Test Bank for Guidelines for Nurse Practitioners in Gynecologic Settings 12th Edition Hawkins, Roberto-Nichols, Stanley-Haney | Chapter 1. Well-Woman Initial/Annual Gynecologic Exam
1. Due to the effects of cyclic ovarian changes in the breast, when is the best time for breast selfexamination
a. Between 5 and 7 days after menses ceases
b. Day 1 of the endometrial cycle
c. Midmenstrual cycle
d. Any time during a shower or bath
The physiologic alterations in breast size and activity reach their minimal level approximately 5
to 7 days after menstruation ceases. Therefore, BSE is best performed during this phase of the
menstrual cycle. Day 1 of the endometrial cycle is too early to perform an accurate BSE. After
the midmenstrual cycle, breasts are likely to become tender and increase in size, which is not the
ideal time to perform BSE. Lying down after a shower or bath with a small towel under the
shoulder of the side being examined is appropriate teaching for BSE. A secondary BSE may be
performed while in the shower.
2. Individual irregularities in the ovarian (menstrual) cycle are most often caused by what?
a. Variations in the follicular (preovulatory) phase
b. Intact hypothalamic-pituitary feedback mechanism
c. Functioning corpus luteum
d. Prolonged ischemic phase
Almost all variations in the length of the ovarian cycle are the result of variations in the length of
the follicular phase. An intact hypothalamic-pituitary feedback mechanism would be regular, not
irregular. The luteal phase begins after ovulation. The corpus luteum is dependent on the
ovulatory phase and fertilization. During the ischemic phase, the blood supply to the functional
endometrium is blocked, and necrosis develops. The functional layer separates from the basal
layer, and menstrual bleeding begins.
3. How would the physiologic process of the sexual response best be characterized?
a. Coitus, masturbation, and fantasy
b. Myotonia and vasocongestion
c. Erection and orgasm
d. Excitement, plateau, and orgasm
Physiologically, according to Masters (1992), sexual response can be analyzed in terms of two
processes: vasocongestion and myotonia. Coitus, masturbation, and fantasy are forms of
stimulation for the physical manifestation of the sexual response. Erection and orgasm occur in