1. Which piece of the usual equipment setup for a pelvic examination is omitted with a Pap test?
a. Gloves and eye protectors
b. Speculum
c. Fixative agent
d. Lubricant
ANS: D
Feedback A The examiner should always use Standard Precautions. B A speculum is needed to see the cervix. C A fixative agent is applied to the slide to prevent drying or disruption of the specimen. D Lubricants interfere with the accuracy of the cy
2. The microscopic examination of scrapings from the cervix, endocervix, or other mucous membranes to detect premalignant or malignant cells is called
a. Bimanual palpation
b. Rectovaginal palpation
c. A Papanicolaou test
d. DNA testing
ANS: C
Feedback A Bimanual palpation is a physical examination of the vagina; the Pap test is a microscopic examination for cancer.
B Rectovaginal palpation is a physical examination performed through the rectum; the Pap test is a microscopic examination
3. The nurse providing care in a women's health care setting must be aware that which sexually transmitted disease (STD) can be cured?
a. Herpes
b. Acquired immunodeficiency syndrome (AIDS)
c. Venereal warts
d. Chlamydia
ANS: D
Feedback A Because no cure is known for herpes, treatment focuses on pain relief and preventing secondary infections. B Because no cure is known for AIDS, prevention and early detection are the main focus. C Condylomata acuminata is caused by the h
4. Which statement by a woman diagnosed with premenstrual syndrome indicates that further health teaching is needed?
a. "I will not eat chips or pickles."
b. "Coffee and chocolate can make me more irritable and nervous."
c. "Drinking alcohol makes me more
ANS: D
Feedback A Less intake of salty foods helps decrease fluid retention. B Caffeine consumption increases irritability, insomnia, anxiety, and nervousness. C Alcohol consumption aggravates depression. D The woman should be encouraged to eat six small
5. Which statement by the patient indicates that she understands breast self-examination?
a. "I will examine both breasts in two different positions."
b. "I will perform breast self-examination 1 week after my menstrual period starts."
c. "I will examine
ANS: B
Feedback A She should use four positions: standing with arms at her sides, standing with arms raised above her head, standing with hands pressed against hips, and lying down. B The woman should examine her breasts when hormonal influences are at a
6. A benign breast condition that includes dilation and inflammation of the collecting ducts is called
a. Ductal ectasia
b. Intraductal papilloma
c. Chronic cystic disease
d. Fibroadenoma
ANS: A
Feedback A Generally occurring in women approaching menopause, ductal ectasia results in a firm irregular mass in the breast, enlarged axillary nodes, and nipple discharge. B Intraductal papillomas develop in the epithelium of the ducts of the brea
7. Which patient is most at risk for fibroadenoma of the breast?
a. A 38-year-old woman b. A 50-year-old woman c. A 16-year-old woman d. A 27-year-old woman
ANS: C
Feedback A Ductal ectasia becomes more common as a woman approaches menopause. B Intraductal papilloma develops most often just before or during menopause. C Although it may occur at any age, fibroadenoma is most common in the teenage years. D Fibr
8. Adjuvant treatment with tamoxifen may be recommended for patients with breast cancer if the tumor is
a. Smaller than 5 cm
b. Located in the upper outer quadrant only
c. Contained only in the breast
d. Estrogen receptive
ANS: D
Feedback A Tamoxifen is used depending on age, stage, and hormone receptor status, not size. B Location of the cancer does not determine the usefulness of tamoxifen. C Stage of the cancer is a consideration, but more important is its sensitivity to
9. Which statement is true about primary dysmenorrhea?
a. It occurs in young multiparous women.
b. It is experienced by all women.
c. It may be due to excessive endometrial prostaglandin.
d. It is unaffected by oral contraceptives.
ANS: C
Feedback A It occurs in young nulliparous women. B It is not experienced by all women. C Some women produce excessive endometrial prostaglandin during the luteal phase of the menstrual cycle. Prostaglandin diffuses into endometrial tissue and cause
10. In helping a patient manage PMS, the nurse should
a. Recommend a diet with more body-building and energy food, such as red meat and sugar.
b. Suggest herbal therapies, and massage.
c. Tell the patient to push for medications from the physician as soon
ANS: B
Feedback A Limiting red meat, refined sugar, caffeinated beverages, and alcohol improves the diet and may mitigate symptoms. B Herbal therapies, conscious relaxation and massage have all been reported to have a beneficial effect on PMS. C Medicatio
11. With regard to endometriosis, nurses should be aware that
a. It is characterized by the presence and growth of endometrial tissue inside the uterus.
b. It affects 25% of all women.
c. It may worsen with repeated cycles or remain asymptomatic and disap
ANS: C
Feedback A With endometriosis, the endometrial tissue is outside the uterus. Symptoms vary among women, ranging from nonexistent to incapacitating. B Endometriosis affects 10% of all women and is found equally in Caucasian and African-American wome
12. A 49-year-old patient confides to the nurse that she has started experiencing pain with intercourse and asks, "Is there anything I can do about this?" The nurse's best response is
a. "You need to be evaluated for a sexually transmitted disease."
b. "W
ANS: B
Feedback A This is a normal occurrence with the aging process and does not indicate STDs. B Loss of lubrication with resulting discomfort in intercourse is a symptom of estrogen deficiency. C It is part of the aging process, but the use of lubricat
13. A 70-year-old woman should be taught to report what condition to her health care provider?
a. Vaginal bleeding
b. Pain with intercourse
c. Breasts become smaller
d. Skin becomes thinner
ANS: A
Feedback A Vaginal bleeding after menopause should always be investigated. It is highly suggestive of endometrial cancer. B Pain with intercourse is an expected change that occurs due to the aging process. C Breast shrinkage is an expected change t
14. Which woman is most likely to have osteoporosis?
a. A 50-year-old woman receiving estrogen therapy
b. A 60-year-old woman who takes supplemental calcium
c. A 55-year-old woman with a sedentary lifestyle
d. A 65-year-old woman who walks 2 miles each da
ANS: C
Feedback A Hormone therapy may prevent bone loss. B Supplemental calcium will help prevent bone loss, especially when combined with vitamin D. C Risk factors for the development of osteoporosis include smoking, alcohol consumption, sedentary lifest
15. A woman with a history of a cystocele should contact the physician if she experiences
a. Involuntary loss of urine when she coughs
b. Constipation
c. Backache
d. Urinary frequency and burning
ANS: D
Feedback A Involuntary loss of urine during coughing is stress incontinence and is not an emergency. B Constipation may be a problem with rectoceles. C Back pain is a symptom of uterine prolapse. D Urinary frequency and burning are symptoms of cyst
16. To assist the woman in regaining control of the urinary sphincter, the nurse should teach her to
a. Practice Kegel exercises.
b. Void every hour while awake.
c. Allow the bladder to become distended before voiding. d. Drink 8 to 10 glasses of water ea
ANS: A
Feedback A Kegel exercises, tightening and relaxing the pubococcygeal muscle, will improve control of the urinary sphincter. B A prescribed schedule may help, but every hour is too frequent. C Overdistention of the bladder will cause incontinence.
17. The physician diagnoses a 3 cm ovarian cyst in a 28-year-old woman. The nurse expects the initial treatment to include
a. Beginning hormone therapy
b. Examining the woman after her next menstrual period
c. Scheduling a laparoscopy as soon as possible,
ANS: B
Feedback A Cysts in women of childbearing age may decrease within one cycle, so treatment is not necessary at this point. B Most ovarian cysts regress spontaneously. C It is too early to anticipate removal of the cysts. Most ovarian cysts regress s
18. The drug of choice to treat gonorrhea is
a. Penicillin G
b. Tetracycline
c. Ceftriaxone
d. Acyclovir
ANS: C
Feedback A Penicillin is used to treat syphilis. B Tetracycline is used to treat chlamydial infections. C Ceftriaxone is effective for treatment of all gonococcal infections. D Acyclovir is used to treat herpes genitalis.
19. When a nurse is counseling a woman for primary dysmenorrhea, which non-pharmacologic intervention might be recommended?
a. Increasing the intake of red meat and simple carbohydrates
b. Reducing the intake of diuretic foods, such as peaches and asparag
ANS: D
Feedback A Dietary changes such as eating less red meat may be recommended for women experiencing dysmenorrhea. B Increasing the intake of diuretics, including natural diuretics such as asparagus, cranberry juice, peaches, parsley, and watermelon m
20. Nafarelin (Synarel) is currently used as a treatment for mild to severe endometriosis. The nurse should tell the woman taking this medication that the drug
a. Stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovari
ANS: D
Feedback A Nafarelin is a GnRH agonist that suppresses the secretion of gonadotrophinreleasing hormone. B Nafarelin is administered twice daily by nasal spray. C Nafarelin is administered intranasally. D Nafarelin is a GnRH agonist, and its side ef
21. The nurse who is teaching a group of women about breast cancer should tell the women that
a. Risk factors identify almost all women who will develop breast cancer.
b. African-American women have a higher rate of breast cancer.
c. One in 10 women in th
ANS: D
Feedback A Risk factors help identify a small percentage of women in whom breast cancer eventually will develop. B Caucasian women have a higher incidence of breast cancer; however, AfricanAmerican women have a higher rate of dying of breast cancer
22. The nurse providing education regarding breast care should explain to the woman that fibrocystic changes in breasts are
a. A disease of the milk ducts and glands in the breasts
b. A pre-malignant disorder characterized by lumps found in the breast tis
ANS: C
Feedback A Fibrocystic changes are palpable thickenings in the breast. B Fibrocystic changes are no pre-malignant changes. This information is inaccurate. C Fibrocystic changes are palpable thickenings in the breast usually associated with pain and
23. Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?
a. Mammogram
b. Ultrasound
c. Core needle biopsy
d. CA 15-3
ANS: C
Feedback A Mammography is a clinical screening tool that may aid early detection of breast cancers. B Transillumination, thermography, and ultrasound breast imaging are being explored as methods of detecting early breast carcinoma.
C When a suspici
24. A 36-year-old woman has been diagnosed as having uterine fibroids. When planning care for this patient, the nurse should know that
a. Fibroids are malignant tumors of the uterus that require radiation or chemotherapy.
b. Fibroids will increase in size
ANS: C
Feedback A Fibroids are benign tumors of the smooth muscle of the uterus, and their etiology is unknown. B Fibroids are estrogen-sensitive and shrink as levels of estrogen decline. C The major symptoms associated with fibroids are menorrhagia and t
25. When assessing a woman for menopausal discomforts, the nurse expects the woman to describe the most frequently reported discomfort, which is
a. Headaches
b. Hot flashes
c. Mood swings
d. Vaginal dryness with dyspareunia
ANS: B
Feedback A Headaches may be associated with a decline in hormone levels; however, it is not the most frequently reported discomfort for menopausal women.
B Vasomotor instability, in the form of hat flashes or flushing, is a result of fluctuating es
26. While evaluating a patient for osteoporosis, the nurse should be aware of what risk factor?
a. African-American race
b. Low protein intake
c. Obesity
d. Cigarette smoking
ANS: D
Feedback A Women at risk for osteoporosis are likely to be Caucasian or Asian. B Inadequate calcium intake is a risk factor for osteoporosis. C Women at risk for osteoporosis are likely to be small boned and thin. Obese women have higher estrogen l
27. When discussing estrogen replacement therapy (ERT) with a perimenopausal woman, the nurse should include the risks of
a. Breast cancer
b. Vaginal and urinary tract atrophy
c. Osteoporosis
d. Arteriosclerosis
ANS: A
Feedback A Women with a high risk of breast cancer should be counseled against using ERT . B Estrogen prevents atrophy of vaginal and urinary tract tissue. C Estrogen protects against the development of osteoporosis. D Estrogen has a favorable effe
28. During her annual gynecologic checkup, a 17-year-old woman states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse should document this complaint as
a. Amenorrhea
b. Dysmenorrhea
c. Dyspareunia
d. PMS
ANS: B
Feedback A Amenorrhea is the absence of menstrual flow. B Dysmenorrhea is pain during or shortly before menstruation. Pain is described as sharp and cramping or sometimes as a dull ache. It may radiate to the lower back or upper thighs. C Dyspareun
29. Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a patient with this condition should be aware that the optimal pharmacologic therapy for pain relief is
a. Acetaminophen
b. Oral contraceptives
ANS: C
Feedback A Preparations containing acetaminophen are less effective for dysmenorrhea because they lack the antiprostaglandin properties of NSAIDs. B OCPs are a reasonable choice for women who also want birth control. The benefit of OCPs is the redu
30. A woman is 6 weeks pregnant and has elected to terminate her pregnancy. The nurse knows that the most common technique used for medical termination of a pregnancy in the first trimester is
a. Administration of prostaglandins
b. Dilation and evacuation
ANS: A
Feedback A The most common technique for medical termination of a pregnancy within the first 7 weeks of pregnancy is administration of prostaglandins. B This is the most common method of surgical abortion used if medical abortion fails. C Intraveno
31. The nurse should be aware that a pessary is most effective in the treatment of what disorder?
a. Cystocele
b. Uterine prolapse
c. Rectocele
d. Stress urinary incontinence
ANS: B
Feedback A A pessary is not used for the patient with a cystocele. B A fitted pessary may be inserted into the vagina to support the uterus and hold it in the correct position. C A rectocele cannot be corrected by the use of a pessary. D It is unli
32. A postmenopausal woman who is 54 years old has been diagnosed with two leiomyomas. What assessment finding is most commonly associated with the presence of leiomyomas?
a. Abnormal uterine bleeding
b. Diarrhea
c. Weight loss
d. Acute abdominal pain
ANS: A
Feedback A Most women are asymptomatic. Abnormal uterine bleeding is the most common symptom of leiomyomas, or fibroids. B Diarrhea is not commonly associated with leiomyomas (fibroids). C Weight loss does not usually occur in the woman with leiomy
1. While interviewing a 48-year-old patient during her annual physical examination, the nurse learns that she has never had a mammogram. The American Cancer Society recommends annual mammography screening starting at age 40. Before the nurse encourages th
ANS: A, B, D, E
Feedback Correct All of these are reasons for women to avoid having a mammogram done. Although the test is expensive, it is usually covered by health insurance, and many communities offer low-cost or free screening to women without insuran
2. Which medications can be taken by postmenopausal women to treat and/or prevent osteoporosis? Select all that apply.
a. Calcium
b. Evista
c. Fosamax
d. Actonel
e. Vitamin C
ANS: A, B, C, D
Feedback
Correct All of these medications can be used by postmenopausal women to treat or prevent osteoporosis. Calcitonin is another medication available for treatment of osteoporosis. Incorrect Vitamin D is essential for calcium to be ab
3. The exact cause of breast cancer remains undetermined. Researchers have found that there are a number of common risk factors that increase a woman's chance of developing a malignancy. It is essential for the nurse who provides care to women of any age
ANS: A, D, E
Feedback Correct Family history, race, and nulliparity are known risk factors for the development of breast cancer. Others include age, personal history of cancer, high socioeconomic status, sedentary lifestyle, hormone replacement therapy, r
1. The nurse understands that further health teaching is necessary when her young patient who has just had an abortion states, "I guess I'll have to wear a tampon for the next week." Is this statement true or false?
ANS: T
Bleeding and cramping are normal after the procedure and will last for 1 to 2 weeks. Sanitary pads should be used rather than a tampon for the first week after an abortion to prevent infection. Other necessary health teaching that should be done in
2. Women in the U.S. are now more likely to die of cardiac disease than all cancers combined. Is this statement true or false?
ANS: T
Heart disease is now the leading cause of death for women in the United States, killing 26% of women who died in 2006. Almost twice as many American women die of heart disease or stroke than any form of cancer including breast cancer.