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nr 602 final exam Questions and Correct
Answers
Mr. Y was in his usual state of good health until 5 days prior to admission while on a
road trip with his son
in Colorado. He developed diarrhea, described as loose, somewhat watery occurring
two to three times a
day. The volume of the stool was not more than normal. He also had nausea but no
emesis, and was
able to eat/drink normally. The stool was brown without melena or hematochezia.
At the same time, Mr. Y. also developed a dull, steady, and fairly mild pain in his
right lower quadrant; in
retrospect he would rate it as a 2 or 3 out of 10. If he pressed on the area, the pain
became sharp and
more intense. The pain did not radiate and there were no aggravating or alleviating
factors. He had no
jaundice, odynophagia, change in appetite, dysphagia or heartburn.
3 days prior to admission, Mr. Y.'s symptoms had not improved and he developed
intermittent emesis.
He developed subjective fevers and sweats. His nausea started to keep him up at
night and his appetite
decreased significantly. He tried taking acetaminophen for his symptoms but this did
not provide any
relief.
Mr. Y. returned to Seattle on the day of admission. Having not improved, he saw his
ASCCP recommended management for an ASCUS pap result with high risk hpv 16
cotest in 26 year old no abnormal paps
✓ ~~~ colposcopy
What is included in the well women of an adolescent?
✓ ~~~ health history
menses
gynecologic and pregnancy issues
psychosocial
,abuse drugs alcohol use
physical exam
screening tests
immunizations
When does ACOG pap smear start
✓ ~~~ 21 years old done every three years
ACOG pap for over 30 yrs old
✓ ~~~ every five years with HPV test completed
ACOG when can you stop pap smear
✓ ~~~ can stop at 65 if negative history for 10 years or if they had a hysterectomy with
no history of cervical cancer
Bethesda pap smear report reads LSIL is what classification?
✓ ~~~ CIN 1
A single Pap smear reading of ASCUS in a patient negative for HPV infection should
have what as follow-up?
✓ ~~~ routine screening
,a female patient is 35 years old. she has never had an abnormal PAP smear has
regular screening since age 18. If she has a normal PAP smear with HPV testing
today, when should she have the next cervical cancer screening?
✓ ~~~ 5 years
A young sexually active is having her first pap smear what would you explain?
✓ ~~~ pap smear detects cervical cancer
26 year old pap smear shows negative and positive HPV what do you do?
✓ ~~~ repeat HPV and pap
what is not part of criteria for older women to cease pap smears?
✓ ~~~ over 55 year old
no menarche in a 15 year old with no medical problems and Tanner stage 1 with a
uterus
✓ ~~~ primary amenorrhea
No menses for at least 6 months
✓ ~~~ secondary amenorrhea
female athlete triad
✓ ~~~ disordered eating, amenorrhea, osteoporosis
, labs for female athlete triad
✓ ~~~ HCG
serum prolactin
serum TSH,FSH, LH
if amenorhea lasts longer than 6 months do what?
✓ ~~~ bone density test
treatment plan for female athlete triad
✓ ~~~ increase caloric intake, decrease exercise
prescribe ca and vit d 1200/1500 daily and vitamin e 400 iu daily
lanugo, telogen effluvium hair loss zerosis dry skin, infertility, low body mass,
cachexia, respiratory failure
purpose of progesterone challenge
✓ ~~~ endogenous estrogen
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