Deck 54: Nursing Management: Female Reproductive Problems

Question 1

A patient is diagnosed with vaginal candidiasis and an antifungal vaginal cream is prescribed. Which statement by the patient indicates that the nurse's teaching about the treatment plan has been effective?

A) "I will tell my husband that we cannot have sex for the next month."
B) "I should clean carefully after each urination and bowel movement."
C) "I can douche daily with warm water if the itching continues to bother me."
D) "I will insert the cream using the applicator before I get up in the morning."

Answer 1

"I should clean carefully after each urination and bowel movement."

Question 2

A patient with pelvic inflammatory disease ( PID ) is treated on an outpatient basis with oral antibiotics. Which instruction will be included in patient teaching?

A) Return for a follow-up appointment in 2 days.
B) Abdominal pain may persist for several weeks.
C) Sexual intercourse should be avoided for 1 week.
D) Nonsteroidal antiinflammatory drug ( NSAID ) use may prevent scarring of pelvic organs.

Answer 2

Return for a follow-up appointment in 2 days.

Question 3

Six months after being sexually assaulted, a woman tells the nurse that she has nightmares about the incident and develops acute anxiety if she finds herself alone in situations where several men are present. The most appropriate nursing diagnosis for the patient is

A) anxiety related to effects of being raped.
B) sleep deprivation related to frightening dreams.
C) rape-trauma syndrome related to rape experience.
D) ineffective coping related to inability to resolve incident.

Answer 3

rape-trauma syndrome related to rape experience.

Question 4

A woman has an induced abortion with suction curettage at an ambulatory surgical center. Which instructions will the nurse include when discharging the patient?

A) "Heavy vaginal bleeding is expected for about 2 weeks."
B) "You should abstain from sexual intercourse for 2 weeks."
C) "Irregular menstrual periods are expected for the next few months."
D) "Use of contraceptives should be avoided until your reexamination."

Question 5

A patient who is trying to become pregnant asks the nurse about ways to determine when she is most likely to conceive. The nurse explains that

A) ovulation prediction kits provide accurate information about ovulation.
B) ovulation is difficult to predict unless she has regular menstrual periods.
C) she will need to bring a specimen of cervical mucus to the clinic for testing.
D) she should take her body temperature daily and have intercourse when it drops.

Question 6

A 22-year-old woman who is scheduled for a Pap test tells the nurse that she has had intercourse during the last year with several men. The nurse will plan to teach about the reason for

A) contraceptive use.
B) antibiotic therapy.
C) chlamydia testing.
D) pregnancy testing.

Question 7

A 46-year-old woman tells the nurse that she has not had a menstrual period for 3 months and asks whether she is going into menopause. The best response by the nurse is,

A) "Have you thought about using hormone replacement therapy?"
B) "Most women feel a little depressed about entering menopause."
C) "What was your menstrual pattern before your periods stopped?"
D) "Since you are in your mid-40s, it is likely that you are menopausal."

Question 8

When caring for a 60-year-old patient with persistent menorrhagia, the nurse will plan to monitor the

A) estrogen level.
B) complete blood count ( CBC ).
C) gonadotropin-releasing hormone ( GNRH ) level.
D) serial b-human chorionic gonadotropin ( hCG ) results.

Question 9

A 33-year-old woman who uses oral contraceptives tells the nurse, "I want to have children in a few years." Which response by the nurse is appropriate?

A) "You may have more difficulty becoming pregnant after about age 35."
B) "You have many years of fertility left, so there is no rush to have children."
C) "You should plan to stop taking oral contraceptives several years before you want to become pregnant."
D) "If you do not have children within the next few years, it will be very difficult for you to become pregnant."

Question 10

A 26-year-old who was admitted to the hospital with increasing abdominal pain is diagnosed with an ectopic pregnancy. The patient begins to cry and asks the nurse to leave her alone to grieve. Which action should the nurse take next?

A) Stay with the patient and encourage her to discuss her feelings.
B) Explain the reason for taking vital signs every 15 to 30 minutes.
C) Close the door to the patient's room and minimize disturbances.
D) Provide teaching about options for termination of the pregnancy.

Question 11

A couple is considering the possibility of in vitro fertilization (IVF). The woman tells the nurse that they cannot afford IVF on her husband's salary, and the husband replies that if the wife would get a job, they would have enough money. Which nursing diagnosis is appropriate?

A) Decisional conflict related to inadequate financial resources
B) Ineffective sexuality patterns related to psychological stress
C) Defensive coping related to anxiety about lack of conception
D) Ineffective denial related to frustration about continued infertility

Question 12

A 31-year-old woman tells the nurse that she has noticed increasing headaches with dizziness, abdominal bloating, and unexplained anxiety occurring before her menstrual periods. Which action is best for the nurse to take at this time?

A) Ask the patient to write down her symptoms in a diary for 3 months.
B) Suggest that the patient try aerobic exercise to decrease her symptoms.
C) Teach the patient about appropriate lifestyle changes to reduce premenstrual syndrome (PMS) symptoms.
D) Advise the patient to use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) to control symptoms.

Question 13

A woman is scheduled for an induced abortion using instillation of hypertonic saline solution. Before the procedure, which information will the nurse discuss with the patient?

A) The expulsion of the fetus may take up to a day or longer.
B) There is a possibility that the patient may deliver a live fetus.
C) The patient will require a general anesthetic for the procedure.
D) The procedure may be unsuccessful in terminating the pregnancy.

Question 14

A 58-year-old woman calls the health clinic when she has a moderate amount of vaginal bleeding after 6 years of menopause. The nurse will anticipate teaching the patient about

A) endometrial biopsy.
B) uterine balloon therapy.
C) laser endometrial ablation.
D) dilation and curettage ( D&C ).

Question 15

When the nurse is caring for a patient with pelvic inflammatory disease ( PID ) requiring hospitalization, which nursing intervention will be included in the plan of care?

A) Monitor liver function tests.
B) Use cold packs PRN for pelvic pain.
C) Teach the patient how to perform Kegel exercises.
D) Elevate the head of the bed to at least 30 degrees.

Question 16

Which information will the nurse include when teaching a 51-year-old woman who is considering the use of combined estrogen-progesterone hormone replacement therapy (HRT) during menopause?

A) Use of estrogen-containing vaginal creams provides most of the same benefits as oral HRT.
B) Use of HRT for up to 10 years to prevent symptoms such as hot flashes is generally considered safe.
C) HRT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast cancer.
D) Increased incidence of colon cancer in women taking HRT requires frequent stool assessment for occult blood.

Question 17

A patient with endometriosis is treated with medroxyprogesterone ( Depo-Provera ). The nurse explains that this therapy

A) suppresses the menstrual cycle by mimicking pregnancy.
B) may cause symptoms such as vaginal atrophy and hot flashes.
C) is associated with loss of bone density and increased fracture risk.
D) will lead to permanent suppression of abnormal endometrial tissues.

Question 18

When caring for a patient recently diagnosed with polycystic ovary syndrome, it is most important for the nurse to teach the patient

A) reasons for a total hysterectomy.
B) how to decrease facial hair growth.
C) ways to reduce the occurrence of acne.
D) methods to maintain appropriate weight.

Question 19

When teaching a patient about ways to prevent primary dysmenorrhea, the nurse will suggest that the patient

A) avoid aerobic exercise during her menstrual period.
B) use cold packs on the abdomen and back for pain relief.
C) talk with her health care provider about antidepressant therapy.
D) start taking nonsteroidal antiinflammatory drugs (NSAIDs) regularly when her menstrual period starts.

Question 20

When a patient has oral contraceptives prescribed for endometriosis, the nurse will teach the patient to

A) expect to experience side effects such as facial hair.
B) take the medication every day for the next 9 months.
C) use a second method of contraception to ensure that she will not become pregnant.
D) take calcium supplements to prevent osteoporosis from developing during therapy.

Question 21

A patient who has a large cystocele has not voided since admission 8 hours previously. Which action should the nurse take first?

A) Insert a straight catheter per the PRN order.
B) Encourage the patient to increase oral fluids.
C) Notify the health care provider of the inability to void.
D) Use an ultrasound scanner to check for urinary retention.

Question 22

A 32-year-old patient has minor changes on her Pap test. Which action should the nurse take?

A) Teach the patient about colposcopy.
B) Teach the patient about punch biopsy.
C) Schedule another Pap test in 4 months.
D) Administer the human papilloma virus (HPV) vaccine.

Question 23

After being sexually assaulted, a woman is brought to the emergency department by a friend. The patient is confused and has a large laceration above the left eye. Which action should the nurse take first?

A) Assess the patient's neurologic status.
B) Assist the patient in removing her clothing.
C) Contact the sexual assault nurse examiner (SANE).
D) Ask the patient to describe what occurred during the assault.

Question 24

Which information about a 48-year-old patient indicates that the nurse will need to teach the patient about endometrial biopsy?

A) The patient has had 6 full-term pregnancies.
B) The patient has 3 to 4 alcoholic drinks daily.
C) The patient has used various oral contraceptives since she was 20 years old.
D) The patient has a family history of hereditary nonpolyposis colorectal cancer.

Question 25

Which information will the nurse include when developing a patient teaching plan for a 48-year-old patient with uterine bleeding caused by a leiomyoma?

A) Aspirin or nonsteroidal antiinflammatory drugs (NSAIDs) may be used to control mild to moderate pain.
B) The tumor size is likely to increase throughout the patient's lifetime.
C) The symptoms may decrease after the patient undergoes menopause.
D) The patient will need frequent monitoring to detect any malignant changes.

Question 26

Which statement by a patient who has just been instructed in the treatment for a Chlamydia trachomatis vaginal infection indicates that the nurse's teaching has been effective?

A) "I can purchase an over-the-counter medication to treat this infection."
B) "The symptoms are due to the overgrowth of normal vaginal bacteria."
C) "The medication will need to be inserted once daily with an applicator."
D) "Both my partner and I will need to take the medication for a full week."

Question 27

Which topic will the nurse include in patient teaching for a 29-year-old patient who has been diagnosed with human papilloma virus (HPV) infection and who smokes cigarettes, uses oral contraceptives, and has a history of candidiasis?

A) Use of water soluble lubricants
B) Antifungal cream administration
C) Importance of smoking cessation
D) Possible difficulties with conception

Question 28

A 54-year-old woman tells the nurse that she is postmenopausal but has occasional spotting. Which initial response by the nurse is most appropriate?

A) "A frequent cause of spotting is endometrial cancer."
B) "How long has it been since your last menstrual period?"
C) "Breakthrough bleeding is not unusual in women your age."
D) "Are you using prescription hormone replacement therapy?"

Question 29

A patient with multiple uterine leiomyomas is admitted for an abdominal hysterectomy. Which topic will the nurse include in patient teaching?

A) Leg exercises and the purpose of frequent ambulation
B) Temporary decrease in vaginal sensation after surgery
C) Adverse effects of systemic chemotherapy or radiation
D) Symptoms caused by the sudden drop in estrogen level

Question 30

When caring for a patient who has a radium implant for treatment of cancer of the cervix, the nurse will

A) maintain the patient on complete bed rest.
B) use gloves when changing the patient's bed.
C) allow extra time for patient discussion of concerns.
D) flush the toilet several times after the patient voids.

Question 31

Which action by the nurse will be most important in maintaining the medicolegal chain of evidence for a patient who has been sexually assaulted?

A) Label all specimens and materials obtained from the patient.
B) Educate the patient about the reason for baseline sexually transmitted disease ( STD ) testing.
C) Assist the patient in filling out the application for financial compensation.
D) Discuss the availability of the "morning-after pill" for pregnancy prevention.

Question 32

Stage III ovarian cancer is diagnosed in a 63-year-old woman. A nursing diagnosis that is likely to be appropriate is

A) sexual dysfunction related to loss of vaginal sensation.
B) risk for infection related to impaired immune function.
C) situational low self-esteem related to guilt about delaying medical care.
D) anxiety related to cancer diagnosis and need to make treatment decisions.

Question 33

A 56-year-old woman undergoes an anterior and posterior (A&P) colporrhaphy for repair of a cystocele and rectocele. Which nursing action will be included in the postoperative care plan?

A) Teach the patient correct pessary use.
B) Perform indwelling catheter care daily.
C) Repack the vaginal wound daily with gauze.
D) Provide patient teaching about a high fiber diet.

Question 34

A 45-year-old patient is diagnosed with stage 0 cervical cancer using a punch biopsy. The nurse will plan to teach the patient about

A) radiation.
B) conization.
C) chemotherapy.
D) radial hysterectomy.

Question 35

A 19-year-old requests a prescription for birth control pills to decrease abdominal cramping and headaches during her menstrual periods. Which of these actions should the nurse take first?

A) Determine whether the patient is sexually active.
B) Suggest that the patient use nonsteroidal antiinflammatory drugs (NSAIDs) for symptom relief.
C) Take a personal and family health history from the patient.
D) Teach the patient about the side effects of oral contraceptives.

Question 36

Which assessment finding for a patient who is on the surgical unit after a radical abdominal hysterectomy is most important to report to the health care provider?

A) Decreased bowel sounds in all four abdominal quadrants
B) Urine output of 100 mL in the first 8 hours after surgery
C) One inch area of bloody drainage on the abdominal dressing
D) Complaints of abdominal pain at the incision site with coughing

Question 37

An 18-year-old visits the health clinic for a routine check-up. To determine whether a Pap test is needed, which question should the nurse ask?

A) "Do you use any illegal substances?"
B) "Have you ever had sexual intercourse?"
C) "How old were you when your menstrual periods started?"
D) "Do you have any cramping with your menstrual periods?"

Question 38

A patient who has undergone a radical vulvectomy for vulvar carcinoma returns to the medical-surgical unit after the surgery. The priority nursing diagnosis for the patient at this time is

A) self-care deficit: bathing/hygiene related to pain and difficulty in moving.
B) risk for infection related to contamination of the wound with urine and stool.
C) imbalanced nutrition: less than body requirements related to low-residue diet.
D) risk for ineffective sexual pattern related to disfiguration caused by the surgery.

Question 39

A female patient who is seen in the health clinic is diagnosed with genital warts. The nurse will plan to teach the patient about

A) the need for regular Pap tests.
B) increased risk for endometrial cancer.
C) appropriate use of oral contraceptives.
D) symptoms of pelvic inflammatory disease.

Question 40

Which assessment finding in a woman who recently started taking hormone replacement therapy (HRT) is most important for the nurse to report to the health care provider?

A) Breast tenderness
B) Weight gain of 3 lb
C) Intermittent spotting
D) Unilateral calf swelling

Question 41

The nurse has just received change-of-shift report about the following four patients. Which patient should be assessed first?

A) A patient with a possible ectopic pregnancy who is complaining of severe shoulder pain
B) A patient in the fifteenth week of gestation who is experiencing uterine cramping and spotting
C) A patient who has a radium implant in place to treat cervical cancer and is crying in her room
D) A patient with ovarian cancer who is complaining of 5/10 pain after an abdominal hysterectomy

Question 42

When counseling a healthy perimenopausal woman who prefers not to use hormone replacement therapy (HRT), which nonhormonal therapies will the nurse suggest (select all that apply)?

A) Reduce coffee intake.
B) Exercise several times a week.
C) Take black cohosh supplements.
D) Have a glass of wine in the evening.
E) Increase intake of dietary soy products.

Question 43

A patient tells the nurse that she would like a prescription for oral contraceptives to control her premenstrual dysphoric disorder ( PMD-D ) symptoms. Which patient information is most important to communicate to the health care provider?

A) Chronic breast tenderness
B) Frequent abdominal bloating
C) History of migraine headaches
D) Previous spontaneous abortion