Question 1

Which statement made by a woman who is being discharged after a hysterectomy indicates understanding and acceptance?&#10;A) &#34;I wish I had delayed this surgery so that I could have had one more child.&#34;&#10;B) &#34;I will diet to prevent the weight gain most women have after hysterectomy.&#34;&#10;C) &#34;Now that my uterus will be gone, I'll probably develop stress incontinence.&#34;&#10;D) &#34;My husband and I hope to have more sex because I won't have so much bleeding.&#34;

Accepted Answer

Discontent with loss of fertility and misconceptions about the effects of hysterectomy are common contributors to psychological or adjustment problems following hysterectomy.Positive attitudes and family support decrease the risk for psychological problems.Wanting to delay the surgery for childbearing indicates unresolved grief for fertility.Gaining weight and developing incontinence are misconceptions about the operation.

Question 2

A client has returned to the nursing unit after a total abdominal hysterectomy.The nurse auscultates the client's abdomen and does not hear bowel sounds.Which is the nurse's priority intervention?&#10;A) Document the finding in the chart.&#10;B) Position the client on the right side.&#10;C) Irrigate the nasogastric tube.&#10;D) Measure abdominal girth.

Accepted Answer

Absence of bowel sounds for 1 to 2 days after abdominal surgery is an expected finding that should be documented.No intervention specific to this finding is needed.

Question 3

A client had a total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymph node dissection 2 days ago.The nurse finds the client short of breath,tachycardic,and anxious.What intervention takes priority?

A) Assess oxygen saturation and apply oxygen if needed.
B) Have the client cough and deep breathe or use the spirometer.
C) Call respiratory therapy to provide a nebulizer treatment.
D) Prepare to administer furosemide (Lasix) IV push.

Accepted Answer

Pulmonary embolism is a risk of major abdominal surgery.The client is exhibiting signs of pulmonary embolism.The nurse should first assess and treat oxygenation problems,then notify the Rapid Response Team.Pulmonary hygiene will not be aggressive enough to help this client.No indications suggest that the client needs a nebulizer treatment.Lasix is not warranted.

Question 4

A woman has endometriosis and is visibly upset.She tells the nurse that she just got married and wants to have children but is distressed because now she will be infertile.Which response by the nurse is most appropriate?

A) "Treatment for endometriosis often causes infertility; I can refer you to a support group."
B) "Endometriosis is more common in infertile women, but not all treatments cause infertility."
C) "You shouldn't worry about fertility until after we know that this didn't cause cancer."
D) "Unfortunately, you will have to take birth control pills for the rest of your life."

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Accepted Answer

Endometriosis is more common among infertile women than in the general population.However,treatments can be chosen on the basis of symptoms,extent of the disease,and the woman's desire to remain fertile.Menstrual cycle control with hormones is often a choice and would not leave the woman infertile.Endometriosis only rarely causes cancer.The woman would not have to take birth control pills for the rest of her life.

Question 5

When the history of a female client is taken,which client statement does the nurse refer to the health care provider?&#10;A) &#34;I had a fibroadenoma of the breast when I was 22 years old.&#34;&#10;B) &#34;I had my first child when I was 26 years old and my second child when I was 32.&#34;&#10;C) &#34;I stopped using oral contraceptives when I was no longer sexually active.&#34;&#10;D) &#34;I had my menopause 2 years ago and have started to have vaginal bleeding again.&#34;

Accepted Answer

Vaginal bleeding that occurs after menopause can indicate cancer and should be promptly evaluated.The other statements by the client would not be cause for alarm and would not need to be reported to the provider.

Question 6

For which problem are Kegel exercises recommended?&#10;A) Cyst&#10;B) Fistula&#10;C) Cystocele&#10;D) Rectocele

Accepted Answer

Kegel exercises,alternately tightening and relaxing the pelvic floor muscles,can strengthen muscles sufficiently to support the bladder and reduce the discomfort that accompanies a cystocele.They are not used for treatment for a cyst or fistula.A rectocele,another type of pelvic organ prolapse,is managed by promoting bowel elimination.

Question 7

A client had a uterine artery embolization and has just returned to the nursing unit.She is asking when she can get up to go to the bathroom.Which question does the nurse ask during hand-off report?&#10;A) &#34;Was a vascular closure device used?&#34;&#10;B) &#34;What was her estimated blood loss?&#34;&#10;C) &#34;Is there an order for a catheter?&#34;&#10;D) &#34;When was the client's last sedation?&#34;

Accepted Answer

If a vascular closure device was used after the procedure,the client can get up in about 2 hours.If a closure device was not used,the client needs to be on bedrest for 4 hours.Although all questions are important during hand-off report,the question specific for activity restrictions is the one that asks about the vascular closure device.

Question 8

A client has undergone cryosurgery for stage I cervical cancer.Which precaution or action does the nurse teach this client?&#10;A) &#34;Use sanitary napkins to manage discharge for the next several weeks.&#34;&#10;B) &#34;Avoid sexual intercourse or becoming pregnant for the next 12 months.&#34;&#10;C) &#34;If you should become pregnant, you will be at increased risk for preterm labor.&#34;&#10;D) &#34;Your next menstrual cycle will be delayed because of this procedure.&#34;

Accepted Answer

The effects of cryosurgery include a heavy,watery vaginal discharge for 3 to 6 weeks after the procedure.Clients are cautioned to avoid the use of tampons and intercourse during this time to reduce the risk for infection.The other statements are inaccurate.

Question 9

Which intervention is essential for the nurse to perform for a client who had a total abdominal hysterectomy?&#10;A) Instruct the client on a low-fat diet.&#10;B) Monitor for the onset of menopause.&#10;C) Assess for problems with intercourse.&#10;D) Teach exercises to prevent incontinence.

Accepted Answer

A hysterectomy and the accompanying menopause can lead to vaginal changes.Pain or difficulty with intercourse can occur,and the client should be reassured that gentle dilation will overcome this problem.Sexuality concerns should always be assessed in clients,particularly after they undergo procedures that can alter sexuality.The client would not necessarily need a low-fat diet,and the onset of menopause occurs with surgery.The client will not necessarily have incontinence.

Question 10

A 48-year-old woman reports to the nurse about new &#34;flooding&#34; with her periods.Which other complaint is the nurse prepared to investigate more thoroughly?&#10;A) Hot flashes and sweating episodes&#10;B) Fatigue during typical activity&#10;C) More frequent periods than usual&#10;D) Abdominal cramping with periods

Accepted Answer

A description of "flooding" during the menstrual cycle indicates heavy bleeding,which may be due to dysfunctional uterine bleeding (DUB).DUB usually occurs at the beginning or at the end of a woman's reproductive years.Because this woman is 48,she might be entering the perimenopausal period.Fatigue during usual activities can indicate anemia.Hot flashes with sweating are a manifestation of menopause.More frequent menstrual bleeding also occurs in DUB.Abdominal cramping may be normal for this client.

Question 11

Which symptom experienced by a woman in her 20s alerts the nurse to the possibility of endometriosis?&#10;A) Bleeding between periods&#10;B) Cessation of menstruation&#10;C) Premenstrual tension headache&#10;D) Pain before the onset of menstrual flow

Accepted Answer

The answer of Which symptom experienced by a woman in...

Question 12

A young woman calls the clinic to report a fever and a funny rash with peeling skin on the palms of her hands and the soles of her feet.Which action by the nurse is most appropriate?&#10;A) Make an appointment for her to be seen the next day at the clinic.&#10;B) Instruct her to take warm baths with oatmeal added to the water.&#10;C) Tell her to go to the emergency department immediately.&#10;D) Have her take acetaminophen (Tylenol) every 4 hours and drink fluids.

Accepted Answer

The answer of A young woman calls the clinic to...

Question 13

A woman reports cyclical abdominal pain,and her pelvic examination reveals tender nodules in the posterior vagina.The nurse plans to educate the woman about which treatment?&#10;A) Medroxyprogesterone (Depo-Provera)&#10;B) Radiation therapy&#10;C) Doxycycline (Vibramycin)&#10;D) Endometrial ablation

Accepted Answer

The answer of A woman reports cyclical abdominal pain,and her...

Question 14

A woman is receiving radiation via brachytherapy for endometrial cancer.Which statement by the woman indicates a need for further education about the procedure?&#10;A) &#34;I can go about my usual activities between sessions.&#34;&#10;B) &#34;I might experience more fatigue than usual during therapy.&#34;&#10;C) &#34;I should report any fever over 100 degrees to my doctor.&#34;&#10;D) &#34;I must stay away from my young grandchildren for 6 weeks.&#34;

Accepted Answer

The answer of A woman is receiving radiation via brachytherapy...

Question 15

A client is in the clinic reporting stress incontinence.Which other assessment is the priority for the nurse to perform?&#10;A) Ask the client about vaginal discharge or bleeding.&#10;B) Have the client perform a 24-hour fluid recall.&#10;C) Inquire about fever, chills, and burning on urination.&#10;D) Obtain the client's reproductive history.

Accepted Answer

The answer of A client is in the clinic reporting...

Question 16

A client with pelvic organ prolapse has chosen treatment with a vaginal mesh.Which action by the nurse before the procedure is most important?&#10;A) Administering the preoperative sedative medication&#10;B) Giving the woman the manufacturer's labeling information&#10;C) Ensuring that the woman has a ride home after she recovers&#10;D) Witnessing the client signature on the informed consent

Accepted Answer

The answer of A client with pelvic organ prolapse has...

Question 17

Why are the death rates from ovarian cancer so high?&#10;A) The causative oncovirus is resistant to chemotherapy and to radiation.&#10;B) No symptoms are obvious during the early stages of this disorder.&#10;C) Radiation therapy is ineffective because the ovaries are located deep in the pelvis.&#10;D) Ovarian cancer occurs mostly in women over the age of 70 who have other health problems.

Accepted Answer

The answer of Why are the death rates from ovarian...

Question 18

A client had a posterior colporrhaphy.Which statement by the client indicates an adequate understanding of discharge instructions?&#10;A) &#34;I'll eat a high-fiber diet so I won't get constipated again.&#34;&#10;B) &#34;I'll expect my periods to decrease within the next 6 months.&#34;&#10;C) &#34;I'll need to eat a low-residue diet.&#34;&#10;D) &#34;I'll call the surgeon if I saturate more than one pad in 4 hours.&#34;

Accepted Answer

The answer of A client had a posterior colporrhaphy.Which statement...

Question 19

Which action does the nurse teach the client to prevent toxic shock syndrome?&#10;A) &#34;Use a barrier method of contraception.&#34;&#10;B) &#34;Wash your hands before inserting a tampon.&#34;&#10;C) &#34;Avoid intercourse with more than one partner.&#34;&#10;D) &#34;Empty your bladder immediately after intercourse.&#34;

Accepted Answer

The answer of Which action does the nurse teach the...

Question 20

Which clinical manifestation in a client with invasive cervical cancer alerts the nurse to the possibility of metastasis?&#10;A) Amenorrhea&#10;B) Weight gain&#10;C) Breast tenderness&#10;D) Swelling of one leg

Accepted Answer

The answer of Which clinical manifestation in a client with...

Question 21

A client is scheduled to have a hysteroscopic myomectomy.Which statement by the client indicates that she understands the procedure?&#10;A) &#34;I will need to deliver future children by cesarean section.&#34;&#10;B) &#34;I need to schedule this during the last part of my cycle.&#34;&#10;C) &#34;My uterus will be removed through tiny incisions.&#34;&#10;D) &#34;This operation will make me infertile.&#34;

Accepted Answer

The answer of A client is scheduled to have a...

Question 22

A client is crying because her endometrial cancer is scheduled to be treated with chemotherapy agents that will cause hair loss.Which is the most appropriate response from the nurse?&#10;A) &#34;You should prepare yourself for total hair loss all over your body.&#34;&#10;B) &#34;You can start shopping for wigs and scarves now so you'll have them available.&#34;&#10;C) &#34;Why not shave your hair off now so that you can have it made into a wig?&#34;&#10;D) &#34;Would you like me to put you in touch with a former client so that you can talk?&#34;

Accepted Answer

The answer of A client is crying because her endometrial...

Question 23

The client has been diagnosed with possible vulvovaginitis pending the outcome of laboratory tests.What information does the nurse teach the client?&#10;A) &#34;Use sanitary pads, not tampons, when you have your period.&#34;&#10;B) &#34;Limit douching to once a month or so, after your period.&#34;&#10;C) &#34;Scrub your vulvar area with antibacterial soap when you bathe.&#34;&#10;D) &#34;Wear only cotton underwear and wear looser jeans or slacks.&#34;

Accepted Answer

The answer of The client has been diagnosed with possible...

Question 24

A client has recently undergone an anterior colporrhaphy.Which is the most important discharge instruction that the nurse can provide?&#10;A) &#34;Avoid sexual intercourse for 2 weeks.&#34;&#10;B) &#34;Call us for fever and pain that does not improve.&#34;&#10;C) &#34;Sutures will need to be removed in 2 weeks.&#34;&#10;D) &#34;An ice pack on your incision will help the pain.&#34;

Accepted Answer

The answer of A client has recently undergone an anterior...

Question 25

The nurse is teaching a woman's group about gynecologic cancers.Which does the nurse teach are risk factors?&#10;A) Nulliparity&#10;B) Multiple sex partners&#10;C) Obesity&#10;D) Smoking&#10;E) Delayed first intercourse

Accepted Answer

The answer of The nurse is teaching a woman's group...

Question 26

A woman has been told she has cervical polyps.Which statement by the client indicates a good understanding of the teaching the nurse provided?&#10;A) &#34;I hope my polyp doesn't turn cancerous like colon polyps can.&#34;&#10;B) &#34;These can be removed easily in the doctor's office with little pain.&#34;&#10;C) &#34;I will need to have more frequent screening for cervical cancer.&#34;&#10;D) &#34;I will need to finish all my medication before having sex again.&#34;

Accepted Answer

The answer of A woman has been told she has...

Question 27

A client is recovering from a hysteroscopic myomectomy.The nurse assesses the client and finds the following: 2+ bilateral pedal edema; pulse,108 beats/min; and respiratory rate,28 breaths/min.Which action by the nurse takes priority?

A) Assess lung sounds and oxygen saturation.
B) Call for an immediate electrocardiogram (ECG).
C) Notify the health care provider as soon as possible.
D) Review the client's intake and output pattern.

Accepted Answer

The answer of A client is recovering from a hysteroscopic...

Question 28

A woman had returned to the nursing unit after a total abdominal hysterectomy.After settling the client and performing a thorough assessment including vital signs,which action by the nurse is most important?

A) Consult with physical therapy about ambulating the client.
B) Obtain and apply sequential compression devices.
C) Order the client's next-day chest x-ray and laboratory work.
D) Assist the client to order light food items for dinner.

Accepted Answer

The answer of A woman had returned to the nursing...

Question 29

A woman has had recurrent Bartholin cysts.Which intervention is most appropriate for the nurse to add to the client's care plan?&#10;A) Assess the woman for sexually transmitted diseases (STDs).&#10;B) Prepare a family diagram to investigate a familial pattern.&#10;C) Teach the woman about surgical marsupialization.&#10;D) Instruct the woman to wear only cotton underwear.

Accepted Answer

The answer of A woman has had recurrent Bartholin cysts.Which...

Deck 74: Care of Patients With Gynecologic Problems