First:	MI:
Last:
Agency:
Job title:

Street address:
Address (cont):
City:	State:
Zip:

Daytime phone:
Email:
Nurse license number:
CHES ID #:

Please choose one:
LPN
RN
Nurse Practitioner
Other

Please choose one for contact hours (leave blank for none):
Nursing
CHES
Both

Post-test Questions

1. Over half of the women receiving subsidized family planning services are age 20 or over.
   True
   False

2. Most Title X clients have incomes below the federal poverty level.
   True
   False

3. Which of the following is NOT one of the 4 steps to quality customer service reviewed in this module?
   Listen
   Ask Questions
   Solve
   Offer your opinion

4. HIPPA stands for “Health Insurance Privacy Protection Act”
   True
   False

5. Which of the following statements is not true?
   The uterus is also called the “womb”
   The vagina is the canal leading to the uterus
   The ovaries catch the egg and direct it to the uterus
   The cervix is the opening of the uterus

6. The egg, once released from the ovary, survives only about 24 hours.
   True
   False

7. Semen is fluid that comes from 3 places – the seminal vesicles, prostate, and what gland?

8. The menstrual cycle is exactly 28 days in only about 15% of women.
   True
   False

9. Combination hormonal methods include which of the following?
   Oral contraceptives, the patch and the shot
   Oral contraceptives, the patch and the ring
   Oral contraceptives and the diaphragm

10. The Nuva ring should be refrigerated at the clinic.
    True
    False
11. Progestin-only methods include which of the following?
    Progestin-only pills or mini pills, the shot, and the Mirena IUD
    Progestin-only pills or mini pills, the shot, and the patch
    The cervical cap and the patch

12. The shot may result in some changes in menstrual bleeding, hair loss, and breast tenderness.
    True
    False

13. The shot should be given every 4 weeks.
    True
    False

14. Emergency Contraception is most effective if taken
    As soon as possible after unprotected intercourse
    Within a week after unprotected intercourse
    Any time during the next cycle

15. Chlamydia left untreated may lead to Pelvic Inflammatory Disease (PID).
    True
    False

16. How is testing done for syphilis?
    Blood test
    Urine test
    Pap smear
    Throat culture

17. Trichomoniasis infection can have itching, discharge, burning, or no symptoms.
    True
    False

18. The herpes simplex virus can be shed even when there is no outbreak.
    True
    False

19. Bacterial Vaginosis is treated with
    Metronidazole (by mouth in pills)
    Medicine in a vaginal cream
    Either a) or b) or both
    Neither a) nor b)

20. On average, how long does it take from initial HIV infection to develop AIDS?
    8-10 weeks
    8-10 months
    8-10 years
    More than 10 years

21. How long does it take after infection occurs for an HIV antibody test to detect HIV?
    3-6 hours
    3-6 days
    3-6 weeks
    3-6 months

22. HIV can be present in blood, semen, breast milk, and vaginal discharge of infected persons.
    True
    False

23. The CDC guidelines recommend that infants born to HIV positive moms receive medication for the first 6 weeks of life.
    True
    False

24. Patient Information includes;
    content of patient records
    any information that can directly or indirectly reveal the identity of the individual patient
    both of the above
    neither of the above

25. Blanket, open-ended consent forms are acceptable for use in family planning clinics.
    True
    False

26. Family planning agencies may grant a request for information without patient consent from any third party agency or organization.
    True
    False

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