Deck 17: Reproductive System and the Perineum

Question 1

After a rectal examination of a patient with obstructive jaundice, the nurse expects the stool to be what color?

A) Tan
B) Pale yellow
C) Black
D) Bright red

Answer 1

Tan

Question 2

Which assessment technique does a nurse use to assess the inguinal region and femoral area of a male patient as he is standing and straining?

A) Palpates the femoral artery
B) Palpates the inguinal lymph nodes
C) Observes for a bulge through the inguinal region
D) Observes for discoloration of the inguinal ring

Answer 2

Observes for a bulge through the inguinal region

Question 3

The nurse recognizes which patient has the highest risk of endometrial cancer?

A) A 24-year-old woman with menarche at age 9
B) A 30-year-old woman who started menstruating at age 19
C) A 42-year-old woman who reached menopause at age 40
D) A 64-year-old woman who had irregular, heavy menstrual cycles

Answer 3

A 24-year-old woman with menarche at age 9

Question 4

A patient asks when she can stop having Pap (Papanicolaou) tests. What is the nurse's most appropriate response?

A) "Until you are no longer sexually active."
B) "Through age 65."
C) "Until you begin menopause."
D) "Through the end of menopause."

Question 5

On inspection of the internal structure of the vagina, the nurse notes a rounded protrusion on the posterior wall of the vagina. How does the nurse document this finding?

A) Rectocele
B) Cystocele
C) Bartholin cyst
D) Nabothian cyst

Question 6

In inspecting the scrotum, the nurse documents which finding as normal?

A) The epididymides are round, solid nodular masses.
B) The scrotum is deeply pigmented with a rugous surface.
C) The scrotal skin is a lighter color than the body skin.
D) The vas deferens is palpable bilaterally.

Question 7

On inspection of the external male genitalia, the nurse notes which finding as abnormal?

A) The scrotum is covered with dark rugous skin.
B) The skin covering the penis is hairless and loose.
C) The urinary meatus is located on the upper surface of the penis.
D) The left side of the scrotum hangs slightly lower than the right.

Question 8

During an internal examination of a patient's anus, the nurse notes that the patient has a hypertonic sphincter. What is the most relevant action for the nurse to take at this time?

A) Ask the patient about anxiety or pain related to the examination.
B) Inquire if the patient has had any neurologic injury that causes a hypertonic sphincter.
C) Refer the patient to the physician for evaluation.
D) Question the patient about a history of anal trauma.

Question 9

What procedure does a nurse use to assess the inguinal ring of a male patient for a hernia?

A) Asks the patient to lie supine, lifts the scrotum, asks the patient to take a deep breath, and observes for a bulge
B) Asks the patient to lean over the examination table, inserts a gloved finger into the lower part of the scrotum into the inguinal canal, asks the patient to cough, and palpates for a bulge
C) Asks the patient to lie on the side not being assessed, inserts a gloved finger into the lower part of the scrotum into the inguinal canal, asks the patient to exhale completely, and palpates for a bulge
D) Asks the patient to stand, inserts a gloved finger into the lower part of the scrotum into the inguinal canal, asks the patient to cough, and palpates for a bulge

Question 10

When palpating the epididymis, the nurse considers which finding to be abnormal?

A) The epididymis is located on the posterolateral surface of each testis.
B) The epididymis feels like a tubular, comma-shaped structure.
C) The epididymis collapses on palpation.
D) The epididymis has an irregular, nodular surface.

Question 11

A mother asks a nurse when her daughter should get immunized again for human papilloma virus (HPV). What is the nurse's most appropriate response to this question?

A) "Your daughter does not need this immunization until she becomes sexually active."
B) "The recommended age for this immunization is between 25 and 30 years of age."
C) "Between the ages of 11 and 26 years is the recommended time for this immunization."
D) "When she begins having menstrual periods is the best time for this immunization."

Question 12

The nurse observes that the urinary meatus is located on the undersurface of the penis. How does the nurse document this finding?

A) Balanitis
B) Phimosis
C) Epispadias
D) Hypospadias

Question 13

When does a nurse use transillumination of the scrotum?

A) When the patient has tortuosity of the veins along the spermatic cord
B) When the patient has an indirect hernia
C) When there is a mass or fluid in the epididymis
D) When there is twisting of the testicle and spermatic cord

Question 14

The nurse places a male patient in which position for rectal examination?

A) Lithotomy position
B) Prone with the knees fully extended
C) Bending over the table, with feet everted
D) Left lateral position with knees and hips flexed

Question 15

During the initial inspection of the female genitalia, the nurse recognizes which finding as normal?

A) The labia minora are hair-covered and lying within the labia majora.
B) The cervical os in the multiparous woman has the shape of a small circle.
C) The vaginal vestibule lies between the labia minora and contains the urinary meatus.
D) The openings of Skene and Bartholin glands are visible posteriorly.

Question 16

The nurse documents which finding as expected on inspection of the anus?

A) Skin tone darker and coarser than that of the surrounding skin
B) Sphincter lightly closed when the patient is relaxed
C) Large amount of stiff, curling hair surrounding the anus
D) Slight protrusion under the skin when the patient strains or bears down

Question 17

When performing a well woman examination, the nurse expects what findings?

A) The inner surface of the vestibule is deep pink and moist with a smooth texture.
B) The inguinal skin appears wrinkled and moist with sparse hair distribution.
C) The labia minora is deeply pigmented, and the tissue is ragged and asymmetrical.
D) Pubic hair is distributed evenly over the mons and shaped as a triangle with the apex over the mons.

Question 18

A 50-year-old patient asks the nurse about her risk of developing a cancer of the reproductive system. What is the appropriate response by the nurse?

A) "Human papilloma virus infection and cigarette smoking are major risk factors for cervical cancer."
B) "Some of the risk factors for endometrial cancer include being age 40 or older and having a history of infertility."
C) "Ovarian cancer is not often seen in women under age 50 or those who have a family history of breast cancer."
D) "Women who have had menstrual irregularities for many years are at lower risk of developing any of the reproductive system cancers."

Question 19

The pregnant patient tells the nurse that she has had three pregnancies and two live births to date. How does the nurse record this in the patient's history?

A) Gravida 3, para 3
B) Gravida 3, para 2
C) Gravida 2, para 3
D) Gravida 2, para 2

Question 20

A patient asks when she should make an appointment for her first Pap (Papanicolaou) test to screen for cervical cancer. What is the nurse's most appropriate response?

A) "There is no need for Pap tests until after you have become pregnant."
B) "All women should have the first Pap test after reaching menarche."
C) "All women should have the first Pap test after they are 19 years of age."
D) "All women should have the first Pap test when they become sexually active or at age 21."

Question 21

In teaching a class of adolescents about sexually transmitted diseases, a nurse includes which information about the human papillomavirus (HPV)?

A) HPV is fragile and not easily transmitted.
B) Wartlike growths in the genital area are a sign of HPV infection.
C) There is a specific blood test needed to screen for HPV.
D) Heavy, purulent vaginal discharge is the primary sign of HPV.

Question 22

The patient is unable to tolerate a bimanual pelvic examination due to pain in ovaries and fallopian tubes. Which disorder does the nurse suspect?

A) Tertiary syphilis
B) Genital herpes
C) Human papillomavirus (HPV) infection
D) Pelvic inflammatory disease

Question 23

While giving a history, a patient reports having a weak urinary stream and feeling that his bladder is not empty after urination. Based on these data, what finding does the nurse anticipate upon examination?

A) An enlarged prostate gland palpated on the anterior wall of the rectum
B) An indirect hernia palpated through the inguinal ring when the patient coughs
C) The foreskin of the penis cannot be returned to position after retraction behind the glans
D) A nodular prostate gland palpated on the posterior wall of the rectum

Question 24

During a history, a patient reports rectal bleeding, a warning sign of colorectal cancer. The nurse correlates which clinical finding with colorectal cancer?

A) Thick, blood-tinged mucus within the rectum
B) A pus-filled cavity in the anorectal area
C) An irregular mass with raised edges on the rectal wall
D) A small, smooth nodule protruding from the rectum

Question 25

While giving a history, the patient reports having herpes genitalis. Based on this information, which finding does the nurse anticipate during the assessment?

A) Small vesicles on the genitalia
B) Single, firm, painless, open sore
C) Pain when palpating the cervix
D) Malodorous greenish-yellow vaginal discharge

Question 26

Which comments by a male patient during a health history suggest erectile dysfunction? (Select all that apply.)

A) "I have had type 1 diabetes mellitus since I was 8 years old."
B) "I frequently have urinary tract infections."
C) "I am taking medications to control my blood pressure."
D) "I have an enlarged prostate gland."
E) "I take a diuretic every morning."

Question 27

The nurse correlates which factor to an increased risk of endometrial cancer in women with early menarche or late menopause?

A) Total number of ovulatory cycles
B) Less hormone stimulation
C) Need for estrogen replacement in these patients
D) Extended duration of the menstrual cycle in these patients

Question 28

In educating a male patient about testicular cancer, the nurse includes which statement?

A) The highest incidence of this cancer is in men between 20 and 34 years of age.
B) The incidence of this cancer is correlated with human papillomavirus (HPV) infection.
C) The risk of this cancer increases with multiple sexual partners.
D) This type of cancer more commonly affects uncircumcised males.

Question 29

A patient complains of dysuria, yellow-green vaginal discharge, and vulvar itching. The nurse suspects which sexually transmitted disease?

A) Syphilis
B) Gonorrhea
C) Genital warts
D) Chlamydia

Question 30

The nurse correlates which patient complaint with suspected enlargement of the prostate gland?

A) Constipation
B) Change in bowel patterns
C) Weak urine stream
D) Increased mucus in urine

Question 31

Which patients meet the criteria for Chlamydia screening? (Select all that apply.)

A) A 40-year-old woman who is sexually active and uses barrier protection consistently
B) A 15-year-old female woman who is sexually active with one partner
C) A 22-year-old woman who is sexually active and uses barrier protection inconsistently
D) A 23-year-old woman who has had four sexual partners in the last 3 months
E) A 34 year-old woman who uses barrier protection inconsistently with multiple sexual partners
F) A 36-year-old pregnant woman making the first prenatal visit

Question 32

A nurse examines a patient and finds a single, firm, painless open sore with indurated borders on the vulva. The nurse correlates this finding with which disorder?

A) Human papillomavirus (HPV) infection
B) Herpes infection
C) Gonorrhea
D) Syphilis

Question 33

A nurse expects to find which manifestations in the male patient who has both Chlamydia and gonorrhea?

A) Painful urination and purulent urethral discharge
B) A single, firm painless open sore on the shaft of the penis
C) Red superficial vesicles on the shaft of the penis
D) A single or a cluster of wartlike growth in the anal-rectal area

Question 34

A patient with testicular torsion is experiencing which abnormality?

A) Abnormal dilation and tortuosity of the veins along the spermatic cord
B) Twisting of the testicle and spermatic cord
C) A cystic mass filled with sperm and seminal fluid in the epididymis
D) An accumulation of fluid in the scrotum

Question 35

How does a nurse recognize when a patient has a testicular torsion?

A) The nurse sees a light red glow on transillumination of the scrotum.
B) The nurse palpates testicular edema that is painless.
C) The patient reports a pulling sensation and dull ache of the scrotum.
D) The patient complains of sudden onset of severe pain with edema of the scrotum.

Question 36

Which patient does the nurse recognize as having the highest risk for ovarian cancer?

A) A 24-year-old nulliparous woman who has a history of multiple sexual partners
B) A 32-year-old woman who has had six live births and a history of human papilloma virus (HPV) infection
C) A 55-year-old woman who reached menarche at age 12 and menopause at age 54
D) A 64-year-old nulliparous woman who has taken hormone replacement therapy for 8 years

Question 37

In assessing a patient with suspected Chlamydia, the nurse's actions are guided by which characteristic of this disease?

A) Chlamydia is frequently asymptomatic and requires screening.
B) Chlamydia is associated with a yellow-green vaginal discharge.
C) Chlamydia is accompanied by heavy bleeding and headache.
D) Chlamydia is only seen in immunocompromised patients.

Question 38

Which questions are appropriate for a symptom analysis of a patient with benign prostatic hyperplasia? (Select all that apply.)

A) "How often have you found that you stopped and started again several times when you urinated?"
B) "How often have you had to urinate again less than 2 hours after you finished urinating?"
C) "How often have you been incontinent of urine?"
D) "How often have you had constipation due to the enlarged prostate?"
E) "How often have you had to push or strain to begin urination?"
F) "How often have you had to get up during the night to urinate?"

Question 39

While taking a history of a patient with an enlarged prostate, the nurse expects the patient to report which symptom?

A) Painful urination with each voiding
B) Blood in the urine upon arising
C) Waking from sleep to urinate
D) Incontinence throughout the day

Question 40

A patient tells the nurse that he has been informed he has internal hemorrhoids and asks whether there are different types of hemorrhoids. What is the nurse's most appropriate response?

A) "Internal hemorrhoids are usually seen outside the anus and appear blue."
B) "Sometimes patients have other diseases, such as anal warts, that may be mistaken for internal hemorrhoids."
C) "Internal hemorrhoids are found higher in the rectum and usually can't be felt unless they are infected or prolapsed."
D) "Both internal and external hemorrhoids arise from the same general area and produce the same kinds of symptoms."