NURS 114 Ch. 27 Assessing Female Genitalia & Rectum

What is the greatest risk factor for cervical cancer?

HPV

The nurse suspects a client weighing 161 pounds may be exhibiting signs of sepsis. Which urinary output value indicates acute oliguria?

50 mL in past 2 hours

A 57-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that it has been 14 months since her last period. What should the nurse further assess?

The patient is postmenopausal.

When assessing a pregnant female, the nurse documents Gravida 3, Para 2 regarding obstetrical history in the health record. Which situation correctly corresponds to the obstetrical history of the women?

The woman has been pregnant three times and has delivered two live children

While inspecting the labia minora, a nurse notices that they are asymmetric. Which of the following does this finding most likely point to?

abscess

Which client should the nurse assess for possible primary amenorrhea?

an 18-year-old who has never started menses

When examining the uterus, a nurse finds that the cervix is pointed posteriorly and the body of the uterus is at the level of the pubis over the bladder. How should the nurse document this uterine finding?

anteverted

The Papanicolaou test is a screening tool for what?

cervical cancer

The nurse is working with an anorexic client who complains that sexual intercourse with her partner is painful. The nurse suspects that the client may lack the fat pad that is typically located over the pubic bone in women and that functions to absorb force and protect the pubic bone. Which of the following is the name of this structure?

mons pubis

What information should a nurse give a client who reports a routine of frequent douching?

predisposes the vagina to yeast infections

A client asks the nurse when a colonoscopy is recommended. Which advice provided by the nurse is most appropriate?

"A flexible sigmoidoscopy should be done every five years starting at age 50."

A female client tells the nurse that she may be experiencing premenstrual syndrome. An appropriate question for the nurse to ask the client is

"Do you experience mood swings or bloating?"

The nurse is performing a genitourinary assessment on a 42-year-old client and has explained to her that the assessment will require rectovaginal palpation. The client winces and asks, "Is that really necessary?" Which of the nurse's responses would provide the best rationale for rectovaginal palpation?

"I know this is probably unpleasant, but it's important for me to determine if your uterus is where it's expected."

A 17-year-old client has expressed concern over having a vaginal discharge just before her menses begins. What response should the nurse provide the client to best address her concerns?

"If there are no other signs or symptoms, it is likely a result of normal ovulation."

A 57-year-old woman calls the clinic reporting painful intercourse following by spotting. She tells the nurse that she hasn't had a period in 2 years. What should the nurse tell her?

"These findings are common in postmenopausal women."

A 29-year-old woman with a longstanding diagnosis of genital herpes has presented to the clinic because of a recent "flare-up." What should the nurse expect during inspection of this recurrence of herpes?

A local patch of small, painful lesions on the client's vulva

A female client presents to the clinic with chills and fever for 3 days. She also complains of sores in her genital region. The nurse should prepare to give which instructions to this client?

Abstinence should be practiced while sores are weeping.

A female client with a history of endometriosis tests positive with a urine pregnancy test. She complains of right lower quadrant pain and nausea. During an ultrasound, an empty gestational sac is seen. What is the nurse's priority action?

Advise client to seek treatment right away

The nurse is preparing a client for a pelvic examination. Which of the following would be included in the nurse's instructions?

Ask the client to empty her bladder prior to the exam

A client has been ordered to have a physical examination of the genitalia. Which information should a nurse give a client scheduled for her first Pap test to improve the accuracy of the test?

Avoid douching 48 hours before the examination

A 30-year-old paralegal analyst comes to your clinic, complaining of a bad-smelling vaginal discharge with some mild itching, present for about 3 weeks. She tried douching but it did not help. She has had no pain with urination or with sexual intercourse. She has noticed the smell increased after intercourse and during her period last week. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of one spontaneous vaginal delivery. She is married and has one child. She denies tobacco, alcohol, or drug use. Her mother has high blood pressure and her father died from a heart disease. On examination she appears healthy and has unremarkable vital signs. On examination of the perineum there are no lesions noted. On palpation of the inguinal nodes there is no lymphadenopathy. On speculum examination a thin gray-white discharge is seen in the vault. The pH of the discharge is over 4.5 and there is a fishy odor when potassium hydroxide (KOH) is applied to the vaginal secretions on the slide. Wet prep shows epithelial cells with stippled borders (clue cells). What type of vaginitis best describes her findings?

Bacterial vaginosis

An adult woman presents at the clinic with a grayish vaginal discharge with a 'fishy' odor. What should the nurse suspect?

Bacterial vaginosis

A 24-year-old travel agent comes to your clinic, complaining of pain and swelling in her vulvar area. She states that 2 days earlier she could feel a small tender spot on the left side of her vagina but now it is larger and extremely tender. Her last period was 1 year ago and she is sexually active. She uses the Depo-Provera shot for contraception. She denies any nausea, vomiting, constipation, diarrhea, pain with urination, or fever. Her past medical history is significant for ankle surgery. Her mother is healthy and her father has type 2 diabetes. On examination she appears her stated age and is standing up. She states she cannot sit down without excruciating pain. Her blood pressure, temperature, and pulse are unremarkable. On visualization of her perineum, a large, red, tense swelling is seen to the left of her introitus. Palpation of the mass causes a great deal of pain. What disorder of the vulva is most likely causing her problems?

Bartholin's gland infection

A client is explaining to the nurse how vaginal dryness has decreased her enjoyment of sexual intercourse. The nurse is aware that which of the following are the glands that produce mucus that lubricates the vagina during intercourse?

Bartholin's glands

The nurse notes a white curd-like discharge when inspecting a female client's labia. What should the nurse suspect this client is experiencing?

Candida vaginitis

A female client has been diagnosed with menorrhagia. What information should the nurse provide the client concerning menses flow?

Flow may include clots.

A nurse observes a few small, yellow nodules on the cervix of a client during the speculum exam. They are not painful or odorous, and a thin, clear discharge is present. The nurse recognizes that these are most indicative of what type of condition?

Nabothian cysts

A 35-year-old woman visits her family doctor and reports mood swings, swelling of her breasts, acne, bloating, and weight gain every month, starting about 2 weeks prior to her period. What disorder is this client describing?

Premenstrual syndrome (PMS)

The nurse is reviewing the functions of the ovaries, uterus, clitoris and vagina with a group of nursing students. Based on this information, what would be the best response by a nursing student about the function of the uterus?

Receives the fertilized ovum and provides housing and nourishment for a fetus

When palpating the internal female genitalia, the nurse separates the client's labia and asks her to strain down to assess which of the following?

Support of vaginal walls

A female client tells the nurse she thinks she has a vaginal infection because she has noted inflammation of her vulva and a yellowish green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infections?

Trichomonas vaginalis

When a female client reports a frothy, yellow-green vaginal discharge, the nurse suspects the client has a vaginal infection caused by which organism?

Trichomonas vaginalis

The nurse is assessing the genitalia of a female client and detects a bulging anterior wall in the vagina. The nurse should plan to refer the client to a physician for

cystocele

The outer layer of the vaginal wall is under the direct influence of

estrogen

The nurse suspects that a client is experiencing perimenopause. What client symptom caused the nurse to make this clinical decision?

hot flashes

Which finding in a female client's history would alert the nurse to assess for signs of diabetes mellitus?

recurrent candidiasis infections

Which position occurs when the uterus turns posteriorly as a whole unit?

retroversion

When examining the uterus, a nurse finds that the cervix and the body of the uterus are tilted backward. How should the nurse document this uterine finding?

retroverted

To best secure accurate assessment information, the nurse should complete which part of the reproductive history last?

sexual

A 41-year-old woman is considering the use of hormonal contraceptives. What is contraindicated in this client?

smoking

During a physical examination of a female client's reproductive system, the nurse detects a thick white discharge from the labia. The client's vulva appears inflamed. How should the nurse document this finding?

symptoms of candidal vaginitis

The school nurse is presenting a class on female reproductive health. While discussing prevention the nurse teaches what about a Pap smear?

to detect cervical cancer

During the examination of the external genitalia, the nurse notices drainage from the urethra. The nurse should prepare to assess the client for which condition?

urethritis