practice questions

Question 2.2. Menstrual Cycle Disorders.  Please match diagnosis with definition.
(Points : 8) 

Potential Matches:

1 : More frequent menstrual bleeding

2 : No menstrual cycle for 6+ months

3 : Pain associated with menstrual flow in the absence of pelvic disease

4 : Excessive or prolonged uterine bleeding > 80 ml or > 7 days

5 : Frequent heavy menstrual bleeding

6 : Midcycle or Ovulatory pain

7 : Pain occurring during menses related to or caused by pathologic pelvic disease such as endometriosis, uterine fibroids, adenomyosis, ovarian cysts, etc

8 : Bleeding occurring less frequently, intervals > 35 days

    Answer

     : Menorrhagia

     : Oligomenorrhea

     : Amenorrhea

     : Metrorragia

     : Menometrorrhagia

     : Secondary Dysmenorrhea

     : Mittelschmerz

     : Primary Dysmenorrhea

Question 3.3. Although all of the following are part of the work-up for sexual dysfunction in women, the one thing that will give the most information supporting this diagnosis is (Points : 1)

Question 4.4. If a harmful BRCA1 or BRCA2 mutation is found, which of the following is not an acceptable option to help decrease her cancer risk (Points : 1)

Question 5.5. You are examining a female during a pelvic exam and assess plaques covered with silvery scales on the vulva. Past medical history for this patient includes rheumatoid arthritis. She states sometimes there is itching and pain involved with the lesions. What would be your primary diagnosis for this patient? (Points : 2)

Question 6.6. You are reviewing a patient's transvaginal ultrasound report. She asks you to explain what are "nabothian cysts" which have been identified on the report. You provide teaching and reply with the following: (Points : 1)

Question 7.7. Which information will the NP include when teaching a 48 year old patient with uterine bleeding caused by uterine fibroids (leiomyomas)? (Points : 1)

Question 8.8. A 70 year old female visits the NP for a yearly evaluation. Which physical exam finding should receive the highest priority for immediate diagnosis and treatment? (Points : 1)

Question 9.9. A 32 year old woman presents at the GYN clinic with complaint of pelvic pain.  Which of the following conditions requires immediate diagnosis and management? (Points : 1)

Question 10.10. In a patient with a breast mass suspicious for malignancy, an ultrasound should be ordered if the patient is less than 30 years old, and a mammogram should be ordered if the patient is over 30. (Points : 1)

Question 11.11. A patient is complaining of tender masses in her breasts that tend to change in size related to her menstrual cycle. You can counsel this patient to try: (Points : 1)

Question 12.12. What is the diagnostic tool used to further evaluate abnormal pap smear findings? (Points : 1)

Question 13.13. Which has the highest mortality rate of all GYN cancers? (Points : 1)

Question 14.14. Risk factors for Endometrial Cancer are all of the following except (Points : 1)

Question 15.15. Causes of amenorrhea may include (Points : 1)

Question 16.16. HPV is a causative agent in which of the following cancers:
(Points : 1)

Question 17.17. When educating a woman about guidelines for early detection of breast cancer, it is important to emphasize: (Points : 2)

Question 18.18. You are performing a vaginal exam and when inserting the speculum, you notice a small round, red, moist lesion appearing from the cervical os. The client does not have any pelvic complaints nor show tenderness when adnexa are palpated or moved. Your likely diagnosis is: (Points : 1)

Question 19.19. The NP examines a 52 year old female and while conducting the pelvic exam  notes a lesion on the vaginal vestibule and labia minora. When obtaining a history from the patient, it is noted there has been a long standing history of pruritus. You are suspicious for cancer and obtain a biopsy. What type of cancer is your primary diagnosis? (Points : 1)

Question 20.20. The NP is evaluating a woman who has complaints of changes in skin around the vaginal area  Upon examination, the NP notices a figure-8 appearance of depigmented tissue around the vulvar and perianal area.  What is the most likely diagnosis? (Points : 1)

Question 21.21. Primary dysmenorrhea is (Points : 1)

Question 22.22. The NP is assessing a patient with complaints of "heavy periods", cramping, painful sex, and an urge to urinate frequently. An ultrasound is ordered and uterine fibroids are diagnosed. Treatment options for uterine fibroids may include: (Points : 1)

Question 23.23. Which of the following are not considered risk factors for cervical cancer (Points : 1)

Question 24.24. A 35 year-old has a screening pap with ASCUS, positive HPV. The next appropriate step is:  (Points : 1)

Question 25.25. When evaluating abnormal uterine bleeding (AUB), special populations should be considered. The older woman with postmenopausal uterine bleeding should always be considered to have cancer until proven otherwise. In adolescents, which condition should be considered when bleeding is heavy and unexplained and does not respond to medical therapies? (Points : 1)

Question 26.26. Symptoms of ovarian cancer include all of the following except (Points : 1)

Question 27.27. Match the following benign breast masses with their clinical characteristics:
(Points : 4) 

Potential Matches:

1 : Discrete, smooth, round or oval, nontender and mobile

2 : Ill defined, firm, nontender, nonmobile with inflammatory changes on pathology/histology

3 : Discrete firm, sometimes tender, result from duct dilation following lactation

4 : Discrete, soft, nontender, may or may not be mobile and is composed of fatty tissue

    Answer

     : Galactocele

     : Lipoma

     : Fibroadenoma

     : Fat necrosis

Question 28.28. Which of the following information would be appropriate to share with a woman concerning risk factors for breast cancer? (Points : 2)

Question 29.29. Possible causes of breast pain in adolescents include (Points : 1)

Question 30.30. According to ASCCP guidelines (Points : 1)

Question 31.31. The goals of Healthy People 2020 include (Points : 1)

Question 32.32. A causative agent highly associated with cervical cancer is (Points : 1)

Question 33.33. A 52 year old woman presents to the clinic with complaint of nipple discharge.  Which of the following signs would be the most concerning for breast cancer? (Points : 1)

Question 34.34. Factors that could potentially increase a woman's risk of PID include all of the following except (Points : 1)

Question 35.35. The hormone responsible for causing an ovum to mature in the ovary is called (Points : 1)

Question 36.36. The hormone that determines whether an embryo will develop into a phenotypical male or female is (Points : 1)

Question 37.37. Persistent or recurrent extreme avoidance of all or almost all genital sexual contact with a sexual partner is (Points : 1)

Question 38.38. Your 87 year old patient is brought into the clinic by her part time CNA caregiver.  She lives at home with her daughter.  You are concerned that there is abuse or neglect going on in the home, but the patient denies this allegation.  Upon examination, you see that she is unkempt, dirty, and has some bruises on her upper arms.  She is diagnosed with a UTI and bedsore. It is determined that there has been abuse taking place.  The most likely abuser in this instance is (Points : 1)

Question 39.39. Ovulation is dependent on an increased level of ___________________  . 
(Points : 1)

Question 40.40. Risk factors for sexual dysfunction in women can include (Points : 1)

Question 41.41. Although all of the following are part of the work-up for sexual dysfunction in women, the one thing that will give the most information supporting this diagnosis is (Points : 1)

Question 42.42. Sudden onset pelvic pain that has occurred in the last 7 days, is less than 3 months in duration, and sharp in intensity is (Points : 1)

Question 43.43. A 32 year old woman presents at the GYN clinic with complaint of pelvic pain.  Which of the following conditions requires immediate diagnosis and management? (Points : 1)

Question 44.44. Which of the following are differential diagnoses of acute pelvic pain? (Points : 1)

Question 45.45. Causes of amenorrhea may include (Points : 1)

Question 46.46. 20 year old female presents to the office with c/o pelvic pain and vaginal discharge.  She is single, with a new sex partner.  Takes OCPs for contraception. Periods are regular.  Exam findings include BP 102/76, P 72 T 101.2, lower abdomen painful to palpation.  Speculum exam reveals mucopurulent discharge with an odor, no vaginal or cervical lesions.  Bimanual exam reveals CMT, uterine tenderness, and tenderness in the adnexal area bilaterally.  Microscope evaluation reveals abundant WBC.  The most likely diagnosis for this patient is (Points : 1)

Question 47.47. For the above-described patient, the recommended next step testing includes (Points : 1)

Question 48.48. Which type of breast cancer involves infiltration of the nipple epithelium and has an initial symptom of itching or burning of the nipple? (Points : 1)

Question 49.49. A disorder of androgen excess and ovarian dysfunction presenting with elevated free testosterone levels, hirsuitism, acanthosis nigricans, and irregular or infrequent periods (Points : 1)

Question 50.50. Appropriate diagnostic testing for the above patient includes (Points : 1)

Question 51.51. Which has the highest mortality rate of all GYN cancers? (Points : 1)

Question 52.52. All of the following are benign breast conditions except (Points : 1)

Question 53.53. Match the following vulvar dermatoses with their descriptions:
(Points : 6) 

Potential Matches:

1 : Immunological, 48-72 hour delayed reaction

2 : Localized variant of atopic dermatitis with epidermal thickening, 
"the scratch that itches"

3 : Depigmentation of skin around vulva and perianal area, may result in loss of vulvar architecture including fusing of clitoral hood

4 : Non-immunological, appears quickly after exposure

5 : Inflammatory condition of scalp, skin and nails, often manifests as bright red vulvar patches and/or white lacy patches in oral mucosa

6 : Chronic, immune-mediated disease with may manifest in skin and joints, plaques covered with silvery-white scales

    Answer

     : Lichen Planus

     : Lichen Simplex Chronicus

     : Psoriasis

     : Lichen Sclerosis

     : Allergic Contact Dermatitis 

     : Irritant Contact Dermatitis

Question 54.54. A 52 year old woman presents to the clinic with complaint of nipple discharge.  Which of the following signs would be the most concerning for breast cancer? (Points : 1)

Question 55.55. Symptoms of ovarian cancer can include all of the following except (Points : 1)

Question 56.56. The NP is assessing a patient with complaints of "heavy periods", cramping, painful sex, and an urge to urinate frequently. An ultrasound is ordered and uterine fibroids are diagnosed. Treatment options for uterine fibroids may include: (Points : 1)

Question 57.57. A 32 year old African American female presents to the clinic and complains of feeling like she has "pelvic pressure". Upon further questioning she states pain with intercourse. Upon pelvic exam, there are no gross abnormal findings noted. She has been trying to get pregnant for the past year but has been unsuccessful. You order an HCG, and perform a PAP test all of which return back negative. You then order a transvaginal ultrasound to confirm your preliminary diagnosis of (Points : 1)

Question 58.58. Breast masses that are painless, well-circumscribed, freely moveable masses with a rounded, lobulated or discoid configuration are most likely (Points : 1)

Question 59.59. All of the following are typically benign ovarian masses except (Points : 1)

Question 60.60. A 37 year old woman presents to the clinic for contraceptive management.  Her medical history includes hypothyroidism and eczema.  She drinks alcohol socially, and smokes 1/2 ppd cigarettes.  Her family history includes her mother has Diabetes Type 2 and her sister has epilepsy.  She is not sure if she has completed her family yet or not.  What method of contraception should be recommend to her? (Points : 1)

Question 61.61. Potential outcomes of unintended pregnancy include (Points : 1)

Question 62.62. In the state of Georgia and in the state of Florida, a minor (< 18 years old) may consent to contraception, pregnancy testing, prenatal care, STI/HIV testing and treatment if the health care provider feels her health is at risk otherwise. No consent is needed for emergency contracpetion (Points : 1)

Question 63.63. Match the following types of urinary incontinence with their characteristics:
(Points : 3) 

Potential Matches:

1 : involuntary leakage with effort or exertion, sneezing or coughing

2 : a strong desire to urinate that is difficult to postpone with involuntary leakage accompanied or preceded by urgency

3 : a strong desire to urinate that is difficult to postpone with involuntary leakage with effort or exertion that may or may not be related to urge

    Answer

     : Stress urinary incontinence

     : Urge urinary incontinence

     : Mixed urinary incontinence

Question 64.64. In the first two trimesters of a normal pregnancy, patients are typically seen for prenatal visits every two weeks. (Points : 1)

Question 65.65. Please match the following characteristics with the Tanner Staging definition
(Points : 5) 

Potential Matches:

1 : breast mound with projection of the nipple, adult pubic hair but none on the thighs

2 : pre-adolescent (10-14), nipple, no pubic hair

3 : fully mature breasts, adult pubic hair with inverted triangle pattern

4 : breast buds, beginning of fine pubic hair

5 : middle adolescent (12-14), breast and areola enlarged and elevated, coarser, curlier pubic hair

    Answer

     : Tanner I

     : Tanner II

     : Tanner III

     : Tanner IV

     : Tanner V

Question 66.66. The Affordable Care Act (ACA) offers preventative services for women.  This coverage may include (Points : 1)

Question 67.67. 
The above finding on a wet mount would be consistent with a diagnosis of: (Points : 1)

Question 68.68. Which of the following patients is "Menopausal" by definition? (Points : 1)

Question 69.69. The use of unopposed estrogen by a menopausal women who has recently stopped having periods increases her risk of (Points : 1)

Question 70.70. Mrs K, aged 65, is worried about developing Osteoporosis.  Which of the following assessment findings would indicate that she may be at risk for Osteoporosis? (Points : 1)

Question 71.71. You 24 year old patient has been taking Lo-Ovral for six months and has recently begun experiencing breakthrough bleeding and weight gain over the last three months. What would be the best course of action? (Points : 2)

Question 72.72. The ACOG recommendation for timing of the anatomy ultrasound in pregnancy is: (Points : 1)

Question 73.73. Your 14 year old patient has just moved to the area and is establishing care with your practice. She has not seen a provider for a year. In reviewing her immunization records, you note that she had two doses of Cervarix three months apart at 12 and 15 months ago. You have Cervarix, Gardasil-4 and Gardasil-9 available and her insurance will pay for any of them. Your recommendation should be: (Points : 1)

Question 74.74. What is the best explanation for why don't we screen for HPV in women under 30? (Points : 1)

Question 75.75. A 24 year old female presents with complaint of sharp lower abdominal pain radiating to the lumbar region for 3 hours.  Her LMP was 7 weeks ago.  A CT of the abdomen/pelvis was ordered, and revealed a perforated fallopian tube.  The patient is most likely experiencing: (Points : 1)