Question 1

The nurse at a family practice clinic is providing care to a 47-year-old obese patient. The patient states that she realizes that she has put on extra weight but is reluctant to go to any exercise classes. She states that she often has to cross her legs when she sneezes and cannot do any exercises with her legs crossed. The health care provider has prescribed tolterodine (Detrol). What is the rationale for this medication?

Accepted Answer

Tolterodine (Detrol) is a medication used to treat overactive bladder syndrome. It works by blocking the nerve impulses that stimulate the bladder to contract. This medication can help decrease urinary frequency, urgency, and urge incontinence. It is not used for weight loss or to improve blood flow to the pelvic muscles.

Question 2

The nurse is assessing a 42-year-old patient who presents to the gynecology office with complaints of pelvic pressure, backaches, menorrhagia, and urinary frequency. The health care provider has diagnosed the patient with leiomyoma of the uterus. What are the treatment options for this condition? Select all that apply.

Accepted Answer

Routine pelvic examinations help monitor the condition. Myomectomy is a surgical option for women who wish to preserve fertility. Hysterectomy is a definitive treatment for those who do not desire future pregnancies.

Question 3

The nurse is preparing to teach the community about risk factors for the second most common cancer of the female reproductive system. Which of the following groups of women are at higher risk for this cancer? Select all that apply.

Accepted Answer

A,B,E

Question 4

The nurse is educating a 24-year-old female patient who was newly diagnosed with polycystic ovary syndrome (PCOS). The patient was prescribed an antidiabetic medication. Which medication effects should the nurse educate the patient about? Select all that apply.

Accepted Answer

The answer of The nurse is educating a 24-year-old female...

Question 5

The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?

Accepted Answer

This condition is often associated with use of oral contraceptives and may subside upon discontinuation.

Question 6

The nurse is providing preoperative education on the laparoscope-assisted vaginal hysterectomy. Which statement by the patient verifies understanding of the procedure?

Accepted Answer

Laparoscope-assisted vaginal hysterectomy may result in light vaginal bleeding for several days, which is a normal part of the recovery process.

Question 7

The telephone triage nurse receives a call from a patient who is 5 days postoperative total abdominal hysterectomy. The patient states that her pain is not relieved with the medications and that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the emergency department. What does the nurse suspect as the surgical complication?

Accepted Answer

The presence of blood in the urine suggests a possible injury to the urinary tract, such as the ureters or bladder. This is a serious surgical complication and requires immediate medical attention in the emergency department. Possible complications related to anesthesia, hemorrhage from the internal incision, or peritoneal venous thromboembolism cannot be ruled out but are not supported by the symptoms reported by the patient.

Question 8

The nurse is assessing a 16-year-old sexually active patient in the family practice clinic. The patient's symptoms include breakthrough vaginal bleeding, abdominal pain, nausea, and fever. The health care provider obtains cultures of the cervical epithelial cells during a Pap smear and orders doxycycline 100 mg orally twice a day for 7 days for her and her partner. The nurse understands that this prescription is consistent with the treatment of which medical diagnosis?

Accepted Answer

The symptoms, breakthrough vaginal bleeding, abdominal pain, nausea, and fever, are consistent with a diagnosis of chlamydia. The cervical epithelial cell cultures obtained during the Pap smear can confirm the diagnosis. The prescription of doxycycline 100 mg orally twice a day for 7 days for the patient and her partner is consistent with the treatment for chlamydia. Herpes and condylomas do not typically present with these symptoms and require different treatment modalities. Gonorrhea may present with similar symptoms but typically requires a different medication for treatment.

Question 9

The nurse is providing postoperative care to a patient who underwent a total abdominal hysterectomy 12 hours ago. Which of the following are appropriate nursing interventions? Select all that apply.

Accepted Answer

A) Assisting the patient with ambulation promotes circulation, prevents complications such as deep vein thrombosis, and facilitates recovery.
B) Maintaining the Foley catheter for a prolonged period may increase the risk of infection or trauma to the urinary tract. Removing the catheter as soon as possible is beneficial.
C) Monitoring intake and output and characteristics of urine is essential in assessing kidney function and detecting potential urinary complications such as urinary tract infection or urinary retention.
D) Bedrest should be minimized to prevent complications such as atelectasis or pneumonia. The patient should be encouraged to ambulate as soon as possible, and pain medications can be adjusted accordingly.
E) Initiating antiembolism therapy such as compression stockings or sequential compression devices can prevent blood clots and improve circulation.

Question 10

The nurse is assessing a 70-year-old female patient in the family practice clinic. The patient states that she has been experiencing sudden heavy vaginal bleeding the past 3 months. What is the expected diagnostic procedure for this patient?

Accepted Answer

Endometrial biopsy is the recommended diagnostic procedure for a 70-year-old female patient experiencing sudden heavy vaginal bleeding. This procedure allows for the collection and examination of tissue from the lining of the uterus to evaluate for abnormalities, such as endometrial cancer. Cervical conization, colposcopy, and dilation and curettage are not typically used to evaluate heavy vaginal bleeding in older women.

Question 11

The nurse is assessing the 19-year-old female patient in the women's health clinic. She reports that for the past several months, she has had lower abdominal pain, elimination issues, and mood swings, and her acne is worse the week before menstruation. The health care provider has prescribed oral contraceptives. The patient asks the nurse for the reason for the prescription. Which response by the nurse is appropriate?

Accepted Answer

Oral contraceptives can help regulate hormones and reduce symptoms such as abdominal pain, elimination issues, acne, and mood swings by maintaining a consistent level of estrogen and progesterone in the body throughout the menstrual cycle. They do not affect pregnancy outcomes or fertility and are not used to treat depression.

Question 12

The nurse is providing care to a 35-year-old female patient who complains of low back pain, pain with defecation, pelvic pressure, and premenstrual spotting. The health care provider has prescribed the hormonal therapy Lupron for this condition. What is the goal of this prescription?

Accepted Answer

The symptoms described suggest endometriosis, which may be helped by hormonal therapy such as Lupron. The goal of this medication is to suppress menstruation and further growth of the tissue that is causing the symptoms. It is not prescribed to prevent pregnancy, prevent retrograde menstruation, or increase blood flow.

Question 13

The nurse is preparing a teaching plan for a polycystic ovary syndrome (PCOS) support group. One of the teaching points will include diet and weight loss to decrease hirsutism and acne. What is the reasoning for this rationale?

Accepted Answer

Polycystic ovary syndrome (PCOS) is often associated with hyperandrogenemia, which can cause hirsutism and acne. Weight loss through diet and exercise has been shown to decrease hyperandrogenemia and improve symptoms associated with PCOS.

Question 14

The nurse is providing care to the 24-year-old patient in the OB/GYN clinic. The patient states that she thinks she may be pregnant because she has missed three menstrual cycles. The patient says, "This couldn't be happening at a worse time. I have been training heavily for a triathlon in 4 months." Which response by the nurse is most appropriate?

Accepted Answer

The nurse's response should provide accurate information while also addressing the patient's concerns. Option A is the most appropriate because it acknowledges the patient's missed periods while also educating her on other potential causes, including the heavy athletic training she mentioned. It is important to provide correct information without making assumptions or judgments. Option B may come across as blaming the patient and could potentially cause her to feel guilty, which is not helpful. Option C is incorrect because it suggests an invasive procedure when a pregnancy test is a more appropriate first step. Option D is not the best choice because it does not provide specific information about missed periods or potential causes, and instead focuses on a different issue (nutrition).

Question 15

The nurse is assessing a 22-year-old female patient who arrives at the family clinic. The patient has finished her prescription for a urinary tract infection and now reports a milky discharge from her vagina and has a fishy odor. After microscopic examination of the vaginal discharge, the health care provider prescribed metronidazole gel to be inserted vaginally. What is the suspected medical diagnosis for this patient?

Accepted Answer

The milky discharge with a fishy odor is a classic presentation of bacterial vaginosis, which occurs when there is an overgrowth of anaerobic bacteria in the vagina. Antibiotic therapy for a UTI can disrupt the normal vaginal flora and lead to an increased risk of developing bacterial vaginosis. Metronidazole gel is a common treatment for bacterial vaginosis. Gonorrhea typically presents with painful urination and a yellowish discharge. Genital condylomas are genital warts caused by human papillomavirus (HPV) and would present with visible warts. Candida vaginitis, or a yeast infection, typically presents with a thick, white discharge and itching.

Question 16

The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice?

Accepted Answer

If the patient is managing atrial fibrillation with warfarin, they should avoid cranberry juice as it can increase the risk of bleeding due to its interactions with warfarin. The other health conditions and their management do not contraindicate the use of cranberry juice.

Question 17

The nurse is caring for a 33-year-old female patient who has just undergone laparoscopic removal of endometrial lesions. Which statement by the patient illustrates her understanding of the disease process and prognosis?

Accepted Answer

Option A shows that the patient understands that laparoscopy is not a definitive cure for endometrial lesions and also shows that she understands the impact of the surgery on her fertility. Options B, C, and D are incorrect because laparoscopic removal of endometrial lesions does not cure all of the conditions mentioned. A hysterectomy may still be required, laparoscopy does not cure type 2 diabetes, and growth removal from the bowels does not necessarily prevent the need for a colostomy.

Question 18

The nurse is assessing a 25-year-old female patient when the patient becomes tearful. The patient states that she has thin milky discharge from her nipples and two small masses on her left breast. She has lost over 40 pounds in the past year due to intensive exercises and finds that she needs to wear a sports bra during her sessions. The patient states that she is afraid that she will become the first member of her family to have breast cancer. Besides a negative mammogram, what other symptoms would correlate with this being a benign finding? Select all that apply.

Accepted Answer

The answer of The nurse is assessing a 25-year-old female...

Question 19

The nurse is assessing a 72-year-old female patient in the women's health clinic. The mildly obese patient's history includes 7 vaginal births, 2 of which necessitated forceps deliveries, type 2 diabetes, and hypertension. The patient states that she has become incontinent of urine, has a history of frequent urinary tract infections (UTIs), and has a sense of fullness "down there." What would be an appropriate nursing intervention to help the patient with her symptoms?

Accepted Answer

The patient's symptoms suggest pelvic floor weakness, likely due to multiple childbirths and obesity. Stopping urination midstream is a form of Kegel exercises, which can strengthen pelvic floor muscles and help with urinary incontinence.

Question 20

A 32-year-old female patient arrives to the emergency department with heavy uterine bleeding. The nurse finds that the patient had a positive pregnancy test 1 month prior to the visit. What is the potential medical management for this patient's issue?

Accepted Answer

Given the patient's heavy uterine bleeding and positive pregnancy test, the potential medical management for this patient would be dilation and curettage (D&C) to remove any remaining fetal tissue and stop the bleeding. Endometrial biopsy, colposcopy, and laparoscopy are not appropriate management options for this specific patient presentation.

Quiz 19: Alterations in Womens Health