Beckmann and Ling Obstetrics and Gynecology Nursing 8th Edition - Test Bank

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Beckmann and Ling’s Obstetrics and Gynecology Nursing 8th Edition – Test Bank

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Beckmann and Ling’s Obstetrics and Gynecology / Edition 8/ 8th edition

TESTBANK

Chapter 1: Women’s Health Examination and Women’s Health Care

Management

1:

Elevating the head of the examining table approximately 30 degrees facilitates

a: the observation of the patient’s responses

b: the ability of the patient to comfortably look around to distract her from the examination

c: the contraction of the abdominal wall muscle groups, making the examination easier

d: comfortable blood pressure measurement

e: the physician not being distracted by eye contact with the patient

2:

Which of the following uterine positions is most associated with dyspareunia?

a: Midposition, retroflexed

b: Retroverted, anteflexed

c:

Anteverted, anteflexed

d:

Retroverted, retroflexed

e:

Midpostion, anteflexed

3:

Inquiry concerning adult and child history of sexual abuse should be included in the sexual history

a: if time permits

b: in visits where there are suspicious physical findings but not otherwise

c: in visits where sufficient time is allotted

d: in all new patient visits

e: in visits where a specific indication is noted

4: Peau d’orange change in the breast is associated with

a:

edema of the lymphatics

b: jaundice

c: too vigorous breastfeeding

d: overly tight undergarments

e: galactorrhea

5: Which kind of speculum is often most suitable for examination of the nulliparous patient?

a: Morgan’s speculum

b: Endoscopic speculum

c: Ling speculum

d: Graves speculum

e:

Pederson speculum

6:

Which uterine configuration is most difficult to assess for size, shape, configuration, and mobility?

a: Midposition

b: Anteverted

c:

There is no difference in difficulty

d: Retroverted

7:

Which type of speculum is most appropriate for the examination of a parous menstrual woman?

a: Ling speculum

b: Graves speculum

c:

Pederson speculum

d:

Endoscopic speculum

e: Morgan’s speculum

8: Menopause is defined as the cessation of menses for greater than

a: 9 months

b: 36 months

c: 12 months

d: 18 months

e: 24 months

9:

In a woman describing sufficiently frequent sexual encounters, infertility typically is described as a

failure to conceive after

3 months

b: 9 months

c: 12 months

d: 18 months

e: 6 months 10:

During bimanual examination of the adnexa in normal premenopausal women, the ovaries are palpable

a: all the time

b: almost never

c: about one-half of the time

d:

about thee-quarters/most of the time

e:

about one-quarter of the time

11:

If a patient becomes uncomfortable with a topic during a history-taking session, the best response of the physician is to

a:

address the patient’s discomfort in a positive and supportive manner

b: discontinue discussion of the topic to avoid further patient discomfort

c: discontinue discussion to avoid damage to the patient-physician relationship

d: continue after making a joke to relieve tension

e:

ignore the discomfort and proceed with questioning

12:

Which of the following statements about the steps in the breast examination is correct?

a:

Palpation is done first

b:

Palpation and inspection are done simultaneously

c:

Palpation is only done if inspection is abnormal

d:

Palpation may be done with detailed inspection if a woman is especially modest

e:

Inspection is done first

13:

Questions that promote the physician’s fullest understanding of the patient’s situation are best characterized as a: compassionate

b: chronological

c: sympathetic

d: emphatic

e: evidence based 14:

The last menstrual period is dated from the

a:

first day of the last normal period

b: last day of the last normal period

c: first day of the last bleeding episode

d: last day of the last bleeding episode 15:

The passage of clots during menstruation

a: is always abnormal

b:

may be either normal or abnormal

c: is always normal

d: is extremely rare

16:

In the abbreviation of the obstetric history-G[1] P[2] [3] [4] [5]-“1” stands for the number of

a: living children

b: pregnancies

c: term pregnancies

d: preterm pregnancies

e: abortions

17:

In the abbreviation of the obstetric history-G[1] P[2] [3] [4] [5]-“2” stands for the number of

a: living children

b: pregnancies

c: term pregnancies

d: preterm pregnancies

e: abortions

18:

In the abbreviation of the obstetric history-G[1] P[2] [3] [4] [5]-“3” stands for the number of

a: living children

b: pregnancies

c: term pregnancies

d: preterm pregnancies

e: abortions

19:

In the abbreviation of the obstetric history-G[1] P[2] [3] [4] [5]-“4” stands for the number of

a: living children

b: pregnancies

c: term pregnancies

d: preterm pregnancies

e: abortions

20:

In the abbreviation of the obstetric history-G[1] P[2] [3] [4] [5]-“5” stands for the number of

a: living children

b:

c: term pregnancies

d: preterm pregnancies

e: abortions

21:

Tanner’s classification with respect to the breast relates to changes in the breast

a: before and after lactation

b: associated with malignancy

c: associated with maturation

d: associated with galactorrhea

e: associated with fibrocystic changes

The rectovaginal examination should be performed

a: after 52 years of age

b: at the initial patient visit

c: only for the evaluation of chronic pelvic pain

d: only when there are symptoms of pelvic relaxation

e: at intervals of 5 years

23:

In the gynecologic history, it is often possible to distinguish between vaginitis and pelvic inflammatory disease by inquiring about

a: the duration of the pain

b: the symptoms present (fever/chills, itching)

c:

the timing of pain in relation to menses

d: the association of pain with body position

e: the use of topical medications

24:

The most common reason for failure to visualize the cervix during the speculum examination is

a: failure to use lubricant

b: a full bladder

c: failure to fully insert the speculum

d: use of a speculum that has not been warmed

e: use of the wrong speculum

25:

Prehypertension is defined as a blood pressure range of

a:

80-90/120-139

b: 90-100/120-139

c: 80-90/110-129

d: 70-80/110-129

e:

70-80/120-139

Chapter 2: The Obstetrician–Gynecologist’s Role in Screening and Preventive Care

1: The sensitivity of a screening test is defined as the proportion of

a: unaffected individuals that test positive

b:

affected individuals that test positive

c:

unaffected individuals that test negative

d:

affected individuals that test negative

2:

The specificity of a screening test is defined as the proportion of

a:

affected individuals that test negative

b:

unaffected individuals that test positive

c:

affected individuals that test positive

d: unaffected individuals that test negative

3:

Counseling an obese patient to lose weight is an example of

a:

secondary prevention

b: primary prevention

c: empathy

d: engagement

4:

In women, the thyroid-stimulating hormone screening test should be performed at what interval?

a:

Every 1-2 years from age 40 years, then yearly after age 50 years

b:

Every 5 years after age 50 years

c: Annually from puberty or from the onset of sexual activity

d:

Every 5 years from age 19 years, then every 3-5 years after age 65 years

5:

The Pap smear for cervical dysplasia should be performed at what interval?

a:

Every 2-3 years after age 30 years if three consecutive annual tests are negative

b:

Every 5 years from age 19 years, then every 3-5 years after age 65 years

c:

Every 1-2 years beginning at age 65 years

d:

Every 1-2 years from age 40 years, then yearly after age 50 years

6: A cholesterol/lipid profile should be performed for women without risk factors at what interval?

a:

Every other year from age 40 years, then yearly after age 50 years

b:

Every 5 years after age 45 years

c:

Every 3-5 years after age 65 years

d:

Every 5 years from age 19 years, then every 3-4 years after age 65 years

7:

A mammography to detect breast cancer should be performed at what interval in women at average risk?

a:

Every 1-2 years after age 65 years

b:

Every 5 years after age 19 years, then every 3-4 years after age 65 years

c:

Every other year from age 40 years, then yearly after age 50 years

d:

Every 3-5 years after age 45 years

8:

A colonoscopy to detect colorectal cancer should be performed at what interval for women at average risk?

a:

Every 10 years starting at age 50 years

b:

Every 1-2 years starting at age 40 years

c:

Every 10 years starting at age 65 years

d:

Every 10 years from age 19 years, then every 3-4 years after age 65 years

9:

Which of the following is the most appropriate screening mechanism for cervical dysplasia?

a: Pap smear

b:

Serum HPV titer

c: HPV-DNA testing

d: Colposcopy of suspicious lesions

10:

Which of the following is the most appropriate screening mechanism for colorectal cancer?

a: Hemogram

b: Colonoscopy

c:

Physical examination of suspicious lesions

d: CT scan

11:

Which of the following is the most appropriate screening mechanism for thyroid disease?

a:

Thyroid-stimulating hormone

b: Free thyroxine

c:

Yearly physician examination

d:

Thyroid-binding globulin

12:

What is the appropriate interval for Pap testing in women who have had a total hysterectomy for

reasons other than cervical dysplasia?

a:

Every 2 years following the hysterectomy

b:

Every 5 years following the hysterectomy

c:

No additional Pap testing is needed

d:

Every year following the hysterectomy

13: In sexually active women age 25 or younger, regular screening for Chlamydia should occur

a: only if the woman is at high risk for infection

b: every 3-5 years

c: annually

d: every 2 years

14:

Bone mineral density testing is recommended for women without risk factors for osteoporosis beginning at what age?

a:

40 years

b: 65 years

c: 50 years

d: Testing is not recommended for women with no risk factors

15:

A 40-year-old woman comes for an initial visit. Her BMI is 30 and she had previously given birth to an infant weighing 9.5lb. Which of the following initial screening tests is indicated for this patient?

a: Fasting blood glucose

b: Colonoscopy

c: TSH level

d: Bone mineral density testing

Chapter 3: Ethics, Liability, and Patient Safety in Obstetrics and Gynecology

1:

The principle that the patient should be given what is “due” most closely matches the principle of

a: justice

b: nonmaleficence

c: beneficence

d: autonomy

2:

The principle that there should be respect for the patient’s right to make choices based on her beliefs and values best matches the principle of

a: beneficence

b: nonmaleficence

c: justice

d: autonomy

3:

The principle that there is a duty not to inflict harm or injury best matches the principle of

a: nonmaleficence

b: autonomy

c: justice d: beneficence

4:

The principle that there is a duty to promote the well-being of the patient best matches the principle of

a: justice

b:

c: beneficence

d: nonmaleficence

5:

A 32-year-old patient has delivered at 23 weeks of gestation, 3 days after premature rupture of the membranes. She has discussed the circumstances with her obstetrician and requests that no attempts at resuscitation should be made. At delivery there are rare gasping, breathing movements. The pediatrician recommends that intubation be done. In this case, the individual with the clearest primary responsibility for this decision is the

a: obstetrician

b: pediatrician

c: hospital risk manager

d:

mother

e: hospital attorney

6:

Respect for patient wishes (autonomy) primarily requires that there be assessment of which of the following?

a:

Cost of the proposed treatment

b:

The legal risk to the physician and hospital

c:

Patient’s ability to consider information

d:

Physician’s concurrence with the patient’s wishes

e: Standards of care

7:

A 62-year-old woman with newly diagnosed stage III ovarian cancer refuses chemotherapy. She wants to

“go home to die.” The next step in evaluating this patient is to

a: determine insurance coverage for this action

b: call the family for a conference

c: accept the patient’s wishes and discharge her from the hospital

d: call the state medical licensing board and hospital attorney

e: assess the patient’s comprehension and look for evidence of impaired decision making

8: If a pregnant woman rejects medical recommendations, relying on care given in similar cases would be an example of a: principle-based ethics

b: virtue-based ethics

c: feminist ethics

d:

e: case-based ethics

9:

The concept of informed consent best relates to the principle of

a: autonomy

b: justice

c: beneficence

d: nonmaleficence

10: Paternalism violates the ethical principle of

a: nonmaleficence

b: beneficence

c: standard of care

d: justice

e: autonomy

11:

The person with primary responsibility to providing informed consent is

a:

the person or physician’s staff assigned the task

b: the patient

c: the social worker assigned to the patient

d: the hospital administrator

e: the physician

12:

In medical liability cases the complaint comes from the

a: defendant

b: judge

c: jury

d: attorney

e: plaintiff 13: Most medical errors are associated with a: the use of care guidelines

b: the use of medications

c: the use of standards of care

d:

the use of hospital regulations

e: the use of improper surgical technique

Chapter 4: Embryology and Anatomy

1:

The genital system develops from the embryonic

a: yolk sac

b: endoderm

c: mesoderm

d: ectoderm

e: cytotrophoblast

2: The urogenital ridges give rise to elements of the

a: cardiovascular system

b: reproductive system

c: muscular system

d: skeletal system

e: gastrointestinal system

3:

Congenital adrenal hyperplasia ultimately affects the development of the genitalia of female fetuses

through the

a: stimulation of cortisol production

b: stimulation of cortisone production

c: stimulation of androgen production

d: inhibition of the SRY gene

e: inhibition of the WNT4 gene

4:

Primary oocytes first appear at what stage of development

a: In the primordial follicles

b: At puberty

c: In the primary sex cords

d: At birth

e: In the embryonic yolk sac

5: Primordial germ cells can be identified during the third week of development in the

a:

vaginal plate

b: urogenital sinus

c: cortical cords

d: gonadal ridge

e: yolk sac

6:

In the female, which of the following persists to form the major parts of the reproductive tract?

a: Mesonephric (wolffian) ducts

b: Prmary sex cords

c: Paramesonephric (Mullerian) ducts

d: Gubernaculum

Gartner cysts result from remnants of the

a: tunica albuginea

b: primary sex cords

c: Mullerian ducts

d: mesonephric ducts

8:

Transverse ultrasonography can begin to reliably distinguish between the two sexes at about how many weeks of gestation

a: 15 weeks

b: 5 weeks

c: 10 weeks

d:

20 weeks

e:

25 weeks

9:

Which of the following results in the absence of the uterus?

a:

Degeneration of the Mullerian ducts

b:

Degeneration of the mesonephric ducts

c:

Lack of fusion of the inferior parts of the paramesonephric ducts

d:

Failure of migration of the primordial germ cells

10:

Which of the following results in the formation of a double uterus (uterus didelphys)?

a:

Lack of fusion of the inferior parts of the Mullerian ducts

b:

Failure of migration of the primordial germ cells

c:

Degeneration of the mesonephric ducts

d:

Degeneration of the Mullerian ducts

11:

The labia minora develop from the

a: urogenital folds

b: labioscrotal swellings

c: urogenital sinus

d: genital tubercle

12:

The labia majora develp from the

a: labioscrotal swellings

b:

urogenital sinus

c: genital tubercle

d: urogenital folds

13:

The clitoris develops from the a: urogenital folds

b: genital tubercle

c: labioscrotal swellings

d: urogenital sinus

14:

In the female, the embryologic homologue of the penis is the a: frenulum

b: labia majora

c: labia minora

d: clitoris

15:

The false pelvis and the true pelvis are separated by the

a: linea terminalis

b: acetabulum

c: obturator membrane

d: pelvic outlet

e: sacrospinous ligament

16:

The diagonal conjugate is defined as the distance

a:

between the true and false pelvis

b:

between the lower border of the pubis anteriorly and the lower sacrum at the level of the ischial spines

c:

between the upper border of the pubis anteriorly and the lower sacrum at the level of the ischial spines

d:

measured at the greatest width of the superior aperture

e: between the ischial spines

17:

Which of the following contains the uterine arteries and veins and the ureters?

a: Infundibulopelvic ligament

b: Broad ligament

c: Uterosacral ligament

d:

Sacrospinal ligament

e: Cardinal ligament

18:

The ligament that provides primary support to the uterus is the

a: uterosacral ligament

b: infundibulopelvic ligament

c: broad ligament

d: sacrospinal ligament

e: cardinal ligament

19:

The epithelial lining of the fallopian tube is

a:

Columnar

b: Transitional

c: Simple squamous

d: Stratified columnar

e: Stratified squamous 20:

The fallopian tubes enter into which part of the uterus

a: Fundus

b: Cornu

c: SQ junction

d: Lower uterine segment

Mesosalpinx

21:

The two main anatomic divisions of the uterus are the corpus and the

a: uterotubal junction

b: cornu

c: fundus

d: isthmus

e: cervix

Chapter 5: Maternal–Fetal Physiology

1: Oxygen crosses the placenta by a:

pinocytosis

b: facilitated diffusion

c: simple diffusion

d: active transport

e: phgocytosis

2: Glucose crosses the placenta by a: facilitated diffusion

b: simple diffusion

c: active transport

d: phagocytosis

e:

3:

Amino acids cross the placenta by

a: facilitated diffusion

b: active transport

c: pinocyctosis

d: simple diffusion

e: phagocytosis

4:

Pregnancy has what effect on gastric motility?

a: Gastric motility typically remains the same

b: The effect on gastric motility is unpredictable

c:

Gastric motility typically increases

d:

Gastric motility typically decreases

5:

Pregnancy has what effect on gastric reflux?

a:

The effect on gastric reflux is unpredictable

b:

Gastric reflux is typically unaffected

c:

Gastric reflux typically decreases

d: Gastric reflux typically increases

6:

“Morning sickness” typically begins during which weeks of pregnancy?

a: 1-3 weeks

b:

16-22 weeks

c: 10-12 weeks

d: 14-18 weeks

e: 4-8 weeks

7:

Changes in gastrointestinal motility during pregnancy are related to increased levels of

a: thyrotropin-releasing factor

b: human chorionic gonadotropin

c: estrogen

d: oxytocin

e: progesterone

8:

Transit time in the stomach and small bowel increases by what percent in the second and third

trimesters of pregnancy?

a: 60%-70%

b: 1%-15%

c: 45%-60%

d: 30%-45%

e: 15%-30%

9:

Epulis is a pregnancy-related vascular swelling of the

a: larynx

b: pharynx

c: nares

d: gums

e: epiglottis

10:

Which of the following pulmonary measurements is decreased in pregnancy?

a: Carbon dioxide pressure

b: Tidal volume

c: Oxygen pressure

d: Oxygen requirement

e: Residual volume

11: During pregnancy, total body oxygen consumption

a:

decreases by 50% from nonpregnant levels

b: increases by 20% from nonpregnant levels

c: increases by 50% from nonpregnant levels

d: decreases by 20% from nonpregnant levels

e: increases by 70% from nonpregnant levels

12: By term in a normal pregnancy, maternal blood volume

a: increases by 15%

b: increases by 50%

c: decreases by 15%

d:

decreases by 35%

e: increases by 35%

13:

Iron supplementation in pregnancy is mainly used to

a: maintain fetal hemoglobin concentration

b: prevent iron deficiency in the mother

c: maintain maternal hemoglobin concentration

d: prevent iron deficiency in both the mother and the fetus

e: prevent iron deficiency in the fetus

14:

Which of the following measures of pulmonary function decreases in late pregnancy?

a: Tidal volume

b: Residual volume

c: Respiratory rate

d: Expiratory volume

e: Inspiratory capacity

15:

The increased nasal stuffiness and perception of increased nasal secretions during prenancy are

associated with a: increased immunoglobulin production

b: increased interluminal production of mast cell toxins

c: increased airway conductance

d: decreased airway conductance

e:

mucosal hyperemia

16:

Maternal arterial blood gas analysis during pregnancy would show

a:

mild metabolic acidosis

b:

mild respiratory alkalosis

c:

mild metabolic alkalosis

d: mild respiratory acidosis

e: moderate metabolic alkalosis

17:

As compared with the nonpregnant state, the risk of thromboembolism during pregnancy

a: is not effected by pregnancy

b: is increased during pregnancy and in the puerperium

c: is decreased during prengnancy and in the puerperium

d: is increased during pregnancy and decreased in the puerperium

e: is decreased during pregnancy and increased in the puerperium

18:

Displacement of the maternal heart during pregnancy is caused by

a: constriction of the anteroposterior diameter of the thorax

b: enlargement of the liver

c: elevation of the diaphragm

d: widening of the mediastinum

e: increased lung volume

19:

Which of the following best describes the change in position of the maternal heart during pregnancy?

a:

Displaced downward and to the right into a more vertical position

b:

Displaced upward and to the left into a more horizontal position

c:

Displaced upward and to the right into a more horizontal position

d:

Displaced downward and to the left into a more vertical position

e:

Displaced further into the thoracic cavity

20:

When do changes in maternal cardiac output begin during pregnancy?

a:

Early second trimester

b:

First trimester

c:

Late first trimester

d:

Third trimester

e:

Late second trimester

21:

As compared with the nonpregnant state, the overall increase in maternal cardiac output during pregnancy is approximately

a:

30%-50%

b: 10%-20%

c: 5%-10%

d: 50%-60%

e: 60%-80%

22:

Which of the following factors contributes to the changed maternal cardiac output during pregnancy?

a:

Increased peripheral vascular resistance

b: Decreased maternal heart rate

c: Increased stroke volume

d: Decreased stroke volume

e: Increased venous return

23: During pregnancy, maternal ciculating blood volume increases about how much over nonpregnant

levels?

a: 30%

b: 60%

c: 45%

d:

e: 15%

24:

When does the increase in circulating maternal blood volume reach its peak during pregnancy?

a: 18 weeks

b: 32 weeks

c: 12 weeks

d: 38 weeks

e: 24 weeks

25:

What percent of cardiac output does the uterus receive at term?

a: 10%

Occlusion of the vena cava by the gravid uterus results in shunting of venous return from the lower

extremities primarily through the

a: mesenteric circulation

b: portal vein circulation

c: paravertebral circulation

d: ovarian circulation

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