Deck 55: Assessment and Management of Patients With Female Physiologic Processes

Question 1

A school nurse is presenting information on human development and sexuality. When describing the role of hormones in sexual development, which hormone does the nurse teach the class is the most important one for developing and maintaining the female reproductive organs?

A) Estrogen
B) Progesterone
C) Androgens
D) Follicle-stimulating hormone

Answer 1

Estrogen

Question 2

The nurse is taking the sexual history of an adolescent who has come into the free clinic. What question best assesses the patients need for further information?

A) Are you involved in an intimate relationship at this time?
B) How many sexual partners have you had?
C) What questions or concerns do you have about your sexual health?
D) Have you ever been diagnosed with a sexually transmitted infection?

Answer 2

What questions or concerns do you have about your sexual health?

Question 3

The nurse is being trained to perform assessment screenings for abuse on patients who come into the walk-in clinic where the nurse works. Which of the following assessment questions is most appropriate?

A) Would you describe your relationship as healthy and functional?
B) Have you ever been forced into sexual activity?
C) Do you make your husband uncontrollably angry?
D) How is conflict usually handled in your home?

Answer 3

Have you ever been forced into sexual activity?

Question 4

A premenopausal patient is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is 2 weeks late. The nurse should recognize a need for this patient to be investigated for what health problem?

A) Trichomonas vaginalis
B) Ectopic pregnancy
C) Cervical cancer
D) Fibromyalgia

Question 5

A female patient who has cognitive and physical disabilities has come into the clinic for a routine checkup. When planning this patients assessment, what action should the nurse take?

A) Ensure that a chaperone is available to be present during the assessment.
B) Limit the length and scope of the health assessment.
C) Avoid health promotion or disease prevention education.
D) Avoid equating the patient with her disabilities.

Question 6

A patient calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data?

A) The drainage is physiologic and normal.
B) The patient may have a Candida species infection.
C) The patient needs a Pap smear as soon as possible.
D) The patient may have a Trichomonas infection.

Question 7

A nurse presenting an educational event for a local community group is addressing premenstrual syndrome (PMS). What treatment guideline should the nurse teach this group?

A) Avoid excessive fluid intake.
B) Increase the frequency and intensity of exercise.
C) Limit psychosocial stressors in order to reduce symptoms.
D) Take opioid analgesics as ordered.

Question 8

A nurse is collecting assessment data from a premenopausal patient who states that she does not have menses. What term should the nurse use to document the absence of menstrual flow?

A) Amenorrhea
B) Dysmenorrhea
C) Menorrhagia
D) Metrorrhagia

Question 9

A patient who is in the first trimester of pregnancy has experienced an incomplete abortion. The obstetric nurse should prepare the patient for what possible intervention?

A) Dilation and evacuation
B) Several days of bed rest
C) Administration of hydromorphone
D) IV administration of clomiphene

Question 10

A patient in her late fifties has expressed to the nurse her desire to explore hormone replacement therapy (HRT). Based on what aspect of the patients health history is HRT contraindicated?

A) History of vaginal dryness
B) History of hot flashes and night sweats
C) History of vascular thrombosis
D) Family history of osteoporosis

Question 11

The school nurse is presenting a class on female reproductive health. The nurse should describe what aspect of Pap smears?

A) The test may be performed at any time during the patients menstrual cycle.
B) The smear should be done every 2 years.
C) The test can detect early evidence of cervical cancer.
D) Falsepositive Pap smear results occur mostly from not douching before the examination.

Question 12

A nurse practitioner is preparing to perform a patients scheduled Pap smear and the patient asks the nurse to ensure that the speculum is well-lubricated. How should the nurse proceed with assessment?

A) Reassure the patient that ample petroleum jelly will be used.
B) Reassure that patient that a water-based lubricant will be used.
C) Explain to the patient that water is the only lubricant that can be used.
D) Explain to the patient why the speculum must be introduced dry.

Question 13

A clinic nurse is meeting with a 38-year-old patient who states that she would like to resume using oral contraceptives, which she used for several years during her twenties. What assessment question is most likely to reveal a potential contraindication to oral contraceptive use?

A) Have you ever had surgery?
B) Have you ever had a sexually transmitted infection?
C) When did you last have your blood sugar levels checked?
D) Do you smoke?

Question 14

A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurses best response?

A) You may leave the tampon in overnight.
B) The tampon should be changed at least twice per day.
C) Tampons are dangerous and, ideally, you should not be using them.
D) Tampons need to be changed every 4 to 6 hours.

Question 15

A 51-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that she has been experiencing severe hot flashes, but that she is reluctant to begin hormone therapy (HT). What potential solution should the nurse discuss with the patient?

A) Sodium restriction
B) Adopting a vegan diet
C) Massage therapy
D) Vitamin supplements

Question 16

A newly pregnant patient is being assessed in an obstetric clinic. The patient states that she has been experiencing intense abdominal pain and the nurse anticipates that the patient will be assessed for ectopic pregnancy. In addition to ultrasonography, what diagnostic test should the nurse anticipate?

A) Computed tomography
B) Human chorionic gonadotropin (hCG) testing
C) Estrogen and progesterone testing
D) Abdominal x-ray

Question 17

An adolescent is brought to the clinic by her mother because of abnormal uterine bleeding. The nurse should understand that the most likely cause of this dysfunctional bleeding pattern is what?

A) Lack of ovulation
B) Chronic vaginitis
C) A sexually transmitted infection
D) Ectopic pregnancy

Question 18

The nurse is planning the sexual assessment of a new adolescent patient. The nurse should include what assessment components? Select all that apply.

A) Physical examination findings
B) Laboratory results
C) Health history
D) Interpersonal skills
E) Understanding of menopause

Question 19

By initiating an assessment about sexual concerns what does the nurse convey to the patient? Select all that apply.

A) That sexual issues are valid health issues
B) That it is safe to talk about sexual issues
C) That sexual issues are only a minor aspect a persons identity
D) That changes or problems in sexual functioning should be discussed
E) That changes or problems in sexual functioning are highly atypical

Question 20

The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new patient. According to this model, the nurse should begin with what action?

A) Conducting a preliminary assessment
B) Addressing the patients psychosocial status
C) Asking the patients permission to discuss sexuality
D) Assessing for physiologic problems

Question 21

During the nurses assessment of a female patient, the patient reveals that she experienced sexual abuse when she was a young woman. What is the nurses most appropriate response to this disclosure?

A) Reassure her that this information will be kept a secret.
B) Begin the process of intensive psychotherapy.
C) Encourage the patient to phone 911.
D) Facilitate appropriate resources and referrals.

Question 22

A 15 -year-old girl is brought to the clinic by her mother to see her primary care provider. The mother states that her daughter has not started to develop sexually. The physical examination shows that the patient has no indication of secondary sexual characteristics. What diagnosis should the nurse suspect?

A) Primary amenorrhea
B) Dyspareunia
C) Vaginal atrophy
D) Secondary dysmenorrhea

Question 23

A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply.

A) Loss of appetite
B) Breast tenderness
C) Depression
D) Fluid retention
E) Headache

Question 24

A patient states that PMS that is significantly disrupting her quality of life and that conservative management has failed to produce relief. What pharmacologic treatment may benefit this patient?

A) An opioid analgesic
B) A calcium channel blocker
C) A monoamine oxidase inhibitor (MAOI)
D) A selective serotonin reuptake inhibitor (SSRI)

Question 25

The nurse is assessing a 53-year-old woman who has been experiencing dysmenorrhea. What questions should the nurse include in an assessment of the patients menstrual history? Select all that apply.

A) Do you ever experience bleeding after intercourse?
B) How long is your typical cycle?
C) Did you have any sexually transmitted infections in early adulthood?
D)When did your mother and sisters get their first periods?
E) Do you experience cramps or pain during your cycle?

Question 26

The nurse is working with a couple who have been unable to conceive despite more than 2 years of trying to get pregnant. The couple has just learned that in vitro fertilization (IVF) was unsuccessful and they are both tearful. What nursing diagnosis is most likely to apply to this couple?

A) Hopelessness related to failed IVF
B) Acute confusion related to reasons for failed IVF
C) Compromised family coping related to unsuccessful IVF
D) Moral distress related to unsuccessful IVF

Question 27

A 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The patients need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply.

A) Anaphylaxis
B) Osteoporosis
C) Breast cancer
D) Cardiovascular disease
E) Venous thromboembolism

Question 28

A 27-year-old primipara presents to the ED with vaginal bleeding and suspected contractions. The woman relates that she is 14 weeks pregnant and she thinks she is losing her baby. Diagnostic testing confirms a spontaneous abortion. What nursing action would be a priority at this time?

A) Leave the patient alone so she can grieve in private.
B) Teach the patient that this will not affect her future chance of conception.
C) Take the patient off the obstetric floor so she will not hear a baby cry.
D) Provide opportunities for the patient to talk and express her emotions.

Question 29

A couple has come to the infertility clinic because they have been unable to get pregnant even though they have been trying for over a year. Diagnostic tests are planned for the woman to ascertain if ovulation is regular and whether her endometrium is adequately supported for implantation. What test would the nurse expect to have ordered for this woman?

A) Serum progesterone
B) Abdominal CT
C) Oocyte viability test
D) Urine testosterone

Question 30

The nurse is caring for a couple trying to get pregnant and have not been able to for over a year. The couple asks what kind of problems a man can have that can cause infertility. What should be the nurses response?

A) Men can have increased prolactin levels that decrease sperm viability.
B) Men can have problems that increase the temperature around their testicles and decrease the quality of their semen.
C) Men may inherit the gene that causes low sperm production.
D) Men may produce sperm that are incompatible with the shape of the egg.

Question 31

A couple with a diagnosis of ovarian failure discusses their infertility options with their physician. The nurse should recognize which of the following as the treatment of choice for a patient with ovarian failure?

A) Intracytoplasmic sperm injection
B) Artificial insemination
C) Gamete intrafallopian transfer
D) In vitro fertilization

Question 32

The nurse is working with a couple who is being evaluated for infertility. What nursing intervention would be most appropriate for this couples likely needs?

A) Educating them about parenting techniques in order to foster hope
B) Educating them about the benefits of child-free living
C) Choosing the most appropriate reproductive technology
D) Referring them to appropriate community resources

Question 33

A woman presents at the ED with sharp, colicky pain in her right abdomen that radiates to her right shoulder. She tells the nurse that she has been spotting lightly for the past few days. The patient is subsequently diagnosed with an ectopic pregnancy. What major nursing diagnosis most likely relates to this patients needs?

A) Anxiety related to potential treatment options and health outcomes
B) Chronic sorrow related to spontaneous abortion
C) Chronic pain related to genitourinary trauma
D) Impaired tissue integrity related to keloid scarring

Question 34

The nurse is assessing a patient who believes that she has recently begun menopause. What principle should inform the nurses interactions with this patient?

A) The nurse should express empathy for the patients difficult health situation.
B) The nurse should begin by assuring the patient that her health will be much better in a few years.
C) The nurse must carefully assess the patients feelings and beliefs surrounding menopause.
D) The nurse should encourage the patient to celebrate this life milestone and its accompanying benefits.

Question 35

A 51-year-old woman is experiencing perimenopausal symptoms and expresses confusion around the possible use of hormone therapy (HT). She explains that her mother and aunts used HT and she is unsure why few of her peers have been prescribed this treatment. What should the nurse explain to the patient?

A) Large, long-term health studies have revealed that HT is minimally effective.
B) HT has been largely replaced by other nonpharmacologic interventions.
C) Research has shown that significant health risks are associated with HT.
D) HT has been shown to exacerbate symptoms of menopause in a minority of women.

Question 36

A community health nurse is leading a health education session addressing menopause and other aspects of womens health. What dietary supplements should the nurse recommend to prevent morbidity associated with osteoporotic fractures?

A) Vitamin $\mathrm{B}_{12}$ and vitamin $\mathrm{C}$
B) Vitamin A and potassium
C) Vitamin $\mathrm{B}_{6}$ and phosphorus
D) Calcium and vitamin D

Question 37

The nurse is working with a patient who expects to begin menopause in the next few years. What educational topic should the nurse prioritize when caring for a healthy woman approaching menopause?

A) Patient teaching and counseling regarding healthy lifestyles
B) Referrals to local support groups
C) Nutritional counseling regarding osteoporosis prevention
D) Drug therapy options

Question 38

A womans current health complaints are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). The nurse should first do which of the following?

A) Assess the patients understanding of HT.
B) Assess the patient for risk of suicide.
C) Assure the patient that the problem is self-limiting.
D) Suggest the use of St. Johns wort.

Question 39

A 21-year-old woman has sought care because of heavy periods and has subsequently been diagnosed with menorrhagia. The nurse should recognize which of the following as the most likely cause of the patients health problem?

A) Hormonal disturbances
B) Cervical or uterine cancer
C) Pelvic inflammatory disease
D) A sexually transmitted infection (STI)