620 Adult - Women's Health - AG and

FNP Certification Exam 4th ed. Winland-

Brown and Dunphy
Exam 2023
a sexually active woman should be aware that genital herpes simplex virus:
a. may be transmitted to a partner or newborn even in the absence of lesions because
of viral shedding
b. is suppressed during menstruation, physical or emotional stress,
immunosuppression, sexual intercourse, and pregnancy
c. recurrences usually last the same length of time as the initial outbreak
d. requires the use of condoms only during outbreaks - ANS-a. may be transmitted to a
partner or newborn even in the absence of lesions because of viral shedding

a 17 y/o female pat requests to start Depo-provera injections as her method of birth
control. She discloses that she has had four sexual partners in the past year. Her LMP
was 12 days ago and she had unprotected intercourse 3 days ago. The appropriate
management for this pt would be to:
a. administer the injection today
b. advise her to use another method for now and return with her next menses
c. give the injection after a negative pregnancy test and tell her to use condoms for the
next 7 days
d. give the injection and tell her to use a barrier method for 7 days - ANS-b. advise her
to use another method for now and return with her next menses

in a premenopausal woman, the biggest heart attack risk factor is:

a. cigarette smoking
b. family hx
c. sedentary lifestyle
d. obesity - ANS-a. cigarette smoking

first line tx for polycystic ovary syndrome is:

a. a bilateral oophorectomy
b. oral testosterone therapy
c. a combination of diet modification, wt loss, and stress management
d. a laparoscopy with a bilateral wedge resection - ANS-c. a combination of diet
modification, wt loss, and stress management

if a woman is using the basal body temperature (BBT) method of birth control and does
not want to become pregnant, when would you tell her to avoid unprotected
intercourse?
a. from the beginning of the menstrual cycle until the BBT has been elevated for 3 days
b. whenever the BBT is elevated
c. whenever the BBT is lowered
d. fromt he end of the menstrual cycle until the BBT has been low for 5 days - ANS-a.
from the beginning of the menstrual cycle until the BBT has been elevated for 3 days

which of the following is a sexually transmitted infection?

a. candida vaginitis
b. trichomonal vaginitis
c. atrophic vaginitis
d. lactobacilli vaginitis - ANS-b. trichomonal vaginitis

in a pt dx with cervical gonococcal infection, you would also suspect a co-infection with:
a. candidiasis
b. syphilis
c. trichomoniasis
d. chlamydia - ANS-d. chlamydia

Jane, age 27, is c/o of lower abdominal pain. After doing some lab studies, you find
leukocytosis, an elevated erythrocyte sed rate and an elevated C-reactive protein level.
Which is the most appropriate dx?
a. ovarian cyst
b. PID
c. tubal pregnancy
d. diverticulitis - ANS-b. PID

human papillomavirus may lead to:

a. pelvic inflammatory disease
b. molluscum contagiosum
c. cervical dysplasia
d. genital herpes - ANS-c. cervical dysplasia

Gean, a 33 y/o female pt, c/o external vaginal irritation after adding new fabric softener
to her laundry. You have dx her with reactive vaginitis. The tx of choice for this condition
includes:
a. metronidazole (flagyl) 500mg BID x 7 days
b. conjugated vaginal estrogen cream externally every day for 1 wk
c. rewashing undergarments without fabric softener and applying petroleum jelly to the
affected area
d. rewashing undergarments without fabric softener and applying corticosteroids to the
affected area - ANS-d. rewashing undergarments without fabric softener and applying
corticosteroids to the affected area

a dancer from an adult club down the street comes in for a renewal of ther birth control
pill prescription. She says that everything is fine. On exam, you find grayish-white
vaginal discharge, greenish cervical discharge, and cervical motion tenderness. Which
of the following differential dx is most UNlikely?
a. gonorrhea
b. interstitial cystitis
c. bacterial vaginosis
d. chlamydia - ANS-b. interstitial cystitis

leiomyomas are found:

a. within the uterine wall
b. on the vaginal wall
c. within the cervix
d. on the fallopian tube - ANS-a. within the uterine wall

when a woman complains of dyspareunia in the lower back during orgasm, you should
consider:
a. endometriosis
b. cystitis
c. vaginitis
d. causes r/t pelvic inflammatory disease - ANS-a. endometriosis

a 27 y/o female presents to your office for a Mirena (levonorgestrel intrauterine system)
insertion. She reports that her menses started 3 days ago and is normal. How soon
after insertion will she be able to safely rely on it for contraception?
a. immediately
b. after 48 hrs
c. in one wk
d. in one month - ANS-a. immediately

Melody, age 50, desires hormone replacement therapy (HRT) for her hot flashes, which
she can't stand. You have discussed the pros and cons and given her some alternative
suggestions. Her mother had a hx of osteoporosis. You have decided to initiate therapy
for one year. She asks you if she also needs to take calcium or vitamin D for prevention
of osteoporosis. How do you respond?
a. research has shown that HRT alone is sufficient to protect against osteoporosis
b. yes, calcium intake should be increased to 1200mg/day along with 600mg of vitamin
D to decrease bone turnover and increase intestinal absorption
c. if you decide to take calcium and vitamin D, you can stop the HRT
d. if you are getting sufficient exercise, you don't need to take calcium and vitamin D -
ANS-b. yes, calcium intake should be increased to 1200mg/day along with 600mg of
vitamin D to decrease bone turnover and increase intestinal absorption

Jane, age 60 asks, you about taking alendronate (Fosamax). What do you tell her about
using the medication?
a. if you decide to take it, stick with a lower dose of 5mg because the side effects are
much worse with a 10mg dose
b. fosamax works better in younger women, so you should start this now rather than
wait until you're 70
c. you should take a daily dose because the wkly dose is not as effective
d. in addition to its efficacy in the tx of osteoporosis in postmenopausal women, it is also
useful for the prevention of osteoporosis - ANS-d. in addition to its efficacy in the tx of
osteoporosis in postmenopausal women, it is also useful for the prevention of
osteoporosis

which type of breast cancer involves infiltration of the nipple epithelium and has an initial
sx of itching or burning of the nipple?
a. ductal cancer
b. Paget's disease
c. mammaryd uct ectasia
d. fibroadenoma - ANS-b. Paget's disease

which type of incontinence has an associated sx of recurrent cystitis?

a. stress incontinence
b. urge incontinence
c. overflow incontinence
d. function incontinence - ANS-a. stress incontinence

the most common type of vaginal infection is:

a. candidiasis
b. trichomoniasis
c. gonorrhea
d. bacterial vaginosis - ANS-d. bacterial vaginosis

which of the following is an indication for a colposcopy?

a. pap smear showing dysplasia
b. recurrent STIs
c. HIV infection
d. hx of leiomyomas - ANS-a. pap smear showing dysplasia

which of the following statements do you use when instructing women about their fertile
period (when they are most likely to become pregnant)?
a. ovulation occurs on the 14th day, plus or minus 2 days, before the next menses
b. sperm are viable for 24 hrs
c. the ovum is viable for 6 hrs
d. the ovaries always release one ovum per month - ANS-a. ovulation occurs on the
14th day, plus or minus 2 days, before the next menses

Jenn, a 25 y/o female pt, c/o dysuria. In taking a thorough hx to formulate a dx, it is
most important to ask:
a. do you have painful intercourse?
b. do you have an associated vaginal discharge or irritation?
c. do you also have a problem with defecation?
d. do you have stress incontinence? - ANS-b. do you have an associated vaginal
discharge or irritation?
Sally, age, 21 is taking an oral contraceptive. She c/o acne. How should you adjust the
estrogen in the oral contraceptive?
a. increase the estrogen content
b. decrease the estrogen content
c. delete the estrogen content
d. no adjustment should be made to the estrogen content - ANS-a. increase the
estrogen content

Mary, age 59, presents with depression. According to the diagnostic criteria for a major
depressive d/o, which of the following criterion needs to be met?
a. the depression must have a specific cause, like alcohol, drugs, medication s/e, or
physical illness
b. the sxs must be severe enough to upset the cl'ts daily routine or to impact his/ or her
work or interfere with relationships
c. the depression may be a normal reaction to the death of a loved one
d. there must be some type of sleep disturbance - ANS-b. the sxs must be severe
enough to upset the cl'ts daily routine or to impact his/ or her work or interfere with
relationships

the best method to dx uterine polyps is a:

a. hysteroscopy
b. dilation and curettage
c. colposcopy
d. laparoscopy - ANS-a. hysteroscopy

Dolly, is to undergo a cone-needle biopsy for a suspicious breast mass. This procedure
includes:
a. 21 or 22 gauge needle that is used to aspirate cells from the lesion for analysis
b. removal of a large core of tissue from the lesion for histological eval utilizing a large-
gauge cutting needle
c.removal of a wedge of tissue for exam
d. removal of the entire lesion - ANS-b. removal of a large core of tissue from the lesion
for histological eval utilizing a large-gauge cutting needle

which of the following lifestyle factors is associated with an increased risk for breast
cancer?
a. being underweight
b. having one to two drinks of alcohol per day
c. smoking
d. eating a low-fat diet - ANS-c. smoking

Susan says that her previous doctor never discussed why he took her off HRT. You
share with her some of the results of the women's Health Initiative (WHI). which
statement is true regarding the study?
a. estrogen plus progestin increased the risk of a cardiac event in apparently healthy
women
b. persons on HRT are at a higher risk of colorectal cancer
c. postmenopausal hormones do not actually prevent fxs of the hip
d. estrogen alone is associated with a greater risk of breast cancer than a combination
of estrogen plus progestin - ANS-a. estrogen plus progestin increased the risk of a
cardiac event in apparently healthy women

Mrs. W. would like to schedule an appt to bring her 18 y/o daughter in to see you for her
first gyn exam and Pap smear. the most appropriate reply would include:
a. I would be happy to see your daughter and complete her gyn exam and Pap smear
b. your daughter does not need a gyn exam and Pap at this time
c. Your daughter only needs a gyn exam and Pap smear when she becomes sexually
active
d. I would be happy to see your daughter and complete her gyn exam; however, she
does not need a Pap smear until the age of 21 - ANS-d. I would be happy to see your
daughter and complete her gyn exam; however, she does not need a Pap smear until
the age of 21

women who take oral contraceptives are less likely to experience:

a. human papillomavirus infection
b. migraine headace
c. iron -deficiency anemia
d. herpes simplex virus - ANS-c. iron -deficiency anemia

the average age of menopause int he US is:

a. 45 yrs
b. 48 yrs
c. 50 yrs
d. 53 yrs - ANS-c. 50 yrs

a 26 y/o female comes to your office to discuss birth control options. Her hx includes
migraine headaches with aura while on combination oral contraceptives in the past. She
does not want to become pregnant. Which of the following birth control options would be
the best choice for her?
a. combined hormonal contraceptive pills
b. ortho evra patch
c. mirena IUD
d. vaginal Nuvaring - ANS-c. mirena IUD

unilateral galactorrhea may be present with:

a. an intraductal papilloma
b. a woman who is lactating
c. a ruptured breast implant
d. pregnancy - ANS-a. an intraductal papilloma

which of the following drugs may have their effects enhanced when used in combination
with an oral contraceptive?
a. beta blockers
b. oral anticoagulants
c. antacids
d. anti-convulsants - ANS-a. beta blockers

which of the following drugs may diminish the effectiveness of oral contraceptives?
a. beta blockers
b. oral anticoagulants
c. antibiotics
d. oral hypoglycemis - ANS-c. antibiotics

which of the following drugs may have their effects diminished when used in
combination with an oral contraceptive?
a. corticosteroids
b. oral anticoagulants
c. antibiotics
d. anticonvulsants - ANS-b. oral anticoagulants

during a pelvic exam, you ask Mrs. K to Valsalva (strain). While doing this, a pouching is
seen on the anterior wall of the vagina. This is indicative of:
a. a cystocele
b. a rectocele
c. an enterocele
d. a uterine prolapse - ANS-a. a cystocele

Sally has a dx of a chlamydia vaginal infection. You believe that is is questionable

whether she will fill the prescription that you write or take it for 7 days as order. What
would you do?
a. give azithromycin (zithromax) 1g PO now
b. emphasize the importance of the drug and tell her the consequences of not taking it.
c. send out the public health nurse to follow up on whether she takes the drug for 7 days
d. assume that Sally is an adult and will follow your instructions - ANS-a. give
azithromycin (zithromax) 1g PO now

infertility is best defined as the:

a. inability to conceive with multiple sex partners
b. inability to conceive for 9 months of unprotected intercourse when both partners are
younger than 30 yrs of age
c. state of voluntary childlessness
d. inability to conceive after 1 full yr of unprotected intercourse - ANS-d. inability to
conceive after 1 full yr of unprotected intercourse

Reiter's syndrome is a complication of:

a. bacterial vaginosis
b. syphilis
c. chlamydia
d. gonorrhea - ANS-d. gonorrhea

Mrs. H. inquires about why she needs progestereone in addition to her estrogen for
hormone replacement. Women who have an intact uterus need to add progesterone to
their prescribed estrogen because progestin:
a. assists in relieving the typical hot flashes ofmenopause
b. reduces the incidence of endometrial hyperplasia and cancer
c. decreases the risk of osteoporosis
d. controls mood swings - ANS-b. reduces the incidence of endometrial hyperplasia and
cancer

a 21 y/o woman comes to your ofice and reports a hx of genital warts. In reference to
the HPV vaccination (Gardasil or Cervarix), she should be educated that:
a. she is not in the correct age grp and is not a candidate for the vaccination
b. she should receive the HPV vaccination
c. she already has been exposed to HPV; therefore, she is not a candidate for the
vaccine
d. there is a vaccine coming out shortly specifically for those who have been exposed.
She should wait - ANS-b. she should receive the HPV vaccination

Jane wants to use some form of birth control, but because she is getting married next
year,s he wants to be able to stop the birth control method after the wedding and have
her fertility restored almost immediately. Which method do you recommend for her?
a. birth control pills
b. vaginal ring
c. depot-medroxyprogesterone acetate (DMPA)
d. Lea's shield - ANS-d. Lea's shield

Belle is breastfeeding her 3 month old infant with no supplementation./ She says she
has heard that she cannot get pregnant during this time. What do you tell her?
a. it is highly likely that you may become pregnant, so you should use another method
of birth control
b. yes, you are safe for as long as you breastfeed
c. for the first 6 months, if you breastfeed and have very little supplementation, your
chances are less than 2% that you'l get pregnant
d. you are more at risk for getting pregnant now because of your fluctuating hormone
levels - ANS-c. for the first 6 months, if you breastfeed and have very little
supplementation, your chances are less than 2% that you'l get pregnant

the most common reason for surgery for macromastia is:

a. back and shoulder pain
b. breast cancer
c. fibrocystic breast disease
d. inability to breastfeed - ANS-a. back and shoulder pain
You have just finished a Pap smear on Sally, age 39. during the wet mount, you see
cells with bacteria adherent to the cell wall giving it a stippled, granular appearance.
What do you suspect?
a. candidiasis
b. bacterial vaginosis
c. trichomoniasis
d. cervicitis - ANS-b. bacterial vaginosis

the majority of breast carcinomas are found in which anatomical site in the breast?
a. around the areola
b. in the upper outer quadrant
c. in the lower half of the breast
d. toward the sternum - ANS-b. in the upper outer quadrant

Ann, age 19, is going to begin taking birth control pills. She asks you if she is safe
immediately. How do you respond?
a. yes, you should not get pregnant once you start the pill. However, it doesn't protect
you from STIs
b. for the first month, you need to be on a backup birth-control method. However, it
doesn't protect you from STIs
c. a second birth control method needs to be used during intercourse for the first 7 days
while taking the pill. However, it doesn't protect you from STIs
d. until you have your second period (cycle) with the pill, you are not considered safe -
ANS-c. a second birth control method needs to be used during intercourse for the first 7
days while taking the pill. However, it doesn't protect you from STIs

J. age 42 presents for her well-woman exam and you notice "dimpling" on her left
breast. Your initial reaction is that is may possible be:
a. breast cancer
b. fibrocystic breast disease
c. Paget's disease
d. striae from recent dieting - ANS-a. breast cancer

what is the most common cause of mastitis in breastfeeding women?

a. escherichia coli
b. streptococcus
c. mycobacterium tuberculosis
d. staphylococcus aureus - ANS-d. staphylococcus aureus

which of the following drugs given to nursing mothers may cause a reduction in the milk
supply?
a. antihistamines
b. antithyroid medication
c. oral contraceptives
d. laxatives - ANS-c. oral contraceptives
J. has severe pain monthly with her fibrocystic breast disease. Which medication do you
suggest she try?
a. micronized estradiol (estrace)
b. danazol (danocrine)
c. paroxetine (paxil)
d. venlafaxine (effexor) - ANS-b. danazol (danocrine)

emotional support is best given to the clt with a sexually transmitted infection by:
a. offering many alternatives
b. authentic active listening
c. assuring the clt that everything will be okay
d. emphasizing the duration of the disease - ANS-b. authentic active listening

M., age 40 has been given a dx of rheumatoid arthritis. She asks you whether she
should continue taking her birth control pills. You tell her:
a. to check with her rheumatologist
b. to stop
c. to continue
d. the dose will have to be altered - ANS-c. to continue

Mrs. L. would like to be fitted for a diaphragm. She has been on numerous hormones int
he past and does not like the side effects. It is important to remember that when
properly fitting a pt for a diaphragm, it should:
a. allow a fingertip between it and the pubic arch
b. be small enough to allow for vaginal expansion
c. lie snugly over the pubic arch and under the cervix
d. provide firm tension against the vaginal walls - ANS-a. allow a fingertip between it
and the pubic arch

herpes implex virus can be potentially acquired through maternal transmission. This is
least likely to occur:
a. before labor
b. during delivery
c. postnatally
d. during the neonatal period - ANS-d. during the neonatal period

a tx used to improve the chance of pregnancy in an infertile woman who has minimal or
mild endometriosis is:
a. laparoscopic resection or ablation of the lesions
b. dilation and curettage
c. the use of gonadotropin-releasing hormone analogues
d. the use of birth control pills for 3 months and then abruptly stopping - ANS-a.
laparoscopic resection or ablation of the lesions

S., age 29, c/o premenstrual syndrome. She state she was told that changing her diet
might help in managing some of the sxs. What changes in her diet do you recommend?
a. increase her intake of protein
b. increase her intake of complex carbohydrates
c. increase her intake of sale and salty foods
d. decrease her intake of fatty foods - ANS-b. increase her intake of complex
carbohydrates

which form of estrogen is secreted in the greatest amount by the ovaries during the
reproductive yrs and considered most potent?
a. estrone (E1)
b. estradiol (E2)
c. estriol (E3)
d. the potency and secretion of all of the above are in equal amts - ANS-b. estradiol
(E2)

J., age 26, who has genital herpes, ask if her partner has to use a condom during
sexual intercourse even if she does not have a visible lesion. How do you respond?
a. yes, we are not sure if its still transmitted when the lesions are not visible, so it is
better to be on the safe side
b. no, you are not contagious when the lesions are not visible
c. no, use of spermicidal agent is all that is required
d. yes, shedding of the herpes simplex virus from mucocutaneous surfaces int he
absence of visible lesions is a primary mode of transmission - ANS-d. yes, shedding of
the herpes simplex virus from mucocutaneous surfaces int he absence of visible lesions
is a primary mode of transmission

when a woman has extreme spasticity, which position should she assume for a Pap
smear?
a. OB stirrups position
b. knee-chest position while prone
c. v-shaped position without stirrups
d. side-lying position - ANS-b. knee-chest position while prone

on PE, J., has pubic hair that spreads over her mons pubis with a slt lateral spread. In
addition, her breast development shows breast enlargement with secondary mound
formation by the developing areola. Which Tanner best describes J.'s development?
a. stage II
b. stage III
c. stage IV
d. stage V - ANS-c. stage IV

of the sxs listed below, the most commonly expressed sx of women with premenstrual
syndrome is:
a. fatigue
b. depression
c. breast tenderness
d. swelling of the extremities - ANS-a. fatigue
the Mobiluncus species is responsible for which sexually transmitted infection?
a. condylomata acuminata
b. bacterial vaginosis
c. human papillomavirus
d. lymphogranuloma venereum - ANS-b. bacterial vaginosis

an occurrence of genital herpes is:

a. cured with acyclovir
b. best managed with trichloroacetic acid 80%-90% applied directly to the lesion
c. expected to be completely resolved within 21 days (for the primary lesion)
d. not a factor in continuing with intercourse - ANS-c. expected to be completely
resolved within 21 days (for the primary lesion)

L., age 43 comes to your office in tears, stating that last night she had unprotected sex
and forgot to take her birth control pill. she wants to know about the morning -after pill.
You tell her:
a. if your period does not start at the schedule time, come back to see me
b. I'll go ahead and order the estrogen-only postcoital contraception pill
c. I'll go ahead and order the Yuzpe regimen
d. I'll refer you to a gynecologist - ANS-c. I'll go ahead and order the Yuzpe regimen

L., age 38 states that she has not had a pelvic exam in 5 yrs because she does not like
having the digital rectal exam. How do you respond?
a. let's schedule an exam now because women no longer need a rectal exam with
routine pelvic exams
b. ok, we'll do a pelvic, and I'll just put refused on the chart to cover my liability
c. we really need to don one because the rectal exam has been shown to pick up many
abnormalities such as rectal polyps
d. I'll try to be quick with the rectal exam and get it over with - ANS-a. let's schedule an
exam now because women no longer need a rectal exam with routine pelvic exams

Lactobacilli in the vagina:

a. decreases glycogen metabolism
b. maintains an acid pH range
c. increases the development of WBCs
d. maintains an alkaline pH range - ANS-b. maintains an acid pH range

D., is a 23 y/o pt dx with dyspareunia. Which of the following is NOT a cause for this
condition?
a. vulvovaginitis
b. an incompletely stretch hymen
c. vaginismus
d. multiple pregnancies - ANS-d. multiple pregnancies
there are many causes of amenorrhea. In ballet dancers or marathon runners, which
anatomical structure is the probable cause?
a. outflow tract
b. ovary
c. anterior pituitary
d. hypothalamus - ANS-d. hypothalamus

what is the most common virus to be transmitted in utero?

a. cytomegalovirus
b. rubella
c. varicella
d. toxoplasmosis - ANS-a. cytomegalovirus

S. has been dx with fibrocystic breast disease. Which of the following may exacerbate
the condition?
a. daily dose of aspirin
b. spicy foods
c. chocolate
d. wearing tight bras - ANS-c. chocolate

how long can the vaginal contraceptive ring (Nuvaring) be out of the vagina before an
additional form of contraception is necessary?
a. 3o min
b. one hr
c. 2 hrs
d. 3 hrs - ANS-d. 3 hrs

which of the following ovarian tumors or cysts has the potential for malignancy?
a. follicle cysts
b. Brenner's tumor
c. fibroma
d. secondary ovarian tumors - ANS-d. secondary ovarian tumors

the Jameses are thinking about going for infertility counseling because they have been
married for 5 yrs and have been unable to conceive. They ask you whether the man or
the woman is usually the cause of the infertility. What do you tell them about the
etiology of infertility?
a. in most cases, infertility is related to a female factor
b. in most cases, infertility is related to a male factor
c. in the majority of cases, the etiology cannot be identified
d. male and female infertility rates are almost the same in the majority of cases - ANS-d.
male and female infertility rates are almost the same in the majority of cases

B., age 24 c/o urgency, frequency, and dysuria. Your dipstick test shows no hematuria,
and her urine culture shows no growth. What is your next action?
a. you suspect a sexually transmitted infection, so you obtain a culture of the urethra, do
a potassium hydroxide wet prep, and obtain another urine culture
b. you suspect urethra irritation, so you tell her to take showers, not bubble baths, and
wear white, dry underwear and loose-fitting clothing
c. you suspect a UTI not visible yet on culture, so you start her on Bactrim DS
d. you suspect that the vulva is irritated. You tell her to take a relaxing shower and dry
the area well and come back in 1 wk if there is no improvement - ANS-a. you suspect a
sexually transmitted infection, so you obtain a culture of the urethra, do a potassium
hydroxide wet prep, and obtain another urine culture

J., has a seizure disorder and wants to get pregnant. What is the drug of choice for her
during pregnancy
a. valproate (depakene)
b. trimethadione (tridione)
c. phenobarbital (luminal)
d. phenytoin (dilantin) - ANS-c. phenobarbital (luminal)

when premenstrual syndrome sxs do not respond to dietary and nonmedical therapies,
which of the following drugs might you try?
a. antidepressants
b. antihistamines
c. corticosteroids
d. anticholinergics - ANS-a. antidepressants

a vagina Ph of 4.2 is an expected finding in:

a. a healthy prepubertal age girl
b. a woman with trichomoniasis vaginalis
c. a postmenopausal woman with atropic vaginitis
d. a healthy woman of reproductive age - ANS-d. a healthy woman of reproductive age

J. is nursing her 8 wk old baby and states that he is very irritable and sleeps poorly.
What medication or substance do you ask her if she is taking or using?
a. cimetidine
b. ergotamine
c. nicotine
d. caffeine - ANS-d. caffeine

which of the following conditions is a contraindication to using the copper IUD?

a. hx of ectopic pregnancy
b. nulliparity
c. tx cervical dysplasia
d. heart disease - ANS-d. heart disease

candidiasis is more common in:

a. teenage girls
b. women on low fat diets
c. women with diabetes
d. women with frequent UTIs - ANS-c. women with diabetes

which blood tumor marker is highly specific to epithelial ovarian cancer?

a. PSA
b. CA 125
c. CA 15-3
d. CA 19-9 - ANS-b. CA 125

emergency contraception refers to:

a. an induced abortion inan emergency room
b. quickly starting on birth control pills in anticipation of sexual intercourse
c. having a medroxyrogesterone injection in the ER q12 wks
d. taking emergency contraceptive pills (ECPs) - ANS-d. taking emergency
contraceptive pills (ECPs)

toxic shock syndrome (TSS) may be causes by which of the following?

a. tampon contamination with staphylococcus aureus
b. a short vaginal canal
c. the use of superabsorbent tampons
d. a UTI involving the bladder and kidneys - ANS-a. tampon contamination with
staphylococcus aureus

Mrs. G., called the office to make an appt for her annual Pap smear. She needs to be
given the following instructions prior to her appt:
a. insert nothing in the vagina for 24 hrs before the exam
b. douching enhances visualization of the cervix and should be done before the appt
c. an infection or menstrual period is no reason to cancel the appt
d. the procedure is completely painless - ANS-a. insert nothing in the vagina for 24 hrs
before the exam

Procidentia is a:
a. cystocele
b. rectocele
c. vaginal fistula
d. third-degree uterine prolapse - ANS-d. third-degree uterine prolapse

endometrial cancer, hirsutism, acne, breast cancer, increased risk of diabetes,infertility,

menstrual bleeding problems, and an increased risk of cardiovascular disease are
clinical consequences of:
a. mastalgia
b. menorrhagia
c. endometriosis
d. persistent anovulation - ANS-d. persistent anovulation

menses at irregular intervals with excessive flow and duration is defined as:
a. oligomenorrhea
b. polymenorrhea
c. menorrhagia
d. metrorrhagia - ANS-d. metrorrhagia

the most likely cause of amenorrhea is:

a. an anatomical deviation
b. a genetic factor
c. an endocrine abnormality
d. pregnancy - ANS-d. pregnancy

M., age 42, is having dysfunctional uterine bleeding (DUB) and cannot take oral
contraceptives due to a hx of a blood clot (emboli). Management includes which
medication?
a. medroxyprogestone
b. ethinyl estradiol
c. conjugated estrogen
d. piroxicam - ANS-a. medroxyprogestone

characteristics of polycystic ovary syndrome include:

a. hirsutism, thinness, hypoinsulinemia
b. menopausal onset, vitilgo, hyperinsulemia
c. alopecia, thinness, abdominal cramping
d. premenarchial onset, obesity, hyperinsulinemia - ANS-d. premenarchial onset,
obesity, hyperinsulinemia

dysfunctional uterine bleeding is usually associated with:

a. pregnancy
b. anovulation
c. genital tumor
d. inflammation - ANS-b. anovulation

S., states that she has heard that douching effectively washes out the sperm after
intercourse and that she has been using this as a method of birth control. Which of the
following statements about douching is true?
a. douching prevents sperm from entering the uterus
b. douching should be used at least once a month after menses if not used after
intercourse
c. douching is a reliable contraceptive
d. douching may increase the risk of ectopic pregnancy - ANS-d. douching may
increase the risk of ectopic pregnancy

C., says that her healthcare provider wants to do a colposcopy. She ask you what this
is. You tell her that a colposcopy:
a. visualizes the cervical, vaginal, or vulvar epithelium under magnification to identify
abnormal areas that may require a biopsy
b. involves removal of one or more areas of the endometrium by means of a curette or
small aspiration device without cervical dilation
c. allows visual exam of the uterine cavity with a small fiber-optic endoscope passed
through the cervix
d. allows visualization of the abdominal and pelvic cavity through a small fiber-optic
endoscope passed through a subumbilical incision - ANS-a. visualizes the cervical,
vaginal, or vulvar epithelium under magnification to identify abnormal areas that may
require a biopsy

which type of cyst fo the female reproductive system usually results in pain, redness, a
perineal mass, and dyspareunia?
a. ovarian cyst
b. Bartholin's cyst
c. Gardner's cyst
d. Nabothian cyst - ANS-b. Bartholin's cyst

what is the positionof the uterus when the cervix is on the anterior vaginal wall?
a. midposition
b. retroverted
c. retroflexed
d. anteverted - ANS-d. anteverted

small-quantity incontinence with nearly continous dribbling is symptomatic of which kind

of incontinence?
a. stress incontinence
b. urge incontinence
c. overflow incontinence
d. functional incontinence - ANS-c. overflow incontinence

which of the following terms describes the bluish or purplish discoloration of the vulva,
vagina, and a portion of the cervix that occurs in pregnancy?
a. Goodell's sign
b. Hegar's sign
c. Piskacek's sign
d. Chadwick's sign - ANS-d. Chadwick's sign

which glands are posterior on each side of the vaginal orifice and open onto the sides of
the vestibule int he groove between the labia minora and hymen?
a. Bartholin's glands
b. Skene's glands
c. paraurethral glands
d. cystocele - ANS-a. Bartholin's glands

thelarche is the first sign of puberty in most girls. It usually occurs at about what age?
a. 8 yrs
b. 10 yrs
c. 11 yrs
d. 13 yrs - ANS-c. 11 yrs

which of the following signs and/or sxs of a genital herpes infection usually occurs first?
a. painful or pruritic vesicles
b. dysuria
c. prodromal tingling or pruritus of the genital region
d. white, curdlike plaques on a red base in the vagina - ANS-c. prodromal tingling or
pruritus of the genital region

a 17 y/o female presents to your office with the c/o lower abdominal pain since her
period ended 2 days ago. She has a new sexual partner in the past 3 months and does
not use condms. On PE, you find that she has cervical motion tenderness. You are
concerned that she may have PID. To meet the CDC minimum criteria for empiric tx of
PID, she must also have:
a. an oral temp greater than 101F and mucopurulent cervicitis
b. a positive test for cervical infection and an adnexal mass
c. lower abdominal tenderness and adnexal tenderness
d. mucopurulent cervicitis and an elevated WBC - ANS-c. lower abdominal tenderness
and adnexal tendernes