Chapter 57: Management of Patients With Female Reproductive Disorders

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 ultrasonography corticosteroids oral hypoglycemia agents

1

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 antidepressants herbal aphrodisiacs bisphosphates

1

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." "Contraceptives will allow blood to be diverted to the peritoneal cavity." "Trapping blood causes less pain or discomfort for clients with endometriosis." "Endometriosis is usually cured with surgical menopause."

1

A client with challenging menopausal symptoms has discussed treatment options with the physician and now has some questions for the nurse. The client asks, "What are the potential risks of hormone replacement therapy?" What is the best answer? All options are correct. breast cancer stroke (CVA) heart disease

1

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. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. The potential for transmission to her sexual partner will be eliminated if condoms are used every time she and her partner have sexual intercourse. The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.

1

A nurse who works in a gynecologist's office frequently cares for patients who are diagnosed with vulvovaginal candidiasis. The nurse should teach the patients how to manage and treat the most common symptom of: Vulvar pruritus. Dysuria. Vaginal pain. Dyspareunia.

1

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 rectocele An enterocele A urinary tract infection

1

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." "I will report any signs of irritation or bleeding." "I should have greater ease of emptying my bladder." "I should report any foul odor or drainage."

1

The nurse is providing education regarding sexually transmitted diseases. 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. Transmission of the virus requires sexual contact. The virus is very difficult to kill. Usually, the virus is killed at room temperature by drying.

1

Which is the earliest and the most common symptom of endometrial cancer? bleeding loss of weight pain pressure on the bladder

1

Which of the following is an early symptom of vulvar cancer? Pruritus with genital burning Fever accompanied by chills Severe abdominal pain Dyspareunia

1

Which of the following is the descent of the small intestine into the vaginal vault? Enterocele Rectocele Cystocele Uterine prolapse

1

Which of the following is the preferred medication for bacterial vaginosis? Metronidazole Monistat Gyne-Lotrimin Terazol

1

Which term describes an opening between the bladder and the vagina? Vesicovaginal fistula Cystocele Rectocele Rectovaginal fistula

1

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 unprotected sexual intercourse Avoiding multiple sexual partners Avoiding physical contact with others in crowded places Avoiding IV drug use Avoiding HPV vaccinations

1,2,4

A client is diagnosed with polycystic ovarian syndrome. Which of the following findings would the nurse expect to assess? Select all that apply. Hirsutism Emaciated appearance Impaired glucose tolerance Sleep apnea Menorrhagia

1,3,4

A client is prescribed androgen therapy. Which of the following would the nurse explain as a possible adverse effect? Severe bleeding from the vagina Weight gain Decreased libido Areolar pigmentation

2

A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse? "Don't worry, every woman goes through this." "These are normal, manageable symptoms of menopause." "You need to discuss this with your spouse." "Hormone replacement therapy can resolve your symptoms."

2

A client who has cervical cancer is scheduled to undergo internal radiation. In teaching the client about the procedure, the nurse should tell the client that: she will be in a private room with unrestricted activities. a bowel-cleansing procedure will precede radioactive implantation. she will be expected to use a bedpan for urination. the preferred position in bed will be semi-Fowler's.

2

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? Maintain a reclining position for 30 minutes after inserting vaginal medication. Douche with a dilute vinegar solution twice a day. Wear cotton underwear that is loose-fitting and allows for air flow. Refrain from unprotected sexual intercourse with partners.

2

A patient is receiving chemotherapy with paclitaxel as treatment for ovarian cancer. The patient arrives at the facility for laboratory testing prior to her next dose of chemotherapy. The results are as follows:Hemoglobin: 12.9 gm/dLWhite blood cell count: 2,200 /cu mmPlatelets: 250,000 /cu mmRed blood cell count: 4,400,00/cu mmWhich result would be a cause for concern? Hemglobin level White blood cell count Platelet count Red blood cell count

2

A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do? Stop taking her Premarin (hormonal therapy). See her gynecologist as soon as possible. Disregard this phenomenon because it is common during this life stage. Mention it to her physician during her next annual examination.

2

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? Hodgkin disease Cervical cancer Colorectal cancer Cancer of the urinary tract

2

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oopherectomy 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? Leukopenia Neurotoxicity Bladder dysfunction Clotting deficiencies

3

A client with vaginitis complains of itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms? Use a pure vinegar douche daily. Use skin protectants containing zinc oxide. Take sitz baths frequently Avoid yogurt with active lactobacilli cultures.

3

A patient has a diagnosis of stage III ovarian cancer and wants to know what organs are involved. What information should be provided to the patient? The cancer involves only the ovaries. The cancer involves the ovaries with pelvic extension. The cancer involves metastases outside the pelvis. The cancer involves distant metastases.

3

A woman comes to the emergency department reporting vaginal discharge and pelvic pain that increases with urination. The client also reports nausea and vomiting, headache, and anorexia. A pelvic examination reveals cervical motion tenderness. The client is diagnosed with acute pelvic inflammatory disease (PID) and is admitted. Which of the following would be most appropriate to include in this client's plan of care? Applying cool compresses to the abdomen Instituting airborne infection control precautions Maintaining bedrest in the semi-Fowler's position Inserting an indwelling urinary (Foley) catheter

3

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess? Foul foamy discharge Thick curdy white discharge Fishy smelling watery discharge Yellowish white discharge

3

During a routine sports physical examination, the nurse practitioner recommends HPV vaccination for an 11-year-old girl. Which statements by the client's mother demonstrates understanding of HPV vaccinations? "This vaccination is not indicated for my son, since boys cannot receive the HPV vaccine." "If my daughter is immunized against HPV, she can delay her first scheduled Pap test." "I will track follow-up appointments in my smartphone so she receives all three injections." "It's nice that she can take this vaccination intranasally, to avoid repeated injections."

3

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? Relieving edema to lower extremities Alterations for sexual function Prevention of wound complications Care of colostomy site

3

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? Presence of kyphosis Symptoms of hot flashes Family history of breast cancer History of osteoporosis

3

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

3

Which is the main cause of anemia in a client with active uterine leiomyoma? Poor intake of foods containing iron Hemolysis Menorrhagia Pressure of the fibroid on the pelvic veins

3

Which of the following would be most important to determine when assessing a client being admitted for suspected toxic shock syndrome (TSS)? Existence of menorrhagia Psychological trauma Use of superabsorbent tampons Use of oral contraceptives

3

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), which nursing action minimizes transmission of infection? Strictly adhering to the no visitation policy Implementing reverse isolation precautions Performing hand hygiene when entering the room Keeping the client in a sitting position

3

A client with heart failure is admitted to an acute care facility and is found to have a cystocele. When planning care for this client, the nurse is most likely to formulate which nursing diagnosis? Total urinary incontinence Functional urinary incontinence Reflex urinary incontinence Stress urinary incontinence

4

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? Onset of sporadic sexual activity at age 17 Spontaneous abortion at age 19 Pregnancy complicated with eclampsia at age 27 Human papillomavirus infection at age 32

4

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? Candida albicans Escherichia coli Streptococcus Trichomonas vaginalis

4

A patient has been diagnosed with an invasive vulvar malignancy. What primary treatment for invasive vulvar malignancy will the nurse prepare the patient for? Chemotherapy creams Laser vaporization Radiation Wide excision

4

A patient is diagnosed with Bartholinitis. What organism does the nurse recognize the patient is most likely infected with? Candida albicans Chlamydia Gardnerella vaginalis Trichomonas vaginalis

4

When a female client reports a frothy, yellow-green vaginal discharge, the nurse suspects the client has a vaginal infection caused by which organism? Candida albicans Gardnerella vaginalis Chlamydia Trichomonas vaginalis

4