Deck 42: Nursing Care of Women With Reproductive System Disorders

Question 1

The nurse is caring for a patient who had a left mastectomy earlier in the day and informs the nurse of the following concerns. Which should the nurse attend to first?

A)Her bowels have not moved in 48 hours.
B)She has a pain level of 7 on a 0 to 10 scale.
C)She has a 3-cm area of blood on her wound dressing.
D)She feels anxious about how her husband will react to her surgery.

Answer 1

She has a pain level of 7 on a 0 to 10 scale.

Question 2

A woman tells the nurse, "I am having terrible pain with my period. This has never happened before. What should I do?" What is the best response by the nurse?

A)"Dysmenorrhea is a common occurrence; NSAIDs or aspirin may help."
B)"The best way to combat painful menses is to exercise and drink plenty of fluids."
C)"Sometimes getting into a knee-chest position is helpful."
D)"You should notify your doctor if this is a new experience for you."

Answer 2

"You should notify your doctor if this is a new experience for you."

Question 3

The nurse is teaching a patient how to use a daily vaginal suppository. Which of the following statements indicates that teaching has been effective?

A)"I should put the suppository in at night after I get into bed."
B)"It is best to insert the suppository each morning after a shower or bath."
C)"The suppository should be put in late in the day when I'm less likely to be active."
D)"I should put the suppository in each morning before I get out of bed."

Answer 3

"I should put the suppository in at night after I get into bed."

Question 4

A 16-year-old girl is admitted to the hospital with toxic shock syndrome (TSS). Which action by the nurse should take priority?

A)Teach the girl risk factors for TSS.
B)Teach the girl's mother risk factors for TSS.
C)Determine what the girl understands about risk factors for TSS.
D)Educate the girl on signs and symptoms of TSS.

Question 5

The nurse is caring for a patient who had a mastectomy for breast cancer 2 days ago and is now developing pulmonary congestion. Why is a mastectomy patient at risk for pulmonary complications?

A)Mastectomy patients must remain on bedrest for 48 to 72 hours postoperatively.
B)Pathogens may have been introduced during the surgical procedure.
C)The chest incision makes the patient hesitant to deep breathe and cough.
D)Breast cancer has often spread to the lungs before diagnosis.

Question 6

Which term is used to describe the sagging of the bladder into the vagina?

A)Rectocele
B)Cystocele
C)Dyspareunia
D)Bladder fistula

Question 7

A patient is seen in a clinic for contact vaginitis. What information from her history helps the nurse to plan teaching for the patient?

A)She has had a urinary tract infection (UTI).
B)She has been on oral antibiotics for a sinus infection.
C)She has been under stress at work.
D)She takes bubble baths every night.

Question 8

The nurse is assisting with teaching a patient who has been placed on metronidazole (Flagyl) for bacterial vaginosis. What instruction by the nurse is appropriate?

A)"Take the Flagyl until the discharge is gone for at least 24 hours."
B)"Take the Flagyl as prescribed, even if your symptoms are gone."
C)"Take the Flagyl whenever you feel vaginal itching or irritation."
D)"You will need to take Flagyl for an extended period. This prescription has several refills."

Question 9

A female patient has just learned that she is infertile. She says, "All I ever wanted in life was to have a baby. My life is over." What is the best response by the nurse?

A)"You are overreacting because you are upset. Your life really is not over."
B)"You have a wonderful husband. Maybe you should think about adoption."
C)"A baby must have been very important to you. When you feel ready, we can talk about other alternatives."
D)"There is an infertility clinic I just heard about in Mexico. Do you want the address?"

Question 10

The nurse enters the room of a patient with a new mastectomy and finds her crying. After confirming that the patient is crying because of the loss of her breast, which response by the nurse is best?

A)"I know how you feel. It is difficult to lose a breast."
B)"At least they got all the cancer. You are fortunate."
C)"How have you coped with other problems in your life? Do you have someone you can talk to?"
D)"Here, have a tissue. I know you feel like crying now, but before you know it you will feel much better, and this will all be behind you."

Question 11

A patient at a walk-in clinic requests oral contraceptives (OCs) because she heard they can prevent sexually transmitted diseases (STDs). On which understanding should the nurse base the response to the patient?

A)Only OCs with estrogen and progestin can prevent STDs.
B)Not enough research has been done to prove that OCs can prevent STDs.
C)There is no connection between OC use and risk of STDs.
D)OCs provide excellent protection against most STDs.

Question 12

The nurse is assisting with teaching a woman who is having difficulty conceiving. What instruction should the nurse provide about keeping a basal body temperature chart?

A)"Starting with the first day of your period, record your temperature first thing each morning."
B)"Record your temperature every 4 hours, starting the first day of each month."
C)"Record your temperature in the late afternoon each day for 3 months."
D)"Record your temperature three times each day of your period, then once a day thereafter."

Question 13

A 50-year-old woman states, "It is such a relief not to need birth control any more. I haven't had a period in 3 months." How should the nurse respond?

A)"You may still be fertile for several months after your last period. You should consult with your physician to know when to stop using birth control."
B)"You should continue to use birth control for at least 6 months after cessation of your periods."
C)"Birth control is usually unnecessary after age 50, even if you are still having periods."
D)"It is still possible for you to get pregnant. You should consider having a tubal ligation."

Question 14

A patient must prevent pregnancy while she is receiving chemotherapy that could harm a fetus. What type of birth control does the nurse anticipate teaching the patient about?

A)Condom
B)Diaphragm with spermicide
C)Depot medication
D)Oral contraceptive

Question 15

The nurse is assessing a patient after a mastectomy and thinks the patient's affected arm appears swollen. What is the best way to verify this finding?

A)Measure and document the circumference of the arm.
B)Ask the patient to hang the arm down for 3 minutes and check for increased swelling.
C)Press a finger into the arm and measure the indentation.
D)Measure and compare the circumferences of both arms.

Question 16

The nurse is teaching a woman with a menstrual disorder how to measure menstrual flow. Which instruction should the nurse include?

A)Use a vaginal catheter and collection bag.
B)Use a perineal collection system.
C)Weigh the woman before and after her menses.
D)Weigh her perineal pads before and after use.

Question 17

A patient reports long, heavy, irregular menses accompanied by headache and back pain for the past several months. Which of the following is the best term to use to document these symptoms?

A)Menometrorrhagia
B)Polymenorrhea
C)Oligomenorrhea
D)Hypermenorrhea

Question 18

A patient comes to an outpatient clinic because of premenstrual syndrome (PMS) symptoms. What advice from the nurse may help her reduce her symptoms?

A)"Avoid strenuous exercise for several days before and after your period."
B)"Avoidance of alcohol and caffeine may help reduce your discomfort."
C)"Ask the physician about a mild antianxiety agent."
D)"There is no treatment for PMS other than rest and fluids."

Question 19

The nurse is assisting with a community education class on breast cancer prevention. Which of the following are risk factors the nurse should include?

A)High-fat diet and alcohol intake
B)Early first pregnancy and late menarche
C)Large or pendulous breasts
D)History of breastfeeding

Question 20

The nurse recognizes that which of the following women is most likely predisposed to developing a vaginal yeast infection?

A)A 23-year-old who eats a high-protein diet
B)A 38-year-old woman who frequently uses NSAIDs
C)A 31-year-old woman who runs 2 miles every day
D)A 28-year-old woman who sits at a desk 5 days a week

Question 21

The nurse is providing care for a woman suffering from premenstrual syndrome (PMS). Which of the following nursing actions would be included in the plan of care? (Select all that apply.?

A)Encourage the client to stop smoking.
B)Provide food that promotes increased intake of simple sugars.
C)Teach client to limit alcohol consumption.
D)Encourage the client to develop a regular exercise regimen.
E)Instruct client to increase intake of products containing caffeine.
F)Provide small, frequent meals to reduce food cravings.Completion
Complete each statement.

Question 22

The nurse is assisting a new mother who returns to a clinic for a 6-week visit. What instructions about birth control should the nurse provide?

A)"As long as you are breastfeeding, you will not get pregnant."
B)"You should avoid having intercourse until you are finished breastfeeding."
C)"You should plan to use birth control; breastfeeding is not a reliable form of contraception."
D)"Breastfeeding has no effect on your ability to conceive."

Question 23

What treatment reduces symptoms of primary dysmenorrhea by blocking prostaglandin synthesis?

A)Vitamins
B)Antacids
C)Morphine
D)NSAIDs

Question 24

Although the use of hormone replacement therapy (HRT) for perimenopausal symptoms is still under investigation, the results of a large-scale study halted in 2002 reported which of the following findings related to HRT? (Select all that apply.?

A)A reduction in total fractures
B)A decrease in strokes
C)A decrease in colorectal cancer
D)An increase in thromboembolism
E)An increase in heart attacks
F)A decrease in breast cancer

Question 25

Which of the following are risk factors for the development of cervical cancer? (Select all that apply.?

A)Being nulliparous
B)Having multiple sexual partners
C)Smoking
D)Being infected with herpes simplex virus type II
E)Using barrier contraceptives
F)Being infected with human papillomavirus

Question 26

The nurse is providing care for a woman with trichomoniasis who is being treated with metronidazole (Flagyl). Which of the following statements by the patient indicates that further teaching is necessary? (Select all that apply.?

A)"I should take this medication until the symptoms are gone."
B)"This medication should be taken on an empty stomach."
C)"My partner should see a physician for treatment as well."
D)"I may have some vaginal dryness while taking this medication."
E)"I might notice a metallic taste with this medication."
F)"Drinking alcohol while taking this medication will cause nausea and vomiting."

Question 27

When determining the amount of blood loss during menses, the nurse should know that a 1-g increase in the weight of the perineal pad represents blood loss of ________________mL.

Question 28

A patient is scheduled for a hysterectomy and bilateral salpingo-oophorectomy. She asks what this means. How should the nurse respond?

A)"You are going to have your uterus, fallopian tubes, and ovaries removed."
B)"You will have your uterus and fallopian tubes removed, but your ovaries will remain intact."
C)"You will have your uterus removed and your bladder suspended."
D)"You will have your uterus removed and your fallopian tubes and ovaries sutured in place."

Question 29

A 42-year-old woman is tearful after a hysterectomy. Which of the following understandings helps the nurse to respond appropriately to the patient?

A)Most women are done bearing children by age 42.
B)Most women are happy not to have periods after a hysterectomy.
C)Loss of reproduction function may cause grieving.
D)Hysterectomy is more traumatic for younger women.

Question 30

The nurse is caring for a woman who has just had an uncomplicated abortion. What instructions should the nurse provide? (Select all that apply.?

A)"Call if you have more bleeding than a heavy period."
B)"Call if you bleed for more than 3 days."
C)"You can expect moderate bleeding and a low-grade fever for about a week."
D)"Don't be surprised if you pass clots. Call if they are larger than a golf ball."
E)"The discharge often has a foul odor due to the procedure."
F)"You should abstain from sexual intercourse as directed by your physician."

Question 31

Use of RU-486 results in a chemically induced abortion up to the ________________week of pregnancy.

Question 32

Many of the symptoms of polycystic ovary syndrome (PCOS) are believed to be due to an excess of which hormone?

A)Antidiuretic hormone (ADH)
B)Growth hormone (GH)
C)Insulin
D)Thyroxine
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 33

The nurse is caring for a patient who is breastfeeding and receiving antibiotics for mastitis. What should be included in the teaching? (Select all that apply.?

A)Stop breastfeeding, and switch to bottle feeding.
B)Change the infant's feeding position on the breast frequently.
C)Wash hands before handling the breast.
D)Apply cool packs to the breast to ease pain.
E)Wear a bra to support the swollen painful breast.
F)NSAIDs may be used to help control pain.

Question 34

For the "morning-after pill" to be effective, it should be taken within ________________hour(s) of unprotected sexual intercourse.

Question 35

Nurses should teach women that compared with benign breast growths, cancerous growths tend to have which of the following characteristics? (Select all that apply.?

A)They tend to be more painful.
B)They tend to be harder.
C)They tend to be more irregularly shaped.
D)They tend to have more clearly defined borders.
E)They tend to be less mobile.

Question 36

The nurse is caring for a woman who had a hysterectomy this morning. Four hours later the woman is unable to urinate. What assessment would determine bladder distention and be comfortable for the patient?

A)Palpate for bladder distention.
B)Percuss the bladder for fullness.
C)Perform a scratch test.
D)Palpate for rebound tenderness.

Question 37

The nurse is providing care for a patient after a hysterectomy. Which of the following interventions are appropriate to prevent constipation? (Select all that apply.?

A)Increase oral fluid intake.
B)Provide a high-fiber diet.
C)Encourage ambulation.
D)Withhold pain medication.
E)Provide stool softener as ordered.
F)Increase protein intake.

Question 38

What methods of abortion are most commonly used to terminate a pregnancy of less than 14 weeks? (Select all that apply.?

A)Menstrual extraction
B)Dilation and evacuation (D&E)
C)Vacuum suction
D)Dilation and curettage (D&C)
E)Saline induction