Exam (elaborations)
FNP: Women's Health
- Module
- FPN
- Institution
- Durham University (DUT)
92 free practice test questions for the WHNP Women’s Health Nurse Practitioner Exam Prep
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FNP: Women's Health24years old woman with green-yellow vaginal dc, vaginal erythema, petechial
hemorrhages on cervix, numerous WBC, motile organisms on examination: -
trichomoniasis. TX with Flagyl
All of the following are relative contraindication in copper-containing IUD: - valvular
heart dx, multiple sexual encounters, lack of follow-up care
BP changes in preeclampsia include increases: - >30/15
or reading of >140's/90's. With minimal proteinuria nd pathologic edema, with
presentation after 20th wk. Other problems include RUQ pain, NV. Can progress to
hemolysis or HELLP.
*Gestational HTN is HTN dx after 20th week but resolves within 6 weeks postpartum.
Preeclampsia is HTN after 20th week with proteinuria (>300mg in 24 hrs.) usually
accompanied by edema.
Breast Cancer - Annual breast exam: age > 40 years
Risks: menarche < 12 years, menopause > 55 yrs.
Estrogen supplementation
Dx: Mammography for > 30 with breast complaint. If suspicious, make sure to order b/l
diagnostic mammogram
US differentiates fluid-filled cyst from solid mass. Used in pregnancy and age < 30
COC - -noncontraceptive benefits include lower rates of benign breast tumors,
dysmenorrhea, decreased IDA, endometrial, ovarian and breast cancers.
-BTB can be minimized by taking within same 4-hr period every day. Not harmful and
doesn't indicate lesser contraceptive benefit.
-Nausea common in first few months.
-Causes reduction in therapeutic levels of antiepileptic’s such as phenytoin,
carbamazepine, phenobarbital, primidone. -Depo-Provera works and may cause
reduction in seizures.
Contraception - Combined OCs: Absolute contraindications include hx of DVT, CVA,
CAD, DM, pregnancy, gyn bleeding, age > 35 with HTN or DM, LDL > 160, trigs >250.
Remember ACHES (abd pain, chest pain, HA, eye problems, or severe leg pain)
Progestin only: good choice for lactating women, women with CV risks. If pill is 3h late,
r/o pregnancy rises
Depo-Provera: no effect on milk production, long return to ovulation
Contraindication for COC (Combined OC) use? - factor V Leiden mutation
, Ectopic pregnancy - -Classic triad: abd pain, vaginal bleeding and adnexal mass is
present in <50% of women. Dx includes beta-hCG level. Negative result r/o dx. Usually,
serum quant beta-hCG in ectopic pregnancy at weeks 6-10 (time most common for
presentation) is 1000-6000 IU/m. This compares with =>40,000 IU/m for viable
pregnancy. With + beta-hCG => 1000 IU/m, a gestational sac should be identifiable
within uterus on transvaginal sonogram. Presence r/o dx. 20-30% will have nondx US,
so normal US does not r/o condition. Level of <15ng/mL serum progesterone is seen in
only 11% of normal intrauterine pregnancies and most ectopic/inevitable abortions.
Emergency Contraception - -Multiple methods: COCs, POPs, CU-IUDs.
-Oral tx will not interrupt established pregnancy or increase risk of early pregnancy loss.
-CU-IUD (ParaGard T) can be inserted within 5 days as form of emergency
contraception. Risk of upper reproductive tract infections.
Menstrual bleeding should be expected within 3-4 weeks, if not- pregnancy test!
Fibro adenoma - Most common in < 25 years
Order US to dx
First prenatal visit - -pap smear, CBC, rubella titer, blood type, antibody screen,
VDRL/RPR, HIV, GC/chlamydia, PPD, Hg electrophoresis (consider), HBsAg, UA, urine
C&S
Frequency of prenatal visits - Up to 28 wks.: q4wk
28-36 wks.: q2wk
>36 wks.: week
GU infections - -BV: on microscopic exam: vaginal pH > 4.5, clue cells, positive whiff
test, few WBCs. Flagyl 500mg BID x 7 days
-Candidiasis: candida albicans- itching, burning, thick white to yellow curd-like dc,
miconazole, fluconazole
-Cancroid: caused by h. ducreyi, painless genital ulcer, treat with azithromycin 1g bomb
-Herpes simplex: HHV-2, painful ulcerated lesions with lymphadenopathy, tx with
acyclovir 400mg PO TID x 7-10 days
-Lymph granuloma venereum: vesicular or ulcerative lesion, caused by LI-3 serovar of
c. trachomatis: doxycycline 100mg PO BID x 21 days
-nongonococcal urethritis and cervicitis: c. trachomatis: Azithromycin 1g PO bomb
-gonococcal urethritis and vaginitis: caused by n. gonorrhea, single dose tx for
uncomplicated infection- cefixime 400mg PO, ceftriaxone 125mg IM
-PID: caused by n. gonorrhea, c. tachomatis, E. coli, mycoplasma, take ofloxacin 400mg
PO BID with flagyl 500mg BID x 14 days.
-Trichomoniasis: caused by t. vaginalis, *cervical petechial hemorrhages (strawberry
spots) in 30%. On Exam, motile organisms and WBCs. Take Flagyl 2g Bomb.
-Genital warts: caused by HPV, patient applied TX included podofilox 0.5% or
imiquimod 5% cream.
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