Exam (elaborations)
NURS 6615 Midterm
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Exam of 6 pages for the course Pulmonary Rosh at Pulmonary Rosh (NURS 6615 Midterm)
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NURS 6615 MidtermA 16 year old female presents to you becuase she thinks 'she is not normal'. Her
periods have
never started, but otherwise she has no physical complaints. She has never been
sexually active. Based on the history you have obtained so far, her likely diagnosis is: -
ANS-Primary amenorrhea
A 19 year old female comes to you with the primary complaint of dysmenorrhea. Which
of the following questions is least important to ascertain in her history? - ANS-Do you
have first degree relatives with breast cancer?
A 22 year old client complains of severe dysmenorrhea and menorrhagia. Her
gynecological exam is normal. What management protocol would be most preferred? -
ANS-Assess for contraceptive interest, and suggest the use of oral contraceptives along
with medications to assist with pain management
A 22-year-old married female presents with complaints of severe dysmenorrhea and
menorrhagia. Her gynecologic exam is normal. Which managment protocol is
preferred? - ANS-Assess for contraceptive interest, and combine with NSAID therapy
A 38 year old woman comes into your clinic with pelvic pain and dyspareunia. On exam,
you palpate a fixed uterus in the retroflexed position with pain noted when the posterior
fornix is palpated. You suspect: - ANS-Endometriosis
A 40 year old presents to your office with dull, aching pelvic pain intermittently for two
years. You know that potential gynecological causes of chronic pelvic pain include all of
the following except: - ANS-multiple pregnancies
A 41 year old African-American female presents to your clinic with complaints of 7 days
of
heavy menstrual bleeding every 30-32 days. She is using super absorbency tampons
and a pad to control bleeding. By definition, she is experiencing: - ANS-menorrhagia
A 42 year old smoker presents for her annual exam where you notice a firm lump in her
external labia. She states she was exposed to HPV in the past, but is unsure if it was a
high-risk strain. The primary condition to rule out with this patient would be: -
ANS-Vulvar cancer
, A 46 year old women presents with very heavy menses and no other symptoms. She
denies menopausal symptoms. Her cycles are 21 days apart, lasting 7 days. On exam
you palpate a firm, irregularly enlarged uterus. In discussing her condition you advise
her that fibroids are: - ANS-the most common benign tumor of the female genital tract
A 60 year old woman whose last menstrual period was more than 5 years ago presents
with intermittent uterine bleeding for the past few months. You know that: - ANS-She is
experiencing post menopausal bleeding which is strongly suggestive for endometrial
cancer.
A 65 year old woman reports to your office with intermittent vaginal bleeding over the
last 2 months. Her LMP was more than 10 years ago. Her last pap smear was WNL.
She is not taking any hormone replacement products. What is the most appropriate
response of the nurse practitioner at this time? - ANS-Schedule endometrial biopsy
A 75 year old female presents with skin changes to her left breast. These include
redness, skin thickening, and
swelling. Your chief differential diagnosis for this patient would include: -
ANS-Inflammatory breast carcinoma
A female patient complains of intermittently feeling a strange bulge in her vagina along
with occasional episodes of urinary incontinence. Which of the following statements
about her condition is most accurate? - ANS-Her symptoms are suggestive of a
cystocele causing bladder prolapse through a defect in her anterior vaginal wall.
A patient presents with abnormal uterine bleeding and complaint of excess hair growth.
Your
physical exam shows elevated BMI and acanthosis nigricans skin changes. What is the
most likely diagnosis - ANS-Polycystic ovarian syndrome
A patient presents with moderate abdominal pelvic pain that began suddenly. LMP 2
wks ago. Negative pregnancy test. VS 98, P120, R 20, B/P 90/48. PE positive for
abdominal tenderness with rebound in LLQ. The NP suspects? - ANS-Hemorrhagic
corpus luteum cyst
A young client comes to the office complaining of vaginal bleeding. The client states that
she has used five tampons in the last 3 hours. She admits to sexual activity and takes
OC's. On further questioning, she states that she started her last pack of pills a few
weeks late. The nurse practitioner should: - ANS-Perform a stat urine pregnancy test
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