NURS 659 Exam 3 Guide With
Complete Solution
When assessing a female for HSV, a common spot that is often overlooked is
- ANSWER the perineum
The Bartholean glands are located - ANSWER the lower part of the vaginal
opening, 5 and 7 o'clock
The Skenes glands are located - ANSWER the upper part of the vulva, 11 and
1 o'clock
In a healthy pregnancy, embryo should attach where? - ANSWER The fundus
of the uterus
Where is the most common site for breast cancer? - ANSWER The tail of
spence, or the breast tissue that extends up into the axilla
Where are the breast lymph nodes located and why is this important? -
ANSWER In the axilla
Important to palpate, common site for breast cancer
Define the following terms:
ammenorhea
dysmennorhea
menorrhagia
metorhagia - ANSWER ammenorhea: absence of period
,dysmennorhea: painful periods
menorrhagia: heavy bleeding, periods lasting >7 days
metorhagia: bleeding from uterus between menstrual periods
What is the only way to confirm a diagnosis of endometriosis? - ANSWER
Laproscopy
What is a colposcopy? - ANSWER Colposcopy is a procedure to closely
examine the cervix, vagina and vulva for signs of disease with the use of a
colposcope. It may be recommended after an abnormal pap smear to further
diagnose.
What is the LEEP procedure? - ANSWER procedure for cervical CA that cuts
out or freezes abnormal cells
What are the most common vaginal infections (STI and not STI)? - ANSWER
BV
HPV
Are annual exams the same thing as pap smears? - ANSWER No
Annual exam is performed annually regardless of if there is a pap or not
(paps are not as frequent as annually)
Pelvic exam should be annually
Travel history is important for women of childbearing age for what reason? -
ANSWER many diseases that are dangerous to fetuses are associated with
travel, such as Zika, Ebola
When asking a woman about breast cancer family history, what is a big red
flag? - ANSWER breast cancer on mom's side (higher risk)
,How do you perform a breast exam? - ANSWER Patient should be supine
Uncover one breast at a time
inspect for visual changes: dimpling, retractions, masses, etc.
Palpate in your preferred way (could be circular, up and down, etc) from
nodes to junction of clavicle and sternum
Bare hands are preferred if no open sores or discharge
Press breast tissue against the chest wall in small, circular motions (scoop,
don't pick up hands)
Don't forget about the tail
Palpate around areola and nipple (look for discharge)
Look at breasts in different positions: leaning forward, one arm above head,
arms out, etc, may uncover masses you wouldn't have otherwise seen
If you come across a normal cystic area on breast exam, what should you do?
- ANSWER Have the woman feel it so she can be familiar or tell you if it's
normal for her
What is the timeframe to get a mammogram after an exam? - ANSWER
Within 3 months if screening, ASAP if diagnostic
What is teaching required for a breast self exam? - ANSWER first they are no
longer recommended by USPSTF but it is up to provider and patient
, preference
Second, make sure they know to do it immediately after menses to avoid
increased risk of fibrocystic changes/false positives (if no menses, do it
whenever but just keep it consistent)
Educate on risk of false positives and benefits (getting familiar with what is
normal for her breasts)
What are fibrocystic breast changes? Treatment recommendations? -
ANSWER VERY common source of mastalgia, etiology unknown but suspect
hormonal
Reduce caffeine and nicotine, may use Vit E or evening primrose oil (not
resource based)
These changes are not associated with cancer risk unless in patients who
avoid getting checked out or getting mammograms
What do fibrocystic breast changes feel like? What are symptoms? - ANSWER
Lumpy, bumpy, not a MASS
Mastalgia, bilateral typically, tender axillary nodes, may have nipple
discharge
If you find a mass, how is the mammogram billed? - ANSWER As a diagnostic
mammogram rather than screening
Important to be upfront with your patients so they are not surprised with
Complete Solution
When assessing a female for HSV, a common spot that is often overlooked is
- ANSWER the perineum
The Bartholean glands are located - ANSWER the lower part of the vaginal
opening, 5 and 7 o'clock
The Skenes glands are located - ANSWER the upper part of the vulva, 11 and
1 o'clock
In a healthy pregnancy, embryo should attach where? - ANSWER The fundus
of the uterus
Where is the most common site for breast cancer? - ANSWER The tail of
spence, or the breast tissue that extends up into the axilla
Where are the breast lymph nodes located and why is this important? -
ANSWER In the axilla
Important to palpate, common site for breast cancer
Define the following terms:
ammenorhea
dysmennorhea
menorrhagia
metorhagia - ANSWER ammenorhea: absence of period
,dysmennorhea: painful periods
menorrhagia: heavy bleeding, periods lasting >7 days
metorhagia: bleeding from uterus between menstrual periods
What is the only way to confirm a diagnosis of endometriosis? - ANSWER
Laproscopy
What is a colposcopy? - ANSWER Colposcopy is a procedure to closely
examine the cervix, vagina and vulva for signs of disease with the use of a
colposcope. It may be recommended after an abnormal pap smear to further
diagnose.
What is the LEEP procedure? - ANSWER procedure for cervical CA that cuts
out or freezes abnormal cells
What are the most common vaginal infections (STI and not STI)? - ANSWER
BV
HPV
Are annual exams the same thing as pap smears? - ANSWER No
Annual exam is performed annually regardless of if there is a pap or not
(paps are not as frequent as annually)
Pelvic exam should be annually
Travel history is important for women of childbearing age for what reason? -
ANSWER many diseases that are dangerous to fetuses are associated with
travel, such as Zika, Ebola
When asking a woman about breast cancer family history, what is a big red
flag? - ANSWER breast cancer on mom's side (higher risk)
,How do you perform a breast exam? - ANSWER Patient should be supine
Uncover one breast at a time
inspect for visual changes: dimpling, retractions, masses, etc.
Palpate in your preferred way (could be circular, up and down, etc) from
nodes to junction of clavicle and sternum
Bare hands are preferred if no open sores or discharge
Press breast tissue against the chest wall in small, circular motions (scoop,
don't pick up hands)
Don't forget about the tail
Palpate around areola and nipple (look for discharge)
Look at breasts in different positions: leaning forward, one arm above head,
arms out, etc, may uncover masses you wouldn't have otherwise seen
If you come across a normal cystic area on breast exam, what should you do?
- ANSWER Have the woman feel it so she can be familiar or tell you if it's
normal for her
What is the timeframe to get a mammogram after an exam? - ANSWER
Within 3 months if screening, ASAP if diagnostic
What is teaching required for a breast self exam? - ANSWER first they are no
longer recommended by USPSTF but it is up to provider and patient
, preference
Second, make sure they know to do it immediately after menses to avoid
increased risk of fibrocystic changes/false positives (if no menses, do it
whenever but just keep it consistent)
Educate on risk of false positives and benefits (getting familiar with what is
normal for her breasts)
What are fibrocystic breast changes? Treatment recommendations? -
ANSWER VERY common source of mastalgia, etiology unknown but suspect
hormonal
Reduce caffeine and nicotine, may use Vit E or evening primrose oil (not
resource based)
These changes are not associated with cancer risk unless in patients who
avoid getting checked out or getting mammograms
What do fibrocystic breast changes feel like? What are symptoms? - ANSWER
Lumpy, bumpy, not a MASS
Mastalgia, bilateral typically, tender axillary nodes, may have nipple
discharge
If you find a mass, how is the mammogram billed? - ANSWER As a diagnostic
mammogram rather than screening
Important to be upfront with your patients so they are not surprised with
