Question 1

A woman has arrived for her preoperative testing appointment.She is scheduled for a myomectomy the following day.What condition would require the client to undergo this procedure for symptom relief?&#10;A) Numerous small fibroid tumors&#10;B) Bartholin cysts&#10;C) Fibroid tumors near the outer wall of the uterus with a uterine size no larger than at 12 weeks of gestation&#10;D) Leiomyomas (also known as fibroid tumors) in a uterus larger than 14 weeks of gestation

Accepted Answer

If a fibroid tumor lies near the outer wall of the uterus and the uterine size is no larger than at 12 to 14 weeks of gestation and the symptoms are significant,a myomectomy (i.e.,removal of the tumor)may be performed.This procedure leaves the uterine walls relatively intact,thereby preserving the uterus for future pregnancies.Laser surgery or electrocauterization can be safely used to destroy numerous small fibroid tumors.Bartholin cysts are benign lesions of the vulva.If the cyst is symptomatic or infected,surgical incision and drainage may provide relief.A hysterectomy (i.e.,removal of the entire uterus)is the treatment of choice if bleeding is severe or if the fibroid tumor is obstructing the normal function of other organs.

Question 2

A 48-year-old woman has just had a hysterectomy for endometrial cancer.Which statement alerts the nurse that further teaching is needed?&#10;A) &#34;I can't wait to go on the cruise that I have planned for this summer.&#34;&#10;B) &#34;I know that the surgery saved my life, but I will miss having sexual intercourse with my husband.&#34;&#10;C) &#34;I have asked my daughter to come and stay with me next week after I am discharged from the hospital.&#34;&#10;D) &#34;Well, I don't have to worry about getting pregnant anymore.&#34;

Accepted Answer

Stating that she will miss having sexual intercourse with her husband indicates that further teaching is needed for this client regarding sexual activities after a hysterectomy.Although intercourse may be initially uncomfortable,the use of water-soluble lubricants,relaxation exercises,and changes in position may be helpful.Expressing plans for a vacation is a positive psychologic state with plans for the future.Stating that her daughter will stay with her indicates the client understands that she may need assistance during her acute recovery period.Stating that she no longer needs to worry about getting pregnant indicates knowledge related to the reproductive cycle and a positive outlook.

Question 3

With regard to the treatment plan for a pregnant woman with gynecologic cancer,which statement about timing or type of treatment is correct?&#10;A) The fetus is most at risk during the first trimester.&#10;B) The fetus is most at risk during the second trimester.&#10;C) The fetus is most at risk during the third trimester.&#10;D) Surgery is more risky than chemotherapy in the first trimester.

Accepted Answer

The first trimester is the most vulnerable period for the growing fetus.Women may be faced with making a decision about terminating the pregnancy,depending on the stage and extent of the disease.For advanced disease in the second trimester,alkylating agents,5-fluorouracil (5-FU),and vincristine are relatively safe for the fetus.For advanced disease in the third trimester,alkylating agents,5-FU,and vincristine are relatively safe for the fetus.Surgery is less risky than chemotherapy in the first trimester.

Question 4

Which precaution should the nurse take while caring for a client who is undergoing internal radiation therapy for cervical cancer?&#10;A) Wear gloves when assessing the cervical intracavity implant.&#10;B) Instruct the client to urinate in the lead-lined bedpan or &#34;hat&#34; every 2 hours.&#10;C) Prepare the client for an enema before inserting the implant.&#10;D) Limit staff or visitor exposure to 30 minutes or less in an 8-hour period.

Accepted Answer

Staff and visitor exposure should be limited to 30 minutes or less in an 8-hour period to reduce the risk of overexposure to radiation.Nurses need to protect themselves from overexposure to radiation.Wearing a shield is one method of protection.An indwelling catheter is inserted to prevent urinary distention that could dislodge the applicator.No bowel preparation is necessary.

Question 5

A woman exhibits symptoms that may lead to a possible diagnosis of polycystic ovary syndrome (PCOS).While completing the initial assessment of the client,which clinical finding would the nurse not anticipate?

A) Anorexia
B) Hirsutism
C) Irregular menses
D) Infertility

Accepted Answer

These clients often are obese rather than anorexic with weight loss.Approximately 40% of these women also display glucose intolerance and hyperinsulinemia.Excessive hair growth is often present in women with PCOS.This client is likely to have irregular menses or even amenorrhea.Infertility as a result of decreased levels of follicle-stimulating hormone is common with this syndrome.

Question 6

The nurse provides education to a client about to undergo external radiation therapy.Which statement by the client reassures the nurse that the teaching has been effective?&#10;A) &#34;I am using ointment to keep my skin from drying out.&#34;&#10;B) &#34;I wash the irradiated area with deodorant soap.&#34;&#10;C) &#34;My diet is high in protein, and I drink at least 2000 ml of fluid a day.&#34;&#10;D) &#34;I wash off the markings for the radiation site after each treatment.&#34;

Accepted Answer

To maintain good nutrition,the woman should eat high-protein meals or use protein supplements and should have a high daily fluid intake of 2 to 3 L.The woman is counseled about good skin care and taught to avoid soaps,ointments,cosmetics,and deodorants because these may contain metals that would alter the radiation dose she receives.Markings may be made to indicate the exact location needed for irradiation and should remain until the treatment is complete.

Question 7

What information is important for the nurse to include in planning for the care of a woman who has had a vaginal hysterectomy?&#10;A) Expect to be fully recovered in 4 to 6 weeks.&#10;B) Expect no changes in her hormone levels.&#10;C) Expect surgical menopause.&#10;D) Take tub baths to aid in healing.

Accepted Answer

Unless the ovaries were also removed,hormonal levels should not change.Menses will cease,but the hypothalamus-pituitary-ovarian axis remains intact.The woman should expect to have vaginal discharge for 4 to 6 weeks.Full recovery varies from woman to woman,depending on risk factors and individual healing.Surgical menopause occurs only if the ovaries are also removed.The client should avoid tub baths,intercourse,and douching until after the follow-up examination.

Question 8

Which woman has the highest risk for endometrial cancer?&#10;A) Postmenopausal woman with hypertension&#10;B) Woman who has an intrauterine device (IUD)&#10;C) Client who has been on birth control for 15 years&#10;D) Perimenopausal woman who has a cystocele

Accepted Answer

Endometrial cancer is most often seen in postmenopausal women between the ages of 50 and 65 years.Hypertension is a risk factor associated with the development of this malignancy.The use of an IUD does not increase a woman's risk for endometrial cancer.A client who has been on birth control for 15 years is not at increased risk for endometrial cancer; the birth control contraceptives might actually offer some protection.The development of a cystocele will not increase a woman's risk for endometrial cancer.

Question 9

A postmenopausal woman has been diagnosed with two leiomyomas (fibroids).Which clinical finding is most commonly associated with the presence of leiomyomas?&#10;A) Abnormal uterine bleeding&#10;B) Diarrhea&#10;C) Weight loss&#10;D) Acute abdominal pain

Accepted Answer

Most women are asymptomatic.Abnormal uterine bleeding is the most common symptom of leiomyomas.Diarrhea is not commonly associated with leiomyomas.Weight loss does not usually occur in the woman with leiomyomas,and the client with leiomyomas is unlikely to experience abdominal pain.

Question 10

What is the most common reproductive tract cancer associated with pregnancy?&#10;A) Cervical&#10;B) Uterine&#10;C) Ovarian&#10;D) Fallopian tube

Accepted Answer

The incidence of cervical cancer concurrent with pregnancy is reported to be 1 in 2000 pregnancies making it the most common reproductive tract cancer associated with pregnancy.Uterine cancer is rarely diagnosed during pregnancy.Ovarian cancer is the second most frequent cancer diagnosis in pregnancy.At an incidence rate of approximately 1%,fallopian tube cancer remains a rare occurrence.The peak incidence of tubal cancer is between the ages of 50 and 55 years; for this cancer to be concurrent with pregnancy is only a remote possibility.

Question 11

The nurse should be aware that a pessary is most effective in the treatment of which disorder?&#10;A) Cystocele&#10;B) Uterine prolapse&#10;C) Rectocele&#10;D) Stress urinary incontinence

Accepted Answer

The answer of The nurse should be aware that a...

Question 12

A client in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems,as well as sensations of bearing down and of something in her vagina.What condition would the nurse suspect based upon this report?

A) Pelvic relaxation
B) Cystoceles and/or rectoceles
C) Uterine prolapse
D) Genital fistulas

Accepted Answer

The answer of A client in late middle age who...

Question 13

A client has just returned from a uterine artery embolization (UAE)procedure.Before her discharge,a discussion concerning the symptoms that require a call to the provider postprocedure is very important.Which symptom would reassure the client that the procedure went well with no reason to call the provider?

A) Temperature of 39° C
B) Swelling or hematoma at the puncture site
C) Abnormal vaginal discharge
D) Urinary frequency

Accepted Answer

The answer of A client has just returned from a...

Question 14

When caring for clients with neoplasms of the reproductive system,the nurse must begin by assessing the woman's knowledge of the disorder,its management,and prognosis.This assessment should be followed by a nursing diagnosis.Which diagnosis fails to address the psychologic effect of these disorders?

A) Anxiety, related to surgical procedures
B) Disturbed body image, as a result of changes in anatomy
C) Risk for injury, related to lack of skill for self-care
D) Interrupted family processes

Accepted Answer

The answer of When caring for clients with neoplasms of...

Question 15

Which woman is at the greatest risk for psychologic complications after hysterectomy?&#10;A) 55-year-old woman who has been having abnormal bleeding and pain for 3 years&#10;B) 46-year-old woman who has had three children and has just been promoted at work&#10;C) 62-year-old widow who has three friends who have had uncomplicated hysterectomies&#10;D) 19-year-old woman who had a ruptured uterus after giving birth to her first child

Accepted Answer

The answer of Which woman is at the greatest risk...

Question 16

A woman has preinvasive cancer of the cervix.Which modality would the nurse discuss as an available option for a client with this condition?&#10;A) Cryosurgery&#10;B) Colposcopy&#10;C) Hysterectomy&#10;D) Internal radiation

Accepted Answer

The answer of A woman has preinvasive cancer of the...

Question 17

The client is undergoing treatment for ovarian cancer.Which common nutritional problems are related to gynecologic cancers and the treatment thereof?&#10;A) Stomatitis&#10;B) Constipation&#10;C) Increased appetite&#10;D) Diarrhea&#10;E) Nausea and vomiting

Accepted Answer

The answer of The client is undergoing treatment for ovarian...

Question 18

Which condition is the most common malignancy of the reproductive system?&#10;A) Endometrial cancer&#10;B) Cervical cancer&#10;C) Ovarian cancer&#10;D) Vulvar and vaginal cancer

Accepted Answer

The answer of Which condition is the most common malignancy...

Question 19

The prevalence of urinary incontinence (UI)increases as women age,with more than one third of the women in the United States suffering from some form of this disorder.The symptoms of mild-to-moderate UI can be successfully decreased by a number of strategies.Which of these should the nurse instruct the client to use first?

A) Pelvic floor support devices
B) Bladder training and pelvic muscle exercises
C) Surgery
D) Medications

Accepted Answer

The answer of The prevalence of urinary incontinence (UI)increases as...

Question 20

Which ovarian neoplasm is described as a growth that contains hair,teeth,and sebaceous secretions?&#10;A) Ovarian fibroma&#10;B) Dermoid cyst&#10;C) Uterine polyp&#10;D) Follicular cyst

Accepted Answer

The answer of Which ovarian neoplasm is described as a...

Question 21

Leiomyomas (also known as fibroid tumors)are benign tumors arising from the muscle tissue of the uterus.Which information related to these tumors is accurate?&#10;A) Are rapid growing&#10;B) Are more common in African-American women&#10;C) Are more common in women who have never been pregnant&#10;D) Obesity is a risk factor with leiomyomas&#10;E) Become malignant if left untreated

Accepted Answer

The answer of Leiomyomas (also known as fibroid tumors)are benign...

Question 22

The client has undergone hysteroscopic uterine ablation to destroy a number of smaller fibroids.The nurse is preparing to provide discharge instructions.Which information is a priority for the patient and should be included in the teaching plan?

A) Analgesics and nonsteroidal antiinflammatory drugs can be used for pain control.
B) Vaginal discharge is to be expected for 5 to 7 days.
C) Sexual activity can be resumed after 48 hours.
D) Next menstrual period will be irregular.
E) Provider should be notified if heavy bleeding occurs.

Accepted Answer

The answer of The client has undergone hysteroscopic uterine ablation...

Deck 11: Structural Disorders and Neoplasms of the Reproductive System