Deck 27: Female Genitourinary System

Question 1

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

A)"Now,it's time to talk about your sexual history.When did you first have intercourse?"
B)"Women often feel dissatisfied with their sexual relationships.Would it be okay to discuss this now?"
C)"Often women have questions about their sexual relationships and how they affect their health.Do you?"
D)"Most women your age have had more than one sexual partner.How many would you say you have had?"

Answer 1

"Often women have questions about their sexual relationships and how they affect their health.Do you?"

Question 2

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

A)"You use condoms,don't you?"
B)"Do you use a condom at each episode of sexual intercourse?"
C)"Do you have an STI?"
D)"You are aware of the dangers of unprotected sex,aren't you?"

Answer 2

"Do you use a condom at each episode of 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?

A)The nurse should use Tanner's table on the five stages of sexual development.
B)The nurse should describe her development and compare it with that of other girls her age.
C)Jacobsen's table on expected development on the basis of height and weight data should be used.
D)The nurse should reassure her that her development is within normal limits and tell her not to worry about the next step.

Answer 3

The nurse should use Tanner's table on the five stages 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?

A)If intercourse is avoided,the risk for infection is minimal.
B)A thick mucus plug forms that protects the fetus from infection.
C)The acidic pH of vaginal secretions promotes the growth of pathogenic bacteria.
D)The mucus plug that forms in the cervical canal is a good medium for bacterial growth.

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?

A)Ascertain whether either of them has been using broad-spectrum antibiotics.
B)Explain that couples are considered infertile after 1 year of unprotected intercourse.
C)Immediately refer the woman to an expert in pelvic inflammatory disease (the most common cause of infertility).
D)Explain that couples are considered infertile after 6 months of engaging in unprotected intercourse,and that they will need a referral to a fertility expert.

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?

A)"I have noticed that my muscles ache at night when I go to bed."
B)"I will be very happy when I can stop worrying about having a period."
C)"I have been noticing that I sweat a lot more than I used to,especially at night."
D)"I have only been pregnant twice,but both times I had breast tenderness as my first symptom."

Question 7

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

A)Cervix
B)Uterus
C)Ovaries
D)Fallopian tubes

Question 8

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

A)aging.
B)becoming fibrous.
C)estrogen dependent.
D)able to respond to estrogen.

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?

A)A postmenopausal woman is not at any greater risk for heart disease than a younger woman is.
B)A postmenopausal woman should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.
C)A postmenopausal woman has only stopped menstruating;there really are no other significant changes that she should be concerned with.
D)A postmenopausal woman is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle.

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:

A)hematuria,and usually needs to be evaluated by a urologist.
B)stress incontinence and is usually due to muscle weakness.
C)true urinary incontinence and may mean that she has a kidney infection.
D)urgency incontinence and she should empty her bladder before she sneezes or coughs.

Question 11

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

A)anteverted and anteflexed.
B)retroverted and anteflexed.
C)retroverted and retroflexed.
D)superiorverted 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?

A)G2 P2 A1
B)G3 P2 A0
C)G3 P2 A1
D)G3 P3 A1

Question 13

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

A)urethral meatus and vaginal orifice.
B)vaginal orifice and vestibular (Bartholin's)glands.
C)urethral meatus and paraurethral (Skene's)glands.
D)paraurethral (Skene's)and vestibular (Bartholin's)glands.

Question 14

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

A)labia.
B)clitoris.
C)prepuce.
D)frenulum.

Question 15

Which of the following are changes associated with menopause?

A)Uterine and ovarian atrophy,along with thinning vaginal epithelium
B)Ovarian atrophy,increased vaginal secretions,and increasing clitoral size
C)Cervical hypertrophy,ovarian atrophy,and increased acidity of vaginal secretions
D)Vaginal mucosa fragility,increased acidity of vaginal secretions,and uterine hypertrophy

Question 16

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

A)"Do you have a history of heart murmurs?"
B)"Will you be in a monogamous relationship?"
C)"I wonder if you have thought this choice through carefully."
D)"If you smoke,how many cigarettes do you smoke per day?"

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:

A)"Oh,don't worry.Some cyclic vaginal discharge is normal."
B)"Have you been engaging in unprotected sexual intercourse?"
C)"I'd like some information about the discharge.What colour is it?"
D)"Have you had any urinary incontinence associated with the discharge?"

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?

A)Tanner's sign and Hegar's sign
B)Hegar's sign and Goodell's sign
C)Chadwick's sign and Hegar's sign
D)Goodell's sign and Chadwick's sign

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:

A)"Estrogen replacement therapy is at such a low dose that side effects are very unusual."
B)"Estrogen replacement therapy has several side effects,including fluid retention,breast tenderness or enlargement,and vaginal bleeding."
C)"It would be very unusual to have breast tenderness with estrogen replacement therapy,and I suggest you contact your doctor immediately to have this evaluated."
D)"It sounds as if your dose of estrogen is too high.I think you should decrease the amount you are taking and should call me back in a month to let me know how you're feeling."

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:

A)"Have you noticed a change in your vaginal pH?"
B)"Have you noticed any excessive vaginal bleeding?"
C)"Have you noticed any unusual vaginal discharge or itching?"
D)"Have you noticed any changes in your desire for intercourse?"

Question 21

The nurse has just completed an inspection of a woman's external genitalia.Which of the following describes a finding within normal limits?

A)Redness of the labia majora
B)Multiple nontender sebaceous cysts
C)Discharge that is sticky and yellow-green
D)Swelling of the perineum before onset of menses

Question 22

Which of the following tests are usually collected when screening for cervical cancer?

A)Endocervical specimen,cervical scrape,and vaginal pool
B)Endocervical specimen,vaginal pool,and acetic acid wash
C)Endocervical specimen,KOH prep,and acetic acid wash
D)Cervical scrape,acetic acid wash,and saline mount ("wet prep")

Question 23

During an internal examination of a woman's genitalia,the nurse will use which technique for proper insertion of the speculum?

A)Instruct the woman to bear down,open the speculum blades,and apply in a swift,upward movement.
B)Insert the blades of the speculum on a horizontal plane,turning them to a 45-degree angle while continuing to insert them.Ask the woman to bear down to ease insertion.
C)Push the introitus down and open,instruct the woman to bear down,and insert the speculum with the width of the blades at an oblique angle,applying any pressure downward.
D)Lock the blades open by turning the thumbscrew.Once the blades are open,apply pressure to the introitus and insert the blades at a 45-degree angle downward to bring the cervix into view.

Question 24

When performing an external genitalia examination for a 10-year-old girl,the nurse notes no pubic hair,and that the mons and the labia are covered with fine vellus hair.These findings are consistent with which stage of sexual maturity,according to Tanner's Sexual Maturity Rating scale?

A)Stage 1
B)Stage 2
C)Stage 3
D)Stage 4

Question 25

In performing the bimanual examination,the nurse notes that the cervix feels smooth and firm,is round,and is fixed in place (does not move).When cervical palpation is performed,the patient complains of some pain.Which of the following should be the nurse's interpretation of these results?

A)These findings are all within normal limits.
B)The cervical consistency should be soft and velvety,not firm.
C)The cervix should move when palpated;an immobile cervix may indicate malignancy.
D)It is unusual to have pain when the cervix is palpated,but the rest of the findings are within normal limits.

Question 26

When the nurse is interviewing a preadolescent girl,which of the following opening statements would be least threatening?

A)"Do you have any questions about growing up?"
B)"What has your mother told you about growing up?"
C)"When did you notice that your body was changing?"
D)"I remember being very scared when I got my period.How do you think you'll feel?"

Question 27

A 22-year-old woman is being seen at the clinic for problems with vulvar pain,dysuria,and fever.On physical examination,the nurse notes clusters of small,shallow vesicles with surrounding erythema on the labia.There is also inguinal lymphadenopathy present.The most likely cause of these lesions is:

A)pediculosis pubis.
B)contact dermatitis.
C)human papillomavirus.
D)herpes simplex virus type 2 (HSV-2).

Question 28

The nurse is preparing to examine the external genitalia of a school-age girl.Which of the following positions would be most appropriate in this situation?

A)In the parent's lap
B)In a frog-leg position on the examining table
C)In the lithotomy position with the feet in stirrups
D)Lying flat on the examining table with legs extended

Question 29

When assessing a newborn infant's genitalia,the nurse notes that the genitalia are somewhat engorged.The labia majora are swollen,the clitoris looks large,and the hymen is thick.The vaginal opening is difficult to visualize.The infant's mother states that she is worried about the labia being swollen.The nurse should reply:

A)"This is a normal finding in newborns and should resolve within a few weeks."
B)"This could possibly indicate an abnormality and may need to be evaluated by a physician."
C)"We will need to have estrogen levels evaluated to make sure that they are within normal limits."
D)"We will need to keep close watch over the next few days to see if the genitalia decrease in size."

Question 30

A 46-year-old woman is in the clinic for her annual gynecological examination.She voices a concern about ovarian cancer,because her mother and sister died of it.The nurse knows that which of the following statements is correct regarding ovarian cancer?

A)Ovarian cancer is manifested by severe abdominal pain.
B)The Pap smear detects the presence of ovarian cancer.
C)Women over 40 years of age should have a thorough pelvic examination every year.
D)Women over 40 years of age should have a thorough pelvic examination every 3 years.

Question 31

A patient calls the clinic for instructions before having a Papanicolaou (Pap)smear.The most appropriate instructions from the nurse would be:

A)"If you are menstruating,please use pads to avoid placing anything into the vagina."
B)"Avoid intercourse,inserting anything into the vagina,or douching within 24 hours of your appointment."
C)"If you suspect that you have a vaginal infection,please gather a sample of the discharge to bring with you."
D)"We would like you to use a mild saline douche before your examination.You may pick this up in our office."

Question 32

The nurse is examining a 35-year-old female patient.During the history,the nurse notes that she has had two term pregnancies,with both babies delivered vaginally.The nurse observes the following on internal examination: the cervical os is a horizontal slit with some healed lacerations;the cervix has some nabothian cysts that are small,smooth,and yellow;the cervical surface is granular and red,especially around the os;and stringy,opaque,odorless secretions are present.Which of these findings is abnormal?

A)The presence of nabothian cysts
B)The cervical os a horizontal slit
C)The cervical surface granular and red
D)The presence of stringy and opaque secretions

Question 33

When the nurse is discussing sexuality and sexual issues with adolescents,a permission statement helps to convey that it is normal to think or feel a certain way.Which of the following is the best example of a permission statement?

A)"It's okay that you have become sexually active."
B)"Often girls your age have questions about sexual activity.Do you?"
C)"If it's okay with you,I'd like to ask you some questions about your sexual history."
D)"Often girls your age engage in sexual activity.It's okay to tell me if you have had intercourse."

Question 34

A 65-year-old woman is visiting the office for routine gynecological care.She had a complete hysterectomy 3 months ago.The nurse knows that which of the following statements is true with regard to this visit?

A)Her cervical mucosa will be red and look dry.
B)She will not have a cervix,and thus does not need to have a Pap smear done.
C)The nurse can expect to find that her uterus will be somewhat enlarged,and her ovaries will be small and hard.
D)The nurse should plan to lubricate the instruments and the examining hand well in order to avoid a painful examination.

Question 35

During a vaginal examination of a 38-year-old woman,the nurse notes that the vulva and vagina are erythematous and edematous,with thick,white,curdlike discharge adhering to the vaginal walls.The woman reports intense pruritus and thick white discharge from her vagina.The nurse knows that these history and physical examination findings are most consistent with which of the following?

A)Candidiasis
B)Trichomoniasis
C)Atrophic vaginitis
D)Bacterial vaginosis

Question 36

The nurse is palpating a female patient's adnexa.The findings include a firm,smooth uterine wall,palpable ovaries that feel smooth and firm,and a fallopian tube that is firm and pulsating.The nurse's most appropriate course of action would be to:

A)tell the patient that her examination was normal.
B)give the patient an immediate referral to a gynecologist.
C)suggest that the patient return in a month for a recheck to verify the findings.
D)tell the patient that she may have an ovarian cyst that should be evaluated further.

Question 37

An 18-year-old patient is having her first pelvic examination.It would be appropriate to:

A)invite her mother to be present during the examination.
B)avoid the lithotomy position this first time,because it can be uncomfortable and embarrassing.
C)raise the head of the examination table and give her a mirror so that she can view the exam.
D)drape her fully,leaving the drape between her legs elevated to avoid embarrassing her with eye contact.

Question 38

The order of examination of the internal genitalia is important.The nurse will use which order of examination at this time?

A)Bimanual examination,speculum examination,rectovaginal examination
B)Speculum examination,rectovaginal examination,bimanual examination
C)Speculum examination,bimanual examination,rectovaginal examination
D)Rectovaginal examination,bimanual examination,speculum examination

Question 39

Which of the following statements is true with regard to the history of a postmenopausal woman?

A)The nurse should ask a postmenopausal woman if she ever has vaginal bleeding.
B)Once a woman reaches menopause,the nurse does not need to ask any further history questions.
C)The nurse should screen for monthly breast tenderness.
D)Postmenopausal women are not at risk for contracting STIs,and thus these questions can be omitted.

Question 40

During the examination portion of a patient's visit,she will be in the lithotomy position.Which of the following statements reflect some things that the nurse can do to make this more comfortable for her?

A)Ask her to place her hands and arms behind her head.
B)Elevate her head and shoulders to maintain eye contact.
C)Allow her to choose to have her feet in the stirrups or have them resting side by side on the edge of the table.
D)Allow her to keep her buttocks about 15 cm from the edge of the table to prevent her from feeling as if she will fall off.

Question 41

A 25-year-old woman comes to the emergency department with a sudden fever of 38°C and abdominal pain.Upon examination,the nurse notes that she has rigid,boardlike lower abdominal musculature.When the nurse tries to perform a vaginal examination,the patient has severe pain when the uterus and cervix are moved.The nurse knows that these signs and symptoms are suggestive of:

A)endometriosis.
B)uterine fibroids.
C)ectopic pregnancy.
D)pelvic inflammatory disease.

Question 42

MATCHING
Place the degrees of uterine prolapse listed below in order,from first degree to third degree.

First degree prolapse is:

A)Cervix bulges outside the introitus with straining.
B)The whole uterus protrudes,even without straining.
C)Cervix appears at introitus with straining.

Question 43

A woman has just been diagnosed with HPV infection,or genital warts.The nurse should counsel her to receive regular examinations,because this virus puts her at a higher risk for:

A)uterine cancer.
B)cervical cancer.
C)ovarian cancer.
D)endometrial cancer.

Question 44

During a bimanual examination,the nurse detects a solid tumour on the patient's ovary that is heavy and fixed,with a poorly defined mass.This finding is suggestive of:

A)an ovarian cyst.
B)endometriosis.
C)ovarian cancer.
D)an ectopic pregnancy.

Question 45

MATCHING
Place the degrees of uterine prolapse listed below in order,from first degree to third degree.

Third degree prolapse is:

A)Cervix bulges outside the introitus with straining.
B)The whole uterus protrudes,even without straining.
C)Cervix appears at introitus with straining.

Question 46

During a female external genitalia examination,the nurse notes several lesions around the woman's vulva.The lesions are pink,moist,soft,pointed papules.The patient states that she is not aware of any problems in that area.The nurse recognizes that these lesions may be:

A)syphilitic chancre.
B)HSV-2 (herpes genitalis).
C)human papillomavirus (HPV),or genital warts.
D)pediculosis pubis (crab lice).

Question 47

MATCHING
Place the degrees of uterine prolapse listed below in order,from first degree to third degree.

Second degree prolapse is:

A)Cervix bulges outside the introitus with straining.
B)The whole uterus protrudes,even without straining.
C)Cervix appears at introitus with straining.

Question 48

During an examination,the nurse would expect the cervical os of a woman who has never had children to appear:

A)stellate.
B)small and round.
C)as a horizontal irregular slit.
D)everted.