Guidelines for nurse practitioners in gynecologic settings 12th ed
d d d d d d d d
ition by hawkins roberto nichols stanley haney test bank
d d d d d d d d
Advanced Clinical Studies Ii: Women And Children (Saint Louis University)
d d d d d d d d d
,Guidelines for Nurse Practitioners in Gynecologic Settings, 12th Edition Testb
d d d d d d d d d
ank/Studyguide
Chapterd1.dWell-WomandInitial/AnnualdGynecologicdExam
1. Duedtodthedeffectsdofdcyclicdovariandchangesdindthedbreast,dwhendisdthedbestdtimedfordbreastdself-
dexaminationd(BSE)?
a. Betweend5dandd7ddaysdafterdmensesdceases
b. Dayd1dofdthedendometrialdcycle
c. Midmenstrualdcycle
d. Anydtimedduringdadshowerdordbathd
ANS:dA
Thedphysiologicdalterationsdindbreastdsizedanddactivitydreachdtheirdminimaldleveldapproximatelyd5
tod7ddaysdafterdmenstruationdceases.dTherefore,dBSEdisdbestdperformeddduringdthisdphasedofdthedmen
strualdcycle.dDayd1dofdthedendometrialdcycledisdtoodearlydtodperformdandaccuratedBSE.dAfterdthedmid
menstrualdcycle,dbreastsdaredlikelydtodbecomedtenderdanddincreasedindsize,dwhichdisdnotdthedidealdtim
edtodperformdBSE.dLyingddowndafterdadshowerdordbathdwithdadsmalldtoweldunderdthedshoulderdofdthed
sidedbeingdexamineddisdappropriatedteachingdfordBSE.dAdsecondarydBSEdmaydbedperformeddwhiledi
ndthedshower.
2. Individualdirregularitiesdindthedovariand(menstrual)dcycledaredmostdoftendcauseddbydwhat?
a. Variationsdindthedfolliculard(preovulatory)dphase
b. Intactdhypothalamic-pituitarydfeedbackdmechanism
c. Functioningdcorpusdluteum
d. Prolongeddischemicdphase
dANS:dA
Almostdalldvariationsd indthedlengthdofdthedovariandcycledaredthedresultdofdvariationsdindthedlengthdof
thedfolliculardphase.dAndintactdhypothalamic-
pituitarydfeedbackdmechanismdwoulddbedregular,dnotdirregular.dThedlutealdphasedbeginsdafterdovulat
ion.dThedcorpusdluteumdisddependentdondthedovulatorydphasedanddfertilization.dDuringdthedischemicd
phase,dthedblooddsupplydtodthedfunctionaldendometriumdisdblocked,danddnecrosisddevelops.dThedfun
ctionaldlayerdseparatesdfromdthedbasaldlayer,danddmenstrualdbleedingdbegins.
3. Howdwoulddthedphysiologicdprocessdofdthedsexualdresponsedbestdbedcharacterized?
a. Coitus,dmasturbation,danddfantasy
b. Myotoniadanddvasocongestion
c. Erectiondanddorgasm
d. Excitement,dplateau,danddorgasmd
ANS:dB
Physiologically,daccordingdtodMastersd(1992),dsexualdresponsedcandbedanalyzeddindtermsdofdtwo
processes:dvasocongestiondanddmyotonia.dCoitus,dmasturbation,danddfantasydaredformsdofdstimulati
ondfordthedphysicaldmanifestationdofdthedsexualdresponse.dErectiondanddorgasmdoccurdin
,twodofdthedfourdphasesdofdthedsexualdresponsedcycle.dExcitement,dplateau,danddorgasmdaredthreedofdth
edfourdphasesdofdthedsexualdresponsedcycle.
4. Whichdactiondwoulddbedinappropriatedfordthednursedtodperformdbeforedbeginningdthedhealthdh
istorydinterview?
a. Smiledanddaskdthedclientdwhetherdshedhasdanydspecialdconcerns.
b. Speakdindadrelaxeddmannerdwithdandeven,dnonjudgmentaldtone.
c. Makedthedclientdcomfortable.
d. Telldthedclientdherdquestionsdaredirrelevant.d
ANS:dD
Thedwomandshoulddbedassureddthatdalldofdherdquestionsdaredrelevantdanddimportant.dBeginningdany
clientdinteractiondwithdadsmiledisdimportantdanddassistsdindputtingdthedclientdatdease.dIfdthednursedspea
ksdindadrelaxeddmanner,dthendthedclientdwilldlikelydbedmoredrelaxeddduringdthedinterview.dThedclientsd
comfortdshoulddalwaysdbedensureddbeforedbeginningdthedinterview.
5. Thednursedguidesdadwomandtodthedexaminationdroomdanddasksdherdtodremovedherdclothesdanddp
utdondandexaminationdgowndwithdthedfrontdopen.dThedwomandreplies,dIdhavedspecialdundergarme
ntsdthatdIddodnotdremovedfordreligiousdreasons.dWhichdisdthedmostdappropriatedresponsedfromdthed
nurse?
a. Youdcantdhavedandexaminationdwithoutdremovingdalldyourdclothes.
b. Illdaskdthedphysiciandtodmodifydthedexamination.
Telldmedaboutdyourdundergarments.d Illdexplaindthedexaminationdprocedure,danddthendwe
c. canddiscussdhowdyoudcandcomfortablydhavedyourdexamination.
d. Idhavednodideadhowdwedcandaccommodatedyourdbeliefs.d
ANS:dC
Explainingdthedexaminationdproceduredreflectsdculturaldcompetencedbydthednursedanddshows
respectdfordthedwomansdreligiousdpractices.dThednursedmustdrespectdthedrichdandduniquedqualitiesdth
atdculturalddiversitydbringsdtodindividuals.dThedexaminationdcandbedmodifieddtodensuredthatdmodesty
disdmaintained.dIndrecognizingdthedvaluedofdculturalddifferences,dthednursedcandmodifydthedplandofdcar
edtodmeetdthedneedsdofdeachdwoman.dTellingdthedclientdthatdherdreligiousdpracticesdareddifferentdordst
rangedisdinappropriatedandddisrespectfuldtodthedclient.
6. Adwomandarrivesdatdthedclinicdfordherdannualdexamination.dShedtellsdthednursedthatdshedthinksdshe
dhasdadvaginaldinfection,danddshedhasdbeendusingdandover-the-
counterdcreamdfordthedpastd2ddaysdtodtreatdit.dHowdshoulddthednursedinitiallydrespond?
InformdthedwomandthatdvaginaldcreamsdmaydinterferedwithdthedPapanicolaoud(Pap)dtest
a. fordwhichdshedisdscheduled.
b. Reassuredthedwomandthatdusingdvaginaldcreamdisdnotdadproblemdfordthedexamination.d
Askdthedwomandtoddescribedthedsymptomsdthatdindicatedtodherdthatdshedhasdadvaginal
c. infection.
d. Askdthedwomandtodrescheduledthedappointmentdfordthedexamination.d
ANS:dC
Andimportantdelementdofdthedhealthdhistorydanddphysicaldexaminationdisdthedclientsddescriptiondof
anydsymptomsdshedmaydbedexperiencing.dThedbestdresponsedisdfordthednursedtodinquiredaboutdthedsympto
msdthedwomandisdexperiencing.dWomendshoulddnotddouche,dusedvaginaldmedications,dor
, havedsexualdintercoursedford24dtod48dhoursdbeforedobtainingdadPapdtest.dAlthoughdthedwomandmaydn
eeddtodrescheduledadvisitdfordherdPapdtest,dherdcurrentdsymptomsdshoulddstilldbedaddressed.
7. Preconceptiondanddprenataldcaredhavedbecomedimportantdcomponentsdofdwomensdhealth.dWhatdi
sdthedguidingdprincipaldofdpreconceptiondcare?
a. Ensuredthatdpregnancydcomplicationsddodnotdoccur.
b. Identifydthedwomandwhodshoulddnotdbecomedpregnant.
c. Encouragedhealthydlifestylesdfordfamiliesddesiringdpregnancy.
d. Ensuredthatdwomendknowdaboutdprenataldcare.d
ANS:dC
Preconceptiondcounselingdguidesdcouplesdindhowdtodavoiddunintendeddpregnancies,dhowdto
identifydanddmanagedriskdfactorsdindtheirdlivesdanddindtheirdenvironment,danddhowdtodidentifydhealthy
dbehaviorsdthatdpromotedthedwell-beingdofdthedwomandanddherdpotentialdfetus.
Preconceptiondcareddoesdnotdensuredthatdpregnancydcomplicationsdwilldnotdoccur.dIndmanydcases,dpr
oblemsdcandbedidentifieddanddtreateddanddmaydnotdrecurdindsubsequentdpregnancies.dFordmanydwom
en,dcounselingdcandallowdbehaviordmodificationdbeforedanyddamagedisddone,dordadwomandcandmaked
andinformedddecisiondaboutdherdwillingnessdtodacceptdpotentialdhazards.dIfdadwomandisdseekingdprec
onceptiondcare,dthendshedisdlikelydawaredofdprenataldcare.
8. Ovariandfunctiondanddhormonedproductionddeclinedduringdwhichdtransitionaldphase?
a. Climacteric
b. Menarche
c. Menopause
d. Puberty
dANS:dA
Thedclimactericdphasedisdadtransitionaldperioddduringdwhichdovariandfunctiondanddhormone
productionddecline.dMenarchedisdthedtermdthatddenotesdthedfirstdmenstruation.dMenopausedrefersdon
lydtodthedlastdmenstrualdperiod.Pubertydisdadbroaddtermdthatddenotesdthedentiredtransitionaldperioddbe
tweendchildhooddanddsexualdmaturity.
9. WhichdstatementdindicatesdthatdadclientdrequiresdadditionaldinstructiondregardingdBSE?
a. YellowddischargedfromdmydnippledisdnormaldifdImdhavingdmydperiod.
b. Idshoulddcheckdmydbreastsdatdthedsamedtimedeachdmonth,dafterdmydperiod.
c. Idshoulddalsodfeeldindmydarmpitdareadwhiledperformingdmydbreastdexamination.
d. Idshoulddcheckdeachdbreastdindadsetdway,dsuchdasdindadcirculardmotion.d
ANS:dA
Dischargedfromdthednipplesdrequiresdfurtherdexaminationdfromdadhealthdcaredprovider.dThedbreasts
shoulddbedcheckeddatdthedsamedtimedeachdmonth.dThedarmpitdshoulddalsodbedexamined.dAdcirculardmotion
disdthedbestdmethoddduringdwhichdtodascertaindanydchangesdindthedbreastdtissue.
10. Adblinddwomandhasdarriveddfordandexamination.dHerdguideddogdassistsdherdtodthedexaminationdr
oom.dShedappearsdnervousdanddsays,dIvedneverdhaddadpelvicdexamination.dWhatdresponsedfromdthed
nursedwoulddbedmostdappropriate?
a. Dontdworry.d Itdwilldbedoverdbeforedyoudknowdit.
b. Trydtodrelax.d Illdbedverydgentle,dandd Idwontdhurtdyou.
d d d d d d d d
ition by hawkins roberto nichols stanley haney test bank
d d d d d d d d
Advanced Clinical Studies Ii: Women And Children (Saint Louis University)
d d d d d d d d d
,Guidelines for Nurse Practitioners in Gynecologic Settings, 12th Edition Testb
d d d d d d d d d
ank/Studyguide
Chapterd1.dWell-WomandInitial/AnnualdGynecologicdExam
1. Duedtodthedeffectsdofdcyclicdovariandchangesdindthedbreast,dwhendisdthedbestdtimedfordbreastdself-
dexaminationd(BSE)?
a. Betweend5dandd7ddaysdafterdmensesdceases
b. Dayd1dofdthedendometrialdcycle
c. Midmenstrualdcycle
d. Anydtimedduringdadshowerdordbathd
ANS:dA
Thedphysiologicdalterationsdindbreastdsizedanddactivitydreachdtheirdminimaldleveldapproximatelyd5
tod7ddaysdafterdmenstruationdceases.dTherefore,dBSEdisdbestdperformeddduringdthisdphasedofdthedmen
strualdcycle.dDayd1dofdthedendometrialdcycledisdtoodearlydtodperformdandaccuratedBSE.dAfterdthedmid
menstrualdcycle,dbreastsdaredlikelydtodbecomedtenderdanddincreasedindsize,dwhichdisdnotdthedidealdtim
edtodperformdBSE.dLyingddowndafterdadshowerdordbathdwithdadsmalldtoweldunderdthedshoulderdofdthed
sidedbeingdexamineddisdappropriatedteachingdfordBSE.dAdsecondarydBSEdmaydbedperformeddwhiledi
ndthedshower.
2. Individualdirregularitiesdindthedovariand(menstrual)dcycledaredmostdoftendcauseddbydwhat?
a. Variationsdindthedfolliculard(preovulatory)dphase
b. Intactdhypothalamic-pituitarydfeedbackdmechanism
c. Functioningdcorpusdluteum
d. Prolongeddischemicdphase
dANS:dA
Almostdalldvariationsd indthedlengthdofdthedovariandcycledaredthedresultdofdvariationsdindthedlengthdof
thedfolliculardphase.dAndintactdhypothalamic-
pituitarydfeedbackdmechanismdwoulddbedregular,dnotdirregular.dThedlutealdphasedbeginsdafterdovulat
ion.dThedcorpusdluteumdisddependentdondthedovulatorydphasedanddfertilization.dDuringdthedischemicd
phase,dthedblooddsupplydtodthedfunctionaldendometriumdisdblocked,danddnecrosisddevelops.dThedfun
ctionaldlayerdseparatesdfromdthedbasaldlayer,danddmenstrualdbleedingdbegins.
3. Howdwoulddthedphysiologicdprocessdofdthedsexualdresponsedbestdbedcharacterized?
a. Coitus,dmasturbation,danddfantasy
b. Myotoniadanddvasocongestion
c. Erectiondanddorgasm
d. Excitement,dplateau,danddorgasmd
ANS:dB
Physiologically,daccordingdtodMastersd(1992),dsexualdresponsedcandbedanalyzeddindtermsdofdtwo
processes:dvasocongestiondanddmyotonia.dCoitus,dmasturbation,danddfantasydaredformsdofdstimulati
ondfordthedphysicaldmanifestationdofdthedsexualdresponse.dErectiondanddorgasmdoccurdin
,twodofdthedfourdphasesdofdthedsexualdresponsedcycle.dExcitement,dplateau,danddorgasmdaredthreedofdth
edfourdphasesdofdthedsexualdresponsedcycle.
4. Whichdactiondwoulddbedinappropriatedfordthednursedtodperformdbeforedbeginningdthedhealthdh
istorydinterview?
a. Smiledanddaskdthedclientdwhetherdshedhasdanydspecialdconcerns.
b. Speakdindadrelaxeddmannerdwithdandeven,dnonjudgmentaldtone.
c. Makedthedclientdcomfortable.
d. Telldthedclientdherdquestionsdaredirrelevant.d
ANS:dD
Thedwomandshoulddbedassureddthatdalldofdherdquestionsdaredrelevantdanddimportant.dBeginningdany
clientdinteractiondwithdadsmiledisdimportantdanddassistsdindputtingdthedclientdatdease.dIfdthednursedspea
ksdindadrelaxeddmanner,dthendthedclientdwilldlikelydbedmoredrelaxeddduringdthedinterview.dThedclientsd
comfortdshoulddalwaysdbedensureddbeforedbeginningdthedinterview.
5. Thednursedguidesdadwomandtodthedexaminationdroomdanddasksdherdtodremovedherdclothesdanddp
utdondandexaminationdgowndwithdthedfrontdopen.dThedwomandreplies,dIdhavedspecialdundergarme
ntsdthatdIddodnotdremovedfordreligiousdreasons.dWhichdisdthedmostdappropriatedresponsedfromdthed
nurse?
a. Youdcantdhavedandexaminationdwithoutdremovingdalldyourdclothes.
b. Illdaskdthedphysiciandtodmodifydthedexamination.
Telldmedaboutdyourdundergarments.d Illdexplaindthedexaminationdprocedure,danddthendwe
c. canddiscussdhowdyoudcandcomfortablydhavedyourdexamination.
d. Idhavednodideadhowdwedcandaccommodatedyourdbeliefs.d
ANS:dC
Explainingdthedexaminationdproceduredreflectsdculturaldcompetencedbydthednursedanddshows
respectdfordthedwomansdreligiousdpractices.dThednursedmustdrespectdthedrichdandduniquedqualitiesdth
atdculturalddiversitydbringsdtodindividuals.dThedexaminationdcandbedmodifieddtodensuredthatdmodesty
disdmaintained.dIndrecognizingdthedvaluedofdculturalddifferences,dthednursedcandmodifydthedplandofdcar
edtodmeetdthedneedsdofdeachdwoman.dTellingdthedclientdthatdherdreligiousdpracticesdareddifferentdordst
rangedisdinappropriatedandddisrespectfuldtodthedclient.
6. Adwomandarrivesdatdthedclinicdfordherdannualdexamination.dShedtellsdthednursedthatdshedthinksdshe
dhasdadvaginaldinfection,danddshedhasdbeendusingdandover-the-
counterdcreamdfordthedpastd2ddaysdtodtreatdit.dHowdshoulddthednursedinitiallydrespond?
InformdthedwomandthatdvaginaldcreamsdmaydinterferedwithdthedPapanicolaoud(Pap)dtest
a. fordwhichdshedisdscheduled.
b. Reassuredthedwomandthatdusingdvaginaldcreamdisdnotdadproblemdfordthedexamination.d
Askdthedwomandtoddescribedthedsymptomsdthatdindicatedtodherdthatdshedhasdadvaginal
c. infection.
d. Askdthedwomandtodrescheduledthedappointmentdfordthedexamination.d
ANS:dC
Andimportantdelementdofdthedhealthdhistorydanddphysicaldexaminationdisdthedclientsddescriptiondof
anydsymptomsdshedmaydbedexperiencing.dThedbestdresponsedisdfordthednursedtodinquiredaboutdthedsympto
msdthedwomandisdexperiencing.dWomendshoulddnotddouche,dusedvaginaldmedications,dor
, havedsexualdintercoursedford24dtod48dhoursdbeforedobtainingdadPapdtest.dAlthoughdthedwomandmaydn
eeddtodrescheduledadvisitdfordherdPapdtest,dherdcurrentdsymptomsdshoulddstilldbedaddressed.
7. Preconceptiondanddprenataldcaredhavedbecomedimportantdcomponentsdofdwomensdhealth.dWhatdi
sdthedguidingdprincipaldofdpreconceptiondcare?
a. Ensuredthatdpregnancydcomplicationsddodnotdoccur.
b. Identifydthedwomandwhodshoulddnotdbecomedpregnant.
c. Encouragedhealthydlifestylesdfordfamiliesddesiringdpregnancy.
d. Ensuredthatdwomendknowdaboutdprenataldcare.d
ANS:dC
Preconceptiondcounselingdguidesdcouplesdindhowdtodavoiddunintendeddpregnancies,dhowdto
identifydanddmanagedriskdfactorsdindtheirdlivesdanddindtheirdenvironment,danddhowdtodidentifydhealthy
dbehaviorsdthatdpromotedthedwell-beingdofdthedwomandanddherdpotentialdfetus.
Preconceptiondcareddoesdnotdensuredthatdpregnancydcomplicationsdwilldnotdoccur.dIndmanydcases,dpr
oblemsdcandbedidentifieddanddtreateddanddmaydnotdrecurdindsubsequentdpregnancies.dFordmanydwom
en,dcounselingdcandallowdbehaviordmodificationdbeforedanyddamagedisddone,dordadwomandcandmaked
andinformedddecisiondaboutdherdwillingnessdtodacceptdpotentialdhazards.dIfdadwomandisdseekingdprec
onceptiondcare,dthendshedisdlikelydawaredofdprenataldcare.
8. Ovariandfunctiondanddhormonedproductionddeclinedduringdwhichdtransitionaldphase?
a. Climacteric
b. Menarche
c. Menopause
d. Puberty
dANS:dA
Thedclimactericdphasedisdadtransitionaldperioddduringdwhichdovariandfunctiondanddhormone
productionddecline.dMenarchedisdthedtermdthatddenotesdthedfirstdmenstruation.dMenopausedrefersdon
lydtodthedlastdmenstrualdperiod.Pubertydisdadbroaddtermdthatddenotesdthedentiredtransitionaldperioddbe
tweendchildhooddanddsexualdmaturity.
9. WhichdstatementdindicatesdthatdadclientdrequiresdadditionaldinstructiondregardingdBSE?
a. YellowddischargedfromdmydnippledisdnormaldifdImdhavingdmydperiod.
b. Idshoulddcheckdmydbreastsdatdthedsamedtimedeachdmonth,dafterdmydperiod.
c. Idshoulddalsodfeeldindmydarmpitdareadwhiledperformingdmydbreastdexamination.
d. Idshoulddcheckdeachdbreastdindadsetdway,dsuchdasdindadcirculardmotion.d
ANS:dA
Dischargedfromdthednipplesdrequiresdfurtherdexaminationdfromdadhealthdcaredprovider.dThedbreasts
shoulddbedcheckeddatdthedsamedtimedeachdmonth.dThedarmpitdshoulddalsodbedexamined.dAdcirculardmotion
disdthedbestdmethoddduringdwhichdtodascertaindanydchangesdindthedbreastdtissue.
10. Adblinddwomandhasdarriveddfordandexamination.dHerdguideddogdassistsdherdtodthedexaminationdr
oom.dShedappearsdnervousdanddsays,dIvedneverdhaddadpelvicdexamination.dWhatdresponsedfromdthed
nursedwoulddbedmostdappropriate?
a. Dontdworry.d Itdwilldbedoverdbeforedyoudknowdit.
b. Trydtodrelax.d Illdbedverydgentle,dandd Idwontdhurtdyou.
