Deck 44: Reproductive System

Question 1

A 35-year-old woman has tried for 6 months to become pregnant for the first time.The nurse obtains this reproductive history: onset of menses at 13 years of age;length of monthly cycle,20 to 24 days;5 days of heavy bleeding often accompanied by lower backache during her monthly period,with intermittent spotting between periods.She also states that intercourse is sometimes painful.The nurse should suspect that the client has which of these conditions?

A)cervical cancer
B)endometriosis of undetermined extent
C)extensive endometriosis
D)pelvic inflammatory disease

Answer 1

endometriosis of undetermined extent

Question 2

When a client is hospitalized for treatment for pelvic inflammatory disease (PID),the nurse should place the client in which position?

A)reverse Fowler's,to promote the effectiveness of the vaginal suppositories
B)supine or left-lying,to relieve pressure on the pelvis
C)semi-Fowler's,to aid pelvic drainage
D)knee-chest,to relieve pain

Answer 2

semi-Fowler's,to aid pelvic drainage

Question 3

Client teaching for a client who has fibrocystic breast disease should emphasize which aspect?

A)avoiding foods high in saturated fat
B)performing a self-breast-examination monthly
C)having mammograms every 6 months
D)having the health care provider examine breasts monthly

Answer 3

performing a self-breast-examination monthly

Question 4

In addition to administration of prescribed antibiotics,nursing interventions for a client who has epididymitis would include which of the following?

A)sitz baths and bed rest
B)hot compresses to the area
C)scrotal support
D)indwelling catheter

Question 5

What is the preferred treatment for pelvic inflammatory disease caused by herpes simplex virus type 2?

A)hospitalization for intravenous (IV)antibiotic therapy
B)hysterectomy
C)medicated vaginal suppositories
D)oral antibiotics and bed rest

Question 6

A client who has bilateral epididymitis can result with which condition?

A)impotence
B)premature ejaculation
C)sexual dysfunction
D)sterility

Question 7

For a client who is taking Flagyl oral antibiotic for treatment of trichomonas vaginitis,the nurse should instruct the client to:

A)avoid caffeinated beverages during therapy
B)eat 8 ounces of yogurt with active cultures daily
C)abstain from intercourse during therapy
D)take supplemental vitamins and calcium with meals

Question 8

When explaining to a client about the innermost layer of the uterus that sloughs with menstruation each month,the nurse would identify this as the:

A)cervix
B)endometrium
C)myometrium
D)perimetrium

Question 9

A 36-year-old female who is 26 weeks pregnant is hospitalized due to preterm labor.The client has a history of uterine fibroids.The nurse should recognize that:

A)the fetus must be monitored carefully as the fibroids may increase fetal growth rate
B)the fibroids elevate the levels of estrogen and progesterone,thus retarding fetal growth
C)the hormones of pregnancy may increase the fibroid growth rate,crowding the uterus
D)benign fibroids will not interfere with pregnancy

Question 10

An older adult male client has experienced hesitancy,nocturia,frequency of urination,and a decreased force of urinary stream but tells the nurse these symptoms have subsided and asks what might have caused that to happen.What would be the nurse's BEST response?

A)"Had you decreased your fluid intake in the afternoons when you noticed this change?"
B)"The bladder muscles have enlarged and reduced these symptoms."
C)"You may have had a mild urinary tract infection that has cleared up."
D)"We may never know the exact cause."

Question 11

A 40-year-old woman tells the nurse about having an excessively heavy menstrual flow and a feeling of pressure in the pelvic region.The nurse should recognize the client's symptoms are the result of:

A)cervical dysplasia
B)fibroids
C)miscarriage
D)pelvic inflammatory disease (PID)

Question 12

A client complains of white,thick vaginal discharge accompanied by severe itching of the vagina and vulva.The vulva is reddened and edematous,and white patches are present in the vaginal mucosa.The nurse should suspect the client has developed:

A)candidiasis
B)chlamydia
C)herpes simplex virus type 2
D)trichomoniasis

Question 13

A female client tells the nurse she is experiencing a low-grade fever,pelvic and abdominal pain,dyspareunia,nausea,and vomiting.The nurse should suspect that the client has developed:

A)candidiasis infection
B)gastroenteritis of bacterial origin
C)pelvic inflammatory disease
D)urinary tract infection

Question 14

What is the purpose of cilia in the fallopian tubes?

A)to assist the progress of the sperm toward a released ovum
B)to clear mucus,interstitial fluid,or endometrial tissue from the fallopian tube
C)to impede the progress of the sperm
D)to move the ovum along the path toward the uterus

Question 15

The nurse is aware that the hormone released monthly by the anterior pituitary gland,causing the ovary to ripen one or more ova,is:

A)diethylstilbestrol (DES)
B)follicle-stimulating hormone (FSH)
C)human chorionic gonadotropin (HCG)
D)progesterone

Question 16

If a nurse suspects a male client has epididymitis based on his description of the symptoms,what should the nurse encourage the client to do?

A)Call his health care provider in the morning.
B)Seek immediate evaluation from his health care provider.
C)Take two aspirin tablets,apply ice,and see how he feels the next day.
D)Make an appointment to see his health care provider the next week.

Question 17

If a client who has an inflammatory disorder of the male reproductive system,such as orchitis or prostatitis,begins to experience nausea,what should the nurse recognize about the client's condition?

A)It is deteriorating.
B)It is to be expected.
C)Recuperation is in progress.
D)The acute stage of the illness is still present.

Question 18

A client develops a "sterile" epididymitis.The nurse should recognize this condition can result from direct injury or:

A)a complication of chlamydia
B)an invasive procedure on the urinary tract
C)urinary reflux related to straining with a full bladder
D)prolonged use of an indwelling catheter

Question 19

The nurse should recognize that a client who has gonorrheal urethritis should NOT be catheterized for what reason?

A)Inflammation in the infected tissue will increase.
B)The infection could spread rapidly to the genital organs.
C)Segmented bacteriologic localization cultures can be obtained.
D)Voiding will flush the bacteria out of the urinary tract.

Question 20

The FIRST part of the menstrual cycle during which an ova develops is called:

A)fertilization
B)menstruation
C)ovulation
D)the proliferative phase

Question 21

A client diagnosed with breast cancer elects to have a procedure in which the breast tissue and nearby lymph nodes are removed,but the muscles of the chest wall are left relatively intact.What is the name of this procedure?

A)lumpectomy
B)modified mastectomy
C)partial mastectomy
D)radical mastectomy

Question 22

What is the MOST frequent site of ovarian cancer metastasis?

A)colon
B)diaphragm
C)lungs
D)uterus

Question 23

A bladder of a client who has a transurethral resection of the prostate (TURP)is continuously irrigated with normal saline during the immediate postoperative period to:

A)decrease the amount of scar tissue formation at the operative site
B)reduce clot formation,which would interfere with urinary drainage
C)prevent infection of the operative site by flushing out bacteria
D)soothe pain in the operative area

Question 24

Postsurgical teaching for a client who has just undergone a modified mastectomy would include which of the following?

A)Wear purse straps over the affected arm.
B)Minor injuries on the affected side are to be expected.
C)Slight swelling or bruising of the affected limb is normal in the first month.
D)Vaccinations and blood draws should be done on the unaffected side only.

Question 25

If a client is diagnosed with benign prostatic hyperplasia (BPH),the nurse recognizes that the major concern with this condition is that:

A)without treatment,it may progress to prostatic cancer
B)urinary outlet obstruction,infection,and kidney damage may result
C)impotence occurs in the majority of clients
D)symptoms will worsen

Question 26

What is the MOST useful screening method for prostate cancer?

A)prostate specific antigen (PSA)
B)prostatic biopsy
C)rectal examination
D)transrectal ultrasonic examination

Question 27

Cytoxan is ordered for a client who will be receiving her first chemotherapy for ovarian cancer today.Since no other chemotherapy agent is prescribed for her,the nurse should recognize that:

A)after today's administration of medication,the same therapy will be repeated at regular intervals over the course of a year
B)the client's cancer has not metastasized
C)the client will remain in the hospital to receive a regimen of the drug over the course of 5 days
D)this drug may be given in conjunction with other chemotherapy agents,depending on the severity and extent of the cancer

Question 28

Why is the survival rate for ovarian cancer low?

A)Metastasis occurs in over 75% of cases prior to diagnosis,and the cancer has often spread beyond the pelvis.
B)Ovarian cancer usually originates in some other organs and metastasizes to the ovaries.
C)The cancer cannot be detected until it reaches an advanced stage.
D)Most clients also have breast cancer concurrently.

Question 29

Which clients are at greatest risk for endometrial cancer?

A)postmenopausal women who have taken estrogen replacement therapy for over 5 years
B)nulliparas
C)women who have taken birth control pills for 4 years
D)women who practice abstinence

Question 30

Which sign may indicate postoperative hemorrhage in the client who had a prostatectomy?

A)blood pressure of 100/70
B)pulse of 92
C)temperature of 103 degrees Fahrenheit
D)bright red urine color persisting for several hours in the catheter drainage

Question 31

A client is scheduled for a subtotal hysterectomy,which means that:

A)only the uterus will be removed
B)the surgery will be performed through an abdominal incision to visualize the entire pelvic region
C)the surgery will be performed with a laparoscopic approach
D)the uterus,cervix,and fallopian tubes will be removed

Question 32

A client who is scheduled for a radical hysterectomy to be followed by radium implant therapy has a nursing diagnosis of Impaired skin integrity related to surgical interventions and radiation side effects.Postoperative nursing interventions would include:

A)cleansing the radiation and incision site daily with antibacterial soap
B)having the client move about her room as tolerated to increase circulation
C)assisting the client with activities of daily living (ADLs),including specified perineal care as ordered
D)teaching the client to look for tenderness,pink color (like sunburn),delayed wound healing,and itching

Question 33

A client is hospitalized for chemotherapy following a mastectomy for stage IV breast cancer.What should the nurse recognize about the client's cancer?

A)It involved the proximal lymph nodes.
B)It involved the distal lymph nodes.
C)It had metastasized prior to surgery.
D)It was larger than 5 centimeters in diameter.

Question 34

A client who has uterine cancer is to begin Depo-Provera hormonal therapy.Which statement about this medication is TRUE?

A)It increases the regeneration of healthy cells.
B)The order must be verified with the health care provider because it contains progesterone and can stimulate tumor growth.
C)It is administered to slow tumor growth when the cancer is considered inoperable or has metastasized.
D)It is used for birth control when chemotherapy treatments cause nausea and vomiting and the client can no longer take oral contraceptives.

Question 35

A client who had a TURP becomes confused and agitated.His pulse has become slow and bounding,his systolic blood pressure has increased,and his diastolic blood pressure has decreased.These signs would indicate to the nurse that the client has developed which of the following complications?

A)hemorrhage
B)infection
C)thrombosis
D)water intoxication

Question 36

Which medication is used to reduce the client's bladder spasms after prostate surgery?

A)alpha blockers
B)belladonna and opium suppositories
C)finasteride
D)meperidine

Question 37

When a nurse is caring for a client with radium implants,which action is MOST important?

A)Assess the radium implant sites once every shift.
B)Encourage frequent visitation of the client's close family and friends.
C)Organize care to optimize time spent at the bedside.
D)Encourage the client to walk around in the room.

Question 38

What is the MOST common complication of surgical treatment of prostate cancer?

A)lymphocele formation
B)urinary incontinence
C)fecal incontinence
D)bladder distention

Question 39

A client has a breast tumor 3 centimeters in diameter,with no lymph nodes involved or metastases evident.The client's cancer would be considered to be in which stage?

A)I
B)II
C)III
D)IV

Question 40

Nonsurgical treatment for BPH includes use of:

A)alpha blockers or finasteride
B)an indwelling urinary catheter
C)belladonna and opium suppositories
D)meperidine

Question 41

The nurse is caring for a client with possible cervical cancer who wants to know about what can cause this condition.The nurse's reply should include which of the following? (Select all that apply. )

A)smoking
B)oral contraceptives
C)history of negative Pap smears
D)history of vegetarian diet
E)history of long-term steroid use
F)history of sexually transmitted diseases (STIs)

Question 42

In addition to aging,functional impotence can be the result of:

A)taking antihypertensive medications
B)difficulty with communication or relationships
C)anatomic factors
D)taking too much Viagra

Question 43

In the immediate postoperative period,what activity is permitted for the client who had a radical inguinal orchiectomy?

A)ambulation within 8 hours
B)bed rest for 12 to 24 hours
C)sitting up at the bedside within 6 hours
D)wearing an athletic supporter before ambulating for the first time

Question 44

When is the cryosurgical ablation technique used to treat clients who have prostate cancer?

A)when clients cannot tolerate more extensive surgery
B)as a complementary therapy for clients who undergo radiation treatment
C)as an initial therapy for clients whose symptoms are mild
D)for clients whose tumors have metastasized

Question 45

A vacuum constriction device (VCD)may be used to promote an erection by:

A)strengthening penile vasculature
B)increasing blood supply to the penis
C)reducing inhibitions
D)enhancing sensation

Question 46

Postoperative teaching for a client who has a vasectomy would emphasize which aspect?

A)Apply ice to the scrotum for 1 hour following surgery.
B)Avoid strenuous physical exercise for 1 week.
C)Rest at least 24 hours after surgery.
D)Other contraceptive devices are unnecessary as the sperm pathway has been severed.

Question 47

Initial treatment for clients who have premenstrual syndrome (PMS)includes which of the following?

A)analgesics such as acetaminophen,naproxen,ibuprofen
B)psychological evaluation
C)supplemental estrogen
D)tranquilizers and antidepressants

Question 48

A client who has diabetes with vascular complications and takes antihypertensives develops recent onset impotence.Which type of impotence do the client's symptoms suggest?

A)injury to the spermatic cord
B)anatomic
C)atonic
D)functional

Question 49

A postmenopausal female client is concerned about preventing osteoporosis.What instruction is MOST important for the nurse to give the client?

A)Ask her health care provider about estrogen replacement therapy.
B)Regular exercise decreases the potential for calcium loss from weight-bearing bones.
C)Schedule a baseline bone density study after menopausal symptoms begin.
D)Monitor daily intake of vitamins A and D.

Question 50

A male client develops sudden abdominal and scrotal pain and scrotal edema.The client tells the nurse he recently had a bicycle accident.The nurse should suspect that the client has developed:

A)epididymitis
B)hydrocele
C)hypospadias
D)testicular torsion

Question 51

A client has been diagnosed with a spermatocele,which means that:

A)the urethral opening is abnormally placed on the dorsal surface of the penis
B)a benign cyst containing fluid and sperm has developed
C)a collection of clear amber fluid has occurred within the space of the testes and the tunica vaginalis
D)dilation of the veins of the scrotum has occurred

Question 52

When performing a TSE,a 19-year-old client detects a firm,painless lump on his right testis and notes his scrotum is enlarged.The client's alkaline phosphatase is elevated,and an ultrasound confirms a lesion that is thought to be malignant.What is the usual treatment for testicular cancer?

A)biopsy of the testis
B)removal of the lesion only
C)removal of both testes with examination of the nodes
D)radical inguinal orchiectomy

Question 53

If a client has a third-degree uterine prolapse,what does this mean?

A)The cervix extends beyond the vaginal opening to the perineum.
B)The uterus is displaced to the rectum.
C)The cervix is visible at the vaginal opening.
D)The uterus protrudes outside the vagina.

Question 54

A nurse should recognize that a client diagnosed with Peyronie's disease can have which type of impotence?

A)anatomic
B)functional
C)atonic
D)secondary

Question 55

A client who has been unable to achieve a pregnancy would have which type of infertility?

A)hormonal
B)primary
C)secondary
D)structural

Question 56

A 20-year-old client has an undescended testicle and asks the nurse how he should perform testicular self-examination (TSE).What instruction should the nurse provide?

A)"A normal testis should feel round and soft."
B)"Grasp the testis with both hands,and feel the entire surface between the thumb and forefinger."
C)"If you feel anything strange,repeat the TSE several times to be sure."
D)"Perform the examination before you shower."

Question 57

Oral contraception can be used by female clients who have which of these preexisting conditions?

A)cardiovascular disease
B)diabetes mellitus
C)lupus
D)thrombophlebitis

Question 58

A nurse notes that the urethral catheter of a client who had prostate cancer surgery is draining dark bloody urine with clots,but the tubing is not draining freely.Which action should the nurse take FIRST?

A)Call the health care provider immediately.
B)Increase the tension on the catheter by retaping.
C)Irrigate the catheter with 150 cc of sterile normal saline.
D)Milk the tubing.

Question 59

Client teaching for a client who has moderate to severe premenstrual syndrome (PMS)should include which aspect?

A)avoiding caffeine,salt,and chocolate
B)getting plenty of rest when symptoms begin
C)eating oranges,tomatoes,and yellow vegetables
D)taking a daily calcium supplement

Question 60

A male client tells the nurse about a painless nodular growth on the foreskin and that he is experiencing fatigue and weight loss.The client's penis is uncircumcised,and his medical history indicates treatment for several sexually transmitted infections.The nurse should suspect the client has which condition?

A)a benign lesion of the foreskin
B)epididymitis
C)penile cancer
D)syphilitic lesion

Question 61

The nurse is caring for a client with a possible diagnosis of fibrocystic breast disease.The client asks,"What symptoms should I watch for?" The BEST response by the nurse would include which of the following? (Select all that apply. )

A)cysts that are painless with palpation
B)green,sticky nipple discharge
C)decreased estrogen levels
D)white,sticky nipple discharge
E)cysts that are more tender as the menstrual period approaches