Chapter 24 Prep U
When assessing an adolescent female, the nurse notes long, slightly pigmented, downy hair along the labia. What Tanner's stage of maturation does the nurse document in the health record?
Tanner Stage 2
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.
When assessing an adolescent female, the nurse documents Tanner's stage 2 of maturation in the health record. Which assessment findings best describe Tanner's stage 2?
long, slightly pigmented, downy hair that is straight or only slightly curled along the labia
Research has shown that in vitro fertilization has a higher
risk of fetal loss
Which client should the nurse assess for possible primary amenorrhea?
an 18-year-old who has never started menses
While inspecting the vagina, the nurse observes a thin, grayish-white vaginal discharge with a fishy odor. What would the nurse suspect?
Bacterial vaginosis
A female client has presented for a Pap smear test, and the nurse is discussing risk factors for cervical cancer. What risk factor should the nurse describe?
Having multiple sexual partners
A nurse assesses a 22-year-old client who has never had a Pap test. Which factor should the nurse explain to the client as being a risk for cervical cancer?
Having multiple sexual partners
Which of the following terms refers to painful menstruation?
Dysmenorrhea
What information should a nurse give a client who reports a routine of frequent douching?
predisposes the vagina to yeast infections
A perimenopausal female presents to the clinic with complaints of vaginal dryness and painful intercourse. The woman states, "This has never been a problem before." What is the best response by the nurse?
"As a woman ages, estrogen levels decrease causing vaginal drying and pain during intercourse."
The mother of a 3-year-old girl reports that her toilet-trained daughter is constantly rubbing her perineum. What is the best initial response by the nurse?
"Does your daughter take bubble baths?"
A nurse is preparing a female client for a genitourinary examination that has been scheduled for later in the week. What anticipatory guidance should the nurse provide to the client?
"Make sure not to douche for 48 hours before the examination."
A 57-year-old woman calls the clinic reporting painful intercourse followed 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."
The nurse is conducting a sexual history with a widowed woman who speaks very little English. The nurse recognizes an interpreter is necessary, but a professional interpreter is not available. Which person would be best to serve as an interpreter/translator?
A female employee of the clinic
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.
The nurse is taking a sexual history on a new patient. What action is considered appropriate at this time? (Select all that apply.)
Affirm that your conversation is confidential;, Note that you realize this information is highly personal, Explain why you are taking the sexual history
A 24-year-old travel agent comes to your clinic complaining of pain and swelling in her vulvar area. She states that 2 days before 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 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
The factor that has the most impact in preventing sexually transmitted infections (STI's) is which of the following?
Being in a monogamous sexual relationship
The nurse explains the parts of a female pelvic examination to a young adult female client. What should the nurse explain is being examined in this diagram?
Bimanual palpation of the cervix
A Nurse Practitioner is examining a patient who presented at the free clinic with vulvar pruritus. Which assessment factor would the practitioner look for that may indicate that the patient has an infection caused by Candida albicans?
Cottage cheese-like discharge
The nurse is preparing a client for an assessment of her genitalia and rectum. What action should the nurse perform when preparing the client?
Explain the rationale for using foot stirrups.
The nurse selects the diagram shown to use when teaching a female client. What health problem is the nurse reviewing with this client?
Fibroids
When collecting subjective data, the nurse knows that assessment of the female client can be very invasive. Starting with questions relating to health history allows the nurse to do what?
Gain the client's confidence
When assessing the vaginal orifice of a young female client who has never been sexually active, the nurse notes a fold of fibrous tissue at the introitus. The nurse recognizes this as which structure?
Hymen
Which of the following is true of the HPV vaccine?
It requires three doses at specific intervals.
The nurse is teaching a middle-aged female who smokes about various birth control methods. Which is the most appropriate birth control method for this patient?
Latex condom
What is a lay term for the spontaneous loss of pregnancy?
Miscarriage
A nurse observes a thick, white, cheesy discharge at the vaginal opening, with irritation and swelling of the labia. The nurse recognizes this finding as most likely indicating what type vaginal infection?
Moniliasis
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
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 patient describing?
Premenstrual syndrome (PMS)
A nurse inspects the cervix of a 52-year-old client during a routine assessment. Which coloration of the cervix may indicate that the woman is postmenopausal?
Pale
The nurse is present during a pelvic examination of an adolescent female client. Which action should the nurse prepare for first?
Pap smear specimen collection
During a comprehensive assessment, a female client complains of intense external genital itching. The nurse should carefully assess for which condition that commonly presents with this symptom?
Pediculosis pubis
Which of the following is the most important risk factor for cervical cancer?
Persistent HPV infections
A 29-year-old obese woman with a history of ovarian cysts presents to the emergency department. The patient is in severe left-sided pain and tells the nurse that "this is how it feels every time I have had a cyst." She is found to have a ruptured ovarian cyst, and the physician recommends that she be evaluated
Polycystic ovarian syndrome
The nurse is reviewing the functions of the ovaries, uterus, clitoris and vagina with a group of high school students. Based on this information, what would be the best response by a high school student about the function of the vagina?
Receives sperm, provides an exit for menstrual flow and serves as the birth canal.
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.
Which finding in a female client's history would alert the nurse to assess for signs of diabetes mellitus?
Recurrent candidiasis infections
A nurse inspects the cervix of a 28-year-old non-pregnant client during a routine assessment. Which coloration of the cervix may indicate inflammation?
Red
A nurse inspects the cervix of a 28-year-old, nonpregnant client during a routine assessment. Which coloration of the cervix may indicate inflammation?
Red
During the inspection of a patient's reproductive system, the nurse identifies small lacerations and bruises of the labia majora and minora. What does this finding suggest to the nurse?
Sexual abuse
The nurse is reviewing the functions of the ovaries, uterus, clitoris and vagina with a group of high school students. Based on this information, what would be the best response by the high school student about the function of the clitoris?
Small erectile structure that responds to sexual stimulation.
A 41-year-old woman is considering the use of hormonal contraceptives. What is contraindicated in this client?
Smoking
The nurse is teaching a health class at the local high school and is discussing human papillomavirus (HPV) with a group of 10th-grade female students. What important information should be given to these young women?
Someone with multiple partners has the highest risk of developing HPV.
A client reports the new onset of mucus in the stool. How should the nurse document this in the client's history?
Steatorrhea
An older adult client states, "Sometimes when I sneeze, I notice that I wet my pants." How would the nurse interpret this finding?
Stress incontinence
An older adult client states, "Sometimes when I sneeze, I notice that I wet my pants." The nurse interprets this as which of the following?
Stress incontinence
During a physical examination of a female patient's reproductive system, the nurse detects a thick white discharge from the labia. The patient's vulva appears inflamed. How should the nurse document this finding?
Symptoms of candidal vaginitis
While examining the perineum of a female patient, the nurse notes an enlarged knot to the right side just below the vaginal opening. The nurse will most likely note this as an enlarged Bartholin gland.
True
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.
An adult client has sought care at the clinic, stating that she believes she has "a raging yeast infection." The nurse would expect to assess what type of vaginal discharge?
Thick, white vaginal discharge
The nurse is caring for a 17-year-old girl who is 16 weeks pregnant. The patient's history shows infection with multiple STIs. What should the nurse do?
Verify that prior STIs were treated according to protocol.
A 43-year-old woman comes to the ob/gyn clinic for her yearly examination. She tells the nurse that she wants to renew the prescription for her birth control pills. During the assessment interview, the patient tells the nurse that she smokes ½ pack a day and drinks several drinks a day. What should the nurse include in patient education?
Women older than 40 years who smoke should not take birth control pills.
The nurse is planning to inspect the anal area of an adult female client. To assess for any bulges or lesions, the nurse should ask the client to
bear down.
A female presents to the clinic with complains of vaginal bleeding with intercourse. The woman states, "This has never been a problem before." Which assessment finding would the nurse expect?
cervical polyp
To best secure accurate assessment information, the nurse should complete which part of the reproductive history last?
sexual
