ACOG guidelines regarding well women exams What is the ASCCP recommended management for an ASCUS (atypical squamous cells of undetermined significance) pap result with a positive high-risk HPV 16 cotest in a 26-year-old woman without a history of abnormal pap smears? • Colposcopy A well-woman visit for an adolescent should include which of the following? • A general health history focusing on reproductive and sexual health concerns (menses, gynecologic, and pregnancy related) and psychosocial (family related, peer related, emotional, and physical as well as related to abuse, drug use, and alcohol use) concerns Physical exam, screening tests, and immunizations as indicated by the health history and gynecologic considerations for an external-only inspection of the genitalia ACOG Pap smear guidelines A Bethesda system Pap smear report that reads LSIL is most consistent with which classification? • CIN 1 A single Pap smear reading of ASCUS in a patient negative for HPV infection should have what as follow-up? • Routine screening A female patient is 35 years old. She has never had an abnormal PAP smear and has had regular screening since age 18. If she has a normal PAP smear with HPV testing today, when should she have the next cervical cancer screening? • 5 years A young sexually active client at the family planning clinic is advised to have a Papanicolaou (Pap) smear. She has never had a Pap smear before. What should the nurse include in the explanation of this procedure? • The Pap smear can detect cancer of the cervix Lab results on your 26-year-old patient show a negative Pap smear with a positive human papillomavirus (HPV) screen. Which procedure will be required next? • Repeat Pap and HPV screen Which of the following is not part of the criteria for an older woman to cease having any future Pap tests performed? • Over 55 years of age Amenorrhea (Primary and Secondary) You are evaluating a 17-year-old Emily who presented with amenorrhea and normal secondary sex characteristics. The purpose of the progesterone challenge is to ascertain the presence of? • Endogenous estrogen A 17-year-old female patient presents with amenorrhea for 4 months she did experience menarche at age 15 but had not had a menstrual cycle since. On physical examination, it is noticed that she has normal secondary sexual characteristics. The nurse practitioner will consider a progesterone challenge to determine the presence of adequate • Endogenous estrogen A teenage patient presents with amenorrhea and moral secondary sex characteristics. A progesterone challenge is ordered. The purpose is to determine the presence of ? • Endogenous estrogen A 16year old girl who comes to your office with a history of secondary amenorrhea. She experienced menarche at age 10, regular cycles for 2 years. She has not menstruated now for 4 years. In your initial consideration of differential diagnoses, what is the most frequent etiology of this problem: • Eating disorder 18yo female c/o secondary amenorrhea. On exam, there is normal secondary sex characteristics and normal genitalia. Pregnancy is ruled out. What
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