NR 509 /NR509 FINAL EXAM NEWEST 2024 TEST BANK AND STUDY GUIDE COMPLETE 250 QUESTIONS AND CORRECT DETAILED ASNWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

A 20-year-old college student presents for his annual physical examination. He recently became sexually active and is inquiring about the best means of preventing sexually transmitted infections (STIs). Of the following, which would be the most effective means of prevention? a. Early withdrawal b. Male condoms c. Spermicides d. Diaphragms e. Cervical caps - ....ANSWER...b. Male condoms A 21-year-old college student presents to the student health clinic for a full physical examination. He is generally healthy; however, he reports that he has had sexual intercourse with multiple partners in the past couple of months. He noticed a small lesion on the shaft of his penis a few days ago. While performing the examination, he unwillingly achieves an erection. How should the clinician proceed at this point? a. Stop the examination immediately. b. Have him return to see another provider. c. Explain this is a normal response and finish the examination. d. Tell him the examination cannot proceed until the erection subsides. e. Assume that he is malingering. - ....ANSWER...c. Explain this is a normal response and finish the examination. A 45-year-old driver's education instructor presents to the clinic for heavy periods and pelvic pain during her menses. She reached menarche at age 13 years and has had regular periods except during her pregnancies. She is a G4P3013 and does not use birth control as her husband has had a vasectomy. She states this has been going on for about a year but seems to be getting worse. Her last period was 1 week ago. On bimanual exam, a large midline mass halfway to the umbilicus is palpated. Each adnexal area is nonpalpable. Her rectal exam is normal. Her body mass index (BMI) is 27. What is the best explanation for her physical finding? a. Large colonic stool b. Ovarian mass c. Fibroids d. 4-Month pregnancy e. Bartholin gland enlargement - ....ANSWER...c. Fibroids A 32-year-old G0 woman comes for evaluation on why she and her husband have been unable to get pregnant. Her husband has been married before and has two other children, ages 7 and 4 years. The patient relates she began her periods at age 12 and has been fairly regular ever since. She began oral contraceptive pills from when she got married until last year, when she began to try for a pregnancy. Before this she had regular cycles for 10 years. She has had a history of five prior partners. She relates she was once treated for a severe genital infection when she was in college. Based on this patient's history, what is the best explanation for her infertility? a. Prior pelvic inflammatory disease (PID) b. Prior Bartholin gland infection c. Prior herpes infection d. Metabolic disorder with subsequent hormonal irregularities leading to anovulation e. Secondary amenorrhea - ....ANSWER...a. Prior pelvic inflammatory disease (PID) A 24-year-old retail clerk presents to the clinic for an annual exam. Her last Pap was 3 years ago and was normal. She is a G0 and is currently not sexually active although she has had two lifetime partners. She is on oral contraceptive pills for cycle control and has no medical problems. Based on guidelines, the clinician proceeds to perform a Pap smear and places the speculum. There are two layers of cells, squamous and columnar. Where is the most important area to obtain cells for a Pap smear? a. Zona reticularis b. Transformation zone c. Squamous zone d. Columnar zone e. Linea nigra - ....ANSWER...b. Transformation zone A 35-year-old grade school teacher presents for her annual exam. Her last Pap smear was 4 years ago and normal. She is a G1P1 with a 6-year-old child. She has had four lifetime partners but only one partner in the last 12 years. Otherwise she has no complaints. A speculum exam is done followed by a bimanual examination during which a rectovaginal mass is palpated. Which of the following exam findings would be most reassuring that this is not a colonic mass? a. No cervical motion tenderness b. No pus from the os c. The mass dents with digital pressure d. Both adnexa are nontender e. The perineum has no lesions - ....ANSWER...c. The mass dents with digital pressure A 21-year-old college student presents for her first annual exam. She has been sexually active for 1 year and has had two partners. She is not aware of having had any sexually transmitted diseases (STIs). She is using condoms for birth control and STI prevention but admits to not always using them regularly. Her last menses was 2 weeks ago. On speculum exam, an unusual appearance is noted, which is diagnosed as warts. What is the best description for these lesions? a. Several shallow ulcers with a red base b. Translucent nodules c. Raised friable or lobed lesions d. Bright red, soft lesion arising from the cervical canal e. Strawberry cervix (small red granular spots or petechiae) - ....ANSWER...c. Raised friable or lobed lesions A 23-year-old female comes to the clinic to discuss her birth control options. Although she has been sexually active since age 16 years, she has been with one partner for the last year. She has decided to discontinue condoms and would like a different birth control option. She has not had a pelvic exam for 2 years. She had a normal Pap smear that year and negative sexually transmitted infection (STI) testing. Her last menstrual period was 2 days ago. She states that she is still spotting. She also states that she last had sex with her boyfriend 1 week ago, so the clinician elects to postpone her speculum exam. What is the best explanation for the decision to postpone her exam? a. She is on her menses. b. She has only one current partner and does not need STI testing c. She had a normal Pap smear within the last 3 years. d. She should not be sexually active. e. She has been using condoms. - ....ANSWER...a. She is on her menses.