Question 1

While obtaining a health history from a patient hospitalized with pelvic inflammatory disease,the nurse recognizes that which of the following risk factors related by the patient is significant?

Accepted Answer

Sexual exposure to a partner with urethritis increases the risk of acquiring pelvic inflammatory disease due to the spread of bacteria from the urethra to the upper reproductive tract. The use of oral contraceptives and superabsorbent tampons during menstruation may increase the risk of developing other conditions but are not directly related to pelvic inflammatory disease. Long-term or high-dosage treatment with broad-spectrum antibiotics may also lead to the development of pelvic inflammatory disease but is not a risk factor stated by the patient.

Question 2

A 42-year-old woman has developed amenorrhea.If the woman is experiencing menopause,what would the nurse expect the laboratory findings to include?

Accepted Answer

Menopause is characterized by decreased estrogen levels, which ultimately leads to the cessation of menstruation. Progesterone levels decrease as well. The presence of human chorionic gonadotropin in urine indicates pregnancy, which is not applicable in this case. FSH levels are typically increased in menopause, not decreased.

Question 3

A woman has an induced abortion with suction curettage at an ambulatory surgical centre.During discharge teaching for the patient,what should the nurse instruct the patient to do?

Accepted Answer

The nurse should instruct the patient to avoid sexual intercourse for 2 weeks post-abortion to reduce the risk of infection. Douche is not recommended as it can disrupt the vaginal flora and increase the risk of infection. While some bleeding is expected post-abortion, heavy bleeding beyond 2 weeks may indicate a complication and should be reported to the healthcare provider. The return to normal menstrual periods varies for different women, but usually occurs within 1-2 months after the abortion.

Question 4

A 26-year-old woman is admitted to the emergency department with abdominal cramping and vaginal bleeding.When the patient learns that the results of a vaginal ultrasonogram confirm the presence of an ectopic pregnancy in the left fallopian tube,she begins to cry and says she has been trying to get pregnant for several years.In caring for the patient,what is the most important nursing intervention?

Accepted Answer

Monitoring the patient's vital signs closely is crucial in this situation because an ectopic pregnancy can lead to life-threatening complications such as rupture and internal bleeding, requiring immediate medical attention.

Question 5

After having been sexually assaulted,a woman is brought to the emergency department by a friend.The patient is confused and has a large laceration and ecchymosis above the left eye.Which action should the nurse take first?

Accepted Answer

Assessing the patient's neurological status is the priority in this situation as the patient has a large laceration and ecchymosis above the left eye indicating a head injury. This assessment will help the nurse identify any potential brain damage that may have occurred during the assault. Once the patient's neuro status is assessed and stabilized, the nurse can then proceed to other actions such as contacting the sexual assault nurse examiner and asking the patient to describe what occurred during the assault. Assisting the patient in removing her clothing is not a priority at this time.

Question 6

When teaching a patient about ways to prevent primary dysmenorrhea,which of the following will the nurse suggest?

Accepted Answer

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in reducing the production of prostaglandins, which are linked to the pain and inflammation associated with dysmenorrhea. Starting NSAIDs at the onset of menstruation can help manage and prevent the pain associated with primary dysmenorrhea.

Question 7

A perimenopausal woman does not want to use hormone therapy but is interested in complementary and alternative therapies.Which of the following herbal or supplemental preparations should the nurse suggest is the safest to control menopausal symptoms?

Accepted Answer

The answer of A perimenopausal woman does not want to...

Question 8

Six months after being raped,a woman tells the nurse that she has nightmares about the incident and develops acute anxiety if she finds herself alone in situations where several men are present.What is an appropriate nursing diagnosis that the nurse will document for this patient?

Accepted Answer

Rape-trauma syndrome is a nursing diagnosis that describes the response of a person to the traumatic event of rape. The woman's symptoms of nightmares and anxiety in certain situations are consistent with this syndrome. Option A is too vague and does not specify the cause of the anxiety. Option C only addresses one symptom of the syndrome. Option D may be a secondary diagnosis but doesn't encompass the primary response to the rape.

Question 9

A 46-year-old woman tells the nurse that she has not had a menstrual period for 3 months and asks whether she is going into menopause.What is the best response?

Accepted Answer

Asking about the patient's menstrual pattern before the absence of periods can provide information about whether menopause is the likely cause or if there may be other factors involved. This can guide the nurse's further assessment and response. A and C jump to conclusions without gathering more information, and D is incorrect as the age of menopause can vary and 46 is not too young for menopause to start.

Question 10

A diagnosis of vulvovaginal candidiasis is made when a patient with an abnormal vaginal discharge is seen at the clinic,and an antifungal vaginal cream is prescribed.As she prepares to leave the clinic,which of the following statements by the patient indicates to the nurse that further teaching about her condition is needed?

Accepted Answer

Douching can disrupt the natural balance of bacteria in the vagina and worsen the symptoms of vulvovaginal candidiasis. The patient should avoid douching and instead follow the antifungal treatment plan prescribed by the healthcare provider. The other statements indicate appropriate understanding of the condition and its management.

Question 11

When the nurse is caring for a patient with pelvic inflammatory disease requiring hospitalization,which of the following interventions is used to promote healing and prevent complications?

Accepted Answer

Promoting bed rest in a semi-Fowler's position helps facilitate drainage of the pelvic cavity and reduces the risk of abscess formation, promoting healing and preventing complications in patients with pelvic inflammatory disease.

Question 12

After teaching a perimenopausal patient who has started using HRT,the nurse determines that the teaching has been effective when the patient says which of the following?

Accepted Answer

Hormone replacement therapy (HRT) can cause breast tenderness as a side effect. This is a common experience for women undergoing HRT, reflecting an understanding of potential side effects. Choices A, B, and D reflect misconceptions about HRT and its management.

Question 13

To help a 53-year-old woman make an informed decision about the use of hormone replacement therapy (HRT)to control the effects of menopause,what should the nurse explain?

Accepted Answer

The nurse should explain to the woman that recent studies have indicated an increased risk for breast cancer and cardiovascular disease with estrogen-progesterone combination therapy, which is the most common form of HRT. The nurse should also discuss alternative treatments for managing menopause symptoms and the potential risks and benefits of each option.

Question 14

A 19-year-old community college student requests a prescription for birth control pills at the student health centre.She tells the nurse she always has painful periods with diarrhea and headaches and has heard from her friends that birth control pills stop painful menstruation.What is the most appropriate response?

Accepted Answer

The nurse should inform the patient that birth control pills are often used to treat painful menstruation and that it may be a viable option for her. The nurse should also assess the patient's sexual activity to determine if contraceptive benefits are also needed. Option A is incorrect as it does not address the patient's concerns and it assumes that the only reason for seeking birth control pills is for contraceptive purposes. Option B may be helpful, but it does not address the patient's specific request for medication. Option D is incorrect as it is not factual and uses scare tactics to dissuade the patient from seeking treatment.

Question 15

A young woman who is trying to become pregnant asks the nurse about ways to determine when she is most likely to conceive.What should the nurse explain?

Accepted Answer

Ovulation prediction kits detect the surge of luteinizing hormone (LH) which occurs 12-36 hours before ovulation, making them an accurate tool for predicting when ovulation is about to occur. Taking basal body temperature and monitoring cervical mucus changes can also be helpful but are less reliable methods. However, if the woman has irregular menstrual periods, it may be more difficult to predict ovulation.

Question 16

When advising a patient with persistent menorrhagia,the nurse recognizes that all patients with this condition should be evaluated for which of the following?

Accepted Answer

Persistent menorrhagia can lead to significant blood loss, which may result in anemia. Therefore, evaluating for anemia is essential in all patients with this condition.

Question 17

A patient with pelvic inflammatory disease is treated on an outpatient basis with oral antibiotics.When teaching the patient about follow-up care and management of her condition,what should the nurse instruct the patient to do?

Accepted Answer

The patient should be instructed to return for follow-up within 2 to 3 days to ensure that the antibiotics are working and to assess for any complications. Avoiding sexual intercourse for one week may be recommended, but it is not the most essential instruction. Wearing a vaginal tampon to absorb the drainage is not recommended and may actually increase the risk of infection. Over-the-counter anti-inflammatory drugs may be used for pain management, but they do not prevent scarring of pelvic organs.

Question 18

A 31-year-old woman tells the nurse that she has noticed increasing headaches with dizziness,abdominal bloating,and unexplained anxiety occurring before her menstrual periods.The nurse plans care for the patient based on what knowledge?

Accepted Answer

The patient's symptoms are suggestive of premenstrual syndrome (PMS), but a menstrual diary for 2 to 3 months is necessary to confirm the diagnosis. The diary will help determine the timing and severity of the symptoms in relation to her menstrual cycle. Further treatment options can be explored after a confirmed diagnosis. Vitamin supplements and stress management may be helpful, but are not the primary interventions for PMS. Prostaglandin inhibitors may be considered for symptom relief, but further evaluation is necessary before prescribing any medication.

Question 19

A young woman has arrived at the clinic and tells the nurse she is 15 weeks pregnant and wants an abortion.What does the nurse tell the patient about in relation to having an abortion at 15 weeks' gestation?

Accepted Answer

At 15 weeks gestation, a dilation and evacuation is the most appropriate method of abortion, as the fetus is too large to be effectively removed by suction curettage or medication. Abortion is legal in Canada and may be performed beyond the first trimester in certain circumstances. Methotrexate with misoprostol injection is not a recommended method for a pregnancy of 15 weeks gestation.

Question 20

During a routine health examination,a 32-year-old woman tells the nurse that she uses oral contraceptives because her husband wants to delay having children for a few more years.What is the most appropriate response?

Accepted Answer

The nurse should provide accurate information to the patient regarding fertility and age. Research has shown that it becomes more difficult for women to conceive as they age. By delaying having children for a few more years, the patient is at risk of decreased fertility and pregnancy complications. It is important to educate the patient on the risks associated with delayed childbearing.

Quiz 56: Nursing Management: Female Reproductive Problems