Alcohol Consumption and Women
Recommended daily intake limit? Possible Risks?
Stage two: Breasts and nipples have just started to grow, the areola has become larger, breast tissue bud feels firm behind the nipple, initial growth of pubic hair that is light in color and not curled.
Initial growth of scrotum and testes. The skin on the scrotum has become redder, thinner, and more wrinkled. The penis may have grown a little in length. Few hairs around the root of the penis. the hairs are straight without curls, and light in color.
Stage Three: breasts and nipples have grown additionally. The aureola is darker and the breasts tissue buds have gotten larger. The public hair is more widespread. The hair is darker, and curls may have appeared.
the penis has now grown into length. Scrotum and testes have grown. The skin of the scrotum has become darker and more wrinkled.
Nipples and aerolas are elevated and form an edge towards the breast. The breast has also grown a little larger. More dense pubic hair growth with curls and dark hair. Still not entirely as an adult womens.
the penis has grown in both length and width. The head of the penis has become larger. The scrotum and testes have grown more dense curly and dark hair. the hair growth is reaching the inner thighs.
Primary prevention vs. Secondary Prevention vs Tertiary prevention
Primary prevention: Includes preventative measures that come BEFORE THE ONSET of a disease, illness, or injury, and BEFORE the disease process begins. Examples are, HPV vaccination, Safe sex practices, immunizations, health education, and counseling.
Secondary Prevention: Includes those preventive measures that lead to early diagnosis and prompt treatment of disease, illness, or injury. Examples are, Pap smears, HIV testing, HPV testing, syphilis testing. routine lab screening for early detection of disease.
Tertiary Prevention : Limits the ability and promotes rehab from clinical disease states. (Disease and illness is already here).
U.S. Preventive Task Force
Who are they? What do they do? what do they recommend?
American College of Obstetrics and Gynecologists recommendations
Preventable causes of death for women
Women’s Health Statistics
What is the leading cause of death in females of all races and all origins?
Heart disease (21.8%), Cancer (20.7%), and Chronic Lower Respiratory Disease (6.2%).
Women Health Statistics-What is the most common gynecological cancer in the U.S.?
Women’s Health Statistics
What gynecologic cancer in women causes the most deaths?
Women’s Health Statistics
What gynecological cancer is the MOST preventable?
List all of the possible gynecological cancers for women?
What are the advantages of taking an oral contraceptive for more than five years?
Ovarian and endometrial cancers decrease by 40-50%
What are the disadvantages of taking an oral contraceptive for more than five years?
Increases risk of breast and cervical cancers, even tho it lowers risk of ovarian and endometrial.
Unintended pregnancy Statistics
Unintended pregnancy rates per 1,000 women were highest among women who are
1. 18-24 years old
2. Low income, < 100% of federal poverty level
3. Had never completed high school
4. Were Non-hispanic black or african american
5. Were cohabiting but never married.
Most unintended pregnancies result from not using contraception consistently or correctly or at al.
World Health Organization (WHO): Who are they and what do they do?
They are a world health org that plays an essential role in the global governance of health and disease. They establish, monitor, and enforce international norms and standards.
They define health as a ” state of complete physical, mental, and social well-being and not just the absence of disease or infirmity”. * Definition of Infirmity means physical or mental weakness***
Screening Guidelines for IPV (Intimate Partner Violence).
All women of childbearing ages 14-46 should be screened for IPV.
Factors that put women at risk for IPV
There is still no clinical definition of sexual assault or rape that has gained acceptance. clinicians should become familiar with their states definitions and corresponding laws.
The revised UCR definition of rape is: Penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.
Genital Trauma and Rape Statistics
Evidentiary Examination of a Rape Victim
A evidentiary collection kit should be used and instructions on how to collect, preserve, seal, and store samples should be followed. Collection should be done AFTER inspection of the area and prior to palpitation or physical manipulation of the area. STD possibility should be treated prophylactically even if tested negative, pregnancy test should be given and emergency contraception may be given up to 120 HOURS OF THE ASSAULT (A SINGLE DOSE OF LEVONORGESTREL (PLAN B) 1.5 MG.
What does the Pneumonic EMPOWER stand for?
It is used for intimate partner violence and stands for…
Empathetic listening
Making time to properly document findings
Provide information about domestic violence
Offering options and choices
Working with a domestic abuse specialist
Encouraging the planning for safety and support
Referring to local services
Gravida Para Abortus system GTPAL
Healthy People 2020 who they are and why they are important
Devised using a framework that focuses on determinants of health with an extra focus on social determinants (Personal, social, economic). Healthy people focus areas include…
1. Cancer
2. HIV
3. LBGQT health
second definition from the CDC’s website on healthy people 2020 objectives
provides science-based, 10-year national objectives for improving the health of all Americans. Healthy People has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors; empower individuals toward making informed health decisions; measure impact of prevention activities.
American College of Nurse-Midwives (who can they treat?) definition of scope of practice
An endocrin disorder that results in excessive levels of androgens ( male sex hormones such as testosterone) in the female body. S/S muscular male like body, deepening voice, clitoromegaly, increased iibido, menstrual irregularity, HTN, Hyperlipidemia, glucose intolerance, hirsutism (aka dark course hair in male like matters on face, chest, back). , alopecia, acanthosis nigricans (discolored dark velvety patches in skin folds and creases (armpits, groin, and neck (underlying obesity, tumor, or cancer causes A.N) oily skin, and acne.
Quick Patho: POS –> inc testosterone levels (causes hirsutism (aka facial hair), insulin resistance and hyperinsulemia, –>Inc LH (luteinizing hormone)
Causes: Usually POS (polycystic ovarian syndrome causes 80-90% of cases
Diagnosis includes
Serum Testosterone (normal 20-80)
Serum 17a-hydroxyprogesterone (normal <2)
dehydroepiandrosterone (normal 250-300)
Dexmethasone supression Test,LH, lipid profile
BMI Formula what is considered overweight and underweight
Weight (Lbs) x 703/height (in) squared
BMI
19-24=Normal
25-29 =overwight
30-39= obese
> 40 extreme obese
Screening for Thyroid Dysfunction
TSH screening in all adults ages 35 and repeated tests every 5 years thereafter. If s/s of thyroid problems screened again and if abnormal screenings should be done yearly.
Pregnant women should have TSH measured immediately after becoming pregnant goal TSH levels 2.5-3.5. (Women who are pregnant should only use levothyroxine alone and not combined with any other medications for the thyroid especially liothyronin (triostat).
Screening for Rubella Immunity
A rubella blood test looks for IgG antibodies made by the immune system and will stay in the blood stream for years. The IgG antibodies are produced by the immune system in response to a recent infection, a past infection, or that you have received the vaccine. Women who do contract rubella when they are pregnant are at risk for miscarriage, still birth, and fetal defects with the most common birth defect being **DEAFNESS**
Osteoporosis screening, risk factors, how to measure risk, the name of the screening test
The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older. Those at risk should be screened at age 60
Risk Factors include…
1. postmenopausal women younger than the age of 65 with atleast one risk factor
2. parental history of hip fracture
3. smoking
4. excess alcohol consumption
5. low body weight.
Best way to measure risk is to use a clinical risk assessment tool. Several tools are available to assess osteoporosis risk, such as OST, ORAI, OSIRIS, SCORE, and FRAX.
SCREENING
The most commonly used test is central DXA of the hip and lumbar spine this provides measurement of bone mineral density, and most treatment guidelines use central DXA to define osteoporosis and the treatment threshold to prevent osteoporotic fractures. Other screening tests include peripheral DXA and quantitative ultrasound.
The U.S. Food and Drug Administration has approved multiple drug therapies to reduce osteoporotic fractures, including bisphosphonates, parathyroid hormone, raloxifene, and estrogen. The choice of therapy should be an individual one based on the patient’s clinical situation and the trade-off between benefits and harms.
Other relevant USPSTF recommendations
The USPSTF has made recommendations on interventions to prevent falls in community-dwelling older adults and the use of vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults.
Screening for Cardiovascular Disease
Blood pressure screening at each health care visit and once a year if low bp.
Cholesterol checked every 4-6 years for normal risk if elevated than yearly
BMI yearly at annual well visit
Smoking and physical activity at each visit
If abnormals, EKG and stress tests. EKG yearly if HTN.
Risk factors
older age, male sex, high blood pressure, current smoking, abnormal lipid levels, diabetes, obesity, and physical inactivity. Several calculators and models are available to quantify a person’s 10-year risk of CVD events; the USPSTF recommends that clinicians use the Pooled Cohort Equations to assess CVD risk.
Treatments
Asymptomatic adults at increased risk of CVD events are usually treated with a combination of diet and exercise modifications, lipid-lowering medications, aspirin, hypertension management, and interventions to encourage tobacco cessation.
Other relevant USPSTF recommendations
The USPSTF has made recommendations on many factors related to CVD prevention, including screening for high blood pressure, use of statins, counseling on smoking cessation, and counseling to promote healthful diet and physical activity. In addition, the USPSTF recommends low-dose aspirin use in certain persons at increased risk of CVD events.
Why do we screen for TYPE 2 DIABETES but not TYPE 1?
TYPE 1 DIABETES
Screening for type 1 diabetes is not recommended for the following reasons: patients typically present with an acute onset of symptoms, no established cutoff value is available for antibody tests, no accepted treatment exists for patients who are asymptomatic, and no medication is available to prevent the disease in persons genetically predisposed to type 1 diabetes
TYPE 2 DIABETES
Screening is recommended for type 2 diabetes because reliable tests are available, and lifestyle changes and medications reduce progression and adverse sequelae of the disease, even in persons who are initially asymptomatic.
Diabetes in women (pregnant and nonpregnant)
(USPSTF) recently updated recommendations and suggests screening individuals 40 to 70 years of age who are overweight or obese. Persons with abnormal results should be referred for intensive behavioral counseling interventions focusing on physical activity and a healthy diet. Clinicians should consider screening certain individuals at higher risk. repeat screening every 3 years and a fasting blood glucose yearly.
PREGNANT WOMEN-Glucose test is done between 24-28 weeks. The test may be performed earlier if high glucose levels are in the urine or if they had Gestational DM in previous pregnancies.
Use of the Rectovaginal examination
There are three main types of cervical speculum: pediatric, Pederson and Graves. They come in plastic and medal.
The Pediatric Speculum (smallest most narrow)
Shorter in length, the pediatric speculum is intended for use in patients who have never had sexual intercourse and therefore have narrower vaginal canals
The Pederson Speculum
Flat and narrow, the Pederson speculum is a vaginal speculum used during OB/GYN examinations when women have narrow vaginal canals. This condition can be caused by traumatic injuries and the resulting scar tissue, but is also found in elderly women and women who have never had sexual intercourse. Using this narrow speculum type can eliminate some of the discomfort of a pelvic exam. (also used in menopausal women, transgender men on testostrone, transgender women with neovagina.
The Graves Speculum (resembles a ducks mouth in appearance)
The Graves speculum is the most common variety used by OB/GYNs. This vaginal speculum is commonly available in multiple sizes: small, medium and large. Used in Sexually Active Women.
Abnormal Uterine Bleeding (Diagnostics and lab tests)
The Graves speculum is the most common variety used by OB/GYNs. This vaginalspeculum is commonly available in multiple sizes: small, medium and large. The bills of the Graves speculum, which resemble a duck’s mouth, are wider than the bills of the Pederson speculum, and the sides are also curved
Diagnostics
Pap smear
Vaginal culture
pelvic ultrasound
EMB-Endometrial biopsy
Lab Tests
qualitative/quantitative HcG, CBC with platelets, Pt and PTT, FHS, Progesterone, TSH, Iron, and Prolactin
(Lab Tests Explained)
Prolactin-High levels interfere with the normal production of other hormones such as estrogen and progesterone. This can result in irregular or missed periods, and prevent ovulation. Some women can have high levels and be completely asymptomatic
FHS-
History (EXTRA INFO TO KNOW)
1. Pelvic pain? think….
Miscarriage, ectopic pregnancy, PID, trauma, sexual abuse or assault
2. Nausea, weight gain, urinary frequency, fatigue? think…
Pregnancy
3. Weight gain, cold intolerance, constipation, fatigue? think…..
Hypothyroidism
4.Weight loss, sweating, palpitations?…..
Hyperthyroidism
5.Easy bruising, tendency to bleed? think… Coagulopathy
6. Jaundice, history of hepatitis? Think…
Liver disease
7. Hirsutism, acne, acanthosis nigricans, obesity? Think
Polycystic ovary syndrome
8. Postcoital bleeding (spotting or bleeding after intercourse unrelated to menstrual cycle)? Think…
Cervical dysplasia, endocervical polyps
9.Galactorrhea, headache, visual-field disturbance?Think
Pituitary adenoma
10. Weight loss, excessive exercise, stress? Think
Hypothalamic suppression
11. Thyromegaly, weight gain, edema?
Hypothyroidism
12. Thyroid tenderness, tachycardia, weight loss, velvety skin? Think…
Hyperthyroidism
13. Bruising, jaundice, hepatomegaly? Think..
Liver disease
14. Enlarged uterus?
Pregnancy, leiomyoma, uterine cancer
15. Firm, fixed uterus? Think
Uterine cancer
16. Adnexal mass? Think..
Ovarian tumor, ectopic pregnancy, cyst
Uterine tenderness, cervical motion tenderness
PID, endometritis
Laboratory tests
Beta-subunit human chorionic gonadotropin
Pregnancy
Complete blood count with platelet count and coagulation studies
Coagulopathy
Liver function tests, prothrombin time
Liver disease
Thyroid-stimulating hormone
Hypothyroidism, hyperthyroidism
Prolactin
Pituitary adenoma
Blood glucose
Diabetes mellitus
DHEA-S, free testosterone, 173-hydroxyprogesterone if hyperandrogenic
Ovarian or adrenal tumor
Papanicolaou smear
Cervical dysplasia
Cervical testing for infection
Cervicitis, PID
Imaging and tissue sampling
Endometrial biopsy or dilatation and curettage
Hyperplasia, atypia, or adenocarcinoma
Transvaginal ultrasonography
Pregnancy, ovarian or uterine tumors
Saline-infusion sonohysterography
Intracavitary lesions, polyps, submucous fibroids
Hysteroscopy
Intracavitary lesions, polyps, submucous fibroids
endometerial glnds within the myometrium
–> suspect in a multiparous woman who is more than 40 years old presenting with menorrhagia (heavy bleeding) and dysmenorrhea (painful cramps), chronic pelvic pain. The uterus will be tender to palpation during pelvic exam and the uterus is usually enlarged. Definitive diagnosis requires histological analysis of a hysterectomy specimen, but can diagnose based on transvaginal ultrasound
TX: Hysterectomy or uterine artery embolization (if further children are not desired) or if a women desires childen she could benefit from hormonal medications for symptom relief such as LEVONORGESTREL-RELEASING IUD OR ORAL DIENOGEST
Most common pelvic tumor in women after age 50. 80% in AA women, 70% in white women). Fibroids are benign monoclonal tumors arising from the smooth muscle cells of the myometrium described by their location in the uterus (submucosal, intramural, subseroal, cervical).
***Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus. Somesubmucosal or subserosal fibroids may be pedunculated — hanging from a stalk inside or outside the uterus.***
S/S: Abnormal uterine bleeding, pelvic pressure and pain, reproductive dysfunction
dx: Transvaginal ultrasound
Tx: Surgery is usually the preferred method if causing extensive pain and discomfort..
Menopause causes relief due to steriod hormones decreasing when the menstrual cycle stops. Postmenopausal hormone may cause the pain to resume or current fibroids to grow but will not cause new fibroid growths.
Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women.
s/s thin, white, wrinkled skin localized in the labia minora and majora, but whitening could extend to perineum and around the anus in a keyhole pattern.
MOST COMMON SYMPTOMS: Painful defecations, rectal bleeding, dyspareunia, and dysuria.
fissuring or epithelia hyperplasia from rubbing is common. In end stages the vulva can become fused midline.
TREATMENT: Focused on symptom relief. topical corticosteriod ointment such as clobetasol propionate 0.05% QHS for 6-12 weeks followed by maintenace therapy 2-3x per week if symptoms improve.
Pelvic endometriosis lesions are categorized as superficial peritoneal , ovarian, and deeply infiltrating. These lesions contain fibrous tissue, blood, cysts in addition to endometrial glands and stroma.
Patho-
S/S-pelvic pain, painful period cramps (dysmenorrhea), dyspareunia (painful sexual intercourse). (occurs typically during reproductive years).
LAB: Does not cause lab abnormalities. Imaging will show endometriomas deep nodules of the rectovaginal septum and bladder detrusor and is staged based on severity.
Definitive diagnosis is made by biopsy and tissue histology to establish a true diagnosis and rule out other causes
NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam
NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam
Olivia presents with a complaint of “bumps” around her vagina. They are nonpainful and nonpruritic. Upon inspection, you note several flesh colored and pearly white papules with depressed centers. This appearance is characteristic of:
A. Condyloma lata
B. Genital warts
C. Malignant melanoma
D. Molluscum contagiosum
Pelvic support structures include:
A. Muscles and connective tissue of the pelvic floor
B. Fibromuscular tissue of the vaginal wall
C. Endopelvic connective tissue
D. All of the above NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.
Serum FSH indirectly measures ovarian function, with _ levels of FSH indicating normally functioning ovaries.
A. Lower
B. Median
C. Higher
D. Absent
The term used to describe painful cramps that occur with menstruation is:
A. Amenorrhea
B. Menorrhagia
C. Uterine atony
D. Dysmenorrhea
ORDER A CUSTOM-WRITTEN PAPER OR EXAM
One of the reasons that substance use is a concern in LBQ and TGNC communities is:
A. It has been shown to be a confirmed genetic risk
B. Bars and club scenes have long been safe spaces for gay, LBQ, ad TGNC people
C. A and B
D. None of the above
One of the reasons that substance use is a concern in LBQ and TGNC communities is:
A. It has been shown to be a confirmed genetic risk
B. Bars and club scenes have long been safe spaces for gay, LBQ, ad TGNC people
C. A and B
D. None of the above
n physical examination, pale atrophic depigmented tissue that has a “cigarette paper” appearance is consistent with:
A. Vaginal candidiasis
B. Contact dermatitis
C. Lichen sclerosis
D. Gonorrhea
A type of contraceptive that does not contain hormones is:
A. Paragard IUD
B. Mirena IUD
C. Nuvaring
D. Evra patch
The following are the four basic Caldwell-Moloy pelvic types.
A. Gynecoid, android, anthropoid, platypelloid
B. Gynecoid, antecoid, retrocoid, flexed
C. Anterverted, anteflexed, retroverted, retroflexed
D. None of the above
The least invasive way to assess bladder capacity is through:
A. Filling cystometrogram
B. 3-day voiding diary
C. Quantified standing stress test
D. Urethral pressure profile
Strong evidence shows that first trimester abortions, whenever performed safely, increases a women’s risks of:
A. Subsequent infertility
B. Ectopic pregnancy
C. Birth defects
D. None of the above NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.
Hirsutism is defined as:
A. Excessive terminal hair loss in women
B. Excessive nail growth in women
C. Brittle nail growth in women
D. Excessive terminal hair growth in women
EBP stands for:
A. Experimental based practice
B. Evidence based practice
C. Excellent bedside practice
D. None of the above
The ___ are easily sensitized and become engorged with blood during sexual arousal.
A. Labia Minora
B. Labia Majora
C. Bartholin’s glands
D. Mons pubis
Menopause is defined as:
A. Cessation of periods for six months
B. Cessation of periods for one year
C. Cessation of periods for two years
D. None of the above
Josefina is a 47-year-old patient with family history of diabetes. Her BMI is 30. She has been healthy except for medication-controlled hypertension. She has been very compliant with her appointments. Today, you tell her you need to check her blood sugar. She says “I just read an article that said I only need to have that checked every three years. You just checked it last year.” You tell her:
A. You are correct that in many people, testing should only be every year. However, due to your family history of diabetes and your current weight and BMI, this places you in the high-risk category and you should have this done yearly.
B. You are absolutely correct. I did not see in the chart that we had done that last year. I apologize. You are not due for that for two more years.
C. I’m not sure the article that you read but the recommendation is that every patient have this test done on a yearly basis.
D. Actually, we are supposed to be checking it every three months in high risk individuals, so we are behind on our testing!
All organizations recommend beginning screening mammograms in average-risk women at age____
A. <40 years
B. 40 to 44 years
C. 45 to 49 years
D. 55 years and older
The _ is a sensitive organ that is typically described as the female homologue of the penis.
A. Vulva
B. Clitoris
C. Skene’s gland
D. Bartholin’s gland
A person whose gender identity is the same as their sex when he or she was born is:
A. Bisexual
B. Pansexual
C. Intersexual
D. Cisgender NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.
When females go through puberty, the changes that occur are initiated by the production of:
A. Low amounts of estrogen
B. High amounts of estrogen
C. High amounts of progesterone
D. Low amounts of testosterone
Gale is 36 weeks pregnant. She calls the office to report that she has noticed a sticky fluid coming from her breasts. You let her know that this is most likely:
A. A serious concern and she needs to be evaluated immediately.
B. Colostrum, but she should be evaluated as it should not be noted during pregnancy.
C. Colostrum, which is commonly noted toward the end of the pregnancy.
D. A hormonal response that is indicative that she will most likely go into labor int the next 48 hours.
Endometrial polyps are most commonly identified by:
A. A speculum exam
B. A bimanual exam
C. A pap smear
D. A transvaginal ultrasound
When using the FIGO staging classification for cancer of the ovary, fallopian tube, and peritoneum, Stage I means:
A. The tumor is confined to the ovaries or fallopian tube(s)
B. The tumor involves one or both ovaries or fallopian tubes with pelvic extension or primary peritoneal cancer
C. The tumor involves one or both ovaries or fallopian tubes, or primary periotenal cancer, with cytologically and histologically confirmed spread to the peritoneum outside the pelvis
D. There is distant metastasis excluding peritoneal metastasis
First line pharmacologic treatment for women with PCOS is/are:
A. Progestin-only birth control pills
B. Combined oral contraceptives
C. Lasix
D. Multivitamins with folic acid
Metabolic syndrome typically includes the following except:
A. Sudden weight loss
B. Obesity
C. Insulin resistance
D. Dyslipidemia
E. All of the above NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.
ORDER A CUSTOM-WRITTEN PAPER OR EXAM HERE
On vaginal exam you find that Polly’s cervix is in the most common position, which is:
A. Antiflexion
B. Midline
C. Posterior
D. Backward
Clinicians can participate in primary sexual violence prevention by applying individual prevention skills, such as:
A. Challenging behaviors in others that promote violence
B. Engaging in healthy professional and personal relationships
C. Learning to identify risk factors for sexually abusive behaviors
D. B and C
E. A, B, and C
The following is/are types of sexual violence.
A. Intentional touching of the breast
B. Pornography
C. Threats of sexual violence
D. All of the above
The only antimicrobial medications that are effective against Trichomoniasis vaginalis are:
A. tinidazole or metronidazole
B. Amoxicillin or Augmentin
C. doxycycline or minocycline
D. cephalexin or ceftriaxone
The use of a pain rating scale may assist the clinician to comprehend the intensity of a woman’s pain. Example(s) of pain rating scale(s) include:
A. Numeric ranking scale
B. Visual analog scale
C. Verbal descriptive scale
D. All of the above
The use of a pain rating scale may assist the clinician to comprehend the intensity of a woman’s pain. Example(s) of pain rating scale(s) include:
A. Numeric ranking scale
B. Visual analog scale
C. Verbal descriptive scale
D. All of the above
A cluster of mild to moderate physical and psychological symptoms that occur during the late luteal phase of menses and resolve with menstruation is the definition of
A. Premenstrual dysphoric disorder
B. Premenstrual syndrome
C. Menstrual mood swings
D. Psychosocial syndrome
The timing of an adolescent growth spurt typically occurs __ in puberty than it does for boys.
A. One year later
B. Two years earlier
C. At a similar time
D. None of the above
The following symptoms are consistent with PMS except:
A. Depression
B. Confusion
C. Breast tenderness
D. Uncontrollable fits of laughter NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.
Reproductive coercion includes behaviors:
A. Related to pressuring or coercing a person to have sex without using physical force
B. Related to pressuring or coercing a person to have sex using physical force
C. That interfere with contraception use and/or pregnancy
D. Any of the above
Women in the following profession have a higher rate of UTI
A. Nursing
B. Housecleaning
C. Secretarial
D. Those who do not work outside the home
Women in the following profession have a higher rate of UTI
A. Nursing
B. Housecleaning
C. Secretarial
D. Those who do not work outside the home
Clinicians are required to report certain STIs to their state public health officials. These include:
A. Chlamydia
B. Gonorrhea
C. Syphilis
D. A and B
E. A, B, and C
Bone density testing for osteoporosis should start at age for women and age for men.
A. 60; 60
B. 65; 70
C. 50; 60
D. 65; men do not need this test
A pharmacologic treatment for patients with Hydradenitis Suppurativa (HI) may include
A. Clindamycin
B. Minocycline
C. Metformin
D. All of the above
The following is/are risk factor(s) for bacterial vaginosis.
A. Menstrual bleeding
B. Douching
C. Lack of condom use
D. B and C
E. A, B, and C
All of the following are risk factors for UTI, except:
A. Previous UTI
B. Infrequent sexual activity
C. Incomplete bladder emptying
D. Obesity
n women with PCOS, polycystic ovaries are due to:
A. Excessive ovulation
B. Chronic anovulation
C. Using birth control for an extended period of time
D. None of the above
The following symptoms are associated with peri-menopause and menopause.
A. Excessive eye tearing
B. Headache
C. Fatigue
D. B and C
E. All of the above
Just prior to ovulation, rising levels of estradiol increases the amount of cervical mucus, making it:
A. Thick and sticky
B. Absent
C. Thin and watery
D. Yellowish and thicker
The most common type of UTI affecting women is:
A. Pyelonephritis
B. Asymptomatic bacteriuria
C. Acute bacterial cystitis
D. None of the above
Criteria for clinical diagnosis of bacterial vaginosis include the presence of three out of four of the following Amsel criteria:
A. Yellowish thick vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination
B. Yellowish thick vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of clue cells on microscopic examination
C. White, thin adherent vaginal discharge, pH equal or greater than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination
D. Yellowish thick vaginal discharge, pH equal or less than 4.5; positive whiff/KOH test; presence of WBCs on microscopic examination
The contraceptive implant that is currently available in the U.S. is:
A. Norplant
B. Implanon
C. Nexplant
D. Nexplanon
Approximately 50% to 70% of women with PCOS are insulin resistant. Insulin resistance often results in:
A. Compensatory hyperinsulinemia
B. Compensatory hypoinsulinemia
C. Excessively low blood sugars
D. Weight loss
evidence from randomized trials on intimate partner violence screening support the following intervention(s) for women of childbearing age:
A. Counseling
B. Home visits
C. Mentoring support
D. A and C
E. A, B, and C NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam
Nearly _ pregnant women have been abused by the partner.
A. 1 in 20
B. 1 in 15
C. 1 in 6
D. 1 in 2
When looking from a feminist perspective at research studies, one of the great concerns is that:
A. There are too many studies involving women
B. Most of the research is qualitative, which limits the applicability
C. For many years, studies were done primarily on men with the findings being generalized to women
D. None of the above
Marianne presents for a well woman exam. In gathering her history, she tells you she has been pregnant 3 times. She has two children, both born at 39 weeks, and had one miscarriage. Using the GTPAL system, you note that in her chart as the followingA
A. G3 T2 P0 A1 L2
B. G3 T0 P2 A1 L2
C. G2 T2 P0 A1 L2
D. G2 T2 P2 A1 L3
The frontline analgesics for painful menstrual cramps are:
A. Opioids
B. Corticosteroids
C. NSAIDs
D. Hormone therapy
The endometrial cycle has three phases, which are:
A. Proliferative, luteal, menstrual
B. Luteal, menstrual, post-menstrual
C. Proliferative, secretory, menstrual * (pg. 91)
D. Secretory, luteal, menstrual
A progesterone challenge test that produces withdrawal bleeding is indicative of:
A. No ovarian function
B. Infertility
C. Functioning ovaries
D. Uterine cancer
Neisseria gonorrhea is a _ bacteria
A. Gram positive
B. Gram neutral
C. Gram negative
D. None of the above
Ovarian failure is diagnosed when estrogen production is identified while the serum FSH is ___.
A. Low; Low
B. Low; High
C. High; Low
D. High; High
A waiting period of __ between bariatric surgery and pregnancy is recommended.
A. 6-12 months
B. 6-18 months
C. 12-24 months
D. 3-5 years
Trichomonas vaginalis can be asymptomatic, but when symptomatic, the vaginal discharge tends to be:
A. Thick and green non odorous
B. Yellow to green frothy
C. Bloody
D. Thin and watery NRNP – 6552 Advanced Nurse Practice in Reproductive Health Care Midterm Exam.