[Ex3] - C35 - AP Flashcards
35-1. An 18-year-old female is diagnosed with dysmenorrhea. Which of the following symptoms
will she most likely experience?
a. Absence of menstruation
b. Painful menstruation
c. Unusually long menstrual period
d. Menstrual irregularity
ANS: B
Primary dysmenorrhea is painful menstruation associated with the release of prostaglandins in
ovulatory cycles. Absence of menstruation is referred to as amenorrhea. Dysfunctional
bleeding would describe both unusually long and irregular menstrual periods.
35-2. A 20-year-old female presents with pelvic and back pain severe enough to miss work
beginning with the onset of menses. Physical examination supports the diagnosis of primary
dysmenorrhea. The most likely cause of her condition is:
a. lack of estrogen.
b. stress.
c. elevated prostaglandins.
d. poor nutrition.
ANS: C
Primary dysmenorrhea is painful menstruation associated with the release of prostaglandins in
ovulatory cycles; it is not associated with the lack of estrogen, stress, or poor nutrition.
35-3. A 25-year-old female presents with amenorrhea and hirsutism and is diagnosed with
polycystic ovary syndrome (PCOS). Lab testing will most likely reveal:
a. estrogen deficit.
b. genetic cancerous mutations.
c. cortisol excess.
d. hyperinsulinemia.
ANS: D
Glucose intolerance/insulin resistance (IR) and hyperinsulinemia often run parallel and
markedly aggravate the hyperandrogenic state, thus contributing to the severity of signs and
symptoms of PCOS. Estrogen levels are elevated with PCOS. Cancer is not associated with
the lab findings of PCOS. Cortisol levels are not elevated in PCOS.
35-4. A 30-year-old female with newly diagnosed polycystic ovary syndrome (PCOS) is being
counseled by her OB-GYN. The physician indicates that this condition often results in:
a. ovarian cancer.
b. infertility.
c. early menopause.
d. pelvic inflammatory disease.
ANS: B
Because FSH levels are not totally depressed, new follicular growth is continuously
stimulated but not to full maturation and ovulation. Symptoms are related to anovulation and
hyperandrogenism and include infertility. PCOS is not associated with ovarian cancer, early
menopause, or pelvic inflammatory disease.
35-5. A 23-year-old sexually active female presents with white copious discharge and itch and is
diagnosed with yeast vaginitis. This condition is caused by overgrowth of which
microorganism?
a. Escherichia coli
b. Lactobacillus acidophilus
c. Candida albicans
d. Neisseria gonorrhoeae
ANS: C
The most common cause of yeast vaginitis is C. albicans. Changes in the vaginal pH may
predispose a woman to such an infection by destroying normal vaginal flora, facilitating
overgrowth of C. albicans and causing a yeast infection. Escherichia coli does not cause yeast
vaginitis nor does L. acidophilus. Neisseria gonorrhoeae is the cause of gonorrhea.
35-6. The descent of the bladder and the anterior vaginal wall into the vaginal canal is called a:
a. rectocele.
b. varicocele.
c. cystocele.
d. urethrocele.
ANS: C
A cystocele is the descent of the bladder into the vaginal canal. A rectocele is the bulging of
the rectum and posterior vaginal wall into the vaginal canal. A varicocele is the abnormal
dilation of a vein within the spermatic cord. A urethrocele is sagging of the urethra.
35-7. The nurse would anticipate the treatment for pelvic organ prolapse to be:
a. insertion of a urinary catheter.
b. a pessary.
c. dietary fiber.
d. urinary antispasmodics.
ANS: B
A common first-line treatment is a pessary, which is a removable mechanical device that
holds the uterus in position. The physiologic problem would not be addressed with the
insertion of a urinary catheter, ingestion of dietary fiber, or the administration of urinary
antispasmodics.
35-8. During a routine pelvic exam, a 34-year-old female is found to have an ovarian cyst
containing skin, hair, cartilage, and bone. This cyst is classified as a _____ cyst.
a. follicular
b. dermoid
c. corpus luteal
d. micro
ANS: B
Dermoid cysts are growths that may contain mature tissue including skin, hair, sebaceous and
sweat glands, muscle fibers, cartilage, and bone. Neither follicular, corpus luteal, nor micro
cysts contain skin, hair, or bone.
35-9. A 40-year-old female presents with cramping and excessive vaginal bleeding. Ultrasound
reveals benign uterine tumors in the smooth muscle cells of the myometrium. These tumors
are commonly called:
a. adenomyosis.
b. endometriosis.
c. leiomyomas.
d. adenomas.
ANS: C
Leiomyomas are benign tumors that develop from smooth muscle cells in the myometrium.
Adenomyosis is the presence of islands of endometrial glands surrounded by benign
endometrial stroma within the uterine myometrium. Endometriosis is the presence of
functioning endometrial tissue or implants outside the uterus. Adenomas are tumors that can
grow anywhere but are not specific to the myometrium.
35-10. A 35-year-old female is diagnosed with endometriosis. Suppressing which of the following
would be the most appropriate medical treatment for this disease?
a. Infection
b. Ovulation
c. Prostaglandins
d. Fertilization
ANS: B
Medical therapies include suppression of ovulation with various medications. Endometriosis
is not treated by suppressing prostaglandins, infections, or fertilization.
35-11. A 21-year-old female is infected with human papillomavirus (HPV) following unprotected
sexual intercourse with a male she recently met. She is now at higher risk of developing which
of the following cancers?
a. Cervical
b. Ovarian
c. Endometrial
d. Vulvar
ANS: A
HPV is associated with cervical cancer. HPV 16 accounts for about 60% of cervical cancer
cases and HPV 18 for about another 10%; other types contribute less than 5% of cases. HPV
is not associated with ovarian, endometrial, or vulvar cancers.
35-12. A 38-year-old female was recently diagnosed with cancer. She learns that her mother almost
miscarried while pregnant with her and was given diethylstilbestrol (DES) to prevent it.
Which of the following cancers does she most likely have?
a. Endometrial
b. Vaginal
c. Cervical
d. Uterine
ANS: B
Exposure in utero to nonsteroidal estrogens (DES) has been identified as a risk factor for
vaginal cancer. DES exposure has not been associated with endometrial, cervical, or uterine
cancers.
35-13. The most commonly occurring cancer of the female reproductive tract is _____ cancer.
a. cervical.
b. ovarian.
c. endometrial.
d. fallopian.
ANS: C
Carcinoma of the endometrium is the most common type of uterine cancer and most prevalent
gynecologic malignancy. Neither carcinoma of the cervix, the ovary, nor the fallopian tube is
the most prevalent gynecologic malignancy.
35-14. A 35-year-old female is diagnosed with ovarian cancer. CT scan reveals that the cancer is
limited to the ovaries. It would be classified as stage:
a. I.
b. II.
c. III.
d. IV.
ANS: A
In stage I, growth is limited to the ovaries. In stage II, growth involves one or both ovaries and
involvement of other organs. In stage III, cancer involves one or both ovaries, and one or both
of the following: (i) cancer has spread beyond the pelvis to the lining of the abdomen and (ii)
cancer has spread to lymph nodes. In stage IV, growth involves one or both ovaries with
distant metastases to lungs, liver, or other organs outside the peritoneal cavity.
35-15. A 35-year-old nonpregnant female presents with breast discharge and is diagnosed with
galactorrhea. The condition is most likely caused by:
a. infection.
b. prolactin imbalance.
c. tissue injury.
d. cancer.
ANS: B
The most common cause of galactorrhea is nonpuerperal hyperprolactinemia, or excessive
amounts of prolactin in the blood not related to pregnancy or childbirth. These processes are
chiefly hormone imbalances caused by hypothalamic-pituitary disturbances, pituitary tumors,
or neurologic damage. Galactorrhea is not due to infection, tissue injury, or cancer.
