Question 1

During the interview a patient reveals that she has some vaginal discharge.She is worried that it may be a sexually transmitted infection.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,color,and odor.Normal vaginal discharge is small,clear or cloudy,and always nonirritating.

Question 2

A woman is in the clinic for an annual gynecologic examination.The nurse should plan to begin the interview with the:

Accepted Answer

Menstrual history is usually nonthreatening;thus it is a good place to start.Obstetric,urinary,and sexual histories are also part of the interview but not necessarily the best topics with which to start.

Question 3

A woman who is 22 weeks pregnant has a vaginal infection.She tells the nurse that she is afraid that this infection will hurt the fetus.The nurse knows that which of these 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 4

During an examination the nurse observes a female patient's vestibule and expects 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)glands and the vestibular (Bartholin)glands are present but not visible.

Question 5

The nurse is reviewing the changes that occur with menopause.Which of these 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.The vaginal pH becomes more alkaline,and secretions are decreased.This results in a fragile mucosal surface that is at risk for bleeding and vaginitis.

Question 6

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 suspects that the problem is:

Accepted Answer

Stress incontinence is involuntary urine loss with physical strain,sneezing,or coughing.Dysuria is pain or burning with urination.Hematuria is bleeding with urination.Urge incontinence is involuntary urine loss but it occurs due to an overactive detrusor muscle in the bladder that contracts and causes an urgent need to void.

Question 7

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

Accepted Answer

The nurse should begin with an open-ended question to assess individual needs.The nurse should include appropriate questions as a routine part of the history,because doing so communicates that the nurse accepts the individual's sexual activity and believes it is important.The nurse's comfort with discussion prompts the patient'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 8

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 labeled as anteverted and anteflexed).

Question 9

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 for cardiovascular side effects.If cigarettes are used,then the nurse should assess smoking history.The other questions are not appropriate.

Question 10

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 hormone replacement therapy (HRT)she started 3 months ago.The nurse should tell her:

Accepted Answer

Side effects of hormone replacement therapy include fluid retention,breast pain,and vaginal bleeding.The other responses are not correct.

Question 11

A married couple has come to the clinic seeking advice on pregnancy.They have been trying to conceive for 4 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.The other actions are not appropriate.

Question 12

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 _____ sign and _____ sign.

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 4 to 6 weeks,and the vaginal mucosa and cervix look cyanotic (Chadwick's sign)at 8 to 12 weeks.These changes occur because of increased vascularity and edema of the cervix and hypertrophy and hyperplasia of the cervical glands.Hegar's sign occurs when the isthmus of the uterus softens at 6 to 8 weeks.Tanner's sign is not a correct response.

Question 13

During a health history,a 22-year old woman asks,"Can I get that vaccine for HPV? I have genital warts and I'd like them to go away!" What is the nurse's best response?

Accepted Answer

The HPV (human papillomavirus)vaccine is appropriate for girls and women age 9 to 26 and is given to prevent cervical cancer by preventing HPV infections before girls become sexually active.However,it cannot protect the woman if an HPV infection is already present.

Question 14

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

Accepted Answer

Tanner's table on the five stages of pubic hair development is helpful in teaching girls the expected sequence of sexual development (see Table 26-1).The other responses are not appropriate.

Question 15

A patient has had three pregnancies and two live births.The nurse would record this information as gravida _____,para _____,AB _____.

Accepted Answer

Gravida is number of pregnancies.Para is number of births.Abortions are interrupted pregnancies,including elective abortions and spontaneous miscarriages.

Question 16

During the interview with a female patient,the nurse gathers data that indicate that the patient is perimenopausal.Which of these 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,night sweats,numbness and tingling,headache,palpitations,drenching sweats,mood swings,vaginal dryness,and itching.The other responses are not correct.

Question 17

During a speculum inspection of the vagina,the nurse would expect to see what at the end of the vaginal canal?

Accepted Answer

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

Question 18

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.The other options are not correct.

Question 19

A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination.Which of these statements should the nurse include in patient education? "A postmenopausal woman:

Accepted Answer

Decreased vaginal secretions leave the vagina dry and at risk for irritation and pain with intercourse (dyspareunia).The other statements are incorrect.

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 should ask,"Have you noticed:

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.The other questions are not correct.

Quiz 26: Female Genitourinary System