Chapter 27: Female Genitourinary System Physical Examination and Health Assessment, 8th Edition by Carolyn Jarvis

Chapter 27: Female Genitourinary
System
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis

MULTIPLE CHOICE

1. During a health history, a 22-year old woman asks, Can I get that vaccine for human
papilloma virus (HPV)? I have genital warts and Id like them to go away! What is
thenurses best response?
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 become sexually active.
c. Lets check with thephysician to see if you are a candidate for this vaccine.
d. The vaccine cannot protect you if you already have an HPV infection.
ANS: D
The HPV vaccine is appropriate for girls and women age 9 to 26 years and is
administered to prevent cervical cancer by preventing HPV infections before girls
become sexually active. However, it cannot protect thewoman if an HPV infection
is already present.

DIF: Cognitive Level: Analyzing (Analysis)
MSC: Client Needs: General

2. During an examination, thenurse observes a female patients 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.
ANS: A
The labial structures encircle a boat-shaped space, or cleft, termed thevestibule.
Within thevestibule are numerous openings. theurethral meatus and vaginal orifice
are visible. theducts of theparaurethral (Skene) glands and thevestibular
(Bartholin) glands are present but not visible.

DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation

,3. During a speculum inspection of thevagina, thenurse would expect to see what at theend
of thevaginal canal?
a. Cervix
b. Uterus
c. Ovaries
d. Fallopian tubes
ANS: A
At theend of thecanal, theuterine cervix projects into thevagina. DIF:

Cognitive Level: Remembering (Knowledge)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation

4. The uterus is usually positioned tilting forward and superior to thebladder. This position
is known as:
a. Anteverted and anteflexed.
b. Retroverted and anteflexed.
c. Retroverted and retroflexed.
d. Superiorverted and anteflexed.
ANS: A
The uterus is freely movable, not fixed, and usually tilts forward and superior to
thebladder (a position labeled as anteverted and anteflexed).

DIF: Cognitive Level: Remembering (Knowledge)
MSC: Client Needs: General

5. An 11-year-old girl is in theclinic for a sports physical examination. thenurse notices that
she has begun to develop breasts, and during theconversation thegirl reveals that she is
worried about her development. thenurse should use which of these techniques to best
assist theyoung girl in understanding theexpected sequence for development? thenurse
should:
a. Use theTanner scale on thefive stages of sexualdevelopment.
b. Describe her development and compare it with that of other girls her age.
c. Use theJacobsen table on expected development on thebasis of height and weight
data.
d. Reassure her that her development is within normal limits and tell her not to worry
about thenext step.
ANS: A
The Tanner scale on thefive stages of pubic hair development is helpful in
teaching girls theexpected
sequence of sexual development. theother responses are not appropriate. DIF:

Cognitive Level: Applying (Application)
MSC: Client Needs: Health Promotion and Maintenance

, 6. A woman who is 8 weeks pregnant is in theclinic for a checkup. thenurse reads on her
chart that her cervix is softened and looks cyanotic. thenurse knows that thewoman is
exhibiting sign and sign.
a. Tanner; Hegar
b. Hegar; Goodell
c. Chadwick; Hegar
d. Goodell; Chadwick
ANS: D
Shortly after thefirst missed menstrual period, thefemale genitalia show signs of
thegrowing fetus. thecervix softens (Goodell sign) at 4 to 6 weeks, and thevaginal
mucosa and cervix look cyanotic (Chadwick sign) at 8 to 12 weeks. These
changes occur because of increased vascularity and edema of thecervix and
hypertrophy and hyperplasia of thecervical glands. Hegar sign occurs when
theisthmus of theuterus softens at 6 to 8 weeks. Tanner sign is not a correct
response.

DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Health Promotion and Maintenance

7. Generally, thechanges normally associated with menopause occur because thecells in
thereproductive tract are:
a. Aging.
b. Becoming fibrous.
c. Estrogen dependent.
d. Able to respond to estrogen.
ANS: C
Because cells in thereproductive tract are estrogen dependent, decreased estrogen
levels during menopause bring dramatic physical changes. theother options are not
correct.

DIF: Cognitive Level: Remembering (Knowledge)
MSC: Client Needs: Health Promotion and Maintenance

8. The nurse is reviewing thechanges that occur with menopause. Which changes are
associated with menopause?
a. Uterine and ovarian atrophy, along with a thinning of thevaginal 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
ANS: A
The uterus shrinks because of its decreased myometrium. theovaries atrophy to 1
to 2 cm and are not palpable after menopause. thesacral ligaments relax, and
thepelvic musculature weakens; consequently, theuterus droops. thecervix shrinks