Question 1

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

Question 2

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

A)  Use Tanner's scale on the five stages of sexual development
B)  Describe her development and compare it with that of other girls her age
C)  Use Jacobsen's table on expected development on the basis of height and weight data
D)  Reassure her that her development is within normal limits and tell her not to worry about the next step A

Question 3

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 B

Question 4

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 5

When assessing a newborn infant's genitalia, the nurse notices that the genitalia appear swollen with fluid.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 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 swelling decreases in size."

Question 6

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

Accepted Answer

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 7

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

Accepted Answer

A)  "Do you have a history of heart murmurs?"
B)  "Are you going to 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 8

A patient calls the clinic for instructions before undergoing a Pap test.The most appropriate instructions from the nurse are:

Accepted Answer

A)  "If you are menstruating, please use pads to avoid anything being placed 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 9

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

A)  "Changes in your urination patterns?"
B)  "Excessive vaginal bleeding?"
C)  "Unusual vaginal discharge or itching?"
D)  "Changes in your desire for intercourse?"

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

A)  Cervix with a smooth, small os
B)  Pear-shaped uterus
C)  Oval-shaped ovaries
D)  Cervix with an irregular, enlarged os

Question 11

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 first period.How do you think you'll feel?"

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

A)  Tanner's; Hegar's
B)  Hegar's; Goodell's
C)  Chadwick's; Hegar's
D)  Goodell's; Chadwick's

Question 13

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

A)  Progesterone changes
B)  Fibroid formations
C)  Decreasing estrogen levels
D)  Increasing vaginal secretions

Question 14

When performing the bimanual examination, the advance practice nurse notices that the cervix feels smooth and firm, is round, and is fixed in place.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)  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 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

A)  "The HPV vaccine is for girls and women ages 9 to 26 years, so we can start that today."
B)  "This vaccine is only for girls who have not yet started to be sexually active."
C)  "Let's check with the physician to see if you are a candidate for this vaccine."
D)  "The vaccine cannot protect you if you already have an HPV infection."

Question 16

A 46-year-old woman is in the clinic for her annual gynecological examination.She voices her concern about ovarian cancer because her mother and sister had died as a result of it.Which statement regarding ovarian cancer does the nurse know to be correct?

Accepted Answer

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

Question 17

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

Accepted Answer

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

Question 18

A 35-year-old woman is at the clinic for a gynecological 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)  "Between 25 to 69 years, screening every 3 years is recommended."

Question 19

When performing an external genitalia examination of a 10-year-old girl, the nurse notices that there is no pubic hair and the mons and the labia are covered with fine vellus hair.These findings are consistent with stage __________ of sexual maturity, according to the Sexual Maturity Rating scale.

Accepted Answer

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

Question 20

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

Accepted Answer

A)  "Now, it is 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)  "Women often have questions about their sexual relationship and how it affects their health.Do you have any questions?"
D)  "Most women your age have had more than one sexual partner.How many would you say you have had?"

Exam 27: Female Genitourinary System