Deck 52: Care of the Patient With a Reproductive Disorder

Question 1

A patient,age 41,has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis.She asks the nurse if she will have "hot flashes." What knowledge will guide the nurse's response?

A) Only the uterus was removed,and the ovaries are still producing estrogen and she will not have hot flashes.
B) The patient is too young to have hot flashes associated with menopause.
C) The uterus,ovaries,and fallopian tubes were removed,and she will have surgically induced menopause and may have hot flashes.
D) The uterus and fallopian tubes were removed,and she will not experience "hot flashes."

Answer 1

The uterus,ovaries,and fallopian tubes were removed,and she will have surgically induced menopause and may have hot flashes.

Question 2

The patient reports that she is free of gonorrhea and can now engage in sexual activity.Which response is most appropriate?

A) "If you have been free of symptoms for 2 weeks you are cured."
B) "You should get a rapid plasma reagin (RPR)just to make sure."
C) "No case is considered cured until you have had three consecutive negative cervical smears."
D) "To confirm your cure,you should get a Venereal Disease Research Lab (VDRL)."

Answer 2

"No case is considered cured until you have had three consecutive negative cervical smears."

Question 3

Which condition would prevent the use of a vaginal hysterectomy?

A) A woman with more than four pregnancies
B) Large uterine fibroids
C) Menorrhagia for over 6 months
D) Women over the age of 50

Answer 3

Large uterine fibroids

Question 4

A Gram stain smear of the patient's discharge reveals the presence of Neisseria gonorrhoeae.He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease.Which information should the nurse include in response to his comment?

A) "Women do not develop gonorrhea infections but can serve as carriers to spread the disease to males."
B) "When gonorrhea infections occur in women,the disease affects only the ovaries and not the other genital organs."
C) "Many women are not aware that they have gonorrhea because they often do not have symptoms of infection."
D) "Women develop subclinical cases of gonorrhea that do not cause tissue damage or symptoms."

Question 5

The young husband of a patient who has been scheduled for a hysterectomy because of the discovery of ovarian cancer in both ovaries says to the nurse,"Please go talk to my wife.She is real upset and says she won't be a 'woman' anymore." What is the nurse's most therapeutic response?

A) "Don't be concerned.All young women get upset before this kind of surgery."
B) "Certainly,I will be glad to tell her about hormone replacement."
C) "She will get over this feeling soon."
D) "No matter what I may say to her,it is you that needs to listen to her concerns and assure her."

Question 6

On the second postoperative day,a patient who has had an abdominal hysterectomy complains of gas and abdominal distention.Which intervention would be most appropriate to stimulate a bowel movement?

A) Offering carbonated beverages
B) Encouraging ambulation at least four times per day
C) Administering a 1000-mL soapsuds enema
D) Applying an abdominal binder

Question 7

What instruction should a nurse give a patient with congenital herpes who does not have lesions at the present?

A) "Continued use of acyclovir (Zovirax)will prevent reinfection by the virus."
B) "Condoms should be used during all sexual activity to prevent transmission of the virus,even when lesions are not present."
C) "Acyclovir ointment should be applied to the lesions to increase comfort and speed healing."
D) "Recurrent genital herpes is promoted by any sexual stimulation."

Question 8

At what age should a male be taught testicular self-examination (TSE)?

A) 10
B) 13
C) 15
D) 20

Question 9

A female patient,age 48,is undergoing a routine physical examination for the first time in 5 years.Which procedure would be included in this examination?

A) Culdoscopy
B) Colposcopy
C) Cervical biopsy
D) Papanicolaou smear

Question 10

What is the recommended age range for a baseline mammogram?

A) 25 and 30 years
B) 31 and 34 years
C) 35 and 39 years
D) 40 and 45 years

Question 11

Which patient is most at risk for the infection of epididymitis?

A) 17-year-old athlete who trains for several hours a day
B) 22-year-old who has been exposed to mumps
C) 45-year-old who was circumcised at the age of 10
D) 50-year-old who has smoked for 30 years

Question 12

Why is a mammogram the most useful method of diagnosing breast cancer?

A) It is the most reliable method of detecting breast cancer before it becomes palpable.
B) It is inexpensive and covered by most medical insurance plans.
C) It involves no radiation and takes only a few minutes.
D) It involves no pain or discomfort and is readily available.

Question 13

The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy.Which statement by her indicates to the nurse that the teaching has been successful?

A) "I should sleep on the side opposite my mastectomy."
B) "I should keep my right arm supported in a sling when I am up and around until my incision is healed."
C) "I can do whatever exercises and activities I want as long as I don't elevate my right hand above my head."
D) "I should take aspirin before moving or exercising my arm to prevent pain during the exercises."

Question 14

The patient who had a colporrhaphy for the repair of a cystocele and rectocele asks that the catheter be removed as it is bothersome to her.How should the nurse explain the reason for the catheter?

A) It replaces uncomfortable gauze packing.
B) It will prevent adhesions and will be in place for about 2 weeks.
C) It allows for quick urine sample collection.
D) It keeps the bladder empty and prevents stress on the sutures.

Question 15

What does the diagnosis of secondary infertility refer to?

A) Has never conceived.
B) Is infertile because of repeated infection.
C) Has conceived but is now unable to do so.
D) Is over the age of 38.

Question 16

On the fourth postoperative day after a modified radical mastectomy,the nurse finds the patient with her back to the nurse.She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore.The nurse bases subsequent nursing interventions on what diagnosis?

A) Disturbed body image related to removal of her breast
B) Deficient knowledge related to inadequate education
C) Impaired social interaction related to depression
D) Fear related to the cancer diagnosis and surgical intervention

Question 17

A patient,age 26,has had a tubal insufflation (Rubin test)to ascertain whether her fallopian tubes are patent.She complains of pain in her right shoulder.Which response is most appropriate?

A) "Don't worry,that is a normal reaction."
B) "I'll report the findings immediately to the head nurse."
C) "That is a symptom that resulted from your position on the operating table."
D) "That is from the carbon dioxide passing from the fallopian tubes into your abdomen."

Question 18

Why would the nurse encourage the patient who is recovering from a modified radical mastectomy to exercise the affected arm?

A) To reduce pain.
B) To stimulate appetite.
C) To reduce lymphedema.
D) To increase muscle tension.

Question 19

Which statement made by a patient who has been taught the technique of testicular self-examination indicates the need for further teaching?

A) "The testes feel smooth and egg-shaped."
B) "The best time to perform TSE is after a shower."
C) "I will examine my scrotum after every ejaculation."
D) "The epididymis feels like a soft tube."

Question 20

A 20-year-old patient presents in the emergency room with a temperature of 103°F,blood pressure of 92/58,headache,and desquamation of both palms.What should the nurse make sure to ask about during the interview?

A) Any recent traveling outside the country
B) Immunization against influenza
C) Method of birth control
D) Use of tampons

Question 21

The young woman comes to the free clinic for the complaint of stomach cramps.During the examination,the nurse recommends that she be tested for chlamydia.The woman says "I don't need any test…I don't have any symptoms for a sexual infection…I just came for my stomach." Which response is most informative?

A) "Well,if you get more symptoms come back for testing."
B) "The health care provider may have to order medicine for syphilis and chlamydia.You probably have that too.You need to be tested today!"
C) "Testing is not mandatory…I probably wouldn't bother either since you have no symptoms."
D) "That stomachache may be part of a chlamydia infection.Many women do not have a discharge but are carriers."

Question 22

What are some advantages of a vaginal hysterectomy over the abdominal hysterectomy? (Select all that apply. )

A) Less postoperative discomfort
B) Reduced hospital stay
C) Less expensive
D) Better visualization of the intrapelvic area
E) Faster recovery

Question 23

The nurse gives discharge instructions to a person who has had a modified radical mastectomy of the right side to perform the "elbow pull-in." What is the first step of the exercise?

A) Pull elbows forward until they touch.
B) Lower and straighten the arms.
C) Extend arms sideways to shoulder level.
D) Bring elbows back and extend arms.
E) Clasp hands behind neck.

Question 24

Which of the following statements is TRUE regarding diagnostic tests for cervical cancer?

A) All persons who have a cervix remaining should be screened up to the age of 75.
B) Cervical cancer screening should begin about 3 years following the commencement of intercourse,but no later than 21 years of age.
C) Traditional Pap tests are less than 30% accurate in screening for cervical cell abnormalities
D) False-positive and false-negative results rarely occur with traditional Pap diagnostic tests.

Question 25

A patient,age 46,is recovering from an abdominal hysterectomy.Postoperative nursing assessment findings include a urinary output of 100 mL in 4 hours.What should the nurse do?

A) Force fluids.
B) Report urinary retention to the charge nurse.
C) "Milk" the urinary catheter.
D) Turn the patient onto her right side.

Question 26

Which statement indicates that the patient who has had an abdominal hysterectomy needs further home teaching?

A) "I understand I can lift as much as 20 lb."
B) "I'm leaving today to stay with my daughter,who lives 20 miles away.My husband plans to drive the family car."
C) "The health care provider said I can't have sexual intercourse for 4 to 6 weeks."
D) "I'm going to miss wearing my girdle or knee-high hose."

Question 27

A male patient,age 23,seeks care at the health clinic because he has developed a profuse,purulent urethral discharge,and urination is painful.During assessment of the patient,it is most important that the nurse gather information related to his history of:

A) recent urinary infections.
B) episodes of prostatitis.
C) contagious diseases like mumps.
D) present and past sexual partners and notify them to get treatment.

Question 28

What factor influences older women's reluctance to seek medical care for problems of the reproductive system?

A) Embarrassment and cultural factors
B) Denial
C) Religious convictions
D) Lack of free time

Question 29

A 25-year-old woman comes to the clinic with a yellowish-green malodorous vaginal discharge.She says it makes her itch and makes it hard to urinate.After a microscopic examination that confirms trichomoniasis,the patient is placed on metronidazole (Flagyl)for 7 days.How should the nurse advise the patient?

A) Avoid alcohol while on Flagyl.
B) Be aware that her urine may turn blue and will stain clothing.
C) Wear snug underwear during treatment.
D) Be aware that she need not notify her sexual partners as trichomoniasis is not contagious.

Question 30

When should postmenopausal women be instructed to perform breast self-examination (BSE)?

A) On the same date of their choice each month
B) Every 3 months
C) Every day,because they are at high risk for breast cancer
D) Whenever they begin to take estrogen supplements

Question 31

The nurse is assisting the health care provider in removing a small sample of tissue from the patient's cervix to have it evaluated.This procedure is called a cervical _______________.

Question 32

An alternative remedy,____________,is used by men for the treatment of impotence.

Question 33

The patient with a swollen scrotum is amazed that diagnosis of the condition of hydrocele is such a simple thing as:

A) placing the scrotum on a warm pad.
B) shining light through scrotum.
C) squatting and letting the scrotum hang dependently.
D) packing the scrotum in ice.

Question 34

A ___________ is performed to evaluate living tissue to establish or confirm a diagnosis or to follow the course of a disease.

Question 35

_____________ are the most benign tumors of the uterus and arise from the uterine muscle tissue.

Question 36

Why do false-negative results in mammography occur in specific age-groups?

A) Older women have greater density of breast tissue.
B) Older women have less density of breast tissue.
C) Younger women have greater density of breast tissue.
D) Younger women have less density of breast tissue.

Question 37

________are produced in the seminiferous tubules and stored in the epididymis.

Question 38

A patient,age 36,is scheduled for a unilateral orchiectomy for treatment of testicular cancer.He is withdrawn and does not initiate interaction with the nurse.What is the most appropriate nursing action at this time?

A) Carefully explain the postoperative activity restrictions.
B) Show him a diagram of what the orchiectomy will accomplish.
C) Assure him that he will have adequate future sexual functioning.
D) Assess his concerns related to his diagnosis and treatment.

Question 39

The patient,age 52,is recovering from a modified radical mastectomy.Why is postoperative elevation of the patient's arm important after this procedure?

A) To prevent vascular and lymph stasis,thus lymphedema.
B) To prevent drainage accumulation at the incisional site.
C) To prevent wound infection and dehiscence.
D) To prevent pleural effusion and respiratory distress.

Question 40

Although menopause is a normal part of aging,why do many women enter menopause at an earlier age?

A) Having become sexually active at an early age
B) Living at high altitudes
C) Excessive use of alcohol
D) Morbid obesity

Question 41

When the veins in the scrotum become dilated,and the scrotum becomes enlarged and dilated,the condition is called a __________.