GUIDELINES FOR NURSE PRACTITIONERS IN GYNECOLOGIC
SETTINGS 13TH EDITION BY HAWKINS ROBERTO NICHOLS
STANLEY HANEY TEST BANK
,Guidelines for Nurse Practitioners in Gynecologic Settings, 13th Edition Testbank
Chapter 1. Well-Woman Initial/Annual Gynecologic Exam
1. Due to the effects of cyclic ovarian changes in the breast, when is the best
time for breast self- examination (BSE)?
a. Between 5 and 7 days after menses ceases
b. Day 1 of the endometrial cycle
c. Midmenstrual cycle
d. Any time during a shower or bath
ANS: A
The physiologic alterations in breast size and activity reach their minimal level
approximately 5
to 7 days after menstruation ceases. Therefore, BSE is best performed during this
phase of the menstrual cycle. Day 1 of the endometrial cycle is too early to
perform an accurate BSE. After the midmenstrual cycle, breasts are likely to
become tender and increase in size, which is not the ideal time to perform BSE.
Lying down after a shower or bath with a small towel under the shoulder of the
side being examined is appropriate teaching for BSE. A secondary BSE may be
performed while in the shower.
2. Individual irregularities in the ovarian (menstrual) cycle are most often
caused by what?
a. Variations in the follicular (preovulatory) phase
b. Intact hypothalamic-pituitary feedback mechanism
c. Functioning corpus luteum
d. Prolonged ischemic phase
ANS: A
Almost all variations in the length of the ovarian cycle are the result of variations
in the length of
the follicular phase. An intact hypothalamic-pituitary feedback mechanism would
be regular, not irregular. The luteal phase begins after ovulation. The corpus
luteum is dependent on the ovulatory phase and fertilization. During the ischemic
2
,Guidelines for Nurse Practitioners in Gynecologic Settings, 13th Edition Testbank
phase, the blood supply to the functional endometrium is blocked, and necrosis
develops. The functional layer separates from the basal layer, and menstrual
bleeding begins.
3. How would the physiologic process of the sexual response best be
characterized?
a. Coitus, masturbation, and fantasy
b. Myotonia and vasocongestion
c. Erection and orgasm
d. Excitement, plateau, and orgasm
ANS: B
Physiologically, according to Masters (1992), sexual response can be analyzed in
terms of two
processes: vasocongestion and myotonia. Coitus, masturbation, and fantasy are
forms of stimulation for the physical manifestation of the sexual response.
Erection and orgasm occur in
two of the four phases of the sexual response cycle. Excitement, plateau, and
orgasm are three of the four phases of the sexual response cycle.
4. Which action would be inappropriate for the nurse to perform before
beginning the health history interview?
a. Smile and ask the client whether she has any special concerns.
b. Speak in a relaxed manner with an even, nonjudgmental tone.
c. Make the client comfortable.
d. Tell the client her questions are irrelevant.
ANS: D
The woman should be assured that all of her questions are relevant and
important. Beginning any
client interaction with a smile is important and assists in putting the client at ease.
If the nurse speaks in a relaxed manner, then the client will likely be more relaxed
during the interview. The clients comfort should always be ensured before
beginning the interview.
3
, Guidelines for Nurse Practitioners in Gynecologic Settings, 13th Edition Testbank
5. The nurse guides a woman to the examination room and asks her to remove
her clothes and put on an examination gown with the front open. The woman
replies, I have special undergarments that I do not remove for religious reasons.
Which is the most appropriate response from the nurse?
a. You cant have an examination without removing all your clothes.
b. Ill ask the physician to modify the examination.
Tell me about your undergarments. Ill explain the examination procedure, and
then we
c. can discuss how you can comfortably have your examination.
d. I have no idea how we can accommodate your beliefs.
ANS: C
Explaining the examination procedure reflects cultural competence by the nurse
and shows
respect for the womans religious practices. The nurse must respect the rich and
unique qualities that cultural diversity brings to individuals. The examination can
be modified to ensure that modesty is maintained. In recognizing the value of
cultural differences, the nurse can modify the plan of care to meet the needs of
each woman. Telling the client that her religious practices are different or strange
is inappropriate and disrespectful to the client.
6. A woman arrives at the clinic for her annual examination. She tells the nurse
that she thinks she has a vaginal infection, and she has been using an over-the-
counter cream for the past 2 days to treat it. How should the nurse initially
respond?
Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap)
test
a. for which she is scheduled.
b. Reassure the woman that using vaginal cream is not a problem for the
examination. Ask the woman to describe the symptoms that indicate to her that
she has a vaginal
c. infection.
d. Ask the woman to reschedule the appointment for the examination.
4
SETTINGS 13TH EDITION BY HAWKINS ROBERTO NICHOLS
STANLEY HANEY TEST BANK
,Guidelines for Nurse Practitioners in Gynecologic Settings, 13th Edition Testbank
Chapter 1. Well-Woman Initial/Annual Gynecologic Exam
1. Due to the effects of cyclic ovarian changes in the breast, when is the best
time for breast self- examination (BSE)?
a. Between 5 and 7 days after menses ceases
b. Day 1 of the endometrial cycle
c. Midmenstrual cycle
d. Any time during a shower or bath
ANS: A
The physiologic alterations in breast size and activity reach their minimal level
approximately 5
to 7 days after menstruation ceases. Therefore, BSE is best performed during this
phase of the menstrual cycle. Day 1 of the endometrial cycle is too early to
perform an accurate BSE. After the midmenstrual cycle, breasts are likely to
become tender and increase in size, which is not the ideal time to perform BSE.
Lying down after a shower or bath with a small towel under the shoulder of the
side being examined is appropriate teaching for BSE. A secondary BSE may be
performed while in the shower.
2. Individual irregularities in the ovarian (menstrual) cycle are most often
caused by what?
a. Variations in the follicular (preovulatory) phase
b. Intact hypothalamic-pituitary feedback mechanism
c. Functioning corpus luteum
d. Prolonged ischemic phase
ANS: A
Almost all variations in the length of the ovarian cycle are the result of variations
in the length of
the follicular phase. An intact hypothalamic-pituitary feedback mechanism would
be regular, not irregular. The luteal phase begins after ovulation. The corpus
luteum is dependent on the ovulatory phase and fertilization. During the ischemic
2
,Guidelines for Nurse Practitioners in Gynecologic Settings, 13th Edition Testbank
phase, the blood supply to the functional endometrium is blocked, and necrosis
develops. The functional layer separates from the basal layer, and menstrual
bleeding begins.
3. How would the physiologic process of the sexual response best be
characterized?
a. Coitus, masturbation, and fantasy
b. Myotonia and vasocongestion
c. Erection and orgasm
d. Excitement, plateau, and orgasm
ANS: B
Physiologically, according to Masters (1992), sexual response can be analyzed in
terms of two
processes: vasocongestion and myotonia. Coitus, masturbation, and fantasy are
forms of stimulation for the physical manifestation of the sexual response.
Erection and orgasm occur in
two of the four phases of the sexual response cycle. Excitement, plateau, and
orgasm are three of the four phases of the sexual response cycle.
4. Which action would be inappropriate for the nurse to perform before
beginning the health history interview?
a. Smile and ask the client whether she has any special concerns.
b. Speak in a relaxed manner with an even, nonjudgmental tone.
c. Make the client comfortable.
d. Tell the client her questions are irrelevant.
ANS: D
The woman should be assured that all of her questions are relevant and
important. Beginning any
client interaction with a smile is important and assists in putting the client at ease.
If the nurse speaks in a relaxed manner, then the client will likely be more relaxed
during the interview. The clients comfort should always be ensured before
beginning the interview.
3
, Guidelines for Nurse Practitioners in Gynecologic Settings, 13th Edition Testbank
5. The nurse guides a woman to the examination room and asks her to remove
her clothes and put on an examination gown with the front open. The woman
replies, I have special undergarments that I do not remove for religious reasons.
Which is the most appropriate response from the nurse?
a. You cant have an examination without removing all your clothes.
b. Ill ask the physician to modify the examination.
Tell me about your undergarments. Ill explain the examination procedure, and
then we
c. can discuss how you can comfortably have your examination.
d. I have no idea how we can accommodate your beliefs.
ANS: C
Explaining the examination procedure reflects cultural competence by the nurse
and shows
respect for the womans religious practices. The nurse must respect the rich and
unique qualities that cultural diversity brings to individuals. The examination can
be modified to ensure that modesty is maintained. In recognizing the value of
cultural differences, the nurse can modify the plan of care to meet the needs of
each woman. Telling the client that her religious practices are different or strange
is inappropriate and disrespectful to the client.
6. A woman arrives at the clinic for her annual examination. She tells the nurse
that she thinks she has a vaginal infection, and she has been using an over-the-
counter cream for the past 2 days to treat it. How should the nurse initially
respond?
Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap)
test
a. for which she is scheduled.
b. Reassure the woman that using vaginal cream is not a problem for the
examination. Ask the woman to describe the symptoms that indicate to her that
she has a vaginal
c. infection.
d. Ask the woman to reschedule the appointment for the examination.
4
