Deck 4: Reproductive System Concerns

Question 1

With regard to dysmenorrhea,nurses should be aware that:

A)It is more common in older women.
B)It is more common in leaner women who exercise strenuously.
C)Symptoms can begin at any point in the ovulatory cycle.
D)Pain usually occurs in the suprapubic area or lower abdomen.

Answer 1

Pain usually occurs in the suprapubic area or lower abdomen.

Question 2

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

A)Stress.
B)Excessive exercise.
C)Pregnancy.
D)Eating disorders.

Answer 2

Pregnancy.

Question 3

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

A)Oligomenorrhea.
B)Menorrhagia.
C)Leiomyoma.
D)Metrorrhagia.

Answer 3

Metrorrhagia.

Question 4

A woman has a thick,white,lumpy,cottage cheese-like discharge,with patches on her labia and in her vagina.She complains of intense pruritus.The nurse practitioner would order which preparation for treatment?

A)Fluconazole
B)Tetracycline
C)Clindamycin
D)Acyclovir

Question 5

As relates to dysfunctional uterine bleeding (DUB),the nurse should be aware that:

A)It is most commonly caused by anovulation.
B)It most often occurs in middle age.
C)The diagnosis of DUB should be the first considered for abnormal menstrual bleeding.
D)The most effective medical treatment is steroids.

Question 6

A 36-year-old woman has been given a diagnosis of uterine fibroids.When planning care for this patient,the nurse should know that:

A)Fibroids are malignant tumors of the uterus that require radiation or chemotherapy.
B)Fibroids increase in size during the perimenopausal period.
C)Menorrhagia is a common finding.
D)The woman is unlikely to become pregnant as long as the fibroids are in her uterus.

Question 7

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

A)Premenstrual dysphoric disorder (PMDD) is a milder form of premenstrual syndrome (PMS) and more common in younger women.
B)Secondary dysmenorrhea is more intense and medically significant than primary dysmenorrhea.
C)Premenstrual syndrome is a complex, poorly understood condition that may include any of a hundred symptoms.
D)The causes of PMS have been well established.

Question 8

The U.S.Centers for Disease Control and Prevention (CDC)recommends that HPV be treated with client-applied:

A)Miconazole ointment.
B)Topical podofilox 0.5% solution or gel.
C)Penicillin given intramuscularly for two doses.
D)Metronidazole by mouth.

Question 9

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?

A)The woman says her menstrual flow lasts 5 to 6 days.
B)She describes her flow as very heavy.
C)She reports that she has had a small amount of spotting midway between her periods for the past 2 months.
D)She says the length of her menstrual cycle varies from 26 to 29 days.

Question 10

A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years.She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months.These symptoms are most likely related to:

A)Endometriosis.
B)PMS.
C)Primary dysmenorrhea.
D)Secondary dysmenorrhea.

Question 11

Which symptom described by a patient is characteristic of premenstrual syndrome (PMS)?

A)"I feel irritable and moody a week before my period is supposed to start."
B)"I have lower abdominal pain beginning the third day of my menstrual period."
C)"I have nausea and headaches after my period starts, and they last 2 to 3 days."
D)"I have abdominal bloating and breast pain after a couple days of my period."

Question 12

The viral sexually transmitted infection (STI)that affects most people in the United States today is:

A)Herpes simplex virus type 2 (HSV-2).
B)Human papillomavirus (HPV).
C)Human immunodeficiency virus (HIV).
D)Cytomegalovirus (CMV).

Question 13

The two primary areas of risk for sexually transmitted infections (STIs)are:

A)Sexual orientation and socioeconomic status.
B)Age and educational level.
C)Large number of sexual partners and race.
D)Risky sexual behaviors and inadequate preventive health behaviors.

Question 14

When assessing a patient for amenorrhea,the nurse should be aware that this is unlikely to be caused by:

A)Anatomic abnormalities.
B)Type 1 diabetes mellitus.
C)Lack of exercise.
D)Hysterectomy.

Question 15

With regard to endometriosis,nurses should be aware that:

A)It is characterized by the presence and growth of endometrial tissue inside the uterus.
B)It is found more often in African-American women than in white or Asian women.
C)It may worsen with repeated cycles or remain asymptomatic and disappear after menopause.
D)It is unlikely to affect sexual intercourse or fertility.

Question 16

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

A)Amenorrhea.
B)Dysmenorrhea.
C)Dyspareunia.
D)Premenstrual syndrome (PMS).

Question 17

Nafarelin is currently used as a treatment for mild-to-severe endometriosis.The nurse should tell a woman taking this medication that the drug:

A)Stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity.
B)Should be sprayed into one nostril every other day.
C)Should be injected into subcutaneous tissue BID.
D)Can cause her to experience some hot flashes and vaginal dryness.

Question 18

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:

A)Acetaminophen.
B)Oral contraceptives (OCPs).
C)Nonsteroidal antiinflammatory drugs (NSAIDs).
D)Aspirin.

Question 19

When evaluating a patient for sexually transmitted infections (STIs),the nurse should be aware that the most common bacterial STI is:

A)Gonorrhea.
B)Syphilis.
C)Chlamydia.
D)Candidiasis.

Question 20

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

A)Increasing the intake of red meat and simple carbohydrates
B)Reducing the intake of diuretic foods such as peaches and asparagus
C)Temporarily substituting physical activity for a sedentary lifestyle
D)Using a heating pad on the abdomen to relieve cramping

Question 21

After a mastectomy a woman should be instructed to perform all of the following except:

A)Emptying surgical drains twice a day and as needed.
B)Avoiding lifting more than 4.5 kg (10 lb) or reaching above her head until given permission by her surgeon.
C)Wearing clothing with snug sleeves to support the tissue of the arm on the operative side.
D)Reporting immediately if inflammation develops at the incision site or in the affected arm.

Question 22

An essential component of counseling women regarding safe sex practices includes discussion regarding avoiding the exchange of body fluids.The physical barrier promoted for the prevention of sexually transmitted infections and human immunodeficiency virus is the condom.Nurses can help motivate clients to use condoms by initiating a discussion related to a number of aspects of condom use.The most important of these is:

A)Strategies to enhance condom use.
B)Choice of colors and special features.
C)Leaving the decision up to the male partner.
D)Places to carry condoms safely.

Question 23

Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes?

A)Herpes simplex virus (HSV)-2
B)Human papillomavirus (HPV)
C)Human immunodeficiency virus (HIV)
D)Cytomegalovirus (CMV)

Question 24

The nurse should know that once human immunodeficiency virus (HIV)enters the body,seroconversion to HIV positivity usually occurs within:

A)6 to 10 days.
B)2 to 4 weeks.
C)6 to 8 weeks.
D)6 months.

Question 25

The nurse providing care in a women's health care setting must be aware regarding which sexually transmitted infection that can be successfully treated and cured?

A)Herpes
B)Acquired immunodeficiency syndrome (AIDS)
C)Venereal warts
D)Chlamydia

Question 26

What important,immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

A)The blood pressure (BP) cuff should not be applied to the affected arm.
B)Venipuncture for blood work should be performed on the affected arm.
C)The affected arm should be used for intravenous (IV) therapy.
D)The affected arm should be held down close to the woman's side.

Question 27

The recommended treatment for the prevention of human immunodeficiency virus (HIV)transmission to the fetus during pregnancy is:

A)Acyclovir.
B)Ofloxacin.
C)Podophyllin.
D)Zidovudine.

Question 28

The nurse must watch for what common complications in a patient who has undergone a transverse rectus abdominis myocutaneous (TRAM)flap?

A)Axillary edema and tissue necrosis
B)Delayed wound healing and muscle contractions
C)Delayed wound healing and axillary edema
D)Delayed wound healing and hematoma

Question 29

Care management of a woman diagnosed with acute pelvic inflammatory disease (PID)most likely would include:

A)Oral antiviral therapy.
B)Bed rest in a semi-Fowler position.
C)Antibiotic regimen continued until symptoms subside.
D)Frequent pelvic examination to monitor the progress of healing.

Question 30

A woman has a breast mass that is not well delineated and is nonpalpable,immobile,and nontender.This is most likely:

A)Fibroadenoma.
B)Lipoma.
C)Intraductal papilloma.
D)Mammary duct ectasia.

Question 31

Which of the following statements about the various forms of hepatitis is accurate?

A)A vaccine exists for hepatitis C but not for hepatitis B.
B)Hepatitis A is acquired by eating contaminated food or drinking polluted water.
C)Hepatitis B is less contagious than human immunodeficiency virus (HIV).
D)The incidence of hepatitis C is decreasing.

Question 32

A nurse practitioner performs a clinical breast examination on a woman diagnosed with fibroadenoma.The nurse knows that fibroadenoma is characterized by:

A)Inflammation of the milk ducts and glands behind the nipples.
B)Thick, sticky discharge from the nipple of the affected breast.
C)Lumpiness in both breasts that develops 1 week before menstruation.
D)A single lump in one breast that can be expected to shrink as the woman ages.

Question 33

A healthy 60-year-old African-American woman regularly receives her health care at the clinic in her neighborhood.She is due for a mammogram.At her previous clinic visit,her physician,concerned about the 3-week wait at the neighborhood clinic,made an appointment for her to have a mammogram at a teaching hospital across town.She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure.What would be the most appropriate statement for the nurse to make to this patient?

A)"Do you have transportation to the teaching hospital so that you can get your mammogram?"
B)"I'm concerned that you missed your appointment; let me make another one for you."
C)"It's very dangerous to skip your mammograms; your breasts need to be checked."
D)"Would you like me to make an appointment for you to have your mammogram here?"

Question 34

The nurse who is teaching a group of women about breast cancer would tell the women that:

A)Risk factors identify more than 50% of women who will develop breast cancer.
B)Nearly 90% of lumps found by women are malignant.
C)One in 10 women in the United States will develop breast cancer in her lifetime.
D)The exact cause of breast cancer is unknown.

Question 35

To detect human immunodeficiency virus (HIV),most laboratory tests focus on the:

A)virus.
B)HIV antibodies.
C)CD4 counts.
D)CD8 counts.

Question 36

Fibrocystic changes in the breast most often appear in women in their 20s and 30s.The etiology is unknown,but it may be an imbalance of estrogen and progesterone.The nurse who cares for this client should be aware that treatment modalities are conservative.One proven modality that may provide relief is:

A)Diuretic administration.
B)Including caffeine daily in the diet.
C)Increased vitamin C supplementation.
D)Application of cold packs to the breast as necessary.

Question 37

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?

A)Mammogram
B)Ultrasound
C)Fine-needle aspiration (FNA)
D)CA 15.3

Question 38

On vaginal examination of a 30-year-old woman,the nurse documents the following findings: profuse,thin,grayish white vaginal discharge with a "fishy" odor; complaint of pruritus.On the basis of these findings,the nurse suspects that this woman has:

A)Bacterial vaginosis (BV).
B)Candidiasis.
C)Trichomoniasis.
D)Gonorrhea.

Question 39

A patient has been prescribed adjuvant tamoxifen therapy.What common side effect might she experience?

A)Nausea, hot flashes, and vaginal bleeding
B)Vomiting, weight loss, and hair loss
C)Nausea, vomiting, and diarrhea
D)Hot flashes, weight gain, and headaches

Question 40

A 25-year-old single woman comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap)smear.The test revealed that the patient has human papillomavirus (HPV).The client asks,"What is that? Can you get rid of it?" Your best response is:

A)"It's just a little lump on your cervix. We can freeze it off."
B)"HPV stands for 'human papillomavirus.' It is a sexually transmitted infection (STI) that may lead to cervical cancer."
C)"HPV is a type of early human immunodeficiency virus (HIV). You will die from this."
D)"You probably caught this from your current boyfriend. He should get tested for this."

Question 41

The nurse providing education regarding breast care should explain to the woman that fibrocystic changes in breasts are:

A)A disease of the milk ducts and glands in the breasts.
B)A premalignant disorder characterized by lumps found in the breast tissue.
C)Lumpiness with pain and tenderness found in varying degrees in the breast tissue of healthy women during menstrual cycles.
D)Lumpiness accompanied by tenderness after menses.

Question 42

Which patient is most at risk for fibroadenoma of the breast?

A)A 38-year-old woman
B)A 50-year-old woman
C)A 16-year-old girl
D)A 27-year-old woman

Question 43

A benign breast condition that includes dilation and inflammation of the collecting ducts is called:

A)Ductal ectasia.
B)Intraductal papilloma.
C)Chronic cystic disease.
D)Fibroadenoma.

Question 44

Herbal preparations have long been used for the management of menstrual problems, including dysmenorrhea, cramping and discomfort, and breast pain. For the nurse to counsel adequately the client who elects to use this alternative modality, it is important to understand the action of these herbal preparations. Match the herbal medicine with the appropriate action.

Black cohosh

A)Uterine antispasmodic
B)Uterotonic
C)Antiinflammatory
D)Estrogen-like luteinizing hormone suppressant
E)Decreases prolactin levels

Question 45

Herbal preparations have long been used for the management of menstrual problems, including dysmenorrhea, cramping and discomfort, and breast pain. For the nurse to counsel adequately the client who elects to use this alternative modality, it is important to understand the action of these herbal preparations. Match the herbal medicine with the appropriate action.

Valerian,wild yam

A)Uterine antispasmodic
B)Uterotonic
C)Antiinflammatory
D)Estrogen-like luteinizing hormone suppressant
E)Decreases prolactin levels

Question 46

There is little consensus on the management of premenstrual dysphoric disorder (PMDD).However,nurses can advise women on several self-help modalities that often improve symptoms.The nurse knows that health teaching has been effective when the client reports that she has adopted a number of lifestyle changes,including (Select all that apply):

A)Regular exercise.
B)Improved nutrition.
C)A daily glass of wine.
D)Smoking cessation.
E)Oil of evening primrose.

Question 47

Herbal preparations have long been used for the management of menstrual problems, including dysmenorrhea, cramping and discomfort, and breast pain. For the nurse to counsel adequately the client who elects to use this alternative modality, it is important to understand the action of these herbal preparations. Match the herbal medicine with the appropriate action.

Chaste tree fruit

A)Uterine antispasmodic
B)Uterotonic
C)Antiinflammatory
D)Estrogen-like luteinizing hormone suppressant
E)Decreases prolactin levels

Question 48

Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI)include (Select all that apply):

A)Fellatio.
B)Unprotected anal intercourse.
C)Multiple sex partners.
D)Dry kissing.
E)Abstinence.

Question 49

The drug of choice for treatment of gonorrhea is:

A)Penicillin G.
B)Tetracycline.
C)Ceftriaxone.
D)Acyclovir.

Question 50

Herbal preparations have long been used for the management of menstrual problems, including dysmenorrhea, cramping and discomfort, and breast pain. For the nurse to counsel adequately the client who elects to use this alternative modality, it is important to understand the action of these herbal preparations. Match the herbal medicine with the appropriate action.

Ginger

A)Uterine antispasmodic
B)Uterotonic
C)Antiinflammatory
D)Estrogen-like luteinizing hormone suppressant
E)Decreases prolactin levels

Question 51

Herbal preparations have long been used for the management of menstrual problems, including dysmenorrhea, cramping and discomfort, and breast pain. For the nurse to counsel adequately the client who elects to use this alternative modality, it is important to understand the action of these herbal preparations. Match the herbal medicine with the appropriate action.

Fennel,dong quai

A)Uterine antispasmodic
B)Uterotonic
C)Antiinflammatory
D)Estrogen-like luteinizing hormone suppressant
E)Decreases prolactin levels

Question 52

The exact cause of breast cancer remains undetermined.Researchers have found that there are many common risk factors that increase a woman's chance of developing a malignancy.It is essential for the nurse who provides care to women of any age to be aware of which of the following risk factors (Select all that apply)?

A)Family history
B)Late menarche
C)Early menopause
D)Race
E)Nulliparity or first pregnancy after age 30