Deck 6: Common Gynecologic Problems

Question 1

A client diagnosed with polycystic ovarian disease (PCOS) asks why spironolactone (Aldactone) has been prescribed. How should the nurse respond?
1) "Spironolactone is often used to reduce complications associated with PCOS, including rectocele."
2) "Menstrual irregularities related to polycystic ovarian disease are treated using spironolactone."
3) "Condylomata acuminata, which are sometimes caused by polycystic ovarian disease, are treated with spironolactone."
4) "Spironolactone may be used to decrease symptoms associated with PCOS, such as excessive hair growth and acne."

Answer 1

4

Question 2

A client who has been unable to conceive asks the nurse if it is her fault or her husband's fault that they have not been able to become pregnant. What is the nurse's best response?
1) "The male infertility factors are more common than female."
2) "Female infertility issues are more common than male issues."
3) "The testing the doctor will order will determine who is at fault."
4) "We will know more about what is causing your infertility after some tests are done."

Answer 2

4

Question 3

Which diagnostic test should the nurse question if prescribed for a client with pelvic inflammatory disease (PID)?
1) RPR (rapid plasma reagin)
2) Throat culture for streptococcus A
3) Vaginal culture for Neisseria gonorrhoeae
4) CBC (complete blood count) with differential

Answer 3

2

Question 4

The nurse is explaining a client's abnormal Pap smear results. Which statement should the nurse include?
1) "Your cervix needs to be treated with cryotherapy."
2) "The Pap smear is used to diagnose cervical cancer."
3) "Colposcopy to further examine your cervix is the next step."
4) "A loop electrosurgical excision procedure (LEEP) is needed."

Question 5

The nurse is teaching a class to women who were recently diagnosed with benign breast disease (BBD), commonly known as fibrocystic breast disease. One of the participants reports increased swelling, pain, and pressure in her breasts just before menstruation. What is the best response by the nurse?
1) "It's best to make an appointment with an oncologist."
2) "The pain may be caused by thinning of the normal breast tissue."
3) "Consider asking your healthcare provider about adding a mild diuretic to your regimen."
4) "Breast swelling and pressure are expected symptoms, but pain is abnormal and should be evaluated by your physician."

Question 6

The nurse is creating a care plan for a client who is unable to conceive as a consequence of endometriosis. Which statement accurately reflects a nursing diagnosis that may apply to the care of this client?
1) Acute pain related to dysuria and renal pain secondary to endometriosis
2) Compromised family coping related to depression secondary to infertility
3) Infertility related to endometrial inflammation and adhesions secondary to endometriosis
4) Hyperandrogenism related to elevated serum androgen levels secondary to endometriosis

Question 7

Which statement indicates that client teaching about vaginal infections has been effective?
1) "The fishy vaginal odor I have is caused by a bacterial infection."
2) "I can use this antiyeast medication weekly to prevent another infection."
3) "My diabetes is unrelated to the frequency of my vaginal yeast infections."
4) "I should douche weekly to prevent a recurrence of my bacterial vaginosis."

Question 8

A client undergoing infertility treatment states that her partner is angry all of the time since beginning treatment and is very negative in comments made about the likelihood of their achieving pregnancy. The client states, "I was angry and depressed, but now I am dedicated to following through with treatment and hoping we get pregnant." What statements best describe the partner's behavior? Select all that apply.
1) Showing that he will not be a good parent
2) In a different stage of grief than the client
3) Feeling guilty about not being able to father a child
4) Having difficulty accepting the reality of their infertility
5) Exhibiting signs of the anger stage of grieving the loss of their dreams of having children

Question 9

A client calls his urologist's office to clarify instructions about semen analysis. What should the nurse instruct the client to do?
1) Use a lubricant while obtaining the semen specimen.
2) Remain abstinent for 3 days prior to collecting the specimen.
3) Immediately refrigerate the specimen for a maximum of 8 hours.
4) Deliver the specimen to the laboratory within 1 hour of collection.

Question 10

Which .client in the gynecology clinic should the nurse assess first?
1) 31-year-old, reports increasing dyspareunia
2) 15-year-old, no menses for past 4 months
3) 22-year-old, using tampons, T = 102°F, P = 122, BP = 70/55
4) 18-year-old seeking information on contraception methods

Question 11

The nurse is preparing an education session for women on prevention of urinary tract infections (UTIs). Which statement should be included?
1) Lower urinary tract infections rarely occur in women.
2) Back pain often develops with a lower urinary tract infection.
3) The most common causative organism of cystitis is Escherichia coli.
4) Wiping from back to front after a bowel movement will help prevent a UTI.

Question 12

The physician has prescribed metronidazole (Flagyl) for a woman diagnosed with trichomoniasis. What should the nurse include when teaching about this medication?
1) "It will turn your urine orange."
2) "This medication could produce drowsiness."
3) "Both partners must be treated with the medication."
4) "Alcohol does not need to be avoided while taking this medication."

Question 13

The nurse is preparing a brochure that compares and contrasts cystitis and pyelonephritis. Which information should be included in the brochure?
1) Urine culture is included in the evaluation of both cystitis and pyelonephritis.
2) Dysuria, especially at the end of urination, is often the initial symptom of both conditions.
3) Both conditions usually present with sudden onset of chills, high temperature, and flank pain.
4) Both conditions are associated with pregnancy complications including increased risk of preterm birth and of intrauterine growth restriction.

Question 14

The nurse reviews the consequences of not treating a chlamydial infection with a young couple. Which statements indicate that teaching has been effective? Select all that apply.
1) "She could become pregnant."
2) "It could cause us to develop rashes."
3) "She could have severe vaginal itching."
4) "She could develop a worse infection of the uterus and tubes."
5) "He could get an infection in the tube that carries the urine out."

Question 15

The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statements indicate that teaching was effective? Select all that apply.
1) "Tubal pregnancy could occur after PID."
2) "My PID was caused by a yeast infection."
3) "It is important for me to finish my antibiotics."
4) "I might have infertility because of this infection."
5) "I am going to have an IUD placed for contraception."

Question 16

A 31-year-old woman with normal ovaries, a normal prolactin level, and an intact pituitary gland is undergoing initial pharmacologic treatment of anovulation. Which medication should the nurse anticipate being prescribed for this client?
1) Bromocriptine (Parlodel)
2) Metformin (Glucophage)
3) Clomiphene citrate (Clomid or Serophene)
4) Human menopausal gonadotropins (hMGs)

Question 17

Which client is at greatest risk for developing Chlamydia trachomatis infection?
1) 35-year-old woman on oral contraceptives
2) 22-year-old mother of two, developed dyspareunia
3) 16-year-old, sexually active, using no contraceptive
4) 48-year-old woman with hot flashes and night sweats

Question 18

The nurse is caring for a client diagnosed with endometriosis. Which statement by the client requires immediate follow-up?
1) "I've noticed my voice is lower since I started taking danazol."
2) "I am having many hot flashes since I had the Lupron injection."
3) "The pain I experience with intercourse is becoming more severe."
4) "My leg has become painful and swollen since I started taking birth control pills."

Question 19

The nurse is planning a group session for parents who are beginning infertility evaluation. Which statements should be included in this session? Select all that apply.
1) "Infertility can be stressful for a marriage."
2) "Taking a vacation usually results in pregnancy."
3) "Your insurance will pay for the infertility treatments."
4) "The doctor will be able to tell why you have not conceived."
5) "Keep communicating with one another through this process."

Question 20

Which client should be treated with ceftriaxone (Rocephin) IM and doxycycline (Vibramycin) by mouth?
1) A pregnant client with syphilis
2) A nonpregnant client with gonorrhea and chlamydial infection
3) A pregnant client with gonorrhea and a yeast infection
4) A nonpregnant client with chlamydial infection and trichomoniasis

Question 21

A female client with infertility is suspected as having a problem with patent fallopian tubes and ovum motility. For which health problems should the nurse expect that this client will be evaluated? Select all that apply.
1) Endometriosis
2) Cervical stenosis
3) Ectopic pregnancy
4) Peritubal adhesions
5) Pelvic inflammatory disease

Question 22

The nurse manager is interviewing nurses for a position in an infertility clinic. Which statement best indicates that the interviewee understands the role of the nurse when working with infertile clients?
1) "This position is an assistant to the physician during diagnostic testing for infertility."
2) "My job will be teaching clients how to take their medications and scheduling tests."
3) "I will both teach and support families struggling with emotions as they attempt to become pregnant."
4) "Many of my duties will involve forming therapeutic relationships with clients struggling with infertility."

Question 23

A client asks about the difference between an abdominal hysterectomy and a laparoscopic-assisted vaginal hysterectomy (LAVH). What should the nurse explain to this client? Select all that apply.
1) Recovery will be quicker with an abdominal hysterectomy.
2) The results are nearly the same between the two surgical approaches.
3) An abdominal hysterectomy is indicated for uterine bleeding and small fibroids.
4) Hospitalization will be longer with a laparoscopic-assisted vaginal hysterectomy.
5) A laparoscopic-assisted vaginal hysterectomy does not have an abdominal incision.

Question 24

During an assessment the nurse suspects that a client is at risk for developing a cystocele. What findings did the nurse use to come to this conclusion? Select all that apply.
1) Age 68
2) Body mass index (BMI) 32
3) Pregnant seven times
4) History of diabetes
5) Takes hormone replacement therapy

Question 25

The nurse learns that a client is being considered for a total abdominal hysterectomy. Which health problem should the nurse suspect this client is experiencing? Select all that apply.
1) Small fibroids
2) Ovarian cancer
3) Cervical cancer
4) Pelvic relaxation
5) Abnormal uterine bleeding

Question 26

A client is diagnosed with a uterine prolapse. Which treatments should the nurse prepare to discuss with this client? Select all that apply.
1) Hysterectomy
2) Kegel exercises
3) Vaginal pessary
4) Topical estrogen
5) Systemic estrogen