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APEA 3P PREP 1-7 FULL QNS AND ANS ALL TOPICS AND ASSESSMENTS
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APEA 3P PREP 1-7 FULL QNS AND ANS ALL TOPICS AND ASSESSMENTS
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APEA 3P EXAMPREP 1 – 7
Women’s Health,Sexual
Health,Nephrology,Dermatology,
GI,Ethics
2023/2024
,Three of the following interventions are appropriately used to prevent osteoporosis
after menopause. Which one is NOT?
Avoidance of corticosteroids
Performance of weight-bearing activities for 40 mins at least 5 days/week
Estrogen replacement therapy
Adequate calcium & vitamin D intake
C.
Prevention of osteoporosis may be optimized by elimination of risk factors and
engaging in interventions that maximize bone density. Good nutrition from infancy
throughout adulthood is a major component of good bone health. Others include
engaging in weight-bearing exercises, adequate intake of calcium and vitamin D,
smoking cessation, limiting alcohol consumption to moderate amounts, and
avoidance when possible of medications that may decrease bone density
(corticosteroids, anticonvulsants). Osteoporosis occurs at accelerated rates in
women who are post-menopausal. The lack of estrogen can produce rapid bone loss
due to bone resorption. Estrogen replacement is not used to prevent or treat
osteoporosis.
A patient who is scheduled for pelvic exam with PAP smear should be advised to
avoid douching, sexual intercourse, and tampon use before her exam. For how long
should she be advised to avoid these activities for optimal evaluation?
24 hours
48 hours
36 hours
1 week
B.
,The general recommendation is to avoid these activities and any vaginal medication
for 48 hours prior to the PAP smear. Douching and tampon use can remove
superficial cells, which are the ones collected and used as representative samples
on PAP smear. Sexual intercourse should be avoided because there can be specimen
contamination by the male partner. With vaginal medications or creams, either can
serve as a barrier to epithelial cell sampling.
When collecting cervical cells for a PAP smear, when are the endocervical cells
typically collected?
After the ectocervical specimen with a broom
After the ectocervical specimen with a brush
Before the ectocervical specimen with a broom
Before the ectocervical specimen with a brush
B.
Ectocervical specimens are collected first to minimize any bleeding that can occur
when the endocervical cells are sampled. The brush is considered a superior tool for
the collection of endocervical specimens because it produces the highest yield of
endocervical cells, and thus, is a good reflection of the health of the cervix.
Alternatively, a cervical broom can be used to collect endocervical cells and
ectocervical cells simultaneously. It is rotated for 5 turns before the samples are
placed on the slide. This may be used in pregnant women.
A 16-year-old female is diagnosed with primary dysmenorrhea. She has taken over-
the-counter ibuprofen in 800-mg increments every 8 hours during menses for the
past 3 months, with minimal relief of symptoms. What intervention will provide
greatest relief of dysmenorrhea symptoms?
Flurbiprofen during menses
Combined oral contraceptives
Daily multivitamin with B12 supplementation
30 minutes of regular exercise daily
B.
NSAIDs and hormonal contraceptives represent the mainstay of pharmacologic
treatment for dysmenorrhea. NSAIDs produce an 80-86% response rate when used
for dysmenorrhea. The general recommendation is that when one agent (NSAIDs or
hormonal contraceptives) does not produce relief of symptoms, the other agent
, should be tried. Hence, the best choice is oral contraceptives. Both agents should
be considered for women who are symptomatic with one agent only.
A 22-year-old female states that she has multiple sexual partners and inconsistently
uses barrier protection. Which form of birth control should the nurse practitioner
avoid prescribing in this patient?
Intrauterine device
Progestin-only pill
Diaphragm
Oral contraceptives
A.
Multiple sexual partners place the patient at increased risk for infection with
sexually transmitted diseases. The patient is at very high risk of developing pelvic
inflammatory disease (PID) when there is an implanted foreign body. An example of
this is an intrauterine device (IUD). The risk is also increased with a diaphragm, but,
because it is not implanted for long periods at a time, the risk of PID is less than
with an IUD.
The first step in evaluating a breast lump is:
history and physical exam.
mammogram.
ultrasound. Incorrect
MRI.
A.
Although most patients will need further work-up of a breast mass, historical
information is critically important in directing the health care provider to the next
step. Historical information that should be ascertained is the location of the lump,
how and when it was first noticed, whether there is nipple discharge, and whether it
changes in size related to menses. Other historical information is the patient’s
personal and family history of breast cancer and/or history of breast biopsies.
A patient who takes oral contraceptive pills is at increased risk of:
gallbladder disease.
depression.
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