Ch 27 - Assessing Female Genitalia and Rectum

The nurse is separating the labia of a female client during a reproductive physical examination. The structures that the nurse will inspect include: (Select all that apply.) A. Clitoris B. Urethral meatus C. Rectal opening D. Vaginal opening E. Labia minora

A, B, D, E: Clitoris; Urethral meatus; Vaginal opening; Labia minora When separating the labia of a female client, the nurse will inspect the clitoris, urethral meatus, vaginal opening, and labia minora. The rectal opening is not inspected by separating the labia.

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? A. Bartholin's gland infection B. Vulvar carcinoma C. Secondary syphilis D. Condylomata accuminata

A. Bartholin's gland infection Bartholin's gland infections cause a red-hot tender abscess at the duct opening to the Bartholin's glands. Gonococci, Chlamydia, and other organisms often cause them. Size is variable and if chronic, can present as a nontender cyst.

The nurse is present during a pelvic examination of a 21-year-old female client. Which action should the nurse prepare for first? A. Pap smear specimen collection B. Chlamydia culture specimen collection C. Gonorrhea culture specimen collection D. Apply spray fixative on specimen slides

A. Pap smear specimen collection Collection of cells from the endocervix or cervix may cause some spotting or bleeding; this can occur with a Pap or with an STI screening. It is important to do the Pap smear first so that bleeding is minimal on the cytology specimen. The cultures for chlamydia (CT) and gonorrhea (GC) are done after the Pap smear. Spray fixative is applied after a specimen is collected and applied to a slide.

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? A. Premenstrual syndrome (PMS) B. Dysmenorrhea C. Premenstrual dysphoric disorder (PMDD) D. Ectopic pregnancy

A. Premenstrual syndrome (PMS) Premenstrual syndrome is the emotional and physical symptoms that occur at the same time before menses each month.

A nurse inspects the genitalia of an elderly client and notices that the mucosa is dry and atrophied. The nurse should educate the client about her increased risk of what condition? A. Infection B. Incontinence C. Straining to urinate D. Vaginal bleeding

A. Infection The older client is more susceptible to vaginal infection because of atrophy of the vaginal mucosa associated with aging. Incontinence and difficulty urinating may be signs of infection or a sexually transmitted disease. Vaginal bleeding may indicate a more serious condition such as endometrial or cervical cancer.

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? A. Nabothian cysts B. Chlamydia infection C. Cervical eversion D. Columnar epithelium

A. Nabothian cysts Nabothian cysts are normal findings on the cervix after childbirth. They are small retention cysts, yellow, translucent, odorless, nonirritating, with clear to cloudy, thin to thick discharge. Chlamydia infection causes a mucopurulent, yellowish discharge that is irritating to the cervix and may cause bleeding and redness of the cervical opening. Cervical eversion is a normal finding after childbirth. The columnar epithelium from within the cervical canal is everted and appears as a deep red, rough ring round the cervical os, surrounded by the normal pink color of the cervix.

A nurse practitioner documents as follows: "Client reports pain and tenderness over area of right ovary and a history of irregular menses." With which of the following diagnoses are these findings consistent? A. Ovarian cyst B. Salpingitis C. Pelvic inflammatory disease D. Ovarian cancer

A. Ovarian cyst With an ovarian cyst, there may be pain, tenderness over the ovary, irregular menses, and intraperitoneal bleeding if it ruptures. A solid ovarian mass raises the possibility of ovarian cancer, which is the second most frequent reproductive cancer. Salpingitis and pelvic inflammatory disease are different names for the same condition, which does not manifest with the documented findings.

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 ovaries? A. Produces female gametes (ova) and secretes female sex hormones. B. Receives the fertilized ovum and provides housing and nourishment for a fetus. C. Receives sperm, provides an exit for menstrual flow and serves as the birth canal. D. Small erectile structure that responds to sexual stimulation.

A. Produces female gametes (ova) and secretes female sex hormones. The ovaries function to produce female gametes or ova and secrete female sex hormones. The uterus functions to receive the fertilized ovum and provides housing and nourishment for a fetus. The vagina functions to receive sperm and provide an exit for menstrual flow and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.

A nurse inspects the cervix of a 28-year-old, nonpregnant client during a routine assessment. Which coloration of the cervix may indicate inflammation? A. Red B. Pink C. Blue D. Pale

A. Red Redness of the cervix may indicate inflammation. The surface of the cervix is normally smooth, pink, and even. In a nonpregnant client, a bluish cervix may indicate cyanosis. In pregnant clients, the cervix appears blue; this is also referred to as Chadwick's sign. In a non-menopausal client, a pale cervix may indicate anemia; in older clients the cervix may appear pale after 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? A. Rugae B. Endometrium C. Myometrium D. Peritoneum

A. Rugae The outer layer of the vaginal wall is composed of pink squamous epithelium that lies in transverse folds called rugae. These transverse folds allow the vagina to expand during intercourse; they also facilitate vaginal delivery of a fetus. The endometrium, the myometrium, and the peritoneum are the three layers o the uterine wall.

During the inspection of a client's reproductive system, the nurse identifies small lacerations and bruises of the labia majora and minora. What does this finding suggest to the nurse? A. Sexual abuse B. Sexually transmitted infection C. Pediculosis pubis D. Masculinization

A. Sexual abuse Lacerations and bruising may indicate sexual abuse. Lacerations and bruising are not symptoms of a sexually transmitted infection, pediculosis pubis, or masculinization.

A client reports the new onset of mucus in the stool. How should the nurse document this in the client's history? A. Steatorrhea B. Diarrhea C. Change in bowel habits D. Fecal incontinence

A. Steatorrhea The proper term for mucus in the stool is steatorrhea, which indicates the presence of excessive fat in the stool. Diarrhea is an increase in the frequency of loose stool. Change in bowel habits is not specific to the problem that the client reported. Fecal incontinence is the inappropriate release or inability to control the bowels.

A female client with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually. B. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. C. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse. D. The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.

A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually. HIV-positive women have a higher rate of HPV. Infections with HPV and HIV together increase the risk of malignant transformation and cervical cancer. Thus, women with HIV infection should have frequent Pap smears. Because condylomata acuminata is a virus, there's no permanent cure. Because condylomata acuminata can occur on the vulva, a condom won't protect sexual partners. HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.

During a gynecologic examination, the nurse observes that the client has a yellow-green frothy vaginal discharge. The nurse should plan to test the client for possible A. Trichomonas vaginalis infection. B. bacterial vaginosis. C. atrophic vaginitis. D. Chlamydia trachomatis infection.

A. Trichomonas vaginalis infection. Trichomonas vaginitis is an infection caused by a protozoan organism and is usually sexually transmitted. The discharge is typically yellow-green, frothy, and foul smelling.

During the examination of the external genitalia, the nurse notices drainage from the urethra. The nurse should prepare to assess this client for which condition? A. Urethritis B. Gonorrhea C. Trichomoniasis D. Lice infestation

A. Urethritis Drainage from the urethra indicates possible urethritis, which may have many causes. Lice infestation causes irritation and a whitish dandruff appearance on the pubic hairs but does not cause vaginal discharge or swelling. Abscess of Bartholin's gland with the presence of vaginal discharge can be a sign of infection with Neisseria gonorrhoeae (gonorrhea). Trichomoniasis causes a greenish discharge with a fishy odor.

In the female client, the tube of muscular tissue that extends from the vaginal introitus to the uterus is called what? A. Vagina B. Clitoris C. Vesicovaginal septum D. Mons pubis

A. Vagina The vagina is a tube of muscular tissue that extends from the vaginal introitus to the uterus. The clitoris is the organ of sexual excitement in the female. The mons pubis and vesicovaginal septum are other female genital organs.

Which client should the nurse assess for possible primary amenorrhea? A. an 18-year-old who has never started menses B. a 35-year-old reporting irritability and anxiety beginning 3 days before menses C. a breastfeeding 27-year-old who has not resumed menses D. a 49-year-old reporting having no menses for the last 8 months

A. an 18-year-old who has never started menses Failure of periods to initiate is called primary amenorrhea whereas the cessation of periods after they have been established is termed secondary amenorrhea. Pregnancy, lactation, and menopause are physiologic causes of secondary amenorrhea. Irritability and anxiety associated with menses may indicate premenstrual syndrome.

An older adult client visits the clinic complaining of urinary incontinence. The nurse should explain to the client that this is often due to A. decreased urethral elasticity. B. atrophy of the vaginal mucosa. C. change in the vaginal pH. D. decreased estrogen production.

A. decreased urethral elasticity. Urinary incontinence may develop in older women from muscle weakness or loss of urethral elasticity.

The nurse is taking a sexual history on a new client. What action is considered appropriate at this time? (Select all that apply.) A. Explain to the client what is considered to be normal sexual behavior B. Affirm that your conversation is confidential C. Note that you realize this information is highly personal D. Explain why you are taking the sexual history E. Relate that you gather this history on only high-risk clients

B, C, D: Affirm that your conversation is confidential; Note that you realize this information is highly personal; Explain why you are taking the sexual history Tips for taking the sexual history: explain why you are taking the sexual history; note that you realize this information is highly personal, and encourage the client to be open and direct; relate that you gather this history on all your clients; affirm that your conversation is confidential.

A female client tells the nurse that she may be experiencing premenstrual syndrome. An appropriate question for the nurse to ask the client is A. "How often are your menstrual periods?" B. "Do you experience mood swings or bloating?" C. "Are you experiencing regular menstrual cycles?" D. "How old were you when you began to menstruate?"

B. "Do you experience mood swings or bloating?" Headache, weight gain, mood swings, abdominal cramping, and bloating are common complaints before or during the menstrual period. Some women experience premenstrual syndrome (PMS), in which the symptoms become severe enough to impair the woman's ability to function.

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? A. Emphasize importance of client keeping her one week follow-up appointment. B. Advise client to seek treatment right away. C. Tell the client the heartbeat is usually not seen until 6 weeks. D. Avoid taking over the counter pain medications while pregnant.

B. Advise client to seek treatment right away. Risk factors for ectopic pregnancy include previous ectopic pregnancy, past pelvic infection, endometriosis, or abnormalities of the fallopian tube. The most common symptoms are lower quadrant pain, nausea, and referred pain in the neck or shoulder. Since the client's ultrasound revealed no baby in the uterus, an ectopic pregnancy cannot be ruled out based on the client's history and symptoms. The priority is to prevent complications due to internal bleeding. The client should seek care immediately. Though the other statements are not incorrect; preventing potential hemorrhage is the priority of care.

An adult woman presents at the clinic with a grayish vaginal discharge with a 'fishy' odor. What should the nurse suspect? A. Candidiasis B. Bacterial vaginosis C. Chlamydia D. Gonorrhea

B. Bacterial vaginosis Bacterial vaginosis presents with a creamy white to gray secretion that coats the vaginal walls and exhibits a strong "fishy" odor. This finding is not consistent with candidiasis, chlamydia, or gonorrhea. Chlamydia does not have to present with drainage, but when noted, it is yellowish in color. Gonorrhea does not have to present with drainage, but when noted, is often yellowish-green in color. Candidiasis, a yeast infection, presents as a thick white cottage-cheese like discharge.

Which of the following terms refers to difficult or painful sexual intercourse? A. Amenorrhea B. Dyspareunia C. Dysmenorrhea D. Endometriosis

B. Dyspareunia Dyspareunia is a common problem of the aged female. Amenorrhea refers to absence of menstrual flow. Dysmenorrhea refers to painful menstruation. Endometriosis is a condition in which endometrial tissue seeds in other areas of the pelvis.

What is the greatest risk factor for cervical cancer? A. HIV B. HPV C. Genetics D. Age

B. HPV The greatest risk factor for cervical cancer is infection with HPV.

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? A. Lack of exercise B. Having multiple sexual partners C. Smoking D. Having the human papillomavirus (HPV) vaccination

B. Having multiple sexual partners The nurse should inform the client that having multiple sexual partners is a risk factor for cervical cancer. Having the HPV vaccine lowers the risk. Smoking and lack of exercise are not associated with an increased risk for cervical cancer.

As a class project a group of student nurses are developing a care plan for clients being screened for cervical cancer. When teaching clients about the risk factors of cervical cancer what would the nurse identify as the most important risk factor? A. Late childbearing B. Human papillomavirus (HPV) C. Postmenopausal bleeding D. Obesity

B. Human papillomavirus (HPV) Adenocarcinomas of the cervix begin in the mucus-producing glands and are often due to HPV infection. Risk factors for cervical cancer include multiple sex partners, IV infection, smoking, and early childbearing. Postmenopausal bleeding and obesity are risk factors for uterine 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? A. Vulva B. Mons pubis C. Clitoris D. Fenulum

B. Mons pubis The mons pubis is the fat pad located over the symphysis pubis. The normal adult mons pubis is covered with pubic hair in a triangular pattern. It functions to absorb force and to protect the symphysis pubis during coitus (sexual intercourse). The area of the female external genitalia is sometimes referred to as the vulva, or pudendum, and extends from the mons pubis to the anal opening. The clitoris is located at the anterior end of the labia minora. It is a small, cylindrical mass of erectile tissue and nerves with three parts: the glans, the corpus, and the crura. Inside the labia majora are the thinner skin folds of the labia minora. These folds join anteriorly at the clitoris and form a prepuce, or hood; posteriorly the two folds join to form the frenulum.

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? A. Symptoms of trichomonal vaginitis B. Symptoms of candidal vaginitis C. Symptoms of bacterial vaginosis D. Symptoms of primary syphilis

B. Symptoms of candidal vaginitis Symptoms of candidal vaginitis include a thick white discharge from the labia with possible inflammation of the vulva. The discharge of trichomonas is yellowish green or gray. The discharge of bacterial vaginosis is gray or white and thin. Primary syphilis does not have an associated labial discharge.

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? A. The client has possibly developed cervical cancer. B. The client is postmenopausal. C. The client is perimenopausal. D. The client is premenopausal.

B. The client is postmenopausal. Perimenopause is the period extending from the first signs of menopause, usually hot flashes, vaginal dryness, and irregular menses. Postmenopause is the period beginning from about 1 year after menses cease and beyond. The scenario does not describe a client who has developed cervical cancer, or a client who is premenopausal.

A client calls the clinic and tells the nurse they have a white, curd-like discharge from the vagina. The client asks the nurse what the significance of this discharge is. What should the nurse responds? A. Drainage is physiologic and normal. B. The client may have a Candida species infection. C. Drainage is caused by vaginal dryness. D. The client may have Chlamydia.

B. The client may have a Candida species infection. Mucus or white discharge from the vagina is physiologic and normal. Drainage caused by Candida is curd-like and white, while infection with Trichomonas is often frothy/yellow green in color. Vaginal dryness causes scant mucoid drainage that may be blood-tinged.

A female client tells the nurse that she has pain while urinating. Besides obtaining a urinalysis, the nurse should assess the client for A. kidney trauma. B. sexually transmitted disease. C. tumors. D. infestation.

B. sexually transmitted disease. Urinary frequency, burning, or pain (dysuria) are signs of infection (urinary tract or sexually transmitted infections [STIs].

Which of the following is the most important risk factor for cervical cancer? A. Immunosuppressive illnesses B. Failure to seek Pap smear screening C. Persistent HPV infections D. Poor nutrition and smoking during adolescence

C. Persistent HPV infections High-risk strains of HPV constitute the most significant risk factor for cervical cancer. Immunosuppressive illnesses, poor nutrition, and smoking are not noted risk factors. Failure to seek screening is a risk factor, but of less significance than HPV infection.

A client asks the nurse when a colonoscopy is recommended. Which advice provided by the nurse is most appropriate? A. "A colonoscopy should be done every year starting at age 65." B. "Either a fecal occult blood test or a colonoscopy is acceptable." C. "A flexible sigmoidoscopy should be done every five years starting at age 50." D. "Your doctor will decide what schedule is best for you."

C. "A flexible sigmoidoscopy should be done every five years starting at age 50." Beginning at age 50, men and women should have a fecal occult blood test or a flexible sigmoidoscopy every 5 years. Both of these are preferred over either one separately. All screening should start at age 50, not 65 years of age. Health care providers should adhere to the screening guidelines, not make their own decisions.

Which statement by a client in regards to her ability to conceive should prompt a nurse to ask additional questions about infertility? A. "I have had three (3) sex partners in the past two (2) years" B. "My menses comes about every 40 days and lasts 3 days" C. "My husband and I have had unprotected intercourse for over a year" D. "Vaginal dryness has been a problem for about six (6) months"

C. "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.

A nurse inspects the cervix of a 28-year-old client during a routine assessment. Which coloration of the cervix may indicate that the client is pregnant? A. Red B. Pink C. Blue D. Pale

C. Blue In pregnant clients, the cervix appears blue; this is also referred to as Chadwick's sign. Redness of the cervix may indicate inflammation. The surface of the cervix is normally smooth, pink, and even. In a nonpregnant client, a bluish cervix may indicate cyanosis. In a non-menopausal client, a pale cervix may indicate anemia; in older clients the cervix may appear pale after menopause.

The school nurse is presenting a class on female reproductive health. While discussing prevention the nurse teaches what about a Pap smear? A. The test may be performed at any time during the client's menstrual cycle. B. The smear should be done every two years. C. Detect cervical cancer. D. False-negative Pap smear results occur from not douching before the examination.

C. Detect cervical cancer. The test should be performed when the client is not menstruating, and douching washes away cellular material. The test detects cervical cancer, and false-negative Pap smear results occur mostly from sampling errors or improper technique. A Pap smear should be done annually.

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? A. Produces female gametes or ova and secretes female sex hormones. B. Receives the fertilized ovum and provides housing and nourishment for a fetus. C. Receives sperm, provides an exit for menstrual flow and serves as the birth canal. D. Small erectile structure that responds to sexual stimulation.

C. Receives sperm, provides an exit for menstrual flow and serves as the birth canal. The ovaries function to produce female gametes or ova and secrete female sex hormones. The uterus functions to receive the fertilized ovum and provides housing and nourishment for a fetus. The vagina functions to receive sperm provide an exit for menstrual flow and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.

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? A. Vaginal mucosa lesions B. Edematous labia majora C. Support of vaginal walls D. Bartholin's gland inflammation

C. Support of vaginal walls The nurse assesses for any bulging of the vaginal walls by separating the labia and asking the client to bear down. This specific assessment does not help identify lesions, edema, or inflammation.

A woman who has undergone a total hysterectomy asks a nurse about follow-up Pap smears. Which statement by the nurse is correct? A. "You should continue to have Pap smears every 3 years." B. "If you had 3 or more Pap smears that were normal, you can stop the screening." C. "If you are still sexually active, a Pap smear is recommended every 5 years." D. "Cervical screening is not necessary once a total hysterectomy is performed."

D. "Cervical screening is not necessary once a total hysterectomy is performed." Cervical screening is not necessary once a total hysterectomy (with removal of the cervix) is performed unless the surgery was for cervical cancer. A pap smear is recommended every 3 years for women 21 to 65 years old, regardless of normalcy of previous smears or of sexual activity. Women over the age of 65 who have had adequate prior screening exams and are not otherwise at high risk for cervical cancer may choose to stop cervical cancer screening.

A nurse is providing care to a 1-year-old female client. The parents ask the nurse about having female circumcision performed, saying that it is a part of their culture. What is the best response of the nurse? A. "Let me ask the health care provider." B. "I will check with my supervisor." C. "You will have to travel to another country for that procedure." D. "Female circumcision is against the law in the United States."

D. "Female circumcision is against the law in the United States." Female circumcision, also known as female genitalia mutilation (FMG/C), is against the law in the United States and other countries; if performed here or parents travel abroad for the procedure they could be arrested and receive a jail sentence of 5 years or more. There is no benefit to FMG/C; however, there are many risks, including death. FMG/C continues to be performed in western, eastern, and northeastern parts of Africa and areas of the Middle East and Asia. The World Health Organization (WHO) strongly discourages this cultural/religious practice. Because it is against the law in the United States, there would be no reason for the nurse to ask a doctor or supervisor, and it would be inappropriate for the nurse to advise the parents to travel to another country to have the procedure performed.

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? A. "Don't be concerned; your body is adjusting to the presence of ovarian hormones." B. "Pay close attention to when the discharge begins and what it looks like so we can discuss at your next visit." C. "If you are sexually active, you may have developed a vaginal infection." D. "If there are no other signs or symptoms, it is likely a result of normal ovulation."

D. "If there are no other signs or symptoms, it is likely a result of normal ovulation." Just before menarche, there is a physiologic increase in vaginal secretions—a normal change that sometimes worries a client. As menses become more regular, these increased secretions (leukorrhea) coincide with ovulation. They also accompany sexual arousal. These normal kinds of discharges must be differentiated from those of infectious processes. Vaginal discharge prior to menses is not caused by a physiological adjustment to the presence of ovarian hormones. Collecting further assessment data about the pattern of discharge is not necessary in the absence of abnormal findings. Vaginal discharge prior to menses is an expected finding and not due to a vaginal infection.

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. A small, painless ulcer on the client's vulva B. A firm, round yellowish nodule in the client's labia C. A cauliflower-like lesion on the client's labia D. A local patch of small, painful lesions on the client's vulva

D. A local patch of small, painful lesions on the client's vulva Small, painful ulcers characterize herpes infection. Recurrent infections are usually marked by a local patch of lesions that is less extensive than the initial infection. A firm, round cystic nodule is more likely an epidermoid cyst, while cauliflower-like growths are associated with venereal warts.

While inspecting the labia minora, a nurse notices that they are asymmetric. Which of the following does this finding most likely point to? A. Candidal vaginitis B. Urinary tract infection C. Cervical cancer D. Abscess

D. Abscess Asymmetric labia may indicate abscess. Urinary frequency, burning, and pain are signs of urinary tract infection. Candidal vaginitis is caused by the overgrowth of yeast in the vagina. It causes a thick, white, cheesy discharge. Cervical cancer may produce lesions.

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? A. Cowper's glands B. Sebaceous glands C. Eccrine glands D. Bartholin's glands

D. Bartholin's glands Bartholin's glands in the vaginal orifice secrete mucus, which lubricates the area during sexual intercourse. Cowper's glands are located at the base of the penis in the male and secrete a fluid that helps to lubricate the urethra for sperm to pass through. Sebaceous glands are oil glands int eh skin that secrete sebum. Eccrine glands secrete sweat.

A risk factor for cervical cancer includes: A. Sex with circumcised males B. Underweight status C. Late childbearing D. Exposure to HPV

D. Exposure to HPV Risk factors for cervical cancer include exposure to HPV, sex with uncircumcised males, overweight status, and early childbearing.

A female client has been diagnosed with menorrhagia. What information should the nurse provide the client concerning menses flow? A. The flow will be light. B. Discharge will be dark red. C. Flow will be accompanied by cramping. D. Flow may include clots.

D. Flow may include clots. Menorrhagia is a term used to describe a heavy menstrual flow. Unlike the normal dark red menstrual discharge, excessive flow tends to be bright red and may include "clots" (not true fibrin clots). Because menorrhagia is a heavy menstrual flow, the nurse should not describe the flow as light. The flow may or may not be accompanied by cramping.

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? A. Red B. Pink C. Blue D. Pale

D. Pale Redness of the cervix may indicate inflammation. The surface of the cervix is normally smooth, pink, and even. In a nonpregnant client, a bluish cervix may indicate cyanosis. In a pregnant client, the cervix appears blue; this is also referred to as Chadwick's sign. In a non-menopausal client, a pale cervix may indicate anemia; in older clients the cervix may appear pale after menopause.

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? A. Nabothian cysts b. Genital fissures C. Enlarged inguinal lymph nodes D. Pediculosis pubis

D. Pediculosis pubis Pediculosis pubis (crab lice) commonly presents with itching. Nabothian cysts, genital fissures, and enlarged lymph nodes do not commonly present with intense itching.

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? A. Anteflexed B. Retroflexed C. Anteverted D. Retroverted

D. Retroverted Retroverted uterus is a normal variation that consists of the cervix and body of the uterus tilting backward. Anteflexed uterus is a normal variation that consists of the uterine body flexed anteriorly in relation to the cervix. Retroflexed uterus is a normal variation that consists of the uterine body being flexed posteriorly in relation to the cervix. Anteverted uterus is the most typical position of the uterus; wherein the cervix is pointed posteriorly, and the body of the uterus is at the level of the pubis over the bladder.

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? A. Produces female gametes or ova and secretes female sex hormones. B. Receives the fertilized ovum and provides housing and nourishment for a fetus. C. Receives sperm, provides an exit for menstrual flow and serves as the birth canal. D. Small erectile structure that responds to sexual stimulation.

D. Small erectile structure that responds to sexual stimulation. The ovaries function to produce female gametes or ova and secrete female sex hormones. The uterus functions to receive the fertilized ovum and provides housing and nourishment for a fetus. The vagina functions to receive sperm provide an exit for menstrual flow and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation.

When the female client reports a frothy yellow-green or brown vaginal discharge, the nurse suspects the client has a vaginal infection caused by which of the following? A. Candida albicans B. Gardnerella vaginalis C. Chlamydia D. Trichomonas vaginalis

D. Trichomonas vaginalis Trichomonas vaginalis causes a frothy yellow-green or yellow-brown vaginal discharge. Candidiasis causes a white, cheese-like discharge clinging to the vaginal epithelium. Gardnerella vaginalis causes a gray-white to yellow-white discharge clinging to the external vulva and vaginal walls. Chlamydia causes a profuse purulent discharge.

When examining the genitalia of a client, a nurse observes a yellow-green, frothy, and foul-smelling discharge from the vagina. The nurse recognizes this finding as indicative of what condition? A. Mucopurulent cervicitis B. Exposure to diethylstilbestrol (DES) C. Cancer of the cervix D. Trichomonas vaginitis

D. Trichomonas vaginitis A yellow-green, frothy, and foul-smelling discharge is observed in a client with trichomonas vaginitis. The presence of columnar epithelium that extends onto the vaginal wall indicates exposure to DES as a fetus. DES is a drug that was used more than 50 years ago to prevent spontaneous abortion and premature labor. A mucopurulent yellowish discharge from the external os is observed in a client with mucopurulent cervicitis; it usually indicates infection with Chlamydia or gonorrhea. Lesions that develop into cauliflower-like growths are indicative of cancer of the cervix.

The outer layer of the vaginal wall is under the direct influence of A. androgen. B. progesterone. C. aldosterone. D. estrogen.

D. estrogen. The outer layer is under the direct influence of the hormone estrogen and contains many mucus-producing cells.

The visible portion of the clitoris is termed the A. corpus. B. crura. C. vestibule. D. glans.

D. glans. The clitoris is located at the anterior end of the labia minora. It is a small, cylindrical mass of erectile tissue and nerves with three parts: the glans, the corpus, and the crura. The glans is the visible rounded portion of the clitoris.

During assessment of the vaginal area of an adult client, the client tells the nurse that she has had pain in her vaginal area. The nurse should further assess the client for A. trauma. B. cancer. C. pregnancy. D. infection.

D. infection. Complaints of pain in the area of the vulva, vagina, uterus, cervix, or ovaries may indicate infection.

To best secure accurate assessment information, the nurse should complete which part of the reproductive history last? A. menstrual B. obstetric C. childbearing D. sexual

D. sexual There are three parts to a woman's reproductive history: menstrual history, obstetric history, and sexual history. It is usually more comfortable for the client if the nurse begins with the menstrual and obstetric history and saves sexual history questions for last. Childbearing is not a part of female reproductive history but instead is considered a phase of reproductive health; this should incorporate the needs of this phase as applicable in the health history, but it should be incorporated prior to sexual history.