Test Bank For Guidelines for Nurse Practitioners in Gynecologic Settings 12th Edition By Heidi Collins
Test Bank For Guidelines for Nurse Practitioners in Gynecologic
Settings 12th Edition By Heidi Collins
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?
,Test Bank For Guidelines for Nurse Practitioners in Gynecologic Settings 12th Edition By Heidi Collins
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 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?
,Test Bank For Guidelines for Nurse Practitioners in Gynecologic Settings 12th Edition By Heidi Collins
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.
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.
c. Tell me about your undergarments. Ill explain the examination procedure,
and then we 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.
, Test Bank For Guidelines for Nurse Practitioners in Gynecologic Settings 12th Edition By Heidi Collins
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?
a. Inform the woman that vaginal creams may interfere with the Papanicolaou
(Pap) test
for which she is scheduled.
b. Reassure the woman that using vaginal cream is not a problem for the
examination.
c. Ask the woman to describe the symptoms that indicate to her that she has
a vaginal infection.
d. Ask the woman to reschedule the appointment for the examination.
ANS: C
An important element of the health history and physical examination is the clients
description of any symptoms she may be experiencing. The best response is for
the nurse to inquire about the symptoms the woman is experiencing. Women
should not douche, use vaginal medications, or
have sexual intercourse for 24 to 48 hours before obtaining a Pap test. Although
the woman may need to reschedule a visit for her Pap test, her current symptoms
should still be addressed.
7. Preconception and prenatal care have become important components of
womens health. What is the guiding principal of preconception care?
a. Ensure that pregnancy complications do not occur.
b. Identify the woman who should not become pregnant.
c. Encourage healthy lifestyles for families desiring pregnancy.
Test Bank For Guidelines for Nurse Practitioners in Gynecologic
Settings 12th Edition By Heidi Collins
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?
,Test Bank For Guidelines for Nurse Practitioners in Gynecologic Settings 12th Edition By Heidi Collins
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 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?
,Test Bank For Guidelines for Nurse Practitioners in Gynecologic Settings 12th Edition By Heidi Collins
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.
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.
c. Tell me about your undergarments. Ill explain the examination procedure,
and then we 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.
, Test Bank For Guidelines for Nurse Practitioners in Gynecologic Settings 12th Edition By Heidi Collins
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?
a. Inform the woman that vaginal creams may interfere with the Papanicolaou
(Pap) test
for which she is scheduled.
b. Reassure the woman that using vaginal cream is not a problem for the
examination.
c. Ask the woman to describe the symptoms that indicate to her that she has
a vaginal infection.
d. Ask the woman to reschedule the appointment for the examination.
ANS: C
An important element of the health history and physical examination is the clients
description of any symptoms she may be experiencing. The best response is for
the nurse to inquire about the symptoms the woman is experiencing. Women
should not douche, use vaginal medications, or
have sexual intercourse for 24 to 48 hours before obtaining a Pap test. Although
the woman may need to reschedule a visit for her Pap test, her current symptoms
should still be addressed.
7. Preconception and prenatal care have become important components of
womens health. What is the guiding principal of preconception care?
a. Ensure that pregnancy complications do not occur.
b. Identify the woman who should not become pregnant.
c. Encourage healthy lifestyles for families desiring pregnancy.
