A 22 year old female presents with a complaint of increased vaginal discharge, no itching, and an unpleasant odor.  On examination a grayish white discharge is noted at the introitus and adhering to the vaginal walls.  There is no erythema. She is sexually active. The most likely finding on a wet mount examination would be:

A mother and her young 12 y.o. daughter come to your office frightened and concerned over the daughter’s irregular menstrual patterns and bleeding.  You explain to them that:

A 30-year old woman with bilateral breast implants is scheduled for her yearly exam. You begin to assess her breast health. She asks if it is necessary to do monthly BSE (breast self exam) because she does not know what to feel for.  The most appropriate response would be?  AND You are preparing for her breast exam, the proper exam technique for this woman  would be:

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Your patient is a 58yo postmenopausal female who comes in for her annual examination. She reports a feeling of fullness, bloating, and anorexia for the past 5-6 months. Her pelvic exam reveals a firm, fixed left adnexal mass >8cm. What is the most appropriate next step in managing this patient?  

Your patient MC, G4P2012 comes to your office at 30 weeks gestation with complaints of contractions “on & off” for 2 days since she was gardening in the heat to get ready for her son’s birthday party. You perform a bimanual exam and note a closed thick high cervix. Her urine specific gravity is 1030 +1 ketones, without protein, nitrites, glucose, or leukocytes.  You decide to give her an IV fluid bolus in the office. You know the reason for this is:

A 26 year-old woman is newly diagnosed with early HIV infection.  She is believed to have acquired HIV approximately 4 months prior from a brief sexual relationship with a partner who frequently injects methamphetamine.  She has a new boyfriend and they have regularly had vaginal sex without using a condom during the last 3 months.  She is asking how likely it is that she has passed on HIV to her new partner.

You are performing an evaluation on your obstetric patient who is 32 weeks gestation.  One part of your evaluation involves visualization of a vaginal sample under the microscope, you visualize the above microscopic image and determine the following:

A young adult female presents with a history of vaginal itching and heavy white discharge. The client gives a history of no sexual activity. On exam, the nurse practitioner notes an erythematous vulva with white patches on the vaginal walls. There is no odor to the discharge. The nurse practitioner would expect what factors in the client history?  

A 15 year-old female has never menstruated.  She and her mother are concerned.  What is the most important for the NP to initially assess?