Women’s Gynecologic Health 3rd Edition By Kerri Durnell Schuiling – Test Bank

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Women’s Gynecologic Health, Third Edition
Test Bank

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CHAPTER 1 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. Which of the following best defines the term “gender” as used in this text?
a. A person’s sex
b. A person’s sex as defined by society
c. A societal response to a person’s self-representation as a man or woman
d. A person’s biological presentation as defined by himself or herself
2. Which factor bears most on women’s health care today?
a. The complexity of women’s health
b. Women’s status and position in society
c. Population growth
d. The economy
3. Why is acknowledging the oppression of women more difficult within Western
societies?
a. The multiplicity of minority groups complicates the issue.
b. The availability of health care makes acknowledgment more difficult.
c. The diversity of the news media clouds the issue.
d. Affluence and increased opportunities mask oppression.
4. Which of the following most accurately defines “oppression” as used in the text?
a. Not having a choice
b. Not having a voice
c. An act of tyranny
d. A feeling of being burdened
5. In what way does a model of care based on a feminist perspective contrast sharply with
a biomedical model?
a. It provides a forum for the exploration of gender issues.
b. It seeks equal distribution of power within the healthcare interaction.
c. It emphasizes women’s rights.
d. It opens new avenues for women’s health care.
6. Gender is rooted in _____________ and shaped by ________________ .
a. society, biology
b. self-representation, societal expectations
c. biology, environment and experience
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d. biology, hormones
7. Women’s health risks, treatments, and approaches are not always based in science and
biology because _________________________________________
a. they are often based on outdated treatments and approaches.
b. they are determined by social expectations and gender assumptions.
c. they often rely on alternative treatments and approaches.
d. scientific research often fails to take women into consideration.
8. Reproductive rights were added to the World Health Organization’s human rights
framework in the last _____________ ?
a. 5 years
b. 10 years
c. 20 years
d. 40 years
9. “Safe Motherhood” was added to the human rights framework in order to __________
a. address maternal morbidity and mortality on a global level
b. meet a legal obligation
c. correct an injustice
d. correct an oversight
10. What is a chief failing of the biomedical model in regards to women’s health care?
a. Its reliance on studies comprised exclusively of males
b. Its consideration of women as central the model
c. Its emphasis on science and medicine
d. Its limited definition of “health” as “the absence of disease”
11. The social model of health places the focus of health on _________
a. the community.
b. the individual.
c. environmental conditions.
d. scientific research.
12. Which question below supports the strategy: “Identify women’s agency in the midst
of social constraint and the biomedical paradigm.”?
a. “Are ‘all women’ the same?”
b. “Why do you care about the issue?”
c. “Are women really victims or are they acting with agency?”
d. “Who has a choice within the context of health?”
13. What had been a significant problem in medical research well into the 1990s?
a. The focus on randomized clinical trials over epidemiological investigations
b. The lack of representation of women in research trials
c. The lack of research related to gynecology
d. The focus on randomized clinical trials over observational research

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14. Gender differences in heart disease can be found in __________
a. diagnosis.
b. treatment.
c. identification of symptoms.
d. all of the above.
15. What opportunities are created by applying feminist strategies to gynecologic health?
a. Better insight into research methods related to gynecology
b. Better access to the populations affected by gynecologic health
c. Better understandings from a wellness-oriented, women-centered framework
d. Better understandings of the social construction of gender

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CHAPTER 2 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. How does Erick Erikson’s grand theory of human development differ for females?
a. It recognizes achieving autonomy as a primary focus.
b. It assumes only men desire autonomy.
c. It assumes female dependence on another in order to achieve a sense of self.
d. It assumes females desire dependence on others.
2. What is true about human development theories published before the 1970s?
a. They are based on interviews conducted only with men.
b. They assume androcentric models can be applied correctly to women.
c. They frame women’s development as flawed in comparison to the standard.
d. All of the above.
3. What is the intention of the newer feminist models of development?
a. To offer a new model within the traditional biomedical focus.
b. To offer alternatives to the constrained and previously misapplied models.
c. To replace male generalist models with female generalist models.
d. To present a contrast to privileged, white male-based models.
4. What is a key limitation of prevailing developmental models for women?
a. Gender differences assumed to be biologically determined are more often
socially constructed.
b. They present conflicting and misapplied models.
c. Gender differences are assumed to be socially prescribed.
d. Similarities between male and female are emphasized over differences.
5. What event in female development marks the beginning of a tension between biologic
changes and the social context?
a. Turning 18 years old
b. The onset of menses
c. The accumulation of adipose tissue with the onset of puberty
d. Pregnancy
6. How many stages does the Tanner scale use to stage sexual maturity?
a. 3 stages
b. 5 stages
c. 6 stages
d. 8 stages
7. What is the median age for the onset of menstruation for adolescent girls in the United
States?
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a. 9.8
b. 10.8
c. 12.8
d. 13.8
8. What factor limits an individual’s ability to function productively as an adult?
a. Failure to take into account social and cultural norms
b. The inability to move through the world with credibility and respect
c. Poverty
d. Failure to negotiate the developmental tasks of adolescence successfully
9. The type of thinking that influences the risk-taking behaviors of adolescence
_____________________
a. involves the use of symbols, advanced reasoning and expanded possibilities.
b. works proactively to achieve autonomy.
c. encourages experimentation and foresight.
d. is rooted in the immediate and concrete.
10. What narrow term is often used to refer to the period of Early Adulthood?
a. Productive years
b. Reproductive years
c. Young Adulthood
d. Adolescence
11. Why have women’s changing roles come at a cost to their health?
a. Increases in caregiving expectations compromise health
b. Balancing competing demands increases stress
c. Less attention is being placed on health care
d. Men’s roles have not changed in relation to the change in women’s roles
12. How do Franz and White (1985) expand Erikson’s theory of development?
a. By proposing a two-pathway process that includes both individuation and
capacity for attachment
b. By refining Erikson’s single pathway to include capacity for attachment
c. By expanding issues around career and lifestyle
d. By expanding issues around identity
13. What factors affect the mood changes many women in midlife suffer?
a. Deficiencies of estrogen
b. Psychological transitions
c. Cultural beliefs and expectations
d. All of the above
14. What is the primary reason many older women live in poverty and have health
problems?
a. They outnumber older men.

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b. They have outlived their support systems.
c. Their cognitive abilities decline.
d. They must contend with ageism and sexism.

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CHAPTER 3 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. According to Wuest (1994), the major goal of feminist research is _______________
a. to change the design and evaluation of research.
b. to liberate women from societal expectations.
c. to emancipate the world from systemic bias based on gender and class.
d. to expand notions of gender beyond stereotypes.
2. What concern prompted the initiation of the modern EBP movement in health care?
a. That clinicians often failed to evaluate the effectiveness of their own care
b. That expert opinion was valued over scientific evidence
c. That scientific evidence was valued over expert opinion
d. That patients were demanding more evidence to support care decisions
3. Quine’s (1952) concept of a web of interconnecting beliefs and knowledge supports
_____________________
a. the inferiority of quantitative research.
b. a multiple-method approach to examining phenomena.
c. the superiority of qualitative research.
d. the difficulties of establishing best practices.
4. Why are multiple approaches needed to identify best clinical practices?
a. To reflect the multiple variables within clinical settings
b. To offer alternatives to poorly functioning practices
c. To address the complexity of the human condition
d. To ensure that no single approach dominates
5. What is the third part of the clinical decision-making triad that includes clinical
experience and patient preference?
a. An investigation of treatment pathways
b. A consultation with clinical management
c. An evaluation of current clinical research
d. Establishing research methodology
6. How many classifications are used by the U.S. Preventative Service Task Force to
gauge the strength of recommendations for using research evidence in clinical practice?

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7. What are the corresponding clinical terms for Type I and Type II errors in quantitative
research?
a. “false positive” and “false negative”
b. “negativity” and “positivity”
c. “bias I” and “bias II”
d. “evidence flaw” and “process flaw”
8. What key factor shapes the methodology of qualitative research?
a. A person’s view of the world
b. The ability to establish control over variables
c. The ability to establish cause and effect
d. A well-conducted meta-analysis
9. What is a difference between quantitative and qualitative research?
a. One follows strict protocols while the other does not.
b. One deduces the reason why something happens and the other induces why it
happens.
c. One places greater emphasizes on the expansion of knowledge.
d. All of the above.
10. What field of study informs qualitative research?
a. Anthropology
b. Ecological psychology
c. Sociolinguistics
d. All of the above
11. Which research question most closely exemplifies a qualitative approach?
a. Why do some women experience postpartum depression?
b. How does physical exercise affect menopause?
c. How does Kegel exercise affect a woman’s perinatal outcomes?
d. Does a specific method of contraception cause weight gain?
12. What is a recognized limitation of EBP?
a. Emphasis on the routinization of practice
b. Over-reliance on RCT-derived results
c. The challenge of staying abreast of current research
d. All of the above
13. What is the purpose of the Stetler (2001) model of research utilization?
a. To weigh the risks and benefits of EBP
b. To supply methods for critiquing evidence
c. To encourage a synthesis of all research methods
d. To help move best evidence into the clinical practice setting
14. One common barrier to using EBP in clinical settings is the lack of confidence in
critiquing research studies. The second is _____________________

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a. the lack of time to find studies.
b. the lack of willing colleagues.
c. the lack of support from management.
d. the lack of protocol in using EBP.
15. What is the single most important action a clinician can take to advance EBP in the
clinical setting?
a. Employ quantitative research methods
b. Employ qualitative research methods
c. Question everything
d. Consult with management

 

CHAPTER 4 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. What is the annual medical expenditure nationwide, approximately, due to smoking
and being overweight?
a. $60 billion
b. $100 billion
c. $160 billion
d. $260 billion
2. What approach does Health People 2020 use to achieve its goals and objectives?
a. Social determinants of health
b. Evidence-based determinants of health
c. Quality-of-life determinants of health
d. Longevity promotion determinants of health
3. What percentage of the nation’s gross domestic product was spent on health care in
2005?
a. 0.6 percent
b. 6 percent
c. 16 percent
d. 26 percent
4. Which of the following is a new focus area added for Healthy People 2020?
a. Lesbian, gay, bisexual and transgender health
b. Maternal, infant and child health
c. Nutrition and weight status
d. Family planning
5. Why must definitions of health and prevention be clarified?
a. To provide clinicians with a standard point of view
b. To shift from an illness-centered focus toward wellness
c. To establish clarity and protocol
d. To streamline health counseling and education
6. According to the World Health Organization (WHO), the presence of a disease state
________________
a. necessitates prompt medical attention.
b. excludes a person from being considered healthy.
c. does not exclude a person from being considered healthy.
d. classifies a person as in poor health.

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7. Which approach to health promotion comes closest to that advocated by the text?
a. Is determined primarily by the clinician
b. Pays close attention to cost effectiveness
c. Focuses on the absence of disease
d. Considers the patient and his or her cultural perceptions
8. Which of the following is considered primary prevention?
a. Targeted immunization
b. Serves that limit an existing disability
c. Routine laboratory screening
d. Rehabilitation
9. What ratio of ambulatory visits most closely represents those due to chronic or acute
problems versus preventative care?
a. 2/1
b. 1/1
c. 3/1
d. 5/1
10. What area of injury prevention is a focus of the USPSTF’s guidelines for counseling
all healthy, asymptomatic women?
a. motor vehicle accidents
b. falls
c. domestic violence
d. All of the above
11. What is the USPSTF recommendation regarding firearms?
a. Removed from homes with children under the age of ten
b. Stored in locked compartments
c. Removed from home or stored, unloaded, in locked compartments
d. Removed from private homes
12. Which type of counseling results in a statistically significant reduction in STIs?
a. Abstinence-only education
b. Counseling delivered in multiple individual or group sessions totaling more
than 3 hours
c. Remote counseling via Internet or phone
d. Brief, individual sessions in the primary care setting
13. What is the leading preventable cause of death across all populations in the U.S.?
a. Motor vehicle accidents
b. Tobacco
c. Obesity
d. Alcoholism

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14. What percentage of older women does NOT receive the recommended immunizations
for their age group, according to a recent study?
a. 10 percent
b. 25 percent
c. 50 percent
d. 75 percent

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CHAPTER 5 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. A major contributor to pelvic stability is ____________________
a. the coccyx.
b. the pubis.
c. the ilium and its ligaments.
d. the sacrum.
2. The sheet made up of dense fibrous tissue that spans the opening of the anterior pelvic
outlet is/are the _____________________________
a. sphinter muscles.
b. deep perineal space.
c. perineal membrane.
d. distal vagina.
3. How many different fiber sections subdivide the levator ani muscular sheet?
a. 2
b. 3
c. 4
d. 6
4. What is the function of the Bartholin’s gland?
a. To help prevent infection of the introitus
b. To secrete lubricating mucus into the introitus during sexual excitement
c. To assist in keeping the vaginal introitus closed
d. To secrete estrogen and regulate its levels
5. Which arteries supply blood to the clitoris?
a. Arcuate arteries
b. Dorsal and clitoral cavernosal arteries
c. Two ovarian arteries
d. Coiled arteries
6. What is the approximate number of ovarian follicles at the initiation of puberty?
a. 100,000
b. 200,000
c. 400,000
d. 600,000
7. The four segments of a fallopian tube are the pars interstitialis, the isthus, the ampulla,
and the _________________________
a. infundibulum.
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b. medulla.
c. hilum.
d. myometrium.
8. What causes the epithelium to thicken, differentiate, and accumulate glycogen?
a. Progesterone
b. Pudendal nerve
c. Estrogen
d. Vagus nerves
9. About how many openings are in the nipple?
a. 1 to 5
b. 5 to 10
c. 10 – 15
d. 15 – 20
10. What is one of the most frequent reasons women visit their clinician?
a. Changes in menstruation
b. Family planning
c. Pregnancy
d. Prevention and wellness
11. What is the objective of the endometrial cycle?
a. To emulate the activities of the ovaries
b. To produce an ovum
c. To reach the menstruation phase
d. To prepare a site to nourish and maintain the ovum
12. Ovulation is dependent on an increased level of ___________________
a. enzyme activity.
b. progesterone.
c. prostaglandins.
d. estrogen and the LH surge.
13. What initiates contractions of the uterine muscle leading to menstruation?
a. Lysosomal enzymes
b. Vascular thrombosis
c. Rupture of the basal arterioles
d. Prostaglandins
14. Why does the cervical mucus become thick, viscous and opaque after ovulation?
a. To make an hospitable environment for the sperm
b. To promote stromal vascularization
c. To relax the myometrial fibers that supply the cervix
d. To reduce the risk of ascending infection at the time of implantation

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CHAPTER 6 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. What does the Greek term “gyne” mean from which “gynecology” is derived?
a. Speculum
b. Gender
c. Woman — more as queen
d. To reproduce
2. What is the primary purpose of taking a health history?
a. To learn about a woman’s health concerns
b. To establish a relationship with a woman while learning about her health
c. To identify any unresolved/latent health issues
d. To ensure that a woman’s health care records are up to date
3. Which skills are valued in a clinician taking a health history?
a. Respectful attention
b. Empathy
c. Trust-building
d. All of the above
4. What should be the clinician’s first objective after learning the chief reason the woman
desires care?
a. To give the reason or problem a structural and chronological framework
b. To probe for any additional concerns missed
c. To take a family history related to the presenting concern
d. To gain insight into the woman’s cultural and social influences
5. Which of the following should NOT be a part of taking a health history?
a. Taking a family health history
b. Seeking information on stressors or personal problems
c. Asking about exercise and sleep patterns
d. Counseling for tobacco-use cessation
6. In the GTPAL system for recording pregnancy history, the “T” stands for: _________
a. Term births.
b. Terminal pregnancies.
c. Total number of pregnancies.
d. Type of birth (spontaneous, assisted, or cesarean).
7. In a complete physical examination in the ambulatory gynecology setting, it is
customary to ______________________________________
a. evaluate major organ systems briefly and carefully, but not exhaustively.
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b. ask the woman which physical examination maneuvers should be performed.
c. evaluate major organ systems thoroughly.
d. palpate the precordium.
8. How should the order of examination proceed?
a. Head to toe
b. Toe to head
c. By major organ system
d. By concern presented
9. Where may supernumerary occur?
a. Anywhere from the neck to the ankle unilaterally
b. Anywhere on the torso
c. Anywhere along a vertical line from the axilla to the inner thigh
d. Anywhere on the breast tissue, including the tall of Spence
10. Where in the breast do most malignancies develop?
a. Upper inner quadrant
b. Upper outer quadrant
c. Lower outer quadrant
d. Lower inner quadrant
11. Which type of speculum is best used to examine nulliparous women?
a. Small Graves
b. Pederson
c. Large Graves
d. Pediatric
12. What is the preferred maneuver order of the pelvic examination?
a. Bimanual, external inspection and palpation, speculum
b. External inspection and palpation, bimanual, speculum
c. External inspection and palpation, speculum, bimanual
d. Speculum, bimanual, external inspection and palpation
13. Under what conditions is a rectovaginal examination most useful?
a. Under all conditions
b. If screening for colorectal cancer is indicated
c. If the uterus is anteverted or anteflexed
d. If the uterus is retroflexed or retroverted
14. A clinician should present a therapeutic plan to the patient based on
___________________
a. the individual woman’s desire for information and the degree of severity of the
finding.
b. consultation with another health professional.
c. the examining clinician’s findings and assessments.

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d. the individual woman’s cultural sensitivities and level of education.

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CHAPTER 7 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. What does a service grade of D represent in the U.S. Preventive Services Task Force
(USPSTF) recommendations?
a. Service carries insufficient evidence to recommend it
b. Service is found to be beneficial
c. Service is found to be either of no benefit or potentially harmful
d. Service should not be routinely provided
2. Which statement best defines “risk factor”?
a. Any factor which increases the need for medical attention
b. Any behavior which places an individual at risk for illness
c. The probability that an individual will develop a medical condition
d. An attribute or exposure associated causally with an increased probability of a
disease or injury
3. The USPSTF assigns a certainty level to assess the net benefit of a preventive service
based on __________________________________
a. the nature of the overall evidence available.
b. the cost-effectiveness of a service.
c. known health outcomes.
d. select studies in a limited primary care population.
4. What screening recommendation is similar across all groups for colorectal cancer?
a. Screening women age 76 to 85 based on risk factors
b. Screening only for those women at increased risk
c. Screening for all women starting at age 50
d. Against routine screening in adults age 76 and over
5. What is the screening recommendation by the American College of Obstetricians and
Gynecologists for intimate partner violence (IPV)?
a. Routinely ask all women direct, specific questions about abuse. Refer to
community-based services when identified.
b. Insufficient evidence to recommend for or against routine screening.
c. No screening recommendation.
d. Remain alert for signs of family violence at every patient encounter.
6. Alcohol consumption is considered hazardous for a woman who has ______________
a. either 5 or more drinks in one week or 3 per occasion.
b. either 7 or more drinks in one week or 3 per occasion.
c. either 9 or more drinks in one week or 4 per occasion.
d. either 10 or more drinks in one week or 5 per occasion.

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7. What is the Task Force recommendation grade assigned to screening all adults for
depression?
a. B
b. A
c. C
d. D
8. How is being overweight defined on the BMI table?
a. 18 to 29.9
b. 20 to 29.9
c. 25 to 29.9
d. 30 or greater
9. How is screening for the rubella immunity accomplished?
a. By asking the patient
b. By obtaining a history of vaccination or by ordering serologic studies
c. By ordering serologic studies
d. By obtaining vaccination records
10. What recommendation grade does the Task Force assign to screening all adults for
tobacco use?
a. A
b. B
c. C
d. D
11. What is the Task Force recommendation regarding the efficacy of digital
mammography or MRI versus the standard film mammography?
a. Evidence exists that all screens are equally beneficial
b. Film mammography is recommended as the best screen
c. Digital mammography or MRI is recommended as the best screen
d. Not enough evidence exists to assess benefits and risks as to which provides the
best screen
12. What recommendation grade does the Task Force assign to cholesterol screening
women between 20 and 44 years with preexisting risk factors for coronary artery disease?
a. A
b. B
c. C
d. D
13. Which of the following factor associated with increased risk for developing
osteoporosis appears to be the best predictor of risk?
a. Smoking
b. Low body weight
c. Sedentary lifestyle

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d. Family history
14. Which of the following are screening tests for type 2 diabetes mellitus?
a. Fasting plasma glucose
b. Two-hour post load plasma glucose
c. Hemoglobin A1C
d. All of the above
15. What population of women should be screened for signs and symptoms of thyroid
dysfunction?
a. All women
b. Older women
c. Older women, smokers, women with diabetes
d. Older women, postpartum women, and women with Down syndrome

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CHAPTER 8 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. Approximately how many weight-loss surgeries occur each year?
a. 100,000
b. 150,000
c. 250,000
d. 375,000
2. How is body mass index (BMI) calculated?
a. Weight in pounds divided by height in feet squared
b. Weight in kilograms divided by height in meters squared
c. Height in meters divided by weight in kilograms squared
d. Weight in kilograms squared divided by height in meters
3. Bariatric surgery considered a valid treatment when _________________
a. a person’s BMI is between 35 and 40 and is accompanied by a high-risk
comorbid disease.
b. a person’s BMI is more than 25 and is accompanied by hypertension.
c. a person’s BMI is more than 40 and is accompanied by cardiovascular disease.
d. a person’s BMI is between 25 and 29.9 and is accompanied by a high-risk
comorbid disease.
4. Which statement about women who have had bariatric surgery is false?
a. Her record of weight lost should not be included in her health history.
b. Obesity has been shown to evoke negative responses from clinicians.
c. Subtle, unintentional bias often manifests against these women.
d. Clinicians need to strive to be nonjudgmental regardless of the patient’s body
habitus.
5. Which is NOT a complication following bariatric surgery?
a. Hernia formation
b. Anemia
c. Hearing loss
d. Cholelithiasis
6. Where does iron and calcium absorption primarily occur?
a. Stomach
b. Duodenum
c. Upper intestine
d. Lower intestine
7. What is the recommended waiting period between bariatric surgery and pregnancy?
a. 6 to 12 months
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b. 12 to 24 months
c. 24 months to three years
d. Three to four years
8. Estrogen-containing contraceptive pills are known to increase the incidence of
_____________________
a. kidney disease.
b. kidney stones.
c. gallstones.
d. Addison’s disease.
9. Best practice clinical guidelines for directing the care of women who become pregnant
after bariatric surgery _____________________________
a. have yet to be developed.
b. include nutritional counseling.
c. have been developed using research-based evidence.
d. are incomplete.
10. What is the recommended prenatal weight gain if a woman’s BMI is 25 to 29.9
(overweight)?
a. 8 to 11 pounds
b. 11 to 15 pounds
c. 15 to 25 pounds
d. 25 to 30 pounds
11. Which statement regarding a relationship between obesity and psychological
disorders is true?
a. Psychopathology is both a cause and a consequence of obesity.
b. Psychopathology is a consequence of obesity.
c. Psychopathology is a cause of obesity.
d. It is uncertain whether psychopathology is a cause or a consequence of obesity.
12. Mental health assessments after bariatric surgery may take the form of
________________________________
a. directing the woman to answer a questionnaire focused on mental health status.
b. asking the woman questions during the history and physical examination.
c. observing the woman’s affect, mood and appearance during the visit.
d. All of the above

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ANSWER KEY
MULTIPLE-CHOICE QUESTIONS

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CHAPTER 9 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. Which one of the following is the definition of the term gender identity?
a. People who respond erotically to both sexes.
b. A self-label, regardless of biologic or natal sex.
c. People who are similar in age, class, and sexual status.
d. A label for behavior not usually associated with one’s natal sex.
2. The belief that heterosexuality is the best sexual orientation and that all people should
be heterosexual is called
a. lesbianism.
b. homophobia.
c. heterosexism.
d. psychosocialism.
3. A healthcare facility can make sure it meets nationwide standards for equal and quality
care of LGBT patients by
a. utilizing the Healthcare Equality Index (HEI).
b. participating in National LGBT Health Awareness Week.
c. adopting the policies and practices of integrative medicine.
d. creating research and educational opportunities for its staff.
4. In 1997 the Institute of Medicine (IOM) published a landmark report that:
a. described the discriminatory practices of healthcare institutions.
b. identified the health needs of lesbian and bisexual women.
c. provided guidelines for the critical transition period of transgendered persons.
d. recommended research and mechanisms for disseminating information on
lesbian health.
5. External barriers to quality health care for SGM patients include all of the following
except:
a. clinicians who assume all their patients are heterosexual.
b. intake forms that request the name of spouse, partner, or significant other.
c. the limited education of clinicians on LBT health issues.
d. a paucity of domestic partner health insurance coverage for LBT couples.
6. The most current research on eating disorders suggests that
a. feminist identity and activities do not serve as buffers against negative selfimage.
b. lesbians have less body dissatisfaction than heterosexual women.

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c. eating disorders are more prevalent in bisexual women than in heterosexual
women.
d. the prevalence of eating disorders in African Americans versus Latinos differs
significantly.
7. Which one of the following statements about sexually transmitted infections (STIs) is
false?
a. Lesbians are at very low risk for development of STIs and vaginal infections.
b. HIV has been identified in case studies of women who report sex only with
women.
c. Transgender women (MTF) have extremely high rates of HIV infection.
d. Risky behaviors for STIs include sex during menses.
8. To date _____ prospective empiric studies have definitively determined whether
lesbians are at higher risk for breast cancer than other women.
a. more than half of all
b. only two
c. all
d. no
9. Which one of the following is not among the ways clinicians can provide a welcoming,
safe environment for LBT patients?
a. Avoid the heterosexual assumption by using gender-neutral language.
b. Explain whether and how information will be documented in the patient’s
medical record.
c. Ignore the sexual status or gender identity of all patients.
d. Offer mainstream referrals that are culturally sensitive to SGMs.
10. Compared to heterosexual adolescent girls, LBT girls
a. report having a lower current frequency of intercourse.
b. choose less effective methods of contraception.
c. are more likely to use contraception.
d. are more likely to become pregnant.

MULTIPLE-CHOICE QUESTIONS
1. b

CHAPTER 10 QUESTIONS

MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. A woman’s sexuality is
a. expressed fully only during her middle years.
b. a way to express her need for emotional closeness.
c. experienced the same way every time.
d. precisely the same as every other woman’s.
2. A woman’s sexuality is not
a. coordinated by multiple anatomical systems.
b. influenced by ethical, moral, or spiritual factors.
c. an important aspect of a woman’s health throughout her life.
d. limited by age, attractiveness, partner participation, or sexual orientation.
3. The erotic or romantic attraction or preference for sharing sexual expression with
persons of a specific gender is called
a. sexual orientation.
b. gender role behavior.
c. a social or cultural construct.
d. an anatomic characteristic.
4. The most frequently acknowledged sexual lifestyle and relationship pattern for women
is
a. serial heterosexual monogamy.
b. marital heterosexual monogamy.
c. nonmonogamous heterosexual marriage.
d. heterosexual coupling without marriage.
5. Women are considered _______ when their sexual and affectional preferences are
directed toward individuals of either sex.
a. celibate
b. lesbians
c. bisexual
d. heterosexual
6. The factors that enable women to enjoy and control their sexual and reproductive lives,
including a physical and emotional state of well-being and the quality of sexual and other
close relationships, make up a woman’s
a. sexual health.
b. gender identity.
c. gender role behaviors.

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d. psychosocial orientation.
7. Which one of the following general statements about a woman’s healthy sexual
functioning is true?
a. Compared to men, women have a stronger biologic urge to be sexual for the
release of sexual tension.
b. Unlike men, women experience “drive,” or a sexual desire independent of
context.
c. Unlike men, a woman’s sexual arousal is a subjective mental excitement that
may or may not be associated with genital awareness.
d. Just like men, orgasmic release of sexual tension in women always occurs in
the same way.
8. According to Eaton et al., 2008, what percent of twelfth graders in the United States
has had sexual intercourse?
a. 2%
b. 33%
c. 45.1%
d. 64.6%
9. The current cultural emphasis on youth, beauty, and thinness contributes to the
prevailing societal misperception of women age ______ as asexual.
a. 12 to 16
b. 20 to 40
c. 40 to 60
d. 65 and over
10. Which one of the following statements about clinicians who provide satisfactory
sexual health care is false?
a. They are comfortable with their own sexuality, aware of their own biases, and
have a sincere desire to assist their patients.
b. They perform a sexual health assessment that includes physiologic,
psychologic, and sociocultural evaluations.
c. They know how various health problems, diseases, and their treatment affect
sexual functioning and sexuality.
d. They make assumptions about a woman’s sexual attitudes, values, feelings, and
behavior.

CHAPTER 11 QUESTIONS

MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. Most research studies on methods of contraception use the term efficacy to refer to
a. the rate of success in those who are spacing their pregnancies.
b. likelihood of pregnancy when a method is used exactly as prescribed.
c. number of pregnancies when a method is used improperly or inconsistently.
d. likelihood of user failure or typical-use failure rates in different populations.
2. Which contraceptive methods have inherent failure rates?
a. None
b. Some
c. All
d. All except sterilization
3. All of the following are physiologic methods of nonhormonal contraception except
a. abstinence.
b. lactational amenorrhea.
c. coitus interruptus.
d. spermicide.
4. Although barrier contraception methods are less effective in preventing pregnancy than
more modern methods, interest in them is on the rise because they
a. can help protect against STIs, including HIV.
b. are coitus dependent and require planning.
c. are nonallergenic and male controlled.
d. involve the use of hormones.
5. Tubal sterilization for women who have completed their families is highly effective,
but there are disadvantages such as
a. the women are less likely to use condoms or return for health services.
b. a decreased risk of ovarian cancer and pelvic inflammatory disease.
c. a high likelihood of complications and side effects.
d. the surgery is not covered by insurance.
6. Combined oral contraceptives (COCs) are among the most extensively studied
medications available. Which one of the following statements about their use has been
found to be true?
a. Broad-spectrum antibiotics may enhance their efficacy.
b. They do not increase the risk of venous thromboembolism.
c. They decrease the relative risk of ovarian and endometrial cancers.
d. Among possible side effects are acne, hirsuitism, and benign breast conditions.

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7. Compared to COCs, the combined contraceptive patch and vaginal ring
a. have the same theoretical efficacy.
b. offer more opportunity for user error.
c. have lower failure rates in obese women.
d. are available in a larger variety of formulations.
8. Progestin-only pills (POPs)
a. have no possible side effects.
b. suppress ovulation as reliably as COCs.
c. may be taken earlier or later than prescribed.
d. in combination with lactation are nearly 100% effective.
9. The depot medroxyprogesterone acetate (DMPA) injection (Depo-Provera) is given at _______
week intervals.

a. 3
b. 6
c. 9
d. 12
10. Which one of the following statements about the subdermal progestin implant is
false?
a. It is associated with the development of benign follicular cysts.
b. After removal, its contraceptive effects last 10 more months on average.
c. Based on worldwide data, it appears to be as safe as other progestin-only
methods.
d. The shortage of research due to its only recent availability is a possible
disadvantage.
11. Of the two intrauterine contraceptive devices currently available in the United States
only one provides a local delivery of protestin. It is the
a. combined contraceptive patch (Ortho Evra).
b. copper IUD (T380A, ParaGard).
c. LNG-IUS (Mirena).
d. Dalkon Shield.
12. Emergency contraceptive pills (ECPs) can
a. cause an abortion.
b. prevent fertilization.
c. harm an established pregnancy.
d. offer protection from STIs, including HIV.

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MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. The North American Menopause Society (NAMS) current position on the use of HT in
menopausal women includes
a. HT is indicated for the sole purpose of preventing cardiovascular disease.
b. ET for less than 5 years has significant effect on the risk for breast cancer.
c. HT is recommended for prevention of cognitive aging or dementia.
d. EPT is recommended to decrease risk of endometrial carcinoma.
2. What type(s) of estrogen are usually present in a woman’s body in the postmenopausal
years?
a. Estrone (E1) and estradiol (E2)
b. Estrone (E1) and estriol (E3)
c. Estradiol (E2) only
d. None; women do not produce estrogen after menopause.
3. In general, natural menopause occurs for most women between the ages of _____
years.
a. 40 and 50
b. 44 and 46
c. 48 and 55
d. 39 and 47
4. Which one of the following statements about menopause is false?
a. A diagnosis is based on the absence of menses for 6 consecutive months.
b. Controlling diabetes and hypertension can reduce the severity of symptoms.
c. Similar symptoms may be caused by arrhythmia, thyroid disorders, or tumors.
d. Diagnosis requires a thorough history, a physical exam, and laboratory testing.
5. Which one of the following statements about menopause is true?
a. Symptoms usually begin in the postmenopausal period.
b. Women most frequently report central nervous system symptoms.
c. Hot flashes can last well beyond the first 5 to 7 years following menopause.
d. Women typically experience the most severe symptoms during perimenopause.
6. Among the midlife health issues of women, the number one cause of mortality in the
United States is
a. primary osteoporosis.
b. cardiovascular disease.
c. overweight and obesity.
d. cancer (of the lung and bronchus, breast, and colon).

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42

7. Lifestyle approaches to postmenopausal symptom management include
a. sleeping more than 8 hours per night.
b. avoiding sugar, coffee, chocolate, and alcohol.
c. decreasing levels of physical activity.
d. more than 1,000 international units/day of vitamin E.
8. The standard for managing moderate to severe menopausal symptoms is
a. lifestyle changes, such as dieting and exercising.
b. nonhormone products, such as anticonvulsive medications.
c. alternative care, such as acupuncture, combined with organic herbs.
d. prescription systemic hormone products, such as estrogen and progestogen.
9. When HT is prescribed for relief of the vasomotor symptoms of menopause, patients
should
a. find that their symptoms begin to resolve within 2 to 6 weeks.
b. be told that they ought not to experience side effects if they follow directions.
c. return for follow-up with the clinician within one year after the initial dose.
d. initially be given ET or EPT at higher than standard doses.
10. The use of complementary and alternative medicines (CAM)
a. by women is on the downturn in the United States.
b. is usually reported to the patient’s primary care clinician.
c. must be taken into account by clinicians for proper patient assessment and care.
d. is scientifically proven to be effective in the management of menopausal
symptoms.

MULTIPLE-CHOICE QUESTIONS
1. d
2. a

CHAPTER 13 QUESTIONS

MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. Which one of the following statements about intimate partner violence (IPV) is false?
a. It refers to an escalating pattern of abuse.
b. It includes emotional abuse, such as disregarding what a woman wants.
c. It includes using physical force to make a woman engage in a sexual act against
her will.
d. It refers to a current or former spouse or dating partner of the opposite sex, not
someone of the same sex.
2. Studies have identified the prevalence of IPV during pregnancy as ranging from
_______ in a sample of adolescents and adult women to as high as _______ in a sample
of pregnant adolescents.
a. 18.1%; 37.6%
b. 4.7%; 10.6%
c. 40%; 50%
d. 14%; 23%
3. A U.S. population-based study of self-reported data found the odds of having a
gynecologic problem were _______ times higher for patients who experienced IPV.
a. twenty-five
d. twelve
c. three
d. two
4. Many patients experiencing IPV meet the criteria for diagnosing PTSD. Those criteria
include all of the following except
a. experiencing a traumatic event.
b. reexperiencing the traumatic event.
c. numbness and avoidance.
d. hypovigilance.
5. Clinicians should routinely consider IPV as a possible diagnosis for women who
present with all of the following except
a. chronic stress-related symptoms.
b. denial of any physical health problems.
c. central nervous system (CNS) symptoms.
d. gynecologic problems, especially multiple ones.
6. A theory that includes four categories to describe factors that contribute to a violent
relationship—personal history, microsystem, exosystem, and macrosystem—is called the

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45
a. Heise’s (1998) framework of violence.
b. Walker’s (1979) three-part cycle of violence.
c. National Violence Against Women Survey (1998) study.
a. International Association of Forensic Nurses (IAFN) Annual Scientific
Assembly (2004) report.
7. The ________ is probably the most widely used IPV screen.
a. three-question AAS (McFarlane et al., 1992)
b. Campbell’s Danger Assessment (2003)
c. Sheridan’s HARASS Instrument
d. Helton’s nine-question AAS
8. The most effective means of obtaining the history of abuse is to use a communication
model that
a. avoids having the patient’s children present during the discussion.
b. signals someone is interested and that the woman is not alone.
c. emphasizes the belief that violence is not acceptable, no matter what the
batterer might have said to the patient.
d. allows the patient to talk without interruption and with time to relate,
emphasize, and repeat her full story.
9. The physical examination of any woman suspected of being abused or battered
includes all of the following except
a. a thorough inspection for signs of injury, past and present.
b. a physical assessment just like that of any other adult female.
c. a focus on the patient’s physical appearance, not her behavior.
d. the use of body maps and diagrams to accurately portray the patient’s physical
condition.
10. The words _______ are among the most commonly misused medical forensic terms.
a. laceration, ecchymosis, and hematoma
b. distal, proximal, and lateral
c. rape, assault, and battery
d. states, says, and reports
11. The P in the mnemonic EMPOWER is meant to help the clinician remember to
a. document findings properly.
b. encourage planning for safety and support.
c. provide information about domestic violence.
d. refer to program services such as IPV hotlines and shelters.
12. Which one of the following statements about IPV during pregnancy is false?
a. It affects women more than the most serious antepartum complications.
b. Complications are more the result of trauma than psychological abuse.
c. IPV is associated with low-birth-weight infants.
d. Pregnancy can be a time of escalating violence.

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13. Plichta (1996) reported that rates of depression, eating disorders, and drug, alcohol,
and tobacco use were _______ in girls who reported physical or sexual dating violence as
compared to girls who had not been abused.
a. about the same
b. more than twice as high
c. four times as high
d. more than ten times as high
14. IPV affects women of all ages, but in elderly women
a. the physical and mental sequelae of IPV is much more apparent.
b. mistreatment in elder care facilities is the cause, not domestic violence.
c. even so-called “low-severity violence” can cause serious injury or death.
d. cognitive impairment prevents clinicians from conducting the necessary
assessments.

 

CHAPTER 14 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. There is no one legal definition of rape, which means
a. clinicians must learn their own state’s definitions and statutes.
b. it is easier to monitor the incidence of sexual violence in the nation.
c. it may be considered a social problem, not a public health problem.
d. measuring risk and identifying protective measures is a simple task.
2. According to Basile & Saltzman (2002) an example of “noncontact sexual abuse,”
which involves either nonconsent or the inability to give consent, is
a. an attempted but not completed sex act.
b. intentional exposure of an individual to exhibitionism.
c. contact between the penis and anus involving penetration.
d. intentional touching of the genitalia through clothing.
3. The U.S Department of Justice estimates that _______ forcible rapes occurred in the
United States in 2008.
a. 1,200
b. 24,000
c. 89,000
d. 303,000
4. The National Violence Against Women (NVAW) national survey conducted between
1995 and 1996 showed that in the United States
a. men experience significantly more IPV than women.
b. 5% of women have survived a completed or attempted rape.
c. violence against women is primarily perpetrated by strangers.
d. over 20% of female rape survivors were younger than 12 when first raped.
5. Data from the NVAW study reveal that women are _______ men to be physically
injured during a rape
a. less likely than
b. just as likely as
c. twice as likely as
d. 20% more likely than
6. Which one of the following statements about genital trauma associated with rape is
false?
a. No method currently available can differentiate genital trauma caused by rape
from tampon use.

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49
b. There is a clear need for studies to determine specific patterns of genital injury.
c. Few victims sustain significant genital trauma as a result of a sexual assault.
d. The absence of genital trauma proves consent.
7. Which one of the following statements about the consequences of rape is true?
a. Rates of successful suicide after rape are low.
b. Sexual dysfunction is an unlikely or rare result.
c. STIs are a result of an active sex life, not of rape.
d. A victim’s alcohol and drug use usually decreases.
8. If a patient has not reported a sexual assault to law enforcement, all of the following
clinician actions are important except
a. asking if reporting is something she wants to consider.
b. discussing any fears or concerns that she may have about reporting.
c. explaining that only some forced sexual contacts are reportable crimes.
d. telling her that women who report do better psychologically than those who do
not.
9. In respect to an evidentiary examination
a. the patient may not withhold consent if the clinician is a mandated reporter.
b. the clinician is required to strictly follow local agency protocols, no others.
c. the time frame within which it must take place depends on local standards.
d. maintaining the chain of custody of all evidence collected is recommended, not
required.
10. The clinician’s role in the care of an adult sexual assault victim should
a. encompass all aspects of the biopsychosocial needs of the patient.
b. include testing for all sexually transmitted infections (STIs).
c. avoid discussion of vulnerability to future abuse.
d. only focus on the related physical trauma.
11. Both very young and elderly sexual assault victims
a. are addressed in most state mandatory reporting laws.
b. may have difficulty describing the incident and related symptoms.
c. require the same equipment for proper examination that others do.
d. have fewer injuries than victims of other age groups.
12. Which one of the following statements about sexual and gender minorities is false?
a. Gays and lesbians are more frequently assaulted by heterosexual males.
b. Similar to heterosexuals, many LGBT individuals do not report sexual assault.
c. The needs of LGBT people who have been sexually assaulted are represented
well in research.
d. Crimes against them are likely to be more violent than crimes motivated by
race, ethnicity, or religion.

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51

CHAPTER 15 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. Cyclic mastalgia
a. more likely causes unilateral, localized pain that is sharp or burning in nature.
b. has an increased risk of occurrence in women whose diets are low in fat.
c. occurs most frequently in women who are 18 to 30 years old.
d. is caused by hormonal changes associated with menstruation.
2. The possibility of cancer is associated with mastalgia when the pain
a. occurs in perimenopausal women who are receiving HT.
b. is accompanied by skin changes or palpable abnormality.
c. is felt in both breasts equally and is related to a cyclic pattern.
d. is reproducible with palpation of the chest wall.
3. Effective for 85% of women who have mild or moderate symptoms of mastalgia, the
first line of treatment is
a. reassurance.
b. reduction mammoplasty.
c. isoflavones, or naturally occurring phytoestrogens.
d. 2% lidocaine injection and 40 mg of methyl prednisone.
4. Mammary duct ectasia
a. is one of the most common causes of milky nipple discharge.
b. like intraductal papilloma, is typically unilateral and uniductal.
c. usually occurs in women 20 to 35 years of age.
d. discharge may be green, brown, or black in color.
5. If a woman is complaining of bilateral, milky nipple discharge, the clinician is to first
a. perform a pregnancy test.
b. perform a mammogram and an ultrasound of the breasts.
c. assess the sella turcica with magnetic resonance imaging (MRI).
d. obtain a serum prolactin level and a thyroid-stimulating hormone (TSH)
measurement.
6. The most common benign breast masses are
a. galactoceles.
b. hamartomas.
c. fibroadenomas and cysts.
d. lipomas and phyllodes tumors.

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7. Which breast tissue sampling procedure is best to use when density or calcification is
seen on a mammogram in a location that cannot be effectively assessed with a core
biopsy?
a. Fine-needle aspiration
b. MRI-guided needle biopsy
c. Needle-localized breast biopsy
d. Excisional breast biopsy
8. Among women aged 55 years and older
a. macromastia is the most common cause of breast masses.
b. breast masses are presumed malignant until proven otherwise.
c. most breast masses decrease in size over time and many resolve completely.
d. diagnostic imaging of a breast mass and tissue sampling should be deferred.
9. A woman’s lifetime risk of being diagnosed with breast cancer is
a. 1 in 3.
b. 1 in 8.
c. 1 in 29.
d. 1 in 233.
10. No risk factors other than age are identifiable in ______ of women with breast cancer.
a. 100%
b. 85%
c. 60%
d. 24%
11. The genetic counselor has a significant role in the care of women because BRCA1
and BRCA2 genetic mutations account for 5% to 10% of all _______ cancer cases
a. breast
b. ovarian
c. uterine
d. pancreatic
12. The most common sites of metastatic spread of invasive breast cancer include all of
the following except
a. bones.
b. lungs.
c. pituitary.
d. lymph nodes.

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ANSWER KEY

54
CHAPTER 16 QUESTIONS

MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. A national study with 31,581 respondents found that ________ of women reported
having some type of sexual problem, such as orgasm difficulties.
a. 67%
b. 44%
c. 22.3%
d. 10%
2. A woman’s sexual complaint may be attributed to
a. physical or mental health factors.
b. sociocultural influences.
c. normal variations of sexuality.
d. any of the above.
3. Which one of the following statements about androgen supplementation is false?
a. Adverse effects of its use include acne, liver damage, and decreased levels of
HDL cholesterol.
b. There are no androgen therapies approved by the U.S. Food and Drug
Administration (FDA) for use in women.
c. Correlations between testosterone levels and sexual dysfunction have been
found to be consistent across numerous studies.
d. Transdermal preparations are frequently used in women, though dosing is
difficult because they are packaged in doses appropriate for men.
4. The absence or markedly diminished feelings of sexual excitement and sexual pleasure
from any type of sexual stimulation is called _______ sexual arousal disorder.
a. genital
b. subjective
c. combined genital and subjective
d. persistent
5. All of the following medications may cause sexual arousal problems except
a. SSRIs and MAOIs.
b. tricyclic antidepressants.
c. sildenafil, alprostadil, and tibolone.
d. antihistamines and antihypertensives.
6. Management of sexual arousal disorders in women may include any one of the
following except
a. treatments that decrease blood flow to the genital tissues.

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55
b. the use of vaginal lubricants to increase stimulation.
c. use of the Eros-CTD, a clitoral therapy device.
d. localized estrogen therapy.
7. In a randomized controlled trial, women who used _______ had significantly greater
mean improvement in the desire and arousal domains of the FSFI compared to women
who used placebo.
a. Yohimbine, an extract from the bark of an African tree
b. L-Arginine, one of the ingredients in a nutritional supplement
c. Zestra, a topical formulation that contains botanical oils and extracts
d. None of the above
8. For the woman who has never experienced orgasm, the clinician should
a. diagram and describe female genital anatomy to her.
b. recommend Kegel exercises to help inhibit orgasmic response.
c. suggest psychotherapy before suggesting any self-help measures.
d. explain that most women achieve orgasm only through penetration of the
vagina.
9. Which one of the following is the best definition of vaginismus?
a. Persistent difficulty to allow vaginal entry of a penis, finger, or any object
b. Semen hypersensitivity that causes pain, diffuse urticaria, and malaise
c. A form of vaginal spasm that results from fearful anticipation of pain
d. Recurrent pain upon vaginal entry and/or penile vaginal intercourse
10. Management of dyspareunia
a. depends on the etiology of the pain.
b. requires nonpharmacologic treatment modalities.
c. is 100% effective with vestibulectomy and advancement plasty.
d. is only a matter of teaching the patient to change the angle of the uterus during
intercourse.

CHAPTER 17 QUESTIONS

MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. About half of all pregnancies in the United States are unintended and occur most
frequently in women who
a. are married or divorced.
b. have finished high school.
c. are between the ages of 18 and 24.
d. are members of the majority group.
2. Estimates from the 2002 National Survey of Family Growth indicate that _______ of
infants born to never-married women younger than 45 years of age were relinquished for
adoption between 1996 and 2002.
a. 1%
b. 11%
c. 24%
d. 49%
3. Unintended pregnancy is associated with
a. tobacco and alcohol use during pregnancy.
b. less risk of physical abuse and depression.
c. higher number of total prenatal care visits.
d. higher infant birth weights.
4. One study of more than 10,000 women who had abortions found that _______ had
been using a contraceptive method in the month they conceived.
a. 14%
b. 34%
c. 54%
d. 74%
5. When a patient’s decision about an unintended pregnancy causes an irreconcilable
conflict between a clinician’s personal beliefs and professional responsibilities, the
clinician should
a. make sure the patient understands what those personal beliefs are.
b. continue to work in settings where such conflicts occur frequently.
c. deny comprehensive pregnancy options counseling to the patient.
d. refer the patient to a colleague or to a different setting entirely.
6. All of the alternatives that follow are included in pregnancy options counseling except
a. discontinue the pregnancy.
b. carry the pregnancy and parent the child.

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c. assess the need for additional attention after abortion.
d. carry the pregnancy and place the infant for adoption
7. Women who present for pregnancy options counseling
a. understand the time-sensitive nature of the decision-making process.
b. should be made aware of the gestational age of the pregnancy.
c. have made their decision and do not need to discuss it.
d. need no further resources to establish a plan of action.
8. The most recent data on the timing of abortions indicate that __________ are
performed prior to 13 weeks’ gestation.
a. 99%
b. 88%
c. 77%
d. 66%
9. The methods of abortion used in the United States—in order, with the most common
method listed first—are
a. aspiration, medication, induction, surgical.
b. medication, induction, aspiration, surgical.
c. surgical, induction, medication, aspiration.
d. induction, aspiration, surgical, medication.
10. The World Health Organization (2007) estimates that _______ unsafe abortions took
place annually between 1993 and 2003, resulting in enough deaths to render unsafe
abortion one of the leading causes of maternal mortality.
a. 19 to 20 million
b. 19 to 20 thousand
c. 1 to 2 million
d. 1 to 2 thousand

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60
CHAPTER 18 QUESTIONS

MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. For women younger than 35, infertility is defined as failure to achieve a successful
pregnancy after _______ of regular unprotected intercourse.
a. 6 weeks
b. 6 months
c. 12 weeks
d. 12 months
2. For a woman older than 35, the clinician will consider infertility treatment after six
months of attempting a pregnancy because
a. fecundity begins to increase gradually at age 28.
b. there is a higher risk of pregnancy loss in the older woman.
c. the older woman is not as frivolous as a younger woman might be.
d. conditions that impair fertility decline after age 35.
3. Approximately 72 _______ are required for spermatogenesis, after which sperm
mature in the epididymis and then travel out of the vas deferens during ejaculation.
a. days
b. hours
c. minutes
d. seconds
4. Among the causes of infertility in women are all of the following except
a. endometriosis.
b. a luteal-phase deficiency.
c. a bicornuate or septate uterus.
d. tubal scarring as a result of an STI.
5. The fertility test that involves radiologic imaging of an injection of a water- or oilsoluble contrast traveling through a women’s reproductive system is called
a. transvaginal ultrasound and hysteroscopy.
b. hysterosalpingogram.
c. semen analysis.
d. laparoscopy.
6. All of the following diagnostic testing and procedures are now infrequently performed
in clinical practice except
a. hysterosalpingogram.
b. sperm penetration assay.
c. the postcoital test (PCT).

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d. endometrial biopsy (EMB).
7. The infertility evaluation is an opportune time to suggest health promotion behaviors
that may specifically improve fertility, including
a. achieving a BMI in the range of 30 to 35, if the woman is under- or overweight.
b. reducing alcohol consumption to about 4 drinks per week.
c. reducing caffeine consumption to no more than 350 per day.
d. none of the above.
8. The form of assisted reproductive technology that requires fertilization to occur within
a patent fallopian tube, instead of a laboratory dish, is called
a. intracytoplasmic sperm injection (ICSI).
b. gamete intrafallopian transfer (GIFT).
c. zygote intrafallopian transfer (ZIFT).
d. in vitro fertilization (IVF).
9. For women and men with infertility an option that involves a sperm or egg donor is
called
a. assisted reproductive technology (ART).
b. collaborative reproduction.
c. child-free living.
d. adoption.
10. An ethical question that is specifically about pre-implantation testing with ART has to
do with
a. ownership of frozen embryos after the couple has divorced.
b. a surrogate deciding she does not want to relinquish the infant.
c. genetic engineering and the ability to reject embryos affected by inherited
disorders.
d. the implantation of multiple embryos, which can create high risk for the
embryos and the woman.

MULTIPLE-CHOICE QUESTIONS
1. d

CHAPTER 19 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. What is the major source of normal vaginal secretions?
a. Bartholin’s glands
b. Apocrine glands
c. Sebaceous glands
d. Cervical mucosa
2. What is the term for the inflammation of the vagina characterized by an increased
vaginal discharge containing numerous white blood cells?
a. Vaginitis
b. Vaginosis
c. Cystitis
d. Vaginal mucosa
3. How does vaginosis differ from vaginitis?
a. It must be treated with metronidazole.
b. The discharge does not contain white blood cells.
c. The discharge does not have an odor.
d. It causes itching and/or burning.
4. What is the most important step in preventing vaginal infections?
a. Good personal hygiene
b. Healthy diet
c. Scented sanitary products
d. Douching
5. What can bacterial vaginosis lead to?
a. Vulvovaginal candidiasis
b. Pelvic inflammatory disease
c. Toxic shock syndrome
d. Trichomoniasis
6. Approximately what percentage of women with bacterial vaginosis are asymptomatic?
a. 25%
b. 40%
c. 75%
d. 50%
7. What is the most common symptom of bacterial vaginosis?

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a. Vaginal itching and/or burning
b. Cottage cheese-like discharge
c. Fishy odor
d. Yeasty odor
8. Vulvovaginal candidiasis accounts for what percentage of all vaginal infections?
a. 10-15%
b. 20-25%
c. 50-55%
d. 60-65%
9. Which organism causes 90% of vulvovaginal candidiasis episodes in women?
a. Candida tropicalis
b. Candida albicans
c. Candida glabrata
d. Candida krusei
10. What is the most common symptom of vulvovaginal candidiasis?
a. Fishy odor
b. Fever
c. Thin, grayish-white discharge
d. Vulvar pruritis
11. What percentage of Toxic Shock Syndrome cases are related to menses?
a. 50%
b. 25%
c. 75%
d. 90%
12. Women who have had Toxic Shock Syndrome should be instructed not to use
tampons or
a. barrier contraception methods.
b. hormonal contraception methods.
c. intravaginal antibiotic cream.
d. oral antibiotics.
13. What is generally the cause of Bartholin’s cyst?
a. Complications from gonorrhea
b. Cystic fluid in Bartholin’s gland becomes infected
c. A fungal infection in Bartholin’s gland
d. Obstruction of a duct in Bartholin’s gland

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CHAPTER 20 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. Approximately how many Americans will contract one or more sexually transmitted
infections during their lifetime?
a. 50%
b. 25%
c. 40%
d. 60%
2. Why is it often more difficult to detect STIs in women than in men?
a. Men are two times more likely to transmit STIs to women than the reverse.
b. The risk of a woman contracting an STI is much higher than a man’s risk.
c. The anatomy of women’s genital tracts makes examination more difficult.
d. Women tend to have fewer sexual partners than men do.
3. Who should be screened regularly for STIs?
a. Women who have more than one sexual partner
b. Women over the age of 21
c. Women who are sexually active
d. Women over the age of 15
4. Of the more than 100 known serotypes of human papillomavirus (HPV),
approximately how many can infect the genital tract?
a. 80
b. 60
c. 20
d. 40
5. Routine HPV vaccination is recommended for girls of what age?
a. 8-9
b. 13-14
c. 6-7
d. 11-12
6. An initial or primary genital herpes infection characteristically lasts about
a. one week.
b. three weeks.
c. one month.
d. six weeks.

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7. How do systemic antivirul drugs treat genital herpes?
a. They can control the symptoms.
b. They can reduce the frequency of recurrences after discontinuation.
c. They can prevent transmission to sexual partners.
d. They can prevent secondary infection.
8. Which of the following is caused by an anaerobic one-celled protozoan that commonly
lives in the vagina?
a. Trichomoniasis
b. Chlamydia
c. Gonorrhea
d. Syphilis
9. The prevalence of chlamydia is how many times higher in black women than in white
women?
a. Two times
b. Three times
c. Five times
d. Four times
10. The second most commonly reported STI after chlamydia is
a. gonorrhea.
b. pelvic inflammatory disease.
c. syphilis.
d. hepatitis B.
11. Why do adolescents have the highest risk of developing pelvic inflammatory disease
(PID)?
a. They have the highest risk for bacterial vaginosis.
b. They are the least at risk for developing other STIs.
c. They are the most sexually active.
d. They have decreased immunity to infectious organisms.
12. What is different about syphilis as compared to other bacterial STIs?
a. The incidence in women is much higher than in men.
b. The rates are higher for white women than for black women.
c. It cannot be spread by kissing.
d. It persists past age 25, into the 30s and 40s.
13. What has contributed to the decreased incidence of Hepatitis B over the past 20
years?
a. The decrease in PID
b. The HBV vaccination
c. The increase in condom use
d. More precise screening methods

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14. Patients presenting for STI treatment should be screened for HIV
a. at each visit.
b. at the end of treatment.
c. at the beginning of treatment.
d. each year.

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70

CHAPTER 21 QUESTIONS
MULTIPLE-CHOICE QUESTIONS
Select the one correct answer to each of the following questions.
1. Half of all women have experienced a urinary tract infection (UTI) by age
a. 18.
b. 24.
c. 40.
d. 32.
2. How does women’s anatomy make them more susceptible to UTIs?
a. Asymptomatic UTIs do not resolve themselves without treatment.
b. Women tend to get UTIs when they are pregnant.
c. There is a longer distance between the urethra and anus.
d. Their urethras are shorter.
3. What is the most common type of UTI that affects women?
a. Acute bacterial cystitis
b. Pyelonephritis
c. Asymptomatic bacteruria
d. Pyelitis
4. Uncomplicated acute bacterial cystitis occurs in women who
a. are pregnant.
b. have no signs of upper tract infection.
c.

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