Deck 56: Nursing Management Female Reproductive Problems

Question 1

The nurse is caring for a client who has an induced abortion with suction curettage at an ambulatory surgical centre. Which of the following instructions should the nurse include when discharging the client?

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."

Answer 1

"You should abstain from sexual intercourse for 2 weeks."

Question 2

The nurse is caring for a client who has been hospitalized with endometriosis. Which of the following medications should the nurse anticipate preparing for the client?

A)Ganirelix
B)Cetrorelix
C)hCG
D)Nafarelin

Answer 2

Nafarelin

Question 3

A client who is 58-years-old calls the health clinic and tells the nurse that she has a moderate amount of vaginal bleeding after 6 years of menopause. Which of the following procedures should the nurse will anticipate teaching the client about?

A)Endometrial biopsy
B)Uterine balloon therapy
C)Laser endometrial ablation
D)Dilation and curettage (D&C)

Answer 3

Endometrial biopsy

Question 4

The nurse is teaching a client about ways to prevent primary dysmenorrhea. Which of the following information should the nurse provide to the client?

A)Avoid aerobic exercise during her menstrual period.
B)Use cold packs on the abdomen and back for pain relief.
C)Talk with health care provider about antidepressant therapy.
D)Start taking nonsteroidal anti-inflammatory drugs (NSAIDs) regularly when menstrual period starts.

Question 5

A client is diagnosed with vaginal candidiasis and an antifungal vaginal cream is prescribed. Which of the following client statements indicate 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."

Question 6

Aclient is scheduled for an induced abortion using methotrexate with misoprostol. Before the procedure, which of the following information should the nurse discuss with the client?

A)Several trips to the health care provider will be required.
B)There is a possibility that the client may deliver a live fetus.
C)The client will require a general anaesthetic for the procedure.
D)The procedure may be unsuccessful in terminating the pregnancy.

Question 7

A client who is scheduled for a Pap test tells the nurse that she has had intercourse during the last year with several men. Which of the following information should the nurse teach to the client?

A)Contraceptive use
B)Antibiotic therapy
C)Chlamydia testing
D)Pregnancy testing

Question 8

The nurse is caring for a client recently diagnosed with polycystic ovary syndrome. Which of the following information is most important for the nurse to teach the client?

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 9

Aclient who is trying to become pregnant asks the nurse about ways to determine when she is most likely to conceive. Which of the following information is the basis of the nurses' response?

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 10

Which of the following information should the nurse include when teaching a 51-year-old female client who is considering the use of combined estrogen-progesterone hormone therapy (HT) during menopause?

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

Question 11

Acouple 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 of the following nursing diagnoses is appropriate?

A)Decisional conflict related to insufficient support system (financial resources)
B)Ineffective sexuality pattern related to impaired relationship with significant other
C)Defensive coping related to uncertainty (lack of conception)
D)Ineffective denial related to insufficient sense of control (continued infertility)

Question 12

The nurse is admitting a client with increasing abdominal pain who is diagnosed with an ectopic pregnancy. The client begins to cry and asks the nurse to leave her alone to grieve. Which of the following actions should the nurse take next?

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

Question 13

The nurse is caring for a client who tells the nurse that she has noticed increasing headaches with dizziness, abdominal bloating, and unexplained anxiety occurring before her menstrual periods. Which of the following actions is best for the nurse to take at this time?

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

Question 14

A33-year-old female client who uses oral contraceptives tells the nurse, "I want to have children in a few years." Which of the following responses by the nurse is best?

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 15

The nurse is caring for an older-adult client who is recently diagnosed with stage III ovarian cancer. Which of the following nursing diagnoses is best for this client?

A)Sexual dysfunction related to insufficient knowledge about sexual function (loss of vaginal sensation)
B)Risk for infection as evidenced by immunosuppression
C)Situational low self-esteem related to unrealistic self-expectations
D)Anxiety related to threat to current status (cancer diagnosis and need to make treatment decisions)

Question 16

The nurse is caring for a client with pelvic inflammatory disease (PID) requiring hospitalization. Which of the following nursing interventions should be included in the plan of care?

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

Question 17

The nurse is counselling a couple who are interested in intrauterine insemination (IUI) with sperm from a donor and ask the nurse how long the procedure will take. Which of the following time frames is the basis for the nurses' response?

A)About 1 hour
B)2-4 hours
C)At least a full day
D)2-3 days

Question 18

A client with pelvic inflammatory disease (PID) is treated on an outpatient basis with oral antibiotics. Which of the following instructions should be included in client 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 anti-inflammatory drug (NSAID) use may prevent scarring of pelvic organs.

Question 19

The nurse is caring for a client with endometriosis who is treated with medroxyprogesterone. Which of the following information related to this therapy should the nurse explain to the client?

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 20

A client who is 45 years of age tells the nurse that she has not had a menstrual period for 3 months and asks whether she is going into menopause. Which of the following responses is best by the nurse?

A)"Have you thought about using hormone 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 21

The nurse is caring for a client who has been diagnosed with human papilloma virus (HPV) infection and who smokes cigarettes, uses oral contraceptives, and has a history of candidiasis. Which of the following topics should the nurse include in the teachingplan?

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

Question 22

Which of the following statements by a client 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 23

The nurse is caring for a female client in the health clinic who is diagnosed with genital warts. Which of the following information should the nurse include in the teaching plan?

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 24

Which of the following assessment findings in a client who is taking premarin is most important for the nurse to report to the health care provider?

A)Breast tenderness
B)Weight gain of 1.4 kg
C)Intermittent spotting
D)Unilateral calf swelling

Question 25

The nurse is caring for a client who has a large cystocele and has not voided since admission 8 hours previously. Which of the following actions should the nurse take first?

A)Insert a straight catheter per the PRN order.
B)Encourage the client to increase oral fluids.
C)Notify the health care provider of the inability to void.
D)Assess for urinary retention.

Question 26

A client tells the nurse that she needs something to control the negative mood associated with premenstrual dysphoric disorder (PMDD). Which of the following medications should the nurse anticipate administering to the client?

A)Potassium supplement
B)Vitamin B?
C)Folic acid
D)Ibuprofen

Question 27

A client tells the nurse that she is postmenopausal but has occasional spotting. Which of the following responses should the nurse make initially?

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 therapy?"

Question 28

The nurse is admitting a client with multiple uterine leiomyomas for an abdominal hysterectomy. Which of the following topics should the nurse include in client 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 29

The nurse is caring for a client who has a radium implant for treatment of cancer of the cervix. Which of the following actions should the nurse implement?

A)Maintain the client on complete bed rest.
B)Use gloves when changing the client's bed.
C)Allow extra time for client discussion of concerns.
D)Flush the toilet several times after the client voids.

Question 30

The nurse is planning an educational session at a local community centre related to health promotion during menopause. Which of the following information should the nurse include related to management of hot flashes?

A)Limit daily calcium intake
B)Vitamin E daily supplement
C)Have a glass of wine before bedtime
D)Daily rigorous exercise in the evening

Question 31

The nurse is conducting a health history on a client who is pregnant and wants to know if she is too far along in her pregnancy to use drug therapy to induce a medical abortion. Which of the following time frames for the use of drug therapy to induce abortionis the basis of the nurse'response?

A)14 days gestation
B)35 days gestation
C)49 days gestation
D)90 days gestation

Question 32

A 32-year-old client has minor changes on her Pap test. Which of the following actions should the nurse take?

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

Question 33

The nurse is assessing a client who is on the surgical unit after a radical abdominal hysterectomy. Which of the following findings 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)Symptom of pain at the incision site with coughing

Question 34

The nurse is caring for a client who had an anterior and posterior (A&P) colporrhaphy for repair of a cystocele and rectocele. Which of the following nursing actions should be included in the postoperative care plan?

A)Teach the client correct pessary use.
B)Perform in-dwelling catheter care daily.
C)Repack the vaginal wound daily with gauze.
D)Provide client teaching about a high fibre diet.

Question 35

An 18-year-old visits the health clinic for a routine check-up. To determine whether a Pap test is needed, which of the following questions 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 36

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

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

Question 37

Which of the following information about a client indicates that the nurse will need to teach the client about endometrial biopsy?

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

Question 38

The nurse is caring for a client who has undergone a radical vulvectomy for vulvar carcinoma. Which of the following nursing diagnoses is priority at this time?

A)Bathing self-care deficit related to pain
B)Risk for infection as evidenced by invasive procedure (contamination of the wound with urine and stool)
C)Imbalanced nutrition: less than body requirements related to insufficient dietary intake
D)Risk for ineffective sexual pattern as evidenced by impaired relationship with significant other (disfiguration caused by the surgery)

Question 39

The nurse is caring for a client who is diagnosed with stage 0 cervical cancer using a punch biopsy. Which of the following treatments should the nurse include in the teaching plan?

A)Radiation
B)Conization
C)Chemotherapy
D)Radial hysterectomy

Question 40

Which of the following information should the nurse include when developing a client teaching plan for a client who is premenopausal with symptoms of uterine bleeding caused by a leiomyoma?

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

Question 41

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

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

Question 42

The nurse is counselling a healthy perimenopausal woman who prefers not to use hormone therapy (HT). Which of the following treatment options should the nurse discuss with the client? (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.