Question 1

The nurse is caring for a 20-year-old patient with pelvic inflammatory disease (PID)requiring hospitalization.Which nursing intervention will be included in the plan of care?

Accepted Answer

The head of the bed should be elevated to at least 30 degrees to promote drainage of the pelvic cavity and prevent abscess formation higher in the abdomen.Although a possible complication of PID is acute perihepatitis,liver function tests will remain normal.There is no indication for increased fluid intake.Application of heat is used to reduce pain.Kegel exercises are not helpful in PID.

Question 2

A 49-year-old woman is considering the use of combined estrogen-progesterone hormone replacement therapy (HT)during menopause.Which information will the nurse include during their discussion?

Accepted Answer

Data from the Women's Health Initiative indicate an increased risk for cardiovascular disease and breast cancer in women taking combination HT but a decrease in hip fractures.Vaginal creams decrease symptoms related to vaginal atrophy and dryness,but they do not offer the other benefits of HT,such as decreased hot flashes.Most women who use HT are placed on short-term treatment and are not treated for up to 10 years.The incidence of colon cancer decreases in women taking HRT.

Question 3

A 32-year-old patient has oral contraceptives prescribed for endometriosis.The nurse will teach the patient to

Accepted Answer

When oral contraceptives are prescribed to treat endometriosis,the patient should take the medications continuously for 9 months.Facial hair is a side effect of synthetic androgens.The patient does not need to use additional contraceptive methods.The hormones in oral contraceptives will protect against osteoporosis.

Question 4

A 34-year-old woman who is discussing contraceptive options with the nurse says,"I want to have children,but not for a few years." Which response by the nurse is appropriate?

Accepted Answer

The probability of successfully becoming pregnant decreases after age 35,although some patients may have no difficulty in becoming pregnant.Oral contraceptives do not need to be withdrawn for several years for a woman to become pregnant.Although the patient may be fertile for many years,it would be inaccurate to indicate that there is no concern about fertility as she becomes older.Although the risk for infertility increases after age 35,not all patients have difficulty in conceiving.

Question 5

A female patient tells the nurse that she has been having nightmares and acute anxiety around men since being sexually assaulted 3 months ago.The most appropriate nursing diagnosis for the patient is

Accepted Answer

The patient's symptoms are most consistent with the nursing diagnosis of rape-trauma syndrome.The nursing diagnoses of sleep deprivation,ineffective coping,and anxiety address some aspects of the patient's symptoms but do not address the problem as completely as the rape-trauma syndrome diagnosis.

Question 6

A 29-year-old patient who is trying to become pregnant asks the nurse how to determine when she is most likely to conceive.The nurse explains that

Accepted Answer

Ovulation prediction kits indicate when luteinizing hormone (LH)levels first rise.Ovulation occurs about 28 to 36 hours after the first rise of LH.This information can be used to determine the best time for intercourse.Body temperature rises at ovulation.Postcoital cervical smears are used in infertility testing,but they do not predict the best time for conceiving and are not obtained by the patient.Determination of the time of ovulation can be predicted by basal body temperature charts or ovulation prediction kits and is not dependent on regular menstrual periods.

Question 7

A 28-year-old patient was recently diagnosed with polycystic ovary syndrome.It is most important for the nurse to teach the patient

Accepted Answer

Obesity exacerbates the problems associated with polycystic ovary syndrome,such as insulin resistance and type 2 diabetes.The nurse should also address the problems of acne and hirsutism,but these symptoms are lower priority because they do not have long-term health consequences.Although some patients do require total hysterectomy,this is usually performed only after other therapies have been unsuccessful.

Question 8

Which statement by the patient indicates that the nurse's teaching about treating vaginal candidiasis has been effective?

Accepted Answer

Cleaning of the perineal area will decrease itching caused by contact of the irritated tissues with urine and reduce the chance of further infection of irritated tissues by bacteria in the stool.Sexual intercourse should be avoided for 1 week.Douching will disrupt normal protective mechanisms in the vagina.The cream should be used at night so that it will remain in the vagina for longer periods of time.

Question 9

A 25-year-old woman has an induced abortion with suction curettage at an ambulatory surgical center.Which instructions will the nurse include when discharging the patient?

Accepted Answer

Because infection is a possible complication of this procedure,the patient is advised to avoid intercourse until the reexamination in 2 weeks.Patients may be started on contraceptives on the day of the procedure.The patient should call the doctor if heavy vaginal bleeding occurs.No change in the regularity of the menstrual periods is expected.

Question 10

When caring for a 58-year-old patient with persistent menorrhagia,the nurse will plan to monitor the

Accepted Answer

Because anemia is a likely complication of menorrhagia,the nurse will need to check the CBC.Estrogen and GNRH levels are checked for patients with other problems,such as infertility.Serial hCG levels are monitored in patients who may be pregnant,which is not likely for this patient.

Question 11

A 28-year-old patient with endometriosis asks why she is being treated with medroxyprogesterone (Depo-Provera),a medication that she thought was an oral contraceptive.The nurse explains that this therapy

Accepted Answer

Depo-Provera induces a pseudopregnancy,which suppresses ovulation and causes shrinkage of endometrial tissue.Menstrual bleeding does not occur during pregnancy.Vaginal atrophy and hot flashes are caused by synthetic androgens such as danazol or gonadotropin-releasing hormone agonists (GNRH)such as leuprolide.Although hormonal therapies will control endometriosis while the therapy is used,endometriosis will recur once the menstrual cycle is reestablished.

Question 12

A 28-year-old patient reports anxiety,headaches with dizziness,and abdominal bloating occurring before her menstrual periods.Which action is best for the nurse to take at this time?

Accepted Answer

The patient's symptoms indicate possible PMS,but they also may be associated with other diagnoses.Having the patient keep a symptom diary for 2 or 3 months will help in confirming a diagnosis of PMS.The nurse should not implement interventions for PMS until a diagnosis is made.

Question 13

A 32-year-old who was admitted to the emergency department with severe abdominal pain is diagnosed with an ectopic pregnancy.The patient begins to cry and asks the nurse to leave her alone to grieve.Which action should the nurse take next?

Accepted Answer

Because the patient is at risk for rupture of the fallopian tube and hemorrhage,frequent monitoring of vital signs is needed.The patient has asked to be left alone,so staying with her and encouraging her to discuss her feelings are inappropriate actions.Minimizing contact with her and closing the door of the room is unsafe because of the risk for hemorrhage.Because the patient has requested time to grieve,it would be inappropriate to provide teaching about options for pregnancy termination.

Question 14

A 24-year-old patient with pelvic inflammatory disease (PID)is being treated with oral antibiotics as an outpatient.Which instruction will be included in patient teaching?

Accepted Answer

The patient is instructed to return for follow-up in 48 to 72 hours.The patient should abstain from intercourse for 3 weeks.Abdominal pain should subside with effective antibiotic therapy.Corticosteroids may help prevent inflammation and scarring,but NSAIDs will not decrease scarring.

Question 15

A 47-year-old woman asks whether she is going into menopause if she has not had a menstrual period for 3 months.The best response by the nurse is which of the following?

Accepted Answer

The initial response by the nurse should be to assess the patient's baseline menstrual pattern.Although many women do enter menopause in the mid-40s,more information about this patient is needed before telling her that it is likely she is menopausal.Although hormone therapy (HT)may be prescribed,further assessment of the patient is needed before discussing therapies for menopause.Because the response to menopause is very individual,the nurse should not assume that the patient is experiencing any adverse emotional reactions.

Question 16

A 56-year-old woman is concerned about having a moderate amount of vaginal bleeding after 4 years of menopause.The nurse will anticipate teaching the patient about

Accepted Answer

A postmenopausal woman with vaginal bleeding should be evaluated for endometrial cancer,and endometrial biopsy is the primary test for endometrial cancer.D&C will be needed only if the biopsy does not provide sufficient information to make a diagnosis.Endometrial ablation and balloon therapy are used to treat menorrhagia,which is unlikely in this patient.

Question 17

A 32-year-old woman is scheduled for an induced abortion using instillation of hypertonic saline solution.Which information will the nurse plan to discuss with the patient before the procedure?

Accepted Answer

Uterine contractions take 12 to 36 hours to begin after the hypertonic saline is instilled.Because the saline is feticidal,the nurse does not need to discuss any possibility of a live delivery or that the pregnancy termination will not be successful.General anesthesia is not needed for this procedure.

Question 18

The nurse in the infertility clinic is explaining in vitro fertilization (IVF)to a couple.The woman tells the nurse that they cannot afford IVF on her husband's salary.The man replies that if his wife worked outside the home,they would have enough money.Which nursing diagnosis is appropriate?

Accepted Answer

The statements made by the couple are consistent with the diagnosis of defensive coping.No data indicate that ineffective sexuality and ineffective denial are problems.Although the couple is quarreling about finances,the data do not provide information indicating that the finances are inadequate.

Question 19

A 19-year-old has been diagnosed with primary dysmenorrhea.How will the nurse suggest that the patient prevent discomfort?

Accepted Answer

NSAIDs should be started as soon as the menstrual period begins and taken at regular intervals during the usual time frame in which pain occurs.Aerobic exercise may help reduce symptoms.Heat therapy,such as warm packs,is recommended for relief of pain.Antidepressant therapy is not a typical treatment for dysmenorrhea.

Question 20

A 25-year-old woman who is scheduled for a routine gynecologic examination tells the nurse that she has had intercourse during the last year with several men.The nurse will plan to teach about the reason for

Accepted Answer

Chlamydia testing is recommended annually for women with multiple sex partners.There is no indication that the patient needs teaching about contraceptives,pregnancy testing,or antibiotic therapy.

Quiz 54: Nursing Management: Female Reproductive Problems

The nurse is caring for a 20-year-old patient with pelvic inflammatory disease (PID) requiring hospitalization.Which nursing intervention will be included in the plan of care?

A 49-year-old woman is considering the use of combined estrogen-progesterone hormone replacement therapy (HT) during menopause.Which information will the nurse include during their discussion?