GYN Navigator Quiz (Ovarian, Endometrial, Cervical)
Which of the following is UNTRUE about cervical anatomy?
The cervix consists of the lower portion of the uterus
It is composed of the exocervix and the endocervix
It is surrounded by paracervical tissues rich in lymph nodes
It is comprised of the external genital organs, such as the labia majora and minora
Which area of the cervix is characterized by continuous cell renewal, leading it to be the ideal environment for HPV infection and a common site for cancer?
Squamocolumnar junction, or transformation zone
Endometrium
Transatlantic zone
Columnar epithelium
A primary function of the cervix is:
Securing and protecting the fertilized ovum
Serving as a mechanical barrier to infectious microorganisms present in the vagina
Providing a passageway for birth of a newborn
Serving as the primary female reproductive organ
Which of the following statements about squamous cell cervical cancer is correct?
Cervical cancer is a hereditary disease
Oral contraceptives are protective for cervical cancer
Cervical cancer is caused by the Epstein-Barr virus
Certain human papillomavirus (HPV) subtypes are known to be oncogenic
Which of the following is the most common type of cervical cancer?
Adenocarcinoma
Squamous cell carcinoma
B cell
Small cell
Which of the following tumor markers would you expect to be elevated in 80-90% of clients with advanced epithelial ovarian cancer?
CA 125
CEA
CA 19-9
CA 27-29
Which of the following is NOT a function of the ovaries?
Production of estrogen and progesterone
Development and release of ova
Production of androgens and relaxin
Propel ovum to the uterus via peristalsis
Which of the following is not one of the 4 phases of the ovarian cycle?
The follicular/proliferative phase
PID phase
Ovulation
Menstruation
Which of the phases of the ovarian cycle is marked by the degeneration of the corpus luteum?
The follicular phase
Ovulation
Secretory phase
Menstruation
All of the following are considered common benign ovarian pathophysiology EXCEPT:
Ovarian cysts
Polycystic ovarian syndrome
Premature ovarian failure
Bartholinitis
Which of the following is NOT a primary function of the endometrium?
Provides vascular and nutrient supply for developing fetus
Responds to variations in estrogen and progesterone levels in a cyclic fashion
Serves as a lining for the uterus
Maintains sterility of the upper female reproductive tract and site of the transformation zone
The most common type of endometrial cancer is:
Adenocarcinoma
Clear cell
Adenosquamous
Uterine papillary serous
Which of the following is NOT true about endometriosis?
It is an abnormal proliferation of uterine endometrial tissue outside the uterus and the pelvic cavity
Endometriosis is more common in women who are obese
Increasing estrogen levels will help decrease symptoms; therefore, women are encouraged to stop taking hormonal contraceptives
Endometriosis is usually of benign pathophysiology
Changes in vaginal discharge may be caused by each of the following EXCEPT:
Malignancy
Gastroenteritis
Vaginitis
HPV
Amenorrhea is...
Painful menstruation
A complex set of symptoms that occur 4-10 days prior to menstruation
Absence of menstrual flow
Abnormally heavy menstrual flow
A woman recently given the diagnosis of endometrial cancer says she does not understand how she can have cancer when her Papanicolaou (Pap) test was negative 8 months ago. Which of the following responses is most appropriate?
Many Pap tests are not interpreted correctly
Endometrial cancer may develop in a short time
The Pap test may have been obtained incorrectly
Pap tests do not detect endometrial cancer
Ms. Michaels is referred for colposcopy after an abnormal Pap Test. Pre-procedure education would include
Avoiding vaginal intercourse for 1 month before the colposcopy
Expecting copious vaginal drainage after the colposcopy
Expecting a swabbing of the cervix with acetic acid solution during the colposcopy
Douching with a betadine solution every night for 1 week prior to colposcopy
Which of the following gynecologic malignancies is staged by clinical examination?
Ovarian cancer
Endometrial cancer
Cervical cancer
Bladder cancer
Which of the following statements should alert the nurse that further education is needed?
A woman should have a Pap test 3 years after beginning vaginal intercourse or by the age of 21
A woman who has had a hysterectomy for cervical cancer no longer needs a Pap test for screening
A 30 year-old woman who has had 3 consecutive normal Pap tests can begin having Pap tests every 2-3 years when using liquid-based testing
Pap tests are an effective screening tool for cervical cancer
The nurse is helping to educate a patient prior to her first MRI. Which of the following should the patient verbalize as a potential threat during the scan?
Lying still during the scan
Asking questions during the scan
Thumping sounds coming from the machine
Wearing her watch and wedding band
Mina, who is suspected to have ovarian cancer, is scheduled for pelvic ultrasound. Which pre-procedure instructions must Mina understand?
She is allowed to only eat a light breakfast
She is required to maintain NPO status prior to the procedure
She should wear comfortable clothing and shoes for the procedure
She should drink 6-8 glasses of water without voiding before the procedure
When reviewing the chart for a patient with cervical cancer, the nurse notes that the cancer is staged as Tis, NO, MO. The nurse will teach the patient that:
The cancer cells are well-differentiated
It is difficult to determine the original site of the cervical cancer
Further testing is needed to determine the spread of the cancer
The cancer is localized to the cervix
Which of the following is NOT a diagnostic procedure for endometrial cancer?
Endometrial aspiration or biopsy
Endocervical curettage to rule out cervical cancer
Endometrial ultrasound
Fractional dilation and curettage (D and C)
Which of the following is NOT a poor prognostic indicator for cervical cancer?
Bulky tumor
Parametrial extension
Well-differentiated cell type
Poor performance status
GYN cancers can be staged by AJCC or FIGO standards. FIGO staging standards are determined by which group?
Society of Gynecologic Oncology
National Ovarian Cancer Coalition
International Federation of Gynecology and Obstetrics
Foundation for Women’s Cancer
Mrs. Smith will begin radiation therapy for locally advanced cervical cancer next week and is scheduled to receive concurrent chemotherapy. Your pre-treatment education review would include assessing patient understanding of:
Cisplatin (Platinol) as a radiosensitizer
Paclitaxel as an antineoplastic agent
Dexrazoxane (Zinecard) as a cytoprotectant
Mesna as a uroprotectant
A patient is going to have internal radiation or a cervial radiation implant. Prior to the procedure, the nurse should ensure that the patient understands her post-procedure activity orders during her hospital stay. Which of the following will the patient need to understand?
She will be on complete bed rest
She will be allowed out of bed ad lib
She will be allowed out of bed only to sit in the chair
She will be allowed out of bed only to ambulate to the bathroom
The nurse is reviewing the possible complications of cervical conization with a client who has microinvasive cervical cancer. Which complication, if identified by the client, indicates a need for further teaching?
Infection
Hemorrhage
Cervical stenosis
Ovarian perforation
External-beam radiation is planned for a patient with endometrial cancer. The nurse teaches the patient that an important measure to prevent complications from the effects of the radiation is to:
Test all stools for the presence of blood
Inspect the mouth and throat daily for the appearance of thrush
Perform perianal care with sitz baths and meticulous cleaning
Maintain a high-residue, high-fat diet
A 40 year-old divorced mother of 4 school-age children is diagnosed with metastatic ovarian cancer. The patient calls the navigator crying and tells her that she does not know what will happen to her children when she dies. The most appropriate response by the navigator is:
Why don’t we talk about the options you have for the care of your children?
Many patients with cancer live for a long time, so there is time to plan for your children
For now, you need to concentrate on getting well, not worrying about your children
Perhaps your ex-husband will take the children when you can’t care for them
Surgical complications specific to radical hysterectomy may include all of the following except:
Fistula formation
Lymphedema
Urinary dysfunction
Deviated septum
A woman in her 20s was recently diagnosed with cervical cancer. Which of the statements by the nurse is the best way to discuss patient fertility options?
I want to take a minute to talk with you about your potential fertility concerns and your options for fertility preservation
Fertility preservation is very expensive, so you may not want to think about it on top of all of your medical bills
Patients often have psychological issues after cancer diagnosis and treatment. You might be too depressed to think about having children
The nurse shouldn’t discuss fertility with the patient. Fertility preservation is a personal choice and the patient will bring it up if she wants to discuss it
Ms. Lynch presents with presumed endometrial cancer. Which of the following would increase her risk of endometrial cancer?
A diet high in beta carotene and retinoic acid
A history of unopposed estrogen therapy
Use of talc in the perineal area
A family history of ulcerative colitis
Mary, age 41, visits the gynecologist. After examination, the physician suspects cervical cancer. The nurse reviews Mary’s history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?
Onset of sporadic sexual activity at age 17
Spontaneous abortion at age 19
Pregnancy complicated with eclampsia at age 27
Human papillomavirus infection at age 32
Which of the following does NOT increase a woman’s risk for cervical cancer?
Smoking
History of cardiovascular disease
Immunosuppression from bone marrow or organ transplant
Long-term use of combined oral contraceptives when HPV positive
Which of the following is NOT a risk factor for developing ovarian cancer?
Personal history of breast cancer
Mutation of the BRCA1 or BRCA2 genes
Nulliparity
Premenstrual Dysphoric Disorder (PMDD)
Which of the following hereditary patterns is associated with endometrial cancer?
Li-Fraumeni Syndrome
Lynch Syndrome II
HBOC
Tardive dyskinesia
The most common presenting symptom of endometrial cancer is:
Acute abdominal pain
Increased abdominal girth
Abnormal vaginal bleeding
Milky vaginal drainage
The nurse recognizes which symptom as typical of advanced ovarian cancer?
Diarrhea
Hypermenorrhea
Abdominal bleeding
Abdominal distention
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