A 19-year-old woman presents to her provider requesting the chickenpox vaccine. She is also complaining of nausea, malaise, and moderate weight gain. She gradually developed these symptoms over the past 2 weeks. Her past medical history is unremarkable, and her last menstruation was about 6 weeks ago. She has one sexual partner and uses a “natural planning” method for contraception. Her blood pressure is 110/70 mm Hg, pulse is 92/min, respirations are 14/min, and temperature is 37.2°C (99°F). Physical exam reveals non-painful breast engorgement and nipple hyperpigmentation. There is no neck enlargement and no palpable nodules in the thyroid gland. The urine beta-hCG is positive. What is the most appropriate recommendation regarding chickenpox vaccination in this patient?

A 28-year-old patient presents to the clinic with concerns about discomfort during sexual intercourse. The nurse practitioner suspects that the position of the vaginal fornices might be contributing to the patient’s symptoms. Which of the following options best describes the location of the vaginal fornices in the female reproductive anatomy?

A family member brings their 70-year-old relative to a healthcare provider’s office, expressing concern about the older adult’s cognitive function. The family member reports memory problems, confusion about time and place, and difficulty completing familiar tasks. Which of the following tests would you complete to evaluate cognition?

During a well-woman visit, a patient asks about the recommended frequency of mammograms. She is 42 years old and has no known family history of breast cancer. What would be your appropriate recommendation, and what factors influence this decision?

A 25-year-old woman, gravida 1, para 0, is admitted to the hospital at 36 weeks’ gestation with a severe frontal headache. Her blood pressure is 170/90 mm Hg, pulse is 85/min, respirations are 15/min, and temperature is 36.9℃ (98.4℉). The fetal heart rate is 159/min. There is 1+pitting edema of both lower extremities on physical exam. A dipstick urine assessment shows 2+ proteinuria. While being evaluated, the patient has a generalized tonic-clonic seizure. What pharmacologic agent is the most appropriate for preventing recurrent seizures?

A 22-year-old sexually active woman reports to the healthcare provider with a chief complaint of thick, yellow, vaginal discharge that began 1 week ago. She had unprotected vaginal intercourse 2 weeks earlier with a partner whose sexually transmitted disease status is unknown. She denies pelvic pain or fever. Upon examination, her vital signs are within normal limits. Her bimanual examination is normal. A speculum examination of her cervix reveals inflammation with a thick, yellow, mucopurulent discharge without odor. A specimen collection was conducted to send for laboratory evaluation. While waiting for these results, what is the most appropriate treatment for this patient?

A 22-year-old transgender woman presents to your clinic for a routine check-up. She mentions that she’s interested in hormone therapy to feminize her appearance. What is the first step in addressing her request, and why is it essential?

A 38-year-old patient presents to the clinic with a complaint of heavy and prolonged menstrual bleeding. The nurse practitioner suspects an abnormality in the endometrial cycle. During which phase of the endometrial cycle does the thickening and development of the uterine lining occur?

You are working in the Intensive Care Unit (ICU) and are assigned an assigned male at birth (AMAB) patient with a past medical history (PMH) of asthma and diabetes.  The patient initially presented to the Emergency Department with severe dehydration and was immediately transferred to the intensive care unit (ICU) for intravenous (IV) fluids.  Upon reviewing the patient’s labs, which crystalloid solutions would you recommend as an option to the Health Care Provider (HCP)? Labs: Sodium: 158  Potassium: 5.4 Glucose: 210  Creatinine: 1.34  BUN: 42 

While completing your assigned male at birth (AMAB) patient’s physical assessment, you notice various abnormal findings.  You decide to review the patient’s labs that were drawn last week as they were started on new medications at that time.  Which medication do you anticipate that your patient is currently taking based on these abnormal findings? Labs: Lipid Panel Results HDL 22 LDL 210 Triglycerides (TG) 130 Total Cholesterol 367   Physical Assessment: Neurological: Alert and Oriented to person, place, situation and time.  Opens eyes spontaneously.  Respiratory: Clear to auscultation, unlabored, symmetrical chest expansion, no cough, denies shortness of breath (SOB) Perfusion (Cardiac): S1/S2, no murmur, +2 bilateral radial pulses, +1 bilateral pedal pulses, capillary refill less than 2 seconds, mild bilateral extremity edema Musculoskeletal: Strong bilateral finger grasps, moderate bilateral dorsiflexion and plantar flexion with moderate discomfort Gastrointestinal: Bowel sounds normoactive in all 4 quadrants, soft, non-tender, last bowel movement yesterday Genitourinary: Cola-colored, no odor