Question 1

The nurse is reviewing the changes that occur with menopause.Which changes are 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; consequently, 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, which results in a fragile mucosal surface that is at risk for vaginitis.

Question 2

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 3

An 11-year-old girl is in the clinic for her annual checkup.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

Using Tanner's scale on the five stages of sexual development is the best technique to assist the young girl in understanding the expected sequence for development. Tanner's scale provides a standardized method for describing the physical changes that occur during puberty, including the development of breasts. This information can help the girl understand that her development is normal and expected, and can also provide her with a framework for understanding future changes that may occur. Describing her development and comparing it with that of other girls her age may not be accurate or helpful, as there is a wide range of normal variation in the timing and pattern of puberty. Jacobsen's table on expected development on the basis of height and weight data may be useful in some situations, but it does not provide detailed information about the stages of sexual development. Reassuring the girl that her development is within normal limits and telling her not to worry about the next step may be comforting, but it does not provide her with the information she needs to understand her development and feel more confident about the changes that are occurring.

Question 4

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

Accepted Answer

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

Question 5

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 6

A 22-year-old woman has been considering using oral contraceptives.As a part of her health 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 the patient's smoking history.The other questions are not appropriate.

Question 7

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 that occurs as a result of an overactive detrusor muscle in the bladder that contracts and causes an urgent need to void.

Question 8

When obtaining a sample for a Papanicolaou ("Pap") test from a 60-year-old postmenopausal female patient, the nurse recognizes that the cervix is smaller and paler in response to:

Accepted Answer

Because cells in the reproductive tract are estrogen dependent, decreased estrogen levels during menopause bring dramatic physical changes.The cervix shrinks and looks paler, with a thick, glistening epithelium.The other options are not correct.

Question 9

A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if these changes could be attributable to the hormone replacement therapy (HRT) she had started 3 months earlier.The nurse should tell her:

Accepted Answer

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

Question 10

During a speculum inspection of the vagina of a 25-year-old female who has never been pregnant, what would the nurse expect to see at the end of the vaginal canal?

Accepted Answer

At the end of the canal, the uterine cervix projects into the vagina.In nulliparous women, the cervix appears as a smooth, doughnut-shaped area with a small circular hole (the os).After childbirth, the os is slightly enlarged and irregular.

Question 11

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 any ..."

Accepted Answer

Several medications may increase the risk for vaginitis.Broad-spectrum antibiotics alter the balance of normal flora, which may lead to the development of vaginitis.The other questions are not appropriate.

Question 12

A 54-year-old woman who has just completed menopause is in the clinic today for her 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 during intercourse (dyspareunia).The other statements are incorrect.

Question 13

A nurse is assessing a patient's risk for contracting an STI.An appropriate question to ask would be:

Accepted Answer

In reviewing a patient's risk for STIs, the nurse should ask in a nonconfrontational manner whether condoms are being used during each instance of sexual intercourse.Asking a person whether he or she has an infection does not address the risk.

Question 14

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 15

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

Accepted Answer

The HPV vaccine is appropriate for girls and women ages 9 to 26 years and is administered 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 16

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

Accepted Answer

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

Question 17

During the interview with a female patient, the data gathered by the nurse 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 18

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

Questions that help the patient reveal more information about her symptoms should be asked in a nonthreatening manner.Asking about the amount, colour, and odour of the vaginal discharge provides the opportunity for further assessment.Normal vaginal discharge is small, clear or cloudy, and always nonirritating.

Question 19

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 health history because doing so communicates that the nurse accepts the individual's sexual activity and believes it is important.The nurse's comfort with the discussion prompts the patient's interest and, possibly, relief that the topic has been introduced.The initial discussion establishes a database for comparison with any future sexual activities and provides an opportunity to screen sexual problems.

Question 20

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 the vestibule 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.

Quiz 27: Female Genitourinary System