Question 1

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

Accepted Answer

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 2

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. Based on these findings, what two signs is the patient exhibiting?

Accepted Answer

A)  Tanner and Hegar 
B)  Hegar and Goodell 
C)  Chadwick and Hegar 
D)  Goodell and Chadwick

Question 3

A 35-year-old woman is at the clinic for a gynecologic examination. During the examination, she asks the nurse, "How often do I need to have this Pap test done?" Which reply by the nurse is correct?

Accepted Answer

A)  "It depends. Do you smoke?" 
B)  "A Pap test needs to be performed annually until you are 65 years of age." 
C)  "If you have two consecutive normal Pap tests, then you can wait 5 years between tests." 
D)  "After age 30 years, if you have three consecutive normal Pap tests, then you may be screened every 2 to 3 years."

Question 4

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?

Accepted Answer

A)  "You can continue with hormone replacement therapy as it actually decreases your risk for breast cancer." 
B)  "You should be aware that you're at increased risk for dyspareunia because of decreased vaginal secretions." 
C)  "You have only stopped menstruating and there are not really any other changes that you need to be concerned about." 
D)  "You likely may have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle."

Question 5

The nurse is palpating an ovarian mass during an internal examination of a 63-year-old woman. Which findings of the mass's characteristics would suggest the presence of an ovarian cyst? (Select all that apply.)

Accepted Answer

A)  Fixed 
B)  Poorly defined 
C)  Heavy and solid 
D)  Mobile and solid 
E)  Smooth and round
F) Mobile and fluctuant

Question 6

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

Accepted Answer

A)  The woman is instructed to bear down, the speculum blades are opened and applied in a swift, upward movement. 
B)  The woman is instructed to bear down, the width of the blades is horizontally turned, and the speculum is inserted downward at a 45-degree angle toward the small of the woman's back. 
C)  The blades of the speculum are inserted on a horizontal plane, turning them to a 30-degree angle while continuing to insert them. The woman is asked to bear down after the speculum is inserted. 
D)  The blades are locked open by turning the thumbscrew. Once the blades are open, pressure is applied to the introitus and the blades are inserted downward at a 45-degree angle to bring the cervix into view.

Question 7

The nurse is reviewing the changes that occur with menopause. Which changes are expected?

Accepted Answer

A)  Uterine and ovarian atrophy, along with thinning of 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 8

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

Accepted Answer

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

Question 9

During an examination, which tests will the nurse collect to screen for cervical cancer?

Accepted Answer

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

Question 10

The nurse is palpating a female patient's adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. How should the nurse proceed?

Accepted Answer

A)  Tell the patient that her examination is normal. 
B)  Give her an immediate referral to a gynecologist. 
C)  Suggest that she 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 11

A 65-year-old woman is in the office for routine gynecologic care. She had a complete hysterectomy 3 months ago after cervical cancer was detected. Which statement does the nurse know to be true regarding this visit?

Accepted Answer

A)  Her cervical mucosa will be red and dry looking. 
B)  She will not need to have a Pap smear performed. 
C)  The nurse can expect to find that her uterus will be somewhat enlarged and her ovaries small and hard. 
D)  The nurse should plan to lubricate the instruments and the examining hand adequately to avoid a painful examination.

Question 12

A nurse is assessing a patient's risk for contracting a sexually transmitted infection (STI). What is an appropriate question to ask this patient?

Accepted Answer

A)  "Do you have a sexually transmitted infection?" 
B)  "You are aware of the dangers of unprotected sex, aren't you?" 
C)  "You know that it's important to use condoms for protection, right?" 
D)  "Do you use a condom with each episode of sexual intercourse?"

Question 13

During an internal examination, the nurse notices that the cervix bulges outside the introitus when the patient is asked to strain. How should the nurse document this finding?

Accepted Answer

A)  A normal finding 
B)  Uterine prolapse, graded first degree 
C)  Uterine prolapse, graded third degree 
D)  Uterine prolapse, graded second degree

Question 14

A woman has just been diagnosed with HPV or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for what type of cancer?

Accepted Answer

A)  Uterine 
B)  Cervical 
C)  Ovarian 
D)  Endometrial

Question 15

During an external genitalia examination of a woman, the nurse notices several lesions around the vulva. The lesions are pink, moist, soft, and pointed papules. The patient states that she is not aware of any problems in that area. What do these findings likely indicate?

Accepted Answer

A)  Syphilitic chancre 
B)  HPV or genital warts 
C)  Pediculosis pubis (crab lice) 
D)  Herpes simplex virus type 2 (herpes genitalis)

Question 16

An 18-year-old patient is having her first pelvic examination. Which action by the nurse is appropriate?

Accepted Answer

A)  Inviting her mother to be present during the examination. 
B)  Avoiding the lithotomy position for this first time because it can be uncomfortable and embarrassing. 
C)  Raising the head of the examination table and giving her a mirror so that she can view the examination. 
D)  Fully draping her, leaving the drape between her legs elevated to avoid embarrassing her with eye contact.

Question 17

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

Accepted Answer

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

Question 18

When assessing a newborn infant's genitalia, the nurse notices 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. How should the nurse reply?

Accepted Answer

A)  "This is a normal finding in newborns and should resolve within a few weeks." 
B)  "This finding could indicate an abnormality and may need to be evaluated by a physician." 
C)  "We will need to have estrogen levels evaluated to ensure 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 19

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

Accepted Answer

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

Question 20

The nurse is preparing to interview a postmenopausal woman. Which of these statements is true as it applies to obtaining the health history of a postmenopausal woman?

Accepted Answer

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

Exam 27: Female Genitourinary System