Question 1

A nulliparous 53-year-old woman is in the clinic complaining of lower abdominal fullness,heavy menses,and severe menstrual cramping.What treatment does the nurse anticipate for this woman?

Accepted Answer

These are symptoms of a uterine leiomyoma (fibroid).The medical treatment includes nonsteroidal anti-inflammatory drugs,oral contraceptives,and Lupron.Ovarian cysts often resolve spontaneously.For ovarian cancer,a complete hysterectomy with bilateral salpingo-oopherectomy is the procedure of choice.Because some of these symptoms are also seen in ovarian cancer,the nurse should be sure to assess the patient further.

Question 2

A postmenopausal woman asks the nurse about reducing her breast cancer risk.The woman is overweight,consumes one alcoholic drink daily,does not smoke,and works at a desk.What response by the nurse is best?

Accepted Answer

Alcohol intake,smoking,and weight maintenance all affect breast health.However,this woman's highest risk factor is being overweight.After menopause,estrogen is produced in body fat cells.The combination of estrogen and dietary fat significantly increases the chance of breast cancer development.Exercise can be part of a weight-loss regimen,but this is not the most comprehensive answer.Drinking one drink a day is not linked to increased breast cancer risk,although drinking two to five drinks a day is associated with an increased risk.Taking an aspirin daily is for promotion of heart health.

Question 3

A nurse in a family practice clinic sees several generations of the same family.For which family members should the nurse arrange routine screening colonoscopies?

Accepted Answer

Individuals aged 50 and older should have screening colonoscopies,so the daughter should be scheduled for this procedure.The CDC does not recommend routine screening for patients aged 75-85 and recommends no screening after age 85,so the grandparents do not need to be screened.For patients with family history of colon polyps or cancer,screening should begin in their 40s,so the grandson does not yet need screening.

Question 4

A patient is in the clinic for an annual exam.Her past medical history includes endometriosis for which she takes medroxyprogesterone (Depo-Provera).What assessment finding would the nurse relate to the medical condition or medication?

Accepted Answer

Depo-Provera is used to treat endometriosis,but one undesirable side effect is weight gain.Danazol (Danocrine)is also used to treat this condition,but side effects of acne and facial hair growth cause this medication to be prescribed less often.Cold intolerance is not a common side effect of medications used to treat endometriosis.

Question 5

A nurse is reviewing the results of several patients' cholesterol and lipid screenings.For which patient is the action appropriate?

Accepted Answer

A cholesterol below 200 mg/dL is desirable,so this patient's level is high.The nurse should plan to teach this patient about heart-healthy lifestyle changes.The other laboratory values are in the desirable range,so no action is necessary.

Question 6

An older patient has never exercised,but wants to begin now.What response by the nurse is best?

Accepted Answer

Older adults who are beginning to exercise for the first time in their lives (or for the first time in a long time)should begin with only 5 minutes per day.Exercise is beneficial at any age.Reminders about stretching and praising the patient are also good options,but safety comes first.

Question 7

A nurse reads in a patient's chart that the Bethesda system terminology used to describe her cervical cytology and histology is AIS.What can the nurse conclude about this woman's treatment?

Accepted Answer

The Bethesda System terminology describes categories of epithelial cell abnormalities.The categories are ASC (atypical squamous cells),LSIL (low-grade squamous intraepithelial lesions),HSIL (high-grade squamous intraepithelial lesions),AGC (atypical glandular cells),and AIS (adenocarcinoma in situ).Treatment for cancer of the cervix includes surgery,chemotherapy,radiation,or a combination of these.The other options are not appropriate for this situation.

Question 8

A nurse is working with an older adult who has never exercised despite understanding the health benefits.What can the nurse do to improve the chances that this adult will begin an exercise regimen?

Accepted Answer

Maintaining physical fitness in later years contributes to health,well-being,and independence.If the patient already understands the health benefits of exercising,asking about dancing and joining fitness clubs is not likely to get the desired response.However,if the nurse can show the patient how being physically fit may mean more years of independent living,the patient might be willing to make some small changes.Asking the family to talk with the patient is not showing the nurse in action.

Question 9

A preoperative nurse is caring for a patient who will undergo an open breast biopsy.What action by the nurse takes priority?

Accepted Answer

All actions are appropriate,but the priority action is in ensuring that an informed consent form has been signed and properly witnessed.

Question 10

A woman suffering from severe vasomotor menopausal symptoms wants to use complementary or alternative therapies instead of hormone therapy.What advice by the nurse is best?

Accepted Answer

There is no evidence that either herbal preparations or complementary approaches such as acupuncture,mind-body therapies,or manipulative therapies significantly reduce the symptoms of menopause.However,body-related therapies are considered safer because they do not have the side effects of herbal preparations.The nurse's best answer is to explain this to the patient.

Question 11

A nurse is teaching a 24-year-old male about reproductive health.Which information should the nurse provide this patient about testicular cancer?

Accepted Answer

Although cancer of the epididymis is considered rare,it is still the most common cancer found in men aged 20-34.Men should be taught the technique of testicular self-examination,which is best performed after a warm shower when the scrotum is more relaxed.Annual screening is not recommended other than during a clinical exam.The epididymis is normally slightly tender to pressure.

Question 12

A 21-year-old woman who has not been sexually active is in the clinic and requests a Gardasil vaccination.After giving the shot,what instruction does the nurse provide to her?

Accepted Answer

Gardasil is given in a series of three injections.The second shot is 2 months after the first.The third shot is 6 months after the first.The other options are incorrect.

Question 13

The nurse notes that a patient's chart contains the results of an MMSE.What can the nurse surmise about this patient?

Accepted Answer

The MMSE (Mini-Mental State Examination)is a screening test for

Question 14

A 53-year-old woman is having her annual physical and tells the nurse she has not had a period for 7 months.She wants to know if she has undergone menopause.What response by the nurse is best?

Accepted Answer

Menopause can only be diagnosed with certainty after 1 year without menstrual periods.Although fluctuations in a woman's cycle are normal during the perimenopausal years,this answer is not correct,as it appears to signify that there is no relationship between the lack of periods and menopause,and so is misleading.The average age of menopause in the United States is 51.4 years,with a range of 35-60 years.

Question 15

A woman presents to the family practice clinic complaining of abdominal pain,pain during ovulation,and heavy periods.What action by the nurse is best?

Accepted Answer

This woman has manifestations of endometriosis.Diagnosis can be made via a pelvic exam,although it is often difficult to do so.Some physicians will order ultrasounds or laparoscopy with biopsy.The first step,however,is the pelvic exam,so the nurse should prepare the woman for this to occur.After making a diagnosis of endometriosis,the nurse can educate the woman on medical management,which includes using ibuprofen for pain.

Question 16

A nurse is evaluating several patients for possible hormone therapy to reduce severe symptoms of menopause.For which patient would hormone therapy be recommended?

Accepted Answer

Estrogen therapy for women who have had a hysterectomy or estrogen-progestin therapy offers the greatest benefit and smallest risk to those who are within 10 years of menopause.The patient who is 55 and has had a hysterectomy would be the best candidate.The 53-year-old smoker has a double risk for venous thromboembolism (VTE)because smoking increases the risk along with the combination hormone therapy.Estrogen-only therapy increases the risk of endometrial cancer,so it is not used in patients who have a history of endometrial cancer.The smallest risk is seen in women within 10 years of menopause,so the 76-year-old woman is too far removed from menopause to receive hormone therapy.

Question 17

A young woman has had three urinary tract infections (UTIs)in the last year.What teaching should the nurse plan for this patient?

Accepted Answer

Preventative measures for UTIs include drinking plenty of water,voiding when the urge is felt,wiping from front to back,taking showers instead of baths,not using perfumes or bath oil if baths are taken,wearing cotton underwear,and avoiding feminine hygiene sprays and scented douches.The other options are not related.

Question 18

The nurse prepares to offer health screening and promotion activities for women aged 40-60.Which activity does the nurse plan to include as a priority for this group?

Accepted Answer

Breast cancer is the second leading cause of cancer death in women in the United States and is the leading cause of death in women aged 40-55.The priority screening activity is for breast cancer.Alzheimer's disease screening is typically done in the older patient.Gardasil is recommended for females aged 9-26.Influenza vaccinations are important for all ages.

Question 19

A nurse notes that a woman's chart lists "dyspareunia" as a diagnosis.In planning education for the patient,which topics would the nurse include?

Accepted Answer

Dyspareunia is painful intercourse,often seen in postmenopausal women.Prolonged foreplay and the use of water-based vaginal lubricants are helpful suggestions to ease this symptom.Black cohosh and soy nuts are often used to relieve menopausal symptoms.Kegel exercises and pessaries are used for urinary incontinence.Nonsteroidal anti-inflammatory medications are used for mild pain and swelling.

Question 20

A nurse is volunteering for the local chapter of the cancer society and is planning breast cancer screening and educational activities in the community.In order to have the most impact on this disease,which women should the nurse target?

Accepted Answer

African American women are more likely to die from breast cancer because of late diagnosis,and in women under 45 in this group,breast cancer is more common.To have the greatest impact,the nurse should target this group of women.Asian,Hispanic,and Native American women have a lower risk of developing and dying from breast cancer.Caucasian women tend to develop breast cancer more frequently than African American women,but they die less often.

Quiz 4: Caring for Women, Families, and Children Across the Life Span