ch 27 female genitalia
A 35-year-old client tells the nurse that she is concerned that she may be already starting menopause. The nurse should explain that the normal range of years for menopause to occur is which of the following?
40 to 58 years old (normal) menopause before 30 is premature menopause. 31-40 is early menopause. 58+ delayed menopause
A news is interviewing a client who is from Bangladesh. Which of the following should the nurse not find unusual, based not the clients country of origin?
Late menarche Menarche (the beginning of menstruation) tends to begin earlier in women living in developed countries & later in women who live in under developed countries. PMS and amenorrhea is not associated w/ women from undeveloped countries
While inspecting the labia minora, a nurse notices that they are asymmetric. Which of the following does this finding most likely point to?
Access Asymmetric labia incites access. Urinary tract infection (frequency urination, burning, & pain). Candidate vaginitis is overgrowth of yeast in vagina (thick white cheesy discharge). Cervical cancer may produce lesions.
A client presents to the health care clinic and reports a 7-day history of vaginal discharge and swelling of the labia. During the examination of the external genitalia, the nurse notices an enlarged Bartholin's gland. The nurse should prepare to culture this client for which condition?
Gonorrhea Abscess of Bartholin's gland with discharge can be sign of infection (gonnarhea). Drainage from the urethra insides urethritis. Trichomoniasis causes green discharge w/ fish odor. Lice causes irritation & whitish dandruff on pubic hairs but does not cause vaginal swelling.
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 (fat pad located over pubis ). Vulva area of the female external genitalia extends from mons pubis to the anal opening. Clitoris is located at the anterior end of the labia minora. 2 folds join to form frenulum
Which statement by a client in regards to her ability to conceive should prompt a nurse to ask additional questions about infertility?
My husband and I have had unprotected intercourse for over a year Infertility is defined as unprotected sex for one year without becoming pregnant. Multiple sex partners increases a woman's risk of sexually transmitted diseases and cervical cancer. A normal menstrual cycle occurs approximately every 28-45 days and lasts 3-7 days. Vaginal dryness may be a sign of entering menopause.
While inspecting a client's vagina, the nurse notes transverse folds in the outer layer of pink squamous epithelium. These folds are known as which of the following?
Rugae (outer layer of wall) Endometrium, myometrium and peritoneum are 3 layers of the uterine wall
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." Starting at 50 men &women should have fecal occult blood test or flexible sigmoid every 5 years. All screening should start at 50,not 65. Health car providers should follow guidelines not make their own decisions.
A nurse begins the speculum examination and finds the vaginal orifice tight. What is the appropriate action by the nurse to facilitate the insertion of the speculum?
Ask the client to bear down to relax the muscles of the perineum Asking the client to bear down promotes opening. Lubricant should not be applied to the speculum because it is typically bacteriostatic & will alter with Ph & specimens being collected. The speculum should be held vertical & blades closed until the base touches the examiners fingertips inside the vagina
A male nurse greets a new client in the waiting room of a gynecologist office. The woman is wearing a burka and does not make eye contact with the nurse. How should the nurse reposed to this client?
Ask the client whether she would prefer to be seen by a female nurse Some clients from diff cultures want a female nurse. Explaining educational credentials and experience would not alleviate her primary concern. It may not be feasible for he gynecologist to come and great the client. Escorting the client without speaking would be awkward
In non pregnant women where should a nurse anticipate palpating for the fundus of the uterus?
At the level of the pubis in nonpregat woman, the funds or large upper end of utters should be at the level of the pubis. Above this level is considered enlarged and further examination should be completed
A client has been ordered 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. The nurse should ask the client to urinate before the examination so that she does not experience bladder discomfort. The client is helped by the nurse into a dorsal lithotomy position, which is a supine with feet in the stirrups. The clients head & shoulders may be elevated to allow the nurse to maintain eye contact with the client. The client should be asked not to place the hands over the head as this tightens the abdomen muscles.
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 Bartholin's glands secret mucus which lubricates. Coopers glands help lubricate the urethra for sperm to pass. Sebaceous glands are oil glands in skin that secrete sebum. Eccrine glands secrete sweat
A woman who has undergone a total hysterectomy asks a nurse about follow-up pap smears. Which statement by the nurse is correct?
Cervical screening is not necessary once a total hysterectomy is performed Once cervix is removed there is no need for pap unless surgery was for cervical cancer. Pap is recommended every 3 years to women 21-65 regardless of normalcy of previous paps or sexual activity. Women over 65 who had prior screenings with good results are not at high risk for cervical cancer can choose to stop screening
A 35-year-old client has a Pap test with a normal test result. The client has had two previous tests with normal results. Which information is correct for the nurse tell this client with regard to future screening for cervical cancer?
Continue exams every 3 years Screening for cervical cancer in women ages 21 to 65 years with cytology(pap smear) every 3 years or screening with a combination of cytology and HPV testing every 5 years for women ages 30 to 65 years who want to lengthen the screening interval.
When asking a client to bear down as the labia minora is separated, a nurse notices a bulging of the anterior wall of the vaginal musculature. How should this finding be documented by the nurse?
Cystocele (anterior wall) Bulging of the posterior vaginal wall indicates rectocele. Uterine prolapse is seen when the cervix or uterus protrudes downward. Decreased uterine tone is assessed by asking client to squeeze examines finger.
A client presents to health care clinic for a routine pelvic examination. The client tells the nurse that she has experienced several yeast infections over the past year. The nurse should ask the client about the presence of which disease process?
Diabetes mellitus Diabetes mellitus predisposes women to yeast infections because the increased glucose levels are good for yeast to grow. Heart disease,kidney stones and STI do not predispose women to yeast infection
The nurse is present during a pelvic examination of a female client. The healthcare provider states that the multiparous client has several small nodules at the cervix that look like yellow pustules. The nurse should prepare for which action?
Document the findings.
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 Having multiple sex partners is risk for cervical cancer. Having HPV vaccine can lower the risk. Smoking & lack of exercise are not associated with cervical cancer
A nurse inspects the genitalia of an elderly client and notices the mucosa is dry and atrophied. The nurse should educate the client about her increased risk of what condition?
Infection Older client is more susceptible to vaginal infection because of atrophy of the vaginal mucosa associated w/ aging. Incontinence and difficultly urinating may be signs of infection or STD. Vaginal bleeding indicate more serious condition like endometrial or cervial cancer
Which position is it most logical for the nurse to place the female client in for the anus and rectum examination?
Lithotomy (on back legs up) Mot logical female will already be in this position from vaginal exam
A nurse observes a think, white cheesy discharge at the vaginal opening, with irrigation and swelling of the labia. The nurse recognizes this finding as most likely indicating what type of vaginal infection?
Moniliasis (overgrowth of yeast in vagina) Trichomonias is caused by protozoan organism & STI (yellow-green & foul smell). Chlamydia produces mucopurulent yellow discharge (not always visible). Bacterial Vaganois produces thin-graywhite discharge w/fishy smell & coats the vaginal walls & ectocervix
A nurse observes a few small, yellow colored nodules on the cervix of a client during the speculum exam. They are not painful, nonodorous, and thin clear discharge is present. The nurse recognizes these are most indicative of what type of condition?
Nabothian cysts (found after childbirth) Chlamydia causes mucopurulent, yellow discharge that irritates & may causes bleeding & redness. Cervical eversion is normal a after child birth. Columnar epithelium is everted and appears deep red, rough ring round the cervical os, surrounded by the normal pink color of the cervix
A college student presents to the health care center for a routine pap smear. She states that she is thinking about becoming sexually active with her boyfriend of 1 year but afraid she might get pregnant. She has a history of no smoking, no substance abuse and drinks occasionally on weekend. She asks about BC options and their safety. What is the appreciate diagnosis
Readiness for Enhanced Health Management Client is asking for info about BC to prevent pregnancy
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 Redness of the cervix may indicate inflammation. The surface of the cervix is usually smooth,pink & even. In a Non pregnant client a bluish cervix may indicate cyanosis. In a pregnant client blue cervix is Chadwick's sign. In a nonmenopausual client a pale cervix indicates anemia; older clients cervix may appear pale after menopause
A client reports the new onset of mucus in the stool. How should the nurse document this in the client's history?
Steatorrhea (mucus in the stool) Diarrhea is a loose stool. Change in bowel habits is not specific to the problem reported. Fatal incontinence is the inappropriate release or inability to control the bowels
A nurse is preparing a client for a Pap smear. The nurse knows that the area where 90% of the neoplasms of the lower genital track originate and the area from which cells will be obtained for the Pap smear is which of the following?
Transformational Zone Squamocolumnar junction is the point where the 2 types of epithelium meet at the cervical os. Fallopian tubes aid the travel of the ovum 8-12 cm tubes begin near the ovaries & ender uterus under the funds. Fimbriae finger like extensions on end of tube near ovary
When examining the genitalia of a client, a nurse observes a columnar epithelium that extends onto the vaginal wall. The nurse recognizes this finding as indicative of what condition?
exposure to diethylstilbestrol The presence of columnar epithelium that extends onto the vaginal wall indicates exposure to diethylstilbestrol (DES) as a fetus. DES is a drug that was used more than 50 years ago to prevent spontaneous abortion & premature labor. Mucopurulent yellowish discharge from the external os is seen when client has mucopurulent cervicitis; it usually indicates infection with Chylamdia or gonorrhea. Lesions that develop into cauliflower life growths are indicative of cancer of the cervix. A Yellow-green frothy foul smelling discharge is observed in a client with Trichomonas vaginitis
What information should a nurse give a client who reports a routine of frequent douching?
predisposes the vagina to yeast infections The nurse should inform the client that frequent douching changes the natural flora of the vagina, predisposing the vagina to yeast infections. It does not contaminate the vagina and urethra, cause toxic shock syndrome or cause abrasions that bleed easily.Wiping the perineal area from back to front can contaminate the vaginal & urethral openings. Toxic shock syndrome is life-threatening infection that can be prevented by frequently changing tampons. Atrophic vaginitis causes itching,burning, dryness & painful urination.
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 Retroverted uterus is a normal variation that consists of the cervis & the body of the uterus tilting backward. Anteflexed is normal consists of uterine body flexed anteriorly in relation to the cervix. Retroflexed uterus is normal uterine body is flexed posteriorly in relation to the cervix. Anteverted uterus is most typical position; cervix is pointed posteriorly and the body of the uterus is at level of the pubis over the bladder
What intervention should a nurse follow when obtaining the specimen for a gonorrhea culture
spread specimen in a "Z" pattern onto a special culture plate The nurse should spread the specimen in a "Z" pattern onto a special culture plate for Neisseria gonorrhoae cultures. A cotton-tipped applicator is inserted into the cervical os & rotated in a full circle. The applicator is left in place for app. 20 seconds to make sure it becomes saturated with specimen
