NURS 6551 Midterm Exam Study Guide
NURS 6551 Midterm Exam Study Guide
How can liver and renal diseases result in abnormal uterine bleeding (AUB)?
|
a. |
They cause an imbalance in platelet aggregation. |
|
b. |
They result in an inability to adequately clear estrogen from the body. |
|
c. |
They cause thyroid dysfunction, which leads to bleeding abnormalities. |
|
d. |
They result in elevated prolactin levels, which lead to bleeding abnormalities. |
What is now thought to be the most important causative agent in cervical cancer?
|
a. |
PCOS |
|
b. |
Vulvar cancer |
|
c. |
Herpes simplex |
|
d. |
HPV |
An initial or primary genital herpes infection characteristically lasts about:
|
a. |
1 week |
|
b. |
3 weeks |
|
c. |
1 month |
|
d. |
6 weeks |
Which contraceptive methods have inherent failure rates?
|
a. |
None |
|
b. |
Some |
|
c. |
All |
|
d. |
All except sterilization |
Why do adolescents have the highest risk of developing pelvic inflammatory disease (PID)?
|
a. |
They have the highest risk for bacterial vaginosis. |
|
b. |
They are the least at risk for developing other STIs. |
|
c. |
They are the most sexually active. |
|
d. |
They have decreased immunity to infectious organisms. |
Exercise-induced amenorrhea is probably due to the combination of low body fat and decreased secretion of:
|
a. |
Estrogen |
|
b. |
Prolactin |
|
c. |
Progesterone |
|
d. |
GnRH |
What can result from an imbalance in the vaginal flora?
|
a. |
Herpes simplex virus |
|
b. |
Human papillomavirus |
|
c. |
Chlamydia |
|
d. |
Bacterial vaginosis |
The most effective means of obtaining the history of abuse is to use a communication model that:
|
a. |
Avoids having the patient’s children present during the discussion |
|
b. |
Signals someone is interested and that the woman is not alone |
|
c. |
Emphasizes the belief that violence is not acceptable, no matter what the batterer might have said to the patient |
|
d. |
Allows the patient to talk without interruption and with time to relate, emphasize, and repeat her full story |
What is the most common STI in the United States?
|
a. |
Gonorrhea |
| |
b. |
Chlamydia |
|
c. |
Syphilis |
|
d. |
Herpes simplex virus |
Progestin-only pills (POPs):
|
a. |
Have no possible side effects |
|
b. |
Suppress ovulation as reliably as COCs |
|
c. |
May be taken earlier or later than prescribed |
|
d. |
In combination with lactation are nearly 100% effective |
According to the World Health Organization (WHO), the presence of a disease state:
|
a. |
Necessitates prompt medical attention |
|
b. |
Excludes a person from being considered healthy |
|
c. |
Does not exclude a person from being considered healthy |
|
d. |
Classifies a person as in poor health |
Which of the following might be a sign of hyperandrogenism?
|
a. |
Irritable bowel syndrome |
|
b. |
Decreased sebum secretion in the skin |
|
c. |
Decreased muscle mass |
|
d. |
Acne associated with menstrual dysfunction |
Surgical abortion represents an option for women who desire termination of pregnancy beyond:
|
a. |
8 weeks’ gestation |
|
b. |
12 weeks’ gestation |
|
c. |
4 weeks’ gestation |
|
d. |
15 weeks’ gestation |
How can weight loss specifically control symptoms of polycystic ovary syndrome (PCOS)?
|
a. |
It decreases SHBG. |
|
b. |
It increases insulin resistance. |
| |
c. |
It decreases androgen levels. |
|
d. |
It increases estrogen levels. |
Why is acknowledging the oppression of women more difficult within Western societies?
|
a. |
The multiplicity of minority groups complicates the issue. |
|
b. |
The availability of health care makes acknowledgment more difficult. |
|
c. |
The diversity of the news media clouds the issue. |
|
d. |
Affluence and increased opportunities mask oppression. |
How does vaginosis differ from vaginitis?
|
a. |
It must be treated with metronidazole. |
| |
b. |
The discharge does not contain white blood cells. |
|
c. |
The discharge does not have an odor. |
|
d. |
It causes itching and/or burning. |
What area of injury prevention is a focus of the USPSTF’s guidelines for counseling all healthy, asymptomatic women?
|
a. |
Motor vehicle accidents |
|
b. |
Falls |
|
c. |
Domestic violence |
|
d. |
All of the above |
What approach does Healthy People 2020 use to achieve its goals and objectives?
|
a. |
Social determinants of health |
|
b. |
Evidence-based determinants of health |
|
c. |
Quality-of-life determinants of health |
|
d. |
Longevity promotion determinants of health |
Approximately what percentage of women with bacterial vaginosis are asymptomatic?
|
a. |
25% |
|
b. |
40% |
|
c. |
75% |
| |
d. |
50% |
The genetic counselor has a significant role in the care of women because BRCA1 and BRCA2 genetic mutations account for 5 to 10 percent of all _______ cancer cases.
|
a. |
Breast |
|
b. |
Ovarian |
|
c. |
Uterine |
|
d. |
Pancreatic |
Which organism causes 90% of vulvovaginal candidiasis episodes in women?
|
a. |
Candida tropicalis |
|
b. |
Candida albicans |
|
c. |
Candida glabrata |
|
d. |
Candida krusei |
What term refers to the period from about 7 to 10 days before menstrual flow begins until the first or second day of menstrual flow?
|
a. |
Amenorrhea |
|
b. |
Premenstrual |
|
c. |
Dysmenorrhea |
|
d. |
Perimenstrual |
The ParaGard IUD is impregnated with copper and is effective for:
|
a. |
15 years |
|
b. |
3 years |
|
c. |
5 years |
| |
d. |
10 years |
What is the danger of giving estrogen replacement therapy (ERT) to menopausal women with an intact uterus?
|
a. |
A higher risk of heart disease |
|
b. |
An increased likelihood of blood clots |
|
c. |
An increased likelihood of osteoporosis |
|
d. |
A higher risk of endometrial cancer |
Although barrier contraception methods are less effective in preventing pregnancy than more modern methods, interest in them is on the rise because they:
|
a. |
Can help protect against STIs, including HIV |
|
b. |
Are coitus dependent and require planning |
|
c. |
Are nonallergenic and male controlled |
|
d. |
Involve the use of hormones |
A risk factor that could lead to endometrial cancer is:
|
a. |
Early menopause |
|
b. |
Late menopause |
|
c. |
High blood pressure |
|
d. |
Cervical cancer |
Of the two intrauterine contraceptive devices currently available in the United States only one provides a local delivery of protestin. It is the:
|
a. |
Combined contraceptive patch (Ortho Evra) |
|
b. |
Copper IUD (T380A, ParaGard) |
|
c. |
LNG-IUS (Mirena) |
|
d. |
Dalkon Shield |
Approximately what percentage of vulvar cancers occur in women older than the age of 50?
|
a. |
50% |
|
b. |
70% |
|
c. |
85% |
|
d. |
60% |
What is the best definition of abnormal uterine bleeding (AUB)?
|
a. |
Uterine bleeding for which no pelvic pathology is found |
|
b. |
Uterine bleeding that is irregular during a woman’s menstrual cycle |
|
c. |
Uterine bleeding that is irregular in amount or frequency |
|
d. |
Uterine bleeding that is related to systemic conditions |
The most common benign breast masses are:
|
a. |
Galactoceles |
|
b. |
Hamartomas |
|
c. |
Fibroadenomas and cysts |
|
d. |
Lipomas and phyllodes tumors |
Which cancer has the highest mortality rate of all gynecological cancers?
|
a. |
Vulvar cancer |
|
b. |
Endometrial cancer |
|
c. |
Cervical cancer |
| |
d. |
Ovarian cancer |
Vulvovaginal candidiasis accounts for what percentage of all vaginal infections?
|
A. |
10–15% |
|
B. |
20–25% |
|
C. |
50–55% |
|
D. |
60–65% |
Which type of counseling results in a statistically significant reduction in STIs?
|
a. |
Abstinence-only education |
| |
b. |
Counseling delivered in multiple individual or group sessions totaling more than 3 hours |
|
c. |
Remote counseling via Internet or phone |
|
d. |
Brief, individual sessions in the primary care setting |
Which of the following is an ethical issue that is specifically associated with pre-implantation testing with ART?
|
a. |
Ownership of frozen embryos after the couple has divorced |
|
b. |
A surrogate deciding she does not want to relinquish the infant |
|
c. |
Genetic engineering and the ability to reject embryos affected by inherited disorders |
|
d. |
The implantation of multiple embryos, which can create high risk for the embryos and the woman |
What symptom is present in 80 to 90 percent of women with cervical cancer?
| |
a. |
Abnormal vaginal bleeding |
|
b. |
Abnormal vaginal discharge |
|
c. |
Pelvic pain |
|
d. |
Ectopic pregnancy |
If a patient has not reported a sexual assault to law enforcement, all of the following clinician actions are important except:
|
a. |
Asking if reporting is something she wants to consider |
|
b. |
Discussing any fears or concerns that she may have about reporting |
| |
c. |
Explaining that only some forced sexual contacts are reportable crimes |
|
d. |
Telling her that women who report do better psychologically than those who do not |
What test should be ordered for a woman who is experiencing abnormal uterine bleeding (AUB) as well as headaches and peripheral vision changes?
|
a. |
Thyroid-stimulating hormone test |
|
b. |
Nucleic acid amplification test |
| |
c. |
Complete blood count |
|
d. |
Prolactin level test |
What had been a significant problem in medical research well into the 1990s?
|
a. |
The focus on randomized clinical trials over epidemiological investigations |
|
b. |
The lack of representation of women in research trials |
|
c. |
The lack of research related to gynecology |
|
d. |
The focus on randomized clinical trials over observational research |
What is the definitive diagnostic technique for vulvar dermatoses?
|
a. |
Pap test |
| |
b. |
Biopsy |
|
c. |
Colposcopy |
|
d. |
Physical exam |
Where in the breast do most malignancies develop?
|
a. |
Upper inner quadrant |
| |
b. |
Upper outer quadrant |
|
c. |
Lower outer quadrant |
|
d. |
Lower inner quadrant |
Approximately how many Americans will contract one or more sexually transmitted infections during their lifetime?
|
a. |
50% |
|
b. |
25% |
|
c. |
40% |
|
d. |
60% |
In the GTPAL system for recording pregnancy history, the “T” stands for:
| |
a. |
Term births |
|
b. |
Terminal pregnancies |
|
c. |
Total number of pregnancies |
|
d. |
Type of birth (spontaneous, assisted, or cesarean) |
Both very young and elderly sexual assault victims:
| |
a. |
Are addressed in most state mandatory reporting laws |
|
b. |
never has any difficulty describing the incident and related symptoms |
|
c. |
Require the same equipment for proper examination that others do |
|
d. |
Have fewer injuries than victims of other age groups |
What is one of the side effects of hormonal contraceptives?
|
a. |
Reduction in ovarian cancer risk |
|
b. |
Increased menstrual blood loss |
| |
c. |
Increased risk of endometrial cancer |
|
d. |
Heavier menstrual flow |
Tubal sterilization for women who have completed their families is highly effective, but there are disadvantages such as:
|
a. |
Women are less likely to use condoms or return for health services. |
|
b. |
There is a decreased risk of ovarian cancer and pelvic inflammatory disease. |
|
c. |
There is a high likelihood of complications and side effects. |
|
d. |
The surgery is not covered by insurance. |
What is the current (2006) recommendation by the CDC regarding HIV testing?
|
a. |
Test all patients who report risk behaviors associated with HIV. |
| |
b. |
Test all patients unless they explicitly decline to be tested. |
|
c. |
Test all patients. |
|
d. |
Test only those patients who ask to be tested. |
What is generally the cause of Bartholin’s cyst?
|
a. |
Complications from gonorrhea |
|
b. |
Cystic fluid in Bartholin’s gland becomes infected |
|
c. |
A fungal infection in Bartholin’s gland |
|
d. |
Obstruction of a duct in Bartholin’s gland |
Which of the following factors associated with increased risk for developing osteoporosis appears to be the best predictor of risk?
|
a. |
Smoking |
|
b. |
Low body weight |
|
c. |
Sedentary lifestyle |
|
d. |
Family history |
What is the definition of primary amenorrhea?
|
a. |
The cessation of menses for an interval of 6 months |
|
b. |
The failure to begin menses by age 14 |
|
c. |
The cessation of menses due to outflow tract obstruction |
|
d. |
The failure to begin menses by age 16 |
In respect to an evidentiary examination:
|
a. |
The patient may not withhold consent if the clinician is a mandated reporter. |
|
b. |
The clinician is required to strictly follow local agency protocols, no others. |
|
c. |
The time frame within which it must take place depends on local standards. |
|
d. |
Maintaining the chain of custody of all evidence collected is recommended, not required. |
QUESTION 1
- Which of the following is a diagnostic label that is listed in the Diagnostic and Statistical Manual IV-TR?
|
- a.
|
- Premenstrual dysphoric disorder
|
|
- b.
|
- Premenstrual magnification
|
|
- c.
|
- Dysmenorrhea
|
|
- d.
|
- Premenstrual syndrome
|
- About half of all pregnancies in the United States are unintended and occur most frequently in women who:
|
- a.
|
- Are married or divorced
|
|
- b.
|
- Have finished high school
|
|
- c.
|
- Are between the ages of 18 and 24
|
|
- d.
|
- Are members of the majority group
|
What is one factor that can reduce the risk for the development of ovarian cancer?
|
a. |
Multiple pregnancies |
|
b. |
Transvaginal ultrasounds |
|
c. |
Identification of recurrence |
|
d. |
Weight loss |
What percentage of toxic shock syndrome cases are related to menses?
|
a. |
50% |
|
b. |
25% |
| |
c. |
75% |
|
d. |
90% |
Tubal sterilization for women who have completed their families is highly effective, but there are disadvantages such as:
|
a. |
Women are less likely to use condoms or return for health services. |
|
b. |
There is a decreased risk of ovarian cancer and pelvic inflammatory disease. |
|
c. |
There is a high likelihood of complications and side effects. |
|
d. |
The surgery is not covered by insurance. |
Women who report experiencing the most severe symptoms of PMS tend to be: In their late 40s
|
- a.
|
- In their late 40s
|
|
- b.
|
- In their early 20s
|
|
- c.
|
- In their late teens
|
|
- d.
|
- In their late 30s
|
What is the definition of primary amenorrhea?
|
a. |
The cessation of menses for an interval of 6 months |
|
b. |
The failure to begin menses by age 14 |
|
c. |
The cessation of menses due to outflow tract obstruction |
| |
d. |
The failure to begin menses by age 16 |
How many stages does the Tanner scale use to stage sexual maturity?
|
a. |
3 stages |
|
b. |
5 stages |
|
c. |
6 stages |
|
d. |
8 stages |
Which contraceptive methods have inherent failure rates?
|
- a.
|
- None
|
|
- b.
|
- Some
|
|
- c.
|
- All
|
|
- d.
|
- All except sterilization
|
What is the most common type of menstrual dysfunction related to hyperandrogenism?
|
a. |
Painful menstruation |
|
b. |
Absence of menses |
| |
c. |
Irregular bleeding |
|
d. |
Early menopause |
Combined oral contraceptives (COCs) are among the most extensively studied medications available. Which one of the following statements about their use has been found to be true?
|
a. |
Broad-spectrum antibiotics may enhance their efficacy. |
|
b. |
They do not increase the risk of venous thromboembolism. |
|
c. |
They decrease the relative risk of ovarian and endometrial cancers. |
|
d. |
Among possible side effects are acne, hirsuitism, and benign breast conditions. |
Many patients experiencing intimate partner violence (IPV) meet the criteria for diagnosing PTSD. Those criteria include all of the following except:
|
- a.
|
- Experiencing a traumatic event
|
|
- b.
|
- Reexperiencing the traumatic event
|
|
- c.
|
- Numbness and avoidance
|
|
- d.
|
- Hypovigilance
|
Which of the following is an ethical issue that is specifically associated with pre-implantation testing with ART?
|
- a.
|
- Ownership of frozen embryos after the couple has divorced
|
|
- b.
|
- A surrogate deciding she does not want to relinquish the infant
|
|
- c.
|
- Genetic engineering and the ability to reject embryos affected by inherited disorders
|
|
- d.
|
- The implantation of multiple embryos, which can create high risk for the embryos and the woman
|
The ________ is probably the most widely used intimate partner violence (IPV) screen.
| |
a. |
Three-question AAS (McFarlane et al., 1992) |
|
b. |
Campbell’s Danger Assessment (2003) |
|
c. |
Sheridan’s HARASS Instrument |
|
d. |
Helton’s nine-question AAS |
What is the term for the absence of menses for 3 to 6 months in a woman who has previously menstruated and is not pregnant, breastfeeding, or menopausal?
|
- a.
|
- Primary amenorrhea
|
|
- b.
|
- Initial dysmenorrhea
|
|
- c.
|
- Secondary amenorrhea
|
|
- d.
|
- Primary dysmenorrhea
|
Among women age 55 years and older:
|
a. |
Macromastia is the most common cause of breast masses. |
| |
b. |
Breast masses are presumed malignant until proven otherwise. |
|
c. |
Most breast masses decrease in size over time and many resolve completely. |
|
d. |
Diagnostic imaging of a breast mass and tissue sampling should be deferred. |
Both very young and elderly sexual assault victims:
|
- a.
|
- Are addressed in most state mandatory reporting laws
|
|
- b.
|
- never has any difficulty describing the incident and related symptoms
|
|
- c.
|
- Require the same equipment for proper examination that others do
|
|
- d.
|
- Have fewer injuries than victims of other age groups
|
What is the major source of normal vaginal secretions?
|
a. |
Bartholin’s glands |
|
b. |
Apocrine glands |
|
c. |
Sebaceous glands |
|
d. |
Cervical mucosa |
Which one of the following statements about intimate partner violence (IPV) is false?
|
- a.
|
- It refers to an escalating pattern of abuse.
|
|
- b.
|
- It includes emotional abuse, such as disregarding what a woman wants.
|
|
- c.
|
- It includes using physical force to make a woman engage in a sexual act against her will.
|
|
- d.
|
- It refers to a current or former spouse or dating partner of the opposite sex, not someone of the same sex.
|
How is being overweight defined on the BMI table?
|
a. |
18–29.9 |
|
b. |
20–29.9 |
| |
c. |
25–29.9 |
|
d. |
30 or greater |
What has contributed to the decreased incidence of hepatitis B over the past 20 years?
|
- a.
|
- The decrease in PID
|
|
- b.
|
- The HBV vaccination
|
|
- c.
|
- The increase in condom use
|
|
- d.
|
- More precise screening methods
|
Which are the most common forms of hepatitis seen in women’s health practices?
|
a. |
A and B |
|
b. |
A and D |
|
c. |
B, C, and D |
| |
d. |
B and C |
The factors that enable women to enjoy and control their sexual and reproductive lives, including a physical and emotional state of well-being and the quality of sexual and other close relationships, make up a woman’s:
|
- a.
|
- Sexual health
|
|
- b.
|
- Gender identity
|
|
- c.
|
- Gender role behaviors
|
|
- d.
|
- Psychosocial orientation
|
What test should be ordered for a woman who is experiencing abnormal uterine bleeding (AUB) as well as headaches and peripheral vision changes?
|
a. |
Thyroid-stimulating hormone test |
|
b. |
Nucleic acid amplification test |
|
c. |
Complete blood count |
| |
d. |
Prolactin level test |
Surgical abortion represents an option for women who desire termination of pregnancy beyond:
|
- a.
|
- 8 weeks’ gestation
|
|
- b.
|
- 12 weeks’ gestation
|
|
- c.
|
- 4 weeks’ gestation
|
|
- d.
|
- 15 weeks’ gestation
|
What population of women should be screened for signs and symptoms of thyroid dysfunction?
|
- a.
|
- All women
|
|
- b.
|
- Older women
|
|
- c.
|
- Older women, smokers, and women with diabetes
|
|
- d.
|
- Older women, postpartum women, and women with Down syndrome
|
All of the following diagnostic testing and procedures are now infrequently performed in clinical practice except:
|
- a.
|
- Hysterosalpingogram
|
|
- b.
|
- Sperm penetration assay
|
|
- c.
|
- The postcoital test (PCT)
|
|
- d.
|
- Endometrial biopsy (EMB)
|
The most common site for endometrial implants found in other parts of the body is:
|
- a.
|
- The appendix
|
|
- b.
|
- The uterus
|
|
- c.
|
- The ovaries
|
|
- d.
|
- The fallopian tubes
|
Women who have had toxic shock syndrome should be instructed not to use tampons or:
|
a. |
Barrier contraception methods |
|
b. |
Hormonal contraception methods |
|
c. |
Intravaginal antibiotic cream |
|
d. |
Oral antibiotics |
Cyclic mastalgia:
|
a. |
More likely causes unilateral, localized pain that is sharp or burning in nature |
|
b. |
Has an increased risk of occurrence in women whose diets are low in fat |
|
c. |
Occurs most frequently in women who are 18 to 30 years old |
|
d. |
Is caused by hormonal changes associated with menstruation |
The incidence of uterine fibroids:
|
- a.
|
- Increases with age
|
|
- b.
|
- Decreases with age
|
|
- c.
|
- Is often caused by early menopause
|
|
- d.
|
- Is related to the age of first menses
|
Patients presenting for STI treatment should be screened for HIV:
|
a. |
At each visit |
|
b. |
At the end of treatment |
|
c. |
At the beginning of treatment |
|
d. |
Each year |
- What screening recommendation is similar across all groups for colorectal cancer?
|
- a.
|
- Screening women age 76 to 85 based on risk factors
|
|
- b.
|
- Screening only for those women at increased risk
|
|
- c.
|
- Screening for all women starting at age 50
|
|
- d.
|
- Against routine screening in adults age 76 and over
|
Approximately what percentage of vulvar cancers occur in women older than the age of 50?
|
a. |
50% |
|
b. |
70% |
|
c. |
85% |
|
d. |
60% |
Signs of endometrial or cervical cancer may present abnormal uterine bleeding, often as heavy, prolonged bleeding or:
|
- a.
|
- Menometrorrhagia
|
|
- b.
|
- Amenorrhea
|
|
- c.
|
- Oligomenorrhea
|
|
- d.
|
- Polymenorrhea
|
In the GTPAL system for recording pregnancy history, the “T” stands for:
| |
a. |
Term births |
|
b. |
Terminal pregnancies |
|
c. |
Total number of pregnancies |
|
d. |
Type of birth (spontaneous, assisted, or cesarean) |
What is now thought to be the most important causative agent in cervical cancer?
|
a. |
PCOS |
|
b. |
Vulvar cancer |
|
c. |
Herpes simplex |
|
d. |
HPV |
The most common sites of metastatic spread of invasive breast cancer include all of the following except:
|
- a.
|
- Bones
|
|
- b.
|
- Lungs
|
|
- c.
|
- Pituitary
|
|
- d.
|
- Lymph nodes
|
Who should be screened regularly for STIs?
|
a. |
Women who have more than one sexual partner |
|
b. |
Women over the age of 21 |
|
c. |
Women who are sexually active |
|
d. |
Women over the age of 15 |
What is a common vasomotor symptom of menopause?
|
- a.
|
- Blood clots
|
|
- b.
|
- Night sweats
|
|
- c.
|
- Osteoporosis
|
|
- d.
|
- Hysterectomy
|
What is the best definition of abnormal uterine bleeding (AUB)?
|
a. |
Uterine bleeding for which no pelvic pathology is found |
|
b. |
Uterine bleeding that is irregular during a woman’s menstrual cycle |
|
c. |
Uterine bleeding that is irregular in amount or frequency |
|
d. |
Uterine bleeding that is related to systemic conditions |
What should be the clinician’s first objective after learning the chief reason the woman desires care?
|
a. |
To give the reason or problem a structural and chronological framework |
|
b. |
To probe for any additional concerns missed |
|
c. |
To take a family history related to the presenting concern |
|
d. |
To gain insight into the woman’s cultural and social influences |
No risk factors other than age are identifiable in ______ of women with breast cancer.
|
a. |
100% |
| |
b. |
85% |
|
c. |
60% |
|
d. |
24% |
The highest prevalence of human papillomavirus (HPV) is found among women ages:
|
a. |
18–20 |
|
b. |
20–24 |
|
c. |
25–30 |
|
d. |
30–35 |
Although barrier contraception methods are less effective in preventing pregnancy than more modern methods, interest in them is on the rise because they:
|
a. |
Can help protect against STIs, including HIV |
|
b. |
Are coitus dependent and require planning |
|
c. |
Are nonallergenic and male controlled |
|
d. |
Involve the use of hormones |