Health Assessment-Chapter 25 + 27-Male + Female Genitourinary System

Which conditions would the nurse assess for in a patient whose blood urea nitrogen (BUN) level is 40 mg/dL? Select all that apply. 1 Dehydration 2 High protein intake 3 Overhydration 4 Undescended testes 5 Malnutrition

1 Dehydration 2 High protein intake The nurse would assess for dehydration and a high protein intake. BUN measures urea, which is the end product of protein metabolism in the body. The normal range of BUN is 10 to 20 mg/dL. The BUN level may rise because of a decrease in fluid volume, which may occur as a result of dehydration. High protein intake results in increased protein metabolism, which may also contribute to increased BUN levels. Overhydration would produce a low BUN level. Cryptorchidism is undescended testicles in the scrotal sac and would not cause BUN to elevate. Malnutrition (lack of nutrients and protein) would cause the BUN to decrease. (pg. 698)

Which instructions would the nurse include in patient medication teaching regarding nocturia from diuretics? Select all that apply. 1 "Avoid drinking alcohol at night." 2 "Wear an adult diaper during the night." 3 "Restrict fluid intake 3 hours before bedtime." 4 "Use scrotal support during the night." 5 "Drink a small cup of coffee before going to bed."

1 "Avoid drinking alcohol at night." 3 "Restrict fluid intake 3 hours before bedtime." The nurse would instruct the patient to do the following: avoid drinking alcohol at night and restrict fluid intake 3 hours before bedtime. Nocturia refers to excessive urination during the night. It is characterized by frequent awakening and the urgency to void urine. The patient should avoid alcohol intake because alcohol has a diuretic effect, which may increase urine voiding. The patient should restrict fluid intake for 3 hours before bedtime, because increased fluid intake before bedtime may increase the frequency of voiding. The nurse would not tell the patient to wear adult diapers during the night. The excess moisture could lead to skin breakdown. The nurse would not instruct the patient to use scrotal support because this would be ineffective for nocturia. Scrotal support is used for a scrotum that is swollen. The nurse would not advise the patient to drink a cup of coffee before bedtime, because coffee contains caffeine, which has a diuretic effect.

Which conditions are examples of vulvovaginal inflammation? Select all that apply. 1 Candidiasis 2 Trichomoniasis 3 Acute salpingitis 4 Atrophic vaginitis 5 Human papillomavirus infection

1 Candidiasis 2 Trichomoniasis 4 Atrophic vaginitis Candidiasis, trichomoniasis, and atrophic vaginitis are vulvovaginal inflammations. Candidiasis is characterized by thick, whitish, clumpy discharge with intense pruritus in the vulvovaginal area. Trichomoniasis is characterized by pruritus, watery vaginal discharge, urinary frequency, terminal dysuria, and itching. Atrophic vaginitis is characterized by dryness, a burning sensation, dyspareunia, and mucoid discharge. Acute salpingitis is the enlargement of adnexa; it is characterized by sudden fever, suprapubic pain, and tenderness. Human papillomavirus infection is usually confined to the cervix. It is characterized by warty growth on the cervical epithelium. (pg. 760)

Which infection would the nurse suspect in the patient who presents with yellow mucopurulent vaginal discharge and a friable cervix during the pelvic assessment and who complains of painful urination and postcoital bleeding? 1 Chlamydia 2 Gonorrhea 3 Candidiasis 4 Trichomoniasis

1 Chlamydia Painful urination, increased urinary frequency, and postcoital bleeding are characteristics of a chlamydial infection. Patients with a chlamydia infection have a friable cervix, with yellow or green mucopurulent cervical discharge. Therefore the nurse concludes that the patient has chlamydia. Dysuria, vaginal bleeding, and abnormal uterine bleeding indicate gonorrhea. Thick, white, curdlike discharge from an erythematous vagina indicates candidiasis. Red, granular papules and frothy, foul-smelling discharge from the vagina indicate trichomoniasis. (pg. 761)

A patient with a urinary tract infection reports painful urination. Which additional urine sample finding would the nurse monitor for in the patient? 1 Cloudiness of urine 2 3 red blood cells (RBCs) 3 2 white blood cells (WBCs) 4 Amber-colored urine

1 Cloudiness of urine Cloudy urine indicates the presence of a urinary tract infection. Painful urination indicates dysuria, which is a symptom of urinary tract infection. Increased RBCs and WBCs indicate urinary tract infection. However, fewer than 5 RBCs and WBCs are normal findings and do not indicate a urinary tract infection. In this situation, the patient's RBCs are 3 and the WBCs are 2, making these both normal because both are below 5. The normal color of the urine ranges from yellow to deep amber color and should be clear. Amber urine does not indicate a urinary tract infection. (pg. 688)

Which are risk factors for developing candidiasis? Select all that apply. 1 Diabetes mellitus 2 Vaginal douching 3 Cigarette smoking 4 Prolonged use of antibiotics 5 Unopposed estrogen therapy

1 Diabetes mellitus 2 Vaginal douching 4 Prolonged use of antibiotics Diabetes mellitus, vaginal douching, and prolonged use of antibiotics are risk factors for developing candidiasis. Increased glycogen content because of diabetes mellitus favors the growth of pathogens that may result in candidiasis. Vaginal douching alters the vaginal pH, which favors the growth of pathogens and therefore causes infection. Use of antibiotics and frequent vaginal douching disrupt the normal flora and favor the growth of pathogens, resulting in candidiasis. Cigarette smoking increases the risk for vascular problems and cervical cancer. Unopposed estrogen therapy (estrogen only without progesterone) increases the risk for endometrial cancer. (pg. 760)

Which would the nurse infer when the patient reports having pain and a burning sensation during urination? 1 Dysuria 2 Oliguria 3 Hematuria 4 Stress incontinence

1 Dysuria Pain or a burning sensation with urination indicates dysuria. If the urinary output is less than 400 mL per day, it indicates that the patient has oliguria. Presence of blood in the urine is referred to as hematuria. Involuntary loss of urine during coughing or sneezing caused by weakness of the pelvic floor is referred to as stress incontinence. (pg. 734)

Which developmental changes would the nurse be able to observe in a male preadolescent during physical examination? Select all that apply. 1 Enlargement of the testis 2 Increase in the penis size 3 Appearance of pubic hair 4 Pendulous appearance of the scrotum 5 Migration of the testis along the inguinal canal

1 Enlargement of the testis 2 Increase in the penis size 3 Appearance of pubic hair The nurse would look for enlargement of the testis, increase in penis size, and appearance of pubic hair. The nurse can observe the signs of puberty during physical examination in preadolescents. Enlargement of the testis is the first sign of puberty, which starts around 9─10 years of age. Next pubic hair appears, and then penis size increases. The appearance of a pendulous scrotum occurs because of decreased tone of muscle mass and decreased rugae; it is seen in older adult males. Migration of the testis along the inguinal canal occurs before birth.

A patient reports local pain and a burning sensation during urination. Upon examination, the nurse finds that the patient has a fever and clusters of small, shallow erythematous vesicles on the genital areas. Which would the nurse suspect from these findings? 1 Herpes genitalis 2 Syphilitic chancre 3 Urethral caruncle 4 Haemophilus vaginalis infection

1 Herpes genitalis Herpes genitalis is a sexually transmitted infection caused by the type 2 herpes simplex virus. Any pain or burning sensation during urination indicates dysuria. Local pain, dysuria, and fever are symptoms of herpes infection. The presence of clusters of small, shallow erythematous vesicles on the genital areas and inner thighs indicates that the patient has herpes genitalis. Small, round, solitary, silvery papules that transform into superficial ulcers with a yellowish discharge indicate syphilitic chancre. A small, deep red benign mass protruding from the meatus resulting in painful urination indicates urethral caruncle. Thin, creamy, gray-white malodorous discharge from the vagina indicates Haemophilus vaginalis, which is caused by bacteria. (pg. 756)

Which finding would the nurse consider abnormal when inspecting the patient's cervix and its opening? 1 Lateral position of the cervix 2 Diameter of cervix as 2.5 cm 3 Pink-colored cervical mucosa 4 Small, round cervical opening

1 Lateral position of the cervix Normally, the position of the uterine cervix should be anterior or posterior, but a lateral position of the cervix may indicate that the patient has a cervical adhesion or tumor. The normal diameter of the cervix is 2.5 cm. The diameter of the cervix increases with a tumor or inflammation. Normally, the cervical mucosa is pink in color. Redness of the cervical mucosa indicates inflammation. The cervical opening is small and round in a normal patient. (pg. 742)

Which conditions would be examples of penile abnormalities? Select all that apply. 1 Phimosis 2 Epididymitis 3 Hypospadias 4 Diffuse tumor 5 Spermatocele 6 Peyronie disease

1 Phimosis 3 Hypospadias 6 Peyronie disease Phimosis, hypospadias, and Peyronie disease are examples of abnormalities of the penis. Phimosis is a condition in males in which the foreskin is advanced, extremely tight, and cannot be retracted over the glans penis. Hypospadias refers to the presence of urethral meatus on the ventral side of the glans penis. Peyronie disease is the presence of hard, nontender, subcutaneous palpable plaques on the dorsal or lateral surface of the penis. Epididymitis, diffuse tumor, and spermatocele are examples of scrotal abnormalities. Epididymitis is the acute infection and inflammation of epididymis. Diffuse tumor is the nontender enlargement of a cancerous testis. Spermatocele is the presence of a fluid cyst in the epididymis.

Which changes would the nurse observe in an older adult female patient during a genital examination? Select all that apply. 1 Shrinkage of the uterus 2 Thinning of the pubic hair 3 Increase in the vaginal pH 4 Increased size of the clitoris 5 Enlargement of the mons pubis

1 Shrinkage of the uterus 2 Thinning of the pubic hair 3 Increase in the vaginal pH Because female hormone levels decrease rapidly with age, the nurse can observe dramatic changes in the reproductive system of an older adult patient. The uterus shrinks in size because of a decreased myometrium, which decreases the production of hormones such as progesterone and estrogen. Pubic hair becomes thin and sparse because of a lack of ovarian hormones. The vaginal pH becomes more alkaline as the pH increases. This is the result of decreased estrogen levels. The size of the clitoris gradually decreases with age, and the mons pubis becomes smaller because of atrophy of the fat pad. (pg. 732)

Which procedures would the nurse include when doing a vaginal examination? Select all that apply. 1 Situate the patient in the lithotomy position. 2 Have the patient raise her arms over her head. 3 Put an examination glove on each of the stirrups. 4 Elevate the end of the examination table near the head. 5 Teach the patient to keep quiet during the examination.

1 Situate the patient in the lithotomy position. 3 Put an examination glove on each of the stirrups. 4 Elevate the end of the examination table near the head. The lithotomy position requires the patient to lie on her back with hips and knees flexed, feet placed in the stirrups, thighs apart, and the perineum at the end of the examination table. This position is most commonly used for vaginal examinations. The nurse would place an examination glove over each stirrup to warm up the stirrups and prevent the patient's feet from slipping. Elevating the head end of the examination table helps the nurse maintain eye contact with the patient during the examination. The nurse would not instruct the patient to place her hands over her head because this position tightens the abdominal muscles during the examination. The nurse would communicate and explain every part of the examination and encourage the patient to ask any questions during the examination. (pg. 738)

Which signs and symptoms would the nurse find in a young child who has an indirect inguinal hernia? Select all that apply. 1 Stops crying after being laid down 2 Has nausea, vomiting, and tenderness 3 Whines because of pain while expelling stools 4 Has swelling that increases with intra-abdominal pressure 5 Has swelling close to pubis in area of internal inguinal ring

1 Stops crying after being laid down 3 Whines because of pain while expelling stools 4 Has swelling that increases with intra-abdominal pressure The following findings are consistent with indirect inguinal hernia: stops crying after being laid down, whines because of pain while expelling stools, and has swelling that increases with intra-abdominal pressure. Indirect inguinal hernia is the most common of all hernias. In indirect inguinal hernia, the sac of the peritoneum herniates through the internal inguinal ring and may pass into the scrotum. The child may have decreased pain while lying down, because this position may decrease intra-abdominal pressure. The child may report pain while expelling stools, because this activity exerts strain on the abdominal muscles. When there is an increase in the intra-abdominal pressure, the intestinal contents are pushed through the inguinal canal, producing swelling or a bulge. The child may have nausea, vomiting, and tenderness in the case of a strangulated femoral hernia. The child may have a swelling close to the pubis in the area of the internal inguinal ring in the case of a direct (not indirect) inguinal hernia.

The patient reports a burning sensation during urination, and the nurse observes urethral inflammation and purulent discharge from the urethral meatus, which is consistent with which condition? 1 Urethritis 2 Herpes genitalis 3 Syphilitic chancre 4 Urethral caruncle

1 Urethritis Urethritis is referred to as the inflammation of the urethra, which causes a burning sensation during urination. Erythema, tenderness of the anterior vaginal wall, and purulent discharge from the urethral meatus are characteristics of urethritis. Clusters of small, shallow vesicles with erythema emerging around genital areas and the inner thigh indicate herpes genitalis. Small, round, solitary, silvery papules, which transform into superficial ulcers with yellowish discharge, indicate syphilitic chancres. A small, deep red benign mass protruding from the meatus resulting in painful urination indicates urethral caruncle. (pg. 757)

Which assessment finding is consistent with atrophic vaginitis? Select all that apply. 1 Vaginal itching, dryness with a mucoid vaginal discharge 2 Shortened, narrowed vaginal opening and decreased rugae 3 Thick, white, curdlike discharge from erythematous vagina 4 Thin, creamy, gray-white malodorous discharge from vagina 5 Red granular papules and frothy, foul-smelling vaginal discharge

1 Vaginal itching, dryness with a mucoid vaginal discharge 2 Shortened, narrowed vaginal opening and decreased rugae Vaginal itching, a burning sensation with dryness, and mucoid discharge from the vagina are characteristics of atrophic vaginitis. This condition is caused by the loss of estrogen. Estrogen keeps the vaginal tissues thick, moist, and rugated. Therefore the loss of estrogen causes decreased rugae along with a shortened, narrowed vagina. A thick, white, curdlike discharge from an erythematous vagina indicates candidiasis. Thin, creamy, gray-white malodorous discharge from the vagina indicates bacterial vaginosis. Red granular papules and frothy, foul-smelling discharge from the vagina indicate trichomoniasis. (pg. 760)

After reviewing the results of a male genitourinary assessment, which findings would the nurse consider normal? Select all that apply.

1. Presence of pubic hair at the base of the penis 2. Left scrotal sac is lower than right 3. Central urethral meatus The normal findings include presence of pubic hair at the base of the penis; left scrotal sac is lower than right; and central urethral meatus. Pubic hair is normally located at the base of the penis. The left scrotal sac appears low because the left testis has a longer spermatic cord when compared with the right testis. The urethral meatus is normally centrally located. Normally the scrotal sac is nontender, not tender. A tender scrotal sac is abnormal and is indicative of inflammation of the scrotal contents. A narrowed opening of the prepuce indicates phimosis, which is an abnormal finding. Hard and enlarged nodes in the inguinal area are abnormal. Normally lymph nodes may not be palpable but may feel small, soft, discrete, and movable.

Which medical condition would cause a patient's scrotum to have a red glow of serous fluid upon transillumination? 1 Hernia 2 Hydrocele 3 Orchitis 4 Testicular tumor

2 Hydrocele If the serous fluid transilluminates and shows a red glow, it indicates the patient has a hydrocele. Transillumination is performed by shining a strong flashlight from behind the scrotal contents. The absence of transillumination of the scrotal contents is normal. Blood and solid tissue do not transilluminate. Therefore transillumination does not occur in other conditions such as hernia, orchitis, and testicular tumor. (pg. 710)

Which instruction to the patient is appropriate just before inserting the vaginal speculum? 1 "Place your hips midway down the examining table." 2 "Bear down so that the perineal muscles can relax." 3 "Squeeze your perineal muscles so that I can assess the pelvic floor strength." 4 "Relax your perineal muscles so that the instrument can be placed in an upward position toward the bladder."

2 "Bear down so that the perineal muscles can relax." The nurse instructs the patient to bear down so that the perineal muscles can relax. This helps open the introitus and eases the speculum insertion. The hips are placed to the edge of the table for ease of insertion. Squeezing the perineal muscles will not open the introitus and will hinder examination. The nurse can elevate the bed to decrease the patient's discomfort. The speculum is placed in a downward position toward the small of the back. (pg. 741)

A patient with a urinary tract infection (UTI) presents with dysuria. Which additional assessment findings would the nurse monitor for in the patient? Select all that apply. 1 Pinpoint, constricted meatus opening 2 Frequency 3 Urgency 4 Suprapubic pain 5 Penile shaft indurated along ventral side

2 Frequency 3 Urgency 4 Suprapubic pain The nurse would assess for frequency, urgency, and suprapubic pain. UTI presents with dysuria, frequency, urgency, suprapubic pain, nocturia, occasionally gross hematuria, and possibly fever. A pinpoint, constricted opening at meatus indicates a urethral stricture, not a UTI. With a urethral stricture the penile shaft feels indurated along the ventral aspect at the site of the stricture.

Which findings obtained during the assessment of a newborn female require further evaluation? Select all that apply. 1 Thick hymen 2 Large clitoris 3 Engorged labia 4 Fusion of the labia 5 Ambiguous genitalia

2 Large clitoris 4 Fusion of the labia 5 Ambiguous genitalia Routine screening of the newborn genitalia is limited to visual inspection of the external genitalia. The clitoris is a small, pea-shaped erectile body. An enlarged clitoris makes it appear like a penis, which is a characteristic of ambiguous genitalia and should be evaluated. Fusion of the labia minora and labia majora resembles the scrotum of a male newborn and requires further evaluation. The hymen is a thin, circular crescent-shaped organ that partly or completely covers the vaginal orifice. A thick hymen because of the engorgement of genitalia during birth is a normal finding, and it doesn't require further evaluation. Engorged labia are caused by transient enlargement of the genitalia and are a normal finding after the birth of a newborn. (pg. 765)

Which characteristic accurately describes the inguinal lymph nodes? 1 Receive drainage from the testes 2 Lie along the groin inferior to the inguinal ligament 3 Receive drainage from the superficial knee region 4 Lie below the junction of the lower outer thigh

2 Lie along the groin inferior to the inguinal ligament The inguinal lymph nodes horizontal chain lies along the groin inferior to the inguinal ligament. The inguinal lymph nodes receive drainage from the lymphatics of the penis and the scrotal surface. The lymphatics of the testes drain into the abdomen. The inguinal lymph nodes do not receive drainage from the superficial knee region; the inguinal lymph nodes receive drainage from the penis and scrotal surfaces. The inguinal lymph nodes vertical chain lies along the upper inner thigh, not below the junction of the lower outer thigh. (pg. 684)

When assessing a patient with a history of excessive uterine bleeding during menses, the uterine ultrasound reveals enlarged, painless nodules, which is consistent with which condition? 1 Polyps 2 Myomas 3 Endometriosis 4 Acute salpingitis

2 Myomas An enlarged uterus along with bloating, and hard, painless nodules on the uterine wall, indicates myomas, or uterine fibroids. The presence of fibroids in the uterine wall causes heaviness, bloating, backache, and excessive uterine bleeding, the latter of which in turn leads to anemia. A bright red, soft, pedunculated growth emerging from the cervical opening is referred to as a polyp. An enlarged uterus, which is fixed, tender on movement, and has small, firm nodular masses on the posterior part of the fundus indicates endometriosis. A fever greater than 100.4°F (38°C) along with suprapubic pain, tenderness, and purulent discharge from the cervix indicates acute salpingitis. (pg. 762)

A patient with a varicocele reports a dragging sensation in the scrotal area. Which additional assessment finding would the nurse monitor for upon palpation? 1 Solitary nodule on testicle 2 Scrotal "bag of worms" 3 Extremely tender scrotum 4 Absence of testis

2 Scrotal "bag of worms" Varicocele refers to the dilation of the varicose veins in the spermatic cord, which feels like a "bag of worms" on palpation. A solitary nodule on a testicle is testicular cancer, not a varicocele. An extremely tender scrotum occurs in epididymitis, not varicocele. Absence of testis is cryptorchidism, not varicocele. (pg. 709)

Which action would the female nurse take during a genitalia examination of a male patient? 1 Engage in friendly talk and then proceed. 2 Use a confident, relaxed, businesslike approach. 3 Defer the physical assessment and record that the patient refused. 4 Discuss genitourinary history while performing the examination.

2 Use a confident, relaxed, businesslike approach. The female nurse would be confident and relaxed, unhurried yet businesslike to perform the genitalia assessment to reduce the male patient's discomfort. Engaging in friendly talk will not lessen the patient's discomfort, and the patient may also perceive it as an invasion of his privacy. The nurse would not defer the physical assessment, because it is an important process to gather patient data, and the nurse would not chart that the patient refused; only factual information would be charted by the nurse. Do not discuss genitourinary history or sexual practices while examining the patient as this may be perceived as judgmental. (pg. 692)

Which information would the nurse include in a teaching session regarding testicular self-examinations? 1 "Testicular cancer usually affects men after 50 years of age." 2 "Avoid self-examination because lesions are difficult to detect." 3 "The cure rate of testicular cancer is almost 100% when detected early." 4 "There is no need to worry if any hard lumps on the testicles are painless."

3 "The cure rate of testicular cancer is almost 100% when detected early." The cure rate of testicular cancer is almost 100% if the treatment begins before metastasis. Testicular cancer usually occurs in males between 15 and 35 years of age. The nurse would teach testicular self-examination to the patient, because the patient can detect any lumps and report immediately. The nurse would instruct the patient to report any painless hard lumps on the testicles, because some tumors are painless. (pg. 697)

The infant's urethral meatus is located ventrally. Which penis abnormality would the infant have? 1 Phimosis 2 Epispadias 3 Hypospadias 4 Paraphimosis

3 Hypospadias Hypospadias is a congenital birth defect in which the infant's urinary meatus is located ventrally. The urethral meatus is generally positioned at the center of the penis. Phimosis is a condition in which the foreskin cannot be retracted because of a narrowed opening of the prepuce. If the urethral meatus is located dorsally, it indicates that the infant has epispadias. Painful constriction of the glans by a retracted, fixed foreskin is referred to as paraphimosis. (pg.693, 698)

Which drug classification would the nurse administer to a patient who presents with clusters of painful vesicles and eruptions on the glans and foreskin of the penis? 1 Antifungal 2 Antibiotic 3 Oral antiviral 4 Local anesthetic

3 Oral antiviral The initial infection of genital herpes, a viral infection, is treated with oral antivirals. Clusters of painful vesicles and eruptions on the glans and foreskin indicate the patient has genital herpes. Genital herpes is a sexually transmitted infection, the acute stage of which lasts for 7 to 10 days. Antifungals are used to treat tinea cruris. Antibiotics, like Penicillin G, are effective against some sexually transmitted infections, such as syphilis. Lidocaine-prilocaine cream (EMLA) is a local anesthetic used during minor invasive procedures such as circumcision. (pg. 705)

Circumcision in males would cause a decreased risk for which medical conditions in their female sexual partners? Select all that apply. 1 Genital ulcer disease 2 Herpes simplex virus 3 Trichomoniasis 4 Bacterial vaginosis 5 Human papillomavirus infection

3 Trichomoniasis 4 Bacterial vaginosis There is a decreased risk for trichomoniasis and bacterial vaginosis in female partners of men who have had circumcisions. The area under the foreskin serves as a good breeding ground for bacteria and infection, but circumcision helps in preventing the growth and transmission of sexually transmitted infections. Circumcised males receive medical benefits such as a reduced risk of acquiring genital ulcer disease, herpes simplex virus, and human papillomavirus infection. (pg. 687)

While assessing a patient, the nurse finds that the patient has a body temperature of 102.2°F (39°C), suprapubic pain, and purulent discharge from the cervix and complains of severe pain when the nurse attempts to palpate the adnexa. Which would the nurse infer from these findings? 1 Ovarian cyst 2 Ovarian carcinoma 3 Acute salpingitis 4 Ectopic pregnancy

3 Acute salpingitis A body temperature of 102.2°F (39°C) indicates a fever. A fever greater than 100.4°F (38°C), suprapubic pain, tenderness, and purulent discharge from the cervix are signs that indicate acute salpingitis. The patient with this condition has rigid abdominal musculature, which causes intense pain when manually palpating the uterus and examining the cervix. Thus it is difficult to palpate the bilateral adnexal masses because of intense pain and muscle spasms. A smooth, round, mobile, and nontender mass on an ovary is referred to as an ovarian cyst. Ovarian cancer is characterized by a heavy, solid, fixed, poorly defined mass in the ovary. The symptoms associated with ovarian cancer include abdominal pain, pelvic pain, and increased abdominal size. Abdominal or pelvic pain with vaginal spotting and softening of the uterus and fundus are characteristics of ectopic pregnancy. (pg. 763)

Which complication would the nurse expect in a patient who reports chronic pelvic pain and irregular uterine bleeding and has an enlarged uterus with small, firm, nodular masses on the posterior part of the fundus? 1 Polyp 2 Myomas 3 Endometriosis 4 Pelvic inflammatory disease

3 Endometriosis Endometriosis is a condition characterized by an enlargement of the uterus, which is tender on movement and has the presence of small, firm, nodular masses on the posterior part of the uterine fundus. It causes cyclic or chronic pelvic pain with irregular uterine bleeding. A bright red, soft, pedunculated growth emerging from the cervical opening with mucoid discharge is referred to as a polyp. Painless, hard nodules on the uterine wall that cause enlargement of the uterus are referred to as myomas. A sudden fever greater than 100.4°F (38°C) along with suprapubic pain, tenderness, and purulent discharge from the cervix may indicate pelvic inflammatory disease. (pg. 762)

Which condition would be caused by hyperactivity of the detrusor muscle? 1 Direct inguinal hernia 2 Pendulous scrotum 3 Urge incontinence 4 Testicular torsion

3 Urge incontinence Urge incontinence is caused by a hyperactive detrusor muscle. The overactive detrusor muscle causes an urge to urinate, which may in turn result in the involuntary leakage of urine. This condition is referred to as urge incontinence. A direct inguinal hernia can be caused by muscle atrophy, not from a hyperactive detrusor muscle. A pendulous scrotum results in the older adult male because of decreased tone of the dartos muscle, not from an overactive detrusor muscle. Testicular torsion occurs from faulty anchoring of testis on the wall of the scrotum, not from a hyperactive detrusor muscle. (689)

Which condition is consistent with a posteriorly swollen labia, tenderness, and a palpable mass on the labia? 1 Leiomyomas 2 Genital warts 3 Atrophic vaginitis 4 Abscess on the Bartholin gland

4 Abscess on the Bartholin gland Normally, the labia should feel soft and homogenous on palpation. Posteriorly swollen labia, tenderness, and the presence of a palpable mass in the labia with severe local pain indicate that the patient has an abscess on the Bartholin gland. Irregular enlargement of the uterus with painless, hard nodules on the uterine wall is characteristic of leiomyomas. Red- or pink-colored, soft, pointed, and moist warty papules around the cervix, vagina, introitus, anus, and vulva indicate genital warts. Atrophic vaginitis is characterized by dryness, burning sensation, dyspareunia, and mucoid discharge. (pg. 757)

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

4 Human papillomavirus (HPV) HPV genital warts are the most common sexually transmitted infection, especially in adolescents. An early age of menarche and multiple sexual partners increase the risk for genital warts. A cystocele occurs when the urinary bladder prolapses. This condition is not transmitted sexually. A urethral caruncle is a deep red mass protruding from the meatus. It is not sexually transmitted. An abscess of the Bartholin gland also cannot be sexually transmitted. (pg. 732)

Which is an abnormal assessment finding in a female patient? 1 The cervix is pink. 2 Bartholin glands are not palpable. 3 Ovaries are smooth, firm, and nontender on palpation. 4 The cervix and uterus are fixed and tender on internal palpation.

4 The cervix and uterus are fixed and tender on internal Fixed and tender uterus and cervix may indicate endometriosis in a patient. The cervix is normally pink. Redness of the cervix would be an abnormal finding. Bartholin glands would be palpable in the case of Bartholin duct cysts or gland abscesses. Normal Bartholin glands are not palpable. Smooth, firm, and nontender ovaries on palpation are a normal finding in a healthy patient. (pg. 748)