Question 1

When performing the bimanual examination,the nurse notices 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.The nurse's interpretation of these results should be which of these?

Accepted Answer

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)  Pain may occur during palpation of the cervix.

Question 2

When the nurse is interviewing a preadolescent girl,which opening statement 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 3

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.The nurse's most appropriate course of action would be to:

Accepted Answer

A)  tell the patient that her examination was 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 4

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

Accepted Answer

A)  menstrual history because it is generally nonthreatening. 
B)  obstetric history because it is the most important information. 
C)  urinary system history because there may be problems in this area as well. 
D)  sexual history because it will build rapport to discuss this first.

Question 5

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

Accepted Answer

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

Question 6

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

Accepted Answer

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

Question 7

During a vaginal examination of a 38-year-old woman,the nurse notices 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 these conditions?

Accepted Answer

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

Question 8

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

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 3 months of engaging in unprotected intercourse and that they will need a referral to a fertility expert.

Question 9

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.The nurse should reply:

Accepted Answer

A)  "This is a normal finding in newborns and should resolve within a few weeks." 
B)  "This could 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 10

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

Accepted Answer

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 11

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

Accepted Answer

A)  Nabothian cysts are present. 
B)  The cervical os is a horizontal slit. 
C)  The cervical surface is granular and red. 
D)  Stringy and opaque secretions are present.

Question 12

A nurse is assessing a patient's risk of contracting a sexually transmitted infection (STI).An appropriate question to ask would be:

Accepted Answer

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

Question 13

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

Accepted Answer

A)  2; 2; 1 
B)  3; 2; 0 
C)  3; 2; 1 
D)  3; 3; 1

Question 14

During an internal examination,the nurse notices that the cervix bulges outside the introitus when the patient is asked to strain.The nurse will document this as:

Accepted Answer

A)  uterine prolapse, graded first degree. 
B)  uterine prolapse, graded second degree. 
C)  uterine prolapse, graded third degree. 
D)  a normal finding.

Question 15

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

Accepted Answer

A)  Ovarian cancer rarely has any symptoms. 
B)  The Pap smear detects the presence of ovarian cancer. 
C)  Women at high risk for ovarian cancer should have annual transvaginal ultrasonography for screening. 
D)  Women over age 40 years should have a thorough pelvic examination every 3 years.

Question 16

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.The nurse knows that which of these statements is true with regard to this visit?

Accepted Answer

A)  Her cervical mucosa will be red and dry looking. 
B)  She will 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 small and hard. 
D)  The nurse should plan to lubricate the instruments and the examining hand well to avoid a painful examination.

Question 17

A 25-year-old woman comes to the emergency department with a sudden fever of 101° F and abdominal pain.Upon examination,the nurse notices 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:

Accepted Answer

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

Question 18

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

A)  "Hormone replacement therapy is at such a low dose that side effects are very unusual." 
B)  "Hormone replacement therapy has several side effects, including fluid retention, breast tenderness, and vaginal bleeding." 
C)  "It would be very unusual to have vaginal bleeding with hormone replacement therapy, and I suggest you come in to the clinic immediately to have this evaluated." 
D)  "It sounds as if your dose of estrogen is too high; I think you may need to decrease the amount you are taking and then call back in a week."

Question 19

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

Question 20

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

Accepted Answer

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

Exam 26: Female Genitourinary System

When performing the bimanual examination,the nurse notices 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.The nurse's interpretation of these results should be which of these?