NUR 245 Chapter 27: Female Genitourianry System

The patient presents with new onset abnormal vaginal bleeding. Which question should the nurse ask as part of the history of present illness to obtain more information about the character of the bleeding? a. "Have you had a hysterectomy?" b. "Do you experience bleeding between periods?" c. "Have you experienced abnormal vaginal bleeding before?" d. "Do your mother or sisters experience abnormal bleeding?"

b

Vaginal lubrication during intercourse is produced by a. Skene glands. b. Bartholin glands. c. sebaceous glands. d. adrenal glands.

b

What steps could the nurse take to prepare the environment for a genitalia examination? a. Cool the speculum b. Close the door and draw the privacy curtain c. Ask all chaperones to leave the room to ensure patient privacy d. Turn the temperature up because the patient will be exposed

b

What type of discharge is expected upon inspection of female newborn external genitalia? a. Black discharge b. Whitish discharge c. Yellowish discharge d. Greenish discharge

b

When discussing sexuality or sexual feelings with teenagers, a permission statement helps to communicate that it is normal and healthy to think or to feel a certain way. Which of the following would you choose to be a permission statement? a. "It's OK that girls your age are having sex." b. "Often girls your age have questions about sex and sexual activity. What questions do you have" c. "Now I want to ask you some questions about sexual activity. I ask all girls these questions." d. "Do you use condoms every time you have sex?"

b

When the nurse is discussing sexuality and sexual issues with an adolescent, a permission statement helps convey that it is normal to think or feel a certain way. Which statement is the best example of a permission statement? a. It is okay that you have become sexually active. b. Girls your age often have questions about sexual activity. Do you have any questions? c. If it is okay with you, Id like to ask you some questions about your sexual history. d. Girls your age often engage in sexual activities. It is okay to tell me if you have had intercourse.

b

Which describes a function of the fallopian tubes? a. Secrete estrogen and progesterone b. Transport the ovum to the uterus c. Secrete mucus for lubrication of the introitus d. Support the pelvic contents

b

Which female genitalia finding is normal in newborns? a. Thinning cervix b. Protruding hymen c. Edema of Skene glands d. Urinary meatus within the vaginal introitus

b

Which structures make up the pelvic floor? a. Bony pelvis b. Pelvic muscles c. Bartholin glands d. Vaginal vestibule

b

A 20-year-old woman with a history of an HPV infection reports bleeding outside of her normal menstrual cycle and is concerned because her mother died of cervical cancer. On examination, the nurse notes a hard granular surface at the cervical os that bleeds on palpation. Which information would the nurse document as objective data? Select all that apply. a. History of HPV b. Bleeding on palpation c. Hard granular surface at cervical os d. Bleeding outside of menstrual cycle e. Patient's mother died of cervical cancer

b,c

A genetically female child is born with an enlarged clitoris, fused labia, and a urethral opening above the clitoris. The nurse should document which information as family history related to female genitalia? Select all that apply. a. Fused labia b. Infertility of a sister c. Unexplained death of an infant sibling d. Genetic abnormalities of a stepsister e. Cervical cancer of a mother-in-law

b,c

As part of a history of the present illness, which questions should the nurse ask a young couple who has had difficulty getting pregnant? Select all that apply. a. "Have you ever been pregnant?" b. "Do you know when you ovulate?" c. "How long have you been trying to get pregnant?" d. "How many children do you have?" e. "Did your mother have a difficult time conceiving?"

b,c

A sexually active patient reports painless sores in the genital area. The nurse observes round flesh-colored papules with a central umbilication from which creamy discharge can be expressed. Which findings should the nurse document as objective data? Select all that apply. a. Painless sores b. Creamy discharge c. Central umbilication d. Flesh-colored papules e. Sexually active state of the patient

b,c,d

During a rectovaginal examination, which elements of the stool are assessed? Select all that apply. a. Amount of stool b. Blood in the stool c. Color of the stool d. Mucus in the stool e. Consistency of stool

b,c,d

The nurse is inspecting a 3-day-old newborn's genitalia and notes a mucoid white discharge mixed with blood, a protruding thick hymen, and large clitoris, with a central hymen opening of 0.1 cm. Which findings would the nurse note as normal? Select all that apply. a. Enlarged clitoris b. Mucoid discharge c. Blood in the discharge d. Protruding thick hymen e. Central hymen opening of 0.1 cm

b,c,d

Which structures make up the corpus uterus? Select all that apply. a. Cervix b. Fundus c. Body d. Isthmus e. Adnexa

b,c,d

The patient comes to clinic for her first prenatal visit. Which questions should the nurse ask about her obstetric history? Select all that apply. a. "Are there any twins in your family?" b. "Have you had any preterm pregnancies?" c. "How many living children do you have?" d. "How many times have you been pregnant?" e. "Have you had any complications with any pregnancies?"

b,c,d,e

What aspects should be assessed while palpating the uterus during a bimanual examination? Select all that apply. a. Color of the uterus b. Size of the uterus c. Mobility of the uterus d. Position of the uterus e. Smoothness of the uterine walls

b,c,d,e

What should be assessed when palpating the labia minora? Select all that apply. a. Shape b. Irregularities c. Nodules d. Tenderness e. Caking of discharge

b,c,d,e

Which aspects of a patient's sexual history would the nurse document on as part of a detailed personal/social history when assessing the genitalia? Select all that apply. a. Previous sexually transmitted illnesses (STIs) b. Lack of orgasm c. Pain on penetration d. Use of contraception e. Current sexual activity

b,c,d,e

Which elements of the cervix should be assessed during bimanual examination? Select all that apply. a. Color b. Shape c. Position d. Consistency e. Tenderness

b,c,d,e

Which questions should the nurse ask to assess a 35-year-old patient who reports irregular periods as part of a medical/surgical history? Select all that apply. a. "Are you sexually active?" b. "Have you had a hysterectomy?" c. "Have you had a cesarean section?" d. "Have you had any vaginal infections?" e. "What was the date of your last normal menstrual period?"

b,c,d,e

About which aspects of a patient's personal/social history would the nurse document as part of a detailed assessment of the genitalia? Select all that apply. a. Miscarriages b. Douching history c. Cleansing routines d. Cervical motion tenderness e. Performance of a self-examination

b,c,e

If the ovaries are palpable, which findings would be considered normal when palpating? Select all that apply. a. Nodularity b. Smoothness c. Ovoid in shape d. Soft to the touch e. Slight tenderness on palpation

b,c,e

The patient and her sexual partner are concerned about unusual vaginal discharge. Which questions should the nurse ask the patient to learn more about the history of the present illness related to the discharge? Select all that apply. a. "Have you been douching?" b. "Does the vaginal discharge have an odor?" c. "What is the color of the vaginal discharge?" d. "Have you been previously diagnosed with an STI?" e. "How much vaginal discharge have you been experiencing?"

b,c,e

What should the nurse do to prepare the examination environment prior to a genital examination? Select all that apply. a. Drape the table b. Provide for privacy c. Ensure adequate lighting d. Ask the chaperone to leave the room e. Ensure comfortable room temperature

b,c,e

Which component of the uterus should be assessed during a bimanual examination? Select all that apply. a. Cysts b. Size c. Position d. Masses e. Contour

b,c,e

Prior to inserting the speculum for an internal female genital examination, which techniques would be used to encourage the patient to relax? Select all that apply. a. Warm the speculum under water b. Coach the patient to breathe slowly c. Have the patient empty her bladder d. Insert a finger into the vagina and apply downward pressure e. Drape the patient's knees so she cannot see the nurse during the examination

b,d

What happens during the pre-ovulatory phase of the menstrual cycle? Select all that apply. a. FSH levels decrease b. Uterine lining thickens c. Ovum released from the follicle d. Ova matures in the ovary e. FSH levels increase

b,d,e

Which techniques could the nurse use to warm the speculum prior to an internal genital examination? Select all that apply. a. Hot water b. Warm water c. Electric warming unit d. Indirect heat from lamp e. Warmth from gloved hands

b,d,e

A 44-year-old woman reports heavy bleeding during menses, with painful cramping and urinary frequency. On examination, the nurse notes an enlarged uterus with firm, irregular nodules. Which information would the nurse document as objective data? Select all that apply. a. Heavy bleeding b. Enlarged uterus c. Painful cramping d. Urinary frequency e. Firm, irregular nodules

b,e

The nurse is palpating an ovarian mass during an internal examination of a 63-year-old woman. Which findings of the masss characteristics would suggest the presence of an ovarian cyst? Select all that apply. a. Heavy and solid b. Mobile and fluctuant c. Mobile and solid d. Fixed e. Smooth and round f. Poorly defined

b,e

A 25-year-old woman has some vaginal discharge and is worried she has a sexually transmitted infection (STI). What is your next best response? a. "Tell me more about the discharge: Color? Smell? Amount?" b. "Have you been having sex with a new partner?" c. "How about condoms? Do you use one every time you have sex?" d. "This is normal for some time within the menstrual cycle. Don't worry?"

a

A 65-year-old woman tells you she "wets" her self a little when she sneezes or coughs. Your next best responce is a. "This sounds like 'stress incontinence' and usually is due to some weakness in the pelvic muscles" b. "This may be a sign of infection, so let's test a urine sample for bacteria." c. "This is called 'urge incontinence' and is usually due to an overactive bladder muscle." d. "This is a sign of blood in the urine, and we will need to refer you to a specialist."

a

A red, soft protrusion from the endocervical canal (as imaged) is indicative of which abnormal finding? a. Cervical polyp b. Cervical cancer c. Endometriosis d. Uterine prolapse

a

A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the: a. Menstrual history, because it is generally nonthreatening. b. Obstetric history, because it includes the most important information. c. Urinary system history, because problems may develop in this area as well. d. Sexual history, because discussing it first will build rapport.

a

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

a

During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal? a. cervix b. uterus c. ovaries d. fallopian tubes

a

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

a

During an examination, the nurse observes a female patients vestibule and expects to see the: a. Urethral meatus and vaginal orifice. b. Vaginal orifice and vestibular (Bartholin) glands. c. Urethral meatus and paraurethral (Skene) glands. d. Paraurethral (Skene) and vestibular (Bartholin) glands.

a

During an examination, which tests will the nurse collect to screen for cervical cancer? a. Endocervical specimen, cervical scrape, and vaginal pool b. Endocervical specimen, vaginal pool, and acetic acid wash c. Endocervical specimen, potassium hydroxide (KOH) preparation, and acetic acid wash d. Cervical scrape, acetic acid wash, saline mount (wet prep)

a

During which phase of the menstrual cycle is the ovum released from the follicle? a. Ovulation b. Secretory c. Premenstrual d. Pre-ovulatory

a

In order to obtain accurate subjective assessment data from a female adolescent, what would be the most appropriate action by the nurse? a. Ask parent/caregiver to step out of the room and return to the lobby. b. Share what life was like for the nurse at the patient's age. c. Ask questions such as, "you're not sexually active, right?" d. Stand when asking questions.

a

The nurse is preparing to interview a postmenopausal woman. Which of these statements is true as it applies to obtaining the health history of a postmenopausal woman? a. The nurse should ask a postmenopausal woman if she has ever had vaginal bleeding. b. Once a woman reaches menopause, the nurse does not need to ask any history questions. c. The nurse should screen for monthly breast tenderness. d. Postmenopausal women are not at risk for contracting STIs; therefore, these questions can be omitted.

a

The nurse is reviewing the changes that occur with menopause. Which changes are associated with menopause? a. Uterine and ovarian atrophy, along with a thinning of the vaginal epithelium b. Ovarian atrophy, increased vaginal secretions, and increasing clitoral size c. Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions d. Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy

a

The provider palpates the adnexa on a 23-year-old woman who presents to the clinic following two missed menstrual periods. The findings regarding the adnexa are: nonpalpable ovaries; a firm, smooth uterine wall; a fallopian tube that feels firm and pulsating. What is your next best action? a. Refer the woman promptly to the ED. b. A pulsating fallopian tube occasionally is present due to the nearby iliac artery. Proceed with the exam. c. Schedule a return appointment in 2 weeks to recheck the findings. d. Request an ultrasound image to confirm presence of ovaries and both fallopian tubes.

a

The uterus is usually positioned tilting forward and superior to the bladder. This position is known as: a. Anteverted and anteflexed. b. Retroverted and anteflexed. c. Retroverted and retroflexed. d. Superiorverted and anteflexed.

a

What is the most appropriate recommendation to prevent cervical cancer in females? a. Administration of HPV vaccine around 11 and 12 years old b. Use barrier protection method during sexual intercourse. c. Start birth control if sexually active. d. There is nothing that can prevent cervical cancer.

a

A 40-year-old woman with constant lower abdominal cramping made worse by sexual activity reports purulent vaginal discharge and a recent fever and vomiting. The nurse notes cervical motion tenderness on bimanual examination. Which findings would the nurse document as part of the history of the present illness? Select all that apply. a. Fever b. Vomiting c. Cervical motion tenderness d. Lower abdominal cramping e. Purulent vaginal discharge

a,b,d,e

On inspection of a female newborn's external genitalia, which features should be assessed? Select all that apply. a. Size of clitoris b. Appearance of labia c. Tenderness of clitoris d. Presence of adhesions e. Odor of discharge

a,b,d,e

What should the nurse do to prepare a female patient for a genital examination? Select all that apply. a. Drape the patient b. Have the patient empty her bladder c. Ask the patient to face the door d. Ensure the patient cannot see the examination e. Show the patient the examination equipment and explain its use

a,b,e

When examining the labia, which findings suggest genital warts (Condyloma acuminatum)? Select all that apply. a. Soft growths b. Clustering of lesions c. Homogeneous color d. Nontender on palpation e. Reddish-brown growths on labia

a,b,e

Which medical conditions should the nurse assess for during the family history component of a gynecology assessment? Select all that apply. a. Diabetes b. Uterine cancer c. Crohn's disease d. Hyperlipidemia e. Pregnancies with multiple births

a,b,e

A 32-year-old woman reports abnormal bleeding, lower back pain on the left side, and lightheadedness. On examination, the nurse notes pelvic tenderness and rigidity, along with cervical motion tenderness and an adnexal mass. Which findings should the nurse document as objective data? Select all that apply. a. Pelvic rigidity b. Adnexal mass c. Abnormal bleeding d. Lower back pain e. Lightheadedness f. Pelvic tenderness

a,b,f

A 46-year-old woman is in the clinic for her annual gynecologic examination. She voices a concern about ovarian cancer because her mother and sister died of it. Which statement does the nurse know to be correct regarding ovarian cancer? a. Ovarian cancer rarely has any symptoms. b. The Pap smear detects the presence of ovarian cancer. c. Women at high risk for ovarian cancer should have annual transvaginal ultrasonography for screening. d. Women over age 40 years should have a thorough pelvic examination every 3 years.

c

A patient has had three pregnancies and two live births. The nurse would record this information as grav___, para_____,AB____. a. 2; 2; 1 b. 3; 2; 0 c. 3; 2; 1 d. 3; 3; 1

c

A woman states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic. As a part of the interview, the nurse should ask, Have you noticed any: a. Changes in your urination patterns? b. Excessive vaginal bleeding? c. Unusual vaginal discharge or itching? d. Changes in your desire for intercourse?

c

An 18-year-old patient is having her first pelvic examination. Which action by the nurse is appropriate? a. Inviting her mother to be present during the examination b. Avoiding the lithotomy position for this first time because it can be uncomfortable and embarrassing c. Raising the head of the examination table and giving her a mirror so that she can view the examination d. Fully draping her, leaving the drape between her legs elevated to avoid embarrassing her with eye contact

c

During a bimanual examination, the nurse detects a solid tumor on the ovary that is heavy and fixed, with a poorly defined mass. This finding is suggestive of: a. Ovarian cyst. b. Endometriosis. c. Ovarian cancer. d. Ectopic pregnancy.

c

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

c

During an internal examination of a womans genitalia, the nurse will use which technique for proper insertion of the speculum? a. The woman is instructed to bear down, the speculum blades are opened and applied in a swift, upward movement. b. The blades of the speculum are inserted on a horizontal plane, turning them to a 30-degree angle while continuing to insert them. The woman is asked to bear down after the speculum is inserted. c. The woman is instructed to bear down, the width of the blades are horizontally turned, and the speculum is inserted downward at a 45-degree angle toward the small of the womans back. d. The blades are locked open by turning the thumbscrew. Once the blades are open, pressure is applied to the introitus and the blades are inserted downward at a 45-degree angle to bring the cervix into view.

c

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

c

During the interview, a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurses most appropriate response to this would be: a. Oh, dont worry. Some cyclic vaginal discharge is normal. b. Have you been engaging in unprotected sexual intercourse? c. Id like some information about the discharge. What color is it? d. Have you had any urinary incontinence associated with the discharge?

c

During which phase of the menstrual cycle does implantation of the fertilized ovum occur? a. Secretory b. Menstrual c. Premenstrual d. Pre-ovulatory

c

Generally, the changes normally associated with menopause occur because the cells in the reproductive tract are: a. Aging. b. Becoming fibrous. c. Estrogen dependent. d. Able to respond to estrogen.

c

How should the speculum be inserted into the vaginal opening for a female internal examination? a. Insert along a straight path. b. Insert along a slight upward path. c. Insert along a slight downward path. d. Insert along a steep downward path.

c

In which position should the nurse hold a newborn during inspection and palpation of female external genitalia? a. Hold legs over head b. Hold legs out straight c. Hold legs in frog position d. Hold legs in abducted position

c

The Bartholin glands perform which function? a. Secrete FSH b. Secrete LH c. Secrete mucus d. Secrete estrogen

c

The most common sexually transmitted infection in the United States is a. gonorrhea. b. syphilis. c. chlamydia. d. trichomoniasis.

c

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

a

When performing an external genitalia examination of a 10-year-old girl, the nurse notices that no pubic hair has grown in and the mons and the labia are covered with fine vellus hair. These findings are consistent with stage of sexual maturity, according to the Sexual Maturity Rating scale. a.1 b.2 c.3 d. 4

a

Which finding is considered normal when palpating the cervix of a non-pregnant patient? a. Firm b. Soft c. Offset d. Pear-shaped

a

Which findings would the nurse consider normal on palpation of the perineum of a woman who has borne five children? a. Thin tissue b. Inflammation c. Tenderness d. Smooth tissue

a

Which of the following describes a normal and expected finding when inspecting the adult female's external genitalia? a. Occasional yellowish, 1-cm nodules that are firm and nontender. b. Swelling in the perineum just before the onset of menses. c. Redness of the labia majora. d. A yellow-green discharge at midcycle.

a

A female patient reports burning with urination. What additional questions should the nurse ask as part of the history of the present illness to better understand the symptoms? Select all that apply. a. "Do you have any flank pain?" b. "Do you have any abdominal pain?" c. "Do you have any vaginal discharge?" d. "Have you ever been diagnosed with a UTI?" e. "Do you have any new sexual partners?"

a,b,c

A 25-year-old woman presents several days before her expected menses with breast swelling and tenderness and reports weight gain and bloating. There are no unexpected findings on physical examination by the nurse. Which findings would the nurse document as part of the history of the present illness? Select all that apply. a. Bloating b. Weight gain c. Breast swelling d. Breast tenderness e. Lack of unexpected findings on physical examination

a,b,c,d

When assessing the cervix during the speculum examination, what should be noted? Select all that apply. a. Color b. Discharge c. Position d. Surface characteristics e. Temperature of the cervix

a,b,c,d

Which aspects of the cervix should be assessed during the speculum examination? Select all that apply. a. Color b. Position c. Size and shape d. Surface characteristics e. Specimens for PAP smear

a,b,c,d

Which elements of the vaginal wall should be assessed during the speculum examination? Select all that apply. a. Color b. Moisture c. Presence of cystocele d. Presence of lesions e. Hair distribution

a,b,c,d

When inspecting and palpating the labia majora, which findings would be identified as normal? Select all that apply. a. Dry b. Closed c. Gaping d. Shriveled e. Soft tissue f. Heterogeneous texture

a,b,c,d,e

A 30-year-old woman reports a sensation of pelvic heaviness and that something "feels like it is falling out" of her vagina. Additionally, the patient reports lower back pain and urinary incontinence. On examination, the nurse notes that the cervix is at the introitus. Which information would the nurse document as part of the history of the present illness? Select all that apply. a. Pelvic heaviness b. Lower back pain c. Urinary incontinence d. Cervix at the introitus e. Feeling of something falling out of the vagina

a,b,c,e

A 50-year-old woman reports nonspecific symptoms such as abdominal pain, gas, indigestion, and cramps. On bimanual examination, the nurse notes that the patient's ovary is palpable. Which data would the nurse document as part of the history of the present illness? Select all that apply. a. Gas b. Cramps c. Indigestion d. Palpable ovary e. Abdominal pain

a,b,c,e

The vulva consists of which structures? Select all that apply. a. Labia majora b. Labia minora c. Vagina d. Clitoris e. Uterus

a,b,d

Which cervical surface characteristics should the nurse assess during the speculum examination? Select all that apply. a. Texture b. Moisture c. Tenderness d. Presence of lesions e. Size and shape status

a,b,d

Which characteristics of the labia majora, labia minora, and hymen would be considered normal in a 3-day-old newborn? Select all that apply. a. Edema of the labia b. Protruding hymen c. Thinning hymen d. Vascular hymen e. More prominent labia majora

a,b,d

Which personal/social history questions are important to ask a patient who verbalizes concerns about sexual health? Select all that apply. a. "Do you use contraception?" b. "Do you use recreational substances?" c. "How many times have you been pregnant?" d. "How many sexual partners do you currently have?" e. "Do you have a history of sexually transmitted illnesses?"

a,b,d

During a routine examination, a 33-year-old woman reports experiencing intermittent severe lower back pain. The patient is concerned because her mother died of uterine cancer, and the patient has had problems with fibroids in the past. On examination, the nurse notes a palpable mass in the abdomen and cervical motion tenderness. Which information would the nurse document as objective data? Select all that apply. a. Palpable mass b. Patient's past fibroids c. Cervical motion tenderness d. Intermittent severe lower back pain e. Patient's mother died of uterine cancer

a,c

Which characteristics should the nurse assess while examining the female newborn's hymen? Select all that apply. a. Size b. Odor c. Shape d. Consistency e. Temperature

a,c

A 24-year-old woman reports pelvic pain associated with a heavy menstrual flow that lasts "longer than normal". There are no unexpected findings on initial inspection, but on bimanual examination the nurse notes tender nodules palpable along the uterosacral ligaments. Which information would the nurse note as part of the history of the present illness? Select all that apply. a. Pelvic pain b. Tender nodules c. Heavy menstrual flow d. Longer-than-normal menstrual flow e. Normal findings on initial inspection

a,c,d

Which findings would be considered abnormal on palpation of the uterus? Select all that apply. a. Soft walls b. Pear-shaped c. Fixed in place d. 9 cm in length e. Rounded contour

a,c,d

Which types of vaginal discharge are considered normal in newborns? Select all that apply. a. Bloody b. Foul odor c. Whitish in color d. Mucoid in nature e. Discharge resulting from diaper irritation

a,c,d

Which abnormal findings of the labia minora may suggest vaginal infection or poor hygiene? Select all that apply. a. Caking b. Asymmetry c. Excoriation d. Tenderness e. Inflammation

a,c,d,e

Which cervical specimens can be obtained during an internal female genital examination? Select all that apply. a. HPV b. Blood c. PAP smear d. Gonorrhea e. Chlamydia

a,c,d,e

You are preparing a patient for a pelvic examination in the lithotomy position. What measures can you employ to ease comfort? Select all that apply. a. Elevate patient's head and shoulders to keep eye contact during the exam. b. Place patient's arms up and behind the head. c. Position a chaperone standing by the patient's head. d. Make sure bladder is empty before the exam. e. Position the buttocks 6 inches up from the edge of the table so patient will not feel as if falling off. f. State, "Now I'm going to ..." before each step in the exam. Touch the inner thigh before you directly touch the vulva.

a,c,d,f,g

What aspects of the ovaries, if palpable, should be assessed as part of the bimanual genital examination? Select all that apply. a. Size b. Tone c. Shape d. Mobility e. Tenderness

a,c,e

Which aspects of the mons pubis should the nurse assess during an external genital examination? Select all that apply. a. Skin b. Vaginal drainage c. Hair distribution d. Labia majora edema e. Presence of infestation

a,c,e

A 33-year-old woman reports a vaginal discharge with a foul odor, pain in the upper right abdomen, and painful intercourse. The nurse notes bilateral tender adnexal areas and patient guarding in response to bimanual examination. Which findings should the nurse document as objective data? Select all that apply. a. Patient guarding b. Painful intercourse c. Foul vaginal discharge d. Bilateral tender adnexal areas e. Pain in upper quadrant of abdomen

a,d

Which aspects of the clitoris should the nurse assess as part of the genital examination? Select all that apply. a. Size b. Polyps c. Discharge d. Inflammation e. Tenderness

a,d

Which describes the function of the endometrium? Select all that apply. a. Lines the uterus b. Covers the uterus c. Supports the uterus d. Supports implantation of the fertilized ovum e. Separates the uterus from the rectum

a,d

Which structures make up the adnexa of the uterus? Select all that apply. a. Fallopian tubes b. Isthmus c. Cervix d. Ovaries e. Fundus

a,d

Which patient positions facilitate examination of genitalia? Select all that apply. a. Feet in stirrups b. Sitting erect with knees open c. Supine on the examination table d. Buttocks at edge of examination table e. Lithotomy position on examination table

a,d,e

Which aspects of the labia minora should be assessed by inspection as part of the genital examination? Select all that apply. a. Color b. Temperature c. Consistency d. Tenderness e. Presence of lesions

a,e

Which findings related to cervix color are considered normal? Select all that apply. a. Pink in color b. Dark red in color c. Slight yellow hue d. Heterogeneous in color e. Even distribution of color

a,e

A 48-year-old woman seeks care because of a depressed feeling, episodes of unusual heat not sleeping well and feeling exhausted and irritable her last menstrual period was 14 days prior to this appointment she describes these symptoms in detail hen states this cant be menopause, because i still have my periods what is your next best response? a. " it sounds more like stress. Let's schedule an appointment with our psychotherapist here in the office." b. "Actually, 'perimenopause' can start well before your periods stop, and you may now be having symptoms of low estrogen." c. "How are things at work? Any new problems there that could cause stress?" d. "Have you noticed any vaginal dryness when having sex?"

b

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

b

A 52-year-old patient states that when she sneezes or coughs she wets herself a little. She is very concerned that something may be wrong with her. The nurse suspects that the problem is: a. Dysuria. b. Stress incontinence. c. Hematuria. d. Urge incontinence.

b

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

b

A caruncle is a(n) a. vestibular gland located on either side of the vaginal orifice. b. small, red mass protruding from the urethral meatus. c. aberrant growth of endometrial tissue. d. hard, painless nodule in the uterine wall.

b

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

b

A nurse is assessing a patients risk of contracting a sexually transmitted infection (STI). An appropriate question to ask would be: a. You know that its important to use condoms for protection, right? b. Do you use a condom with each episode of sexual intercourse? c. Do you have a sexually transmitted infection? d. You are aware of the dangers of unprotected sex, arent you?

b

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

b

A woman has just been diagnosed with HPV or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for cancer. a. Uterine b. Cervical c. Ovarian d. Endometrial

b

After the patient relaxes her internal muscles and buttocks, what is the next step of the vaginal examination to prepare for speculum insertion? a. Warm the speculum b. Separate the labia minora with fingers c. Manipulate the speculum to expose the cervix d. Insert finger into vagina and apply pressure downward

b

As part of the history of the present illness, which question should the nurse ask the patient reporting abdominal cramping? a. "Have you ever had a cesarean section?" b. "Can you describe the intensity of the cramping?" c. "Have you been playing any high-impact sports?" d. "Have you ever experienced abdominal cramping?"

b

Cessation of menses is known as a. menarche. b. menopause. c. salpingitis. d. adnexa.

b

During a newborn genital examination, what elements of the labia minora are assessed by the nurse? a. Color b. Presence of edema c. Presence of atrophy d. Presence of malformations

b

During an examination, the nurse would expect the cervical os of a woman who has never had children to appear: a. Stellate b. Small and round. c. As a horizontal irregular slit. d. Everted.

b

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

b

During the examination portion of a patients visit, she will be in lithotomy position. Which statement reflects some things that the nurse can do to make this position more comfortable for her? a. Ask her to place her hands and arms over her head. b. Elevate her head and shoulders to maintain eye contact. c. Allow her to choose to have her feet in the stirrups or have them resting side by side on the edge of the table. d. Allow her to keep her buttocks approximately 6 inches from the edge of the table to prevent her from feeling as if she will fall off.

b

Hematuria is a term used for a. bloody discharge. b. blood in the urine. c. bleeding after intercourse. d. urine in the blood.

b

The nurse has just completed an inspection of a nulliparous womans external genitalia. Which of these would be a description of a finding within normal limits? a. Redness of the labia majora b. Multiple nontender sebaceous cysts c. Discharge that is foul smelling and irritating d. Gaping and slightly shriveled labia majora

b

The nurse is interviewing a patient who reports vaginal discharge. The patient discloses having multiple sexual partners and does not regularly use a condom. Which personal/social history questions should the nurse ask to further assess the patient's sexual activity? a. "Are your periods regular?" b. "What contraception do you currently use?" c. "Are you currently experiencing any itching?" d. "Have you ever had a sexually transmitted infection?"

b

The nurse is palpating a female patients adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurses most appropriate course of action would be to: a. Tell the patient that her examination is normal. b. Give her an immediate referral to a gynecologist. c. Suggest that she return in a month for a recheck to verify the findings. d. Tell the patient that she may have an ovarian cyst that should be evaluated further.

b

The nurse is preparing to examine the external genitalia of a school-age girl. Which position would be most appropriate in this situation? a. In the parents lap b. In a frog-leg position on the examining table c. In the lithotomy position with the feet in stirrups d. Lying flat on the examining table with legs extended

b

The nurse is examining a 35-year-old female patient. During the health history, the nurse notices that she has had two term pregnancies, and both babies were delivered vaginally. During the internal examination, the nurse observes that the cervical os is a horizontal slit with some healed lacerations and that the cervix has some nabothian cysts that are small, smooth, and yellow. In addition, the nurse notices that the cervical surface is granular and red, especially around the os. Finally, the nurse notices the presence of stringy, opaque, odorless secretions. Which of these findings are abnormal? Nabothian cysts are present. The cervical os is a horizontal slit. The cervical surface is granular and red. Stringy and opaque secretions are present.

c

The nurse is preparing for an internal genitalia examination of a woman. Which order of the examination is correct? a. Bimanual, speculum, and rectovaginal b. Speculum, rectovaginal, and bimanual c. Speculum, bimanual, and rectovaginal d. Rectovaginal, bimanual, and speculum

c

When assessing the Bartholin glands, which finding is considered normal? a. Edema b. Non-tender mass c. They are nonpalpable d. Presence of odor-free discharge

c

When palpating the uterus, which findings would be considered abnormal in a nonpregnant woman? a. Firm walls b. Smooth walls c. 3.0 cm in length d. Rounded contour

c

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

c

When the nurse is interviewing a preadolescent girl, which opening question would be least threatening? a. Do you have any questions about growing up? b. What has your mother told you about growing up? c. When did you notice that your body was changing? d. I remember being very scared when I got my period. How do you think youll feel?

c

Which internal structures support the internal genitalia? a. Hymen b. Tendons c. Ligaments d. Uterus

c

Which speculum should be used to perform an internal examination on a woman with a small vaginal opening? a. Plastic speculum b. Graves speculum c. Pederson speculum d. Virginal speculum

c

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

c

The vestibule of the female external genitalia contains which openings? Select all that apply. a. Labia majora b. Labia minora c. Vagina d. Urethra e. Anus

c,d

When inspecting and palpating the labia minora, which findings would the nurse identify as normal? Select all that apply. a. Rough texture b. Dry inner surface c. Dark pink inner surface d. Asymmetric appearance e. Tenderness on palpation

c,d

When documenting family history related to assessment of the genitalia, the nurse would record a family history of which cancers? Select all that apply. a. Lung b. Brain c. Ovarian d. Uterine e. Cervical

c,d,e

Which newborn female genitalia structures would the nurse assess after birth and expect to find edema? Select all that apply. a. Anus b. Hymen c. Clitoris d. Labia minora e. Labia majora

c,d,e

When assessing the cervix, which findings may be considered abnormal? Select all that apply. a. Soft appearing surface b. Uniform pink color of the entire cervix c. Protrusion of the cervix through vaginal introitus d. Clear discharge seen at the cervical os e. Granular surface observed around the cervical os

c,e

Which findings would the nurse consider normal upon inspection of the anus? Select all that apply. a. Fissure b. Scarring c. Course skin d. Inflammation e. Dark pigmentation

c,e

Which statement describes the vaginal opening? Select all that apply. a. The vaginal opening opens into the uterus. b. The vaginal opening is an internal genital structure. c. The vaginal opening is posterior to the urethral opening. d. The vaginal opening occupies the anterior portion of the vestibule. e. The vaginal opening occupies the posterior portion of the vestibule.

c,e

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

d

A 22-year-old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the nurse notices clusters of small, shallow vesicles with surrounding erythema on the labia. Inguinal lymphadenopathy present is also present. The most likely cause of these lesions is: a. Pediculosis pubis. b. Contact dermatitis. c. HPV. d. Herpes simplex virus type 2.

d

A 25-year-old woman comes to the emergency department with a sudden fever of 38.3 C and abdominal pain. Upon examination, the nurse notices that she has rigid, boardlike lower abdominal musculature. When the nurse tries to perform a vaginal examination, the patient has severe pain when the uterus and cervix are moved. The nurse knows that these signs and symptoms are suggestive of: a. Endometriosis. b. Uterine fibroids. c. Ectopic pregnancy. d. Pelvic inflammatory disease.

d

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

d

A 65-year-old woman is in the office for routine gynecologic care. She had a complete hysterectomy 3 months ago after cervical cancer was detected. Which statement does the nurse know to be true regarding this visit? a. Her cervical mucosa will be red and dry looking. b. She will not need to have a Pap smear performed. c. The nurse can expect to find that her uterus will be somewhat enlarged and her ovaries small and hard. d. The nurse should plan to lubricate the instruments and the examining hand adequately to avoid a painful examination.

d

A deep recess formed by the peritoneum between the rectum and the cervix is called a. the Chadwick sign. b. a cystocele. c. a rectocele. d. a rectouterine pouch.

d

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

d

An 11-year-old girl comes to your clinic for a sports physical and shows breast bud development. How can you help her understand usual growth and development? What is your best approach? a. Avoid commenting on her breasts because girls this age are very self-conscious. b. Ask her if her breasts are growing about the same way as other girls in her class. c. Tell her not to worry; by age 18 all girls will have their full breast development d. use tanner sexual development charts to show her where she is now in the stages and what to expect e. check her height and weight on the growth charts and tell her that after she gains more weight her breast will develop

d

As part of the assessment of the genitalia, the nurse would document if the patient's mother received which drug while pregnant? a. Aspirin b. Codeine c. Methadone d. Diethylstilbestrol

d

During a health history, a 22-year old woman asks, Can I get that vaccine for human papilloma virus (HPV)? I have genital warts and Id like them to go away! What is the nurses best response? a. The HPV vaccine is for girls and women ages 9 to 26 years, so we can start that today. b. This vaccine is only for girls who have not yet started to become sexually active. c. Lets check with the physician to see if you are a candidate for this vaccine. d. The vaccine cannot protect you if you already have an HPV infection.

d

Dysmenorrhea is a. painful intercourse. b. pain with defecation. c. pain with urination. d. pain associated with menstruation.

d

How would the nurse test pelvic muscle tone of the female patient during an external genital examination? a. Having the patient bear down b. Palpating over the abdominal region c. Palpating over the patient's suprapubic region d. Having patient squeeze vaginal opening around the examiner's finger

d

Progesterone increases during which phase of the menstrual cycle? a. Ovulation b. Pre-ovulatory c. Premenstrual d. Secretory

d

The first sign of puberty in girls is a. the first menstrual cycle (menarche). b. axillary hair development. c. rapid increase in height. d. breast and pubic hair development.

d

When palpating the uterus, which characteristics would be considered normal? a. Pink in color b. Tenderness c. Limited motility d. Motility in the anteroposterior plane

d

When preparing for a genital examination, what is the proper way to drape a female patient? a. Place the drape to cover the knees and allow it to extend mid-calf. b. Place the drape to cover the abdomen, keeping the knees exposed. c. Place the drape to cover the knees and tent the drape to run parallel to the examination table. d. Place the drape to cover the knees and depress the drape between the knees.

d

Which characteristics of the newborn hymen are considered normal? a. Absent b. Imperforate c. Opening of 2 cm in diameter d. Opening of 0.5 cm in diameter

d

Which internal structures do the fallopian tubes connect? a. Ovaries and vagina b. Ovaries and body of the uterus c. Ovaries and isthmus of the uterus d. Ovaries and fundus of the uterus

d

Which priority personal/social history question should the nurse ask to learn more about the sexual history of a patient who is concerned that her period is late? a. "How many sexual partners do you have?" b. "Have you ever been sexually abused?" c. "Have you ever had a sexually transmitted infection?" d. "Have you had sexual intercourse since your last period?"

d

Which questions should the nurse ask a 70-year-old woman related to her menopausal status as part of history of the present illness? a. "Did you have any fertility problems?" b. "Do you have frequent urinary tract infections?" c. "At what age did your mother experience menopause?" d. "How old were you when you completed menopause?" e. "Did you have any problems with your pregnancies?"

d

Which questions should the nurse ask a patient to evaluate the menopausal history as part of the medical/surgical history of the reproductive system? a. "How do you treat hot flashes?" b. "Have your siblings gone through menopause?" c. "Do you take any over-the-counter medications?" d. "How old were you when you started menopause?"

d

Which questions should the nurse ask a patient to evaluate the menstrual history as part of the medical/surgical history of the reproductive system? a. "Do you use pads or tampons?" b. "Are you experiencing cramping?" c. "Did your mother have heavy periods?" d. "When was your first menstrual period?"

d

Which questions should the nurse ask to assess family history related to female genital health? a. "Do you have any children?" b. "Do you perform vaginal douching?" c. "What form of birth control do you use?" d. "Has your mother or sister ever had cervical cancer?"

d

Which technique assesses anal sphincter tone during a rectovaginal examination? a. Ask patient about bowel habits b. Gently palpate around Anus with fingers c. Have Patient tighten and relax Anal sphincter naturally d. Have patient tighten and relax anal sphincter around the examiner's finger

d

You are beginning a health history for a 25-year old female who comes to the clinic for her first pelvic exam. her knees are jumpy her voice is a bit breathless you choose to begin the history with questions about her menstrural period. what directs your question choice? a. If she is having her period now, she will have to go home and schedule another appointment b. this is a good screening question to tell if she is pregnant c. this question is a good test of memory to screen if she will be a reliable historian d. young women are used to discussing their menstrual periods so this is a comfortable line of questioning to ask

d

You are examining a 1-day-old baby girl following an uncomplicated vaginal delivery. The mother is present, and both are to be discharged to return home. During the exam, you note the baby's labia majora are swollen, the clitoris appears large, there is a small amount of mucoid discharge, and the vaginal opening is difficult to see. What is your next best action? a. Ask to have the pediatrician check the baby in 2 days to make sure the genitalia decrease in size. b. Refer the baby to a specialist to evaluate ambiguous genitalia. c. Request an order for estrogen levels on the baby. d. Proceed with the exam; this is a normal finding.

d

What are the functions of the ovaries? Select all that apply. a. Secrete LH b. Secrete mucus c. Secrete FSH d. Secrete estrogen e. Secrete progesterone

d,e

Which description of the size and shape of the cervical os would be considered normal for a multiparous woman who has had vaginal births? Select all that apply. a. Oval b. Round c. Small d. Stellate e. Irregular slit

d,e

Which question should be included in the gynecologic history of a patient being seen for her first gynecology visit as part of the medical/surgical history?Select all that apply. a. "How often do you douche?" b. "Do you have any abdominal pain?" c. "Describe the character of your abnormal bleeding." d. "Have you ever had pelvic inflammatory disease?" e. "Have you ever been diagnosed with sexually transmitted infections?"

d,e