LEIK FNP GENDER HEALTH

LEIK FNP GENDER HEALTH Which of the following findings is most likely in a young primigravida with pregnancy-induced hypertension? A) Abdominal cramping and constipation B) Edema of the face and the upper extremities C) Shortness of breath D) Dysuria and frequency B) Edema of the face and the upper extremities Common signs and symptoms of pregnancy-induced hypertension include edema of the face and the upper extremities, weight gain, blurred vision, elevated BP, proteinuria, and headaches. A second triple screen on a 35-year-old primigravida reveals abnormally low levels of the alpha fetoprotein and estriol and high levels of human chorionic gonadotropin. Which of the following interventions is the best choice? A) Order an ultrasound B) Order a computed tomography (CT) scan of the abdomen C) Order a 24-hour urine for protein clearance D) Assess for a history of illicit drug or alcohol use A) Order an ultrasound Abnormally low levels of alpha fetoprotein and estriol and high levels of human chorionic gonadotropin are abnormal during pregnancy. An ultrasound should be ordered to further evaluate the fetus for characteristics of Down syndrome and/or fetal demise. A 35-year-old primigravida who is at 28 weeks of gestation is expecting twins. What would you would expect her alpha fetoprotein (AFP) values to be? A) Normal B) Higher than normal C) Lower than normal D) None of the above B) Higher than normal Alpha fetoprotein is produced in the fetal and maternal liver. Higher levels of alpha fetoprotein are commonly seen in multiple gestations due to the growing fetuses and enlargement of the livers. Fetal TORCH infections can cause microcephaly, mental retardation, hepatospleno- megaly, and intrauterine growth retardation. The acronym TORCH stands for: A) Toxoplasma gondii, other infections, rubella, cytomegalovirus, and herpes B) Toxic shock syndrome, ocular infections, rubella, cytomegalovirus, and herpes zoster C) Tetanus, ophthalmic infections, roseola, cancer, and head abnormalities D) Toxins, other infections, roseola, candidiasis, and head abnormalities A) Toxoplasmagondii, other infections, rubella, cytomegalovirus, and herpes The acronym TORCH stands for Toxoplasma gondii, Other infections, Rubella, Cytomegalovirus, and Herpes. Although several of the conditions listed in the other answer options can also cause fetal problems, they are not included in the TORCH acronym. Human papilloma virus (HPV) infection of the larynx has been associated with: A) Laryngeal neoplasia B) Esophageal stricture C) Cervical cancer D) Metaplasia of esophageal squamous cells A) Laryngeal neoplasia HPV infection of the larynx has been associated with laryngeal neoplasia; HPV infection of the cervix is associated with cervical cancer. A multigravida who is at 28 weeks of gestation has a fundal height of 29 cm. Which of the following is the best recommendation for this patient? A) Advise the mother that her pregnancy is progressing well B) Order an ultrasound of the uterus C) Refer her to an obstetrician for an amniocentesis D) Recommend bed rest with bathroom privileges A) Advise the mother that her pregnancy is progressing well From 20-35 weeks' gestation, fundal height should equal weeks gestation. If greater than 2 cm within the gestational week of pregnancy, further testing should be performed to evaluate fetal growth A multigravida who is at 34 weeks of gestation wants to know at what level her uterine fundus should be. The best answer is to advise the mother that her fundus is: A) Midway between the umbilicus and the lower ribs B) At the level of the umbilicus C) From 33 to 35 cm D) From 32 to 34 cm C) From 33 to 35 cm After 20 weeks gestation, fundal height in centimeters should measure approximately the same as the number of weeks of gestation Precocious puberty is defined as the onset of secondary sexual characteristics before the age of: A) Age 7 in girls and age 8 in boys B) Age 8 in girls and age 9 in boys C) Age 9 in girls and age 10 in boys D) Age 9 for both girls and boys B) Age 8 in girls and age 9 in boys Precocious puberty is defined as onset of secondary sexual characteristics by the age of 8 years in girls and 9 years in boys. At what Tanner stage does puberty start? A) Tanner Stage I B) Tanner Stage II C) Tanner Stage III D) Tanner Stage IV B) Tanner Stage II Puberty is defined as the period in life when secondary sexual characteristics begin to develop, identified as Tanner Stage II for boys and girls. A 14-year-old teen is worried that she has not started to menstruate like most of her friends. During the gynecological examination, the nurse practitioner tells the mother, who is in the room with the patient, that her daughter is starting Tanner Stage II. What are the physical exam findings during this stage? A) Breast buds and some straight pubic hair B) Fully developed breasts and curly pubic hair C) Breast tissue with the areola on a separate mound with curly pubic hair D) No breast tissue and no pubic hair A) Breast buds and some straight pubic hair Tanner Stage II in females includes breast buds and few straight, fine pubic hairs. You note that your 11-year-old female patient is at Tanner Stage II. You would advise her mother that menarche will probably start in: A) 1 to 2 years B) 2.5 to 3 years C) 4 years D) It is dependent on the girl's genetic makeup A) 1 to 2 years Menarche normally begins approximately 1-2 years following Tanner Stage II. Average age is 11.8 years old. The mother of a 16-year-old boy is concerned that her son is not developing normally. On physical exam, the patient is noted to have small testes with no pubic or facial hair. What is the most appropriate statement to the mother? A) Her son is developing normally B) Her son's physical development is delayed and should be evaluated by a pediatric endocrinologist C) Her son should be rechecked in 3 months; if he still does not have secondary sexual characteristics, a thorough hormonal workup should be initiated D) Her son's physiological development is slower than normal but is within the lower limit of normal for his age group B) Her son's physical development is delayed and should be evaluated by a pediatric endocrinologist A 16-year-old male without secondary sexual characteristics should be referred to an endocrinologist. If there is no testicular development by 14 years of age, referral to an endocrinologist is recommended. During a sports physical of a 14-year-old female, you note her breast development. The areola and the breast tissue are all in one mound. In which Tanner stage is this patient? A) Tanner Stage I B) Tanner Stage II C) Tanner Stage III D) Tanner Stage IV C) Tanner Stage III Tanner stages for breast development: I = prepuberty II = breast bud III = breast and areola one mound IV = breast and areola secondary mound; V = adult pattern When an adolescent male's penis grows more in length than width, at which of the following Tanner stages is he classified? A) Tanner Stage II B) Tanner Stage III C) Tanner Stage IV D) Tanner Stage V B) Tanner Stage III Tanner Stage III in males consists of penis lengthening and darker, coarse pubic hair, which begins to curl What Tanner stage is a girl at when her breasts form a secondary mound? A) Tanner Stage II B) Tanner Stage III C) Tanner Stage IV D) Tanner Stage V C) Tanner Stage IV Tanner stages for breast development: I, prepuberty; II, breast bud; III, breast and areola one mound; IV, breast and areola secondary mound; V, adult pattern. When an adolescent female's areola and nipples elevate above the level of the breasts to form a secondary mound, which of the following is the correct Tanner stage for this phase of breast development? A) Tanner Stage I B) Tanner Stage II C) Tanner Stage III D) Tanner Stage IV