Ch. 27 - Assessing Female Genitalia and Rectum
Which position is it most logical for the nurse to place the female client in for the anus and rectum examination? A. Supine B. Standing C. Knee-chest D. Lithotomy
D
The opening in the center of the cervix is called the
os
A nurse is describing some of the complications of sexually transmitted diseases (STDs) to a teenaged girl. Which of the following should the nurse mention? Select all that apply A. Pelvic inflammatory disease B. Scarring and adhesions on the fallopian tubes C. Infertility D. Breast cancer E. Ectopic pregnancy
A,B,C,E
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
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. Frenulum
B
The nurse suspects that a client is experiencing perimenopause. What client symptom caused the nurse to make this clinical decision? A. bloating B. hot flashes C. dyspareunia D. swollen hands
B
What is the purpose of the rectovaginal examination? A. Palpate the vaginal wall for evidence of a cystocele B. Palpate the vaginal wall for evidence of a rectocele C. Palpate the vaginal wall for evidence of uterine prolapse D. Palpate the vaginal wall for evidence of a urethral caruncle
B
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
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
Which finding in a female client's history would alert the nurse to assess for signs of diabetes mellitus? A. Vaginal secretions with a fishy odor B. Purulent vaginal discharge and pain C. Vaginal bleeding after intercourse D. Recurrent candidiasis infections
D
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
This is the most typical position of the uterus. The cervix is pointed posteriorly, and the body of the uterus is at the level of the pubis over the bladder
anteverted uterus
*Occurs after menopause when estrogen production is low *The discharge produced may be blood-tinged and is usually minimal *The labia and vaginal mucosa appear atrophic *The vaginal mucosa is typically pale, dry, and contains areas of abrasion that bleed easily *Causes itching, burning, dryness, and painful urination
atrophic vaginitis
*The cause is unknown (possibly anaerobic bacteria), but it is thought to be sexually transmitted *The discharge is thin and gray-white, has a positive amine (fishy smell), and coats the vaginal walls and ectocervix *The labia and vaginal walls usually appear normal and pH is greater than 4.5 (5.5-6.0)
bacterial vaginosis
*A hardened ulcer is usually the first indication of cervical cancer, but it may not be visible on the ectocervix. *In later stages, the lesion may develop into a large cauliflower-like growth. *A Pap smear is essential for diagnosis.
cancer of the cervix
*This infection is caused by the overgrowth of yeast in the vagina *It causes a thick, white, cheesy discharge *The labia may be inflamed and swollen *The vaginal mucosa may be reddened and typically contains patches of the discharge *This infection causes intense itching and discomfort
candidal vaginitis (moniliasis)
*This condition differs from cervical eversion in that normal tissue around the external os is inflamed and eroded, appearing reddened and rough *Usually occurs with mucopurulent cervical discharge
cervical erosion
*This is a normal finding in many women and usually occurs after vaginal birth or when the woman takes oral contraceptives *The columnar epithelium from within the endocervical canal is everted and appears as a deep red, rough ring around the cervical os, surrounded by the normal pink color of the cervix
cervical eversion
*Typically develops in the endocervical canal and may protrude visibly at the cervical os *It is soft, red, and rather fragile *Benign
cervical polyp
*This is a normal variation *The cervix is pointed slightly more anteriorly (compared with the anteverted position), and the body of the uterus is positioned more posteriorly than the anteverted position, midway between the bladder and the rectum *It may be difficult to palpate the body through the abdominal and rectal walls with the uterus in this position
midposition uterus
*This condition produces a mucopurulent yellowish discharge from the external os *It usually indicates infection with Chlamydia or gonorrhea *However, these STIs may also occur with no visible signs, although the discharge may change the cervical pH (3.8-4.2)
mucopurulent cervictis
*Results from pregnancy and fetal growth *In such cases, the isthmus feels soft (Hegar sign) on palpation, and the fundus and isthmus are compressible at between 10 and 12 weeks of pregnancy
normal enlargement: pregnancy
Masses that are cancerous are usually solid, irregular, nontender, and fixed
ovarian cancer
*Benign masses on the ovary *They are usually smooth, mobile, round, compressible, and nontender
ovarian cyst
What refers to the number of births a woman has had after 20 weeks even if the fetus died at birth?
para
*Typically caused by infection of the fallopian tubes (salpingitis) or fallopian tubes and ovaries (salpingo-oophoritis) with an STI (i.e., gonorrhea, Chlamydia) *It causes extremely tender and painful bilateral adnexal masses (positive Chandelier sign)
pelvic inflammatory disease (PID)
A normal menstrual cycle usually occurs approximately every
18-45 days
The average length of menstrual blood flow is
3-7 days
A 22-year-old architecture major comes to the office reporting severe burning with urination, a fever, and aching all over. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe acne. She is currently taking an oral contraceptive. She has had no pregnancies or surgeries. She reports one new sexual partner within the last month. She does not smoke but drinks occasionally. Her parents are both in good health. Examination reveals a young woman appearing slightly ill. Temperature is 38.0°C; pulse and blood pressure are unremarkable. Head, ears, eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable. Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and bimanual examinations are unremarkable for findings, although she is very tender at the introitus. Urine analysis has some white blood cells but no red blood cells or bacteria. Her urine pregnancy test is negative. Which disorder of the vulva is most likely in this case? A. Genital herpes B. Condylomata accuminata C. Syphilitic chancre D. Epidermoid cyst
A
A 23-year-old waitress comes to your clinic reporting severe pelvic pain radiating to her right side. The pain began yesterday and is getting much worse. She has had no burning with urination and denies any recent sexual activity. She has no nausea, vomiting, constipation, diarrhea, fever, or vaginal discharge. Her last period was 3 to 4 weeks ago. Her past medical history consists of severe acne, depression, and mild obesity. She has had no surgeries. She broke up with her boyfriend 6 months ago and denies dating anyone else. She smokes one pack of cigarettes a day, drinks three to four beers two to three times a week, and denies any illegal drug use. Her mother has diabetes; her father has coronary artery disease. Examination shows a mildly obese woman in moderate distress. Her blood pressure is 130/80 and her pulse is 90. She is afebrile. On auscultation she has active bowel sounds. She has no rebound or guarding in any abdominal quadrant. Speculum examination shows no lesions on the cervix and no discharge or bleeding from the os. During the bimanual examination she has no cervical motion tenderness, but her right adnexal area is swollen and tender. A urine analysis is normal, and the urine pregnancy test is pending. What disorder of the adnexa is most likely the diagnosis? A. Ovarian cyst B. Tubal pregnancy C. Pelvic inflammatory disease
A
A nurse begins the speculum examination and finds the vaginal orifice tight. What is the appropriate action by the nurse to facilitate the insertion of the speculum? A. Ask the client to bear down to relax the muscles of the perineum B. Apply a small amount of lubricant to the end of the speculum C. Rotate the speculum until the blades are in a horizontal position D. Slightly open the blades of the speculum to relax the labia
A
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
A nurse is preparing a client for a Pap smear. The nurse knows that the area where 90% of the neoplasms of the lower genital track originate and the area from which cells will be obtained for the Pap smear is which of the following? A. Transformational zone B. Squamocolumnar junction C. Fallopian tubes D. Fimbriae
A
The skin folds of the labia majora and the labia minora form a boat-shaped area termed the A. vestibule. B. corpus. C. Skene glands. D. urethral meatus.
A
When examining the genitalia of a client, a nurse observes a yellowish discharge from the external os. The nurse recognizes this finding as indicative of what condition? A. Mucopurulent cervicitis B. Exposure to diethylstilbestrol (DES) C. Cancer of cervix D. Trichomonas vaginitis
A
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? A. Anteflexed B. Retroflexed C. Anteverted D. Retroverted
A
Which characteristic is associated with stage 3 of sexual maturity in girls? A. Pubic hair is sparely observed over the pubic symphysis. B. Menses has just begun. C. Only nipples are elevated. D. Areola has receded. E. Pubic hair is seen on medial surfaces of the thighs.
A
While assessing the anus of an adult client, the nurse detects the presence of small nodules. The nurse should refer the client to a physician for possible A. polyps. B. anorectal fistula. C. hemorrhoids. D. rectocele.
A
A female client has a history of multiple sexual partners, which puts her in the high-risk group for developing HPV and cervical cancer. What should the nurse recommend to this client to help prevent these problems? Select all that apply. A. Monogamy B. Abstinence C. Consistent use of condoms D. Hormonal contraceptives E. Prophylactic antibiotics
A,B,C
The wet mount prepared after a female client's pelvic examination reveals motile organisms greater than 10 WBCs per high powered microscopy. The nurse should gather supplies for which diagnostic follow-up? (Select all that apply.) A. Chlamydia culture B. Gonorrhea culture C. HIV testing D. Syphilis serology E. Ureteroscopy
A,B,C,D
A client's ovaries are not able to be palpated during a pelvic examination. What should the nurse identify as a possible reason for this finding? Select all that apply. A. Obesity B. Postmenopausal C. Has an intrauterine device D. Tense during the examination E. Takes hormone replacement therapy
A,B,D
The client states that she does not enjoy sex because she does not attain adequate vaginal lubrication. The nurse should be aware of what potential causes of sexual dysfunction? (Select all that apply.) A. Psychiatric conditions B. Medical illness C. Excessive testosterone D. Amenorrhea E. Lack of estrogen
A,B,E
In an interview with a client, the client tells the nurse that she is currently taking estrogen replacement therapy. The nurse should mention which of the following conditions that this therapy is a risk factor for? Select all that apply. A. Breast cancer B. Colorectal cancer C. Yeast infections D. Hemorrhoids E. Diabetes mellitus
A,C
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 A. Client smokes cigarettes B. Lacto-ovo-vegetarian diet C. Infrequent sexual intercourse D. Vitamin A, D, and C deficiencies E. Vaginal drying because of menopause
A,C,E
After an assessment, the nurse identifies that a female client is at risk for the development of colorectal cancer. Which non-modifiable risk factors did the nurse assess to make this clinical determination? Select all that apply. A. Age 53 B. Smokes cigarettes C. Sedentary lifestyle D. African American race E. Treatment for type 2 diabetes mellitus
A,D,E
A 27-year-old female client with a history of endometriosis and amenorrhea reports severe right-sided pelvic pain. What is the nurse's priority action? A. Collect a stool specimen. B. Assess the client's vital signs. C. Inquire if client has multiple sexual partners. D. Palpate for liver enlargement.
B
A client presents to the health care clinic and reports a 7-day history of vaginal discharge and swelling of the labia. During the examination of the external genitalia, the nurse notices an enlarged Bartholin's gland. The nurse should prepare to culture this client for which condition? A. Urethritis B. Gonorrhea C. Trichomoniasis D. Lice infestation
B
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
A nurse is interviewing a client who is from Bangladesh. Which of the following should the nurse not find unusual, based on this client's country of origin? A. Early menarche B. Late menarche C. Severe premenstrual syndrome symptoms D. Amenorrhea
B
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
In a nonpregnant woman, where should a nurse anticipate palpating for the fundus of the uterus? A. Above the level of the pubis B. At the level of the pubis C. Level with the top of the iliac crest D. Halfway between the pubis & the umbilicus
B
Inspection of the female external genitalia begins with what? A. Inguinal area B. Mons pubis C. Pubic hair D. Skin
B
The nurse should use the term menorrhagia to describe which menses-related occurrence? A. intervals of fewer than 21 days between menses B. an excessive flow during menses C. bleeding that occurs after vaginal sex D. a light menses flow
B
When collecting a specimen from the cervix for cytology, the nurse does which of the following? A. Presses firmly on a glass slide with the applicator end B. Labels glass slides and treats them immediately with fixative C. Uses water-soluble lubricant to ease insertion of the speculum D. Collects specimens from the endocervix, ectocervix, and lateral fornices
B
When examining the genitalia of a client, a nurse observes a columnar epithelium that extends onto the vaginal wall. The nurse recognizes this finding as indicative of what condition? A. Mucopurulent cervicitis B. Exposure to diethylstilbestrol C. Cancer of the cervix D. Trichomonas vaginitis
B
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? A. Anteflexed B. Retroflexed C. Anteverted D. Retroverted
B
Which of the following is a downward displacement of the bladder toward the vaginal orifice? A. Rectocele B. Cystocele C. Vulvodynia D. Fistula
B
Which of the following terms refers to difficult or painful sexual intercourse? A. Amenorrhea B. Dyspareunia C. Dysmenorrhea D. Endometriosis
B
Women going through menopause typically experience which of the following signs and symptoms? A. Polyuria, weight loss, increased sweating B. Vasomotor changes, increased cholesterol levels, bone loss C. Increased self-concept, decreased cholesterol levels, polyuria D. Decreased cholesterol levels, vaginal atrophy, mood instability
B
A nurse assesses a 30-year-old client who has never had a Pap test. Which factors should the nurse explain to the client are a risk for cervical cancer? Select all that apply. A. Sexual monogamy B. Diet low in fruits C. Multiple pregnancies D. Diet rich in folate E. History of Chlamydia infection
B,C,E
How should the normal cervix feel to the nurse's fingers? Select all that apply. A. Hard B. Firm C. Immobile D. Soft E. Round
B,D,E
A 24-year-old delivers a healthy female infant. Incidentally, the client had used diethylstilbestrol (DES) during her pregnancy. It is important that the nurse stress frequent gynecological examinations of client's daughter when she reaches a certain age due to which of the following? A. To ensure regularized menstruation cycles in client's daughter. B. To ensure that the client's daughter has a complication-free pregnancy. C. To prevent the onset of vaginal carcinoma in the client's daughter. D. To prevent the onset of vulvar cancer in the client's daughter.
C
A 30-year-old paralegal analyst comes to the clinic reporting a bad-smelling vaginal discharge with some mild itching, present for about 3 weeks. Douching did not help. She has had no pain with urination or with sexual intercourse. She has noticed that the smell increases after intercourse and during her period last week. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Past medical history consists of one spontaneous vaginal birth. She is married with one child. She denies tobacco, alcohol, or drug use. Her mother has high blood pressure, and her father died from heart disease. On examination she appears healthy and has unremarkable vital signs. On examination of the perineum no lesions are noted. On palpation of the inguinal nodes there is no lymphadenopathy. On speculum examination a thin gray-white discharge is seen in the vault. The pH of the discharge is over 4.5, and there is a fishy odor when potassium hydroxide KOH is applied to the vaginal secretions on the slide. Wet prep shows epithelial cells with stippled borders (clue cells). What type of vaginitis best describes her findings? A. Trichomonas vaginitis B. Candida vaginitis C. Bacterial vaginosis D. Atrophic vaginitis
C
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? A. 30 to 48 years B. 35 to 53 years C. 40 to 58 years D. 45 to 63 years
C
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
A nurse observes a thick, white, cheesy discharge at the vaginal opening, with irritation and swelling of the labia. The nurse recognizes this finding as most likely indicating what type vaginal infection? A. Trichomoniasis B. Chlamydia C. Moniliasis D. Vaginosis
C
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
What information should a nurse give a client who reports a routine of frequent douching? A. contaminates the vagina and the urethra B. May cause toxic shock syndrome C. predisposes the vagina to yeast infections D. Can cause abrasion that bleeds easily
C
When examining the genitalia of a client, a nurse observes cauliflower-like growth on the client's cervix. 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
C
When inserting the vaginal speculum, the nurse angles the blades obliquely and presses along the posterior vaginal wall to: A. Promote relaxation B. Facilitate identification of the cervix C. Prevent pressure on the urethra D. Avoid sensitive posterior structures
C
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
Which position occurs when the uterus turns posteriorly as a whole unit? A. Anteversion B. Retroflexion C. Retroversion D. Anteflexion
C
What care should a nurse take when using a speculum to assess a client's cervix? Select all that apply. A. Place the fingers of the dominant hand against the anterior vagina B. Lubricate the blades using commercial ointments C. Encourage the client to take deep breaths and keep her feet in the stirrups D. Choose the instrument that is the correct size for the client E. Insert the speculum at a 45-degree angle downward
C,D,E
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 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
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 A. normal pregnancy. B. endometriosis. C. pelvic inflammatory disease. D. ectopic pregnancy.
D
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
The nurse practitioner is performing a pelvic examination on an female adult client during her annual examination. With an index finger inserted into the client's vagina, the nurse asks the client to bear down slightly. For what is the nurse assessing? A. Vaginal tone B. Rectocele C. Cystocele D. Pelvic organ prolapse
D
To best secure accurate assessment information, the nurse should complete which part of the reproductive history last? A. menstrual B. obstetric C. menopausal D. sexual
D
What intervention should a nurse follow when obtaining the specimen for a gonorrhea culture? A. Moisten cotton-tipped applicator with saline. B. Rotate applicator into the cervical os in a half circle. C. Leave applicator in place for just 10 seconds. D. Spread specimen in a "Z" pattern onto a special culture plate.
D
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
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
While assessing the genitalia of a female client, the nurse observes moist fleshy lesions on the client's labia. The nurse should refer the client to a physician for possible A. gonorrhea. B. herpes simplex virus infection. C. nabothian cysts. D. genital warts.
D
*A normal variation that consists of the uterine body flexed anteriorly in relation to the cervix *The position of the cervix remains normal
anteflexed uterus
While performing a gynecologic examination, the nurse observes small, painful, ulcer-like lesions with red bases on the client's labia. The nurse should refer the client to a physician for possible A. herpes simplex virus infection. B. syphilis. C. lice. D. herpes zoster virus infection.
A
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
A Nurse Practitioner is examining a client who presented at the free clinic with vulvar pruritus. Which assessment factor would the practitioner look for that may indicate that the client has an infection caused by Candida albicans? A. Cottage cheese-like discharge B. Yellow-green discharge C. Gray-white discharge D. Discharge with a fishy odor
A
A client visits the clinic and tells the nurse that her stools have been pale for the past 2 days and her skin has been itching. The nurse should refer the client to a physician for possible A. biliary disease. B. cancer. C. gastrointestinal infection. D. hemorrhoids.
A
A female client tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and a yellowish green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infections? A. Trichomonas vaginalis B. Candidiasis C. Gardnerella D. Chlamydia
A
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
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
A nurse is teaching a sex education class at the local university. In a pre-lecture quiz, the nurse asks what the two small folds that extend from the clitoral hood to the posterior fourchette of the vagina are called. What would be the correct answer? A. Labia minora B. Labia majora C. Posterior fourchette D. Vestibule
A
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
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
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
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
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
The nurse documents assessment findings of amenorrhea, obesity, and hirsutism in a 20-year-old college student. Which condition does the nurse suspect? A. polycystic ovarian syndrome B. endometriosis C. salpingitis D. cervical dysplasia
A
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? A. Ectopic pregnancy B. Birth defects C. Sepsis D. Toxic shock syndrome
A
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
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
The nurse notes a white curd-like discharge when inspecting a female client's labia. What should the nurse suspect this client is experiencing? A. candida vaginitis B. bacterial overgrowth C. trichomonas vaginalis D. human papilloma infection
A
While examining the perineum of a female client, the nurse notes an enlarged knot to the right side just below the vaginal opening. The nurse will most likely note this as an enlarged Bartholin gland. A. True B. False
A
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
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? A. Red B. Pink C. Blue D. Pale
B
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
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 A. stress incontinence. B. rectocele. C. tumor of the vagina. D. cystocele.
D
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 A. hold her breath. B. breathe deeply through her mouth. C. breathe normally. D. bear down.
D
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. Carcinoma of the cervix B. Mucopurulent cervicitis C. Cervical polyp D. Retention cyst
C
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? A. Ovarian cyst B. Tubal pregnancy C. Pelvic inflammatory disease
C
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
The skin folds of the labia majora are composed of adipose tissue, sebaceous glands, and A. Skene ducts. B. vestibular glands. C. sweat glands. D. Bartholin glands.
C
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? A. Anteflexed B. Retroflexed C. Anteverted D. Retroverted
C
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
*Occurs when the uterus protrudes into the vagina *It is graded according to how far it protrudes into the vagina
uterine prolapse
*The cervix normally appears bluish in the client who is in her first trimester of pregnancy *However, if the client is not pregnant, a bluish color to the cervix indicates venous congestion or a diminished oxygen supply to the tissues
cyanosis of the cervix
*A bulging in the anterior vaginal wall caused by thickening of the pelvic musculature *As a result, the bladder, covered by vaginal mucosa, prolapses into the vagina
cystocele
*Occurs when a fertilized egg attaches to the fallopian tube and begins developing instead of continuing its journey to the uterus for development *A solid, mobile, tender, and unilateral adnexal mass may be palpated if tenderness allows *The cervix and uterus will be softened, and movement of these structures will cause pain
ectopic pregnancy
*The uterus is fixed and tender *Growths of endometrial tissue are usually present throughout the pelvic area and may be felt as firm, nodular masses *Pelvic pain and irregular bleeding are common
endometriosis
What degree of uterine prolapse? *the cervix is seen at the vaginal opening
first degree
*Caused by the human papilloma virus (HPV) *Are moist, fleshy lesions on the labia and within the vestibule *They are painless and believed to be sexually transmitted.
genital warts
What refers to the number of pregnancies a woman has had, including the present pregnancy?
gravida
What is the first indication of cervical cancer?
hardened ulcer
*DES, a drug used more than 50 years ago to prevent spontaneous abortion and premature labor, was learned to be teratogenic (capable of causing malformations in the fetus) *Women who were exposed to this drug as fetuses may have cervical abnormalities that may progress to cancer *Some abnormalities associated with maternal DES use include columnar epithelium that covers most or all of the ectocervix; columnar epithelium that extends onto the vaginal wall; a circular column of tissue that separates the cervix from the vaginal wall; transverse ridge; and enlarged upper ectocervical lip
malformations from exposure to diethylstilbestrol (DES)
*A bulging in the posterior vaginal wall caused by weakening of the pelvic musculature *Part of the rectum covered by the vaginal mucosa protrudes into the vagina
restocele
* Normal variation that consists of the uterine body being flexed posteriorly in relation to the cervix *The position of the cervix remains normal *The body of the uterus may be felt through the posterior fornix or the rectal wall
retroflexed uterus
*Normal variation that consists of the cervix and body of the uterus tilting backward *The uterine wall may not be palpable through the abdominal wall or the rectal wall
retroverted uterus
What degree of uterine prolapse? *the uterus bulges outside of vaginal openings
second degree
*Often first appear on the perianal area as silvery white papules that become superficial red ulcers *Painless *Sexually transmitted and usually develop at the site of initial contact with the infecting organism
syphilitic chancre
What degree of uterine prolapse? *the uterus bulges completely out of the vagina
third degree
*This type of vaginal infection is caused by a protozoan organism and is usually sexually transmitted *The discharge is typically yellow-green, frothy, and foul smelling *The labia may appear swollen and red, and the vaginal walls may be red, rough, and covered with small red spots (or petechiae) *This infection causes itching and urinary frequency in the client *Upon testing, the pH of vaginal secretion will be greater than 4.5 (usually 7.0 or more). If a sample of vaginal secretions is stirred into a potassium hydroxide solution (KOH prep), a foul odor (typically known as a "+" amine) may be noted.
trichomonas vaginitis (trichomoniasis)
*The uterus may be enlarged with a malignant mass *Irregular bleeding, bleeding between periods, or postmenopausal bleeding may be the first sign of a problem
uterine cancer (cancer of the endometrium)
*Tumors that are common and benign *They are irregular, firm nodules that are continuous with the uterine surface *They may occur as one or many and may grow quite large *The uterus will be irregularly enlarged, firm, and mobile
uterine fibroids (myomas)
