Family Nurse Practitioner Exam

What should be the best follow-up action for a 20-year-old student with a Pap smear showing inflammation?

1. The NP needs to do cervical cultures to verify the presence of gonorrhea

2. Prescribe metronidazole vaginal cream for the patient over the phone

3. Call the patient and tell her she needs a repeat Pap smear in 6 months

4. Advise the patient to use a Betadine douche at bedtime x 3 days

The correct answer is: The NP needs to do cervical cultures to verify the presence of gonorrhea

Following a Pap smear that indicates inflammation, it is crucial to identify any underlying infections that could be contributing to the abnormal results. Cervical cultures are a valuable diagnostic tool in this scenario, as they can detect sexually transmitted infections such as gonorrhea, which may cause cervical inflammation. Identifying the presence of infection would guide appropriate treatment and further management, helping to ensure the health and safety of the patient. The other responses do not adequately address the importance of diagnosing potential infections. While prescribing metronidazole vaginal cream may be beneficial if there is a diagnosis of bacterial vaginosis or trichomoniasis, doing so over the phone without confirming the diagnosis would not be appropriate. Advising a repeat Pap smear in six months does not address the immediate need to understand the cause of inflammation. Lastly, recommending a Betadine douche is inappropriate as douching can disrupt normal vaginal flora and potentially worsen the condition or lead to further complications. These alternatives do not provide the necessary follow-up action to determine the underlying cause of the inflammation observed in the Pap smear.