Deck 53: Female Reproductive and Genital Problems

Question 1

A 19-yr-old patient has been diagnosed with primary dysmenorrhea. How will the nurse suggest that the patient manage discomfort?

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 beginning antidepressant therapy.
D)Take nonsteroidal antiinflammatory drugs (NSAIDs) when her period starts.

Answer 1

Take nonsteroidal antiinflammatory drugs (NSAIDs) when her period starts.

Question 2

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

A)Abdominal pain may persist for several weeks.
B)Return for a follow-up appointment in 2 to 3 days.
C)Instruct a male partner to use a condom during sexual intercourse for the next week.
D)Nonsteroidal antiinflammatory drug (NSAID) use may prevent pelvic organ scarring

Answer 2

Return for a follow-up appointment in 2 to 3 days.

Question 3

A patient who is scheduled for a routine gynecologic examination tells the nurse that she has had intercourse during the past 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.

Answer 3

Chlamydia testing.

Question 4

A patient who was admitted to the emergency department with severe 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 5

Which statement by the patient indicates that the nurse's teaching about treating vaginal candidiasis was effective?

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

Question 6

A 32-yr-old 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)take calcium supplements to prevent developing osteoporosis during therapy.
D)use a second method of contraception to ensure that she will not become pregnant.

Question 7

The nurse in the infertility clinic is explaining in vitro fertilization (IVF)to a couple. The woman tells the nurse that they cannot afford IVF on her husband's salary. The man replies that if his wife worked outside the home,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 8

A patient with endometriosis asks why she is being treated with medroxyprogesterone,a medication that she thought was a contraceptive. The nurse explains that this therapy

A)suppresses the menstrual cycle by mimicking pregnancy.
B)relieves symptoms such as vaginal atrophy and hot flashes.
C)prevents a pregnancy that could worsen the menstrual bleeding.
D)leads to permanent suppression of abnormal endometrial tissues.

Question 9

A 28-yr-old patient reports anxiety,headaches with dizziness,and abdominal bloating occurring before her menstrual periods. Which action is best for the nurse to take at this time?

A)Ask the patient to keep track of 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 antiinflammatory drugs (NSAIDs) such as ibuprofen to control symptoms.

Question 10

When caring for a 58-yr-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 human chorionic gonadotropin (hCG) results.

Question 11

A patient is scheduled for an induced abortion using instillation of hypertonic saline solution. Which information will the nurse plan to discuss with the patient before the procedure?

A)The patient will require a general anesthetic.
B)The expulsion of the fetus may take 1 to 2 days.
C)There is a possibility that the patient may deliver a live fetus.
D)The procedure may be unsuccessful in terminating the pregnancy.

Question 12

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)Elevate the head of the bed at least 30 degrees.
D)Teach the patient how to perform Kegel exercises.

Question 13

A 34-yr-old patient who is discussing contraceptive options with the nurse says,"I want to have children but not for a few years." Which response by the nurse is accurate?

A)"If you do not become pregnant within the next few years, you never will."
B)"Women often have more difficulty becoming pregnant after about age 35."
C)"Stop taking oral contraceptives several years before you want to have a child."
D)"You have many more years of fertility left, so there is no rush to have children."

Question 14

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

A)"Avoid contraceptives until your reexamination."
B)"Heavy vaginal bleeding is expected for 2 weeks."
C)"Abstain from sexual intercourse for the next 2 weeks."
D)"Irregular menstrual periods are expected for a few months."

Question 15

A patient is considering the use of combined estrogen-progesterone hormone replacement therapy (HRT)during menopause. Which information will the nurse include during their discussion?

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

Question 16

A female patient tells the nurse that she has been having nightmares and acute anxiety around men since being sexually assaulted 3 months ago. 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.

Question 17

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

A)ovulation is unpredictable unless there are regular menstrual periods.
B)ovulation prediction kits can provide accurate information about ovulation.
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 18

A 47-yr-old patient asks whether she is going into menopause if she has not had a menstrual period for 3 months. Which response by the nurse is appropriate?

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)"Because you are in your mid-40s, it is likely that you are menopausal."

Question 19

A 56-yr-old patient is concerned about having a moderate amount of vaginal bleeding after 5 years of menopause. The nurse will anticipate teaching the patient about

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

Question 20

A patient was 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 21

A 49-yr-old patient tells the nurse that she is postmenopausal but has recently had occasional spotting. Which initial response by the nurse is 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 22

A 58-yr-old patient is on the medical-surgical unit after undergoing a radical vulvectomy for vulvar carcinoma. The greatest risk to the patient at this time is

A)self-care deficit.
B)wound infection.
C)inadequate nutrition.
D)ineffective sexual pattern.

Question 23

A patient who has a large cystocele was admitted 10 hours ago but has not yet voided. If the patient reports no urge to void,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 24

A 19-yr-old patient visits the health clinic for a routine checkup. Which question should the nurse ask to determine whether a Pap test is needed?

A)"Have you had sexual intercourse?"
B)"Do you use any illegal substances?"
C)"Do you have cramping with your periods?"
D)"At what age did your menstrual periods start?"

Question 25

A patient brought to the emergency department reports being sexually assaulted. The patient is confused about where she is and she has a laceration above the right eye. Which action should the nurse take first?

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

Question 26

Which nursing assessment finding in a patient who recently started taking hormone replacement therapy (HRT)requires discussion with the health care provider about a change in therapy?

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

Question 27

A patient is on the surgical unit after a radical abdominal hysterectomy. Which finding requires a report to the health care provider?

A)Urine output of 125 mL in the first 8 hours after surgery
B)Decreased bowel sounds in all four abdominal quadrants
C)One-inch area of bloody drainage on the abdominal dressing
D)Complaints of abdominal pain at the incision site with coughing

Question 28

The nurse will plan to teach the female patient with genital warts about the

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

Question 29

The nurse will plan to teach a 34-yr-old patient diagnosed with stage 0 cervical cancer about

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

Question 30

Which topic will the nurse include in the preoperative teaching for a patient admitted for an abdominal hysterectomy?

A)Purpose of ambulation and leg exercises
B)Adverse effects of systemic chemotherapy
C)Decrease in vaginal sensation after surgery
D)Symptoms caused by the drop in estrogen level

Question 31

A 31-yr-old patient who has been diagnosed with human papillomavirus (HPV)infection gives a health history that includes smoking tobacco,taking oral contraceptives,and having been treated twice for vaginal candidiasis. Which topic will the nurse include in patient teaching?

A)Use of water-soluble lubricants
B)Risk factors for cervical cancer
C)Antifungal cream administration
D)Possible difficulties with conception

Question 32

A patient requests a prescription for birth control pills to control severe abdominal cramping and headaches during her menstrual periods. Which action should the nurse take first?

A)Determine whether the patient is sexually active.
B)Teach about the side effects of oral contraceptives.
C)Take the patient's personal and family health history.
D)Suggest nonsteroidal antiinflammatory drugs (NSAIDs).

Question 33

A patient 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)Encourage a high-fiber diet.
B)Perform urinary catheter care.
C)Repack the vagina with gauze daily.
D)Teach the patient to insert a pessary.

Question 34

A 50-yr-old patient is diagnosed with uterine bleeding caused by a leiomyoma. Which information will the nurse include in the patient teaching plan?

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

Question 35

A patient in the emergency department reports that she has been sexually assaulted. Which action by the nurse will help to maintain the medicolegal chain of evidence?

A)Labeling all specimens and other materials obtained from the patient
B)Assisting the patient in filling out the application for financial compensation
C)Discussing the availability of the "morning-after pill" for pregnancy prevention
D)Educating the patient about baseline sexually transmitted infection (STI) testing

Question 36

Which patient in the women's health clinic will the nurse expect to teach about an endometrial biopsy?

A)A 55-yr-old patient who has 3 to 4 alcoholic drinks each day
B)A 35-yr-old patient who has used oral contraceptives for 15 years
C)A 25-yr-old patient who has a family history of hereditary nonpolyposis colorectal cancer
D)A 45-yr-old patient who has had six previous full-term pregnancies and two spontaneous abortions

Question 37

A patient has just been instructed in the treatment for a Chlamydia trachomatis vaginal infection. Which patient statement 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 38

Which action should the nurse take when a 35-yr-old patient has a Pap test result of minor cellular changes?

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

Question 39

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

A)assist the patient to ambulate every 2 to 3 hours.
B)use gloves and gown when changing the patient's bed.
C)flush the toilet several times right after the patient voids.
D)encourage the patient to discuss any concerns by telephone.

Question 40

A nursing diagnosis that is likely to be appropriate for a 67-yr-old patient who has just been diagnosed with stage III ovarian cancer is

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

Question 41

A healthy 24-yr-old patient who has been vaccinated against human papillomavirus (HPV)has a normal Pap test result. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test?

A)You can wait until after age 30 before having another Pap test.
B)Pap testing is recommended every 3 years for women your age.
C)No further Pap testing is needed until you decide to become pregnant.
D)Yearly Pap testing is suggested for women with multiple sexual partners.

Question 42

Which nonhormonal therapies will the nurse suggest for a healthy perimenopausal patient who prefers not to use hormone replacement therapy (HRT)?

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

Question 43

The nurse in the women's health clinic has four patients who are waiting to be seen. Which patient should the nurse see first?

A)A 22-yr-old patient with persistent red-brown vaginal drainage 3 days after having balloon thermotherapy
B)A 42-yr-old patient with secondary amenorrhea who says that her last menstrual cycle was 3 months ago
C)A 35-yr-old patient with heavy spotting after having a progestin-containing IUD (Mirena) inserted a month ago
D)A 19-yr-old patient with menorrhagia who has been using superabsorbent tampons and has fever with weakness

Question 44

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 that contraindicates oral contraceptives should be communicated to the health care provider?

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

Question 45

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

Question 46

A 22-yr-old patient tells the nurse that she has not had a menstrual period for the past 3 months. Which action is most important for the nurse to take?

A)Obtain a urine specimen for a pregnancy test.
B)Ask about any recent stressful lifestyle changes.
C)Measure the patient's current height and weight.
D)Question the patient about prescribed medications.

Question 47

Which information will the nurse include when teaching a patient who has developed a small vesicovaginal fistula 2 weeks into the postpartum period?

A)Take stool softeners to prevent fecal contamination of the vagina.
B)Limit oral fluid intake to minimize the quantity of urinary drainage.
C)Change the perineal pad frequently to prevent perineal skin breakdown.
D)Call the health care provider immediately if urine drains from the vagina.

Question 48

Which nursing actions can the nurse working in a women's health clinic delegate to experienced unlicensed assistive personnel (UAP)?

A)Call a patient with the results of an endometrial biopsy.
B)Assist the health care provider with performing a Pap test.
C)Draw blood for CA-125 levels for a patient with ovarian cancer.
D)Question a patient about use of medications that may cause amenorrhea.
E)Teach the parent of a 10-yr-old about human papilloma virus (HPV) vaccine (Gardasil).

Question 49

To prevent pregnancy in a patient who has been sexually assaulted,the nurse in the emergency department will plan to teach the patient about the use of

A)mifepristone .
B)dilation and evacuation.
C)methotrexate with misoprostol.
D)levonorgestrel (Plan-B One-Step).