A Nurse Practitioner is trying to encourage

A Nurse Practitioner is trying to encourage a 38-year-old man who has a 21 year history of smoking two packs per day, has a BMI of 40 and has stage I hypertension to stop smoking. To possibly be successful, she must do all of the following EXCEPT: 1.Assess at every available time patient’s readiness to quit 2.Remind the patient that if he could get past his personal failings then he could quit smoking 3.Conduct motivational intervention at every appointment utilizing the 5 R’s 4. Take note of the patient’s socio-economic status as that may affect his ability to stop smoking Depo-Provera (medroxyprogesterone) is: Group of answer choices Is contraindicated in women on anti-seizure medications Is contraindicated in women with known Factor V Leiden Best administered immediately before the onset of menses Effective for 12 weeks Which of the following is NOT a relative or absolute contraindication to taking OCP? Group of answer choices Severe Lupus Ischemic heart disease Thrombophlebitis or thromboembolic disorder Tension headaches Ariel, age 20, is going to begin taking birth control pills. She asks you if she is “safe” from pregnancy immediately. How do you respond? Group of answer choices “Until you have your second period (cycle) on the pill, you are not considered safe.” “A backup method of birth control method needs to be used during intercourse for the first 7 days when starting the pill.” Yes, you should not get pregnant once you start taking the pill. “For the first 3 months, you need to use a back-up birth control method. Your 38 year old client is asking about birth control methods. She has a history of diabetes and poorly controlled hypertension, smokes a pack of cigarettes a day, and has stated that she frequently forgets to take her medications. Which of the following would you LEAST likely recommend for her? Group of answer choices Condoms Xulane patch Cervical cap Diaphragm PreviousNext All of the following are true statements EXCEPT: Group of answer choices IUDs are safe for nulliparous women Nexplanon is effective for at least 3 years Blood sugar levels should be regularly monitored in patients taking birth control pills Diaphragms must be left in place at least 6 hours after intercourse for optimal efficacy An 18 year old reports having intercourse with her boyfriend 20 hours ago. She is concerned because the condom broke and she uses no other form of contraception. She has normal periods, is mid cycle, and requests something to prevent pregnancy. Which of the following are appropriate options (select TWO): Group of answer choices Plan B Reassure her that it is unlikely she will get pregnant and have her return to the clinic if she misses her next period Insert an IUD Give her IM methotrexate Noncontraceptive benefits of oral contraceptives include a decrease in all of the following EXCEPT: Group of answer choices Iron deficiency anemia cervicitis acne ovarian cancer Your 53 year old client states that she has had a total hysterectomy due to a benign condition. Your advice to her regarding further pap smear testing is: Group of answer choices Continue with annual pap smears. She no longer needs pap smears because her hysterectomy was performed for a benign condition. After three consecutive negative annual pap smears, the screening interval will change to a pap smear every 3 years. She will need an annual pap smears until age 70. A 38 year old woman has a pap report indicating LSIL (Low grade squamous intraepithelial lesion). She is asymptomatic and all of her prior paps have been within normal limits. Your next best action is: Group of answer choices Repeat her pap again in a year unless she becomes symptomatic Schedule her for a repeat pap in 4-6 months Schedule her for a LEEP immediately Refer her for colposcopy You are reviewing pap smear results on a client and the report indicates that the pap smear is normal, though the specimen is unsatisfactory for evaluation. Your treatment plan is: Group of answer choices Call the client, inform her of the results, and tell her that she will get a pap smear in 1 year at her next annual exam anyway. Call the client, inform her of the results and request that she returns for a repeat pap within 4 months. Call the client and explain that she needs a colposcopy due to her current test results. Do nothing since she was asymptomatic at her visit. Of the following, which choice are the best instructions to give the patient in preparation for their pap smear? Group of answer choices “Douching enhances visualization of the cervix and should be done before the appointment.” “An infection or a very heavy menstrual period is no reason to cancel the appointment.” “The procedure is completely painless.” “Insert nothing in the vagina for 24 hours before the exam.” Your patient needs a colposcopy. She asks you what this is. You tell her: Group of answer choices A colposcopy visualizes the cervical, vaginal, or vulvar epithelium under magnification to identify abnormal areas that may require a biopsy. A colposcopy allows visualization of the abdominal and pelvic cavity through a small fiber optic endoscope passed through a subumbilical incision. A colposcopy involves removal of one or more areas of the endometrium by means of a curette or small aspiration device without cervical dilation. A colposcopy allows visual examination of the uterine cavity with a small fiberoptic endoscope passed through the cervix. PAP smear results on your 39 year old female patient are reported as atypical squamous cells of undetermined significance (ASCUS) with positive HPV changes. What is your next step? Group of answer choices Prescribe estrogen cream Prescribe Aldara Refer or perform a colposcopy Repeat PAP in six months Your patient is a 67 year old female coming in for her yearly well-woman exam. She is post-menopausal with a self-reported LMP of 15 years ago. She is a G1P1 with no significantPMH or FMH. During her visit the patient asks, “I got my last pap smear 3 years ago, will you perform one today?” What is the best response? Group of answer choices “Oh, I didn’t realize it had been so long, I will make sure we do that today.” “Post-menopausal women never develop cervical cancer so we stop testing for it at age 65.” “We will start performing pap smears every 5 years now that you are above the age of 65.” “Per CDC recommendations, we will stop doing these screenings regularly as you are over the age of 65, have had several negative screening tests over the last 10 years, and are not at high risk for cervical cancer. However, you should make me aware of any abnormal uterine bleeding.”

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