A 22-year-old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the nurse notices clusters of small, shallow vesicles with surrounding erythema on the labia. Inguinal lymphadenopathy is present. The most likely cause of these lesions is:

Correct Answer: D

Rationale: The correct answer is D: Herpes simplex virus type 2. The presence of small, shallow vesicles with surrounding erythema on the labia, along with symptoms of vulvar pain, dysuria, and fever, are classic signs of genital herpes caused by HSV-2. The inguinal lymphadenopathy further supports the diagnosis. Herpes simplex virus is known for causing painful vesicular lesions in the genital area. Choice A, Pediculosis pubis, is incorrect as it presents with itching and nits (eggs) attached to the hair shafts, not vesicles. Choice B, Contact dermatitis, typically presents with red, itchy, and inflamed skin due to an allergic reaction. Choice C, HPV, does not typically present with vesicles but rather with warts or abnormal cell changes on the skin or mucous membranes.

Correct Answer: A

Rationale: The correct answer is A: 5 to 10 years. IUDs are long-acting reversible contraceptives effective for 5 to 10 years depending on the type. Hormonal IUDs last around 5 years, while copper IUDs can last up to 10 years. This extended duration provides reliable contraception for an extended period with minimal user intervention. Choice B: 1 to 2 years is incorrect because IUDs have a longer duration of effectiveness. Choice C: 3 to 5 years is incorrect as it falls short of the typical duration of effectiveness for most IUD types. Choice D: Indefinitely is incorrect as IUDs do have a maximum effective period, after which they need to be removed or replaced.

Correct Answer: D

Rationale: The correct answer is D: Pelvic inflammatory disease (PID). PID can lead to scarring and narrowing of the fallopian tubes, increasing the risk of ectopic pregnancy. This is because the fertilized egg may get stuck in the narrowed tube, leading to an ectopic pregnancy. A: Previous pelvic surgery is a risk factor, but it is not the most common one for ectopic pregnancy. B: Endometriosis can also affect fallopian tubes but is not the most common risk factor for ectopic pregnancy. C: Tubal ligation is a form of contraception that reduces the risk of pregnancy but does not increase the risk of ectopic pregnancy. In summary, PID is the most common risk factor for ectopic pregnancy due to its potential to cause fallopian tube scarring and narrowing, leading to the implantation of the fertilized egg outside the uterus.

Correct Answer: A

Rationale: The correct answer is A: Albumin. Albumin is a protein normally found in blood but not in urine. Its presence in urine, known as proteinuria, may indicate a problem with the kidneys such as kidney damage or dysfunction in filtering blood. Bilirubin (B) is a product of red blood cell breakdown and its presence in urine indicates liver or bile duct issues. Ammonium (C) is a normal byproduct of protein metabolism and is excreted in urine. Urea (D) is a waste product of protein metabolism and is normally found in urine.

Correct Answer: D

Rationale: The correct answer is D. Angiotensin II does not decrease blood pressure; it actually increases blood pressure through vasoconstriction. Renin cleaves angiotensinogen to form angiotensin I, and ACE converts angiotensin I to angiotensin II. Aldosterone acts on the kidneys to increase sodium and water reabsorption, leading to increased blood volume and pressure. Therefore, D is incorrect because Angiotensin II causes vasoconstriction and increases blood pressure.