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Exam 26: Female Genitourinary System

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Question 1

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

A) The woman is instructed to bear down, the speculum blades are opened and applied in a swift, upward movement.
B) 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.
C) The woman is instructed to bear down, the width of the blades are horizontally turned, and the speculum is inserted downward at a 45-degree angle toward the small of the woman's back.
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.

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Question 2

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During the interview with a female patient,the nurse gathers data that indicate the patient is perimenopausal.Which of these statements made by this patient leads to this conclusion?

A) "I have noticed that my muscles ache at night when I go to bed."
B) "I will be very happy when I can stop worrying about having a period."
C) "I have been noticing that I sweat a lot more than I used to, especially at night."
D) "I have only been pregnant twice, but both times I had breast tenderness as my first symptom."

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Question 3

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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?

A 25-year-old woman comes to the emergency department with a sudden fever of 38.3° C 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:

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

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?

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 started 3 months earlier.The nurse should tell her:

During the examination portion of a patient's visit,she will be in lithotomy position.Which statement reflects some things that the nurse can do to make this position more comfortable for her?

The nurse is examining a 35-year-old female patient.During the health 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?

Generally,the changes normally associated with menopause occur because the cells in the reproductive tract are:

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:

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?

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

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:

The uterus is usually positioned tilting forward and superior to the bladder.This position is known as:

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

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?

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

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:

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