NRNP 6552-16-Advanced Nursing Practice Reproductive Health Midterm Exam

NRNP 6552-16-Advanced Nursing Practice Reproductive Health Midterm Exam

1. Olivia presents with a complaint of “bumps” around her vagina. They are nonpainful and nonpruritic. Upon inspection, you note several flesh colored and pearly white papules with depressed centers. This appearance is characteristic of:

	A.	Condyloma lata
	B.	Genital warts
	C.	Malignant melanoma
	D.	Molluscum contagiosum

2. Pelvic support structures include:

	A.	Muscles and connective tissue of the pelvic floor
	B.	Fibromuscular tissue of the vaginal wall
	C.	End pelvic connective tissue
	D.	All of the above

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3. Serum FSH indirectly measures ovarian function, with _______ levels of FSH indicating normally functioning ovaries.

	A.	Lower
	B.	Median
	C.	Higher
	D.	Absent

4. The term used to describe painful cramps that occur with menstruation is:

	A.	Amenorrhea
	B.	Menorrhagia
	C.	Uterine atony
	D.	Dysmenorrhea

5. One of the reasons that substance use is a concern in LBQ and TGNC communities is:

	A.	It has been shown to be a confirmed genetic risk
	B.	Bars and club scenes have long been safe spaces for gay, LBQ, ad TGNC people
	C.	A and B
	D.	None of the above

6. One of the reasons that substance use is a concern in LBQ and TGNC communities is:

	A.	It has been shown to be a confirmed genetic risk
	B.	Bars and club scenes have long been safe spaces for gay, LBQ, ad TGNC people
	C.	A and B
	D.	None of the above

7. On physical examination, pale atrophic depigmented tissue that has a “cigarette paper” appearance is consistent with:

	A.	Vaginal candidiasis
	B.	Contact dermatitis
	C.	Lichen sclerosis
	D.	Gonorrhea

8. A type of contraceptive that does not contain hormones is:

	A.	Paragard IUD
	B.	Mirena IUD
	C.	Nuvaring
	D.	Evra patch

9. The following are the four basic Caldwell-Moloy pelvic types.

	A.	Gynecoid, android, anthropoid, platypelloid
	B.	Gynecoid, antecoid, retrocoid, flexed
	C.	Anterverted, anteflexed, retroverted, retroflexed
	D.	None of the above

10. The least invasive way to assess bladder capacity is through:

	A.	Filling cystometrogram
	B.	3-day voiding diary
	C.	Quantified standing stress test
	D.	Urethral pressure profile

11. Strong evidence shows that first trimester abortions, whenever performed safely, increases a women’s risks of:

	A.	Subsequent infertility
	B.	Ectopic pregnancy
	C.	Birth defects
	D.	None of the above

12. Hirsutism is defined as:

	A.	Excessive terminal hair loss in women
	B.	Excessive nail growth in women
	C.	Brittle nail growth in women
	D.	Excessive terminal hair growth in women

13. EBP stands for:

	A.	Experimental based practice
	B.	Evidence based practice
	C.	Excellent bedside practice
	D.	None of the above

14. The _______________ are easily sensitized and become engorged with blood during sexual arousal.

	A.	Labia Minora
	B.	Labia Majora
	C.	Bartholin’s glands
	D.	Mons pubis

15. Menopause is defined as:

	A.	Cessation of periods for six months
	B.	Cessation of periods for one year
	C.	Cessation of periods for two years
	D.	None of the above

16. Josefina is a 47-year-old patient with family history of diabetes. Her BMI is 30. She has been healthy except for medication-controlled hypertension. She has been very compliant with her appointments. Today, you tell her you need to check her blood sugar. She says “I just read an article that said I only need to have that checked every three years. You just checked it last year.” You tell her:

	A.	You are correct that in many people, testing should only be every year. However, due to your family history of diabetes and your current weight and BMI, this places you in the high-risk category and you should have this done yearly.
	B.	You are absolutely correct. I did not see in the chart that we had done that last year. I apologize. You are not due for that for two more years.
	C.	I’m not sure the article that you read but the recommendation is that every patient have this test done on a yearly basis.
	D.	Actually, we are supposed to be checking it every three months in high risk individuals, so we are behind on our testing!

17. All organizations recommend beginning screening mammograms in average-risk women at age____

	A.	<40 years
	B.	40 to 44 years
	C.	45 to 49 years
	D.	55 years and older

18. The _________ is a sensitive organ that is typically described as the female homologue of the penis.

	A.	Vulva
	B.	Clitoris
	C.	Skene’s gland
	D.	Bartholin’s gland

19. A person whose gender identity is the same as their sex when he or she was born is:

	A.	Bisexual
	B.	Pansexual
	C.	Intersexual
	D.	Cisgender

20. When females go through puberty, the changes that occur are initiated by the production of:

	A.	Low amounts of estrogen
	B.	High amounts of estrogen
	C.	High amounts of progesterone
	D.	Low amounts of testosterone

21. Gale is 36 weeks pregnant. She calls the office to report that she has noticed a sticky fluid coming from her breasts. You let her know that this is most likely:

	A.	A serious concern and she needs to be evaluated immediately.
	B.	Colostrum, but she should be evaluated as it should not be noted during pregnancy.
	C.	Colostrum, which is commonly noted toward the end of the pregnancy.
	D.	A hormonal response that is indicative that she will most likely go into labor int the next 48 hours.

22. Endometrial polyps are most commonly identified by:

	A.	A speculum exam
	B.	A bimanual exam
	C.	A pap smear
	D.	A transvaginal ultrasound

23. When using the FIGO staging classification for cancer of the ovary, fallopian tube, and peritoneum, Stage I means:

	A.	The tumor is confined to the ovaries or fallopian tube(s)
	B.	The tumor involves one or both ovaries or fallopian tubes with pelvic extension or primary peritoneal cancer
	C.	The tumor involves one or both ovaries or fallopian tubes, or primary periotenal cancer, with cytologically and histologically confirmed spread to the peritoneum outside the pelvis
	D.	There is distant metastasis excluding peritoneal metastasis

24. First line pharmacologic treatment for women with PCOS is/are:

	A.	Progestin-only birth control pills
	B.	Combined oral contraceptives
	C.	Lasix
	D.	Multivitamins with folic acid

25. Metabolic syndrome typically includes the following except:

	A.	Sudden weight loss
	B.	Obesity
	C.	Insulin resistance
	D.	Dyslipidemia
	E.	All of the above

26. On vaginal exam you find that Polly’s cervix is in the most common position, which is:

	A.	Antiflexion
	B.	Midline
	C.	Posterior
	D.	Backward

27. Clinicians can participate in primary sexual violence prevention by applying individual prevention skills, such as:

	A.	Challenging behaviors in others that promote violence
	B.	Engaging in healthy professional and personal relationships
	C.	Learning to identify risk factors for sexually abusive behaviors
	D.	B and C
	E.	A, B, and C

28. The following is/are types of sexual violence.

	A.	Intentional touching of the breast
	B.	Pornography
	C.	Threats of sexual violence
	D.	All of the above

29. The only antimicrobial medications that are effective against Trichomoniasis vaginalis are:

	A.	tinidazole or metronidazole
	B.	Amoxicillin or Augmentin
	C.	doxycycline or minocycline
	D.	cephalexin or ceftriaxone

30. The use of a pain rating scale may assist the clinician to comprehend the intensity of a woman’s pain. Example(s) of pain rating scale(s) include:

	A.	Numeric ranking scale
	B.	Visual analog scale
	C.	Verbal descriptive scale
	D.	All of the above
D

The use of a pain rating scale may assist the clinician to comprehend the intensity of a woman’s pain. Example(s) of pain rating scale(s) include:

	A.	Numeric ranking scale
	B.	Visual analog scale
	C.	Verbal descriptive scale
	D.	All of the above

31. A cluster of mild to moderate physical and psychological symptoms that occur during the late luteal phase of menses and resolve with menstruation is the definition of

	A.	Premenstrual dysphoric disorder
	B.	Premenstrual syndrome
	C.	Menstrual mood swings
	D.	Psychosocial syndrome

32. The timing of an adolescent growth spurt typically occurs ____________ in puberty than it does for boys.

	A.	One year later
	B.	Two years earlier
	C.	At a similar time
	D.	None of the above

33. The following symptoms are consistent with PMS except:

	A.	Depression
	B.	Confusion
	C.	Breast tenderness
	D.	Uncontrollable fits of laughter

34. Reproductive coercion includes behaviors:

	A.	Related to pressuring or coercing a person to have sex without using physical force
	B.	Related to pressuring or coercing a person to have sex using physical force
	C.	That interfere with contraception use and/or pregnancy
	D.	Any of the above

35. Women in the following profession have a higher rate of UTI

	A.	Nursing
	B.	Housecleaning
	C.	Secretarial
	D.	Those who do not work outside the home

36. Women in the following profession have a higher rate of UTI

	A.	Nursing
	B.	Housecleaning
	C.	Secretarial
	D.	Those who do not work outside the home

37. Clinicians are required to report certain STIs to their state public health officials. These include:

	A.	Chlamydia
	B.	Gonorrhea
	C.	Syphilis
	D.	A and B
	E.	A, B, and C

38. Bone density testing for osteoporosis should start at age _______ for women and age _______ for men.

	A.	60; 60
	B.	65; 70
	C.	50; 60
	D.	65; men do not need this test

39. A pharmacologic treatment for patients with Hydradenitis Suppurativa (HI) may include

	A.	Clindamycin
	B.	Minocycline
	C.	Metformin
	D.	All of the above

40. The following is/are risk factor(s) for bacterial vaginosis.

	A.	Menstrual bleeding
	B.	Douching
	C.	Lack of condom use
	D.	B and C
	E.	A, B, and C

41. All of the following are risk factors for UTI, except:

	A.	Previous UTI
	B.	Infrequent sexual activity
	C.	Incomplete bladder emptying
	D.	Obesity

42. In women with PCOS, polycystic ovaries are due to:

	A.	Excessive ovulation
	B.	Chronic anovulation
	C.	Using birth control for an extended period of time
	D.	None of the above

43. The following symptoms are associated with peri-menopause and menopause.

	A.	Excessive eye tearing
	B.	Headache
	C.	Fatigue
	D.	B and C
	E.	All of the above

44. Just prior to ovulation, rising levels of estradiol increases the amount of cervical mucus, making it:

	A.	Thick and sticky
	B.	Absent
	C.	Thin and watery
	D.	Yellowish and thicker

45. The most common type of UTI affecting women is:

	A.	Pyelonephritis
	B.	Asymptomatic bacteriuria
	C.	Acute bacterial cystitis
	D.	None of the above

46. Criteria for clinical diagnosis of bacterial vaginosis include the presence of three out of four of the following Amsel criteria:

	A.	Yellowish thick vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination
	B.	Yellowish thick vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of clue cells on microscopic examination
	C.	White, thin adherent vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination
	D.	Yellowish thick vaginal discharge, pH equal or less than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination

47. The contraceptive implant that is currently available in the U.S. is:

	A.	Norplant
	B.	Implanon
	C.	Nexplant
	D.	Nexplanon

48. Approximately 50% to 70% of women with PCOS are insulin resistant. Insulin resistance often results in:

	A.	Compensatory hyperinsulinemia
	B.	Compensatory hypoinsulinemia
	C.	Excessively low blood sugars
	D.	Weight loss

49. Evidence from randomized trials on intimate partner violence screening support the following intervention(s) for women of childbearing age:

	A.	Counseling
	B.	Home visits
	C.	Mentoring support
	D.	A and C
	E.	A, B, and C

50. Nearly _________ pregnant women have been abused by the partner.

	A.	1 in 20
	B.	1 in 15
	C.	1 in 6
	D.	1 in 2

51. When looking from a feminist perspective at research studies, one of the great concerns is that:

	A.	There are too many studies involving women
	B.	Most of the research is qualitative, which limits the applicability
	C.	For many years, studies were done primarily on men with the findings being generalized to women
	D.	None of the above

52. Marianne presents for a well woman exam. In gathering her history, she tells you she has been pregnant 3 times. She has two children, both born at 39 weeks, and had one miscarriage. Using the GTPAL system, you note that in her chart as the followingA

	A.	G3 T2 P0 A1 L2
	B.	G3 T0 P2 A1 L2
	C.	G2 T2 P0 A1 L2
	D.	G2 T2 P2 A1 L3

53. The frontline analgesics for painful menstrual cramps are:

	A.	Opioids
	B.	Corticosteroids
	C.	NSAIDs
	D.	Hormone therapy

54. The endometrial cycle has three phases, which are:

	A.	Proliferative, luteal, menstrual
	B.	Luteal, menstrual, post-menstrual
	C.	Proliferative, secretory, menstrual * (pg. 91)
	D.	Secretory, luteal, menstrual

55. A progesterone challenge test that produces withdrawal bleeding is indicative of:

	A.	No ovarian function
	B.	Infertility
	C.	Functioning ovaries
	D.	Uterine cancer

56. An appropriate medication for Herpes Simplex virus is:

	A.	Acyclovir
	B.	Valacyclovir
	C.	Famciclovir
	D.	All of the above

57. Infertility related to ___________ is a common problem among women who are obese.

	A.	Depression and anxiety
	B.	Ovarian dysfunction and anovulation
	C.	Irregular menstrual bleeding
	D.	Dyspareunia

58. The following is an appropriate sexual health assessment question:

	A.	Do you masturbate?
	B.	Have you ever had an orgasm?
	C.	Are there any sexual problems or concerns that you would like to discuss with me today?
	D.	All of the above

59. Emergency contraception therapy may be given to a woman who seeks treatment immediately following sexual assault. It may be given within ____________ hours of the assault.

	A.	36
	B.	60
	C.	72
	D.	All of the above

60. Normal vaginal discharge has a pH of:

	A.	3.5 to 4.5
	B.	5.2 to 6.1
	C.	6.3 to 7.3
	D.	None of the above

61. Approximately __________ of infertility cases are due to female factors and _________ are due to male factors.

	A.	50%; 50%
	B.	10%; 90%
	C.	90%; 10%
	D.	55%; 35%

62. The most common pathogen leading to urinary tract infection is:

	A.	Escherichia coli
	B.	Enterobacter
	C.	Pseudomonas
	D.	Proteus mirabilis

63. Uterine fibroids are also known as:

	A.	Myomas
	B.	Leiomyomatas
	C.	Cancerous tumors
	D.	A and B
	E.	All of the above

64. When performing a pain history, the term OLD CAARTS is an aid. This stands for:

	A.	Onset; location; duration; characteristics; alleviating or aggravating factors; associated symptoms; radiation; temporal; severity
	B.	Origination; location; duration; characteristics; assessment; aggravating factors; radiation; temporal; severity
	C.	Onset; level; duration; characteristics; alleviating or aggravating factors; assessment; reaction; temporal; severity
	D.	Origination; location; duration; character; aggravating factors; alleviating factors; radiation; temporal; severity

65. Most malignancies in breast tissue occur in:

	A.	The areolar area
	B.	The upper outer quadrant
	C.	The lower outer quadrant
	D.	None of the above

66. When conducting qualitative research, data can be derived from:

	A.	Fieldwork
	B.	Media
	C.	Interviews
	D.	A and C
	E.	A, B, and C

67. For women at high risk for breast cancer, National Comprehensive Cancer Network (NCCN)  recommends annual screening with mammography and ________ beginning at age 30.

	A.	Ultrasound
	B.	CT scan
	C.	MRI
	D.	Nuclear medicine testing

68. Patients identified as being at increased risk for Sexually Transmitted Infections need to receive information about risk factors and ways to reduce the likelihood of infection. This would include:

	A.	Use of latex condoms
	B.	Being mutually monogamous
	C.	Abstinence-only education
	D.	A and B

69. Endometriosis is:

	A.	The presence of endometrial glands and stroma on the lining of the uterus.
	B.	The presence of endometrial glands and stroma outside the lining of the uterus.
	C.	The presence of endometrial glands and stroma only lining the ovaries
		None of the above The ___________glands are oil-producing glands on the areola that protect and lubricate the nipple during lactation. A. Montgomery B. Skenes C. Lactogenic D. Sebum   The name of the act in the U.S. that addresses domestic violence, dating violence, sexual assault, stalking, and human trafficking is: A. The Violence Against Women Act (VAWA) B. The Megan Jones Act (MJA) C. The Anti-Abuse Act (TAAA) D. The No More Abuse Act (NMAA)

72. Abnormal uterine bleeding can sometimes be caused by

	A.	Hypothyroidism
	B.	Hyperthyroidism
	C.	A and B
	D.	None of the above

73. Jenna comes in complaining of intense itching in the vaginal area. She also has some itching in the vulvar area. It is really bad after she has intercourse. In gathering her history, she tells you she had an ear infection a few weeks ago and took amoxicillin for it but otherwise, has been healthy. On exam, you note a thick, white, lumpy discharge with the consistency of cottage cheese. The vulva is red and swollen as are the labial folds. There is no strong odor. The most likely diagnosis is:

	A.	Bacterial vaginosis
	B.	Trichomoniasis
	C.	Urinary tract infection
	D.	Vulvovaginal candidiasis

74. Barriers for providers related to intimate partner violence screening include:

	A.	Discomfort with the topic
	B.	Having too much power that might be intimidating
	C.	Time constraints
	D.	A and C
	E.	A, B, and C

75. The _____________ is often considered the most important muscle of the pelvic floor.

	A.	Anococcygeal rapine
	B.	Urethrovaginal sphincter muscle
	C.	Urogenital diaphragm
	D.	Levator ani

76. An endometrial biopsy can be done in the office setting. It has a _________ overall accuracy in diagnosing endometrial cancer.

	A.	Low
	B.	Average
	C.	High
	D.	None of the above; it is not a good test for diagnosis of endometrial cancer

77. Angela just adopted an 11-year-old from another country. Unfortunately, there are no records of previous immunizations on this child. When discussing immunizations, you mention that the child needs several, including the MMR. Angela asks you what MMR stands for. You tell her:

	A.	Measles, Meningococcal, and Rubeola
	B.	Measles, Meningococcal, and Rubella
	C.	Measles, Mumps, and Rubella
	D.	Mumps, Meningococcal, and Rubella

78. In women, fertility declines gradually beginning at age ___________ and more rapidly after age _______.

	A.	25; 30
	B.	32; 37
	C.	35; 40
	D.	45; 52

79. The majority of female infertility is due to:

	A.	Ovulatory dysfunction and tubal and peritoneal pathology
	B.	Uterine pathology
	C.	Low sperm count
	D.	None of the above

80. The following are risk factors for endometrial cancer.

	A.	Age 40 years or older
	B.	Tamoxifen therapy
	C.	Unopposed estrogen stimulation of the endometrium
	D.	A and C
	E.	A, B, and C

81. Infected hair follicles on the vulvar skin that are small and scattered often occur because of:

	A.	Oral sex
	B.	Masturbation
	C.	Shaving the pubic hair
	D.	Pediculosis

82. The most common symptoms of uterine cancer are:

	A.	Amenorrhea and cramping
	B.	Abnormal uterine bleeding and postmenopausal bleeding
	C.	Sudden expulsion of blood clots from the vagina with pain
	D.	Abnormal pap results

83. Margaret has several risk factors for osteoporosis. She is 72 years old, is a 30-pack year smoker, and has never had children. Which one of these risk factors was nonmodifiable?

	A.	Advanced age
	B.	Cigarette smoking
	C.	Nulliparity
	D.	All of the above

84. The USPTF, ACOG, and ACS all recommend pap tests to begin at:

	A.	Onset of sexual activity
	B.	Age 18
	C.	Age 21
	D.	Age 30

85. An umbrella term that describes all people with non-heterosexual gender identities is:

	A.	Queer
	B.	Intersex
	C.	Transgender
	D.	Binary

86. When concerned about ectopic pregnancy in a patient with abdominal pain, two diagnostic aids include:

	A.	CT scan and HCG
	B.	HCG and ultrasound
	C.	HCG and MRI
	D.	HCG and pelvic exam

87. The new guideline for systolic blood pressure cut-off for hypertension is:

	A.	150
	B.	140
	C.	130
	D.	120

88. The test for the fishy odor that occurs in bacterial vaginosis is called the:

	A.	Smell test
	B.	Odor test
	C.	Sniff test
	D.	Whiff test

89. Symptoms of Polycystic Ovary Syndrome (PCOS) include all of the following except:

	A.	Acne
	B.	Menstrual irregularity
	C.	Hirsutism
	D.	Hypopigmentation of the extremities

90. Martha is a 65-year-old woman who is a new patient to you. In telling you her history, she states that she has a history of a rare type of breast cancer. She cannot remember the name of it but tells you that it also involved itchy eczema-like nipple changes. With this info and your knowledge of breast cancer, you surmise that she may be referring to:

	A.	Bowen’s disease
	B.	Lobular neoplasia
	C.	Paget’s disease
	D.	Wernicke’s disease

91. The act that was established that mandated every American to carry health insurance is called:

	A.	Health Insurance Portability and Accountability Act (HIPAA
	B.	Healthy People 2020
	C.	The Insurance Requirement Act (IRA)
	D.	The Affordable Care Act (ACA)

92. The American Cancer Society (ACS) has recently updated its colorectal cancer screening guidelines. The new guidelines recommend screening average-risk patients for that disease at age ________

	A.	40
	B.	45
	C.	50
	D.	55

93. The most common STI in the United States is:

	A.	HPV
	B.	Gonorrhea
	C.	Chlamydia
	D.	HIV

94. Pelvic muscle exercises, where the woman performs a repetitive pelvic floor muscle contraction regimen are known as:

	A.	Knack Skills
	B.	Kegel Exercises
	C.	Reverse Bladder exercises
	D.	Barrier exercises

95. Lichen planus is typically treated with:

	A.	Antibiotics
	B.	Lubricant ointments
	C.	Hormone therapy
	D.	Corticosteroids

96. “A movement to end sexism, sexist exploitation, and oppression” is a definition for:

	A.	Homophobia
	B.	Sexism
	C.	Feminism
	D.	Classism

97. Female orgasmic disorder is present when there is a marked delay in, marked infrequency of, or absence of orgasm or reduced intensity of orgasm sensations that last more than _________.

	A.	1 month
	B.	6 months
	C.	1 year
	D.	5 years

98. Neisseria gonorrhea is a ___________ bacteria

	A.	Gram positive
	B.	Gram neutral
	C.	Gram negative
	D.	None of the above

99. Ovarian failure is diagnosed when _______ estrogen production is identified while the serum FSH is __________.

	A.	Low; Low
	B.	Low; High
	C.	High; Low
	D.	High; High

100. A waiting period of ____________ between bariatric surgery and pregnancy is recommended.

	A.	6-12 months
	B.	6-18 months
	C.	12-24 months
	D.	3-5 years

101. Trichomonas vaginalis can be asymptomatic, but when symptomatic, the vaginal discharge tends to be:

	A.	Thick and green non odorous
	B.	Yellow to green  frothy
	C.	Bloody
	D.	Thin and watery