Deck 49: Nursing Care of Women With Reproductive System and Breast Disorders

Question 1

A female patient tells the nurse that lately she "isn't interested in sex" but is concerned that her husband will divorce her. Which would be an appropriate response for the nurse to make to this patient?

A) "I'm sure it's nothing and will go away in time."
B) "There are other activities you and your husband can do together."
C) "Sex isn't that important in a marriage anyway."
D) "Let's talk more about how you are feeling right now."

Answer 1

"Let's talk more about how you are feeling right now."

Question 2

A mass is found on a mammogram of a 42-year-old female patient and a cyst is confirmed by an ultrasound of the breast. The nurse understands that the next course of action for this patient would be to:

A) adopt the "watch and wait" approach.
B) reduce caffeine intake.
C) apply warm soaks to the cyst.
D) undergo a surgical biopsy.

Answer 2

undergo a surgical biopsy.

Question 3

The mother of a 16-year-old female is concerned that even though the teen began menstruating at age 14, her menses stopped around 6 months ago. How should the nurse respond to the mother?

A) "That's normal for a 16-year-old. That happened to me when I was 16."
B) "Have you considered pregnancy?"
C) "It's probably psychological."
D) "Have you noticed any weight loss or changes in her diet and activity level?"

Answer 3

"Have you noticed any weight loss or changes in her diet and activity level?"

Question 4

A female patient complains about increasing premenstrual symptoms over the past few years and thinks "something must be wrong." The nurse realizes that this patient is experiencing which health condition?

A) early menopausal symptoms
B) premenstrual dysphoric disorder
C) interpersonal relationship difficulties
D) normal pattern of premenstrual syndrome

Question 5

A patient is scheduled for an endometrial ablation for extreme uterine bleeding. Which patient statement indicates understanding of the long-term effects of this treatment?

A) "My future menstrual cycles will be normal."
B) "My menstrual cycles will be irregular from now on."
C) "I will stop menstruating and I can't get pregnant now."
D) "I will need hormone replacement therapy to regulate my menstrual cycles."

Question 6

A female patient is diagnosed with "chocolate" cysts. The nurse recognizes that these cysts are caused by which factor?

A) pelvic inflammatory disease
B) use of oral contraceptives
C) endometrial overgrowth
D) hormone imbalance

Question 7

The nurse is assisting a patient with ways to reduce the severity of the monthly discomfort associated with premenstrual syndrome. What information should the nurse review with this patient?

A) Apply ice packs to the lower abdominal region.
B) Practice abdominal breathing.
C) Balance exercise with rest.
D) Increase sodium intake.
E) Restrict caffeine intake.

Question 8

A female patient is concerned that she will develop ovarian cancer because great-grandmother had the disease. Which information from the patient's health history will help reduce the risk for this patient?

A) The patient began her menses at age 10.
B) The patient has never had long-term antibiotic therapy.
C) The patient had her first child at the age of 20.
D) The patient has asymptomatic menstrual cycles.

Question 9

A patient who is recovering from a complete hysterectomy for endometrial cancer is concerned that she will not be able to continue a sexual relationship with her husband because of the related activity intolerance. What should the nurse suggest to assist this patient?

A) The patient should engage in other activities with her spouse.
B) The patient should discuss her fears with a marriage counselor.
C) The patient and her husband should be thankful she survived cancer surgery.
D) The patient and her husband can coordinate sexual activity with rest periods and pain-free periods.

Question 10

A 13-year-old female patient asks the school nurse when her menstrual cycle will start, as she is already developing breasts. What should the nurse include in the response to this patient?

A) The teenager should be referred to a gynecologist for a pelvic examination.
B) The teenager should have started her period by now.
C) Menses will probably start within a few years.
D) The teenager should be tested for hormonal imbalances.

Question 11

During a routine patient admission history, a patient reports light bleeding between her menstrual periods. What initial action by the nurse is most appropriate?

A) determining the timing of the bleeding episodes
B) determining the amount of bleeding
C) assessing for the presence of sexually transmitted infections
D) reviewing the length of the patient's normal menstrual cycles

Question 12

A 25-year-old female is diagnosed with endometriosis. What should the nurse include when teaching the patient about this disorder?

A) Endometriosis can be treated without any long-term effects.
B) If the woman desires children, she should be encouraged to become pregnant before the disease progresses.
C) Laser ablation and birth control pills are the treatments for this condition.
D) Leaving the condition untreated will not result in any long-term health issues.
E) Dyspareunia can occur.

Question 13

A female patient of childbearing age is diagnosed with large uterine fibroids. Because the patient wants to have children, the nurse recognizes that the treatment of choice will probably be:

A) oral contraceptives.
B) estrogen replacement.
C) iron replacement therapy.
D) leuprolide acetate (Lupron).

Question 14

A female patient is recovering from breast cancer surgery that included axillary node dissection. The nurse realizes that this patient will need education regarding the potential development of which complication?

A) lymphedema
B) metastasis
C) anemia and bleeding
D) altered shoulder movement

Question 15

A female patient who is experiencing menopause is "tired of the night sweats." What should the nurse suggest to help this patient?

A) Ensure that the bedroom temperature is cool, and limit sleeping attire.
B) Reduce intake of milk and milk products.
C) Talk with the physician about a hysterectomy.
D) Exercise 1 hour before going to sleep.

Question 16

A patient who was recently diagnosed with ovarian cancer wants to have children. Which type of treatment should the nurse expect to be prescribed first for this patient?

A) chemotherapy
B) radiation therapy
C) surgery to remove one ovary
D) hormone replacement therapy

Question 17

A female patient is experiencing a recurrence of endometrial cancer. Which treatment should the nurse expect to be prescribed for this patient?

A) radiation therapy
B) hormone therapy
C) partial abdominal hysterectomy
D) chemotherapy
E) endometrial ablation

Question 18

A postmenopausal woman is diagnosed with cervical dysplasia caused by the human papillomavirus. For which procedure that would both diagnose and treat the dysplasia should the nurse prepare this patient?

A) Pap smear
B) colposcopy
C) cervical biopsy
D) loop diathermy

Question 19

A 52-year-old female patient thinks she is "losing her mind" because of her constant anxiety, inability to sleep, and headaches. The nurse realizes that this patient is describing symptoms of which health condition?

A) amenorrhea
B) perimenopause
C) postmenopause
D) dysmennorrhea

Question 20

A patient is diagnosed with uterine prolapse into the vagina. The nurse understands that which factor likely contributed to this disorder?

A) multiple pregnancies
B) endometriosis
C) pelvic inflammatory disease
D) cervical tumor

Question 21

A patient believes that she is beginning menopause. For which manifestations should the nurse assess this patient?

A) increased body hair
B) vaginal dryness
C) hot flashes
D) night sweats
E) vaginitis

Question 22

The nurse is preparing to counsel a 46-year-old woman who has been postmenopausal for 1 year about the common health risks associated with menopause. What should the nurse include in this teaching?

A) hypertension
B) heart disease
C) diabetes
D) macular degeneration
E) osteoporosis

Question 23

A patient shares with the nurse that she has pain during intercourse. For which health problems should the nurse assess this patient?

A) perforated hymen
B) vaginal scarring
C) fear of sexual abuse
D) vaginismus
E) climacteric

Question 24

A patient is scheduled to undergo a laparoscopic procedure. Which patient statement indicates a need for further education about the procedure?

A) "I can expect to go home a few hours after the procedure."
B) "I might experience some abdominal pain after the procedure."
C) "There might be some vaginal bleeding after the procedure."
D) "Shoulder pain should be reported, as it might signal a complication."

Question 25

Long-term hormone replacement therapy (HRT) is being discussed with a patient who is scheduled for a total hysterectomy. The patient should be informed that she will be at an increased risk for which health problems as a result of HRT?

A) breast cancer
B) stroke
C) venous thrombosis
D) colon cancer
E) heart attack

Question 26

A 41-year-old patient reports that her menstrual periods have become irregular, with the last period occurring approximately 4 months ago. What information should be provided to the patient concerning the use of contraceptives during the perimenopausal period?

A) Contraceptives should continue to be used.
B) Contraceptives are no longer needed.
C) Contraceptives will only be needed if menstruation occurs.
D) Contraceptive use will only be needed for another 2 months.

Question 27

A patient is preparing to be discharged to home after a panhysterectomy. Which patient statements indicate that discharge teaching has been successful?

A) "I will need to report a temperature greater than 101 degrees."
B) "I might experience vaginal bleeding for about 1 week."
C) "I will need to report any hot flashes and night sweats."
D) "I will still need to see my physician for gynecological examinations."
E) "I should not drive my car for the next few weeks."

Question 28

The nurse is planning care for a woman with premenstrual syndrome (PMS). On which problems should the nurse focus when planning this patient's care?

A) issues with self-esteem
B) problems managing acute pain
C) difficulty coping
D) potential problems with body image
E) sexual dysfunction

Question 29

A patient is suspected of having endometrial cancer. For which diagnostic procedures should the nurse prepare this patient?

A) abdominal x-ray
B) transvaginal ultrasound
C) dilatation and curettage (D&C)
D) intravenous pyelogram
E) CT scan of abdomen

Question 30

A 30-year-old patient reports increased irritability during the days preceding the onset of her menstrual cycle. What should the nurse suggest to assist in the management of her irritability?

A) increasing dietary sugar intake to promote energy
B) increasing intake of simple carbohydrates
C) reducing caffeine intake
D) using guided imagery
E) drinking two glasses of red wine each evening

Question 31

A patient has been experiencing the clinical manifestations associated with menopause and expresses an interest in using alternative and complementary therapies to manage them. What is the best response by the nurse?

A) "Alternative and complementary therapies seldom work."
B) "Many women report success with those measures."
C) "What types of therapies are of interest to you?"
D) "Have you discussed this with the healthcare provider?"

Question 32

A 25-year-old patient has been experiencing anovulatory dysfunctional uterine bleeding and is concerned about maintaining her fertility. About which therapies should the nurse instruct this patient?

A) oral contraceptives
B) progestin therapy
C) therapeutic D&C
D) endometrial ablation
E) iron replacement therapy

Question 33

A patient is concerned about developing cervical cancer. For which risk factors should the nurse assess this patient?

A) history of HPV infections
B) first intercourse before the age of 20
C) multiple sex partners
D) long-term use of birth control pills
E) alcohol abuse

Question 34

The nurse is reviewing the manifestations of premenstrual syndrome (PMS) with a group of community women. Which dietary changes should the nurse recommend?

A) eating a diet high in complex carbohydrates
B) eating a diet high in protein
C) increasing caffeine intake
D) increasing fat intake
E) reducing sodium and alcohol consumption

Question 35

The nurse is preparing to review the sexual response cycle with a 19-year-old client. In which order should the nurse review the phases of the cycle?

A) plateau
B) resolution
C) excitement
D) orgasm
E) none of the above

Question 36

A patient asks the nurse about alternative and complementary therapies that she might consider in place of hormone replacement therapy after menopause. Which herbal supplements should the nurse review with the patient?

A) black cohosh
B) ginseng
C) ginger
D) flaxseed
E) St. John's wort

Question 37

A patient with dysfunctional uterine bleeding (DUB) has been informed that this problem requires surgical intervention. Which procedures should the nurse review with this patient?

A) hysterectomy
B) laparoscopy
C) endometrial ablation
D) hormonal agents
E) therapeutic dilatation and curettage (D&C)

Question 38

The nurse is developing a teaching plan for a postmenopausal woman who has stress incontinence secondary to a prolapsed uterus. The nurse would include which interventions in the teaching plan?

A) Kegel exercises
B) increased caffeine intake
C) use of progesterone supplements
D) proper perineal care
E) use of perineal pads

Question 39

A patient who has been experiencing premenstrual syndrome (PMS) reports to the clinic with a diet diary she has kept over the past several weeks. The nurse should suggest the patient make a dietary modification based on which entry in her diary?

A) daily intake of caffeine-free soda
B) daily intake of low-fat yogurt
C) daily intake of foods rich in magnesium
D) daily intake of white bread

Question 40

The nurse is caring for a patient who will be receiving radiation therapy for cervical cancer. Patient education should include which skin care interventions?

A) wound and skin care
B) applying oil-based lotions to the skin
C) how to remove the markings from the skin
D) monitoring for evidence of fistula formation
E) applying heat to the abdomen with a heating pad

Question 41

During a health history of a patient with uterine dysfunction, the nurse determines that oral contraceptives would be contraindicated for this patient. What did the nurse assess to make this clinical determination?

A) The patient takes vitamin C every day.
B) The patient smokes one ppd of cigarettes.
C) The patient takes antihypertensive medication.
D) The patient was treated for thrombophlebitis after her last pregnancy.
E) The patient's father has had several joints replaced because of arthritis.

Question 42

A patient is preparing to return home after repair of a vaginal fistula. What teaching should the nurse provide before this patient is discharged?

A) Maintain bed rest for a week.
B) Use perineal pads as directed.
C) Perform perineal irrigation as prescribed.
D) Cleanse the perineal area daily with a sitz bath.
E) Apply topical antibacterial ointment to the area.

Question 43

A patient is to receive hormone therapy as adjunct treatment for advanced breast cancer. The nurse should anticipate that the primary care provider will choose which oral medication for this patient?

A) trastuzumab (Herceptin)
B) bevacizumab (Avastin)
C) goserelin (Zoladex)
D) fulvestrant (Faslodex)

Question 44

The nurse is caring for a patient diagnosed with cancer of the vulva. About which treatments should the nurse prepare teaching material for this patient?

A) imiquimod therapy
B) chemotherapy
C) hormone therapy
D) surgical resection
E) radiation therapy