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..Exam 4: NSG554/ NSG 554 (Latest 2024/
2025 Update) – Nurse Practitioners in
Primary Care I Exam Review| Complete
Guide with Questions and Verified Answers|
All Modules Covered|100% Correct| Grade A
Q: most common breast problem in primary care
Answer:
mastalgia or mastodynia
Q: galactorrhea
Answer:
milky breast discharge–associated with pituitary adenoma or hypothyroidism
Q: chronic pelvic pain
Answer:
continues or episodic NONmenstrual pain of at least 6 mos. at or below umbilicus. interrupts
normal activities. May involve GI, uro, gyn, onco, musco, psycho systems. cause is often
multifactoral
Q: Increased risk of chronic pelvic pain
Answer:
history of:
ØPhysical and sexual abuse
ØPelvic inflammatory disease
ØEndometriosis
ØInterstitial cystitis
ØIrritable bowel syndrome
ØMusculoskeletal D/O
ØPostsurgical pain
Q: PE and diagnostics of chronic pelvic pain
Answer:
detailed abd., pelvic, back, dx: vaginal/cervical cultures, UA, urine culture, CBC, pregnancy test,
ESR
transvaginal/renal ultrasound and/or laparoscopy, CT or MRI
Q: management of chronic pelvic pain
Answer:
NSAIDS, TCAs, anticonfulsants, neurostim, laparoscopy
Q: abnormal uterine bleeding
Answer:
wide range. can be acute episodic or chronic
Q: workup for abnormal uterine bleeding
Answer:
eval s/s blood loss, systemic disease, pelvic exam, labs: hcg, CBC, TSH, prolactin, transvaginal
US, endometrial sampling
Q: causes of anormal uterine bleeding
Answer:
polyp, adenomyosis, leiomyoma, malignancy, ovulatory disorder (PCOS, hypothyroid,
hyperprolactin), endometrial, iatrogenic, not otherwise classified
Q: management of abnormal uterine bleeding
Answer:
hormones, hemostatic therapy with tranexamic acid (antifibrinolytic) and high dose NSAIDs,
surgery
Q: dysmenorrhea
Answer:
painful menstruation
primary: painful despite normal anatomy and ovulation occuring within 6-12 mos after menarche
secondary: painless menses assoc. with endometriosis, fibroids, adenomyosis, PID, infertility,
cysts, polyps, intrauterine adhesions, cervical stenosis, other conditions or IUD use
Q: diagnostis for dysmenorrhea
Answer:
pelvic US, genital cultures, laparoscopy, hysteroscopy, dilations and curettage, CT, labs: CBC,
ESR
Q: management of dysmenorrhea
Answer:
NSAIDs, hormonal contraceptives, CCB, tocolytic, diet changes, supplements (MVI), TENS,
hysterectomy
Q: dyspareunia
Answer:
recurrent/persistent genital pain with sex
can develop due to other vulvar problems like vaginismus or volvodynia, PID, early postpartum,
perimenopausal, hx of sexual abuse, psych factors
often caused by endometriosis
Q: Q-tip test
Answer:
In a normal patient, the angle of the Q-tip is less than 30 degrees from the horizontal, and will
remain at this angle when the patient strains.
In patients with inadequate bladder neck support and stress incontinence, the Q-tip angle
generally exceeds 30 degrees from the horizontal.
Q: diagnostics dyspareunia
Answer:
vaginal KOH and wet mounts
pap smear
chlamydia, n. gonorrhea cultures
CBC
ESR
UA
HCG
Q: management of dyspareunia
Answer:
lubrication, topical estrogen, botulinum tox A, pelvic floor exercises, alternative sexual positions
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