Deck 16: Assessing the Female Breasts, Axillae, and Reproductive System

Question 1

A woman comes to the clinic because of spotting or bleeding in between her menstrual cycles. Which question is most important for the nurse to ask?

A) "Does the spotting occur during ovulation?"
B) "Does the spotting occur after your period?"
C) "Does the spotting occur during or after sexual intercourse?"
D) "Does the spotting occur during heavy stress?"

Answer 1

"Does the spotting occur during or after sexual intercourse?"

Question 2

A woman with a history of dysmenorrhea comes to the clinic for a follow-up appointment. Which question indicates that the nurse understands the major symptoms associated with this condition?

A) "Have you missed any more work during your periods?"
B) "How many pads or tampons did you use last month?"
C) "Has your partner been supportive of your mood swings?"
D) "Did it help to use a nonpetroleum-based lubricant?"

Answer 2

"Have you missed any more work during your periods?"

Question 3

A woman comes to the clinic because of heavy menstrual bleeding each month. Which question is most important for the nurse to ask?

A) "Have you noticed if anything you do makes the bleeding worse?"
B) "How long ago did you start having heavy periods?"
C) "Do you get cramps when you have your period?"
D) "How many pads/tampons do you generally use in 24 hours?"

Answer 3

"How many pads/tampons do you generally use in 24 hours?"

Question 4

A woman comes to the clinic because she has noticed nipple discharge from her left breast. Which information should the nurse communicate immediately to the health-care provider?

A) Clear discharge
B) Yellow discharge
C) Green discharge
D) Bloody discharge

Question 5

When conducting a health history and physical examination of the breasts, which information is most significant?

A) Patient reports that one breast has always been larger than the other breast.
B) Inspection reveals an area of dimpling or retraction around the nipple.
C) Palpation elicits breast tenderness in both breasts.
D) Inspection reveals inverted nipples.

Question 6

A 36-year-old female patient visits an outpatient clinic for a routine gynecological examination. When conducting a review of systems, which information would the nurse find as most significant?

A) White or yellow vaginal discharge
B) Frequent abdominal bloating
C) Spotting during ovulation
D) Breast tenderness before menses

Question 7

When observing how a new graduate nurse does an inspection of the female breast, which position illustrates a need for further teaching?

A) Patient seated with the arms hanging by her side
B) Patient seated with the arms placed over her head
C) Patient seated with her hands behind her back
D) Patient seated leaning forward

Question 8

A college student is in an outpatient clinic for a routine gynecologic examination. When taking the patient's history, which information is most significant?

A) "I have had such lumpy breasts lately, especially before my periods."
B) "Lately I have noticed that the area around my right nipple has a rash that is sore and itchy all the time."
C) "It seems like a week and a half before my period I get a whitish yellow vaginal discharge."
D) "How come I get a really bad side ache for about a day in the middle of every cycle?"

Question 9

Which approach is best for the nurse to use when palpating the female breast?

A) A circular pattern
B) A radial spoke method
C) A vertical strip pattern
D) A horizontal pattern

Question 10

A nurse is reviewing the chart of a clinic patient and notes the following: "Denies pain, lump, nipple discharge, rash, swelling or trauma." The nurse recognizes this data relates most directly to which part of a health assessment and physical examination?

A) Biographic data
B) Past history
C) Review of systems
D) Physical examination

Question 11

A female patient presents with a possible diagnosis of polycystic ovary syndrome (PSOS). Which question indicates that the nurse understands the major symptoms associated with PSOS?

A) "Have you noticed a lack of facial hair?"
B) "Have you lost a lot of weight?"
C) "Have your periods been irregular?"
D) "Do you have dysmenorrhea?"

Question 12

A nurse is inspecting the external genitalia of a 34-year-old woman and notices sparse pubic hair. This symptom may be a result of:

A) Candidiasis.
B) Endocrine disease.
C) Fungal infections.
D) Pediculosis pubis.

Question 13

In order to determine a woman's self-care ability related to breast self-examination, the nurse finds which statement by the patient indicates the need for further teaching?

A) "I make a check mark on the calendar every month after I do a breast examination."
B) "As soon as I notice symptoms of premenstrual syndrome I make sure I conduct a breast self-examination."
C) "I always stand in front of the mirror before my shower to inspect my breasts."
D) "When I examine my breast, I lie flat on the bed, placing a pillow under the side being examined."

Question 14

The nurse is correct to question which of the following comments made by a 27-year-old sexually active patient with a history of multiple partners?

A) "I had a Pap test last year, so I need another Pap test in 2 years."
B) "I was screened for sexually transmitted infections 2 to 3 years ago."
C) "I was told I should be checked for human papillomavirus (HPV) with my Pap test."
D) "I do not need to have a mammogram until I am 40 years old."

Question 15

The nurse is correct to question which of the following comments regarding a woman's understanding of contraceptive choice(s)?

A) "My birth control pills are a form of contraception to prevent pregnancy."
B) "I recommend a male or female condom to all my single friends because it may protect them from sexually transmitted infections."
C) "I hate taking birth control pills because they make me nauseous."
D) "I have a friend with regular periods and she successfully used the rhythm method and never got pregnant until she was ready."

Question 16

A 51-year-old patient comes in for a gynecological examination and complains of dry skin, mood changes, irritability, and weight gain. She reports no menstruation in the past 12 months. To obtain further information, which question best encourages the patient to express herself?

A) "Have you had trouble sleeping?"
B) "Have you noticed your hair getting thinner?"
C) "Have you tried a nonpetroleum-based lubricant to help with vaginal dryness?"
D) "How has menopause affected your quality of life?"

Question 17

Which assessment finding relates most directly to a diagnosis of fibrocystic breast disease?

A) Painless lumps in the breast tissue noted to be associated with a woman's menstrual cycle
B) Painful, fluid-filled lumps located in the breast
C) A solid, round breast lump in a 23-year-old female that moves easily when pushed
D) A hard, fixed, isolated lump in the right upper quadrant of the right breast

Question 18

A 36-year-old female patient complains she is missing work because of heavy menstrual bleeding. The patient is having heavy menstrual bleeding if she is:

A) Passing small clots.
B) Passing clots the size of a penny.
C) Changing tampons or pads every 1 to 2 hours.
D) Changing tampons or pads every 3 to 4 hours.

Question 19

A female patient is on the schedule for a routine Pap smear today. The patient calls to report she has been using an over-the-counter cream for several days for a possible vaginal infection. The nurse knows that the patient:

A) Will need to reschedule the Pap smear.
B) Needs to be reassured that vaginal creams will not interfere with the examination.
C) Will need to douche before coming in for the examination.
D) Will need a prescription of antibiotics after the Pap smear to treat the infection.

Question 20

Which of the following patients is most at risk for the development of breast cancer?

A) A 49-year-old woman with history of menarche at age 14 and menopause at age 48
B) A 64-year-old woman with history of menarche at age 10 and menopause at age 53
C) A 45-year-old woman who drinks alcohol on special occasions
D) A 45-year-old woman who had four children and each child was breastfed 9 to 12 months

Question 21

Which symptoms most clearly relates to trichomoniasis?

A) Fishy odor
B) Frothy discharge
C) Thick, white, curd-like discharge
D) Bleeding after sexual intercourse

Question 22

Which question by the nurse best illustrates an understanding of the importance of a patient-centered approach that includes cultural considerations when performing a breast examination?

A) "May I have permission to uncover and expose your breasts?"
B) "Would you ask your partner to please wait outside while I do the examination?"
C) "I am training new students today and they need to observe a breast examination, is that okay?"
D) "Did you know your left breast is a lot bigger than your right breast?"

Question 23

With a patient standing and leaning forward, the nurse uses the assessment technique of inspection to observe for:

A) Lumps and tenderness.
B) Tissue density and lumps.
C) Tenderness and nipple deviations.
D) Nipple deviations and skin changes.

Question 24

A female patient is scheduled for a gynecologic examination and Pap smear. The most common position to prepare the patient for a pelvic examination would be to place the patient in:

A) The Trendelenburg position.
B) The supine position.
C) The prone position.
D) The lithotomy position.

Question 25

When conducting a patient history, which symptom indicates that the patient is experiencing normal changes associated with menopause?

A) Vaginal bleeding
B) Urinary and bowel incontinence
C) Decreased vaginal secretions
D) Increased breast tenderness

Question 26

A patient states her menstrual cycle is very regular and, according to her calendar, she had a period that started on March 2 that included bleeding for 4 days. Her last menstrual period started on March 31 and she bled 3 to 4 days. Based on this information the patient has a menstrual cycle that lasts how many days?

A) 28 days
B) 29 days
C) 30 days
D) 31 days

Question 27

During a breast examination, the nurse palpates the lymph nodes under the axilla. The nurse knows that which of the following statements is true?

A) Finding a soft, tender, movable lump in the axilla is always a significant finding.
B) The axillary lymph nodes are the last place that cancer may spread.
C) Breast infection or disease may cause enlargement of the lymph node(s).
D) The lymphatic circulation moves from the axilla toward the breast.

Question 28

A 23-year-old woman comes to the clinic because of heavy bleeding during her periods that lasts for 7 days. The nurse would document this as:

A) Amenorrhea.
B) Menorrhagia.
C) Metrorrhagia.
D) Oligomenorrhea.

Question 29

A 16-year-old student tells the school nurse she cannot participate in the school field trip today because of severe menstrual cramps, nausea, and diarrhea. These symptoms most clearly relate to:

A) Amenorrhea.
B) Menorrhagia.
C) Primary dysmenorrhea.
D) Secondary dysmenorrhea.

Question 30

In the accompanying figure, what is the breast palpation technique pattern for assessing the breasts?

A) Vertical strip pattern
B) Radial spoke pattern
C) Circular pattern
D) Bimanual pattern

Question 31

You are performing a breast assessment and start by inspecting the breast. In the accompanying figure, what do you see?

A) Breast dimpling
B) Breast nodule
C) Nipple inversion
D) Nipple eversion

Question 32

You are inspecting the nipples of both breasts. What should you assess? Select all that apply.

A) Size
B) Position
C) Firmness
D) Discharge
E) Crusting
F) Tenderness
G) Presence of accessory nipple

Question 33

To determine a woman's risk for ovarian cancer, which of the following risk factor(s) should the nurse consider? Select all that apply.

A) Increasing age
B) Underweight in early adulthood
C) Family history
D) Multiparity
E) Use of oral contraceptives
F) Use of estrogen hormone replacement therapy (HRT)
G) BRCA1 or BRCA2 gene mutation

Question 34

A thorough breast assessment requires the patient to be in several positions. The recommended positions for inspecting the breasts include which of the following? Select all that apply.

A) Seated with the arms hanging by each side
B) Seated with the arms placed over the head
C) Seated with the hands on the hips
D) Standing and leaning forward
E) Supine and turning to the right and left side

Question 35

You are performing a breast assessment and start palpating the breasts using the vertical strip method. You feel a lump in the right upper quadrant of the left breast and further assess for which of the following? Select all that apply.

A) Shape
B) Color
C) Consistency
D) Location
E) Size
F) Movable or fixed
G) Tenderness