ATI RN
Genitourinary System Diseases Questions
Question 1 of 5
A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the:
Correct Answer: A
Rationale: The correct answer is A: Menstrual history, because it is generally nonthreatening. Starting with the menstrual history is appropriate as it is a common and noninvasive topic that can help build rapport and make the patient feel more comfortable. It also provides important insights into the patient's overall health and reproductive system. By addressing this topic first, the nurse can establish a foundation for a more in-depth discussion of other aspects of the patient's gynecologic health. Summary of other choices: B: Obstetric history is not the most appropriate to start with as it may not be relevant for all patients during an annual gynecologic examination. C: Urinary system history may not be the most relevant starting point for a routine gynecologic exam and may not be as nonthreatening as discussing menstrual history. D: Sexual history, while important, may be more sensitive and personal for some patients, making it less suitable as an initial topic for building rapport and establishing trust.
Question 2 of 5
When performing the bimanual examination, the nurse notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse's interpretation of these results should be which of these?
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C): 1. The cervix is normally mobile and should move when palpated. A fixed cervix may indicate malignancy. 2. Pain during cervical palpation can be a sign of inflammation, infection, or other abnormalities. 3. Smooth and firm cervix, along with pain, raise suspicion of an underlying issue. 4. Therefore, the nurse should interpret these findings as potentially concerning and further assessment is needed. Summary: Choice A is incorrect because the findings are not within normal limits. Choice B is incorrect as the cervix should not be firm. Choice D is incorrect as pain during palpation is significant and should not be dismissed.
Question 3 of 5
During an examination, the nurse would expect the cervical os of a woman who has never had children to appear:
Correct Answer: B
Rationale: The correct answer is B: Small and round. In a woman who has never had children, the cervical os is typically small and round due to the lack of previous childbirth stretching. This is considered normal and expected in nulliparous women. A: Stellate - This is incorrect as a stellate appearance of the cervical os is more commonly associated with trauma or previous childbirth. C: As a horizontal irregular slit - This is incorrect as an irregular slit appearance is more commonly seen in women who have had children. D: Everted - This is incorrect as an everted cervical os is typically seen in conditions such as cervical ectropion or inflammation, not necessarily related to parity status.
Question 4 of 5
During a pelvic examination, the nurse notes that the patient's cervix is irregular and hard to the touch. The nurse's next best action would be to:
Correct Answer: B
Rationale: The correct answer is B: Referral to a gynecologist for further examination. This is the best course of action because an irregular and hard cervix can indicate various underlying issues such as cervical dysplasia, fibroids, or cervical stenosis. A gynecologist can conduct a more thorough evaluation including additional tests like colposcopy or ultrasound to determine the cause and appropriate treatment. A: Performing a Pap smear test may not provide sufficient information about the specific condition causing the irregularity. C: Completing a cervical cancer screening may not address the immediate concern of the irregular and hard cervix. D: Completing an endometrial biopsy is not indicated for assessing cervical abnormalities, as it focuses on the endometrium rather than the cervix.
Question 5 of 5
A 30-year-old woman presents to the clinic with a complaint of a delayed period and abdominal discomfort. The nurse suspects pregnancy. Which of the following is the earliest and most reliable sign of pregnancy?
Correct Answer: C
Rationale: The correct answer is C: Changes in breast size. This is because hormonal changes in early pregnancy can cause breast tenderness, swelling, and darkening of the areola. This typically occurs before a missed period or a positive urine pregnancy test. A missed period (choice A) is a common sign of pregnancy, but not the earliest. A positive urine pregnancy test (choice B) confirms pregnancy but may not be the earliest sign. Abdominal tenderness and bloating (choice D) can occur due to various reasons and are not specific to pregnancy. Therefore, changes in breast size are the earliest and most reliable sign of pregnancy in this scenario.