Papanicolaou Test (Pap Smear) Practice Exam

1. The nurse is counseling a mother who wants her teenage daughter to have a Pap smear and pelvic examination. Which statement by the nurse is most accurate?

1. “If your daughter is over 18, she needs a pelvic examination and Pap smear.”
2. “A teenager does not need this examination unless she is sexually active.”
3. “Teach her to have her first examination by the age of 21 at the latest.”
4. “It is not needed unless you are worried about sexually transmitted diseases.”

2. When scheduling an annual pelvic examination and Pap test, the client asks if she should abstain from intercourse before the test. Which is the nurse’s best response?

1. “Yes. Avoid having intercourse for 24 hours before the test.”
2. “Yes. Avoid having intercourse for 2 hours before the test.”
3. “No. Intercourse does not interfere with this test.”
4. “No. Intercourse can actually enhance the test results.”

3. A client is in the clinic for an annual examination and questions the need for a pelvic examination and Pap smear because she had a hysterectomy many years ago. Which response by the nurse is most appropriate?

1. “Do you still have your cervix?”
2. “Are you sexually active?”
3. “We can skip it if you like.”
4. “Let’s see what the doctor says.”

4. The nurse is teaching high school girls about the female reproductive tract. Which statements by the nurse are accurate? (Select all that apply.)

1. The vagina has an acidic environment.
2. The cervix is where the Pap smear is taken from.
3. The ovum is fertilized in the uterus.
4. Ovaries produce sex steroid hormones.
5. The breasts contain fat tissue.

1. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.
2. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
3. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
4. The human papillomavirus (HPV), which causes condylomata acuminata, can’t be transmitted during oral sex.

1. Presence of completely undifferentiated tumor cells that don’t resemble cells of the tissues of their origin.
2. Increase in the number of normal cells in a normal arrangement in a tissue or an organ.
3. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn’t found.
4. Alteration in the size, shape, and organization of differentiated cells.

7. When the results of a Pap smear are reported as class 5, the nurse recognizes that the common interpretation is

1. malignant.
2. normal.
3. probably normal.
4. suspicious.

8. For women aged 19-39 years, recommended health screening diagnostic testing includes which of the following?

1. Pap smear
2. Mammography
3. Cholesterol and lipid profile
4. Bone mineral density testing

9. A 25 year old patient is inquiring about the methods or ways to detect cancer earlier. The nurse least likely identify this method by stating:

1. Annual chest x-ray.
2. Annual Pap smear for sexually active women only.
3. Annual digital rectal examination for persons over age 40.
4. Yearly physical and blood examination

10. A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

1. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.
2. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
3. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
4. The human papillomavirus (HPV), which causes condylomata acuminata, can’t be transmitted during oral sex.

Answer & Rationale

1. C. A woman needs to have her first pelvic examination with Pap smear by the age of 21, or within 3 years of becoming sexually active. The other statements are not accurate.
2. A. The woman should not douche, use vaginal medications or deodorants, or have sexual intercourse for at least 24 hours before the test. Such activities may prevent the accurate evaluation of smears, cultures, and cytologic data.
3. A. Women who still have their cervix after hysterectomy still need a Pap smear according to the guidelines established for other women. Sexual activity is not relevant. Simply stating that it can be skipped does not help the woman protect her health. Asking the provider does not help the nurse further assess the client.
4. A, B, D, E. The acidic environment of the vagina helps protect against infection. The cervix is the site for Pap testing. The ovaries produce sex steroid hormones. The breasts contain fat, glandular, fibrous, and ductal tissue. Ova are fertilized in the fallopian tubes.
5. A. Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection. Because condylomata acuminata is a virus, there is no permanent cure. Because condylomata acuminata can occur on the vulva, a condom won’t protect sexual partners. HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.
6. D. Dysplasia refers to an alteration in the size, shape, and organization of differentiated cells. The presence of completely undifferentiated tumor cells that don’t resemble cells of the tissues of their origin is called anaplasia. An increase in the number of normal cells in a normal arrangement in a tissue or an organ is called hyperplasia. Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn’t found is called metaplasia.
7. A. A class 5 Pap smear, according to the Bethesda Classification, indicates squamous cell carcinoma.
8. A. A Pap smear is recommended for women aged 19-39 years, as well as for women aged 40 and older.
   • Mammography is recommended for health screening for women aged 40 years and older.
   • Cholesterol and lipid profile is recommended for women aged 40 years and older.
   • Bone mineral density testing is recommended for women aged 40 years and older.
9. B. Early detection of cancer is promoted by annual oral examination, monthly BSE from age 20, annual chest x-ray, yearly digital rectal examination for persons over age 40, annual Pap smear from age 40 and annual physical and blood examination. Letter B is wrong because it says Pap smear should be done yearly for sexually active women. All women should have an annual pap smear by age 40 and up whether sexually active or not.
10. A. Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection. Because condylomata acuminata is a virus, there is no permanent cure. Because condylomata acuminata can occur on the vulva, a condom won’t protect sexual partners. HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.