D120 Exam Questions With Correct Answers.

D120 Exam Questions With Correct Answers. A young woman is complaining of tenderness and burning of her vulva. On exam, the vulva is edematous and excoriated. The FNP performs a wet mount preparation of vaginal secretions. It reveals pseudohyphae and spores. What is the diagnosis for this patient? - answervulvovaginal candidiasis; Pseudohyphae and spores on the wet mount with potassium hydroxide are diagnostic for candida infection. A young woman presents with complaints of irritation in the vaginal area. This is the first time this has occurred. On exam, the cervix is inflamed and friable. Flagellated protozoa are seen on the wet mount. What is the most likely diagnosis? - answertrichomoniasis; Flagellated protozoan confirms the diagnosis of trichomoniasis. A 21-year-old female patient presents for her first well-woman exam. She has never been sexually active. Her family history and past medical history are negative for any gynecologic diseases. Her menses occur every 28 days, lasting 5 days, with a relatively moderate flow and no significant dysmenorrhea. Her physical exam should include which tests? - answerPap smear; The recommended age for females to begin screening pap smears is at the age of 21, regardless of sexual activity history. STD screening is not necessary as the patient is not sexually active. Hemoccult and mammogram are not recommended for this age group of patient. A young adult patient presents with a history of vaginal itching and heavy white discharge. The patient denies a history of sexual activity. On exam, the FNP finds a red, edematous vulva and white patches on the vaginal walls. The discharge has no odor. What finding would the FNP suspect in the patient's history? - answerrecent antibiotic use; Almost half of all vaginal infections are caused by candida. The majority of women who develop this infection have recently taken antibiotics. A 46-year-old female patient is being seen in the clinic by the FNP. She was last seen 2 weeks ago for an upper respiratory tract infection and was treated with amoxicillin 250mg PO TID x 10days. She completed her medication last week, but now complains of vaginal itching and thick white discharge. She states that she has never experienced such intense itching. She is in a mutually monogamous relationship. Her LMP was 2 weeks ago. Her partner had a vasectomy. Wet mount shows negative whiff test, rare clue cells, positive lactobacilli, positive hyphae, positive spores, few WBCs, and no trichomonads. She is leaving tomorrow for a week long cruise. She is not taking any medications and has no known drug allergies. The FNP should prescribe which of the following? - answerfluconazole 150mg 1 tab PO x1 dose; Fluconazole is approved for a single-dose oral treatment of uncomplicated vulvovaginal candidiasis. It is the most convenient treatment for this patient who will is unlikely to be compliant with vaginal creams given the upcoming travel. A 25-year-old patient presents with complaints of malodorous vaginal discharge, which is white and watery. She douches with vinegar and water every 2 weeks. She uses a diaphragm for contraception and has been sexually active with her boyfriend for two years, using condoms for STD prevention. Her LMP was 1 week ago, and there are no noted changes in her normal menstrual pattern. Her wet mount shows a positive whiff test, clue cells too numerous to count, no lactobacilli, no hyphae, no spores. What is the diagnosis and treatment for this patient? - answerbacterial vaginosis: metronidazole vaginal gel 1 applicator HS x 5 days.; Metronidazole vaginal gel is the treatment of choice for bacterial vaginosis in the non-pregnant female. The presence of clue cells, and the associated malodorous discharge and absence of lactobacilli are markers for the diagnosis of bacterial vaginosis. A 41-year-old patient is seen for her 6-week postpartum exam by the FNP. She is breastfeeding without difficulty and plans to continue for a year. She wants to begin using contraception and plans no further pregnancies. Which of the following is not an appropriate choice for this patient? - answerCombination OC; Combination OCs are not recommended for breastfeeding mothers because of the effect of estrogen on milk supply. Progestin only OCs, IUDs, and Depo-Provera are acceptable methods of contraception for breastfeeding mothers. Which two patients should have a Pap smear test performed by the FNP? - answerBased on USPSTF guidelines, pap smear tests should be performed on female patients aged 21 and older, regardless of sexual activity. What finding is considered a normal surface characteristic of the cervix? - answerSmall, yellow, raised round area on the cervix.; A nabothian cyst is a small, white or yellow, raised round area on the cervix and is considered to be a normal variant. The FNP is reviewing the lab results of a 28-year-old patient recently seen for a pap smear. Classification is high-grade squamous intraepithelial lesion, endocervical cells seen, and adequate smear. The FNP phones the patient and tells her which of the following? - answerYour pap smear shows abnormal tissue that needs to be evaluated. Please schedule an appointment for a colposcopy.; The pap smear is a screening test for cervical cancer and precancerous states. The diagnostic test needed to confirm the diagnosis of a high-grade lesion is a colposcopy with guided biopsies.