Chapter 27: Common Reproductive Conditions

Which statement would be most appropriate when explaining endometriosis as a cause of a woman's infertility? 1 "Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum." 2 "Your uterine cervix fails to close because it is engorged with tissue." 3 "Menstrual sloughing does not occur, so there is never a new base for embryo growth." 4 "You do not ovulate because of endometrial implants on the ovaries."

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Which symptom is an early symptom of vulvar cancer? 1 pruritus with genital burning 2 fever accompanied by chills 3 severe abdominal pain 4 dyspareunia

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The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease: 1 involves one or both ovaries and extends into the pelvis. 2 has spread to the lymph nodes and other organs within the abdomen. 3. has metastasized to distant sites. is limited to the ovary. 4. Disease limited to the ovary characterized

1 Stage II ovarian cancer involves one or both ovaries, with pelvic extension. Disease limited to the ovary characterizes stage I ovarian cancer. Stage III ovarian cancer has spread to the lymph nodes and other organs and structures inside the abdominal cavity. Stage IV disease typically involves metastasis to distant sites.

A nurse assesses and suspects vulvar cancer based on which assessment finding? 1 vulvar itching that responds to creams 2 fleshy, ulcerated mass on the labia majora 3 vulvar bleeding 4 dysuria

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Which of the following teenage girls is most likely to have secondary amenorrhea? 1 15-year-old, 15 percent above desired body weight 2 12-year-old, breast buds present and pubic hair 3 17-year-old, gymnast preparing for competition 4 14-year-old, at desired body weight

3 Girls who are thin or athletic may have too little body fat and be at risk for secondary amenorrhea. Being overweight will not affect the menstrual cycle. The presence of buds and pubic hair are not related to the menstrual cycle. If the patient were at the normal weight, her menstrual cycle would most likely be normal

A nurse is assessing a female client and suspects that the client may have endometrial polyps based on which clinical manifestation? 1 bleeding after intercourse 2 vaginal discharge 3 bleeding between menses 4 metrorrhagia

4 The most common clinical manifestation of endometrial polyps is metrorrhagia (irregular, acyclic uterine bleeding). Cervical and endocervical polyps are often asymptomatic, but they can produce mild symptoms such as abnormal vaginal bleeding (after intercourse or douching, between menses) or discharg

The nursing student exhibits an understanding of pelvic organ prolapse (POP) when she correctly identifies which factors as contributing to its development? Select all that apply. vaginal birth obesity lifting chronic cough chronic diarrhea estrogen deficiency

all but chronic diarrhea

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common? 1 endometriosis 2 multigravida status 3 hormonal imbalance 4 perimenopause

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When preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects that the lesion would most likely be located at which area? 1 labia majora 2 labia minora 3 clitoris 4 prepuce

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A client with abnormal uterine bleeding is diagnosed with small ovarian cysts. The nurse has to educate the client on the importance of routine check-ups. Which assessment is most appropriate for this client's condition? 1 Monitor gonadotropin level every month. 2 Monitor blood sugar level every 15 days. 3 Schedule periodic Papanicolau tests. 4 Schedule an ultrasound every 3 to 6 months.

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Assessment of a client reveals evidence of a cystocele. The nurse interprets this as: 1 herniation of the rectum into the vagina. 2 protrusion of intestinal wall into the vagina. 3 downward displacement of the cervix. 4 bulging of the bladder into the vagina.

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A client diagnosed with uterine prolapse is to undergo surgery. The nurse would prepare a preoperative teaching plan for which surgery? 1 vaginal hysterectomy 2 anterior culporrhaphy 3 posterior culporrhaphy 4 abdominal hysterectomy

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A client was in labor for more than 36 hours and now reports urine leaking from her vagina. On examination the nurse would be inspecting for: 1 urethrovaginal fistula. 2 vesicovaginal fistula. 3 urge incontinence fistula. 4 rectovaginal fistula.

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A client with large uterine fibroids is scheduled to undergo a hysterectomy. Which intervention should the nurse perform as a part of the preoperative care for the client? 1 Teach turning, deep breathing, and coughing. 2 Instruct the client to reduce activity level. 3 Educate the client on the need for pelvic rest. 4 Instruct the client to avoid a high-fat diet.

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A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct? 1 "Human papillomavirus is the cause of essentially all cases of cervical cancer." 3 "At least antibiotics will cure a sexually transmitted infection." 4 "Gonorrhea and syphilis are an infection seen only in men." 5 "STIs can't be transmitted through oral sexual intercourse."

1

A nurse is assisting with the pelvic exam of a woman who has come to the clinic with reports of abnormal vaginal bleeding. The client is diagnosed with an endocervical polyp. The nurse understands that the pelvic exam most likely revealed a polyp appearing as: 1 cherry red. 2 grayish-white. 3 purplish-blue. 4 pinkish-gray.

1

A nurse is conducting an in-service program for a group of staff nurses. After teaching the group about ovarian cysts, the nurse determines that the teaching was successful when the group identifies which type of cyst as being associated with hydatidiform mole? 1 Theca-lutein cyst 2 corpus luteum cyst 3 follicular cyst 4 polycystic ovarian syndrome

1

A nurse is reviewing the various treatment options with a client diagnosed with uterine fibroids. The nurse determines that the teaching was successful based on which statement? 1 "If I use hormone therapy, my fibroids may grow back when I stop the medication." 2 "A myomectomy will not allow me to keep my uterus." 3 "Uterine artery embolization is associated with minimal pain." 4 "Laser surgery won't affect my ability to have children."

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A postmenopausal client is to have a pelvic ultrasound to evaluate her vague feelings of abdominal fullness and discomfort. Which finding would the nurse interpret as being suspicious? 1 small ovarian cyst 2 enlarged endometrial fibroid 3 small endometrial polyp 4 atrophic uterine wall

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After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? 1 "I've been having bleeding off and on that's irregular and sometimes heavy." 2 "I get sharp pain in my lower abdomen usually starting soon after my period comes." 3 "I get really irritable and moody about a week before my period." 4 "My periods have been unusually long and heavy lately."

1

The nursing student correctly identifies which procedure as the treatment of choice for endometrial cancer? 1 hysterectomy and salpingo-oophorectomy 2 hysterectomy 3 salpingo-oophorectomy 4 dilation and curettage (D&C;)

1 Surgery is the usual and best treatment for endometrial cancer. It usually involves remmoval of the uterus (hysterectomy) and the fallopian tubes and ovaries (salpingo-oophorectomy). In a D&C;the surgeon dilates the cervix and removes part of the lining of the uterus and/or contents of the uterus

A client is to have a vaginal hysterectomy to repair her stage IV uterine prolapse. The nurse realizes she needs more education when she states: 1 "I'm not going home with a Foley catheter in place." 2 "The leg bag will be covered by my clothes, once I am home." 3 "My husband is not crazy about the six weeks of pelvic rest." 4 "I have already picked up the stool softeners."

1 A Foley catheter will be left in place for up to one week to allow the surgical site time to heal properly. The client may also experience some dysuria once it is removed due to the swelling that can occur.

A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? Select all that apply. 1 rectocele 2 fecal incontinence 3 cystocele 4 urinary incontinence 5 enterocele

1, 2, 5

A 47-year-old woman is being seen at the local clinic reporting irregular menstrual cycles. The nurse would explain to the client that the irregularity is most likely due to: 1 pregnancy. 2 menopause. 3 hormonal fluctuations. 4 an underlying endocrine problem.

2

A postmenopausal client is told at her routine gynecological exam that the primary care provider has found a cyst on her right ovary. The nurse notices that this does not cause worry for this client. What should the nurse and/or care provider tell this client? 1 "You are correct not to be concerned; after all, it is only a cyst." 2 "After menopause a mass on an ovary is not a cyst and should be considered cancerous until proven otherwise." 3 "We will keep a eye on it and recheck it at your next yearly appointment." 4 "You may get a second opinion if you would like."

2

A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. "I've also been waking up at night feeling really hot and sweating. The nurse interprets these findings as: 1 menopause. 2 perimenopause. 3 climacteric. 4 menarche.

2

After undergoing diagnostic testing, a woman is diagnosed with a corpus luteum cyst. The nurse anticipates that the woman will require: 1 biopsy. 2 no treatment. 3 oral contraceptives. 4 metformin.

2

The nurse is reviewing the laboratory test results of a client with dysfunctional uterine bleeding (DUB). Which finding would be of concern? 1 Negative pregnancy test 2 Hemoglobin level of 10.1 g/dL 3 Prothrombin time of 60 seconds 4 Serum cholesterol of 140 mg/dL

2

A patient you are caring for has returned to her room after vulvar surgery. What would be an important intervention during the initial postoperative period? 1 Placing the patient in high Fowler's position 2 Sitz baths are recommended 3 Monitoring the surgical site for signs of infection 4 Analgesics will be administered on a prn basis

3

The nurse is reviewing with a new client the diagnosis of polycystic ovarian syndrome (PCOS). Which long-term health problems would the nurse review as a risk with this syndrome? 1 migraine 2 celiac disease 3 type 2 diabetes 4 cellulitis

3

The nurse would expect which client to be at a high risk for developing a pelvic support disorder? 1 an 18-year-old college freshman 2 a 29-year-old mother of one son 3 a 60-year-old mother with four children 4 a 30-year-old who just gave birth to twin girls

3

When reviewing the medical record of a client diagnosed with endometriosis, the nurse would identify which finding as a risk factor for this woman? 1 low fat in the diet 2 age of 14 years for menarche 3 menstrual cycles of 24 days 4 short menstrual flow

3 Risk factors for developing endometriosis include increasing age, family history of endometriosis in a first-degree relative, short menstrual cycle (less than 28 days), long menstrual flow (more than 1 week), high dietary fat consumption, young age at menarche (younger than age 12), and few (one or two) or no pregnancies.

A client is diagnosed with a leiomyoma. The client asks the nurse what this is. The nurse describes this as a: 1 cyst. 2 pelvic organ prolapse. 3 fistula. 4 fibroid.

4

A client is to be examined for the presence and extent of endometriosis. For which test should the nurse prepare the client? 1 tissue biopsy 2 hysterosalpingogram 3 clomiphene citrate challenge test 4 laparoscopy

4

The nurse is assessing a 52-year-old perimenopausal female who is concerned about the changes occurring in her body. When questioned about the most serious changes, which effect should the nurse point out? 1 pelvic support muscles lose tone 2 dense breast tissue is replaced with adipose tissue 3 the uterus and ovaries decrease in size 4 bone mineral density decreases

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Which action would the nurse emphasize when teaching postmenopausal women about ways to reduce the risk of osteoporosis? 1 swimming daily 2 taking vitamin A 3 using hormone replacements 4 taking calcium supplements

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