Adult Health Ch. 57

An elderly client, who can void only while standing and pushing upward on the vagina, is ordered a pessary. Which comment from the client indicates a need for further teaching about this device?

"I will remove and clean it every day."

When a female client reports a frothy, yellow-green vaginal discharge, the nurse suspects the client has a vaginal infection caused by which organism?

Trichomonas vaginalis

In which group is it most important for the client to understand the importance of an annual Papanicolaou test?

Clients infected with the human papillomavirus (HPV)

A patient has been diagnosed with a vaginal infection and received a prescription for metronidazole (Flagyl). The nurse knows that this is the recommended treatment for a vaginal infection caused by what organism?

Trichomonas vaginalis

Which is the main cause of anemia in a client with active uterine leiomyoma?

Menorrhagia

Over the past 2 months, a client has been receiving treatment for multiple ear infections and tonsillitis. The client reports vaginal discharge and itching. What is likely the cause of the client's vaginitis?

antibiotics

Which is the earliest and the most common symptom of endometrial cancer?

bleeding

Which client has the highest risk of ovarian cancer?

45-year-old woman who has never been pregnant

Which condition is a downward displacement of the bladder toward the vaginal orifice?

Cystocele

Pelvic infection is most commonly caused by which of the following?

Sexual transmission

A client is being treated for trichomoniasis. The client has received instructions about the prescribed drug therapy. The nurse determines that the client needs additional teaching when she states which of the following?

"My partner will not need any treatment."

A client who wishes to preserve childbearing asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?

"Symptoms of endometriosis are increased during normal menstrual cycle."

A nurse is preparing a teaching plan for a client with a vulvovaginal infection. Which teaching would not be appropriate for the nurse to include?

Douche with a dilute vinegar solution twice a day.

The client is asking if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy?

Family history of breast cancer

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy-smelling watery discharge

The nurse is providing education regarding sexually transmitted infections. Which statement regarding herpes virus 2 (herpes genitalis) is accurate?

In pregnant women with active herpes, babies delivered vaginally may become infected with the virus.

A pelvic examination reveals that a woman's uterus is retroflexed. Which of the following best depicts this position?

In retroflexion, the uterus bends posteriorly, as shown in option B

A young client presenting at the health clinic with fever and mucopurulent vaginal drainage is diagnosed with acute pelvic inflammatory disease (PID). Which long-term affect is of greatest concern in the care of this client?

Infertility

A patient is diagnosed with stage 3 ovarian cancer. The nurse's best response would be to explain that the majority of women (75%) respond to treatment. The nurse should also explain that stage 3 ovarian cancer involves which of the following?

Peritoneal metastasis

Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client?

Prevention of wound complications

A client with vaginitis complains of itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms?

Take sitz baths frequently

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.

A nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective?

"I will wear loose cotton underwear."

A 32-year-old client has been diagnosed with an ovarian cyst and asks the nurse, "Should I be worried about cancer?" Which response by the nurse would be most appropriate?

"Most cysts are benign in younger women, but it's good to have it checked out."

A patient reports to the nurse that she has a sense of pelvic pressure and urinary problems such as incontinence, frequency, and urgency. The problem has gotten much worse since the birth of her third child. What does the nurse suspect the patient is experiencing?

A cystocele

A client reports intermittent pelvic pain that does not seem to have a predictable occurrence. She recalls that these episodes began approximately 8 months ago. Following months of physical and diagnostic tests, the physician diagnoses the client with chronic pelvic pain. Which choices could be used as possible treatment options? Select all that apply.

Analgesics Oral contraceptives Antidepressants

A client has been diagnosed with genital herpes. Knowing that education is an essential part of nursing care of the client with a genital herpes infection, the nurse plans to include which method(s) to minimize HIV transmission? Select all that apply.

Avoiding multiple sexual partners Avoiding IV drug use Avoiding unprotected sexual intercourse

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?

Bladder dysfunction

During consultations with the oncologist, a client with cervical cancer is informed that radioactive materials will be inserted in the area of the tumor. She has to undergo these sessions over a period of 3 weeks. Which method of cancer treatment is being described?

Brachytherapy

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following?

Bulging of the bladder into the vagina

Over the past 2 months, a client has been receiving treatment for multiple ear infections and tonsillitis. The client reports a curdy white vaginal discharge and burning with urination. What is the most likely cause of these symptoms?

Candida albicans

A client who underwent an anterior colporrhaphy 6 hours ago has not voided. She reports some discomfort in her suprapubic area. Which of the following would the nurse expect to do?

Catheterize the client.

A woman in her late 30s has been having unusually heavy menstrual periods combined with occasional urine and stool leakage over the past few weeks. Upon further enquiry, she reveals that she also has postcoital pain and bleeding. To which diagnosis will the investigation most likely lead?

Cervical cancer

A nurse practitioner examines a patient suspected of having endometriosis. The nurse knows that although a definitive diagnosis could not be made without diagnostic treatment (transvaginal ultrasound), the most frequent symptom is:

Chronic pelvic pain.

Which of the following is the descent of the small intestine into the vaginal vault?

Enterocele

A client is diagnosed with polycystic ovarian syndrome. Which of the following findings would the nurse expect to assess? Select all that apply.

Hirsutism Impaired glucose tolerance Sleep apnea

A client, age 42, visits the gynecologist. After examining the client, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer?

Human papillomavirus infection at age 32

The nurse is providing an educational presentation on toxic shock syndrome to a group of adolescents. Which preventive measure is a primary focus for this group?

If using tampons, change frequently.

A patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which information in teaching the patient about this type of fibroid?

It grows within the wall of the uterine muscle.

Which of the following is a term used to describe excessive menstrual bleeding?

Menorrhagia

Which of the following is the preferred medication for bacterial vaginosis?

Metronidazole

The nurse is gathering data about a client's menstruation. The client reports that she has been experiencing some bleeding that occurs suddenly and without a regular pattern in between her normal menstrual periods. The nurse documents this finding as which of the following?

Metrorrhagia

A client has a history of dysmenorrhea. During monthly menses, the client experiences incapacitating cramping and passes large clots. The client's primary care physician initiates conservative treatment. What interventions would the physician to recommend?

NSAIDs

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), which nursing action minimizes transmission of infection?

Performing hand hygiene when entering the room

Upon examination, the nurse practitioner notes a backward positioning of the client's uterus. How would the nurse document this finding?

Retroversion

Which position occurs when the uterus turns posteriorly as a whole unit?

Retroversion

A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do?

See her gynecologist as soon as possible.

A 34-year-old client has been diagnosed with endometriosis. What topic should the nurse emphasize during health education?

The importance of reporting a possible pregnancy as soon as it occurs

A nurse is reviewing a client's medical history. Which factor indicates the client is at risk for candidiasis?

Use of corticosteroids

Which of the following would be most important to determine when assessing a client being admitted for suspected toxic shock syndrome (TSS)?

Use of superabsorbent tampons

A client with HIV has recently completed a 7-day regimen of antibiotics. She reports vaginal itching and irritation. In addition, the client has a white, cheese-like vaginal discharge. Which condition is the client most likely experiencing?

Vulvovaginal candidiasis

A client who had intracavity radiation treatment for cervical cancer 1 month earlier reports small amounts of vaginal bleeding. This finding most likely represents:

an expected effect of the radiation therapy.

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), the nurse insists on keeping the client in a semi-sitting position. The nurse advises this in order to:

facilitate pelvic drainage and minimize the upward extension of the infection.

A client is experiencing symptoms associated with menopause. What is a likely recommendation to increase the client's interest in sexual activity?

low-dose androgens