Advanced Health Assessment of Women
Clinical Skills and Procedures 4th Edition
Carcio Secor test bank questions and answers
2024
Menopause - defined as 1 year without menstrual cycles. 51 years of age is the national
U.S average.
PapanicolaouTest - designed to detect cancer cells in the cervix and vagina. It is
generally recommended by age 18 years or in sexually active females, and is repeated
every 3 to 5 years depending on history
Adnexa of the uterus - comprise the fallopian tubes and ovaries-uterine appendages
Vulva - the whole female genital area- labia, clitoris, vagina, and the opening to the
urethra
Know the meaning of menarche and its significance in young girls. What defines
delayed puberty in females? - Menarche is the first menstrual period. The significance is
that now if you have sex, you can get pregnant. If the adolescent is PH stage 4 but has
not had a menses, then primary amenorrhea should be diagnosed. However, if the
adolescent does not meet the age and maturation criteria, then suscpect she is
experiencing delayed puberty or is a so-called "late bloomer". With this, she likely to
have a family history in her mother and/or sisters
What are the complications of pelvic inflammatory disease? - PID can damage the
fallopian tubes and tissues in and near the uterus and ovaries. PID can lead to serious
consequences including infertility, ectopic pregnancy, abscess formation, and chronic
pelvic pain
Cervical polys - bright red, soft, and fragile. They usually arise from the endocervical
canal.
Carcinoma of the cervix - a hard granular surface at or near the cervical os. The lesion
can evolve to form an extensive irregular cauliflower growth that bleeds easily. Found
by pap smear and not physical exam
,Nabothian cysts - may be observed as small, white or yellow, raised round areas on the
cervix. These are retention cysts of the endocervical glands are considered an expected
finding
Batholin's gland abscess - the buildup of pus that forms a lump in one of the glands.
Becomes very hot, red, tender, and swollen. Walking and sitting can cause severe pain
by putting pressure on the vulva.
Urinary Tract Infection - No fever in adults; appears well; no CVA tenderness; may have
suprapubic tenderness; neonates and young infants present with FTT, bacteremia and
fever.
Urine dipstick:+blood, +leukocyte esterase +nitrites; Microscopic analysis: RBCs,
WBCs, no casts; C&S; In children, voiding cystourethrogram and renal ultrasound are
recommended.
Pyelonephritis - Feels and looks ill. Fever, CVA tenderness; abdomen may be tender.
Urine dipstick:+blood, +leukocyte esterase +nitrites; Microscopic analysis: WBCs may
have white cell casts or bacterial casts; C &S; e.coli, klebsiella, proteus mirabillis,
enterobacter; blood cultures
Stress Incontinence - leakage of urine during activities that increase abdominal
pressure, such as coughing, sneezing, and laughing. It occurs most often in females ad
is caused by hyper motility at the base of the bladder and urethra associated with pelvic
floor relaxation
Urge incontinence - an abrupt and strong desire to void with the inability to delay
urination and is caused by bladder hyperactivity or hypersensitive bladder
Overflow incontinence - occurs with overdistention of the bladder caused by an
underactive or acontractile detrusor muscle. It occurs in the presence of obstruction or
interruption in the nervous system. Sphincter weakness can occur from damage to the
urethra or its innervation or from pelvic floor muscle relaxation (Dains, 374). Small
volume incontinence with symptoms of dribbling and hesitancy.
Overactive bladder - having many strong sudden urges to urinate during the day and
night. You may not have the ability to hold your urine until you can reach the bathroom.
You urinate 8 or more times a day or 2 or more times at night.
BPH - The patient would report hestitancy, slow urine stream, dribbling, and nocturia.
The physical findings would show prostate protrusion into rectum, median sulcus
reduced, prostate boggy. Digital rectal exam, PSA, and transrectal ultrasound are used
to assess/diagnose.
Ureterolithiasis - When kidney stones are formed in the ureter. Presents with hematuria
and pain. Urethral pain that is colicky and cyclic in nature.
,Balanitis - Typical in uncircumsized males who might have a hygiene issue. Phyiscal
findings are localized erythema and edema. Also the presence of smegma. There are
no diagnostic studies; diagnosed based on history and physical examination
Orchitis - -The patient reports an acute-onset of testicular pain and swelling. Pain
ranges from mild discomfort to severe pain. Ask about a history of mumps. Physical
findings include enlarged tender testis, erythematous and edematous scrotal skin.
Doppler flow studies are used to diagnose.
Epididymitis - Ask if patient has recently had a UTI (often seen in association with).
Patient presents with a painful scrotum, urethral discharge, fever, pyuria, and recent
sexual activity. The epididymis feels firm, lumpy, and is tender. Vas deferentia may be
beaded. Overlying scrotum may be markedly erythematous
Testicular Torsion - Ask about previous episodes of testicular pain. The history indicates
a rapid onset of acute pain. Nausea and vomiting may have occurred or be present.
Absence of systemic symptoms. Absence of cremasteric reflex on side of acute swelling
. Scrotal discoloration is often present. Doppler blood flow studies may identify lack of
blood flow. Surgical intervention must take place in 4 to 6 hours to salvage the testicle
Cryptorchidism - undescended testicles . During third trimester of pregnancy, the testes
descend from the retroperitoneal space through the inguinal canal to the scrotum. At full
term, one or both testes may still lie within the inguinal canal with the final descent into
the scrotum occurring in the early postnatal period. (Seidel 602). Uncommon expect in
premature infants.
Bacterial Vaginosis - Homogenous thin, white or gray discharge; pH >4.5. +KOH whiff
test; wet mount + clue cells
Trich - Profuse, frothy greenish discharge. Ph 5.0-6.6. The vaginal mucosa is inflamed
and often speckled with petechial lesions. In adolescents, petechial hemorrhage can
also be found on the cervix resulting in Strawberry Cervix (Seidel, 589). Wet mount :
round or pear-shaped protozoa; motile gyrating flagella
Gonorrhea - Purulent discharge from cervix; Skene/Bartholin gland inflammation; cervix
and vulva may be inflamed. DNA probe
Vaginal Candidiasis - White curdy discharge; pH 4.0 to 5.0; cervix may be red; cervix
may have erythema of perineum and thighs. KOH prep: myvelia, budding branching
yeast, pseudohyphae
Genital Herpes - Grouped vesicles on red base, erode to an ulcer; if on mucous
membrane, exudates form; if on skin, crusts from exudates form; redness, edema,
tender inguinal lymph nodes. Viral culture and Tzanck smear. (Dains, 421). Tzanck
smear characteristic findings are multinucleated giant cells that are likely to be found if
specimen is from an intact herpes lesion.
, Cervictitis - often results from STIs such as Chlamydia or gonorrhea. Same as the STIs
previously listed. Should treat those in order to treat the cervictitis. Abnormal vaginal
bleeding/discharge can be seen. Painful intercourse. But can also present without
symptoms. Exam may show discharge, redness of cervix, or swelling of vagina.
What is included under each section of the SOAP note. - • Include date, name,
occupation, marital status, source of information, reliability, referral source
• Subjective data- the information including the absence or presence of pertinent
symptoms that the patient tells you. Chief complaint, HPI, medications, allergies,
tobacco, alcohol, drugs, past medical history, family and social history, review of
systems that are pertinent
• Objective data- your direct observations from what you see, hear, smell, and touch.
ROS (same as from subjective data), vital signs, height and weight
• Assessment- your interpretations and conclusions, your rationale, the diagnostic
possibilities, present and anticipated problems
• Plan- diagnostic testing, therapeutic modalities, need for consultation, and rationale,
medication, education
Be able to recognize examples of objective data and subjective data. - • Subjective
data- information the patient tells you, quality or character of pain, also absence of
symptoms, "denies n/v/d", "sharp abdominal pain", "feels tired"
• Objective data- what you can directly see, touch, hear, and measure, physical findings
from inspection, palpation, auscultation, and percussion, examples: vital signs,
"distended abdomen with tenderness", "vaginal discharge", "wheezing on inspiration".
What are the components of the health history (chief complaint, present illness, past
history, family history, ROS, functional history, etc.) and what is included under each
section. - • Chief complaint- brief description of patients reason for seeking care
• History of present illness- description of problem; OLDCARTS
• Past medical history- surgeries, illnesses, injuries, immunizations, medications,
allergies, emotional status, recent lab tests
• Family history-pedigree of 3 generations with medical problems (HTN, DM, CA)
• Review of systems- General, skin, head, neck, EENT, chest, lungs, breasts,
vasculature, GI, GU, diet, endocrine, musculoskeletal, neuro, psych
• Functional history/Personal and social history- cultural background, home conditions,
occupation, environment of work/school/home, health habits (diet, exercise, smoking,
alcohol, drugs), any handicap or disability, exposure to chemicals, sexual health,
concerns about costs or health coverage.
After someone presents with a complaint, what is the next step in the health
assessment process? (Hint...what do you do prior to initiating the physical exam) -
History of present illness: onset, location, duration, character, aggravating and
associated factors, relieving factors, temporal factors, and severity: medications,
allergies
