Question 1

How would the physiologic process of the sexual response best be characterized?

Accepted Answer

Physiologically,according to Masters (1992),sexual response can be analyzed in terms of two processes: vasocongestion and myotonia.Coitus,masturbation,and fantasy are forms of stimulation for the physical manifestation of the sexual response.Erection and orgasm occur in two of the four phases of the sexual response cycle.Excitement,plateau,and orgasm are three of the four phases of the sexual response cycle.

Question 2

A woman arrives at the clinic for her annual examination.She tells the nurse that she thinks she has a vaginal infection,and she has been using an over-the-counter cream for the past 2 days to treat it.How should the nurse initially respond?

Accepted Answer

An important element of the health history and physical examination is the client's description of any symptoms she may be experiencing.The best response is for the nurse to inquire about the symptoms the woman is experiencing.Women should not douche,use vaginal medications,or have sexual intercourse for 24 to 48 hours before obtaining a Pap test.Although the woman may need to reschedule a visit for her Pap test,her current symptoms should still be addressed.

Question 3

Which action would be inappropriate for the nurse to perform before beginning the health history interview?

Accepted Answer

The woman should be assured that all of her questions are relevant and important.Beginning any client interaction with a smile is important and assists in putting the client at ease.If the nurse speaks in a relaxed manner,then the client will likely be more relaxed during the interview.The client's comfort should always be ensured before beginning the interview.

Question 4

Ovarian function and hormone production decline during which transitional phase?

Accepted Answer

The climacteric phase is a transitional period during which ovarian function and hormone production decline.Menarche is the term that denotes the first menstruation.Menopause refers only to the last menstrual period.Puberty is a broad term that denotes the entire transitional period between childhood and sexual maturity.

Question 5

Which information regarding substance abuse is important for the nurse to understand?

Accepted Answer

Although a very small percentage of childbearing women have alcohol-related problems,alcohol abuse during pregnancy has been associated with a number of negative outcomes.Cigarette smoking impairs fertility and is a cause of low-birth-weight infants.Caffeine consumption has not been related to birth defects.Psychotherapeutic drugs have some effect on the fetus,and that risk must be weighed against their benefit to the mother.

Question 6

Individual irregularities in the ovarian (menstrual)cycle are most often caused by what?

Accepted Answer

Almost all variations in the length of the ovarian cycle are the result of variations in the length of the follicular phase.An intact hypothalamic-pituitary feedback mechanism would be regular,not irregular.The luteal phase begins after ovulation.The corpus luteum is dependent on the ovulatory phase and fertilization.During the ischemic phase,the blood supply to the functional endometrium is blocked,and necrosis develops.The functional layer separates from the basal layer,and menstrual bleeding begins.

Question 7

Which female reproductive organ(s)is(are)responsible for cyclic menstruation?

Accepted Answer

The uterus is responsible for cyclic menstruation and also houses and nourishes the fertilized ovum and the fetus.The ovaries are responsible for ovulation and the production of estrogen.The vaginal vestibule is an external organ that has openings to the urethra and vagina.The urethra is not a reproductive organ,although it is found in the area.

Question 8

Due to the effects of cyclic ovarian changes in the breast,when is the best time for breast self-examination (BSE)?

Accepted Answer

The physiologic alterations in breast size and activity reach their minimal level approximately 5 to 7 days after menstruation ceases.Therefore,BSE is best performed during this phase of the menstrual cycle.Day 1 of the endometrial cycle is too early to perform an accurate BSE.After the midmenstrual cycle,breasts are likely to become tender and increase in size,which is not the ideal time to perform BSE.Lying down after a shower or bath with a small towel under the shoulder of the side being examined is appropriate teaching for BSE.A secondary BSE may be performed while in the shower.

Question 9

Which statement best describes Kegel exercises?

Accepted Answer

Kegel exercises help control the urge to urinate.Although these exercises may be fun for some,the most important factor is the control they provide over incontinence.Kegel exercises help manage urination,not stress.Calcium in the diet is important but not related to Kegel exercises.

Question 10

A blind woman has arrived for an examination.Her guide dog assists her to the examination room.She appears nervous and says,"I've never had a pelvic examination." What response from the nurse would be most appropriate?

Accepted Answer

The client who is visually impaired needs to be oriented to the examination room and needs a full explanation of what the examination entails before the nurse proceeds.Telling the client that the examination will be over quickly diminishes the client's concerns.The nurse should openly and directly communicate with sensitivity.Women who have physical disabilities should be respected and involved in the assessment and physical examination to the full extent of their abilities.Telling the client that she will not be hurt does not reflect respect or sensitivity.Although anxiety may be common,the nurse should not discuss her own issues nor compare them to the client's concerns.

Question 11

What fatty acids (classified as hormones)are found in many body tissues with complex roles in many reproductive functions?

Accepted Answer

PGs affect smooth muscle contraction and changes in the cervix.GnRH is part of the hypothalamic-pituitary cycle,which responds to the rise and fall of estrogen and progesterone.FSH is part of the hypothalamic-pituitary cycle,which responds to the rise and fall of estrogen and progesterone.LH is part of the hypothalamic-pituitary cycle,which responds to the rise and fall of estrogen and progesterone.

Question 12

As part of their participation in the gynecologic portion of the physical examination,which approach should the nurse take?

Accepted Answer

Breathing techniques are important relaxation techniques that can help the client during the examination.The nurse should encourage the client to participate in an active partnership with the health care provider.Explanations during the procedure are fine,but many women are uncomfortable answering questions in the exposed and awkward position of the examination.Vulvar self-examination on a regular basis should be encouraged and taught during the examination.

Question 13

Which part of the menstrual cycle includes the stimulated release of gonadotropin-releasing hormone (GnRH)and follicle-stimulating hormone (FSH)?

Accepted Answer

The cyclic release of hormones is the function of the hypothalamus and pituitary glands.The menstrual cycle is a complex interplay of events that simultaneously occur in the endometrium,hypothalamus,pituitary glands,and ovaries.The endometrial cycle consists of four phases: menstrual phase,proliferative phase,secretory phase,and ischemic phase.The ovarian cycle remains under the influence of FSH and estrogen.

Question 14

The microscopic examination of scrapings from the cervix,endocervix,or other mucous membranes to detect premalignant or malignant cells is called what?

Accepted Answer

The Pap test is a microscopic examination for cancer that should be regularly performed,depending on the client's age.Bimanual palpation is a physical examination of the vagina.Rectovaginal palpation is a physical examination performed through the rectum.The four As procedure is an intervention to help a client stop smoking.

Question 15

Which statement indicates that a client requires additional instruction regarding BSE?

Accepted Answer

Discharge from the nipples requires further examination from a health care provider.The breasts should be checked at the same time each month.The armpit should also be examined.A circular motion is the best method during which to ascertain any changes in the breast tissue.

Question 16

Which phase of the endometrial cycle best describes a heavy,velvety soft,fully matured endometrium?

Accepted Answer

The secretory phase extends from the day of ovulation to approximately 3 days before the next menstrual cycle.During this secretory phase,the endometrium becomes fully mature again.During the menstrual phase,the endometrium is shed.The proliferative phase is a period of rapid growth.During the ischemic phase,the blood supply is blocked and necrosis develops.

Question 17

Which body part both protects the pelvic structures and accommodates the growing fetus during pregnancy?

Accepted Answer

The bony pelvis protects and accommodates the growing fetus.The perineum covers the pelvic structures.The vaginal vestibule contains openings to the urethra and vagina.The fourchette is formed by the labia minor.

Question 18

The nurse guides a woman to the examination room and asks her to remove her clothes and put on an examination gown with the front open.The woman replies,"I have special undergarments that I do not remove for religious reasons." Which is the most appropriate response from the nurse?

Accepted Answer

Explaining the examination procedure reflects cultural competence by the nurse and shows respect for the woman's religious practices.The nurse must respect the rich and unique qualities that cultural diversity brings to individuals.The examination can be modified to ensure that modesty is maintained.In recognizing the value of cultural differences,the nurse can modify the plan of care to meet the needs of each woman.Telling the client that her religious practices are different or strange is inappropriate and disrespectful to the client.

Question 19

Which questionnaire would be best for the nurse to use when screening an adolescent client for an eating disorder?

Accepted Answer

A screening tool specifically developed to identify eating disorders uses the acronym SCOFF.Each question scores 1 point.A score of 2 or more indicates that the client may have anorexia nervosa or bulimia.The letters represent the following questions:
•Do you make yourself Sick because you feel too full?
•Do you worry about loss of Control over the amount that you eat?
•Have you recently lost more than One stone (14 pounds)in a 3-month period?
•Do you think that you are too Fat,even if others think you are thin?
•Does Food dominate your life?
The 4 Cs are used to determine cultural competence.Dietary Guidelines for Americans provide nutritional guidance for all,not only for those with eating disorders.The DEXA scan is used to determine bone density.

Question 20

Preconception and prenatal care have become important components of women's health.What is the guiding principal of preconception care?

Accepted Answer

Preconception counseling guides couples in how to avoid unintended pregnancies,how to identify and manage risk factors in their lives and in their environment,and how to identify healthy behaviors that promote the well-being of the woman and her potential fetus.Preconception care does not ensure that pregnancy complications will not occur.In many cases,problems can be identified and treated and may not recur in subsequent pregnancies.For many women,counseling can allow behavior modification before any damage is done,or a woman can make an informed decision about her willingness to accept potential hazards.If a woman is seeking preconception care,then she is likely aware of prenatal care.

Quiz 4: Assessment and Health Promotion