Chapter 32: Alterations of the Reproductive Systems Including Sexually Transmitted Infections My Nursing Test Banks

Huether and McCance: Understanding Pathophysiology, 5th Edition

Chapter 32: Alterations of the Reproductive Systems Including Sexually Transmitted Infections

Test Bank

MULTIPLE CHOICE

1. In the majority of cases delayed puberty is due to:

a.

A disruption in the hypothalamus

b.

A disruption of the pituitary

c.

Slow maturation

d.

Ambiguity in sex determination

ANS: C

In about 95% of cases, delayed puberty is a normal physiologic event. Hormonal levels are normal, the hypothalamic-pituitary-gonadal axis is intact, and maturation is happening slowly.

Only about 5% of the occurrences of delayed puberty are due to a disruption in the hypothalamus.

Only about 5% of the occurrences of delayed puberty are due to a disruption in the pituitary.

Ambiguity in sex determination could play a role in delayed puberty, but this occurrence is rare.

REF: p. 800

2. 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, but not with pelvic disease.

Absence of menstruation is amenorrhea.

Unusually long menstrual periods would be termed dysfunctional uterine bleeding.

Menstrual irregularity is termed dysfunctional uterine bleeding.

REF: p. 801

3. A 20-year-old female presents with pelvic and back pain severe enough to miss work. She reports that the pain occurs with the onset of menses. Physical examination fails to find pelvic pathology. 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, but not with pelvic disease.

Painful menstruation is associated with increased prostaglandins, not lack of estrogen.

Painful menstruation is associated with increased prostaglandins, not stress.

Painful menstruation is associated with increased prostaglandins, not poor nutrition.

REF: p. 801

4. A 25-year-old female presents with amenorrhea and hirsutism. She is diagnosed with 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 the lab findings of PCOS.

Cortisol levels are not elevated in PCOS.

REF: p. 803

5. A 30-year-old female with newly diagnosed 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

PCOS is a leading cause of infertility in the United States.

PCOS is most often associated with infertility, not cancer.

PCOS is more often associated with infertility. It does not result in early menopause.

Pelvic inflammatory disease is an infectious process.

REF: p. 803

6. A 23-year-old sexually active female presents with white copious discharge and itch. She is diagnosed with yeast vaginitis 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 Candida albicans.

The most common cause of yeast vaginitis is Candida albicans. E coli does not cause yeast vaginitis.

The most common cause of yeast vaginitis is Candida albicans. Lactobacillus acidophilus does not cause yeast vaginitis.

The most common cause of yeast vaginitis is Candida albicans. Neisseria gonorrhoeae is the cause of gonorrhea.

REF: p. 807

7. 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.

REF: p. 809

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.

Follicular cysts do not contain skin, hair, or bone.

Corpus luteal cysts do not contain skin, hair, or bone.

Micro cysts do not contain skin, hair, or bone.

REF: p. 811

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.

REF: p. 811

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

The treatment for endometriosis is suppressing ovulation.

The treatment for endometriosis is suppressing ovulation; it is not due to infection.

The treatment for endometriosis is suppressing ovulation; it is not treated by suppressing prostaglandins.

The treatment for endometriosis is suppressing ovulation, not fertilization.

REF: p. 813

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 is associated with cervical cancer, not ovarian.

HPV is associated with cervical cancer, not endometrial.

HPV is associated with cervical cancer, not vulvar.

REF: p. 813

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.

Exposure in utero to nonsteroidal estrogens (DES) has been identified as a risk factor for vaginal cancer, not endometrial.

Exposure in utero to nonsteroidal estrogens (DES) has been identified as a risk factor for vaginal cancer, not cervical.

Exposure in utero to nonsteroidal estrogens (DES) has been identified as a risk factor for vaginal cancer, not uterine.

REF: p. 815

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 prevalent gynecologic malignancy.

Carcinoma of the endometrium, not the cervix, is the most prevalent gynecologic malignancy.

Carcinoma of the endometrium, not the ovary, is the most prevalent gynecologic malignancy.

Carcinoma of the endometrium, not the fallopian tube, is the most prevalent gynecologic malignancy.

REF: p. 816

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: (1) cancer has spread beyond the pelvis to the lining of the abdomen, and (2) 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.

REF: p. 818

15. A 30-year-old male presents with penile tenderness and discharge. Physical examination reveals that his foreskin cannot be retracted back over the glans penis. He is suffering from:

a.

Paraphimosis

b.

Phimosis

c.

Peyronie disease

d.

Priapism

ANS: B

Phimosis is a condition in which the foreskin cannot be retracted back over the glans.

Paraphimosis is the opposite: the foreskin is retracted and cannot be moved forward (reduced) to cover the glans.

Peyronie disease is a fibrotic condition that causes lateral curvature of the penis during erection.

Priapism is a prolonged erection.

REF: p. 819

16. A 68-year-old male presents complaining of difficulty having sexual intercourse. He reports that his penis curves during erection. This condition is referred to as:

a.

Phimosis

b.

Cryptorchidism

c.

Paraphimosis

d.

Peyronie disease

ANS: D

Peyronie disease is a fibrotic condition that causes lateral curvature of the penis during erection.

Phimosis is a condition in which the foreskin cannot be retracted back over the glans.

Cryptorchidism is a condition of testicular maldescent.

Paraphimosis is the opposite: the foreskin is retracted and cannot be moved forward (reduced) to cover the glans.

REF: p. 820

17. _____ is inflammation of the glans penis.

a.

Phimosis

b.

Balanitis

c.

Priapism

d.

Hydrocele

ANS: B

Balanitis is an inflammation of the glans penis.

Phimosis is a condition in which the foreskin cannot be retracted back over the glans.

Priapism is a prolonged erection.

A hydrocele is a collection of fluid within the tunica vaginalis.

REF: p. 820

18. Cryptorchidism can be defined as:

a.

A normal developmental state of the testes

b.

An abnormal state in which the testes are overdeveloped

c.

Lack of a scrotum

d.

Problems with testicular descent

ANS: D

Cryptorchidism is a condition of testicular maldescent.

Cryptorchidism is a condition of testicular maldescent; it is not a description of normalcy.

Cryptorchidism is a condition of testicular maldescent, not overdevelopment.

Cryptorchidism is a condition of testicular maldescent, not a lack of a scrotum.

REF: p. 823

19. A 21-year-old male presents with inflammation of the testes. He has a high fever and edema and redness of the testes. Which organism is the most likely the cause of his symptoms?

a.

Herpes virus

b.

Escherichia coli

c.

Mumps

d.

Cytomegalovirus

ANS: C

Mumps is the most common infectious cause of orchitis and usually affects postpubertal males.

Herpes would not result in testicular swelling.

Escherichia coli infection would not result in testicular swelling and redness.

Cytomegalovirus is a sexually transmitted disease and is not manifested in testes.

REF: p. 825

20. An important risk factor in the development of benign prostatic hypertrophy (BPH) is:

a.

Recurrent prostatitis

b.

A diet high in fat

c.

Cigarette smoking

d.

Increased age

ANS: D

The greatest risk factor for BPH is increased age.

The greatest risk factor for BPH is increased age, not prostatitis.

The greatest risk factor for BPH is increased age, not a diet high in fat.

The greatest risk factor for BPH is increased age, not cigarette smoking.

REF: p. 826

21. A middle-aged male speaks to his physician about benign BPH. He reveals that his father was recently diagnosed with this condition, and he wants to know if he could have it. The physician tells him that a common complaint from men with mild to moderate BPH is:

a.

Decreased urinary stream

b.

Infertility

c.

Sexual dysfunction

d.

Prostatodynia

ANS: A

The most common complaint of men with BPH is decreased urine stream.

Infertility is not associated with benign prostatic hypertrophy.

Sexual dysfunction could be associated with BPH, but it is not as common a complaint as decreased stream.

A painful prostate is not a frequent complaint of men with BPH.

REF: p. 827

22. Symptoms of prostatitis are similar to symptoms of:

a.

Prostate cancer

b.

BPH

c.

Urinary tract infection (UTI)

d.

Epididymitis

ANS: C

Clinical manifestations of acute bacterial prostatitis are those of UTI or pyelonephritis.

Clinical manifestations of acute bacterial prostatitis are those of UTI or pyelonephritis. Cancer often has no symptoms.

Clinical manifestations of acute bacterial prostatitis are those of UTI or pyelonephritis. Symptoms could include difficulty with urinary stream, but more commonly it is of UTI.

The main symptom of epididymitis is scrotal or inguinal pain caused by inflammation of the epididymis and surrounding tissues.

REF: p. 828

23. A 40-year-old male is concerned about the possibility of developing prostate cancer. He reports that his father died of prostate cancer, and he wants to take all preventive measures. He is told to consume a diet low in:

a.

Fat

b.

Lycopene

c.

Fiber

d.

Calcium

ANS: A

To prevent prostate cancer, the patient should consume a diet low in fat.

To prevent prostate cancer, the patient should consume a diet low in fat, not lycopene.

To prevent prostate cancer, the patient should consume a diet low in fat. The diet should be high in fiber.

To prevent prostate cancer, the patient should consume a diet low in fat, not calcium.

REF: p. 830

24. A 35-year-old nonpregnant female presents complaining of breast discharge. She is diagnosed with galactorrhea. The condition is most likely caused by:

a.

Infection

b.

Hormonal imbalances

c.

Tissue injury

d.

Cancer

ANS: B

Galactorrhea is not a breast disorder but, rather, a manifestation of pathophysiologic processes elsewhere in the body. These processes are chiefly hormone imbalances caused by hypothalamic-pituitary disturbances, pituitary tumors, or neurologic damage.

Galactorrhea is not due to infection, but a hormonal imbalance.

Galactorrhea is not due to tissue injury, but to a hormonal imbalance.

Galactorrhea is not due to cancer, but to a hormonal imbalance.

REF: p. 838

25. Which of the following signs is usually the first clinical manifestation of breast cancer?

a.

Dimpling

b.

Nipple discharge

c.

Chest pain

d.

A painless lump

ANS: D

The first sign of breast cancer is usually a painless lump.

The first sign of breast cancer is usually a painless lump. Dimpling is a later sign.

The first sign of breast cancer is usually a painless lump. Nipple discharge is a later sign.

The first sign of breast cancer is usually a painless lump. Chest pain is a later sign.

REF: p. 852

26. The patients medication has a side effect of gynecomastia. The patient asks the nurse to define this term. The nurse would respond that gynecomastia is:

a.

Lack of breast development in women

b.

Overdevelopment of breast tissue in males

c.

A type of breast cancer

d.

Inflammation of the mammary glands in lactating women

ANS: B

Gynecomastia is overdevelopment of breast tissues in males.

Gynecomastia is overdevelopment of breast tissues in males. It is not a lack of breast development.

Gynecomastia is overdevelopment of breast tissues in males. It is not a type of breast cancer.

Gynecomastia is overdevelopment of breast tissues in males. It is not inflammation of the mammary glands.

REF: p. 856

27. A 35-year-old female presents with infertility and gradual blindness. She reports that she has otherwise been healthy. History reveals that she was promiscuous and had unprotected sexual intercourse several times when she was younger. She now has neurological involvement. Which of the following sexually transmitted infection (STI) does she most likely have?

a.

Syphilis

b.

Chlamydia

c.

Gonorrhea

d.

Genital herpes

ANS: A

Neurosyphilis and life-threatening hypersensitivities can develop without treatment.

Syphilis leads to neurological involvement, not Chlamydia.

Syphilis leads to neurological involvement, not gonorrhea.

Syphilis leads to neurological involvement, not genital herpes.

REF: p. 858

28. A 19-year-old female presents with genital warts. Which of the following would cause this condition?

a.

Chlamydia trachomatis

b.

Adenovirus

c.

HPV

d.

Herpes simplex virus

ANS: C

Genital warts are due to HPV.

Genital warts are due to HPV, not Clamydia trachomatis.

Genital warts are due to HPV, not adenovirus.

Genital warts are due to HPV, not herpes simplex, which leads to blisters.

REF: p. 815

29. A 25-year-old sexually active female presents with urethritis, dysuria, and cervical discharge. She is diagnosed with the most common bacteria STI in the United States. The student would identify this infection is due to:

a.

Gonorrhea

b.

Syphilis

c.

Chlamydia

d.

Herpes

ANS: C

Chlamydia is the most common bacterial STI in United States and the leading cause of infertility for both men and women.

Chlamydia is the most common.

Chlamydia is the most common.

Herpes is a virus.

REF: p. 858

30. An example of a parasitic STI that is transmitted through close skin-to-skin contact is:

a.

Chlamydia

b.

Syphilis

c.

Scabies

d.

Gardnerella

ANS: C

Scabies is a parasite that can be transmitted through sexual contact.

Chlamydia is a bacteria.

Syphilis is a bacteria.

Gardnerella is an anaerobe.

REF: p. 859

31. A syndrome often associated with cystocele is:

a.

Cystitis

b.

Renal calculi

c.

Stress incontinence

d.

Urinary retention

ANS: C

Cystocele is commonly associated with stress incontinence.

Cystitis is an infection in the bladder and is not associated with cystocele.

Renal calculi are kidney stones and not associated with cystocele.

Urinary retention is the inability to void normally, and although it may be associated with cystocele, it is not a common occurrence.

REF: p. 809

32. 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

Treatment for pelvic organ prolapse may include the insertion of a pessary, which is a removable mechanical device that holds the uterus, bladder, or bowel in position.

Treatment is a pessary. A urinary catheter would not address the problem.

Dietary fiber is always important, but is not a treatment of pelvic organ prolapse.

Antispasmodics may help with urinary urgency, but does not address prolapse.

REF: p. 810

MULTIPLE RESPONSE

1. Conditions that contribute to dysfunctional uterine bleeding include (select all that apply):

a.

Polycystic ovarian syndrome (PCOS)

b.

Obesity

c.

Thyroid disease

d.

Hepatitis

e.

Excessive exercise

ANS: A, B, C

Polycystic ovary syndrome (PCOS), obesity, and thyroid disease also are common contributors to dysfunctional uterine bleeding. Hepatitis and excessive exercise are not.

REF: p. 802

2. An 18-year-old male presents with urethral itching and burning and increased frequency and urgency with urination. He reports recently having unprotected sex with a new partner. Which of the following could be the cause of his symptoms? (Select all that apply.)

a.

Neisseria gonorrhea

b.

Chlamydia trachomatis

c.

Herpes infection

d.

Escherichia coli

e.

Candida albicans

ANS: A, B

His symptoms are most likely due to Neisseria gonorrhea or Chlamydia trachomatis. Chlamydia trachomatis leads to prostatitis. Herpes and Candida do not manifest with urinary symptoms.

REF: p. 819

3. The risk of testicular cancer is greater for which group? (Select all that apply.)

a.

With a history of cryptorchidism

b.

With a history of phimosis

c.

Who are of Caucasian ethnicity

d.

Who are of African-American descent

e.

With a history of HIV

ANS: A, C, E

Genetic predisposition is supported statistically showing that the disease is relatively rare among native Africans, African-Americans, Asians, and native New Zealanders. Risk factors include history of cryptorchidism, abnormal testicular development, HIV and AIDS, Klinefelter syndrome, and history of testicular cancer.

REF: p. 825

4. Which of the following are true regarding prostate cancer? (Select all that apply.)

a.

It is responsible for the majority of cancer-related deaths in males.

b.

It usually occurs before age 50.

c.

It is the leading type of cancer in men in the United States.

d.

It is more common in Caucasian men in the United States.

e.

Prostate cancer rates have been declining.

ANS: C, E

Prostate cancer is the second leading cause of cancer deaths in men. Prostate cancer is among the most common male cancers, but the incidence varies greatly worldwide. It is the most common cancer in American males, but the third most common cancer worldwide. African-American men are more greatly affected. Rates have been declining.

REF: p. 829

Mosby items and derived items 2012 Mosby, Inc., an imprint of Elsevier Inc.

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