sample for screening for adenocarcinoma and its precursors. The KOH (potassium hydroxide) prep is helping with the diagnosis of all of the following except: A. Tinea infections B. Candida albicans infections of the skin C. Bacterial vaginosis D. Atypical bacterial infections - ANS-D. Atypical bacterial infections. A KOH is done to determine if a fungus is causing a skin infection. A postmenopausal woman who has been on low-dose estrogen and progesterone replacement hormone therapy for her severe vasomotor symptoms complains to the nurse practitioner that she has had a few episodes of small amounts of vaginal bleeding that seems to occur at random over the past 4 months. She denies uterine cramping or dyspareunia. Which of the following would be the best treatment plan for this patient? A. Recommend a dilatation and curettage procedure, which is very helpful in cases of postmenopausal bleeding. B. Schedule the patient for a uterine ultrasound and biopsy C. Prescribe a 13 day course of progesterone pills to induce uterine shedding of the thickened endometrial lining at the end of the month. D. Refer the patient to a gynecologist for further evaluation. - ANS-B - Postmenopausal bleeding should always be investigated because it could be a sign of endometrial carcinoma. Although endometrial carcinoma is the most serious cause of postmenopausal bleeding, an atrophic endometrium with dyssynchronous shedding is he most common cause. A less common cause is cervical or endometrial polyps. A uterine ultrasound is ordered to evaluate the lining of the endometrium and rule out polyps. A uterine biopsy is ordered to sample for pathology.