Female Genitalia - Assessment

Question 1

Important questions to ask when assessing for STIs

Answer 1

• Have you been sexually active in the last year?
• Do you have sex with men, women, or both?
• How many sexual partners have you had?
• Sexual orientation? Gender identity?
• Have you had sex with someone you don’t know well or had just met?
• Have you been coerced or pressured to have sex?
• Have you ever had an STI?

Question 2

Tips for a successful pelvic exam (examiner)

Answer 2

• Obtains permission - select chaperone
• Explains each step of the exam in advance
• Drapes the pateint from mid-abdomen to knees; depress the drape between the knees to provide eye contact with the pt
• Avoids unexpected or sudden movements
• Speculum the correct size-warmed with tap water
• Monitors the pt’s comfort
• Uses excellent but gentle technique, esp. when inserting the speculum

Question 3

Tips for successful pelvic exam (patient)

Answer 3

• Avoids intercourse, douching, or use of vaginal suppositories for 24-48 houre before exam
• Empties bladder before exam
• Lies supine w/ head and shoulders elevated, arms at her sides or folded across the chest to enhance eye contact and reduce tightening of abdomenal muscles

Question 4

Painful intercourse

Answer 4

dyspareunia

Question 5

STI screening in sexually active females over age 25

Answer 5

GC/Chlamydia - annually

Question 6

Recommendations for HIV testing

Answer 6

At least once between age 13 and 64

Annually for unsafe sex practices or IVDU, gay, or bisexual men (q3-6mo)

Question 7

TRUE or FALSE

The FNP should apply a small amount of lubricant to the speculum prior to Pap testing to increase patient comfort.

Answer 7

False

lubricant can distort the results of a Pap smear

Question 8

Onset of Menses

Answer 8

Menarche

Question 9

Pain with menses

Answer 9

dysmenorrhea

Question 10

A cluster of emotional, behavioral, and physical symptoms occurring 5 days before menses for 3 consecutive cycles - cessation of signs and symptoms within 4 days after onset of menses - interference with ADLs

Answer 10

Pre-Menstrual Syndrome (PMS)

Question 11

Less than 21 day interval between menses

Answer 11

Polymenorrhea

Question 12

Infrequent bleeding

Answer 12

Oligomenorrhea

Question 13

Excessive menses flow

Answer 13

Menorrhagia

Question 14

Current cervical cancer screening recommendations

Answer 14

• Begin at age 21 - end at age 65 assuming 3 consecutive negative cytology results

Age 21-65 cytology q 3 years OR

Age 21-29 cytology q 3 years then

Age 30-65 cytology + HPV testing (for high risk or oncogenic HPV types) q 5 years

Screening after hysteretomy with removal of cervix (for benign reasons) - not recommended

Question 15

TRUE or FALSE

Your 55 year old patient is s/p TAH BSO for uterine fibroids. She should continue cervical cancer screening per guidelines.

Answer 15

FALSE

continued screening is only needed if surgery was done due to cancer

Question 16

Which organization recommends that mammography start at age 40 and occur annually for the duration of a female’s life?

Answer 16

ACOG

Question 17

How many characteristics of a breast nodule should be described?

Answer 17

Seven (location, size, shape, consistency, delimitation, tenderness, and mobility)

Question 18

At which age does cervical cancer screening start?

Answer 18

Age 21

Question 19

A hymen with two orificies is known as what?

Answer 19

a septate hymen