Question 1

A client complains of a cloudy vaginal discharge with a slight odor. Microscopic examination reveals epithelial cells, leukocytes, and normal vaginal flora. Given these findings, the nurse would assesses that the discharge is

Accepted Answer

All women have normal, non-bloody, asymptomatic vaginal discharge called leukorrhea. As this exudate passes through the vagina, it may become cloudy and acquire a slight odor as desquamated epithelial cells, leukocytes, and normal vaginal flora are added.

Question 2

The nurse teaching a menopausal client about hormone replacement therapy (HRT) would include that HRT decreases the risk of

Accepted Answer

Estrogen replacement therapy and HRT decrease the risk of osteoporosis. The other disorders listed are reasons not to prescribe these therapies.

Question 3

After the physician has prescribed danazol (Danocrine) for treatment of a client's endometriosis, the nurse would explain that this drug may cause

Accepted Answer

Danazol may cause side effects such as acne, hirsutism, weight gain, decreased breast size, hot flashes, and vaginal dryness.

Question 4

The nurse is providing health education to a group of women about ovarian cancer. The nurse would include information on health maintenance activities for both low- and high-risk women, because ovarian cancer

Accepted Answer

Ovarian cancer tends to grow and spread silently (without manifestations) until it causes pressure on adjacent organs or abdominal distention. When these pressure-related manifestations finally appear, the malignancy has usually spread to the fallopian tubes, uterus, and ligaments. Routine pelvic exams are important for all women and high-risk women can be screened with CA-125 antigen levels and transvaginal ultrasound.

Question 5

A woman is being taught self-care for a vaginal pessary to treat vaginal prolapse. The nurse would realize that additional discharge instructions are needed when the woman says

Accepted Answer

Pessary care includes daily washing with mild soap and water. A client must be able to remove and reinsert it without difficulty. Pessaries can cause vaginal irritation especially if left in place too long. The follow-up appointment is made for 2 weeks after the fitting. Estrogen cream can be used intravaginally at night to preserve vaginal tissue.

Question 6

The postprocedure teaching plan for a client receiving cryosurgery for cervical cancer would include the instruction to

Accepted Answer

After cryosurgery, mild pain may continue for several days. A clear, watery discharge occurs, followed by discharge containing debris that may be malodorous. If the discharge continues longer than 8 weeks, an infection is suspected. The client should take showers or sponge baths during this time, avoiding tub or sitz baths. Clients should practice meticulous perineal hygiene.

Question 7

The question that the nurse would initially ask an 18-year-old client being assessed for amenorrhea is

Accepted Answer

Pregnancy must be ruled out for any woman of childbearing age experiencing secondary amenorrhea.

Question 8

The nurse planning care for the client who had a repair of a uterine prolapse 2 days ago would include which intervention?

Accepted Answer

After prolapse repair, the client has a Foley catheter that is removed as soon as the client is ambulatory. Once the catheter is removed, the client voids every 2 hours to keep pressure off the suture line. This client should be ambulatory by now. Low fiber is not part of the treatment plan.

Question 9

The nurse teaches a client self-care measures after a hysterectomy, which include avoiding

Accepted Answer

Until the physician gives permission, activities that increase pelvic congestion should be avoided, including aerobic activity, horseback riding, and prolonged standing. Heavy lifting and vaginal intercourse should also be avoided for 6 weeks.

Question 10

A woman complains of severe PMS symptoms. Based on research, the nurse could suggest which of the following over-the-counter products might be beneficial in reducing the symptoms?

Accepted Answer

Research has shown that calcium and vitamin D can reduce the manifestations of PMS. As hormone levels increase during the menstrual cycle, they reduce the level of calcium, and this dysregulation has been postulated to be part of the pathophysiology of PMS. Aspirin and ibuprofen do relieve pain, but do not work on other manifestations. Vitamin B₆ may also have some effect.

Question 11

After a client's hysterectomy for removal of a leiomyoma, the nurse formulates the nursing diagnosis of Constipation related to bowel manipulation during surgery. The best measure that the nurse would take to prevent constipation is

Accepted Answer

Early, frequent ambulation helps improve GI function.

Question 12

A client is suspected of having premenstrual syndrome (PMS). A somatic complaint the nurse would assess for is a client report of

Accepted Answer

Somatic problems may include headache, breast tenderness and abdominal bloating, peripheral edema, joint pain and backache, hives, constipation, and exacerbation of pre-existing conditions such as migraine and herpes.

Question 13

To help a client diagnosed with endometrial cancer effectively deal with this disease, the nurse would base supportive interventions on the fact that endometrial cancer

Accepted Answer

The cell type in endometrial cancer is usually adenocarcinoma, a tumor that involves the glands. This relatively slow-growing tumor metastasizes late in its course and tends to spread slowly to other organs. If caught early, the cure rate approaches 96%.

Question 14

A vaginal mass is found in a client experiencing vaginal discharge, painless vaginal bleeding, and pruritus. The client's statement that would alert the nurse to the possible etiology is

Accepted Answer

A risk factor for vaginal cancer is maternal ingestion of diethylstilbestrol (DES), which is associated with clear-cell vaginal cancer.

Question 15

The nurse would be aware that a client with the diagnosis of endometriosis may require additional emotional support, because the major complication of this disease is

Accepted Answer

Infertility is a major complication of endometriosis and is usually caused by scarring, leading to obstruction of the fallopian tubes.

Question 16

The nurse would assess a client with leiomyoma for a history of

Accepted Answer

The most common clinical manifestation of leiomyomas is abnormal uterine bleeding, which is excessive in either amount or duration.

Question 17

The nurse explains to a client that the cause of the client's primary dysmenorrhea is a/an

Accepted Answer

The causes of primary dysmenorrhea can be grouped according to (a) elevated uterine prostaglandins, (b) endocrine factors, (c) myometrial factors, (d) biochemical factors, and (e) psychosocial factors.

Question 18

A nurse is counseling an adolescent and her mother about preventing cervical cancer. The most important health promotion action the nurse could suggest is to

Accepted Answer

Infection with HPV (human papillomavirus) is the leading cause of cervical cancer. The vaccine that is now available is best given before a woman becomes sexually active (see Chapter 41). Option b is not the best answer because the girl will probably become sexually active at some point in her life and because STDs do not need sexual intercourse to be spread. Smoking is a risk factor for cervical cancer, although the link is not as strong as the link with HPV. Alcohol is not a risk factor.

Question 19

The nurse would determine that a client with menorrhagia is at risk for significant blood loss if the client reports changing the perineal pad or tampon at least every

Accepted Answer

The nurse should consider significant blood loss if the client is changing her pad or tampon 3-4 times in a 4-hour period.

Question 20

The nurse explains that because there is no screening method to detect endometrial cancer, the first manifestation is

Accepted Answer

Vaginal bleeding in a menopausal woman is frequently the first manifestation that is noted in endometrial cancer.

Quiz 39: Management of Women with Reproductive Disorders