APEA EXAM – WOMEN’S HEALTH TEST BANK
APEA EXAM – WOMEN’S HEALTH TEST BANK
1. Question:
When palpating the cervix during the bimanual exam, cervical motion tenderness (chandelier sign) is
noted. This tenderness could be suggestive of:
pelvic inflammatory disease
Explanation:
Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal tenderness, suggest pelvic
inflammatory disease, ectopic pregnancy, or appendicitis.
2. Question:
In a female diagnosed with a first-degree uterine prolapse, the cervix:
has slipped but is well within the vagina
Explanation:
Uterine prolapse occurs in progressive stages. The uterus becomes retroverted and descends down the
vaginal canal to the exterior. In first-degree prolapse, the cervix is still well within the vagina. In second-
degree prolapse, it is at the introitus. In third-degree prolapse (procidentia), the cervix and vagina are
outside the introitus.
3. Question:
Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at a high risk for developing
all of the following abnormalities except:
a slit- like cervical os. Correct
Explanation:
Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at greatly increased risk for
several abnormalities: columnar epithelium that covers most or all of the cervix vaginal adenosis, and a
circular collar or ridge of tissue, of varying shapes, between the cervix and vagina. The slit-like cervical os
is a normal variation.
4. Question:
A female patient presents with a profuse, yellowish, green vaginal discharge that is malodorous. This
vaginal discharge is most consistent with:
,APEA EXAM – WOMEN’S HEALTH TEST BANK
Trichomonal vaginitis
Explanation:
Trichomonas vaginalis causes trichomonal vaginitis. Presenting symptoms include a profuse, yellowish,
green vaginal discharge that is malodorous. Candidal vaginitis produces a white and curd-like thin
discharge that is rarely malodorous. With bacterial vaginosis, the discharge can be gray or white, thin,
malodorous (fishy), and not usually profuse. The discharge associated with gonorrhea is usually thick
and bloody.
5. Question:
The most common causes of sexual problems in females are related to:
psychosocial factors
Explanation:
The most common problems that occur during sexual activity are related to situational or psychosocial
factors. Although lack of desire, inadequate vaginal lubrication, and pelvic disorders may all contribute
to sexual problems, the most common causes are situational and psychosocial in origin. Therefore,
obtaining a comprehensive sexual history is of utmost importance.
6. Question:
Chronic pelvic pain refers to pain that does not respond to therapy and:
lasts more than 6 months
Explanation:
According to the International Pelvic Pain Society, chronic pelvic pain refers to pain that lasts more than
6 months without response to treatment.
7. Question:
In female patients with dyspareunia, superficial pain is most likely related to all of the following except:
pressure on a normal ovary
Explanation:
In females, dyspareunia, or painful intercourse, can occur at the vaginal opening, occurring at the start
of intercourse, or when the partner is pushing deeper. It is important to differentiate the pain to
determine the etiology. Superficial pain suggests local inflammation, atrophic vaginitis, or inadequate
lubrication. Deeper pain may be from pelvic disorders or pressure on a normal ovary.
8. Question:
, APEA EXAM – WOMEN’S HEALTH TEST BANK
If urethritis or inflammation of the paraurethral glands is suspected in a female patient, the index finger
should be inserted into the vagina and:
milk the urethra gently from the inside outward
Explanation:
If urethritis or inflammation of the paraurethral glands is suspected, the examiner should insert the
index finger into the vagina and milk the urethra gently from inside outward. Note any discharge from or
about the urethral meatus. If present, it should be cultured.
9. Question:
Upon examination of the vagina, a swollen red ring is noted around the urethral opening. This finding is
most consistent with a:
prolapse of the urethral mucosa
Explanation:
A prolapsed urethral mucosa forms a swollen red ring around the urethral meatus. A urethral caruncle is
a small, red, benign tumor visible at the posterior part of the urethral meatus. It usually occurs in
postmenopausal women. A cystocele is a bulge of the upper two-thirds of the anterior vaginal wall and
the bladder above it. It results from weakened supporting tissues. When the entire anterior vaginal wall,
together with the bladder and urethra, is involved in the bulge, a cystourethrocele is present.
10. Question:
When performing a bimanual vaginal exam, a solid, nodular-like lesion is palpated over the right ovary.
This finding is most consistent with:
an ovarian tumor
Explanation:
Ovarian tumors appear solid and often nodular upon palpation. Ovarian cancer is relatively rare and
usually presents at an advanced stage with symptoms of pelvic pain, increased abdominal size, and
urinary tract symptoms. An ovarian cyst tends to be smooth and compressible and if uncomplicated,
nontender. A right tubal pregnancy does not typically present with an ovarian lesion. A tubo-ovarian
abscess is difficult to palpate and typically presents with severe pain and purulent vaginal discharge.
11. Question:
Indications for performing a rectovaginal exam include all of the following except to:
assess an inguinal hernia
Explanation:
APEA EXAM – WOMEN’S HEALTH TEST BANK
1. Question:
When palpating the cervix during the bimanual exam, cervical motion tenderness (chandelier sign) is
noted. This tenderness could be suggestive of:
pelvic inflammatory disease
Explanation:
Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal tenderness, suggest pelvic
inflammatory disease, ectopic pregnancy, or appendicitis.
2. Question:
In a female diagnosed with a first-degree uterine prolapse, the cervix:
has slipped but is well within the vagina
Explanation:
Uterine prolapse occurs in progressive stages. The uterus becomes retroverted and descends down the
vaginal canal to the exterior. In first-degree prolapse, the cervix is still well within the vagina. In second-
degree prolapse, it is at the introitus. In third-degree prolapse (procidentia), the cervix and vagina are
outside the introitus.
3. Question:
Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at a high risk for developing
all of the following abnormalities except:
a slit- like cervical os. Correct
Explanation:
Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at greatly increased risk for
several abnormalities: columnar epithelium that covers most or all of the cervix vaginal adenosis, and a
circular collar or ridge of tissue, of varying shapes, between the cervix and vagina. The slit-like cervical os
is a normal variation.
4. Question:
A female patient presents with a profuse, yellowish, green vaginal discharge that is malodorous. This
vaginal discharge is most consistent with:
,APEA EXAM – WOMEN’S HEALTH TEST BANK
Trichomonal vaginitis
Explanation:
Trichomonas vaginalis causes trichomonal vaginitis. Presenting symptoms include a profuse, yellowish,
green vaginal discharge that is malodorous. Candidal vaginitis produces a white and curd-like thin
discharge that is rarely malodorous. With bacterial vaginosis, the discharge can be gray or white, thin,
malodorous (fishy), and not usually profuse. The discharge associated with gonorrhea is usually thick
and bloody.
5. Question:
The most common causes of sexual problems in females are related to:
psychosocial factors
Explanation:
The most common problems that occur during sexual activity are related to situational or psychosocial
factors. Although lack of desire, inadequate vaginal lubrication, and pelvic disorders may all contribute
to sexual problems, the most common causes are situational and psychosocial in origin. Therefore,
obtaining a comprehensive sexual history is of utmost importance.
6. Question:
Chronic pelvic pain refers to pain that does not respond to therapy and:
lasts more than 6 months
Explanation:
According to the International Pelvic Pain Society, chronic pelvic pain refers to pain that lasts more than
6 months without response to treatment.
7. Question:
In female patients with dyspareunia, superficial pain is most likely related to all of the following except:
pressure on a normal ovary
Explanation:
In females, dyspareunia, or painful intercourse, can occur at the vaginal opening, occurring at the start
of intercourse, or when the partner is pushing deeper. It is important to differentiate the pain to
determine the etiology. Superficial pain suggests local inflammation, atrophic vaginitis, or inadequate
lubrication. Deeper pain may be from pelvic disorders or pressure on a normal ovary.
8. Question:
, APEA EXAM – WOMEN’S HEALTH TEST BANK
If urethritis or inflammation of the paraurethral glands is suspected in a female patient, the index finger
should be inserted into the vagina and:
milk the urethra gently from the inside outward
Explanation:
If urethritis or inflammation of the paraurethral glands is suspected, the examiner should insert the
index finger into the vagina and milk the urethra gently from inside outward. Note any discharge from or
about the urethral meatus. If present, it should be cultured.
9. Question:
Upon examination of the vagina, a swollen red ring is noted around the urethral opening. This finding is
most consistent with a:
prolapse of the urethral mucosa
Explanation:
A prolapsed urethral mucosa forms a swollen red ring around the urethral meatus. A urethral caruncle is
a small, red, benign tumor visible at the posterior part of the urethral meatus. It usually occurs in
postmenopausal women. A cystocele is a bulge of the upper two-thirds of the anterior vaginal wall and
the bladder above it. It results from weakened supporting tissues. When the entire anterior vaginal wall,
together with the bladder and urethra, is involved in the bulge, a cystourethrocele is present.
10. Question:
When performing a bimanual vaginal exam, a solid, nodular-like lesion is palpated over the right ovary.
This finding is most consistent with:
an ovarian tumor
Explanation:
Ovarian tumors appear solid and often nodular upon palpation. Ovarian cancer is relatively rare and
usually presents at an advanced stage with symptoms of pelvic pain, increased abdominal size, and
urinary tract symptoms. An ovarian cyst tends to be smooth and compressible and if uncomplicated,
nontender. A right tubal pregnancy does not typically present with an ovarian lesion. A tubo-ovarian
abscess is difficult to palpate and typically presents with severe pain and purulent vaginal discharge.
11. Question:
Indications for performing a rectovaginal exam include all of the following except to:
assess an inguinal hernia
Explanation:
