Chapter 27, Female Genitourinary System: Assessing Female Genitalia- Sherpath

Question 1 of 18

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What should the nurse do to prepare a female patient for a genital examination?

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  • Drape the patientDraping the patient minimizes exposure and enhances privacy during the examination.
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  • Have the patient empty her bladderHaving the patient empty her bladder prepares the patient for a genital examination. It is uncomfortable for the female patient to undergo a genital examination with a full bladder.
• • Ask the patient to face the doorThe patient should be facing away from the door to ensure privacy during the examination.
• • Ensure the patient cannot see the examinationThere is no reason the patient should not view the examination if they so choose.
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  • Show the patient the examination equipment and explain its useEducating the patient about the examination procedure prepares the patient for a genital examination. Providing information will help alleviate any examination related anxieties. When the patient is anxious, pelvic muscles may not relax, making the examination difficult and potentially uncomfortable for the patient.

Question 2 of 18

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What steps could the nurse take to prepare the environment for a genitalia examination?

• • Cool the speculumThe speculum should be warmed to ensure patient comfort during the examination.
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  • Close the door and draw the privacy curtainClosing the door and drawing the curtain will ensure patient privacy during the examination.
• • Ask all chaperones to leave the room to ensure patient privacyAny chaperones should be able to view the procedure and should not be asked to leave the room for an examination.
• • Turn the temperature up because the patient will be exposedThe room should be maintained at a comfortable temperature so the patient is comfortable at all stages of examination, regardless of exposure.

Question 3 of 18

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What should the nurse do to prepare the examination environment prior to a genital examination?

• • Drape the tableThe patient, not the table, should be draped in preparation for a genital examination.
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  • Provide for privacyProviding for privacy with shut doors and drawn curtains prepares the environment for a genital examination.
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  • Ensure adequate lightingEnsuring adequate lighting does prepare the environment for a genital examination.
• • Ask the chaperone to leave the roomThe chaperone should stay in the room during the genital examination.
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  • Ensure comfortable room temperatureAssuring the examination room has a comfortable temperature is an activity the nurse does to prepare the environment for a genital examination.

Question 4 of 18

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What should be assessed when palpating the labia minora?

• • ShapeThe shape of the labia minora would not be assessed on palpation.
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  • IrregularitiesThe labia minora should be assessed for irregularities, which are an abnormal finding.
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  • NodulesThe labia minora should be assessed for nodules, which are an abnormal finding.
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  • TendernessTenderness of the labia minor is assessed with palpation. The tissue should be without tenderness.
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  • Caking of dischargeThe tissue folds should be assessed for caking of discharge, which suggests vaginal infection or poor hygiene.

Question 5 of 18

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How would the nurse test pelvic muscle tone of the female patient during an external genital examination?

• • Having the patient bear downHaving the patient bear down does not test pelvic muscle tone; it tests for incontinence and uterine prolapse.
• • Palpating over the abdominal regionPalpating over the patient’s abdominal region does not test pelvic muscle tone. It tests for tenderness of abdominal tissues and structures or presence of abnormal lumps or bumps.
• • Palpating over the patient’s suprapubic regionPalpating over the patient’s suprapubic region does not test pelvic muscle tone. It tests for tenderness of pelvic tissues and structures or presence of abnormal lumps or bumps.
• Correct
  • Having patient squeeze vaginal opening around the examiner’s fingerHaving the patient squeeze her vaginal opening around the examiner’s finger tests pelvic muscle tone.

Question 6 of 18

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Which aspects of the clitoris should the nurse assess as part of the genital examination?

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  • SizeSize of the clitoris is an aspect of the genital examination; the nurse should note enlargement or atrophy.
• • PolypsPolyps do not occur on the clitoris and are therefore not part of the clitoris assessment.
• • DischargeDischarge does not occur from the clitoris and is therefore not part of the clitoris assessment.
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  • InflammationInflammation of the clitoris is an aspect of the genital examination.
• • TendernessThe clitoris should not be palpated to assess for tenderness as this may be uncomfortable for the patient.

Question 7 of 18

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Which techniques could the nurse use to warm the speculum prior to an internal genital examination?

• • Hot waterHot water should not be used to warm the speculum prior to an internal genital examination. Extremely hot temperatures could burn the internal tissues.
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  • Warm waterWarm water can be used to warm the speculum prior to an internal genital examination.
• • Electric warming unitAn electric warming unit should not be used to warm the speculum prior to an internal genital examination. Extremely hot temperatures could burn the internal tissues.
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  • Indirect heat from lampHeat from a lamp can be used to warm the speculum prior to an internal genital examination.
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  • Warmth from gloved handsWarmth from gloved hands can be used to warm the speculum prior to an internal genital examination.

Question 8 of 18

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How should the speculum be inserted into the vaginal opening for a female internal examination?

• • Insert along a straight path.Inserting the speculum along a straight path is not the proper technique for insertion and could cause discomfort or injury.
• • Insert along a slight upward path.Inserting the speculum along an upward path is not the proper technique for insertion and could cause discomfort or injury.
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  • Insert along a slight downward path.Inserting the speculum along a slight downward path is the proper technique and follows the natural anatomical plane of the vaginal canal.
• • Insert along a steep downward path.Inserting the speculum along a steep downward path is not the proper technique for insertion and could cause discomfort or injury.

Question 9 of 18

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After the patient relaxes her internal muscles and buttocks, what is the next step of the vaginal examination to prepare for speculum insertion?

• • Warm the speculumThe speculum should be warmed prior to the start of the examination.
• Correct
  • Separate the labia minora with fingersSeparating the labia minora with fingers is the next step of the vaginal examination once the patient relaxes her internal muscles and buttock and prior to speculum insertion.
• • Manipulate the speculum to expose the cervixManipulating the speculum to expose the cervix occurs after the speculum has been inserted.
• • Insert finger into vagina and apply pressure downwardInserting a finger into the vagina and applying downward pressure occurs as part of the procedure to encourage relaxation of the internal muscles and buttocks.

Question 10 of 18

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When assessing the cervix during the speculum examination, what should be noted?

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  • ColorColor of the cervix should be noted on speculum examination. Expect the cervix to be pink, with the color evenly distributed.
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  • DischargePresence of discharge from the cervix should be noted on speculum examination of the cervix. Note any discharge. Determine whether the discharge comes from the cervix itself, or whether it is vaginal in origin and has only been deposited on the cervix.
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  • PositionPosition of the cervix should be noted on speculum examination. The anterior-posterior position of the cervix should correlate with the position of the uterus.
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  • Surface characteristicsSurface characteristics of the cervix should be noted on speculum examination. This includes texture and presence of lesions.
• • Temperature of the cervixThe temperature of the cervix is not assessed during the speculum examination.

Question 11 of 18

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Which cervical specimens can be obtained during an internal female genital examination?

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  • HPVSpecimens for HPV testing can be obtained during an internal female genital examination to test for sexually transmitted illnesses.
• • BloodBlood is not obtained during the internal female genital examination.
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  • PAP smearSpecimens for PAP smear testing can be obtained during an internal female genital examination to test for cervical cancer.
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  • GonorrheaSpecimens for gonorrhea testing can be obtained during an internal female genital examination to test for sexually transmitted illnesses.
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  • ChlamydiaSpecimens for chlamydia testing can be obtained during an internal female genital examination to test for sexually transmitted illnesses.

Question 12 of 18

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Which elements of the vaginal wall should be assessed during the speculum examination?

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  • ColorThe color of the vaginal wall should be assessed during the speculum examination. Similar to the cervix, pink is the expected color.
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  • MoistureThe moisture status of the vaginal wall should be assessed during the speculum examination. The surface should be moist.
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  • Presence of cystoceleThe vaginal wall should be assessed for the presence of a cystocele, a hernial protrusion of the urinary bladder through the anterior wall of the vagina.
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  • Presence of lesionsThe vaginal wall should be assessed for the presence of lesions, which would be an abnormal finding.
• • Hair distributionThe vaginal wall does not contain hair and therefore would not be assessed for hair distribution.

Question 13 of 18

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During a rectovaginal examination, which elements of the stool are assessed?

• • Amount of stoolThe amount of stool is not assessed during the rectovaginal examination.
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  • Blood in the stoolBlood in the stool is assessed during the rectovaginal examination. Presence of blood can be gross or occult.
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  • Color of the stoolThe color of the stool is assessed during the rectovaginal examination. The normal color is brown. Black, clay-colored, pale, yellow, or green stools may signify a problem.
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  • Mucus in the stoolMucus in the stool is assessed during the rectovaginal examination and may indicate an infection.
• • Consistency of stoolConsistency of the stool is not assessed during the rectovaginal examination.

Question 14 of 18

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What aspects should be assessed while palpating the uterus during a bimanual examination?

• • Color of the uterusColor is an unnecessary aspect to assess while palpating the uterus as it is not visible during a bimanual examination.
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  • Size of the uterusThe size of the uterus should be assessed during a bimanual examination because an enlarged uterus, larger than 5.5 to 8 cm long, is suggestive of pregnancy, tumor, or fibroid.
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  • Mobility of the uterusMobility of the uterus should be assessed during a bimanual examination because a fixed uterus can indicate adhesions.
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  • Position of the uterusKnowing the position of the uterus is essential before performing any intrauterine procedure, including insertion of an intrauterine contraceptive device.
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  • Smoothness of the uterine wallsUterine walls that are smooth upon palpation suggest the woman is not pregnant and should therefore be assessed during a bimanual examination.

Question 15 of 18

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Which technique assesses anal sphincter tone during a rectovaginal examination?

• • Ask patient about bowel habitsAsking the patient to describe usual bowel habit does not assess anal sphincter tone.
• • Gently palpate around Anus with fingersPalpating the anus with fingers exteriorly does not assess anal sphincter tone.
• • Have Patient tighten and relax Anal sphincter naturallyHaving the patient tighten and relax anal sphincter naturally does not assess anal sphincter tone.
• Correct
  • Have patient tighten and relax anal sphincter around the examiner’s fingerHaving the patient tighten and relax the anal sphincter around the examiner’s inserted finger is the proper technique to assess anal sphincter tone during a rectovaginal examination.

Question 16 of 18

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During a newborn genital examination, what elements of the labia minora are assessed by the nurse?

• • ColorThe color of the labia minora is not assessed during an infant genital examination.
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  • Presence of edemaThe labia minora of a newborn is edematous after birth and could be assessed as such during a newborn genital examination.
• • Presence of atrophyThe labia minora of a newborn is not atrophied and could not be assessed as atrophied during a newborn genital examination.
• • Presence of malformationsMalformations in infant genitalia are difficult to assess in an examination because of the variations in structures naturally. Genital malformations could not be assessed during a newborn genital examination.

Question 17 of 18

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Which newborn female genitalia structures would the nurse assess after birth and expect to find edema?

• • AnusThe anus of a newborn is not edematous after birth.
• • HymenThe hymen of a newborn is not edematous after birth, but it is often protruding, simulating a mass.
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  • ClitorisThe clitoris of a newborn appears edematous or enlarged after birth and usually has no significance.
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  • Labia minoraThe labia minora of a newborn is edematous after birth due to maternal hormonal influence.
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  • Labia majoraThe labia majora of a newborn is edematous after birth due to maternal hormonal influence.

Question 18 of 18

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Which characteristics should the nurse assess while examining the female newborn’s hymen?

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  • SizeThe size of the newborn’s hymen opening should be assessed and should be approximately 0.5 cm in diameter.
• • OdorThe consistency of discharge or secretions may be assessed, but not the odor of the hymen.
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  • ShapeThe shape of the newborn’s hymen opening should be assessed. The hymen may be edematous after a breech delivery.
• • ConsistencyThe consistency of discharge may be assessed, but not the consistency of the hymen.
• • TemperatureThe temperature of the hymen would not be assessed during examination of the female newborn’s hymen.