Question 1

On the fourth postoperative day after a modified radical mastectomy, the nurse finds the patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore. The nurse bases subsequent nursing interventions on diagnosis?

Accepted Answer

After losing a breast, many patients experience grief over the loss of a body part. The process of grieving is essential for personal adaptation to the loss. The nurse can assist the patient to find helpful coping mechanisms.

Question 2

The discharge instructions should include arm exercises for which postoperative patient?

Accepted Answer

Patients who have undergone a modified radical mastectomy should be instructed to avoid sleeping on the involved arm. An exercise regimen, built up gradually, can help reduce lymphedema.

Question 3

The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy. Which statement by her indicates to the nurse that the teaching has been successful?

Accepted Answer

The patient should be instructed to avoid sleeping on the involved arm.

Question 4

The recommended age for a baseline mammogram is between

Accepted Answer

The American Cancer Society recommends that mammograms be performed on women between 35 and 39 and annually for women 40 years of age and older.

Question 5

If severe or chronic pelvic inflammatory disease is present, the complication that may result is

Accepted Answer

Infections of the reproductive tract, such as pelvic inflammatory disease or sexually transmitted diseases (such as syphilis), are frequently associated with infertility.

Question 6

On the second postoperative day, a 63-year-old patient who has had an abdominal hysterectomy complains of gas pains and abdominal distention. She has not had a bowel movement since surgery. Which nursing intervention will best stimulate peristalsis and relieve distention?

Accepted Answer

Early ambulation is very helpful to return the bowel to normal function.

Question 7

A mammogram is the most useful method of diagnosing breast cancer because it

Accepted Answer

Mammography is radiography of the soft tissue of the breast to allow identification of various benign and neoplastic processes, especially those not palpable on physical exam.

Question 8

A female patient, age 48, is undergoing a routine physical examination for the first time in 5 years. As a part of this examination she can expect to have a

Accepted Answer

The American Cancer Society recommends that all women who are or have been sexually active or who are at least 18 years of age have an annual Pap smear for 3 consecutive years and then every 3 years until middle age.

Question 9

A Gram-stain smear of the patient's discharge reveals the presence of N. gonorrhoeae. He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease. Which information should the nurse include in response to his comment?

Accepted Answer

Most women remain asymptomatic but may show a greenish-yellow discharge from the cervix.

Question 10

The nurse has taught a 23-year-old patient how to perform a testicular self-examination. Which statement by the patient indicates the need for further teaching?

Accepted Answer

Perform TSE after a bath or shower when scrotum is warm and most relaxed. The testes should feel smooth and be firm to touch.

Question 11

The patient, age 30, was diagnosed with primary genital herpes when she sought care for lesions on her vulva and perineum. Which instructions should the nurse give to her?

Accepted Answer

Sexual transmission of HSV (genital herpes, a virus) has been documented even in the absence of clinical lesions, and the use of condoms should be encouraged.

Question 12

Female infertility is most often related to

Accepted Answer

Infections of the reproductive tract, such as pelvic inflammatory disease or sexually transmitted diseases (such as syphilis), are frequently associated with infertility.

Question 13

A 20-year-old college student regularly uses tampons while she is menstruating. She asks the nurse what outstanding sign she should report that might indicate toxic shock syndrome. The most correct response by the nurse would be to observe for

Accepted Answer

The patient may have an elevated temperature (up to 102° F).

Question 14

A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She asks the nurse if she will have "hot flashes." The nurse's response is based on the knowledge that

Accepted Answer

A total abdominal hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, fallopian tubes, and ovaries. If the ovaries are removed in these surgeries, the surgery will induce menopause and hot flashes may occur.

Question 15

Epididymitis may occur because of ____ to the testicle.

Accepted Answer

Symptoms can occur after trauma to the genital area, after instrumentation of the urethra and cystoscopy, and after physical exertion or prolonged sexual activity.

Question 16

The nurse admits a patient, age 72, who is scheduled for a vaginal hysterectomy. In what position will this patient be placed in the operating room for her surgery?

Accepted Answer

The patient is placed in a lithotomy position, and the uterus is removed through the vagina.

Question 17

At what age should a male be taught testicular self-exam (TSE)?

Accepted Answer

Young men should be taught to perform TSE monthly beginning at puberty.

Question 18

The patient, age 56, is a mother of nine children. She undergoes an anterior and posterior colporrhaphy for repair of a cystocele and rectocele. On her return from the postanesthesia care unit, the nurse would expect which finding on assessment?

Accepted Answer

A retention catheter is usually inserted into the bladder to keep it empty and prevent pressure on sutures.

Question 19

A patient, age 26, has had a tubal insufflation (Rubin's test) to ascertain whether her fallopian tubes are patent. She complains of pain in her right shoulder. The nurse's most appropriate response would be

Accepted Answer

Rubin's insufflation test determines tubal patency. Carbon dioxide escapes into the abdominal cavity through the patent left Fallopian tube.

Question 20

A patient tells the nurse that his wife, who has been diagnosed with inoperable ovarian cancer, is talking about dying and fear of death. He asks the nurse for suggestions that will be of assistance to his wife. Which response by the nurse would be most helpful?

Accepted Answer

In patients with inoperable cancer, a nursing diagnosis of Fear related to diagnosis of cancer is appropriate. Assisting patients with recognizing and clarifying fears and with developing coping strategies for those fears by listening is helpful.

Quiz 12: Care of the Patient With a Reproductive Disorder