Jarvis Ch. 27: Female Genitourinary

A 35-year-old woman is at the clinic for a gynecologic examination. During the examination, she asks the nurse, "How often do I need to have this Pap test done?" Which reply by the nurse is correct? A) "It depends. Do you smoke?" B) "This will need to be done annually until you are 65." C) "If you have 2 consecutive normal Pap tests, then you can wait 5 years between tests." D) "After age 30, if you have 3 consecutive normal Pap tests, then you may be screened every 2 to 3 years."

"After age 30, if you have 3 consecutive normal Pap tests, then you may be screened every 2 to 3 years."

A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are: A) "If you are menstruating, please use pads to avoid placing anything into the vagina." B) "Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment." C) "If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you." D) "We would like you to use a mild saline douche before your examination. You may pick this up in our office."

"Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment."

what does the nurse instruct the patient to do during the speculum examination? A. "Place your hips midway down the examining table." B. "Bear down so that the perineal muscles can relax." C. "Squeeze your perineal muscles so that I can assess the pelvic floor strength." D. "Tell me if there is any discomfort, so that the speculum will be removed."

"Bear down so that the perineal muscles can relax."

Which instructions should the nurse provide to a patient regarding a pelvic examination? 1 "Do not douche or have intercourse 24 hours before the examination." 2 "You can hold your breath during the examination if you feel uncomfortable." 3 "It is best if you do not view the procedure because you may find it disturbing." 4 "You will have to remove all clothing including shoes and socks before the examination."

"Do not douche or have intercourse 24 hours before the examination."

The nurse teaches a student nurse about obtaining a female patient's reproductive health history. Which statement, if made by the student nurse, indicates effective learning? A. "It should be obtained during the pelvic examination." B. "It should include the pattern of menstruation and sexual satisfaction." C. "It should focus on physical complaints such as discharge, pain, or rash." D. "It should be obtained every 3 to 5 years in a patient without complaints."

"It should include the pattern of menstruation and sexual satisfaction."

The parent of a 12-year-old child asks why the human papillomavirus (HPV) vaccine is given to a child who is not sexually active. What is the nurse's best response? A. "This gives time for immunity to develop before a child becomes sexually active." B. "This is how the insurance company requires the vaccination to be administered." C. "This vaccination is designed to prevent the onset of pelvic inflammatory disease." D "The vaccination includes three injections to be given one year apart for effectiveness."

"This gives time for immunity to develop before a child becomes sexually active."

When assessing a newborn infant's genitalia, the nurse notices that the genitalia are somewhat engorged. The labia majora are swollen, the clitoris looks large, and the hymen is thick. The vaginal opening is difficult to visualize. The infant's mother states that she is worried about the labia being swollen. The nurse should reply: A) "This is a normal finding in newborns and should resolve within a few weeks." B) "This could indicate an abnormality and may need to be evaluated by a physician." C) "We will need to have estrogen levels evaluated to make sure that they are within normal limits." D) "We will need to keep close watch over the next few days to see if the genitalia decrease in size."

"This is a normal finding in newborns and should resolve within a few weeks."

When performing an external genitalia examination of a 10-year-old girl, the nurse notices that there is no pubic hair, and the mons and the labia are covered with fine vellus hair. These findings are consistent with stage _____ of sexual maturity, according to the Sexual Maturity Rating scale. A) 1 B) 2 C) 3 D) 4

1

A patient has had three pregnancies and two live births. The nurse would record this information as gravida _____, para _____, AB _____. A) 2; 2; 1 B) 3; 2; 0 C) 3; 2; 1 D) 3; 3; 1

3; 2; 1

During an examination the nurse observes a female patient's vestibule and expects to see the: A) urethral meatus and vaginal orifice. B) vaginal orifice and vestibular (Bartholin) glands. C) urethral meatus and paraurethral (Skene) glands. D) paraurethral (Skene) and vestibular (Bartholin) glands.

A. Urethral meatus and vaginal orifice

While doing an assessment of the external genitalia, the nurse finds that the patient has a posteriorly swollen labia, tenderness, and a palpable mass on the labia. Which condition should the nurse expect to find in the patient? A. Leiomyomas B. Genital warts C. Atrophic vaginitis D Abscess on the Bartholin gland

Abscess on the Bartholin gland

structure is highly sensitive to tactile stimulation? A. Hymen B. Vagina C. Clitoris D Vestibule

Clitoris

The nurse is palpating an ovarian mass during an internal examination of a 63-year-old woman. Which findings of the mass's characteristics would suggest the presence of an ovarian cyst? Select all that apply. A) Heavy and solid B) Mobile and fluctuant C) Mobile and solid D) Fixed E) Smooth and round F) Poorly defined

B, E

A patient complains of vaginal pruritus and burning. The nurse notes a fishy smell and watery gray drainage. What does this finding indicate? A. Candidiasis B. Trichomoniasis C. Bacterial vaginosis D. Atrophic vaginitis

Bacterial vaginosis.

A patient reports to the nurse about having pain during urination with increased frequency and postcoital bleeding. The nurse also notices yellow mucopurulent discharge and a friable cervix during the pelvic assessment. Which infection does the nurse suspect in the patient? A. Chlamydia B. Gonorrhea C. Candidiasis D. Trichomoniasis

Chlamydia

While examining a patient who has stress incontinence, the nurse observes that the patient's bladder is prolapsed into the vagina. Which condition does this finding suggest? A. Rectocele B. Cystocele C. Atrophic vaginitis D. Uterine prolapse

Cystocele

During a health history, a 22-year old woman asks, "Can I get that vaccine for HPV? I have genital warts and I'd like them to go away!" What is the nurse's best response? A) "The HPV vaccine is for girls and women ages 9 to 26, so we can start that today." B) "This vaccine is only for girls who have not started to have intercourse yet." C) "Let's check with the physician to see if you are a candidate for this vaccine." D) "The vaccine cannot protect you if you already have an HPV infection."

D. The vaccine cannot protect you if you already have HPV.

A nurse is assessing a patient's risk of contracting a sexually transmitted infection (STI). An appropriate question to ask would be: A) "You know that it's important to use condoms for protection, right?" B) "Do you use a condom with each episode of sexual intercourse?" C) "Do you have a sexually transmitted infection?" D) "You are aware of the dangers of unprotected sex, aren't you?"

Do you use a condom with each episode of sexual intercourse?

A married couple has come to the clinic seeking advice on pregnancy. They have been trying to conceive for 4 months and have not been successful. What should the nurse do first? A) Ascertain whether either of them has been using broad-spectrum antibiotics. B) Explain that couples are considered infertile after 1 year of unprotected intercourse. C) Immediately refer the woman to an expert in pelvic inflammatory disease—the most common cause of infertility. D) Explain that couples are considered infertile after 3 months of engaging in unprotected intercourse and that they will need a referral to a fertility expert.

Explain that couples are considered infertile after 1 year of unprotected intercourse

6. A woman who is 8 weeks pregnant is in the clinic for a checkup. The nurse reads on her chart that her cervix is softened and looks cyanotic. The nurse knows that the woman is exhibiting __________ sign and __________ sign. a.Tanner; Hegar b.Hegar; Goodell c.Chadwick; Hegar d.Goodell; Chadwick

Goodell; Chadwick

During an external genitalia examination of a woman, the nurse notices several lesions around the vulva. The lesions are pink, moist, soft, and pointed papules. The patient states that she is not aware of any problems in that area. The nurse recognizes that these lesions may be: A) syphilitic chancre. B) herpes simplex virus type 2 (herpes genitalis). C) human papillomavirus (HPV), or genital warts. D) pediculosis pubis (crab lice).

HPV or genital warts.

Which symptoms should the nurse expect to find in a menopausal patient? Select all that apply. 1 Hot flashes 2 Night sweats 3 Mood swings 4 Fluid retention 5 Vaginal bleeding

Hot flashes Night sweats Mood swings

before withdrawing the speculum, the examiner swabs the cervix with a swab soaked in acetic acid. This exam is done to assess for

Human Papillomavirus

Which condition presented here can be sexually transmitted? 1 Urethral caruncle 2 Abscess of the Bartholin gland 3 Human papillomavirus (HPV) genital warts 4 Cystocele

Human papillomavirus (HPV) genital warts

During the interview with a female patient, the nurse gathers data that indicate that the patient is perimenopausal. Which of these statements made by this patient leads to this conclusion? A) "I have noticed that my muscles ache at night when I go to bed." B) "I will be very happy when I can stop worrying about having a period." C) "I have been noticing that I sweat a lot more than I used to, especially at night." D) "I have only been pregnant twice, but both times I had breast tenderness as my first symptom."

I have been noticing that I sweat a lot more than I used to, especially at night.

During the interview a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurse's most appropriate response to this would be: A) "Oh, don't worry. Some cyclic vaginal discharge is normal." B) "Have you been engaging in unprotected sexual intercourse?" C) "I'd like some information about the discharge. What color is it?" D) "Have you had any urinary incontinence associated with the discharge?"

I'd like some information about the discharge. What color is it?

A 22-year-old woman has been considering using oral contraceptives. As a part of her history, the nurse should ask: A) "Do you have a history of heart murmurs?" B) "Will you be in a monogamous relationship?" C) "Have you thought this choice through carefully?" D) "If you smoke, how many cigarettes do you smoke per day?"

If you smoke, how many cigarettes do you smoke per day?

While assessing a female adolescent patient, the nurse finds that the patient's hymen is bluish in color and bulging. The patient reports to the nurse that she has not started her menses. For which condition should the nurse screen in this patient? A. Dyspareunia B. Delayed puberty C. Imperforate hymen D. Physiologic leucorrhea

Imperforate hymen

What is a characteristic of the adnexal structures of the uterus? 1 Palpable in a healthy patient 2 Include the bladder and rectum 3 Include the fallopian tubes and ovaries 4 Include an arterial pulse in a normal pregnancy

Include the fallopian tubes and ovaries

How does the nurse assume an obstetric position for the vaginal examination of a patient? 1 Index, middle, and fourth fingers extended and the thumb adducted 2 The four fingers extended together and the thumb folded down on the palm 3 The index finger extended opposed by the thumb so that tissues can be palpated between them 4 Index and middle fingers extended, thumb abducted, and fourth and little fingers folded down onto the palm

Index and middle fingers extended, thumb abducted, and fourth and little fingers folded down onto the palm

During an internal examination of a woman's genitalia, the nurse will use which technique for proper insertion of the speculum? A) Instruct the woman to bear down, open the speculum blades, and apply in a swift, upward movement. B) Insert the blades of the speculum on a horizontal plane, turning them to a 30-degree angle while continuing to insert them. Ask the woman to bear down after the speculum is inserted. C) Instruct the woman to bear down, turn the width of the blades horizontally, and insert the speculum at a 45-degree angle downward toward the small of the woman's back. D) Lock the blades open by turning the thumbscrew. Once the blades are open, apply pressure to the introitus and insert the blades at a 45-degree angle downward to bring the cervix into view.

Instruct the woman to bear down, turn the width of the blades horizontally, and insert the speculum at a 45-degree angle downward toward the small of the woman's back.

Which statement best describes the clitoris? A. It has a visible length of 5 cm. B. It is composed of erectile tissue. C. It is a thin circular fold covering the vaginal opening. D. It is composed of glandular tissue that secretes vaginal moisture.

It is composed of erectile tissue.

Which finding does the nurse consider abnormal when inspecting the patient's cervix and its opening? A. Lateral position of the cervix B. Diameter of cervix as 2.5 cm C. Pink-colored cervical mucosa D. Small, round cervical opening

Lateral position of the cervix

When the nurse is discussing sexuality and sexual issues with adolescents, a permission statement helps to convey that it is normal to think or feel a certain way. Which of these is the best example of a permission statement? A) "It is okay that you have become sexually active." B) "Often girls your age have questions about sexual activity. Have you any questions?" C) "If it is okay with you, I'd like to ask you some questions about your sexual history." D) "Often girls your age engage in sexual activity. It is okay to tell me if you have had intercourse."

Often girls your age have questions about sexual activity. Have you any questions?

Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview? A) "Now it is time to talk about your sexual history. When did you first have intercourse?" B) "Women often feel dissatisfied with their sexual relationships. Would it be okay to discuss this now?" C) "Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?" D) "Most women your age have had more than one sexual partner. How many would you say you have had?"

Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?

What is the shape of the uterus of a patient who is 24 weeks pregnant? A. Pear B. Oval C. Round D. Globular

Oval

On reviewing a patient's laboratory results, the nurse finds that the patient has chlamydia. What potential complication should the nurse explain to the patient to ensure treatment compliance? A. Trauma B. Infection C. Dyspareunia D. Pelvic inflammatory disease

Pelvic inflammatory disease

A female patient complains of watery, bubbly, malodorous, yellowish green discharge. Which condition does the nurse suspect in the patient? A. Pubic lice B. Candidiasis C. Trichomoniasis D. Gardnerella vaginalis

Trichomoniasis

The nurse is examining the genitourinary system of a female patient. Which procedures should the nurse include when doing a vaginal examination? Select all that apply. A.Situate the patient in the lithotomy position. B. Have the patient raise her arms over her head. C. Put an examination glove on each of the stirrups. D. Elevate the end of the exam table near the head. E. Teach the patient to keep quiet during the exam.

Situate the patient in the lithotomy position. Put an examination glove on each of the stirrups. Elevate the end of the exam table near the head.

When doing a genital assessment of a patient who has a genital infection, the nurse finds small, round, solitary, and silvery papules with yellowish serous discharge. Upon palpation, the nurse notes nontender, button-like structures, and enlarged lymph nodes. Which condition should the nurse expect in the patient? A. Urethritis B. Herpes genitalis C.Syphilitic chancre D.Urethral caruncle

Syphilitic chancre

While doing a genital examination, the nurse finds that a part of the rectum is covered by the vaginal mucosa and is prolapsed into the vagina. What should the nurse infer from this finding? A. The patient has a rectocele. B. The patient has a cystocele. C. The patient has cervical cancer. D. The patient has a uterine prolapse.

The patient has a rectocele.

A female patient reports to the nurse of having pain during her menstrual period and a feeling of being bloated. On further assessment, the nurse also finds that the patient has breast tenderness. What should the nurse conclude from these findings? A. The patient has menorrhagia. B. The patient has amenorrhea. C. The patient has dysmenorrhea. D. The patient has vaginal pooling.

The patient has dysmenorrhea.

While examining a patient who has a genital infection, the nurse finds that the patient has a fever and clusters of small, shallow erythematous vesicles on the genital areas. The patient reports local pain and a burning sensation during urination. What should the nurse suspect from these findings? A. The patient has herpes genitalis. B. The patient has syphilitic chancre. C. The patient has urethral caruncle. D. The patient has Haemophilus vaginosis infection.

The patient has herpes genitalis.

A female patient reports to the nurse about having pelvic and abdominal pain. On reviewing the diagnostic reports, the nurse finds that the patient has a heavy, solid, fixed, and poorly defined mass on the ovary. What does the nurse infer from these findings? A. The patient has ovarian cysts. B. The patient has ovarian cancer. C. The patient has acute salpingitis. D. The patient has an ectopic pregnancy.

The patient has ovarian cancer

The nurse is assessing an elderly female patient who has diabetes mellitus. The patient reports to the nurse that she has night sweats, vaginal dryness, itching, and numbness. What should the nurse infer from these findings? A. The patient is at increased risk of vaginitis. B. The patient is at increased risk of cervical cancer. C. The patient is at increased risk of vascular problems. D. The patient is at an increased risk of endometrial cancer.

The patient is at increased risk of vaginitis.

While assessing a patient, the nurse finds that the patient has a body temperature of 102.2° F (39° C), suprapubic pain, and purulent discharge from the cervix. The nurse finds it difficult to palpate the bilateral adnexal masses, because the patient complains of having severe pain during the palpation. What should the nurse infer from these findings? A. The patient may have an ovarian cyst. B. The patient may have ovarian cancer. C. The patient may have acute salpingitis. D. The patient may have an ectopic pregnancy.

The patient may have acute salpingitis.

To what does "version" refer in the female genitourinary system? A. The position of the uterus in a female body B. The classification system of cervical neoplasia C.The placement of the ovaries in relation to the uterus D. When the long axis of the uterus is not straight but is bent on itself

The position of the uterus in a female body

Which assessment finding in a patient would indicate a third-degree uterine prolapse? A. The bladder prolapses into the vagina. B. A bulge emerges from the posterior fornix. C. The whole uterus is outside the introitus. D. The cervix is visible at the introitus when the client strains.

The whole uterus is outside the introitus.

Which developmental change should the nurse expect to find in a 9-year-old female child? A. Flat labia majora B. Thin labia minora C. Thickened mons pubis D. Tissue paper-thin hymen

Thickened mons pubis

A patient tells the nurse, "I am experiencing severe pain in the lower abdomen for the past 3 months during menses." Which test should the nurse advise the patient to undergo? A. Serum CA 125 test B. Papanicolaou (Pap) test C. Nucleic acid amplification tests D. Transvaginal ultrasound imaging

Transvaginal ultrasound imaging

What does the nurse use to lubricate the speculum to obtain a Pap smear? A. Mineral oil B.Warm water C. Liquid paraffin

Warm water

When the nurse is interviewing a preadolescent girl, which opening statement would be least threatening? A) "Do you have any questions about growing up?" B) "What has your mother told you about growing up?" C) "When did you notice that your body was changing?" D) "I remember being very scared when I got my period. How do you think you'll feel?"

When did you notice that your body was changing?

The uterus is usually positioned tilting forward and superior to the bladder. This position is known as: A) anteverted and anteflexed. B) retroverted and anteflexed. C) retroverted and retroflexed. D) superiorverted and anteflexed.

anteverted and anteflexed

A woman states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic. As a part of the interview, the nurse should ask, "Have you noticed: A) a change in your urination patterns?" B) any excessive vaginal bleeding?" C) any unusual vaginal discharge or itching?" D) any changes in your desire for intercourse?"

any unusual vaginal discharge or itching?

vaginal lubrication is provided during intercourse by labia minora sebacious follicles skene glands bartholin glands

bartholin glands

During a vaginal examination of a 38-year-old woman, the nurse notices that the vulva and vagina are erythematous and edematous with thick, white, curdlike discharge adhering to the vaginal walls. The woman reports intense pruritus and thick white discharge from her vagina. The nurse knows that these history and physical examination findings are most consistent with which of these conditions? A) Candidiasis B) Trichomoniasis C) Atrophic vaginitis D) Bacterial vaginosis

candidiasis

a woman has come for health care complaining of a thick, white discharge with intense itching. These symptoms are suggestive of atrophic vaginitis trichomoniasis chlamydia candidiasis

candidiasis

A woman has just been diagnosed with HPV, or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for _____ cancer. A) uterine B) cervical C) ovarian D) endometrial

cervical

in placing a finger on either side of the cervix and moving it side to side, you are assessing

cervical motion tederness

During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal? A) Cervix B) Uterus C) Ovaries D) Fallopian tubes

cervix

a woman has come for an exam because of a missed menstrual period and a positive home pregnancy test. exam reveals a cervix that appears cyanotic. this is referred to as goodell sign hegar sign tanner sign chadwick sign

chadwick sign

which of the following is the most common bacterial sexually transmitted infection in the US chlamydia gonorrhea trichomoniasis syphilis bacterial vaginosis

chlamydia

for a woman, history of her mother's health during pregnancy is important. A med that requires frequent follow-up is corticosteroid theophylline diethylstillbestrol aminoglycoside

diethylstillbestrol

During the examination portion of a patient's visit, she will be in lithotomy position. Which statement below reflects some things that the nurse can do to make this more comfortable for her? A) Ask her to place her hands and arms behind her head. B) Elevate her head and shoulders to maintain eye contact. C) Allow her to choose to have her feet in the stirrups or have them resting side by side on the edge of the table. D) Allow her to keep her buttocks about 6 inches from the edge of the table to prevent her from feeling as if she will fall off.

elevate her head and shoulders to maintain eye contact.

During an examination, which tests will the nurse collect to screen for cervical cancer? A) Endocervical specimen, cervical scrape, and vaginal pool B) Endocervical specimen, vaginal pool, and acetic acid wash C) Endocervical specimen, KOH preparation, and acetic acid wash D) Cervical scrape, acetic acid wash, saline mount ("wet prep")

endocervical specimen, cervical scrape, and vaginal pool.

The changes normally associated with menopause occur generally because the cells in the reproductive tract are: A) aging. B) becoming fibrous. C) estrogen dependent. D) able to respond to estrogen.

estrogen dependent

The nurse is palpating a female patient's adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse's most appropriate course of action would be to: A) tell the patient that her examination was normal. B) give her an immediate referral to a gynecologist. C) suggest that she return in a month for a recheck to verify the findings. D) tell the patient that she may have an ovarian cyst that should be evaluated further.

give her an immediate referral to a gynecologist

A 22-year-old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the nurse notices clusters of small, shallow vesicles with surrounding erythema on the labia. There is also inguinal lymphadenopathy present. The most likely cause of these lesions is: A) pediculosis pubis. B) contact dermatitis. C) human papillomavirus. D) herpes simplex virus type 2.

herpes simplex virus type 2

A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if they could be due to the hormone replacement therapy (HRT) she started 3 months ago. The nurse should tell her: A) "Hormone replacement therapy is at such a low dose that side effects are very unusual." B) "Hormone replacement therapy has several side effects, including fluid retention, breast tenderness, and vaginal bleeding." C) "It would be very unusual to have vaginal bleeding with hormone replacement therapy, and I suggest you come in to the clinic immediately to have this evaluated." D) "It sounds as if your dose of estrogen is too high; I think you may need to decrease the amount you are taking and then call back in a week."

hormone replacement therapy has several side effects, including fluid retention, breast tenderness, and vaginal bleeding.

The nurse is preparing to examine the external genitalia of a school-age girl. Which of these positions would be most appropriate in this situation? A) In the parent's lap B) In a frog-leg position on the examining table C) In the lithotomy position with the feet in stirrups D) Lying flat on the examining table with legs extended

in the frog-leg position on the examining table

which of the following is (are) normal, common finding(s) on inspection and palpation of the vulva and perineum labia majora that are wide apart and gaping palpable bartholin glands clear, thin discharge from paraurethral glands bulging at introitus during valsalva maneuver

labia majora that are wide apart and gaping

to prepare the vaginal speculum for insertion the examiner

lubricates it with warm water

A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the: A) menstrual history because it is generally nonthreatening. B) obstetric history because it is the most important information. C) urinary system history because there may be problems in this area as well. D) sexual history because it will build rapport to discuss this first.

menstrual history because it is generally nonthreatening

The nurse has just completed an inspection of a nulliparous woman's external genitalia. Which of these would be a description of a finding within normal limits? A) Redness of the labia majora B) Multiple nontender sebaceous cysts C) Discharge that is sticky and yellow-green D) Gaping and slightly shriveled labia majora

multiple nontender sebaceous cysts

During a bimanual examination, the nurse detects a solid tumor on the ovary that is heavy and fixed, with a poorly defined mass. This finding is suggestive of: A) an ovarian cyst. B) endometriosis. C) ovarian cancer. D) an ectopic pregnancy.

ovarian cancer

select the best description of the uterus anterverted, round, asymmetric organ pear-shaped, thick-walled organ flattened anteroposteriorly retroverted, almond-shaped, asymmetric organ midposition, thick walled, oval organ

pear-shaped, thick-walled organ flattened anteroposteriorly

A 25-year-old woman comes to the emergency department with a sudden fever of 101° F and abdominal pain. Upon examination, the nurse notices that she has rigid, boardlike lower abdominal musculature. When the nurse tries to perform a vaginal examination, the patient has severe pain when the uterus and cervix are moved. The nurse knows that these signs and symptoms are suggestive of: A) endometriosis. B) uterine fibroids. C) ectopic pregnancy. D) pelvic inflammatory disease.

pelvic inflammatory disease

to insert the speculum as comfortably as possible the examiner

presses the introitus down with one hand and inserts the blades obliquely with the other

An 18-year-old patient is having her first pelvic examination. Which action by the nurse is appropriate? A) Invite her mother to be present during the examination. B) Avoid the lithotomy position this first time because it can be uncomfortable and embarrassing. C) Raise the head of the examination table and give her a mirror so that she can view the exam. D) Drape her fully, leaving the drape between her legs elevated to avoid embarrassing her with eye contact.

raise the head of the examination table and give her a mirror so that she can view the exam.

A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination. Which of these statements should the nurse include in patient education? "A postmenopausal woman: A) is not at any greater risk for heart disease than a younger woman is." B) should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions." C) has only stopped menstruating; there really are no other significant changes with which she should be concerned." D) is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle."

should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.

During an examination, the nurse would expect the cervical os of a woman who has never had children to appear: A) stellate. B) small and round. C) as a horizontal irregular slit. D) everted.

small and round

a young woman has come for her first gynecologic exam. because she has not had any children, the examiner would expect the cervical is to appear smooth and circular irregular and sliktlike irregular and circular smooth and enlarged

smooth and circular

The nurse is preparing for an internal genitalia examination of a woman. Which order of the examination is correct? A) Bimanual, speculum, rectovaginal B) Speculum, rectovaginal, bimanual C) Speculum, bimanual, rectovaginal D) Rectovaginal, bimanual, speculum

speculum, bimanual, rectovaginal

A 52-year-old patient states that when she sneezes or coughs she "wets herself a little." She is very concerned that something may be wrong with her. The nurse suspects that the problem is: A) dysuria. B) stress incontinence. C) hematuria. D) urge incontinence.

stress incontinence

When performing the bimanual examination, the nurse notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse's interpretation of these results should be which of these? A) These findings are all within normal limits. B) The cervical consistency should be soft and velvety—not firm. C) The cervix should move when palpated; an immobile cervix may indicate malignancy. D) Pain may occur during palpation of the cervix.

the cervix should move when palpated; an immobile cervix may indicate malignancy

The nurse is preparing to interview a postmenopausal woman. Which of these statements is true with regard to the history of a postmenopausal woman? A) The nurse should ask a postmenopausal woman if she ever has vaginal bleeding. B) Once a woman reaches menopause, the nurse does not need to ask any further history questions. C) The nurse should screen for monthly breast tenderness. D) Postmenopausal women are not at risk for contracting sexually transmitted infections and thus these questions can be omitted.

the nurse should ask a postmenopausal woman if she ever has vaginal bleeding.

A 65-year-old woman is in the office for routine gynecologic care. She had a complete hysterectomy 3 months ago after cervical cancer was detected. The nurse knows that which of these statements is true with regard to this visit? A) Her cervical mucosa will be red and dry looking. B) She will not need to have a Pap smear done. C) The nurse can expect to find that her uterus will be somewhat enlarged and her ovaries small and hard. D) The nurse should plan to lubricate the instruments and the examining hand well to avoid a painful examination.

the nurse should plan to lubricate the instruments and the examining hand well to avoid painful examination

what does the notation in a health record indicating the patient is a "G2 P3 Ab0" mean?

the woman has been pregnant twice (G2) with 3 children (P3), and all her children are living

during the exam of the genitalia of a 70 year old woman, a normal finding would be hypertrophyof the mons pubis increase in vaginal secretions thin and parse pubic hair bladder prolapse

thin and parse pubic hair

what problems are associated with smoking and the use of oral contraceptives

thrombophlebitis and pulmonary emboli

An 11-year-old girl is in the clinic for a sports physical. The nurse notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. The nurse should use which of these techniques to best assist the young girl in understanding the expected sequence for development? The nurse should: A) use the Tanner's table on the five stages of sexual development. B) describe her development and compare it with that of other girls her age. C) use Jacobsen's table on expected development on the basis of height and weight data. D) reassure her that her development is within normal limits and should tell her not to worry about the next step.

use the Tanner's table on the five stages of sexual development

The nurse is reviewing the changes that occur with menopause. Which of these are changes associated with menopause? A) Uterine and ovarian atrophy along with thinning vaginal epithelium B) Ovarian atrophy, increased vaginal secretions, and increasing clitoral size C) Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions D) Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy

uterine and ovarian atrophy along with thinning vaginal epithelium

During an internal examination, the nurse notices that the cervix bulges outside the introitus when the patient is asked to strain. The nurse will document this as: A) uterine prolapse, graded first degree. B) uterine prolapse, graded second degree. C) uterine prolapse, graded third degree. D) a normal finding.

uterine prolapse, grade second degree.

A 46-year-old woman is in the clinic for her annual gynecologic examination. She voices a concern about ovarian cancer because her mother and sister died of it. The nurse knows that which of these statements is correct regarding ovarian cancer? A) Ovarian cancer rarely has any symptoms. B) The Pap smear detects the presence of ovarian cancer. C) Women at high risk for ovarian cancer should have annual transvaginal ultrasonography for screening. D) Women over age 40 years should have a thorough pelvic examination every 3 years.

women at high risk for ovarian cancer should have annual transvaginal ultrasonography for screening.