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AGNP BOARD EXAM {70 QUESTIONS and Answers with Explanation} Women’s Health Assessment
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AGNP BOARD EXAM {70 QUESTIONS and Answers with Explanation}Women’s Health Assessment
Question:
A woman complains of infrequent menses with intervals greater than 35 days. This
condition is termed:
oligomenorrhea. Correct
polymenorrhea.
metrorrhagia.
menorrhagia.
Explanation:
Oligomenorrhea is infrequent bleeding with menses occurring at greater than 35- day
intervals, or 4-9 menstrual cycles per year. Polymenorrhea occurs when there are fewer
than 21-day intervals between menses. Menorrhagia refers to excessive or prolonged
menstrual flow occurring at regular intervals. Metrorrhagia refers to intermenstrual
bleeding.
Question:
Upon examination of the vagina, a swollen red ring is noted around the urethral
opening. This finding is most consistent with a:
prolapse of the urethral mucosa. Correct
urethral caruncle.
cystocele.
cystourethrocele.
Explanation:
A prolapsed urethral mucosa forms a swollen red ring around the urethral meatus. A
urethral caruncle is a small, red, benign tumor visible at the posterior part of the
urethral meatus. It usually occurs in postmenopausal women. A cystocele is a bulge of
the upper two-thirds of the anterior vaginal wall and the bladder above it. It results from
weakened supporting tissues. When the entire anterior vaginal wall, together with the
bladder and urethra, is involved in the bulge, a cystourethrocele is present.
Question:
When palpating the cervix during the bimanual exam, cervical motion tenderness
(chandelier sign) is noted. This tenderness could be suggestive of:
retroversion of the uterus.
pelvic inflammatory disease. Correct
vulvar lesions.
Bartholin gland infection.
Explanation:
Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal
tenderness, suggest pelvic inflammatory disease, ectopic pregnancy, or appendicitis.
,Question:
When performing a rectal exam on a female, a hard nodular rectal "shelf" is palpable at
the tip of the examiner's finger. This finding is suggestive of:
an ovarian cyst.
metastatic tissue in the rectouterine pouch. Correct
rectal polyp.
carcinoma of the rectum.
Explanation:
Widespread peritoneal metastases from any source may develop in the area of the
peritoneal reflection anterior to the rectum. A firm to hard nodular rectal “shelf” may
be just palpable with the tip of the examining finger. In a woman, this shelf of
metastatic tissue develops in the rectouterine pouch, behind the cervix and the uterus.
Rectal polyps and carcinoma of the rectum, if palpable, are typically located in the
lower section of the rectum. To palpate the ovaries, a bimanual pelvic examination
would be more appropriate.
Question:
When performing an examination of the external genitalia of a female patient, a small,
firm, round cystic nodule in the labia is identified. This lesion is most consistent with:
a syphilitic chancre.
an epidermoid cyst. Correct
Condylomata acuminata.
genital herpes.
Explanation:
A small, firm, round cystic nodule in the labia suggests an epidermoid cyst. They appear
yellowish in color with a dark punctum marking the blocked opening of the gland. A
syphilitic chancre appears as a firm, painless ulcer and suggests the chancre of primary
syphilis. Because most chancres in women develop internally, they often go undetected.
Genital warts or Condylomata acuminata are warty lesions on the labia and within the
vestibule resulting from infection with human papillomavirus. Genital herpes appears as
shallow, small, painful ulcers on red bases.
Question:
In a female diagnosed with a first-degree uterine prolapse, the cervix:
is located in its normal position.
has slipped but is well within the vagina. Correct
is located in the introitus.
and vagina are outside the introitus.
Explanation:
Uterine prolapse occurs in progressive stages. The uterus becomes retroverted and
descends down the vaginal canal to the exterior. In first-degree prolapse, the cervix is
still well within the vagina. In second-degree prolapse, it is at the introitus. In third-
degree prolapse (procidentia), the cervix and vagina are outside the introitus.
,Question:
When performing a bimanual exam of the vagina, the examiner should lubricate the
index and middle fingers of a gloved hand. From a standing position, the fingers should
be inserted into the vagina while exerting pressure primarily:
anteriorly.
posteriorly. Correct
toward the "4-o"clock" position.
toward the "8-o"clock" position.
Explanation:
When performing a bimanual exam of the vagina, the examiner should lubricate the
index and middle fingers of one of the gloved hands, and from a standing position,
insert them into the vagina while exerting pressure primarily posteriorly.
Question:
Chronic pelvic pain may be secondary to all of the above except:
sexually transmitted diseases.
sexual abuse.
fibroids.
peptic ulcer disease. Correct
Explanation:
Chronic pelvic pain (CPP) refers to pain of at least 6 months duration that occurs below
the umbilicus. While gynecologic etiologies are common, CPP may be secondary to
conditions in the urinary tract, GI tract, musculoskeletal system, and in the setting of
mental health issues. Peptic ulcer disease affects the upper GI tract and produces
symptoms above the umbilicus.
Question:
To palpate the uterus during a bimanual exam, the examiner would lubricate the index
and middle fingers of one hand and insert them into the vagina. The other hand would
be placed on the abdomen:
near the symphysis pubis while pressing downward and elevating the cervix and
uterus with the other hand.
about midway between the umbilicus and symphysis pubis while elevating the cervix
and uterus with the other hand. Correct
just above the umbilicus while pressing downward and elevating the cervix and uterus
with the other hand.
just below the umbilicus while pressing downward and elevating the cervix and uterus
with the other hand.
Explanation:
To palpate the uterus during a bimanual exam, the examiner would lubricate the index
and middle fingers of one hand and insert them into the vagina. The other hand would
be placed on the abdomen about midway between the umbilicus and the symphysis
pubis. While elevating the cervix and uterus with the pelvic hand, press the abdominal
hand in and down, trying to grasp the uterus between the two hands.
, Question:
Examination of a female patient's right breast reveals a retraction of the nipple and
areola. This finding is consistent with:
breast cancer. Correct
mastitis.
Paget's disease of the
breast. fibrocystic breast
disease.
Explanation:
Retraction of the nipple and areola are suggestive of an underlying tumor. Mastitis is an
inflammation of the breast tissue. Paget's disease is an uncommon form of breast
cancer that starts with a scaly, eczema-like lesion that may weep, crust, or erode.
Fibrocystic breast disease findings include lumps, thickening and swelling in the breast
tissue, and becomes prominent immediately before onset of menses.
Question:
When performing the bimanual vaginal exam, uterine enlargement is noted. This
enlargement could suggest:
a malignancy. Correct
retroversion of the uterus.
retroflexion of the uterus.
pelvic inflammatory disease.
Explanation:
Uterine enlargement may suggest pregnancy, uterine myomas (fibroids), or malignancy.
Retroversion or retroflexion of the uterus, and pelvic inflammatory disease are not
typical findings with enlargement of the uterus.
Question:
Upon examination of the vagina, a small, red, benign tumor is noted at the posterior
part of the urethral meatus. This finding is most consistent with a:
prolapse of the urethral mucosa.
urethral caruncle. Correct
cystocele.
cystourethrocele.
Explanation:
A urethral caruncle is a small, red, benign tumor visible at the posterior part of the
urethral meatus. A cystocele is a bulge of the upper two-thirds of the anterior vaginal
wall and the bladder above it. It results from weakened supporting tissues. A prolapsed
urethral mucosa forms a swollen red ring around the urethral meatus. When the entire
anterior vaginal wall, together with the bladder and urethra, is involved in the bulge, a
cystourethrocele is present.
Question:
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