Test Bank For Guidelines for Nurse Practitioners in Gynecologic Settings
13th Edition By Heidi Collins Fantasia, PhD, RN, WHNP-BC; All
Chapters 1-26|| Latest Edition
Purepasspro
stuvia
,Guidelines for Nurse Practitioners in Gynecologic Settings, 12th Edition
x x x x x x x x
Testbank/Studyguide x
Chapter 1. Well-Woman Initial/Annual Gynecologic Exam
x x x x x
1. Due to the effects of cyclic ovarian changes in the breast, when is the best time for breast self-
x x x x x x x x x x x x x x x x x x
examination (BSE)?
x x
a. Between 5 and 7 days after menses ceases x x x x x x x
b. Day 1 of the endometrial cycle
x x x x x
c. Midmenstrual cycle x
d. Any time during a shower or bath x x x x x x
xANS: A x
The physiologic alterations in breast size and activity reach their minimal level approximately 5
x x x x x x x x x x x x x
to 7 days after menstruation ceases. Therefore, BSE is best performed during this phase of the
x x x x x x x x x x x x x x x
xmenstrual cycle. Day 1 of the endometrial cycle is too early to perform an accurate BSE. After
x x x x x x x x x x x x x x x x
xthe midmenstrual cycle, breasts are likely to become tender and increase in size, which is not the
x x x x x x x x x x x x x x x x
xideal time to perform BSE. Lying down after a shower or bath with a small towel under the
x x x x x x x x x x x x x x x x x
xshoulder of the side being examined is appropriate teaching for BSE. A secondary BSE may be
x x x x x x x x x x x x x x x
xperformed while in the shower. x x x x
2. Individual irregularities in the ovarian (menstrual) cycle are most often caused by what?
x x x x x x x x x x x x
a. Variations in the follicular (preovulatory) phase x x x x x
b. Intact hypothalamic-pituitary feedback mechanism
x x x
c. Functioning corpus luteum x x
d. Prolonged ischemic phase x x
xANS: A x
Almost all variations in the length of the ovarian cycle are the result of variations in the length of
x x x x x x x x x x x x x x x x x x
the follicular phase. An intact hypothalamic-pituitary feedback mechanism would be regular, not
x x x x x x x x x x x
xirregular. The luteal phase begins after ovulation. The corpus luteum is dependent on the
x x x x x x x x x x x x x
xovulatory phase and fertilization. During the ischemic phase, the blood supply to the functional
x x x x x x x x x x x x x
xendometrium is blocked, and necrosis develops. The functional layer separates from the basal
x x x x x x x x x x x x
xlayer, and menstrual bleeding begins.
x x x x
3. How would the physiologic process of the sexual response best be characterized?
x x x x x x x x x x x
a. Coitus, masturbation, and fantasy x x x
b. Myotonia and vasocongestion x x
c. Erection and orgasm x x
d. Excitement, plateau, and orgasm x x x
ANS: B
x x
Physiologically, according to Masters (1992), sexual response can be analyzed in terms of two
x x x x x x x x x x x x x
processes: vasocongestion and myotonia. Coitus, masturbation, and fantasy are forms of
x x x x x x x x x x
stimulation for the physical manifestation of the sexual response. Erection and orgasm occur in
x x x x x x x x x x x x x x
,two of the four phases of the sexual response cycle. Excitement, plateau, and orgasm are three of
x x x x x x x x x x x x x x x x
xthe four phases of the sexual response cycle.
x x x x x x x
4. Which action would be inappropriate for the nurse to perform before beginning the health
x x x x x x x x x x x x x
xhistory interview? x
a. Smile and ask the client whether she has any special concerns. x x x x x x x x x x
b. Speak in a relaxed manner with an even, nonjudgmental tone.
x x x x x x x x x
c. Make the client comfortable. x x x
d. Tell the client her questions are irrelevant. x x x x x x
ANS: D
x x
The woman should be assured that all of her questions are relevant and important. Beginning any
x x x x x x x x x x x x x x x
client interaction with a smile is important and assists in putting the client at ease. If the nurse
x x x x x x x x x x x x x x x x x
speaks in a relaxed manner, then the client will likely be more relaxed during the interview. The
x x x x x x x x x x x x x x x x x
clients comfort should always be ensured before beginning the interview.
x x x x x x x x x x
5. The nurse guides a woman to the examination room and asks her to remove her clothes and
x x x x x x x x x x x x x x x x
put on an examination gown with the front open. The woman replies, I have special
x x x x x x x x x x x x x x x
undergarments that I do not remove for religious reasons. Which is the most appropriate
x x x x x x x x x x x x x x
response from the nurse?
x x x x
a. You cant have an examination without removing all your clothes. x x x x x x x x x
b. Ill ask the physician to modify the examination.
x x x x x x x
Tell me about your undergarments. Ill explain the examination procedure, and then we
x x x x x x x x x x x x
c. can discuss how you can comfortably have your examination.
x x x x x x x x
d. I have no idea how we can accommodate your beliefs.
x x x x x x x x x
xANS: C x
Explaining the examination procedure reflects cultural competence by the nurse and shows
x x x x x x x x x x x
respect for the womans religious practices. The nurse must respect the rich and unique qualities
x x x x x x x x x x x x x x
that cultural diversity brings to individuals. The examination can be modified to ensure that
x x x x x x x x x x x x x x
modesty is maintained. In recognizing the value of cultural differences, the nurse can modify the
x x x x x x x x x x x x x x x
plan of care to meet the needs of each woman. Telling the client that her religious practices are
x x x x x x x x x x x x x x x x x x
different or strange is inappropriate and disrespectful to the client.
x x x x x x x x x x
6. A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks
x x x x x x x x x x x x x x x x
she has a vaginal infection, and she has been using an over-the-counter cream for the past 2 days
x x x x x x x x x x x x x x x x x x
to treat it. How should the nurse initially respond?
x x x x x x x x x
Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test x x x x x x x x x x x x
a. for which she is scheduled. x x x x
b. Reassure the woman that using vaginal cream is not a problem for the examination.
x x x x x x x x x x x x x
xAsk the woman to describe the symptoms that indicate to her that she has a vaginal
x x x x x x x x x x x x x x x
c. infection.
d. Ask the woman to reschedule the appointment for the examination. x x x x x x x x x
ANS: C
x x
An important element of the health history and physical examination is the clients description of
x x x x x x x x x x x x x x
any symptoms she may be experiencing. The best response is for the nurse to inquire about the
x x x x x x x x x x x x x x x x
symptoms the woman is experiencing. Women should not douche, use vaginal medications, or
x x x x x x x x x x x x x
, have sexual intercourse for 24 to 48 hours before obtaining a Pap test. Although the woman may
x x x x x x x x x x x x x x x x
need to reschedule a visit for her Pap test, her current symptoms should still be addressed.
x x x x x x x x x x x x x x x x
7. Preconception and prenatal care have become important components of womens health. What
x x x x x x x x x x x
is the guiding principal of preconception care?
x x x x x x x
a. Ensure that pregnancy complications do not occur. x x x x x x
b. Identify the woman who should not become pregnant.
x x x x x x x
c. Encourage healthy lifestyles for families desiring pregnancy. x x x x x x
d. Ensure that women know about prenatal care. x x x x x x
xANS: C x
Preconception counseling guides couples in how to avoid unintended pregnancies, how to
x x x x x x x x x x x
identify and manage risk factors in their lives and in their environment, and how to identify
x x x x x x x x x x x x x x x
xhealthy behaviors that promote the well-being of the woman and her potential fetus.
x x x x x x x x x x x x
Preconception care does not ensure that pregnancy complications will not occur. In many cases,
x x x x x x x x x x x x x
xproblems can be identified and treated and may not recur in subsequent pregnancies. For many
x x x x x x x x x x x x x x
xwomen, counseling can allow behavior modification before any damage is done, or a woman can
x x x x x x x x x x x x x x
xmake an informed decision about her willingness to accept potential hazards. If a woman is
x x x x x x x x x x x x x x
xseeking preconception care, then she is likely aware of prenatal care.
x x x x x x x x x x
8. Ovarian function and hormone production decline during which transitional phase?
x x x x x x x x x
a. Climacteric
b. Menarche
c. Menopause
d. Puberty
ANS: A
x x
The climacteric phase is a transitional period during which ovarian function and hormone
x x x x x x x x x x x x
production decline. Menarche is the term that denotes the first menstruation. Menopause refers
x x x x x x x x x x x x
only to the last menstrual period.Puberty is a broad term that denotes the entire transitional
x x x x x x x x x x x x x x x
period between childhood and sexual maturity.
x x x x x x
9. Which statement indicates that a client requires additional instruction regarding BSE?
x x x x x x x x x x
a. Yellow discharge from my nipple is normal if Im having my period. x x x x x x x x x x x
b. I should check my breasts at the same time each month, after my period.
x x x x x x x x x x x x x
c. I should also feel in my armpit area while performing my breast examination.
x x x x x x x x x x x x
d. I should check each breast in a set way, such as in a circular motion.
x x x x x x x x x x x x x x
ANS: A
x x
Discharge from the nipples requires further examination from a health care provider. The breasts
x x x x x x x x x x x x x
should be checked at the same time each month. The armpit should also be examined. A circular
x x x x x x x x x x x x x x x x
motion is the best method during which to ascertain any changes in the breast tissue.
x x x x x x x x x x x x x x x
10. A blind woman has arrived for an examination. Her guide dog assists her to the examination
x x x x x x x x x x x x x x x
room. She appears nervous and says, Ive never had a pelvic examination. What response from
x x x x x x x x x x x x x x x
the nurse would be most appropriate?
x x x x x x
a. Dont worry. It will be over before you know it. x x x x x x x x x
b. Try to relax. Ill be very gentle, and I wont hurt you.
x x x x x x x x x x x
13th Edition By Heidi Collins Fantasia, PhD, RN, WHNP-BC; All
Chapters 1-26|| Latest Edition
Purepasspro
stuvia
,Guidelines for Nurse Practitioners in Gynecologic Settings, 12th Edition
x x x x x x x x
Testbank/Studyguide x
Chapter 1. Well-Woman Initial/Annual Gynecologic Exam
x x x x x
1. Due to the effects of cyclic ovarian changes in the breast, when is the best time for breast self-
x x x x x x x x x x x x x x x x x x
examination (BSE)?
x x
a. Between 5 and 7 days after menses ceases x x x x x x x
b. Day 1 of the endometrial cycle
x x x x x
c. Midmenstrual cycle x
d. Any time during a shower or bath x x x x x x
xANS: A x
The physiologic alterations in breast size and activity reach their minimal level approximately 5
x x x x x x x x x x x x x
to 7 days after menstruation ceases. Therefore, BSE is best performed during this phase of the
x x x x x x x x x x x x x x x
xmenstrual cycle. Day 1 of the endometrial cycle is too early to perform an accurate BSE. After
x x x x x x x x x x x x x x x x
xthe midmenstrual cycle, breasts are likely to become tender and increase in size, which is not the
x x x x x x x x x x x x x x x x
xideal time to perform BSE. Lying down after a shower or bath with a small towel under the
x x x x x x x x x x x x x x x x x
xshoulder of the side being examined is appropriate teaching for BSE. A secondary BSE may be
x x x x x x x x x x x x x x x
xperformed while in the shower. x x x x
2. Individual irregularities in the ovarian (menstrual) cycle are most often caused by what?
x x x x x x x x x x x x
a. Variations in the follicular (preovulatory) phase x x x x x
b. Intact hypothalamic-pituitary feedback mechanism
x x x
c. Functioning corpus luteum x x
d. Prolonged ischemic phase x x
xANS: A x
Almost all variations in the length of the ovarian cycle are the result of variations in the length of
x x x x x x x x x x x x x x x x x x
the follicular phase. An intact hypothalamic-pituitary feedback mechanism would be regular, not
x x x x x x x x x x x
xirregular. The luteal phase begins after ovulation. The corpus luteum is dependent on the
x x x x x x x x x x x x x
xovulatory phase and fertilization. During the ischemic phase, the blood supply to the functional
x x x x x x x x x x x x x
xendometrium is blocked, and necrosis develops. The functional layer separates from the basal
x x x x x x x x x x x x
xlayer, and menstrual bleeding begins.
x x x x
3. How would the physiologic process of the sexual response best be characterized?
x x x x x x x x x x x
a. Coitus, masturbation, and fantasy x x x
b. Myotonia and vasocongestion x x
c. Erection and orgasm x x
d. Excitement, plateau, and orgasm x x x
ANS: B
x x
Physiologically, according to Masters (1992), sexual response can be analyzed in terms of two
x x x x x x x x x x x x x
processes: vasocongestion and myotonia. Coitus, masturbation, and fantasy are forms of
x x x x x x x x x x
stimulation for the physical manifestation of the sexual response. Erection and orgasm occur in
x x x x x x x x x x x x x x
,two of the four phases of the sexual response cycle. Excitement, plateau, and orgasm are three of
x x x x x x x x x x x x x x x x
xthe four phases of the sexual response cycle.
x x x x x x x
4. Which action would be inappropriate for the nurse to perform before beginning the health
x x x x x x x x x x x x x
xhistory interview? x
a. Smile and ask the client whether she has any special concerns. x x x x x x x x x x
b. Speak in a relaxed manner with an even, nonjudgmental tone.
x x x x x x x x x
c. Make the client comfortable. x x x
d. Tell the client her questions are irrelevant. x x x x x x
ANS: D
x x
The woman should be assured that all of her questions are relevant and important. Beginning any
x x x x x x x x x x x x x x x
client interaction with a smile is important and assists in putting the client at ease. If the nurse
x x x x x x x x x x x x x x x x x
speaks in a relaxed manner, then the client will likely be more relaxed during the interview. The
x x x x x x x x x x x x x x x x x
clients comfort should always be ensured before beginning the interview.
x x x x x x x x x x
5. The nurse guides a woman to the examination room and asks her to remove her clothes and
x x x x x x x x x x x x x x x x
put on an examination gown with the front open. The woman replies, I have special
x x x x x x x x x x x x x x x
undergarments that I do not remove for religious reasons. Which is the most appropriate
x x x x x x x x x x x x x x
response from the nurse?
x x x x
a. You cant have an examination without removing all your clothes. x x x x x x x x x
b. Ill ask the physician to modify the examination.
x x x x x x x
Tell me about your undergarments. Ill explain the examination procedure, and then we
x x x x x x x x x x x x
c. can discuss how you can comfortably have your examination.
x x x x x x x x
d. I have no idea how we can accommodate your beliefs.
x x x x x x x x x
xANS: C x
Explaining the examination procedure reflects cultural competence by the nurse and shows
x x x x x x x x x x x
respect for the womans religious practices. The nurse must respect the rich and unique qualities
x x x x x x x x x x x x x x
that cultural diversity brings to individuals. The examination can be modified to ensure that
x x x x x x x x x x x x x x
modesty is maintained. In recognizing the value of cultural differences, the nurse can modify the
x x x x x x x x x x x x x x x
plan of care to meet the needs of each woman. Telling the client that her religious practices are
x x x x x x x x x x x x x x x x x x
different or strange is inappropriate and disrespectful to the client.
x x x x x x x x x x
6. A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks
x x x x x x x x x x x x x x x x
she has a vaginal infection, and she has been using an over-the-counter cream for the past 2 days
x x x x x x x x x x x x x x x x x x
to treat it. How should the nurse initially respond?
x x x x x x x x x
Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test x x x x x x x x x x x x
a. for which she is scheduled. x x x x
b. Reassure the woman that using vaginal cream is not a problem for the examination.
x x x x x x x x x x x x x
xAsk the woman to describe the symptoms that indicate to her that she has a vaginal
x x x x x x x x x x x x x x x
c. infection.
d. Ask the woman to reschedule the appointment for the examination. x x x x x x x x x
ANS: C
x x
An important element of the health history and physical examination is the clients description of
x x x x x x x x x x x x x x
any symptoms she may be experiencing. The best response is for the nurse to inquire about the
x x x x x x x x x x x x x x x x
symptoms the woman is experiencing. Women should not douche, use vaginal medications, or
x x x x x x x x x x x x x
, have sexual intercourse for 24 to 48 hours before obtaining a Pap test. Although the woman may
x x x x x x x x x x x x x x x x
need to reschedule a visit for her Pap test, her current symptoms should still be addressed.
x x x x x x x x x x x x x x x x
7. Preconception and prenatal care have become important components of womens health. What
x x x x x x x x x x x
is the guiding principal of preconception care?
x x x x x x x
a. Ensure that pregnancy complications do not occur. x x x x x x
b. Identify the woman who should not become pregnant.
x x x x x x x
c. Encourage healthy lifestyles for families desiring pregnancy. x x x x x x
d. Ensure that women know about prenatal care. x x x x x x
xANS: C x
Preconception counseling guides couples in how to avoid unintended pregnancies, how to
x x x x x x x x x x x
identify and manage risk factors in their lives and in their environment, and how to identify
x x x x x x x x x x x x x x x
xhealthy behaviors that promote the well-being of the woman and her potential fetus.
x x x x x x x x x x x x
Preconception care does not ensure that pregnancy complications will not occur. In many cases,
x x x x x x x x x x x x x
xproblems can be identified and treated and may not recur in subsequent pregnancies. For many
x x x x x x x x x x x x x x
xwomen, counseling can allow behavior modification before any damage is done, or a woman can
x x x x x x x x x x x x x x
xmake an informed decision about her willingness to accept potential hazards. If a woman is
x x x x x x x x x x x x x x
xseeking preconception care, then she is likely aware of prenatal care.
x x x x x x x x x x
8. Ovarian function and hormone production decline during which transitional phase?
x x x x x x x x x
a. Climacteric
b. Menarche
c. Menopause
d. Puberty
ANS: A
x x
The climacteric phase is a transitional period during which ovarian function and hormone
x x x x x x x x x x x x
production decline. Menarche is the term that denotes the first menstruation. Menopause refers
x x x x x x x x x x x x
only to the last menstrual period.Puberty is a broad term that denotes the entire transitional
x x x x x x x x x x x x x x x
period between childhood and sexual maturity.
x x x x x x
9. Which statement indicates that a client requires additional instruction regarding BSE?
x x x x x x x x x x
a. Yellow discharge from my nipple is normal if Im having my period. x x x x x x x x x x x
b. I should check my breasts at the same time each month, after my period.
x x x x x x x x x x x x x
c. I should also feel in my armpit area while performing my breast examination.
x x x x x x x x x x x x
d. I should check each breast in a set way, such as in a circular motion.
x x x x x x x x x x x x x x
ANS: A
x x
Discharge from the nipples requires further examination from a health care provider. The breasts
x x x x x x x x x x x x x
should be checked at the same time each month. The armpit should also be examined. A circular
x x x x x x x x x x x x x x x x
motion is the best method during which to ascertain any changes in the breast tissue.
x x x x x x x x x x x x x x x
10. A blind woman has arrived for an examination. Her guide dog assists her to the examination
x x x x x x x x x x x x x x x
room. She appears nervous and says, Ive never had a pelvic examination. What response from
x x x x x x x x x x x x x x x
the nurse would be most appropriate?
x x x x x x
a. Dont worry. It will be over before you know it. x x x x x x x x x
b. Try to relax. Ill be very gentle, and I wont hurt you.
x x x x x x x x x x x
