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Well Woman Care

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A 15-year-old adolescent female who is sexually naïve comes to your office for the recommended initial reproductive health visit. She has no complaints related to her reproductive health. Which of the following is NOT indicated during this encounter?

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a. Pelvic examination

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b. Establishment of rapport

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c. Stage of adolescence evaluation

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d. Reproductive health care needs assessment

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The American Cancer Society (ACS) has published guidelines for the conduct of the clinical breast examination. Which of the following components of the examination is no longer recommended?

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a. Axillary lymph node palpation

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b. Inspection for skin abnormalities

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c. Breast palpation with the patient supine

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d. Inspection with patient's arms raised overhead

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In the past, expressing the nipples for the detection of discharge, as shown here, was a standard part of breast examination. This examination component is currently recommended selectively for which of the following indications?

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Reproduced, with permission, from Kawada C: Gynecologic history, examination, & diagnostic procedures. In DeCherney AH, Nathan L (eds): CURRENT Diagnosis & Treatment Obstetrics & Gynecology, 10th ed. New York, McGraw-Hill, 2007, Figure 33-1.

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a. Breast pain (mastalgia)

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b. Current with fever

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c. Spontaneous nipple discharge in a nonlactating woman

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d. Bilateral milky discharge that is present only when expressed by the patient

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Which of the following components of the routine pelvic examination is more often performed for specific indications rather than routinely?

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a. Vulvar inspection

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b. Rectovaginal examination

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c. Bimanual palpation of the uterus and adnexa

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d. Speculum examination of the cervix and vagina

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Assuming that childhood immunizations have been administered correctly, which vaccination warrants repeat dosing at 10-year intervals in adults?

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a. Hepatitis B

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b. Pneumococcal

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