Question 1

Which medication does the Public Health Agency of Canada recommend for the treatment of patients with human papillomavirus (HPV)?

Accepted Answer

Available treatments are imiquimod,podophyllin,and podofilox.Miconazole ointment is used to treat athlete's foot.Penicillin IM is used to treat syphilis.Metronidazole is used to treat bacterial vaginosis.

Question 2

What should the nurse be aware of with regard to abnormal uterine bleeding (AUB)?

Accepted Answer

Inherited bleeding disorders may be an underlying cause of abnormal uterine bleeding,with von Willebrand's disease present in the majority of cases,and should be considered when other causes cannot be determined.AUB can occur at any age.Acute bleeding episodes do not automatically require a dilation and curettage.The most effective medical treatment is oral or intravenous estrogen,not steroids.

Question 3

Which statement is accurate?

Accepted Answer

PMDD is a more severe variant of PMS.PMS may manifest itself with one or more of many physical,mood,and behavioural symptoms and is poorly understood.Secondary dysmenorrhea is characterized by more muted pain than that seen in primary dysmenorrhea;the medical treatment is much the same.The cause of PMS is unknown.It may be a collection of different problems.

Question 4

During her annual gynecological checkup,a woman states that recently she has been experiencing cramping and pain during her menstrual periods.The nurse would use which term to document this complaint?

Accepted Answer

Dysmenorrhea is pain during or shortly before menstruation.Amenorrhea is the absence of menstrual flow.Dyspareunia is pain during intercourse.PMS is a cluster of physical,psychological,and behavioural symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses.

Question 5

Which refers to an alteration in cyclic bleeding that occurs between periods of menstruation?

Accepted Answer

Metrorrhagia is bleeding between periods.It can be caused by progestin injections and implants.Oligomenorrhea is infrequent or scanty menstruation.Menorrhagia is excessive menstruation.Leiomyoma is a common cause of excessive bleeding.

Question 6

A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years.She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months.What are these symptoms most likely related to?

Accepted Answer

Symptoms of endometriosis can change over time and may not reflect the extent of the disease.Major symptoms include dysmenorrhea and deep pelvic dyspareunia (painful intercourse).Impaired fertility may result from adhesions caused by endometriosis.Although endometriosis may be associated with secondary dysmenorrhea,it is not a cause of primary dysmenorrhea or PMS.In addition,this woman is complaining of dyspareunia and infertility,which are associated with endometriosis,not with PMS or primary or secondary dysmenorrhea.

Question 7

When evaluating a patient whose primary complaint is secondary amenorrhea,the nurse must be aware that lack of menstruation is most often the result of which event?

Accepted Answer

Secondary amenorrhea,or the absence of menstrual flow,is most often a result of pregnancy.Although stress,excessive exercise,and eating disorders all may be contributing factors,none is the most common factor associated with amenorrhea.

Question 8

What is the viral sexually transmitted infection (STI)that affects most people in Canada today?

Accepted Answer

HPV infection,an STI,is the most prevalent viral STI seen in ambulatory health care settings.HSV-2,HIV,and CMV are all viral STIs,but are not the most prevalent viral STI.

Question 9

Nafarelin (Synarel)200 mg BID per nasal spray currently is used as a treatment for mild-to-severe endometriosis.What patient teaching should the nurse tell the woman who is taking this medication?

Accepted Answer

Nafarelin is a GnRH agonist,and its adverse effects are similar to those of menopause.The hypoestrogenism effect results in hot flashes and vaginal dryness.Nafarelin is a GnRH agonist that suppresses the secretion of GnRH and is administered twice daily by nasal spray.

Question 10

While interviewing a 31-year-old woman before her routine gynecological examination,the nurse collects data about the patient's recent menstrual cycles.The nurse should collect additional information when the woman makes which statement?

Accepted Answer

Menorrhagia is defined as excessive menstrual bleeding,in either duration or amount.Heavy bleeding can have many causes.The amount of bleeding and its effect on daily activities should be evaluated.A menstrual flow lasting 5 to 6 days is a normal finding.Mittelschmerz,a small amount of bleeding or spotting that occurs at the time of ovulation (14 days before onset of the next menses),is considered normal.During her reproductive years,a woman may have physiological variations in her menstrual cycle.Variations in the length of a menstrual cycle are considered normal.

Question 11

What symptom described by a woman is characteristic of premenstrual syndrome (PMS)?

Accepted Answer

PMS is a cluster of physical,psychological,and behavioural symptoms that begin in the luteal phase of the menstrual cycle and coincide with menses.Complaints of lower abdominal pain,nausea and headaches,and abdominal bloating are all associated with PMS;however,the timing reflected is inaccurate.

Question 12

Management of primary dysmenorrhea often requires a multifaceted approach.What is the optimal pharmacological therapy for pain relief for dysmenorrhea?

Accepted Answer

This pharmacological agent has the strongest research results for pain relief.Often if one NSAID is not effective,another one will provide relief.Approximately 80% of women find relief from these prostaglandin inhibitors.Preparations containing acetaminophen are less effective for dysmenorrhea because they lack the antiprostaglandin properties of NSAIDs.OCPs are a reasonable choice for women who also want birth control.The benefit of OCPs is the reduction of menstrual flow and irregularities.OCPs may be contraindicated for some women and have a number of potential adverse effects.NSAIDs are the drug of choice.If a woman is taking an NSAID,she should avoid taking aspirin.

Question 13

Nurses should be aware of which in relation to endometriosis?

Accepted Answer

Symptoms vary among women,ranging from nonexistent to incapacitating.With endometriosis the endometrial tissue is outside the uterus.Endometriosis is found equally in women from all cultures.Women can experience painful intercourse and impaired fertility.

Question 14

Nurses should be aware that which is true with regard to dysmenorrhea?

Accepted Answer

Pain is described as sharp and cramping or sometimes as a dull ache.It may radiate to the lower back or upper thighs.Dysmenorrhea is more common in younger women ages 17 to 24 and in women who smoke and who are obese.Symptoms begin with menstruation or sometimes a few hours before the onset of flow.

Question 15

What are the two primary areas of risk for sexually transmitted infections (STIs)?

Accepted Answer

Risky sexual behaviours and inadequate preventive health behaviours put a person at risk for acquiring or transmitting an STI.Low socioeconomic status may be a factor in being less able to purchase barrier protection,and sexual orientation does not put one at higher risk.Younger individuals with less education may not be aware of proper prevention techniques: however,these are not the primary areas of risk for STIs.Having a large number of sexual partners is certainly a risk-taking behaviour.Being of a certain race does not increase the risk for STIs.

Question 16

A woman has a thick,white,lumpy,cottage cheese-like discharge,with patches on her labia and in her vagina.She complains of intense pruritus.The nurse would anticipate which preparation for treatment?

Accepted Answer

Fluconazole,metronidazole,and clotrimazole are the drugs of choice to treat candidiasis.Tetracycline is used to treat syphilis.Clindamycin is used to treat bacterial vaginosis.Acyclovir is used to treat genital herpes.

Question 17

When a nurse is counselling a woman for primary dysmenorrhea,which nonpharmacological intervention might be recommended?

Accepted Answer

Heat minimizes cramping by increasing vasodilation and muscle relaxation and minimizing uterine ischemia.Dietary changes such as eating less red meat may be recommended for women experiencing dysmenorrhea.Increasing the intake of diuretics,including natural diuretics such as asparagus,cranberry juice,peaches,parsley,and watermelon,may help ease the symptoms associated with dysmenorrhea.Exercise has been found to help relieve menstrual discomfort through increased vasodilation and subsequent decreased ischemia.

Question 18

When planning care for a woman who has been diagnosed as having uterine fibroids,what is important for the nurse to know?

Accepted Answer

Uterine fibroids are a common cause of menorrhagia.Fibroids are benign tumours of the smooth muscle of the uterus,and their etiology is unknown.Fibroids are estrogen sensitive and shrink as levels of estrogen decline.Fibroids occur in 25% of women of reproductive age and are seen in 2% of pregnant women.

Question 19

When assessing the patient for amenorrhea,the nurse should be aware that which may cause amenorrhea?

Accepted Answer

Type 1 diabetes may cause amenorrhea.Lack of exercise does not cause amenorrhea.It is the use of oral contraception that may cause amenorrhea.Alcohol use does not cause amenorrhea.

Question 20

When evaluating a patient for sexually transmitted infections (STIs),the nurse should be aware that which STI is on the rise in Canada?

Accepted Answer

Chlamydia is the one of the three STIs on the rise in Canada;the other two are gonorrhea and syphilis.Candidiasis is caused by a fungus,not by bacteria.Chancroid is not on the rise in Canada.HSV type 2 is common in women;however,it is not cited as one of the three STIs that are on the increase in Canada.

Quiz 7: Reproductive Health

Which medication does the Public Health Agency of Canada recommend for the treatment of patients with human papillomavirus (HPV) ?

What should the nurse be aware of with regard to abnormal uterine bleeding (AUB) ?