OB Exam 5 Questions (chapter 18 & 19)

The nurse is assessing a 59-year-old female patient for her annual examination. The patient had a full hysterectomy, bilateral salpingo-oophorectomy 1 year ago for a noncancerous condition. The patient states that she wants to stop her menopausal hormone therapy at this time, and she will try black cohosh if the symptoms persist. Which response by the nurse is most appropriate?

"Hormone therapy is the most effective treatment for menopausal symptoms."

The nurse is caring for a 33-year-old female patient who has just undergone laparoscopic removal of endometrial lesions. Which statement by the patient illustrates her understanding of the disease process and prognosis?

"I realize that this is not a cure for the issue, but I want to have more children within the next year."

The nurse is providing preoperative education on the laparoscope-assisted vaginal hysterectomy. Which statement by the patient verifies understanding of the procedure?

"I understand that there will be some light vaginal bleeding for several days."

The nurse is providing care to the 24-year-old patient in the OB/GYN clinic. The patient states that she thinks she may be pregnant because she has missed three menstrual cycles. The patient says, "This couldn't be happening at a worse time. I have been training heavily for a triathlon in 4 months." Which response by the nurse is most appropriate?

"Secondary amenorrhea, or no menses for 3 months, is not always a sign of pregnancy; it may be due to your heavy athletic activity."

the nurse is assessing the 19-year-old female patient in the women's health clinic. She reports that for the past several months, she has had lower abdominal pain, elimination issues, and mood swings, and her acne is worse the week before menstruation. The health care provider has prescribed oral contraceptives. The patient asks the nurse for the reason for the prescription. Which response by the nurse is appropriate?

"The hormones in the oral contraceptives can maintain estrogen-progesterone hormones to alleviate discomfort."

The nurse is educating a 24-year-old female patient who was newly diagnosed with polycystic ovary syndrome (PCOS). The patient was prescribed an antidiabetic medication. Which medication effects should the nurse educate the patient about? Select all that apply.

A change in her integumentary system Low blood sugar until her hormones stabilize A decrease in abdominal obesity and weight

The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice?

Atrial fibrillation, managed with warfarin

What is the common risk factor for hypertension, abnormal menstrual cycles, osteoarthritis, and high-risk pregnancies?

Body mass index over 32

The nurse is assessing a 16-year-old sexually active patient in the family practice clinic. The patient's symptoms include breakthrough vaginal bleeding, abdominal pain, nausea, and fever. The health care provider obtains cultures of the cervical epithelial cells during a Pap smear and orders doxycycline 100 mg orally twice a day for 7 days for her and her partner. The nurse understands that this prescription is consistent with the treatment of which medical diagnosis?

Chlamydia

The nurse is preparing a teaching plan for a polycystic ovary syndrome (PCOS) support group. One of the teaching points will include diet and weight loss to decrease hirsutism and acne. What is the reasoning for this rationale?

Diet and exercise will promote weight loss, which will decrease hyperandrogenemia.

A 32-year-old female patient arrives to the emergency department with heavy uterine bleeding. The nurse finds that the patient had a positive pregnancy test 1 month prior to the visit. What is the potential medical management for this patient's issue?

Dilation and curettage

A 55-year-old postmenopausal female patient presents to the family practice clinic for her annual examination. The nurse notes that the patient has lost 1/2 inch in height. Upon further investigation, the nurse discovers that the patient has a slow-healing fracture of the left radius. What screening will most likely be initiated at this time for the patient?

Dual-energy x-ray absorptiometry scan

A patient arrives to the family practice clinic for her annual examination. The nurse's assessment data includes thin, 35-year-old female, history of weight loss surgery and total hysterectomy, BMI is 19, patient has been taking corticosteroids for severe asthma. Which of the following is an expected diagnostic screening for a potential health problem?

Dual-energy x-ray absorptiometry scan

The nurse is assessing a 70-year-old female patient in the family practice clinic. The patient states that she has been experiencing sudden heavy vaginal bleeding the past 3 months. What is the expected diagnostic procedure for this patient?

Endometrial biopsy

The nurse is providing care to the adult female patient who presents to the emergency department with a suspected myocardial infarction (MI). Which symptom indicates a possible MI for the female patient?

Episodic nausea/indigestion and palpitations

The nurse is providing education for disease prevention to the adult female patient. Which factor puts the patient at a higher risk for multisystem disease processes such as cardiac issues, gynecological issues, and cancers?

Having a body mass index of over 32

The nurse is providing care to a 75-year-old female patient diagnosed with osteoporosis. Which of the following would be the priority nursing diagnosis?

Impaired physical mobility related to pain and skeletal changes

The nurse is assessing a 72-year-old female patient in the women's health clinic. The mildly obese patient's history includes 7 vaginal births, 2 of which necessitated forceps deliveries, type 2 diabetes, and hypertension. The patient states that she has become incontinent of urine, has a history of frequent urinary tract infections (UTIs), and has a sense of fullness "down there." What would be an appropriate nursing intervention to help the patient with her symptoms?

Instruct the patient to stop urinating midstream at least twice a day.

The nurse is providing care to a 46-year-old female patient. The patient appears hesitant when asked of her sexual history, and the nurse discovers that the patient is a lesbian. What education should the nurse provide to this patient pertaining to her health?

Lesbians often are at higher risk for menstrual disorders, abnormal insulin production, and infertility.

The nurse is preparing to teach the community about risk factors for the second most common cancer of the female reproductive system. Which of the following groups of women are at higher risk for this cancer? Select all that apply.

Menopausal women with an intact uterus who receive hormonal therapy Women who have undergone treatment for breast cancer

The nurse is assessing a 25-year-old female patient when the patient becomes tearful. The patient states that she has thin milky discharge from her nipples and two small masses on her left breast. She has lost over 40 pounds in the past year due to intensive exercises and finds that she needs to wear a sports bra during her sessions. The patient states that she is afraid that she will become the first member of her family to have breast cancer. Besides a negative mammogram, what other symptoms would correlate with this being a benign finding? Select all that apply.

Milky discharge from nipples Painful masses Multiple masses

The nurse is arranging education for the menopausal support group regarding the approaches to treat the symptoms. Which of the following would be components of current treatments? Select all that apply.

Moderately intense exercises Balanced diet, rich in calcium Hormone therapy

The nurse is providing care to the 35-year-old female patient at the family practice clinic who is in the office for her annual physical examination. Which tests should the nurse recommend are the most appropriate for this patient? Select all that apply.

Papanicolaou test every 5 years HPV every 5 years

A 48-year-old female patient presents to the OB/GYN clinic for her annual examination. She states that she has had the following symptoms: mood swings, irregular menstrual cycles, forgetfulness, food cravings, and a decrease in libido. Which of the following does the nurse suspect the patient is experiencing?

Perimenopause

The nurse is providing education to the patient that is receiving a bisphosphate medication for osteoporosis. Which instructions should the nurse include in the teaching plan to reduce side effects and enhance absorption while taking bisphosphates? Select all that apply.

Take the medication with at least 8 oz. of water. Remain upright for at least 30 minutes after taking a dose. Take the medication on an empty stomach.

The telephone triage nurse receives a call from a patient who is 5 days postoperative total abdominal hysterectomy. The patient states that her pain is not relieved with the medications and that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the emergency department. What does the nurse suspect as the surgical complication?

Possible injury to the ureters or bladder

The nurse is developing a plan of care for the 65-year-old obese female patient who states she wishes she could lose the weight but has no stamina for activity. Which nursing intervention would best correlate with the patient's statements?

Provide guidelines on how to increase daily activity as tolerated.

The nurse is assembling data for an education session at the local women's shelter. The majority of the guests at the shelter are 25- to 35-year-old American Indian women with young children. What is the leading cause of death for this population?

Risk-taking behaviors

The nurse is assessing a 42-year-old patient who presents to the gynecology office with complaints of pelvic pressure, backaches, menorrhagia, and urinary frequency. The health care provider has diagnosed the patient with leiomyoma of the uterus. What are the treatment options for this condition? Select all that apply.

Routine pelvic examinations to assess rate of disease process Myomectomy for women who desire pregnancy Hysterectomy for women who do not desire pregnancy

The nurse is assessing a 22-year-old female patient who arrives at the family clinic. The patient has finished her prescription for a urinary tract infection and now reports a milky discharge from her vagina and has a fishy odor. After microscopic examination of the vaginal discharge, the health care provider prescribed metronidazole gel to be inserted vaginally. What is the suspected medical diagnosis for this patient?

The patient has bacterial vaginosis due to recent disruption of normal vaginal flora.

The nurse is providing care for the 34-year-old patient diagnosed with polycystic ovarian syndrome. Which interventions would correlate to the common symptoms of this syndrome? Select all that apply.

The patient has been unsuccessful with the ability to conceive. The patient has a history of painful and irregular menstrual cycles. The patient has heart palpitations and hypertension.

The nurse is providing care to a 72-year-old female patient. While providing care, the nurse instructs the patient to slowly rise from a sitting or prone position. What is the pathophysiological reason for this instruction?

The patient is at higher risk for hypotension due to decreased baroreceptor sensitivity.

During the nurse's assessment of a 44-year-old female patient in the family medicine clinic, the patient becomes tearful and states she may be pregnant, as she has some unintentional weight gain, mood swings, and irregular menstrual cycles. The urine hCG reveals that the patient is not pregnant. What is the possible reason for her symptoms at this time?

The patient is perimenopausal.

The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?

This condition is often associated with use of oral contraceptives and may subside upon discontinuation.

The nurse is providing care to a 35-year-old female patient who complains of low back pain, pain with defecation, pelvic pressure, and premenstrual spotting. The health care provider has prescribed the hormonal therapy Lupron for this condition. What is the goal of this prescription?

To suppress menstruation and further growth of the tissue

The nurse at a family practice clinic is providing care to a 47-year-old obese patient. The patient states that she realizes that she has put on extra weight but is reluctant to go to any exercise classes. She states that she often has to cross her legs when she sneezes and cannot do any exercises with her legs crossed. The health care provider has prescribed tolterodine (Detrol). What is the rationale for this medication?

Tolterodine is used to treat overactive bladders and to decrease urinary frequency, urgency, and urge incontinence.

The nurse is providing postoperative care to a patient who underwent a total abdominal hysterectomy 12 hours ago. Which of the following are appropriate nursing interventions? Select all that apply.

assist the patient with ambulation. Monitor intake and output and characteristics of urine. Initiate antiembolism therapy as ordered.

A college-aged female patient states that she understands the risk of sexual assault with overdrinking. She asks the nurse what health risks are associated with excessive alcohol intake for her age. What diseases or conditions should the nurse include in her response? Select all that apply.

infertility Cancer of mouth Brain shrinkage

Which nursing interventions would best correlate with the nursing diagnosis of At risk for disturbed sleep patterns related to night sweats?

take a cool shower before bedtime.

The nurse is providing education on the prevention of heart disease for adult females ages 35 to 44 years old. Which of the following would be most appropriate for this disease process? Select all that apply.

taking a brisk walking for 50 minutes three times a week Consuming a diet rich in vegetables, fruits, and whole grains Recognizing the importance of smoking cessation