Deck 18: Female Genitalia

Question 1

When you plan to obtain cytologic studies, speculum introduction may be facilitated by:

A) lubrication with gel.
B) lubrication with warm water.
C) use of a plastic speculum.
D) opening the blades completely.

Answer 1

lubrication with warm water.

Question 2

Posteriorly, the labia minora meet as two ridges that fuse to form the:

A) fourchette.
B) vulva.
C) clitoris.
D) perineum.

Answer 2

fourchette.

Question 3

The mother of an 8-year-old child reports that she has recently noticed a discharge stain on her daughter's underwear. Both the mother and daughter appear nervous and concerned. You would need to ask questions to assess the child's:

A) drug ingestion.
B) fluid intake.
C) risk for sexual abuse.
D) hormone responsiveness.

Answer 3

risk for sexual abuse.

Question 4

A bluish color to the cervix during pregnancy is called (the):

A) McDonald sign.
B) Spinnbarkeit.
C) Goodell sign.
D) Chadwick sign.

Question 5

The form of gynecologic cancer that is increased in obese women is:

A) vaginal.
B) cervical.
C) ovarian.
D) endometrial.

Question 6

Which of the following findings indicates a possible gonococcal infection?

A) Bulging of the anterior or posterior vaginal wall
B) Discharge from urethra or Skene glands
C) Irregular urethral orifice in midline
D) Irregular vaginal edges at introitus

Question 7

Ms. A, age 32, states that she has a recent history of itchy vaginal discharge. Ms. A has never been pregnant. Her partner uses condoms and she uses spermicide for birth control. Which of the following data are most relevant to Ms. A's problem?

A) Bowel habits
B) Douching routines
C) Menstrual flow
D) Nutritional factors

Question 8

The adnexa of the uterus are composed of the:

A) corpus and cervix.
B) fallopian tubes and ovaries.
C) uterosacral and broad ligaments.
D) vagina and fundus.

Question 9

Which systemic feature is related to the effects of menopause?

A) Increased abdominal fat distribution
B) Decreased LDL levels
C) Cold intolerance
D) Decreased cholesterol levels

Question 10

The risk of ovarian cancer is increased by:

A) the use of oral contraceptives.
B) cigarette smoking.
C) age between 35 and 50 years.
D) early age at first intercourse.

Question 11

The pelvic joint that separates most appreciably during late pregnancy is the:

A) sacroiliac.
B) symphysis.
C) sacrococcygeal.
D) iliofemoral.

Question 12

A cervical polyp usually appears as a:

A) grainy area at the ectocervical junction.
B) bright red, soft protrusion from the endocervical canal.
C) transverse or stellate scar.
D) hard granular surface at or near the os.

Question 13

Mrs. Robinson, a 49-year-old patient, presents to the office complaining of missing her menstrual period. She asks about menopause. You explain to her that the conventional definition of menopause is:

A) the first day of the last menstrual period.
B) 1 year with no menses.
C) the last day of the last menstrual period.
D) the cessation of ovulation.

Question 14

During sexual excitement, how is the vaginal introitus lubricated?

A) The Bartholin glands secrete mucus.
B) The clitoris produces moisture.
C) The Skene glands drain fluid.
D) The urethral surfaces secrete water.

Question 15

Pregnancy-related cervical changes include:

A) flattening and lengthening.
B) thinning and reddening.
C) hardening and pallor.
D) softening and bluish coloring.

Question 16

The examiner should change gloves after touching the patient's:

A) anal area.
B) Bartholin glands.
C) Skene glands.
D) urethra.

Question 17

The female patient should ideally be in which position for the pelvic examination?

A) Fowler
B) Prone
C) Lateral supine
D) Lithotomy

Question 18

The vaginal mucosa of a woman of childbearing years should appear:

A) smooth and pink.
B) moist and excoriated.
C) dry and papular.
D) transversely rugated.

Question 19

Which risk factor is associated with cervical cancer?

A) Endometriosis
B) Low parity
C) Multiple sex partners
D) Obesity

Question 20

Which structure is located posteriorly on each side of the vaginal orifice?

A) Skene glands
B) Clitoris
C) Perineum
D) Bartholin glands

Question 21

When collecting specimens, which sample should be obtained first?

A) Chlamydial swab
B) Gonococcal culture
C) Pap smear
D) Wet mount

Question 22

The presence of a fishy odor after adding potassium hydroxide to a wet mount slide containing vaginal mucus suggests:

A) bacterial vaginosis.
B) yeast infection.
C) chlamydial infection.
D) pregnancy.

Question 23

What accommodations should be used for the position of a hearing-impaired woman for a pelvic examination?

A) The patient should assume the M or V position.
B) Her legs should be farther apart.
C) The head of the table should be elevated.
D) The lithotomy position with obstetric stirrups should be used.

Question 24

Young women who are not sexually active should have their first pelvic examination:

A) by age 15 years.
B) by age 18 years.
C) by age 21 years.
D) only after they become sexually active.

Question 25

A mother brings her 8-year-old daughter to the clinic because the child says it hurts to urinate after she fell while riding her bicycle. On inspection, you find posterior vulvar and gross perineum bruising. These findings are consistent with:

A) chronic masturbation.
B) congenital defects.
C) acute urinary tract infection.
D) sexual abuse.

Question 26

Prominent labia minora are a normal finding in:

A) adolescents.
B) menopausal women.
C) newborns.
D) pregnant women.

Question 27

Which one of the following is a proper technique for the use of a speculum during a vaginal examination?

A) Allow the labia to spread, and insert the speculum slightly open.
B) Insert one finger, and insert the opened speculum.
C) Press the introitus downward, and insert the closed speculum obliquely.
D) Spread the labia, and insert the closed speculum horizontally.

Question 28

An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection?

A) Gonococcal culture
B) Cytology smear
C) Haemophilus smear
D) Trichomonas smear

Question 29

During a digital examination of the vagina, the cervix is noted to be positioned posteriorly. On bimanual examination of this woman, you would expect to palpate a(n) ___________ uterus.

A) retroverted
B) anteverted
C) midline
D) laterally deviated

Question 30

During a pelvic examination for a postmenopausal woman, you would expect to assess:

A) a wider and longer vaginal vault.
B) the absence of vaginal wall rugation.
C) a nonpalpable cervical os.
D) a more mobile cervix.

Question 31

Swollen and bruised genitalia in a newborn are most likely related to:

A) a breech delivery.
B) a congenital defect.
C) an infection.
D) maternal hormones.

Question 32

Bimanual examination of the uterus includes:

A) grasping the cervix between the examining fingers.
B) grasping the vaginal wall and pulling it downward.
C) inserting one finger into the fundus.
D) placing the thumb on the clitoris and the forefinger on the cervix.

Question 33

The assessment of which structure is not part of the bimanual examination?

A) Cervix
B) Bladder
C) Uterus
D) Ovaries

Question 34

A 3-year-old girl is being seen because of a foul vaginal odor. To inspect the vaginal vault, you should first:

A) insert a pediatric vaginal speculum.
B) place the child prone and in the fetal position.
C) insert a cotton-tipped applicator and press down.
D) pull the labia forward and slightly to the side.

Question 35

Mrs. Reilly brings her 6-year-old daughter in with complaints of a foul vaginal discharge noted in her underpants. The most common cause of a foul vaginal discharge in children is a(n):

A) accident.
B) foreign body.
C) infection.
D) ruptured hymen.

Question 36

The rectovaginal examination is an important component of the total pelvic examination because it:

A) is the most direct cervical examination route.
B) is a more comfortable examination for the posthysterectomy patient.
C) is an alternate source for cytology specimens.
D) allows the examiner to reach almost 2.5 cm higher into the pelvis.

Question 37

The visualization of a large proportion of clue cells on your wet mount slide examination suggests:

A) trichomonal infection.
B) bacterial vaginosis.
C) candidiasis.
D) gonorrhea.

Question 38

The presence of cervical motion tenderness may indicate:

A) pregnancy.
B) nulliparity.
C) pelvic inflammatory disease.
D) vulvovaginitis.

Question 39

Dacron swabs are necessary when testing for which condition?

A) Gonorrhea
B) Pregnancy
C) Trichomoniasis
D) Chlamydia

Question 40

Small, pale yellow, raised, and rounded areas are visualized on the surface of the cervix. You should:

A) chart this as nabothian cysts.
B) chart this as a friable cervix.
C) obtain a viral culture.
D) test the pH of the cervical os.

Question 41

Itchy, painful, small red vesicles are typical of:

A) condyloma acuminatum.
B) condyloma latum.
C) herpes simplex lesions.
D) syphilitic chancre.

Question 42

The vaginal discharge of a woman with a typical Trichomonas vaginalis infection is:

A) homogeneous and gray, with a low pH.
B) scant and curdy, with a low pH.
C) profuse and frothy, with a high pH.
D) profuse and curdy, with a low pH.

Question 43

The opening of the cervix is referred to as the:

A) anterior fornix.
B) pouch of Douglas.
C) cervical isthmus.
D) cervical os.

Question 44

A young, sexually active woman comes to the urgent care clinic complaining of suprapubic abdominal pain. She is afebrile with rebound tenderness to the right side. There is no dysuria and no vaginal discharge or odor. A pelvic examination is done. She has pain with cervical motion, and you palpate a painful mass over the left adnexal area. Your prioritized action is to:

A) swab for gonococcal infection and then dip her urine.
B) obtain a surgical consult immediately.
C) remove the foreign body.
D) dip her urine and then swab for Chlamydia.

Question 45

Which of the following is a normal component of vaginal discharge seen on a wet mount?

A) Three to five white blood cells (WBCs)
B) Clue cells
C) Motile flagellates
D) Spores and hyphae

Question 46

Fundal height to the level of the umbilicus normally occurs around week _____ of pregnancy.

Question 47

A fixed uterus may indicate ______________.

Question 48

Prolonged menses is usually defined as bleeding for more than _____ days.

Question 49

Asking the woman to close the introitus during a pelvic examination is a test for:

A) endometriosis.
B) rectocele.
C) cervical polyps.
D) sphincter tone.

Question 50

Softening of the uterine isthmus occurring between 6 and 8 weeks of pregnancy is the _________ sign.