Deck 18: Female Genitalia

Question 1

During sexual excitement, how is the vaginal introitus lubricated?

A)Bartholin glands secrete mucus.
B)Clitoris produces moisture.
C)Skene glands secrete fluid.
D)Urethral surfaces secrete water.
E)Hymen secretes mucus.

Answer 1

Bartholin glands secrete mucus.

Question 2

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

A)sacroiliac.
B)symphysis pubis
C)sacrococcygeal.
D)iliofemoral.
E)sacrosciatic notch.

Answer 2

symphysis pubis

Question 3

The opening of the cervix is referred to as the

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

Answer 3

cervical os.

Question 4

Pregnancy-related cervical changes include

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

Question 5

When you enter the examination room of a patient who is scheduled for a pelvic examination, you note that she seems very anxious. You should

A)tell her that there is nothing to be afraid of.
B)try to determine the source of anxiety.
C)avoid eye contact.
D)proceed as though nothing is wrong.
E)reschedule for another time.

Question 6

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

A)fourchette.
B)vulva.
C)clitoris.
D)perineum.
E)perineal body.

Question 7

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.
E)fat intake.

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)round ligaments and ovaries.
E)vagina and fundus.

Question 9

The vaginal mucosa of a woman of childbearing years should appear

A)transversely rugated.
B)moist and excoriated.
C)dry and papular.
D)smooth and pink.
E)moist with vertical ridges.

Question 10

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

A)Fowler
B)Prone
C)Lateral-supine
D)Lithotomy
E)Trendelenburg

Question 11

The risk of ovarian cancer is increased by a history of

A)low-fat diet.
B)cigarette smoking.
C)age between 35 and 50 years.
D)thin body habitus.
E)nulliparity.

Question 12

Which factor is associated with an increased risk of cervical cancer?

A)Endometriosis
B)Low parity
C)HPV vaccination
D)High socioeconomic status
E)Early parity

Question 13

The conventional definition of menopause is

A)3 months with no menses.
B)1 year with no menses.
C)6 months of progressively shorter menses.
D)3 consecutive anovulatory cycles.
E)the cessation of ovulation.

Question 14

During ovulation, the cervical mucus becomes more

A)scant.
B)bloody.
C)yellow.
D)stringy.
E)odorous.

Question 15

During a pelvic examination, you ask the patient to perform the Valsalva maneuver while you observe for bulging and urinary incontinence, to test for the presence of

A)a cystocele.
B)a rectocele.
C)vaginal prolapse.
D)rectal prolapse.
E)hymenal remnants.

Question 16

The form of gynecologic cancer that is increased in women who have taken tamoxifen is

A)vaginal.
B)cervical.
C)ovarian.
D)endometrial.
E)perineal skin.

Question 17

What structures are located at the 5 o'clock and the 7 o'clock positions of the vaginal orifice and open onto the sides of the vestibule in the groove between the labia minora and the hymen?

A)Skene glands
B)Perineal bodies
C)Labia majora
D)Bartholin glands
E)Labia minora

Question 18

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

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

Question 19

Which of the following findings indicates a possible gonococcal infection?

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

Question 20

Which systemic feature is related to the effects of menopause?

A)Increased intraabdominal fat deposition
B)Decreased LDL levels
C)Cold intolerant
D)Decreased cholesterol levels
E)Decreased risk of cardiovascular disease

Question 21

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.
E)provides better evaluation of the bladder.

Question 22

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

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

Question 23

An examiner 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
E)Fungal cultures

Question 24

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

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

Question 25

The most common cause of a foul vaginal discharge in children is a(n)

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

Question 26

The presence of cervical motion tenderness may indicate

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

Question 27

When collecting specimens, which sample should be obtained first?

A)Chlamydia swab
B)Gonococcal culture
C)Pap smear
D)Wet mount
E)Potassium hydroxide prep

Question 28

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. Upon 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.
E)malignancy.

Question 29

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.
E)an enlarged clitoris.

Question 30

The presence of a fishy odor after dropping potassium hydroxide on a wet mount slide containing vaginal mucus suggests

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

Question 31

When a woman is not sexually active, cervical cancer screening should begin

A)at menarche.
B)by age 15 years.
C)by age 18 years.
D)by age 21 years.
E)by age 30 years.

Question 32

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

A)insert a pediatric vaginal speculum.
B)place your hand firmly against the labia and spread your fingers.
C)insert a cotton-tipped applicator and press down.
D)pull the labia anteriorly and slightly to the side.
E)place the child prone and in the fetal position.

Question 33

A fixed uterus may indicate

A)adhesions.
B)postmenopause.
C)pregnancy.
D)premenopause.
E)a normal finding.

Question 34

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

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

Question 35

When performing a gynecologic exam, the examiner should change gloves after touching the patient's

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

Question 36

Dacron swabs are necessary when testing for which condition?

A)Candidiasis
B)Pregnancy
C)Trichomonas
D)Bacterial vaginosis
E)Chlamydia

Question 37

Prominent labia minora are a normal finding in

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

Question 38

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.
E)cervical cancer.

Question 39

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.
E)chart this as an eroded cervix.

Question 40

During a routine vaginal examination, you insert the speculum and visualize the cervix. The cervix projection into the vaginal vault is approximately 5 cm. Upon bimanual examination, you would expect to find the uterus

A)in the midline position.
B)in the retroverted position.
C)in the anteverted position.
D)deviated to the left or right.
E)in the retroflexed position.

Question 41

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.
E)bloody and thin with a high pH.

Question 42

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 or 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.
E)diagnose ovarian cyst and schedule follow-up.

Question 43

A cervical polyp usually appears as a

A)grainy appearance 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.
E)flesh-colored, firm protrusion at the cervical os.

Question 44

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

A)endometriosis.
B)rectocele.
C)cervical polyps.
D)muscle tone.
E)cystocele.

Question 45

Which of the following is a normal component of physiologic vaginitis seen on a wet mount?

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

Question 46

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

A)Homan
B)McDonald
C)Piskacek
D)Hegar
E)Chadwick

Question 47

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

A)10
B)16
C)20
D)24
E)30

Question 48

Mittelschmerz may occur in which phase of the menstrual cycle?

A)Menstrual
B)Postmenstrual
C)Ovulation
D)Secretory
E)Luteal

Question 49

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

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

Question 50

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

A)The patient should assume the "M" or "V" position.
B)The patient should be in the diamond-shaped position.
C)The head of the table should be elevated.
D)The lithotomy position with obstetric stirrups should be used.
E)The patient should be in the knee-chest position.