NSG 6320 AGNP Board Exam – Women’s Health
Assessment Exam
1. Question:
A woman complains of infrequent menses with intervals greater than 35
days. This condition is termed:
oligomenorrhea. Correct
polymenorrhea.
metrorrhagia.
menorrhagia.
Explanation:
Oligomenorrhea is infrequent bleeding with menses occurring at greater than
35- day intervals, or 4-9 menstrual cycles per year. Polymenorrhea occurs
when there are fewer than 21-day intervals between menses. Menorrhagia
refers to excessive or prolonged menstrual flow occurring at regular
intervals. Metrorrhagia refers to intermenstrual bleeding.
2. Question:
Upon examination of the vagina, a swollen red ring is noted around the
urethral opening. This finding is most consistent with a:
prolapse of the urethral mucosa. Correct
urethral caruncle.
cystocele.
cystourethrocele.
Explanation:
A prolapsed urethral mucosa forms a swollen red ring around the urethral
meatus. A urethral caruncle is a small, red, benign tumor visible at the
posterior part of the urethral meatus. It usually occurs in postmenopausal
women. A cystocele is a bulge of the upper two-thirds of the anterior vaginal
wall and the bladder above it. It results from weakened supporting tissues.
When the entire anterior vaginal wall, together with the bladder and urethra,
is involved in the bulge, a cystourethrocele is present.
3. Question:
When palpating the cervix during the bimanual exam, cervical motion
tenderness (chandelier sign) is noted. This tenderness could be suggestive
of:
retroversion of the uterus.
pelvic inflammatory disease. Correct
vulvar lesions.
Bartholin gland infection.
Explanation:
,Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal
tenderness, suggest pelvic inflammatory disease, ectopic pregnancy, or
appendicitis.
4. Question:
When performing a rectal exam on a female, a hard nodular rectal "shelf" is
palpable at the tip of the examiner's finger. This finding is suggestive of:
an ovarian cyst.
metastatic tissue in the rectouterine pouch. Correct
rectal polyp.
carcinoma of the rectum.
Explanation:
Widespread peritoneal metastases from any source may develop in the area
of the peritoneal reflection anterior to the rectum. A firm to hard nodular
rectal “shelf” may be just palpable with the tip of the examining finger. In a
woman, this shelf of metastatic tissue develops in the rectouterine pouch,
behind the cervix and the uterus. Rectal polyps and carcinoma of the
rectum, if palpable, are typically located in the lower section of the rectum.
To palpate the ovaries, a bimanual pelvic examination would be more
appropriate.
5. Question:
When performing an examination of the external genitalia of a female
patient, a small, firm, round cystic nodule in the labia is identified. This lesion
is most consistent with:
a syphilitic chancre.
an epidermoid cyst. Correct
Condylomata acuminata.
genital herpes.
Explanation:
A small, firm, round cystic nodule in the labia suggests an epidermoid cyst.
They appear yellowish in color with a dark punctum marking the blocked
opening of the gland. A syphilitic chancre appears as a firm, painless ulcer
and suggests the chancre of primary syphilis. Because most chancres in
women develop internally, they often go undetected. Genital warts or
Condylomata acuminata are warty lesions on the labia and within the
vestibule resulting from infection with human papillomavirus. Genital herpes
appears as shallow, small, painful ulcers on red bases.
, 6. Question:
In a female diagnosed with a first-degree uterine prolapse, the cervix:
is located in its normal position.
has slipped but is well within the vagina. Correct
is located in the introitus.
and vagina are outside the introitus.
Explanation:
Uterine prolapse occurs in progressive stages. The uterus becomes
retroverted and descends down the vaginal canal to the exterior. In first-
degree prolapse, the cervix is still well within the vagina. In second-degree
prolapse, it is at the introitus. In third-degree prolapse (procidentia), the
cervix and vagina are outside the introitus.
7. Question:
When performing a bimanual exam of the vagina, the examiner should
lubricate the index and middle fingers of a gloved hand. From a standing
position, the fingers should be inserted into the vagina while exerting
pressure primarily:
anteriorly.
posteriorly. Correct
toward the "4-o"clock" position.
toward the "8-o"clock" position.
Explanation:
When performing a bimanual exam of the vagina, the examiner should
lubricate the index and middle fingers of one of the gloved hands, and from a
standing position, insert them into the vagina while exerting pressure
primarily posteriorly.
8. Question:
Chronic pelvic pain may be secondary to all of the above except:
sexually transmitted diseases.
sexual abuse.
fibroids.
peptic ulcer disease. Correct
Explanation:
Chronic pelvic pain (CPP) refers to pain of at least 6 months duration that
occurs below the umbilicus. While gynecologic etiologies are common, CPP
may be secondary to conditions in the urinary tract, GI tract, musculoskeletal
system, and in the setting of mental health issues. Peptic ulcer disease
affects the upper GI tract and produces symptoms above the umbilicus.
Assessment Exam
1. Question:
A woman complains of infrequent menses with intervals greater than 35
days. This condition is termed:
oligomenorrhea. Correct
polymenorrhea.
metrorrhagia.
menorrhagia.
Explanation:
Oligomenorrhea is infrequent bleeding with menses occurring at greater than
35- day intervals, or 4-9 menstrual cycles per year. Polymenorrhea occurs
when there are fewer than 21-day intervals between menses. Menorrhagia
refers to excessive or prolonged menstrual flow occurring at regular
intervals. Metrorrhagia refers to intermenstrual bleeding.
2. Question:
Upon examination of the vagina, a swollen red ring is noted around the
urethral opening. This finding is most consistent with a:
prolapse of the urethral mucosa. Correct
urethral caruncle.
cystocele.
cystourethrocele.
Explanation:
A prolapsed urethral mucosa forms a swollen red ring around the urethral
meatus. A urethral caruncle is a small, red, benign tumor visible at the
posterior part of the urethral meatus. It usually occurs in postmenopausal
women. A cystocele is a bulge of the upper two-thirds of the anterior vaginal
wall and the bladder above it. It results from weakened supporting tissues.
When the entire anterior vaginal wall, together with the bladder and urethra,
is involved in the bulge, a cystourethrocele is present.
3. Question:
When palpating the cervix during the bimanual exam, cervical motion
tenderness (chandelier sign) is noted. This tenderness could be suggestive
of:
retroversion of the uterus.
pelvic inflammatory disease. Correct
vulvar lesions.
Bartholin gland infection.
Explanation:
,Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal
tenderness, suggest pelvic inflammatory disease, ectopic pregnancy, or
appendicitis.
4. Question:
When performing a rectal exam on a female, a hard nodular rectal "shelf" is
palpable at the tip of the examiner's finger. This finding is suggestive of:
an ovarian cyst.
metastatic tissue in the rectouterine pouch. Correct
rectal polyp.
carcinoma of the rectum.
Explanation:
Widespread peritoneal metastases from any source may develop in the area
of the peritoneal reflection anterior to the rectum. A firm to hard nodular
rectal “shelf” may be just palpable with the tip of the examining finger. In a
woman, this shelf of metastatic tissue develops in the rectouterine pouch,
behind the cervix and the uterus. Rectal polyps and carcinoma of the
rectum, if palpable, are typically located in the lower section of the rectum.
To palpate the ovaries, a bimanual pelvic examination would be more
appropriate.
5. Question:
When performing an examination of the external genitalia of a female
patient, a small, firm, round cystic nodule in the labia is identified. This lesion
is most consistent with:
a syphilitic chancre.
an epidermoid cyst. Correct
Condylomata acuminata.
genital herpes.
Explanation:
A small, firm, round cystic nodule in the labia suggests an epidermoid cyst.
They appear yellowish in color with a dark punctum marking the blocked
opening of the gland. A syphilitic chancre appears as a firm, painless ulcer
and suggests the chancre of primary syphilis. Because most chancres in
women develop internally, they often go undetected. Genital warts or
Condylomata acuminata are warty lesions on the labia and within the
vestibule resulting from infection with human papillomavirus. Genital herpes
appears as shallow, small, painful ulcers on red bases.
, 6. Question:
In a female diagnosed with a first-degree uterine prolapse, the cervix:
is located in its normal position.
has slipped but is well within the vagina. Correct
is located in the introitus.
and vagina are outside the introitus.
Explanation:
Uterine prolapse occurs in progressive stages. The uterus becomes
retroverted and descends down the vaginal canal to the exterior. In first-
degree prolapse, the cervix is still well within the vagina. In second-degree
prolapse, it is at the introitus. In third-degree prolapse (procidentia), the
cervix and vagina are outside the introitus.
7. Question:
When performing a bimanual exam of the vagina, the examiner should
lubricate the index and middle fingers of a gloved hand. From a standing
position, the fingers should be inserted into the vagina while exerting
pressure primarily:
anteriorly.
posteriorly. Correct
toward the "4-o"clock" position.
toward the "8-o"clock" position.
Explanation:
When performing a bimanual exam of the vagina, the examiner should
lubricate the index and middle fingers of one of the gloved hands, and from a
standing position, insert them into the vagina while exerting pressure
primarily posteriorly.
8. Question:
Chronic pelvic pain may be secondary to all of the above except:
sexually transmitted diseases.
sexual abuse.
fibroids.
peptic ulcer disease. Correct
Explanation:
Chronic pelvic pain (CPP) refers to pain of at least 6 months duration that
occurs below the umbilicus. While gynecologic etiologies are common, CPP
may be secondary to conditions in the urinary tract, GI tract, musculoskeletal
system, and in the setting of mental health issues. Peptic ulcer disease
affects the upper GI tract and produces symptoms above the umbilicus.
