Question 1

Which suggestion is appropriate for a client who complains of hot flashes? Choose all that apply.

Accepted Answer

Ice water may help alleviate the hot flashes.Consuming large quantities of caffeine,drinking a glass of wine,eating Mexican food,or drinking warm beverages most likely would exacerbate the hot flashes.

Question 2

While evaluating a client for osteoporosis,the nurse should be aware of what risk factor?

Accepted Answer

Smoking is associated with earlier and greater bone loss and decreased estrogen production.Women at risk for osteoporosis are likely to be Caucasian or Asian.Inadequate calcium intake is a risk factor for osteoporosis.Women at risk for osteoporosis are likely to be small boned and thin.Obese women have higher estrogen levels as a result of the conversion of androgens in the adipose tissue.Mechanical stress from extra weight also helps preserve bone mass.

Question 3

When assessing the client for amenorrhea,the nurse should be aware that this may be caused by all conditions except:

Accepted Answer

Lack of exercise is not a cause of amenorrhea.Strenuous exercise may cause amenorrhea.Anatomic abnormalities are a possible cause of amenorrhea.Type 1 diabetes mellitus is a possible cause of amenorrhea.Hysterectomy is a possible cause of amenorrhea.

Question 4

When discussing estrogen replacement therapy (ERT)with a perimenopausal woman,the nurse includes the risk of:

Accepted Answer

Women with a high risk for breast cancer should be counseled against using ERT.Estrogen prevents atrophy of vaginal and urinary tract tissue.Estrogen protects against the development of osteoporosis.Estrogen has a favorable effect on circulating lipids,reducing low-density lipoprotein (LDL)and total cholesterol and increasing high-density lipoprotein (HDL).It also has a direct antiatherosclerotic effect on the arteries.

Question 5

During her annual gynecologic checkup,a 17-year-old woman states that recently she has been experiencing cramping and pain during her menstrual periods.The nurse documents this complaint as:

Accepted Answer

Dysmenorrhea is pain during or shortly before menstruation.Amenorrhea is the absence of menstrual flow.Dyspareunia is pain during intercourse.PMS is a cluster of physical,psychologic,and behavioral symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses.

Question 6

Alternatives to hormonal therapy for menopausal symptoms include (choose all that apply):

Accepted Answer

Both soy and vitamin E have been reported to help alleviate menopausal symptoms.Vitamins C,K,and A have no apparent effect on menopausal symptoms.

Question 7

When a nurse is counseling a woman for primary dysmenorrhea,which nonpharmacologic intervention might be recommended?

Accepted Answer

Heat minimizes cramping by increasing vasodilation and muscle relaxation and minimizing uterine ischemia.Dietary changes such as eating less red meat may be recommended for women experiencing dysmenorrhea.Increasing the intake of diuretics,including natural diuretics such as asparagus,cranberry juice,peaches,parsley,and watermelon may help ease the symptoms associated with dysmenorrhea.Exercise has been found to help relieve menstrual discomfort through increased vasodilation and subsequent decreased ischemia.

Question 8

Nafarelin (Synarel)is used to treat mild to severe endometriosis.The nurse should tell the woman taking this medication that the drug:

Accepted Answer

Nafarelin is a GnRH agonist,and its side effects are similar to those of menopause.The hypoestrogenism effect results in hot flashes and vaginal dryness.Nafarelin is a GnRH agonist that suppresses the secretion of GnRH.Nafarelin is administered twice daily by nasal spray.Nafarelin is administered intranasally.

Question 9

The absence or cessation of menstrual flow is known as:

Accepted Answer

Amenorrhea is most often the result of pregnancy,although it could be a sign of conditions that require treatment.Dysmenorrhea is painful menstruation that begins 2 to 6 months after menarche.Menorrhagia is abnormally profuse or excessive bleeding from the uterus.Metrorrhagia is bleeding between periods.It can be caused by progestin injections and implants.

Question 10

One of the alterations in cyclic bleeding that occurs between periods is called:

Accepted Answer

Metrorrhagia is bleeding between periods.It can be caused by progestin injections and implants.Oligomenorrhea is infrequent or scanty menstruation.Menorrhagia is excessive menstruation.Leiomyoma is a common cause of excessive bleeding.

Question 11

Management of primary dysmenorrhea often requires a multifaceted approach.The nurse who provides care for a client with this condition should be aware that the optimal pharmacologic therapy for pain relief is:

Accepted Answer

NSAIDs have the strongest research results for pain relief.Often if one NSAID is not effective,another one will provide relief.Approximately 80% of women find relief from these prostaglandin inhibitors.Preparations containing acetaminophen are less effective for dysmenorrhea because they lack the antiprostaglandin properties of NSAIDs.OCPs are a reasonable choice for women who also want birth control.The benefit of OCPs is the reduction of menstrual flow and irregularities.OCPs may be contraindicated for some women and have a number of potential side effects.NSAIDs are the drug of choice.However,if a woman is taking an NSAID she should avoid taking aspirin as well.

Question 12

Which statement concerning cyclic perimenstrual pain and discomfort (CPPD)is accurate?

Accepted Answer

PMS may manifest itself with one or more of a hundred or so physical and psychologic symptoms.PDD is a more severe variant of PMS.Secondary dysmenorrhea is characterized by more muted pain than that seen in primary dysmenorrhea;the medical treatment is much the same.The cause of PMS is unknown.It may in fact be a collection of different problems.

Question 13

When assessing a woman for menopausal discomforts,the nurse would expect the woman to describe the most frequently reported discomfort,which would be:

Accepted Answer

Vasomotor instability,in the form of hot flashes or flushing,is a result of fluctuating estrogen levels and is the most common disturbance of the perimenopausal woman.Headaches may be associated with a decline in hormone levels;however,it is not the most frequently reported discomfort for menopausal women.Mood swings may be associated with a decline in hormone levels;however,it is not the most frequently reported discomfort for menopausal women.Vaginal dryness and dyspareunia may be associated with a decline in hormone levels;however,it is not the most frequently reported discomfort for menopausal women.

Question 14

With regard to dysmenorrhea,nurses should be aware that:

Accepted Answer

Pain is described as sharp and cramping or sometimes as a dull ache.It may radiate to the lower back or upper thighs.Dysmenorrhea is more common in younger women ages 17 to 24.Dysmenorrhea is more common in women who smoke and who are obese.Symptoms begin with menstruation or sometimes a few hours before the onset of flow.

Question 15

When evaluating a client whose primary complaint is amenorrhea,the nurse must be aware that lack of menstruation is most often the result of:

Accepted Answer

Amenorrhea,or the absence of menstrual flow,is most often a result of pregnancy.Although stress may be a contributing factor to amenorrhea,pregnancy is the most common cause.Although excessive exercise may be a contributing factor to amenorrhea,pregnancy is the most common cause.Although eating disorders may be a contributing factor to amenorrhea,pregnancy is the most common cause.

Question 16

A 36-year-old woman has been diagnosed as having uterine fibroids.When planning care for this client,the nurse should know that:

Accepted Answer

The major symptoms associated with fibroids are menorrhagia and the physical effects produced by large myomas.Fibroids are benign tumors of the smooth muscle of the uterus,and their etiology is unknown.Fibroids are estrogen sensitive and shrink as levels of estrogen decline.Fibroids occur in 25% of women of reproductive age and are seen in 2% of pregnant women.

Question 17

While interviewing a 31-year-old woman before her routine gynecologic examination,the nurse collects data about the client's recent menstrual cycles.The nurse should collect additional information with which statement?

Accepted Answer

Menorrhagia is defined as excessive menstrual bleeding,either in duration or in amount.Heavy bleeding can have many causes.The amount of bleeding and its effect on daily activities should be evaluated.A menstrual flow that lasts 5 to 6 days is a normal finding.Mittlestaining,a small amount of bleeding or spotting that occurs at the time of ovulation (14 days before onset of the next menses),is considered normal.During her reproductive years a woman may have physiologic variations in her menstrual cycle.Variations in the length of a menstrual cycle are considered normal.

Question 18

Nurses who provide health care for women should recognize that the most commonly reported gynecologic problem for women of any age-group is:

Accepted Answer

Dysmenorrhea,or pain during or shortly before menstruation,is one of the most common gynecologic problems in women of all ages.Menorrhagia,or excessive bleeding,is an alteration in cyclic bleeding;it is not the most commonly reported gynecologic problem.Dyspareunia,or painful intercourse,is commonly associated with endometriosis.Endometriosis is a type of menstrual disorder,but it is not the most commonly reported gynecologic problem.

Question 19

In helping a client manage premenstrual syndrome (PMS),the nurse should:

Accepted Answer

Herbal therapies,yoga,and massage have been reported to have a beneficial effect on PMS.Limiting red meat,refined sugar,caffeinated beverages,and alcohol improves the diet and may mitigate symptoms.Medication usually is begun only if lifestyle changes fail to provide significant relief.Natural diuretics may help reduce fluid retention.

Question 20

With regard to endometriosis,nurses should be aware that:

Accepted Answer

Symptoms vary among women,ranging from nonexistent to incapacitating.With endometriosis,the endometrial tissue is outside the uterus.Symptoms vary among women,ranging from nonexistent to incapacitating.Endometriosis is found equally in Caucasian and African-American women and is slightly more prevalent in Asian women.Women can experience painful intercourse and impaired fertility.

Quiz 6: Reproductive System Concerns