SOLVED!!! NR 509 COMPREHENSIVE REVIEW OF JARVIS 7TH EDITION CHAPTER 26 QUESTIONS (Female Genitourinary System: Physical Examination & Health Assessment)

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SOLVED!!! NR 509 COMPREHENSIVE REVIEW OF JARVIS 7TH EDITION CHAPTER 26 QUESTIONS (Female Genitourinary System: Physical Examination & Health Assessment) ◇This material contains comprehensive summary... of information in the form of great test questions with descriptive answers helpful for exams study. Thorough Review of Jarvis 7th Edition Chapter 26 Questions. All the best Champions!!! _____ MULTIPLE CHOICE 1. During a health history, a 22-year old woman asks, “Can I get that vaccine for human papilloma virus (HPV)? I have genital warts and I’d like them to go away!” What is the nurse’s best response? a. b. c. d. “The HPV vaccine is for girls and women ages 9 to 26 years, so we can start that today.” “This vaccine is only for girls who have not yet started to become sexually active.” “Let’s check with the physician to see if you are a candidate for this vaccine.” “The vaccine cannot protect you if you already have an HPV infection.” ANS: D The HPV vaccine is appropriate for girls and women age 9 to 26 years and is administered to prevent cervical cancer by preventing HPV infections before girls become sexually active. However, it cannot protect the woman if an HPV infection is already present. DIF: Cognitive Level: Analyzing (Analysis) MSC: Client Needs: General REF: p. 740 2. During an examination, the nurse observes a female patient’s vestibule and expects to see the: a. Urethral meatus and vaginal orifice. b. Vaginal orifice and vestibular (Bartholin) glands. c. Urethral meatus and paraurethral (Skene) glands. d. Paraurethral (Skene) and vestibular (Bartholin) glands. ANS: A The labial structures encircle a boat-shaped space, or cleft, termed the vestibule. Within the vestibule are numerous openings. The urethral meatus and vaginal orifice are visible. The ducts of the paraurethral (Skene) glands and the vestibular (Bartholin) glands are present but not visible. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 737 MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation 3. During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal? a. Cervix b. Uterus c. Ovaries d. Fallopian tubes ANS: A At the end of the canal, the uterine cervix projects into the vagina.DIF: Cognitive Level: Remembering (Knowledge) REF: p. 738 MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation 4. The uterus is usually positioned tilting forward and superior to the bladder. This position is known as: a. Anteverted and anteflexed. b. Retroverted and anteflexed. Retroverted and retroflexed. c. d. Superiorverted and anteflexed. ANS: A The uterus is freely movable, not fixed, and usually tilts forward and superior to the bladder (a position labeled as anteverted and anteflexed). DIF: Cognitive Level: Remembering (Knowledge) MSC: Client Needs: General REF: p. 738 5. An 11-year-old girl is in the clinic for a sports physical examination. The nurse notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. The nurse should use which of these techniques to best assist the young girl in understanding the expected sequence for development? The nurse should: a. Use the Tanner scale on the five stages of sexual development. b. Describe her development and compare it with that of other girls her age. c. d. Use the Jacobsen table on expected development on the basis of height and weight data. Reassure her that her development is within normal limits and tell her not to worry about the next step. ANS: A The Tanner scale on the five stages of pubic hair development is helpful in teaching girls the expected sequence of sexual development (see Table 26-1). The other responses are not appropriate. DIF: Cognitive Level: Applying (Application) MSC: Client Needs: Health Promotion and Maintenance 6. A woman who is 8 weeks pregnant is in the clinic for a checkup. The nurse reads on her chart that her cervix is softened and looks cyanotic. The nurse knows that the woman is exhibiting __________ sign and __________ sign. a. Tanner; Hegar b. Hegar; Goodell Chadwick; Hegar c. d. Goodell; Chadwick ANS: D REF: p. 739Shortly after the first missed menstrual period, the female genitalia show signs of the growing fetus. The cervix softens (Goodell sign) at 4 to 6 weeks, and the vaginal mucosa and cervix look cyanotic (Chadwick sign) at 8 to 12 weeks. These changes occur because of increased vascularity and edema of the cervix and hypertrophy and hyperplasia of the cervical glands. Hegar sign occurs when the isthmus of the uterus softens at 6 to 8 weeks. Tanner sign is not a correct response. DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs: Health Promotion and Maintenance REF: p. 739 7. Generally, the changes normally associated with menopause occur because the cells in the reproductive tract are: a. Aging. b. Becoming fibrous. c. Estrogen dependent. d. Able to respond to estrogen. ANS: C Because cells in the reproductive tract are estrogen dependent, decreased estrogen levels during menopause bring dramatic physical changes. The other options are not correct. DIF: Cognitive Level: Remembering (Knowledge) MSC: Client Needs: Health Promotion and Maintenance REF: p. 740 8. The nurse is reviewing the changes that occur with menopause. Which changes are associated with menopause? a. Uterine and ovarian atrophy, along with a thinning of the vaginal epithelium b. Ovarian atrophy, increased vaginal secretions, and increasing clitoral size Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions c. d. Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy ANS: A The uterus shrinks because of its decreased myometrium. The ovaries atrophy to 1 to 2 cm and are not palpable after menopause. The sacral ligaments relax, and the pelvic musculature weakens; consequently, the uterus droops. The cervix shrinks and looks paler with a thick glistening epithelium. The vaginal epithelium atrophies, becoming thinner, drier, and itchy. The vaginal pH becomes more alkaline, and secretions are decreased, which results in a fragile mucosal surface that is at risk for vaginitis. DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs: Health Promotion and Maintenance REF: p. 740 9. A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination. Which of these statements should the nurse include in patient education? “A postmenopausal woman:a. b. c. d. Is not at any greater risk for heart disease than a younger woman.” Should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.” Has only stopped menstruating; there really are no other significant changes with which she should be concerned.” Is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle.” ANS: B Decreased vaginal secretions leave the vagina dry and at risk for irritation and pain with intercourse (dyspareunia). The other statements are incorrect. DIF: Cognitive Level: Applying (Application) MSC: Client Needs: Health Promotion and Maintenance 10. A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the: a. Menstrual history, because it is generally nonthreatening. b. Obstetric history, because it includes the most important information. c. Urinary system history, because problems may develop in this area as well. d. Sexual history, because discussing it first will build rapport. ANS: A Menstrual history is usually nonthreatening and therefore a good topic with which to begin the interview. Obstetric, urinary, and sexual histories are also part of the interview but not necessarily the best topics with which to start. DIF: Cognitive Level: Applying (Application) REF: p. 740 MSC: Client Needs: Safe and Effective Care Environment: Management of Care 11. A patient has had three pregnancies and two live births. The nurse would record this information as grav _____, para _____, AB _____. 2; 2; 1 a. b. c. d. 3; 2; 0 3; 2; 1 3; 3; 1 ANS: C Gravida (grav) is the number of pregnancies. Para is the number of births. Abortions are interrupted pregnancies, including elective abortions and spontaneous miscarriages. DIF: Cognitive Level: Applying (Application) REF: p. 741 MSC: Client Needs: Safe and Effective Care Environment: Management of Care 12. During the interview with a female patient, the nurse gathers data that indicate the patient is perimenopausal. Which of these statements made by this patient leads to this conclusion? “I have noticed that my muscles ache at night when I go to bed.” a. REF: p. 740b. c. d. “I will be very happy when I can stop worrying about having a period.” “I have been noticing that I sweat a lot more than I used to, especially at night.” “I have only been pregnant twice, but both times I had breast tenderness as my first symptom.” ANS: C Hormone shifts occur during the perimenopausal period, and associated symptoms of menopause may occur, such as hot flashes, night sweats, numbness and tingling, headache, palpitations, drenching sweats, mood swings, vaginal dryness, and itching. The other responses are not correct. DIF: Cognitive Level: Analyzing (Analysis) MSC: Client Needs: Health Promotion and Maintenance 13. A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if these changes could be attributable to the hormone replacement therapy (HRT) she started 3 months earlier. The nurse should tell her: “HRT is at such a low dose that side effects are very unusual.” a. b. c. d. “HRT has several side effects, including fluid retention, breast tenderness, and vaginal bleeding.” “Vaginal bleeding with HRT is very unusual; I suggest you come into the clinic immediately to have this evaluated.” “It sounds as if your dose of estrogen is too high; I think you may need to decrease the amount you are taking and then call back in a week.” ANS: B Side effects of HRT include fluid retention, breast pain, and vaginal bleeding. The other responses are not correct. DIF: Cognitive Level: Applying (Application) REF: p. 741 MSC: Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies 14. A 52-year-old patient states that when she sneezes or coughs she “wets herself a little.” She is very concerned that something may be wrong with her. The nurse suspects that the problem is: a. Dysuria. b. Stress incontinence. c. Hematuria. d. Urge incontinence. ANS: B Stress incontinence is involuntary urine loss with physical strain, sneezing, or coughing. Dysuria is pain or burning with urination. Hematuria is bleeding with urination. Urge incontinence is involuntary urine loss that occurs as a result of an overactive detrusor muscle in the bladder that contracts and causes an urgent need to void. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 742 MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation REF: p. 741 [Show More]

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