During an examination, the nurse notices that a male patient has a red, round, superficial ulcer with a yellowish serous discharge on his penis. On palpation, the nurse finds a nontender base that feels like a small button between the thumb and fingers. At this point the nurse suspects that this patient has:

Correct Answer: D

Rationale: The correct answer is D: Syphilitic chancre. The description of a red, round, superficial ulcer with a yellowish serous discharge on the penis, along with a nontender base that feels like a small button, is indicative of a primary syphilitic chancre. This lesion is typically painless and can be mistaken for other genital ulcers, but the specific characteristics described point towards syphilis. Genital warts (choice B) present as cauliflower-like growths, herpes infection (choice C) typically causes painful blisters, and chancroid (choice A) is characterized by soft, painful ulcers. Syphilitic chancre is the most likely diagnosis based on the presentation described.

Correct Answer: A

Rationale: The correct answer is A: Cervix. During a speculum inspection, the nurse would expect to see the cervix at the end of the vaginal canal. The cervix is the lower part of the uterus that connects the uterus to the vagina. It appears as a small, round structure at the end of the vaginal canal. This is an important part of the female reproductive system that can be visualized during a speculum examination. Summary: B: Uterus - Incorrect as the uterus is located above the cervix and is not visible at the end of the vaginal canal. C: Ovaries - Incorrect as the ovaries are located on either side of the uterus and are not visible during a speculum examination. D: Fallopian tubes - Incorrect as the fallopian tubes are not visible during a speculum examination as they are located above the ovaries and connect the ovaries to the uterus.

Correct Answer: C

Rationale: The correct answer is C: 3; 2; 1. Gravida refers to the total number of pregnancies, including the current one. As the patient has had three pregnancies, the gravida is 3. Para indicates the number of live births, so since the patient has had two live births, the para is 2. AB represents the number of abortions or miscarriages, which is 1 in this case. Therefore, the correct way to record this patient's obstetric history is gravida 3, para 2, AB 1. Choice A (2; 2; 1) is incorrect because the patient has had three pregnancies, not two. Choice B (3; 2; 0) is incorrect as it does not account for the abortion/miscarriage that occurred. Choice D (3; 3; 1) is also incorrect because the patient has had two live births, not three.

Correct Answer: C

Rationale: Correct Answer: C - "When did you notice that your body was changing?" Rationale: 1. This question is open-ended and focuses on the preadolescent girl's personal experience, allowing her to share information at her comfort level. 2. It avoids assumptions and allows the girl to express herself without feeling pressured. 3. By asking about her own observations, it encourages self-reflection and empowers her to communicate about her body changes. Summary: A - Option A might indirectly suggest that the girl should have questions about growing up, potentially creating pressure. B - Option B assumes the mother's role as the primary source of information, potentially overlooking the girl's own experiences. D - Option D introduces the tutor's personal experience, which may lead the girl to compare her feelings to the tutor's, potentially causing unnecessary anxiety.

Correct Answer: B

Rationale: The correct answer is B because the findings of a firm, smooth uterine wall, palpable ovaries, and a firm, pulsating fallopian tube are concerning for possible gynecological issues such as ovarian cancer or pelvic inflammatory disease. A prompt referral to a gynecologist is necessary for further evaluation, which may include imaging studies or biopsies to rule out serious conditions. Choice A is incorrect as the findings are not normal. Choice C delays necessary evaluation, potentially leading to a progression of any underlying condition. Choice D assumes the presence of an ovarian cyst without further investigation, which is not appropriate given the pulsating fallopian tube and the need for a comprehensive assessment by a specialist.