Solutions
A 16-year-old Caucasian female with a BMI of 25 presents to
her primary care provider concerned that she has never
menstruated. The provider's physical exam reveals breast
development consistent with Tanner Stage 1 and pubic hair
pattern/distribution consistent with Tanner Stage 4. These
findings would be considered:
a. consistent with the normal sequence of pubertal changes in
females.
b. inconsistent with the normal sequence of pubertal changes in
females.
c. presumptive signs of possible pregnancy.
d. predictive of the client's chronologic age. Correct Answers
b. inconsistent with the normal sequence of pubertal changes in
females.
A 22-year-old presents complaining of a "breast mass" for 3
weeks. On examination, the provider notes a firm, smooth,
mobile, "rubbery" mass that measures 2cm x 3cm. What
additional testing should the Nurse Practitioner order to evaluate
this finding? Correct Answers breast ultrasound
Abnormal uterine bleeding that is heavy or prolonged during
perimenopause creates a risk for _____? Correct Answers
anemia
According to ACOG guidelines, which of the following health
screenings should be included in the routine well-woman visit
,for females age 30-39 years? Correct Answers b) Clinical
breast exam
Annual pelvic examination:
a) determines the need for a Pap test in asymptomatic women
with a cervical lesion.
b) improves ovarian cancer detection rates.
c) is required in order to screen for go.
d) offers no proven benefit in asymptomatic women. Correct
Answers d) offers no proven benefit in asymptomatic women.
Any MSM who is at high risk for HIV infection should be
offered ____? Correct Answers HIV pre-exposure prophylaxis
(PrEP)
At what point in the menstrual cycle is sperm penetration most
opportunistic and when is it less opportunistic? Correct
Answers - Most opportunistic: around day 9 of the menstrual
cycle, rising levels of estradiol will increase the amount of
cervical mucus, making it thin and watery to enable penetration
of sperm immediately prior to ovulation.
- Less opportunistic: After ovulation occurs, progesterone
secreted from the corpus luteum converts the cervical mucus
into a thickened, tenacious barrier, impeding penetration by
sperm by both its physical properties and immune functions
Average age of menopause in the US Correct Answers 52.54
years
Because pelvic health care mirrors people's consensual and
forced sexual experiences, providers should: Correct Answers
,intentionally choose language and approach during consent
processes and examinations to decrease iatrogenic trauma and
lessen the risk of triggering past trauma.
Bone mineral density screening in average risk women should
begin at age
a. 51
b. 55
c. 65
d. 70 Correct Answers c. 65
Cervical cancer screening guidelines Correct Answers Begin
Screening age 21 Screening Tests:
- 21-29 Papanicolaou (PAP) test every 3 years
- 30-65 Pap test + HPV DNA "co-test" every 5 years
New recommendation - HPV DNA only q 5 years
End screening age 65, or after hysterectomy for benign
indications
Any patient with a cervix should undergo routine cervical cancer
screening
Cervical cancer screening using a Pap test plus HPV co-testing
should begin at age: Correct Answers 30
Clinical presentation of menopause Correct Answers -
Symptoms may vary
- A dramatic decline in estrogen causes both short-term and
long-term symptoms.
, - Irregular menses
- Vasomotor symptoms (hot flashes)
- Urogenital atrophy (vaginal dryness, urinary incontinence,
pelvic floor dysfunction)
- Bone loss
- Mood changes/Irritability
- Poor sleep and decease libido
- Dry skin
- Weight gain
Common side effects of HRT and ERT Correct Answers -
Uterine bleeding (HRT): Caused by Progesterone
- Breast tenderness (HRT and ERT): Estrogen causes the breast
ducts to enlarge, and progesterone causes the milk glands to
swell.
- Nausea (HRT): Caused by Progesterone
- Headaches (HRT and ERT): Caused by Estrogen
- Bloating or fluid retention in extremities (HRT): Caused by
Progesterone
- Mood changes (HRT and ERT): Caused by Estrogen
Consent is a process that equalizes the ability to ______.
Correct Answers respond either yes or no
Define adrenarche Correct Answers growth of pubic hair due
to androgen stimulation
Define gender expression Correct Answers outward gender
presentation