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2024 NURS 546 MIDTERM STUDY SET EXAM WITH CORRECT ANSWERS
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2024 NURS 546 MIDTERM STUDY SET EXAM WITH CORRECT ANSWERS
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2024 NURS 546 MIDTERM STUDYSET EXAM WITH CORRECT
ANSWERS
At what age should women begin cytology screening and what is the
interval? At what age should they begin co-testing with cytology and HPV
and what is the interval? - CORRECT-ANSWERSWomen 21-29: cytology alone
Q3 years
Women 30-65: cytology plus HPV co-testing Q5 years
What is the correct method of dealing with unsatisfactory cytology? -
CORRECT-ANSWERSIf no HPV testing, HPV neg, or HPV + with unknown
genotype:
repeat age based testing in 2-4 months
If HPV positive with 16 or 18 genotype:
colposcopy
Management of absent endocervical cells/transformation zone from cytology
- CORRECT-ANSWERSAge 21-29: continue age based screenings
Age 30-65: HPV testing and manage based on results. (If positive, repeat
HPV testing in 1 year or genotype)
What is the first choice for partner management therapy in partners of those
infected with trichomoniasis, gonorrhea, or chlamydia? - CORRECT-
ANSWERSAttempt to bring partners in for complete clinical evaluation, STD
testing, counseling, and treatment
Recommended treatment of partners with Chlamydia (but not Gonorrhea) -
CORRECT-ANSWERSAzithro 1g x1
Recommended treatment of partners with Gonorrhea - CORRECT-
ANSWERSCefixime (Suprax) 400 mg PO x1
PLUS Azithromycin(Zithromax) 1 gram PO x1
2 reasons why a woman who underwent a hysterectomy would continue
cervical screening: - CORRECT-ANSWERS1. hysterectomy was for a high
grade pre-cancerous or cancerous lesions (even if she does not retain her
cervix)
2. cervix was not removed during hysterectomy
,Reason a woman who had a hysterectomy would discontinue cervical
screening - CORRECT-ANSWERSHysterectomy was for a reason OTHER than
precancerous or cancerous cervical lesion AND her cervix was removed
What is the 9vHPV (Gardasil) vaccine composed of and how many strains
does it cover? - CORRECT-ANSWERSThe 9vHPV is comprised of virus-like
particles, and it prevents infection with 7 HPV types that cause cancer and 2
HPV types that cause genital warts
the HPV vaccine _____ recommended in pregnancy - CORRECT-ANSWERSis
not
Continue to offer the HPV vaccine to both men and women up to age ____,
after which the recommendation is to have a shared discussion with provider
regarding vaccination - CORRECT-ANSWERS26
______________ and __________—are the only class of medications that reliably
treat T. vaginalis infection - CORRECT-ANSWERSMetronidazole, Tinidazole
What initiates cramps leading to menses in the menstrual cycle? - CORRECT-
ANSWERSLoss of corpus luteum production of progesterone causes
the involution of the endometrium and shrinking of spiral arteries, enzyme
release between endometrial layers
prostaglandin release causes cramping/pain
What hormone causes the sloughing of the uterine lining? - CORRECT-
ANSWERSDrop in progesterone at end of luteal phase
What hormone causes breast tenderness? - CORRECT-ANSWERSEstrogen
FSH 2 main jobs - CORRECT-ANSWERSStimulates estrogen production
initiates follicular development
LH big job - CORRECT-ANSWERSLH surge causing ovulation
What is the leading cause of infertility and ectopic pregnancy? - CORRECT-
ANSWERSChlamydia
Management of an HSIL lesion - CORRECT-ANSWERScolposcopy with ECC or
LEEP
Management of an ASC-H lesion - CORRECT-ANSWERScolposcopy
, BV treatment - CORRECT-ANSWERSMetronidazole 500mg BID x 7 days
Metronidazole gel 0.75% 1 application (5g) daily QD x 5 days
Clindamycin cream 2% 1 application (5g) QD at bedtime x 7 days
BV treatment for recurrence - CORRECT-ANSWERSMay consider
Metronidazole 2x weekly 2-4 mo
OR
Nitroimidazole PO, f/b Boric Acid (NOT in pregnancy) and metronidazole
BV risk factors - CORRECT-ANSWERSmultiple sex partners
douching
lack of barrier use
hygiene
absence or dec in lactobacilli, or few H2O2 producing lactobacilli
BV treatment metronidazole education - CORRECT-ANSWERScaution against
drinking alcohol with use, during and 24 hours post use
stomach upset common
metallic taste
BV treatment clindamycin education - CORRECT-ANSWERScream is oil based,
may degrade latex condoms
inc risk of breakage within 72 hours of use
BV Amsel Criteria - CORRECT-ANSWERSDiagnose if 3 or 4 are present:
1. >pH (>4.5)
2. Positive whiff test
3. Clue cells on microscopy
4. Discharge
BV symptomology - CORRECT-ANSWERSodor (amine), discharge (milky
white, thin, "fishy")
usually vulva and cervix are not involved, may be asymptomatic
pH >4.5
positive whiff test
wet mount: clue cells >20% on sample
no or few WBC, few lactobacilli on slide
BV treatment in pregnancy - CORRECT-ANSWERSMetronidazole 500 mg twice
a day for 7 days
treat as early as possible, re-exam for recolonization in 1 month
Candidiasis (VVC) s/s - CORRECT-ANSWERSthickened, curd-like "cottage
cheese" white discharge
*pruritus*
vulva and labial swelling and erythema,
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