Chapter 27: Assessing Female Genitalia and Rectum PQs

cervical cancer

A nurse is caring for a 45-year-old client with human papillomavirus (HPV) infection. The nurse should inform the client that she is at risk for developing what cancer?

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

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?

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?

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?

pink

A nurse inspects the cervix of a 33-year-old, nonpregnant client during a routine assessment. Which coloration of the cervix would indicate normal health in this client?

pale

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?

"female circumcision is against the law in the United States"

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?

Nabothian cysts

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?

place consults for further workup

A nurse palpates a hard, nodular, fixed, painless mass on a client's ovary. What is the best action of the nurse?

the client should also be treated for chlamydia

A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a client with gonorrhea has presented at the clinic. The student knows that the care plan for this client should be include what in the treatment of gonorrhea?

diabetes

A young adult woman presents at the clinic stating, "I think I have a yeast infection." The nurse notes this is the third time in the past 90 days that this client has been to the clinic for yeast infections. What should the nurse consider as a comorbidity to be discussed with this client?

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 high school students. Based on this information, what would be the best response by a high school student about the function of the vagina?

small erectile structure that responds to sexual stimulation

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?

produces female gametes (ova) and secretes female sex hormones

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?

clitoris, urethral meatus, vaginal opening, labia minora

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.) - clitoris - urethral meatus - rectal opening - vaginal opening - labia minora

affirm that your conversation is confidential, note that you realize the information is highly personal, explain why you are taking the sexual history

The nurse is taking a sexual history on a new client. What action is considered appropriate at this time? (Select all that apply.) - explain to the client what is considered to be normal sexual behavior - affirm that your conversation is confidential - note that you realize this information is highly personal - explain why you are taking the sexual history - relate that you gather this history on only high-risk clients

mons pubis

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?

(uterus lies parallel to the rectum)

The nurse notes that a female client has a retroverted uterus. Which diagram will the nurse use to teach the client about this finding?

fibroids

The nurse selects the diagram shown to use when teaching a female client. What health problem is the nurse reviewing with this client?

estrogen

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

detect cervical cancer

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

steatorrhea

A client reports the new onset of mucus in the stool. How should the nurse document this in the client's history?

ovarian cyst

"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?

Bartholin's gland infection

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?

cervical polyp

A 28-year-old married clothing sales clerk comes to the clinic for her annual examination. She requests a refill on her birth control pills. Her only complaint is painless bleeding after intercourse. She denies any other symptoms. Her past medical history consists of two spontaneous vaginal births. Her past six Pap smears have all been normal. She is married with two children. Her mother is in good health, and her father has high blood pressure. Examination shows a young woman appearing healthy and relaxed. Her vital signs are unremarkable, and her head, eyes, ears, throat, neck, cardiac, lung, and abdominal examinations are normal. Visualization of the perineum shows no lesions or masses. Speculum examination shows a red mass at the os. On taking a Pap smear the mass bleeds easily. Bimanual examination shows no cervical motion tenderness. Both ovaries are palpated and nontender. What is the most likely diagnosis related to the abnormality of her cervix?

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

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?

continue exams every 3 years

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 to tell this client with regard to future screening for cervical cancer?

40-58 years

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?

premenstrual syndrome (PMS)

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?

"these findings are common in postmenopausal women"

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?

the client is postmenopausal

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 client may have a Candida species infection

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?

avoid douching 48 hours before the examination

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

Bartholin's glands

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?

ectopic pregnancy

A client visits the clinic because she has missed one period and suspects she is pregnant. While assessing the client, the nurse detects a solid, mobile, tender, unilateral adnexal mass. The client's cervix is soft. The nurse suspects that the client may be experiencing

client smokes cigarettes, infrequent sexual intercourse, vaginal drying because of menopause

A female client complains of pain when the speculum is introduced into the vagina. What should the nurse consider as being a reason for the client's discomfort? Select all that apply - client smokes cigarettes - lacto-ovo-vegetarian diet - infrequent sexual intercourse - vitamin A, D, and C deficiencies - vaginal drying because of menopause

advise the client to seek treatment right away

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?

pelvic inflammatory disease

An 18-year-old college freshman comes to the clinic complaining of severe left-sided lower abdominal pain and a foul yellow discharge. The pain began last night while she was having intercourse with her boyfriend. Afterwards the pain became more severe and the discharge started. By this morning she had a fever of 38.3°C and walking was making the pain worse. Only lying very still makes the pain better. She has tried ibuprofen and acetaminophen without any improvement. She denies any nausea, vomiting, diarrhea, or constipation. Her past medical history is unremarkable. She has had two past sexual partners. She uses the birth control patch instead of condoms. She smokes a half pack of cigarettes a day and drinks four to five beers per weekend night. She denies any illegal drug use. Her parents are both healthy. Examination shows a young woman who appears ill. Her temperature is 38.9°C and her pulse is elevated at 110. She is tender in the left lower quadrant but has no guarding or rebound. Speculum examination reveals yellow purulent drainage from the os. On palpation there is cervical motion tenderness and the left adnexa is swollen and tender. A urine analysis is unremarkable and the urine pregnancy test is pending. What is the best choice of diagnosis for this adnexal swelling?

it is common in adolescents and women approaching menopause

An adolescent is brought to the clinic by her mother because of abnormal uterine bleeding. What should the nurse explain about this bleeding?

bacterial vaginosis

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

onset of the problem, severity of the problem, what makes it better or worse

At the completion of a reproductive health history, a female client tells the nurse about having pain with penetration during intercourse. What should the nurse assess at this time? (Select all that apply.) - blood pressure - heart rate - onset of the problem - severity of the problem - what makes it better or worse

ectopic pregnancy

The nurse is advising a client who is diagnosed with pelvic inflammatory disease (PID) about the side effects of PID. What serious condition may occur as a result of this disease?

Pediculosis pubis

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?

trichomonas vaginalis infection

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

symptoms of candidal vaginitis

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?

infection

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

urethritis

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?

cystocele

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

vagina

In the female client, the tube of muscular tissue that extends from the vaginal introitus to the uterus is called what?

bear down

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

cervical cancer

The Papanicolaou test is a screening tool for what?

predisposes the vagina to yeast infections

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

retroverted

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?

anteverted

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

retroflexed

When examining the uterus, a nurse finds that the uterine body is flexed posteriorly in relation to the cervix. How should the nurse document this uterine finding?

anteflexed

When examining the uterus, a nurse finds that the uterus is flexed anteriorly in relation to the cervix. How should the nurse document this uterine finding?

prevent pressure on the urethra

When inserting the vaginal speculum, the nurse angles the blades obliquely and presses along the posterior vaginal wall to:

support of the vaginal walls

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?

Trichomonas vaginalis

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?

an 18-year-old who has never started menses

Which client should the nurse assess for possible primary amenorrhea?

cystocele

Which of the following is a downward displacement of the bladder toward the vaginal orifice?

persistent HPV infections

Which of the following is the most important risk factor for cervical cancer?

retroversion

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

"my husband and I have had unprotected intercourse for over a year"

Which statement by a client in regards to her ability to conceive should prompt a nurse to ask additional questions about infertility?

rugae

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?

abscess

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