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?
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- About half of all pregnancies in the United States are unintended and occur most frequently in women who:
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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
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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?
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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
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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:
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Which of the following is an ethical issue that is specifically associated with pre-implantation testing with ART?
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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?
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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:
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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?
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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?
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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:
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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:
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What population of women should be screened for signs and symptoms of thyroid dysfunction?
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All of the following diagnostic testing and procedures are now infrequently performed in clinical practice except:
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The most common site for endometrial implants found in other parts of the body is:
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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:
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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?
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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:
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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:
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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
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What is a common vasomotor symptom of menopause?
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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 |