Question 1

Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview?

Accepted Answer

Begin with an open-ended question to assess individual needs.Include appropriate questions as a routine part of the history: this communicates that you accept the individual's sexual activity and believe it is important.Your comfort with discussion prompts the person's interest and possibly relief that the topic has been introduced.This establishes a database for comparison with any future sexual activities and provides an opportunity to screen sexual problems.

Question 2

A nurse is assessing a patient's risk of contracting a STI.An appropriate question would be:

Accepted Answer

In reviewing a patient's risk for STIs,the nurse should ask whether condoms are used every time that the patient has sexual intercourse.

Question 3

An 11-year-old girl is in the clinic for a sports physical.The nurse notes that she has begun to develop breasts,and during the conversation the girl reveals that she is unsure about the progression of development.The nurse should use which of the following to best assist the young girl in understanding the expected sequence for development?

Accepted Answer

Tanner's table on the five stages of pubic hair development is helpful in teaching girls the expected sequence of sexual development.

Question 4

A woman who is 22 weeks pregnant has a vaginal infection.She tells the nurse that she is afraid that this infection will "hurt my baby." The nurse knows that which of the following statements is true?

Accepted Answer

A clot of thick,tenacious mucus forms in the spaces of the cervical canal (the mucus plug),which protects the fetus from infection.Cervical and vaginal secretions increase during pregnancy and are thick,white,and more acidic.The acidic pH keeps pathogenic bacteria from multiplying in the vagina,but the increase in glycogen increases the risk of candidiasis (commonly called a yeast infection)during pregnancy.

Question 5

A married couple has come to the clinic seeking advice on pregnancy.They have been trying to conceive for 6 months and have not been successful.What should the nurse do first?

Accepted Answer

Infertility is considered after 1 year of engaging in unprotected sexual intercourse without conceiving.

Question 6

During the interview with a female patient,the nurse gathers data that indicate that the patient is perimenopausal.Which of the following statements made by this patient leads to this conclusion?

Accepted Answer

Hormone shifts occur during the perimenopausal period,and associated symptoms of menopause may occur,such as hot flashes,numbness and tingling,headache,palpitations,drenching sweats,mood swings,vaginal dryness,and itching.

Question 7

During an inspection of the vagina,the nurse would expect to see what at the end of the vagina?

Accepted Answer

At the end of the canal,the uterine cervix projects into the vagina.

Question 8

The changes normally associated with menopause occur generally because the cells in the reproductive tract are:

Accepted Answer

Because cells in the reproductive tract are estrogen dependent,decreased estrogen levels during menopause bring dramatic physical changes.

Question 9

A 54-year-old woman who has just completed menopause is visiting the clinic for a yearly physical examination.Which of the following should the nurse include in patient education?

Accepted Answer

Decreased vaginal secretions leave the vagina dry and at risk for irritation and pain with intercourse (dyspareunia).

Question 10

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 knows that the problem is:

Accepted Answer

Stress incontinence is loss of urine with physical strain as a result of muscle weakness (urination with a sneeze,laugh,cough,or bearing down).Hematuria is bleeding with urination.True incontinence is loss of urine without warning.Urgency incontinence is sudden loss,as with acute cystitis.

Question 11

The uterus is usually positioned tilting forward and superior to the bladder.This position is known as:

Accepted Answer

The uterus is freely movable,not fixed,and usually tilts forward and superior to the bladder (a position labelled as anteverted and anteflexed).

Question 12

A nonpregnant patient tells the nurse that she has had three pregnancies and two live births.How would the nurse record this information?

Accepted Answer

Gravida (G)is number of pregnancies.Para (P)is number of births.Abortions (A)are interrupted pregnancies,including elective abortions and spontaneous miscarriages.

Question 13

When observing the vestibule,the nurse should be able to see the:

Accepted Answer

The labial structures encircle a boat-shaped space,or cleft,termed the vestibule.Within it are numerous openings.The urethral meatus and vaginal orifice are visible.The ducts of the paraurethral (Skene's)glands and the vestibular (Bartholin's)glands are present but not visible.

Question 14

The female structure that corresponds to the male penis is called the:

Accepted Answer

The clitoris is a small,pea-shaped erectile body,homologous to the male penis,and highly sensitive to tactile stimulation.

Question 15

Which of the following are changes associated with menopause?

Accepted Answer

The uterus shrinks because of its decreased myometrium.The ovaries atrophy to 1 to 2 cm and are not palpable after menopause.The sacral ligaments relax,and the pelvic musculature weakens,so the uterus droops.The cervix shrinks and looks paler with a thick glistening epithelium.The vaginal epithelium atrophies,becoming thinner,drier,and itchy.This results in a fragile mucosal surface that is at risk for bleeding and vaginitis.

Question 16

A 22-year-old woman has been considering using oral contraceptives.As a part of her history,the nurse should ask:

Accepted Answer

Oral contraceptives,together with cigarette smoking,increase the risk of vascular problems.If cigarettes are used,assess the patient's smoking history.

Question 17

During the interview,a patient reveals that she has some vaginal discharge.She is worried that it may be a sexually transmitted infection (STI).The nurse's most appropriate response to this would be:

Accepted Answer

Ask questions that help the patient reveal more information about her symptoms in a nonthreatening manner.Assess vaginal discharge further by asking about the amount,colour,and odour.Normal vaginal discharge is small,clear or cloudy,and always nonirritating.

Question 18

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 which of the following signs?

Accepted Answer

Shortly after the first missed menstrual period,the female genitalia show signs of the growing fetus.The cervix softens (Goodell's sign)at 5 to 6 weeks,and the vaginal mucosa and cervix look cyanotic (Chadwick's sign)at 6 to 8 weeks.These changes occur because of increased vascularity and edema of the cervix,and hypertrophy and hyperplasia of the cervical glands.

Question 19

A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts,and wonders if they could be due to the estrogen replacement therapy she started 3 months ago.The nurse should tell her:

Accepted Answer

Side effects of hormone therapy include fluid retention,breast pain or enlargement,and vaginal bleeding.

Question 20

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 must make sure to ask:

Accepted Answer

Several medications may increase the risk of vaginitis.Broad-spectrum antibiotics alter the balance of normal flora,which may lead to the development of vaginitis.

Quiz 27: Female Genitourinary System