NR 509 FINAL Exam WITH 200
Questions AND ANSWERS
A 66-year-old female presents to the office for a focused visit to discuss
hypertension management strategies. During the interview, the patient asks
the NP if she could be screened today for cervical cancer/HPV. Review of
her medical reco...
A 66-year-old female presents to the office for a focused visit to discuss
hypertension management strategies. During the interview, the patient asks
the NP if she could be screened today for cervical cancer/HPV. Review of
her medical record reveals she was screened at ages 57, 60, and 63, with
no abnormal findings, and no history of cancer. What is the best action the
NP should take regarding the patient's request for screening - ANSWER-
Deny her request, inform the patient that she has had three negative
screenings in the last 10 years and no longer requires screening, and focus
on the reason for the visit
Of the following statements, which is true regarding the human
papillomavirus (HPV) vaccine? - ANSWER-The vaccine can protect against
anogenital lesions
A 21-year-old female presents for her first annual exam. She reports
concern because her female partner was recently diagnosed with
condyloma acuminata and wonders if she could also be infected. If true,
what physical assessment findings would the NP expect to find during the
speculum examination? - ANSWER-Raised friable or lobed lesions
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An 18-year-old female presents to the clinic complaining of a thick and
yellow vaginal discharge along with recent pelvic pain. Her history is
significant for pelvic inflammatory disease (PID). During the speculum
examination, the NP would expect to find purulent discharge in the
following area(s) which is consistent with the diagnosis of PID? - ANSWER-
Cervical os
A 23-year-old female presents to the clinic. She has decided to discontinue
using condoms and would like a different birth control option. Her last pelvic
exam was 2 years ago when she had a negative Pap smear and STI
screening. Her LMP was 2 days ago, and she is still spotting. She last had
sex with her boyfriend 1 week ago. Condoms were used. The NP elects to
postpone her speculum exam during this office encounter. What is the best
evidence-based rationale for the decision to postpone her exam -
ANSWER-She is on her menses
A 24-year-old female presents to the clinic for an annual exam. The NP
proceeds to perform a Pap smear and understands that the most important
area on the cervix to obtain cells for the Pap smear is where? - ANSWER-
Transformation zone
A 45-year-old female presents to the clinic for heavy periods and pelvic
pain during her menses. She reached menarche at age 13 years and has
had regular periods except during her pregnancies. She is a G4P3013 and
does not use birth control as her husband has had a vasectomy. She states
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this has been going on for about a year but seems to be getting worse. Her
LMP was 1 week ago. On a bimanual exam, a large midline mass halfway
to the umbilicus is palpated. Each adnexal area is nonpalpable. Her rectal
exam is normal. Her body mass index (BMI) is 27. Which of the following is
the most likely interpretation of these findings? - ANSWER-These findings
suggest uterine fibroids
A 48-year-old female presents to the clinic with complaints of heavy vaginal
discharge and severe itching for 1 week. On visualization of the vulva, a
thick, white, curdy discharge is seen at the introitus. On speculum
examination, there is a copious amount of this discharge. The pH of the
discharge is 4.1 and the KOH whiff test is negative, with no unusual smell.
Wet prep shows budding hyphae. Which of the following is the most
accurate interpretation of these findings? - ANSWER-These findings
suggest candida vaginitis
Cervical motion tenderness and/or adnexal tenderness are hallmarks of all
the following conditions, EXCEPT? - ANSWER-Bacterial vaginosis
A 30-year-old female presents to the clinic with complaints of a bad-
smelling vaginal discharge with some mild itching for about 3 weeks. She
denies pain with urination or with sexual intercourse. She also reports that
the smell increased after intercourse and during her period last week. After
a careful history and physical assessment, the NP documents the following
pelvic and anorectal examination findings: Bilateral shotty inguinal
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adenopathy. External genitalia without erythema or lesions. Vaginal
mucosa and cervix coated with thin white homogeneous discharge with a
mild fishy odor. After swabbing the cervix, no discharge is visible in the
cervical os. Uterus midline; no adnexal masses. Rectal vault without
masses. Stool brown and negative for fecal blood. pH of vaginal discharge
>4.5. Which of the following is the most accurate interpretation of these
findings? - ANSWER-These findings suggest bacterial vaginosis
The NP knows it is possible to palpate multiple structures in relation to the
inguinal canal and related hernias while performing a physical examination
on male patients. Which of the following is not palpable during an external
examination of the abdominal wall or inguinal region? - ANSWER-Internal
inguinal rings
What are the most predominant risk factors for prostate cancer? -
ANSWER-Age
Ethnicity
Family history
A patient presents with right-upper quadrant (RUQ) pain but does not have
any tenderness on palpation in the RUQ. The NP is suspicious of acute
cholecystitis. The NP knows to perform which assessment test next? -
ANSWER-Murphy Sign
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