,
,Guidelines for Nurse Practitioners in Gynecologic Settings, 12th Edition
th th th th th th th th
Testbank/Studyguide
Chapterth1.thWell-WomanthInitial/AnnualthGynecologicthExam
1. Duethtoththetheffectsthofthcyclicthovarianthchangesthinththethbreast,thwhenthisththethbestthtimethforthbreastthse
lf-thexaminationth(BSE)?
a. Betweenth5thandth7thdaysthafterthmensesthceases
b. Dayth1th ofththethendometrialthcycle
c. Midmenstrualthcycle
d. Anythtimethduringthathshowerthorthbat
hthANS:thA
Thethphysiologicthalterationsthinthbreastthsizethandthactivitythreachththeirthminimalthlevelthapproximatelyth5
toth7thdaysthafterthmenstruationthceases.thTherefore,thBSEthisthbestthperformedthduringththisthphasethofththet
hmenstrualthcycle.thDayth1thofththethendometrialthcyclethisthtoothearlythtothperformthanthaccuratethBSE.thAfte
rththethmidmenstrualthcycle,thbreaststharethlikelythtothbecomethtenderthandthincreasethinthsize,thwhichthisthnotth
thethidealthtimethtothperformthBSE.thLyingthdownthafterthathshowerthorthbaththwiththathsmallthtowelthunderthth
ethshoulderthofththethsidethbeingthexaminedthisthappropriatethteachingthforthBSE.thAthsecondarythBSEthmayt
hbethperformedthwhilethinththethshower.
2. Individualthirregularitiesthinththethovarianth(menstrual)thcycletharethmostthoftenthcausedthbythwhat?
a. Variationsthinththethfollicularth(preovulatory)thphase
b. Intactthhypothalamic-pituitarythfeedbackthmechanism
c. Functioningthcorpusthluteum
d. Prolongedthischemicthphase
thANS:thA
Almostthallthvariationsthinththethlengththofththethovarianthcyclethareththethresultthofthvariationsthinththethlengththof
thethfollicularthphase.thAnthintactthhypothalamic-
pituitarythfeedbackthmechanismthwouldthbethregular,thnotthirregular.thThethlutealthphasethbeginsthafterthov
ulation.thThethcorpusthluteumthisthdependentthonththethovulatorythphasethandthfertilization.thDuringththethis
chemicthphase,ththethbloodthsupplythtoththethfunctionalthendometriumthisthblocked,thandthnecrosisthdevelo
ps.thThethfunctionalthlayerthseparatesthfromththethbasalthlayer,thandthmenstrualthbleedingthbegins.
3. Howthwouldththethphysiologicthprocessthofththethsexualthresponsethbestthbethcharacterized?
a. Coitus,thmasturbation,thandthfantasy
b. Myotoniathandthvasocongestion
c. Erectionthandthorgasm
d. Excitement,thplateau,thandthorgasm
thANS:thB
Physiologically,thaccordingthtothMastersth(1992),thsexualthresponsethcanthbethanalyzedthinthtermsthofthtwo
processes:thvasocongestionthandthmyotonia.thCoitus,thmasturbation,thandthfantasytharethformsthofthstimul
ationthforththethphysicalthmanifestationthofththethsexualthresponse.thErectionthandthorgasmthoccurthin
, twothofththethfourthphasesthofththethsexualthresponsethcycle.thExcitement,thplateau,thandthorgasmthareththreeth
ofththethfourthphasesthofththethsexualthresponsethcycle.
4. Whichthactionthwouldthbethinappropriatethforththethnursethtothperformthbeforethbeginningththethheal
ththhistorythinterview?
a. Smilethandthaskththethclientthwhetherthshethhasthanythspecialthconcerns.
b. Speakthinthathrelaxedthmannerthwiththantheven,thnonjudgmentalthtone.
c. Makeththethclientthcomfortable.
d. Tellththethclientthherthquestionstharethirrelevant
.thANS:thD
Thethwomanthshouldthbethassuredththatthallthofthherthquestionstharethrelevantthandthimportant.thBeginningthany
clientthinteractionthwiththathsmilethisthimportantthandthassiststhinthputtingththethclientthatthease.thIfththethnurset
hspeaksthinthathrelaxedthmanner,ththenththethclientthwillthlikelythbethmorethrelaxedthduringththethinterview.thT
hethclientsthcomfortthshouldthalwaysthbethensuredthbeforethbeginningththethinterview.
5. Thethnursethguidesthathwomanthtoththethexaminationthroomthandthasksthherthtothremovethherthclothestha
ndthputthonthanthexaminationthgownthwithththethfrontthopen.thThethwomanthreplies,thIthhavethspecialthun
dergarmentsththatthIthdothnotthremovethforthreligiousthreasons.thWhichthisththethmostthappropriatethresp
onsethfromththethnurse?
a. Youthcantthhavethanthexaminationthwithoutthremovingthallthyourthclothes.
b. Illthaskththethphysicianthtothmodifyththethexamination.
Tellthmethaboutthyourthundergarments.thIllthexplainththethexaminationthprocedure,thandththenthwe
c. canthdiscussthhowthyouthcanthcomfortablythhavethyourthexamination.
d. Ithhavethnothideathhowthwethcanthaccommodatethyourthbelief
s.thANS:thC
Explainingththethexaminationthprocedurethreflectsthculturalthcompetencethbyththethnursethandthshows
respectthforththethwomansthreligiousthpractices.thThethnursethmustthrespectththethrichthandthuniquethqualitie
sththatthculturalthdiversitythbringsthtothindividuals.thThethexaminationthcanthbethmodifiedthtothensureththatth
modestythisthmaintained.thInthrecognizingththethvaluethofthculturalthdifferences,ththethnursethcanthmodifythth
ethplanthofthcarethtothmeetththethneedsthoftheachthwoman.thTellingththethclientththatthherthreligiousthpracticesth
arethdifferentthorthstrangethisthinappropriatethandthdisrespectfulthtoththethclient.
6. Athwomantharrivesthatththethclinicthforthherthannualthexamination.thShethtellsththethnurseththatthsheththink
sthshethhasthathvaginalthinfection,thandthshethhasthbeenthusingthanthover-the-
counterthcreamthforththethpastth2thdaysthtothtreatthit.thHowthshouldththethnursethinitiallythrespond?
InformththethwomanththatthvaginalthcreamsthmaythinterferethwithththethPapanicolaouth(Pap)thtest
a. forthwhichthshethisthscheduled.
b. Reassureththethwomanththatthusingthvaginalthcreamthisthnotthathproblemthforththethexaminatio
n.thAskththethwomanthtothdescribeththethsymptomsththatthindicatethtothherththatthshethhasthathva
ginal
c. infection.
d. Askththethwomanthtothrescheduleththethappointmentthforththethexaminatio
n.thANS:thC
Anthimportantthelementthofththethhealththhistorythandthphysicalthexaminationthisththethclientsthdescriptionthof
anythsymptomsthshethmaythbethexperiencing.thThethbestthresponsethisthforththethnursethtothinquirethaboutththethsym
ptomsththethwomanthisthexperiencing.thWomenthshouldthnotthdouche,thusethvaginalthmedications,thor
,Guidelines for Nurse Practitioners in Gynecologic Settings, 12th Edition
th th th th th th th th
Testbank/Studyguide
Chapterth1.thWell-WomanthInitial/AnnualthGynecologicthExam
1. Duethtoththetheffectsthofthcyclicthovarianthchangesthinththethbreast,thwhenthisththethbestthtimethforthbreastthse
lf-thexaminationth(BSE)?
a. Betweenth5thandth7thdaysthafterthmensesthceases
b. Dayth1th ofththethendometrialthcycle
c. Midmenstrualthcycle
d. Anythtimethduringthathshowerthorthbat
hthANS:thA
Thethphysiologicthalterationsthinthbreastthsizethandthactivitythreachththeirthminimalthlevelthapproximatelyth5
toth7thdaysthafterthmenstruationthceases.thTherefore,thBSEthisthbestthperformedthduringththisthphasethofththet
hmenstrualthcycle.thDayth1thofththethendometrialthcyclethisthtoothearlythtothperformthanthaccuratethBSE.thAfte
rththethmidmenstrualthcycle,thbreaststharethlikelythtothbecomethtenderthandthincreasethinthsize,thwhichthisthnotth
thethidealthtimethtothperformthBSE.thLyingthdownthafterthathshowerthorthbaththwiththathsmallthtowelthunderthth
ethshoulderthofththethsidethbeingthexaminedthisthappropriatethteachingthforthBSE.thAthsecondarythBSEthmayt
hbethperformedthwhilethinththethshower.
2. Individualthirregularitiesthinththethovarianth(menstrual)thcycletharethmostthoftenthcausedthbythwhat?
a. Variationsthinththethfollicularth(preovulatory)thphase
b. Intactthhypothalamic-pituitarythfeedbackthmechanism
c. Functioningthcorpusthluteum
d. Prolongedthischemicthphase
thANS:thA
Almostthallthvariationsthinththethlengththofththethovarianthcyclethareththethresultthofthvariationsthinththethlengththof
thethfollicularthphase.thAnthintactthhypothalamic-
pituitarythfeedbackthmechanismthwouldthbethregular,thnotthirregular.thThethlutealthphasethbeginsthafterthov
ulation.thThethcorpusthluteumthisthdependentthonththethovulatorythphasethandthfertilization.thDuringththethis
chemicthphase,ththethbloodthsupplythtoththethfunctionalthendometriumthisthblocked,thandthnecrosisthdevelo
ps.thThethfunctionalthlayerthseparatesthfromththethbasalthlayer,thandthmenstrualthbleedingthbegins.
3. Howthwouldththethphysiologicthprocessthofththethsexualthresponsethbestthbethcharacterized?
a. Coitus,thmasturbation,thandthfantasy
b. Myotoniathandthvasocongestion
c. Erectionthandthorgasm
d. Excitement,thplateau,thandthorgasm
thANS:thB
Physiologically,thaccordingthtothMastersth(1992),thsexualthresponsethcanthbethanalyzedthinthtermsthofthtwo
processes:thvasocongestionthandthmyotonia.thCoitus,thmasturbation,thandthfantasytharethformsthofthstimul
ationthforththethphysicalthmanifestationthofththethsexualthresponse.thErectionthandthorgasmthoccurthin
, twothofththethfourthphasesthofththethsexualthresponsethcycle.thExcitement,thplateau,thandthorgasmthareththreeth
ofththethfourthphasesthofththethsexualthresponsethcycle.
4. Whichthactionthwouldthbethinappropriatethforththethnursethtothperformthbeforethbeginningththethheal
ththhistorythinterview?
a. Smilethandthaskththethclientthwhetherthshethhasthanythspecialthconcerns.
b. Speakthinthathrelaxedthmannerthwiththantheven,thnonjudgmentalthtone.
c. Makeththethclientthcomfortable.
d. Tellththethclientthherthquestionstharethirrelevant
.thANS:thD
Thethwomanthshouldthbethassuredththatthallthofthherthquestionstharethrelevantthandthimportant.thBeginningthany
clientthinteractionthwiththathsmilethisthimportantthandthassiststhinthputtingththethclientthatthease.thIfththethnurset
hspeaksthinthathrelaxedthmanner,ththenththethclientthwillthlikelythbethmorethrelaxedthduringththethinterview.thT
hethclientsthcomfortthshouldthalwaysthbethensuredthbeforethbeginningththethinterview.
5. Thethnursethguidesthathwomanthtoththethexaminationthroomthandthasksthherthtothremovethherthclothestha
ndthputthonthanthexaminationthgownthwithththethfrontthopen.thThethwomanthreplies,thIthhavethspecialthun
dergarmentsththatthIthdothnotthremovethforthreligiousthreasons.thWhichthisththethmostthappropriatethresp
onsethfromththethnurse?
a. Youthcantthhavethanthexaminationthwithoutthremovingthallthyourthclothes.
b. Illthaskththethphysicianthtothmodifyththethexamination.
Tellthmethaboutthyourthundergarments.thIllthexplainththethexaminationthprocedure,thandththenthwe
c. canthdiscussthhowthyouthcanthcomfortablythhavethyourthexamination.
d. Ithhavethnothideathhowthwethcanthaccommodatethyourthbelief
s.thANS:thC
Explainingththethexaminationthprocedurethreflectsthculturalthcompetencethbyththethnursethandthshows
respectthforththethwomansthreligiousthpractices.thThethnursethmustthrespectththethrichthandthuniquethqualitie
sththatthculturalthdiversitythbringsthtothindividuals.thThethexaminationthcanthbethmodifiedthtothensureththatth
modestythisthmaintained.thInthrecognizingththethvaluethofthculturalthdifferences,ththethnursethcanthmodifythth
ethplanthofthcarethtothmeetththethneedsthoftheachthwoman.thTellingththethclientththatthherthreligiousthpracticesth
arethdifferentthorthstrangethisthinappropriatethandthdisrespectfulthtoththethclient.
6. Athwomantharrivesthatththethclinicthforthherthannualthexamination.thShethtellsththethnurseththatthsheththink
sthshethhasthathvaginalthinfection,thandthshethhasthbeenthusingthanthover-the-
counterthcreamthforththethpastth2thdaysthtothtreatthit.thHowthshouldththethnursethinitiallythrespond?
InformththethwomanththatthvaginalthcreamsthmaythinterferethwithththethPapanicolaouth(Pap)thtest
a. forthwhichthshethisthscheduled.
b. Reassureththethwomanththatthusingthvaginalthcreamthisthnotthathproblemthforththethexaminatio
n.thAskththethwomanthtothdescribeththethsymptomsththatthindicatethtothherththatthshethhasthathva
ginal
c. infection.
d. Askththethwomanthtothrescheduleththethappointmentthforththethexaminatio
n.thANS:thC
Anthimportantthelementthofththethhealththhistorythandthphysicalthexaminationthisththethclientsthdescriptionthof
anythsymptomsthshethmaythbethexperiencing.thThethbestthresponsethisthforththethnursethtothinquirethaboutththethsym
ptomsththethwomanthisthexperiencing.thWomenthshouldthnotthdouche,thusethvaginalthmedications,thor
