Deck 21: Female Genitalia

Question 1

Your assessment of an 18-year-old,who has not experienced menarche,should include evaluating her for all of the following,EXCEPT

A) eating disorders.
B) intensive athletic training.
C) thyroid disease.
D) premenstrual syndrome.

Answer 1

premenstrual syndrome.

Question 2

Which of the following occurs during the follicular phase of the ovarian cycle?

A) decreased secretion of cervical mucus
B) development of the corpus luteum
C) maturation of the graafian follicle
D) maintenance of high levels of progesterone and estrogen

Answer 2

maturation of the graafian follicle

Question 3

Women in the age group 30 to 50 years of age have a higher incidence of which of the following?

A) atrophic vaginitis
B) cystocele
C) uterine myomas
D) uterine prolapse

Answer 3

uterine myomas

Question 4

Your patient complains of vaginal discharge with itching,dysuria,and cramping.You would assess for aggravating factors,which include

A) taking antibiotics or birth control pills.
B) drinking alcohol recently.
C) ingesting caffeine or spices.
D) wearing cotton underpants.

Question 5

An increased incidence of strokes is reported in women who concurrently use oral contraceptives and

A) eat a diet high in sugar and salt.
B) ingest alcohol.
C) ingest high levels of caffeine.
D) smoke.

Question 6

Pubic hair distribution in a diamond-shaped pattern from the umbilicus that is not associated with cultural or familial differences most likely indicates

A) chronic infestation of parasites.
B) early signs of syphilis.
C) hirsutism resulting from an endocrine disorder.
D) the effects of long-term use of estrogen.

Question 7

The clear,viscid alkaline mucus that improves the viability and motility of sperm is secreted by the

A) Bartholin's glands.
B) paraurethral glands.
C) sebaceous glands.
D) Skene's glands.

Question 8

The distal,funnel-shaped end of the fallopian tube is called the

A) adnexa.
B) broad ligament.
C) cornu.
D) infundibulum.

Question 9

The characteristic findings associated with herpes simplex lesions on the external genitalia are

A) a reddish, round ulcer with a depressed center and raised, indurated edges.
B) raised, round wartlike plaques with a moist surface covered by a gray exudate.
C) small, shallow red vesicles that fuse together to form a large, painful ulcer.
D) white, dry, painless growths with a narrow base.

Question 10

The area located between the two skin folds of the labia minora is known as the

A) labia majora.
B) perineum.
C) mons pubis.
D) vestibule.

Question 11

Which of the following normally occurs during the proliferative phase of the menstrual cycle?

A) The cervical mucus thickens.
B) The endometrium degenerates and sheds.
C) Estrogen causes the endometrium to regenerate.
D) Menstrual flow consisting of blood and mucus occurs.

Question 12

Your findings upon palpation and inspection of a patient's labia include an area of tenderness,swelling,redness,and purulent discharge,which most likely indicate

A) Bartholin's gland infection.
B) infected chancre of primary syphilis.
C) infection of the urethra and Skene's glands.
D) rupture of genital herpes vesicles.

Question 13

Graves' bivalve vaginal specula,sizes medium and large,are used in examining most women who are

A) menopausal.
B) not sexually active.
C) post-hysterectomy.
D) sexually active.

Question 14

Which body change normally occurs with ovulation?

A) Basal body temperature decreases.
B) Cervical mucus becomes clearer, thinner, and threadlike.
C) Pain occurs in the vulva.
D) Menstrual flow begins.

Question 15

Women who use feminine hygiene products,condoms,diaphragms,or the spermicide nonoxynol-9 are more likely than others to experience which problem?

A) allergic reactions
B) bacterial vaginitis
C) cancer of the vagina
D) cervical cancer

Question 16

Which activity should a patient avoid 24 to 48 hours before a scheduled physical assessment to prevent affecting the results of the Pap smear and other cultures?

A) ingesting alcohol or smoking
B) taking a tub bath, swimming, or using a hot tub
C) taking birth control pills or other hormones
D) using vaginal sprays, douching, or having coitus

Question 17

After the fertilized ovum is implanted,the corpus luteum is maintained by the presence of which hormone(s)?

A) estrogen and progesterone
B) follicle-stimulating hormone
C) human chorionic gonadotropin
D) luteinizing hormone

Question 18

Hypertrophy of the clitoris is typically the result of increased levels of

A) androgens.
B) estrogen.
C) follicle-stimulating hormone.
D) progesterone.

Question 19

Most cervical cancer originates at the

A) isthmus.
B) squamocolumnar junction.
C) internal os.
D) lateral fornix.

Question 20

Before starting the assessment,you would instruct the patient to

A) empty her bladder.
B) hold her breath as needed to lessen the discomfort.
C) save her questions until the assessment is completed.
D) undress completely and cover herself with a drape.

Question 21

The recommended method for spreading cells from the Cytobrush onto the slide is to

A) lightly brush the slide.
B) press the Cytobrush down firmly on the slide.
C) use a rolling motion.
D) wipe the Cytobrush back and forth.

Question 22

To obtain a cervical smear,you would insert the Ayre's spatula through the speculum and scrape the surface

A) by rotating the spatula 360° clockwise and then counterclockwise.
B) in three separate locations.
C) with the longer projection placed in the cervical os and the shorter projection snugly against the ectocervix.
D) with the rounded end of the spatula firmly over the cervical os and squamocolumnar junction.

Question 23

To palpate the right ovary,you would move your hand on the patient's abdomen to the right lower quadrant

A) about halfway between the anterior iliac spine and the umbilicus.
B) just inside the anterior iliac spine.
C) just superior to the anterior iliac spine.
D) just to the right of the bladder.

Question 24

To obtain an endocervical smear,you should insert the Cytobrush through the speculum into the cervical os approximately 1 cm and

A) leave the Cytobrush in the cervical os for 30 seconds to ensure saturation.
B) rotate the Cytobrush 360° clockwise and then counterclockwise.
C) rotate the Cytobrush 360° clockwise.
D) swab the endocervix in a forward and backward brushing motion.

Question 25

A pale cervix indicates

A) changes resulting from menopause.
B) pregnancy.
C) Chlamydia infection.
D) venous congestion.

Question 26

If the cervix could not be visualized upon the initial insertion of the speculum,you would close the blades and

A) insert the speculum 2-3 cm farther and check again for the cervix.
B) withdraw the speculum 2-3 cm and reinsert at a slightly different angle.
C) withdraw the speculum and select a larger speculum for reinsertion.
D) withdraw the speculum and select a smaller speculum for reinsertion.

Question 27

Your patient's cervicovaginal culture report indicated a large number of Gram-negative diplococci organisms,which is consistent with

A) Candida albicans.
B) Chlamydia trachomatis.
C) Neisseria gonorrhoeae.
D) Trichomonas vaginalis.

Question 28

The shape of your patient's cervical os is bilateral transverse,which indicates

A) normal findings.
B) cervical tears from rapid childbirth.
C) multiple deliveries.
D) nulliparity.

Question 29

While applying pressure to the posterior vaginal walls with your nondominant index and middle fingers in the vagina,you would initially insert the vaginal speculum at a(n)

A) 45° downward angle.
B) horizontal angle.
C) vertical angle.
D) oblique angle.

Question 30

During a rectovaginal examination,you should assess all of the following,EXCEPT

A) cervix and uterus for posterior lesions.
B) rectouterine pouch for contour lesions.
C) rectovaginal septum for patency.
D) ovaries and fallopian tubes.

Question 31

Which finding indicates a pathology?

A) ovary with pulsations
B) vaginal walls that are deeply rugated
C) cervix that is 2 cm
D) nonpalpable ovaries

Question 32

Palpation of the cervix is performed by inserting into the vagina the index and middle fingers of your

A) dominant hand with the palmar surface of the finger pads facing upward.
B) dominant hand with the palmar surface of the finger pads facing downward.
C) nondominant hand with the palmar surface of the finger pads facing upward.
D) nondominant hand with the palmar surface of the finger pads facing downward.

Question 33

To assess the muscular tone and texture of the perineum using your dominant hand,you would place your

A) index finger in the urethra and instruct the patient to squeeze the vaginal muscles.
B) index finger on one side of the perineum and the thumb on the other.
C) thumb anterior to the perineum and index finger posterior to the perineum.
D) thumb in the vagina and index finger posterior to the perineum.

Question 34

The nurse should monitor which of the following patients for a potential vaginal infection?

A) menstruating patient who uses sanitary napkins
B) patient who changes tampons every 3 hours during her menstrual period
C) patient given broad-spectrum antibiotics for a wound infection
D) patient who wipes from front to back to prevent contamination of the vagina with fecal material

Question 35

To prepare a cervicovaginal specimen for microscopic evaluation of Candida,you would add one drop of

A) 5% acetic acid.
B) normal saline.
C) potassium hydroxide.
D) sterile water.

Question 36

A nabothian cyst is characteristically described as

A) a bright red, soft protrusion through the cervical os.
B) hemorrhagic spots on the surface of the cervix.
C) a reddish circle around the os.
D) a small, round, yellow lesion.

Question 37

To inspect the vaginal walls,you should first disengage the locking device of the vaginal speculum and then withdraw the speculum

A) while rotating the speculum into an oblique position.
B) as you slowly open the blades wider.
C) as you slowly rotate the speculum clockwise.
D) with the blades closed.

Question 38

Blanching of the cervix after swabbing with a cotton-tipped applicator that was soaked in 5% acetic acid most likely indicates

A) bacterial infection.
B) benign cellular changes of the cervix.
C) early cervical cancer.
D) human papillomavirus.

Question 39

Your patient,who is 42 years old,has requested a routine physical examination and states that she has not had one for several years.You observe a cauliflower-like lesion on the patient's cervix,which can indicate

A) carcinoma of the cervix.
B) cervical polyp.
C) ectropion.
D) obstruction of the cervical glands.

Question 40

Chadwick's sign,a significant finding on inspection of the cervix,indicates

A) malignancy.
B) cervical hypertrophy.
C) pelvic inflammatory disease.
D) pregnancy.

Question 41

The uterus is comprised of the ___________________,___________________,___________________,and ___________________.

Question 42

Which of the following are risk factors for endometrial cancer? Select all that apply.

A) Obesity
B) Advanced age
C) Failure to ovulate
D) History of breast cancer
E) Unopposed estrogen therapy
F) Family history of nonpolyposis colon cancer

Question 43

The urinary meatus is located in the __________________.

Question 44

To assess a patient for the risk factors of cervical cancer,you would ask if she has a history of

A) breast cancer.
B) human papillomavirus.
C) infertility.
D) her mother taking diethylstilbestrol during pregnancy.

Question 45

Which of the following are "Grade: A recommendation" from the U.S.Preventive Services Task Force? Select all that apply.

A) Screen persons at increased risk for syphilis infection.
B) Screen for cervical cancer in women who have been sexually active and have a cervix.
C) Screen all sexually active women, including those who are pregnant, for gonorrhea infection if they are at increased risk for infection.
D) Provide high-intensity behavioral counseling to prevent sexually transmitted infections (STIs) for all sexually active adolescents and for adults at increased risk for STIs.
E) Screen for chlamydial infection for all sexually active, non-pregnant young women, aged 24 and younger, and for older non-pregnant women who are at increased risk.
F) Refer women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes for genetic counseling and evaluation for BRCA testing.

Question 46

The beginning of the female reproductive cycle,or onset of menstruation,is called ____________________.

Question 47

The nurse is admitting a patient with vaginal cancer.Which of the following questions should the nurse ask to elicit the most likely causative factor?

A) "Have you been treated for infertility?"
B) "Did you experience your first menses before the age of 11 years?"
C) "Have you ever taken tamoxifen?"
D) "Did your mother take diethylstilbestrol (DES) during pregnancy?"

Question 48

A 32-year-old patient has had three normal serial Pap tests.According to the American Cancer Society,how often would she need a Pap test?

A) yearly
B) every 2 to 3 years
C) every 5 years
D) no longer needs Pap tests

Question 49

A new graduate was asked by the Nursing Supervisor,"What are the components of the internal female genitalia?" Which response by the new graduate would cause the supervisor to be concerned? Select all that apply.

A) Vagina
B) Bartholin's glands
C) Uterus
D) Anus
E) Fallopian tubes
F) Ovaries

Question 50

The function of the labia majora is to ____________________ the components it surrounds.

Question 51

Which of the following sexual characteristics occur at the onset of puberty? Select all that apply.

A) Absence of pubic hair
B) Breast enlargement
C) Contour changes of hips and abdomen
D) Increase in estrogen production
E) Increased urination
F) Elevated testosterone levels

Question 52

Upon examining a patient with a urinary tract infection,which symptoms would you expect the patient to experience? Select all that apply.

A) Stabbing pain
B) Gastrointestinal symptoms
C) Urgency in voiding
D) Frequency in voiding
E) Stress incontinence
F) Flank pain

Question 53

Deaths attributed to uterine and cervical cancer have declined by 50% because of the advent of _________________________.

Question 54

Menstrual blood does not clot,because it lacks ____________________.

Question 55

Your 12-year-old patient complains of pelvic discomfort,which she states is the result of injuries from riding a horse.Your assessment of a patient reveals bruising of the mons pubis and labia.Which additional finding is the strongest evidence that the patient has been sexually abused?

A) lack of eye contact and complete relaxation
B) genital herpes lesions
C) vaginal infection
D) urinary tract infection