Chapter 26 Flashcards
During a health history, a 22-year old woman asks, “Can I get that vaccine for HPV? I have genital warts and I’d like them to go away!” What is the nurse’s best response?
A) “The HPV vaccine is for girls and women ages 9 to 26, so we can start that today.”
B) “This vaccine is only for girls who have not started to have intercourse yet.”
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.”
D) “The vaccine cannot protect you if you already have an HPV infection.”
During an examination the nurse observes a female patient’s vestibule and expects to see the:
A) urethral meatus and vaginal orifice.
B) vaginal orifice and vestibular (Bartholin) glands.
C) urethral meatus and paraurethral (Skene) glands.
D) paraurethral (Skene) and vestibular (Bartholin) glands.
A) urethral meatus and vaginal orifice
During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal? A) Cervix B) Uterus C) Ovaries D) Fallopian tubes
A) Cervix
The uterus is usually positioned tilting forward and superior to the bladder. This position is known as: A) anteverted and anteflexed. B) retroverted and anteflexed. C) retroverted and retroflexed. D) superiorverted and anteflexed.
A) anteverted and anteflexed.
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. A) Tanner’s; Hegar’s B) Hegar’s; Goodell’s C) Chadwick’s; Hegar’s D) Goodell’s; Chadwick’s
D) Goodell’s; Chadwick’s
A woman who is 22 weeks pregnant has a vaginal infection. She tells the nurse that she is afraid that this infection will hurt the fetus. The nurse knows that which of these statements is true?
A) If intercourse is avoided, then the risk for infection is minimal.
B) A thick mucus plug forms that protects the fetus from infection.
C) The acidic pH of vaginal secretions promotes the growth of pathogenic bacteria.
D) The mucus plug that forms in the cervical canal is a good medium for bacterial growth.
B) A thick mucus plug forms that protects the fetus from infection.
The changes normally associated with menopause occur generally because the cells in the reproductive tract are: A) aging. B) becoming fibrous. C) estrogen dependent. D) able to respond to estrogen.
C) estrogen dependent
The nurse is reviewing the changes that occur with menopause. Which of these are changes associated with menopause?
A) Uterine and ovarian atrophy along with thinning 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
A) Uterine and ovarian atrophy along with thinning vaginal epithelium
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? “A postmenopausal woman:
A) is not at any greater risk for heart disease than a younger woman is.”
B) should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.”
C) has only stopped menstruating; there really are no other significant changes with which she should be concerned.”
D) is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle.”
B) should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.”
A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the:
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.
A) menstrual history because it is generally nonthreatening.
A patient has had three pregnancies and two live births. The nurse would record this information as gravida \_\_\_\_\_, para \_\_\_\_\_, AB \_\_\_\_\_. A) 2; 2; 1 B) 3; 2; 0 C) 3; 2; 1 D) 3; 3; 1
C) 3; 2; 1
During the interview with a female patient, the nurse gathers data that indicate that 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)m“I have only been pregnant twice, but both times I had breast tenderness as my first symptom.”
C) “I have been noticing that I sweat a lot more than I used to, especially at night.”
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:
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.”
B) “Hormone replacement therapy has several side effects, including fluid retention, breast tenderness, and vaginal bleeding.”
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: A) dysuria. B) stress incontinence. C) hematuria. D) urge incontinence.
B) stress incontinence.
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) “Oh, don’t worry. Some cyclic vaginal discharge is normal.”
B) “Have you been engaging in unprotected sexual intercourse?”
C) “I’d like some information about the discharge. What color is it?”
D) “Have you had any urinary incontinence associated with the discharge?”
C) “I’d like some information about the discharge. What color is it?”
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:
A) a change in your urination patterns?”
B) any excessive vaginal bleeding?”
C) any unusual vaginal discharge or itching?”
D) any changes in your desire for intercourse?”
C) any unusual vaginal discharge or itching?”
Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview?
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) “Often women 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?”
C) “Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?”
A 22-year-old woman has been considering using oral contraceptives. As a part of her history, the nurse should ask:
A) “Do you have a history of heart murmurs?”
B) “Will you be in a monogamous relationship?”
C) “Have you thought this choice through carefully?”
D) “If you smoke, how many cigarettes do you smoke per day?”
D) “If you smoke, how many cigarettes do you smoke per day?”
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) 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.
B) Explain that couples are considered infertile after 1 year of unprotected intercourse.
A nurse is assessing a patient’s risk of contracting a sexually transmitted infection (STI). An appropriate question to ask would be:
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?”
B) “Do you use a condom with each episode of sexual intercourse?”
When the nurse is interviewing a preadolescent girl, which opening statement would be least threatening?
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?”
C) “When did you notice that your body was changing?”
When the nurse is discussing sexuality and sexual issues with adolescents, a permission statement helps to convey that it is normal to think or feel a certain way. Which of these is the best example of a permission statement?
A) “It is okay that you have become sexually active.”
B) “Often girls your age have questions about sexual activity. Have you any questions?”
C) “If it is okay with you, I’d like to ask you some questions about your sexual history.”
D) “Often girls your age engage in sexual activity. It is okay to tell me if you have had intercourse.”
B) “Often girls your age have questions about sexual activity. Have you any questions?”
The nurse is preparing to interview a postmenopausal woman. Which of these statements is true with regard to the history of a postmenopausal woman?
A) The nurse should ask a postmenopausal woman if she ever has vaginal bleeding.
B) Once a woman reaches menopause, the nurse does not need to ask any further history questions.
C) The nurse should screen for monthly breast tenderness.
D) Postmenopausal women are not at risk for contracting sexually transmitted infections and thus these questions can be omitted.
A) The nurse should ask a postmenopausal woman if she ever has vaginal bleeding.
During the examination portion of a patient’s visit, she will be in lithotomy position. Which statement below reflects some things that the nurse can do to make this more comfortable for her?
A) Ask her to place her hands and arms behind her head.
B) Elevate her head and shoulders to maintain eye contact.
C) Allow her to choose to have her feet in the stirrups or have them resting side by side on the edge of the table.
D) Allow her to keep her buttocks about 6 inches from the edge of the table to prevent her from feeling as if she will fall off.
B) Elevate her head and shoulders to maintain eye contact.
