NRNP 6559 Week 2 Gynecologic Exam Note Example

Course	NRNP 6559 Advanced Primary Care of Women and Diverse Populations
Week	Week 2
Paper type	Gynecologic history and exam note
Length	About 770 words, 5 pages
Format	APA 7 student paper
School	Walden University
Program	Master of Science in Nursing (MSN)
Updated	October 2026

Free sample paper for NRNP 6559 Week 2

Gynecologic History and Exam Note: Thin Gray Discharge in a 29-Year-Old With a Copper IUD and a New Partner

Student Name

College of Nursing, Walden University

NRNP 6559: Advanced Primary Care of Women and Diverse Populations

Instructor Name

Month Day, Year

What this page is doingThe title carries the three facts the assessment depends on: the discharge, the device, and the new partner. A reader can check that each one reappears in the plan, which is the consistency this note is graded on.

Gynecologic History and Exam Note: Thin Gray Discharge in a 29-Year-Old With a Copper IUD and a New Partner

History in Standard Order

Composite case. Chief concern: "a discharge that smells, worse after sex," for 8 days.

History of present illness: thin discharge with a fishy odor, most noticeable after intercourse; no itching, burning, or dysuria; no pelvic or abdominal pain; no fever; no bleeding between periods or after intercourse.

Menstrual history: last menstrual period September 14, 2026; she bleeds for 5 days on a cycle of 28 to 30 days, and flow has been heavier since the IUD was placed; menarche at 12.

Obstetric history: G2 P1011 (one term birth, no preterm births, one early pregnancy loss, one living child).

Contraception: copper IUD, inserted March 11, 2024; she checks the strings monthly.

Sexual history: one male partner, new within the past 2 months; condoms "sometimes, not every time"; no previous sexually transmitted infections; last HIV test 3 years ago.

Cervical screening: up to date according to the chart, with normal results; no interval restated here.

Medications: none. Allergies: none known. Social: works as a veterinary technician; nonsmoker.

Consent and Chaperone First

The purpose of the pelvic exam and each of its parts were explained before starting, and she agreed. A chaperone was offered, and she accepted; the clinic's medical assistant was present throughout. She was told she could ask to pause or stop at any point.

What this page is doingConsent and the chaperone are documented before any finding, with who was present. Graders read the absence of this line as unfamiliarity with gynecologic practice.

Examination

External genitalia: no redness, lesions, or swelling. Speculum: thin, homogeneous gray-white discharge coating the vaginal walls; vaginal walls not inflamed; cervix without friability, lesions, or mucopurulent discharge; IUD strings visible at the os, about 3 cm. Bimanual: no cervical motion tenderness, uterus normal size and nontender, no adnexal masses or tenderness.

Amsel Criteria, Tallied

Point-of-care tests performed on the discharge and tallied against the four Amsel criteria (Amsel et al., 1983):

1. Thin, homogeneous discharge: present.

2. Vaginal pH above 4.5: present, pH 5.0.

3. Positive whiff test, a fishy amine odor when potassium hydroxide is added: present.

4. Clue cells on saline wet mount, more than 20% of epithelial cells: present.

Result: 4 of 4. At least 3 of the 4 are required for a clinical diagnosis of bacterial vaginosis. Also on wet mount: no motile trichomonads, few white cells; potassium hydroxide preparation shows no yeast. Amsel's original study also found bacterial vaginosis associated with IUD use, which fits her history.

Assessment: Two Diagnoses Left Open

1. Bacterial vaginosis, confirmed clinically by all 4 Amsel criteria.

2. Trichomoniasis, open. The wet mount showed no trichomonads, but microscopy misses a substantial share of infections: in a comparison among women attending a sexually transmitted infection clinic, a vaginal swab amplification test was significantly more sensitive than wet mount or culture (Nye et al., 2009), and nucleic acid amplification testing is the recommended method (Workowski et al., 2021). A negative wet mount therefore does not close this diagnosis, and the note records it as open rather than excluded. Her new partner and inconsistent condom use make this a real possibility.

3. Chlamydial or gonococcal cervicitis, open but less likely: no mucopurulent discharge, no friability, no cervical motion tenderness. Testing is indicated because of the new partner regardless of findings.

Pelvic inflammatory disease is not supported: no pelvic pain, no fever, and no cervical motion, uterine, or adnexal tenderness on exam.

Plan

Bacterial vaginosis: metronidazole 500 mg orally twice a day for 7 days, a recommended regimen in the CDC treatment guidelines (Workowski et al., 2021). Treatment of her male partner is not recommended for bacterial vaginosis. The IUD stays in place.

Testing: vaginal nucleic acid amplification tests for Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae. HIV and syphilis testing offered because of the new partner; she accepted both.

Follow-up: results by phone in 3 days, with a callback number she chose so that results are not left on a shared voicemail; treatment and partner management will be added if any test is positive. Return if symptoms persist after treatment or recur. Condoms discussed for infection prevention with the new partner.

A Table of Agreements

New partner in the past 2 months (history) matches testing for trichomoniasis, chlamydia, gonorrhea, HIV, and syphilis (plan).

Copper IUD with strings checked (history) matches strings visible at the os (exam) and IUD left in place (plan).

Thin gray discharge with odor (history) matches the speculum finding and Amsel criteria 1 and 3 (exam and tests).

No pelvic pain or fever (history) matches no cervical motion, uterine, or adnexal tenderness (exam) and pelvic inflammatory disease set aside (assessment).

Cervical screening up to date (history) matches no cervical sample collected today (plan).

What this page is doingThe closing table checks every history item against the exam, assessment, and plan. Contradiction is the defect this week's grading looks for, and the table shows none.

References

Amsel, R., Totten, P. A., Spiegel, C. A., Chen, K. C., Eschenbach, D., & Holmes, K. K. (1983). Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiologic associations. The American Journal of Medicine, 74(1), 14-22. https://doi.org/10.1016/0002-9343(83)91112-9

Nye, M. B., Schwebke, J. R., & Body, B. A. (2009). Comparison of APTIMA Trichomonas vaginalis transcription-mediated amplification to wet mount microscopy, culture, and polymerase chain reaction for diagnosis of trichomoniasis in men and women. American Journal of Obstetrics and Gynecology, 200(2), 188.e1-188.e7. https://doi.org/10.1016/j.ajog.2008.10.005

Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR Recommendations and Reports, 70(4), 1-187. https://doi.org/10.15585/mmwr.rr7004a1

Reading the NRNP 6559 Week 2 instructions

Week 2 of NRNP 6559 typically asks for a gynecologic history and examination note. You take a complete gynecologic, obstetric and sexual history, document consent and chaperone, describe the examination, apply diagnostic criteria, form an assessment and plan testing and treatment. Faculty grade internal consistency closely. Cite the CDC STI guideline in APA 7. GTPAL notation is commonly expected. The IUD and partner history should inform the plan. Respectful language matters throughout. NRNP 6559 faculty want the history in standard order: menstrual, obstetric with GTPAL, gynecologic, sexual and contraceptive. Record consent and chaperone before the examination. Tally the Amsel criteria. Leave diagnoses open until tests return. Include partner advice in the plan.

How the NRNP 6559 Week 2 example is put together

The history uses the conventions a gynecologic note is expected to carry. Menstrual history gives the last period and cycle pattern; obstetric history appears in GTPAL notation; the copper IUD is recorded with its insertion date; and the sexual history notes a new partner within the past three months and condom use described as occasional. Prior cervical screening is recorded as up to date according to the chart, with no interval restated. The exam documents that a chaperone was offered and present, then external findings, a thin gray-white discharge on speculum exam, visible IUD strings, and a bimanual exam without cervical motion or adnexal tenderness. Point-of-care findings are tallied against the Amsel criteria. The assessment ranks bacterial vaginosis first, keeps trichomoniasis and cervicitis open pending tests, and closes with a consistency table.

NRNP 6559 Week 2 rubric: what earns full marks

Contradiction is the defect this week's grading hunts, so points drain from a note in which the plan orders STI testing for a partner the history never recorded, or whose exam finds cervical motion tenderness that goes unaddressed in the assessment. The consistency table guards that credit in this example. Documentation conventions are graded too: GTPAL notation, a menstrual history with dates, and a recorded chaperone are expected, and their absence reads as unfamiliarity with gynecologic practice. Diagnostic accuracy depends on applying the Amsel criteria rather than naming bacterial vaginosis from the odor alone. The plan earns credit for citing the CDC STI Treatment Guidelines on management and on partner treatment, and loses it when pending tests have no follow-up mechanism or when the IUD is never mentioned in a note about discharge.

NRNP 6559 Week 2 help from the desk

Gynecologic notes lose points when the plan contradicts the history, such as partner testing for a partner never recorded. Check agreement. Another common gap is skipping consent and chaperone documentation. Record both. Writers also diagnose bacterial vaginosis without tallying the Amsel criteria. Show each one. Avoid closing the differential before tests return. Keep trichomoniasis open. Address the IUD; it does not need removal for vaginosis. Close with follow-up and partner advice. Writers also forget to record vaginal pH and microscopy results, which the criteria need. Add them. Another frequent slip is treating the partner for bacterial vaginosis, which guidelines do not advise. Explain. Check that the plan's tests match the history. Close with follow-up timing.

Get a NRNP 6559 Week 2 example written to your instructions

Include the Week 2 case, the rubric, and the template your section uses for gynecologic visits, if it has one. A note is drafted to your case in standard gynecologic order, chaperone documented, with a consistency check closing it. You pay nothing for a first custom sample, and it lands in 24-48 hours.

More NRNP 6559 papers and MSN samples

NRNP 6559 Week 2 questions, answered

What is GTPAL notation?

A compact way to record obstetric history: gravida for total pregnancies, then term births, preterm births, abortions including miscarriages, and living children. A gynecologic note is expected to use it or an equivalent system, and graders notice when pregnancies are described loosely instead. The example records it in one line so every later reference to her obstetric history can be checked against it.

What are the Amsel criteria?

Four clinical findings used to diagnose bacterial vaginosis: a thin, homogeneous discharge, an elevated vaginal pH, a positive amine or whiff test, and clue cells on microscopy. Meeting three of the four supports the diagnosis. The example reports each finding and the tally, so the diagnosis rests on documented criteria rather than on an impression the grader cannot verify.

Why is the IUD mentioned in a discharge note?

Because a device in the uterus is part of her gynecologic picture and a reviewer would expect the note to account for it. The example records the insertion date, confirms the strings were seen, and states whether the device bears on the differential. Leaving it out would create exactly the kind of gap between history and exam that this week's rubric looks for first.

Where can I find a free NRNP 6559 Week 2 sample paper?

The gray discharge note is reproduced here with the history in order, consent and chaperone, the Amsel tally, two open diagnoses and the agreements table.

What does the NRNP 6559 Week 2 assessment favor?

Bacterial vaginosis, with trichomoniasis left open until testing returns.