Chapter 43 - 46
A client reporting low abdominal pain, purulent cervical discharge, and painful intercourse is diagnosed with pelvic inflammatory disease (PID). The provider educates the client about this disease mentioning which statement?
Is a polymicrobial infection of the upper reproductive tract
An 18-year-old woman presents at the clinic complaining of new-onset breakthrough bleeding, even though she is taking contraceptives. What contraceptive use, along with new-onset breakthrough bleeding, has been associated with pelvic inflammatory disease?
Intrauterine device
A client asks the nurse how he will know if he has syphilis after sexual contact. What is the nurse's best response?
"You will develop a sore on your penis or scrotum."
It is important to test anyone who has had sex with an individual tests positive for gonorrhea within how many days of the diagnosis?
60 days
A nurse who works in a fertility clinic is conducting a program on options for various fertility issues. The nurse judges that the participants understand the education when they identify that donor eggs are the best option for which woman?
A 42-year-old
Which sexually active woman most likely faces the highest risk of developing an ectopic pregnancy?
A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed
The gonads of the female have a dual function. Which of the following is a function of the female gonads?
Storing female germ cells
A female client whose mother recently died from ovarian cancer asks, "Why the survival rate from ovarian cancer is so low?" Which response is most accurate?
Symptoms of ovarian cancer are nonspecific and therefore difficult to interpret.
Fibrocystic changes in the breast are not uncommon. How is the diagnosis of fibrocystic changes made?
Ultrasonography and mammography
The nurse is caring for a female client who asks, "Will taking estrogen increase my chances of developing breast cancer?" Which statement is an appropriate response by the nurse?
"Currently, there is insufficient evidence to support estrogen as the cause of breast cancer."
Which assessment question is most likely to address the causation of a woman's new case of candidiasis?
"Have you been on antibiotics recently?"
A client is diagnosed with granuloma inguinale. Which question should the nurse ask the client?
"Have you traveled outside of the country recently?"
A client asks how his condition, Condylomata acuminata, is caused. What is the nurse's best response?
"Human papillomavirus (HPV) is the cause of your condition."
A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate the client by making which statement?
"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."
A client diagnosed with endometriosis asks the nurse how it is that she did not know about this when she had it for so long. What is the nurse's best response?
"Its symptoms mimic those of other disorders "
After an office visit with her primary health provider, a female client with an elevated CA-125 test result asks the nurse if that means she has ovarian cancer. What is the nurse's best response?
"The test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation."
A client asks why his partners need to know that he was diagnosed with syphilis. What is the nurse's best response?
"They will have to be treated prophylactically."
In assessing a client, the nurse notes a grayish discharge from the vaginal area accompanied by a foul odor. What is the nurse's best action?
Asking about other symptoms
Which information is essential for a nurse to include in the teaching plan for a client receiving metronidazole for trichomoniasis?
Abstinence is recommended until the therapy is completed.
There is no known cure for genital herpes, and methods of treatment are often symptomatic. Pharmacologic management of genital herpes includes which drugs?
Acyclovir
What is a primary intervention for the nurse to implement for a client with pelvic inflammatory disease ?
Administer antibiotic therapy.
A client presents to the outpatient clinic complaining of gray discharge that has a fishy odor. The health care provider sees "clue cells" on wet-mount microscopic exam. This would most likely lead to the diagnosis of:
Bacterial vaginosis
When screening for a sexually transmitted disease (STD), a microscopic evaluation of a discharge culture reveals hyphae and a pH level of 4.2. Which conditions are not likely to present based on these findings? Select all that apply.
C. trachomatis N. gonorrhoeae T. vaginalis
A sexually active female presents to the clinic with white copious vaginal discharge, itch, swelling, and dysuria. The nurse anticipates the client will be treated for the overgrowth of which organism?
Candida albicans
A client complains of not being able to experience satisfactory sexual intercourse. The nurse knows that erectile dysfunction is now recognized as a marker for:
Cardiovascular disease
There are many cancers of the female reproductive system. The nursing student knows that the most readily detected and most easily cured cancer—if detected early—is:
Cervical
A female receives a Papanicolaou (Pap) test result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse would emphasize the need for continued follow-up to monitor for which potential complication?
Cervical dysplasia
Which condition would the nurse expect a female client with human papillomavirus (HPV) to exhibit?
Cervical intraepithelial neoplasia
Which physiologic changes result in menopause?
Cessation of ovarian function and decreased estrogen levels
Which sexually transmitted infection exists in two morphologically distinct forms, elementary and reticulate bodies?
Chlamydia
Which structure supports the breasts while dividing the breast into 15 to 25 lobes?
Cooper ligaments
A client arrives in the emergency department complaining of severe pain in the left testicular area with nausea and vomiting for 2 hours. The left testicle is large and tender to palpation and radiating to the inguinal area. Which of the following reflexes can the nurse assess the absence of in order to indicate testicular torsion?
Cremasteric reflex
A client has been diagnosed with condylomata acuminata. The nurse recognizes that which treatment may be prescribed to removal visible warts?
Cryotherapy
A 45-year-old client reports "needing to bear down with urination," frequency, and occasional loss of urine when coughing. Based on symptoms, which diagnosis is most appropriate for this client?
Cystocele
Which metabolic effects are caused by the action of estrogen? Select all that apply.
Decreased bone resorption Increased production of thyroid globulins
Which assessment finding correlates to advanced (tertiary) syphilis?
Dementia
What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply.
Dementia Blindness Ataxia
While in its dormant state, what structure provides residence for herpes simplex virus to allow for replication?
Dorsal root ganglia
A female client reports a grayish-green nipple discharge in one breast. Which additional manifestation corresponds with a diagnosis of ductal ectasia?
Ductal inflammation with thickening
When is syphilis highly contagious?
During its primary stage
A female client is experiencing infertility. Which laboratory result would indicate the problem originates in the ovaries?
Elevated FSH
In assessing a client with a fibroadenoma of the breast, what will the nurse find?
Firm, rubbery masses
A client presents to an STI clinic. Her primary complaint is related to purulent exudate and bleeding after intercourse. The health care worker will primarily focus on the diagnosis of which STI?
Gonorrhea
There are two types of vulvar cancer. One type is found in older women, and one type is found in younger women, generally less than 40 years of age. The type found in younger women is thought to be caused by:
Human papillomavirus (HPV)
Which factor in a client's history is most likely related to the diagnosis of cervical squamous dysplasia?
Human papillomavirus (HPV) infection
Which diagnosis is most likely to require surgical correction?
Hypospadias
In primary dysmenorrhea, when contraception is not desired, what is the treatment of choice?
Ibuprofen
The nurse is completing client education on the use of a combination oral contraceptive pill (OCP) to a woman with polycystic ovary syndrome (PCOS). The nurse should include which content in the educational packet?
It contains estrogen and progesterone.
The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine. Which information is appropriate for the nurse to provide? Select all that apply.
It is ideally given before the child is sexually active. It can be given to boys and girls. It prevents a common cause of cervical cancer.
An examination of the external genitalia of a female would concentrate on which structures? Select all that apply.
Labia minora Clitoris
The health care provider suspects a diagnosis of endometriosis. Which procedure provides a definitive diagnosis?
Laparoscopy
The hormone progesterone is metabolized in which organ?
Liver
A 13-year-old client undergoing puberty is alarmed to find small, white bumps surrounding her areolae. The nurse reassures her that these are a normal sign of her sexual maturation and tells her that they are:
Montgomery tubercles.
Select the most common symptom a female diagnosed with chlamydial infection will develop.
Mucopurulent cervical discharge
A client has been diagnosed with acute cervicitis caused by Chlamydia trachomatis. Which clinical manifestation correlates to this diagnosis?
Mucopurulent drainage
The nurse practitioner is reviewing risk factors for the development of pelvic inflammatory disease (PID) with a client. Which information is appropriate to include? Select all that apply.
Multiple sex partners Previous diagnosis of sexually transmitted infection Sexual intercourse before the age of 15 years
A 20-year-old female has come to the clinic complaining of severe menstrual cramps. The clinic nurse practitioner knows that dysmenorrhea occurs when which muscle group contracts?
Myometrium
An male client presents with urethral itching, burning, pain, and a creamy, yellow discharge following unprotected sex with a new partner 3 days ago. The nurse anticipates the client to be diagnosed with which sexually transmitted infection?
Neisseria gonorrhoeae
A college student presents to the nurse's office complaining of premenstrual syndrome. Which clinical manifestations would confirm this diagnosis? Select all that apply.
Painful, edematous breasts Abdominal bloating
A 30-year-old male has contracted an STI caused by Treponema pallidum. Which symptom did he most likely notice first?
Painless chancres on the man's scrotum
A client with herpes simplex virus (HSV) states, "I can stop taking my drugs because I'm cured. My lesions are gone." Knowing the pathophysiology behind the disappearance of HSV symptoms, the health care provider suspects the client is experiencing which phase of infection?
Periods of latency in the nervous system
Which disorder of the female genitourinary system is most likely to result from a disruption in normal endocrine function?
Polycystic ovary syndrome (PCOS)
A client has been diagnosed with endometriosis. What assessment finding does the nurse expect? Select all that apply.
Premenstrual pain Pelvic pain Back pain
Vaginal infections can occur in young girls prior to menarche. What are some of the causes of vaginal infections in premenarchal girls? Select all that apply.
Presence of foreign bodies Intestinal parasites Poor hygiene
The nurse is caring for a pregnant client who is experiencing morning sickness. The nurse understands that which of the following is responsible for many of the common discomforts of pregnancy?
Progesterone
Which physiologic process is caused by estrogens?
Promotion of ovarian follicle growth
The nurse should assess a client with a history of untreated chlamydia for which potential disease process?
Reiter syndrome
Select the most reliable test to diagnose syphilis.
Serology
A female client reports to the health care provider that she has noticed a release of urine when she laughs or sneezes. Which interventions should the provider implement first?
Teach the client to do pelvic floor exercises
An older adult female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms?
Tertiary syphilis
The nurse is performing urinary catheterization on a 13-year-old girl and notices the girl's hymen is intact. What is the most accurate way to document this finding?
The client exhibits normal findings.
The nurse is discussing the menstrual cycle with a female client. The client asks, "Why does my side hurt halfway through my monthly cycle almost every month? The nurse suspects the cause of the pain may be:
The client has a leakage of blood onto the peritoneal surface after ovulation has occurred.
Which clients would the nurse determine are at increased risk of infection with gonorrhea? Select all that apply.
The client who is younger than 25 years of age The client who does not use condoms The client with multiple sexual partners
The nurse is discussing ovulation with a female client and notes an indication of ovulation is spinnbarkeit. What is an accurate description of spinnbarkeit?
The stretchy consistency of cervical mucus during ovulation
A client has been diagnosed with candidiasis. Which symptom was present to diagnose this condition?
Thick white secretions
The nurse is caring for a 54-year-old female client who reports vaginal dryness and painful intercourse. The nurse expects which prescription will be ordered for this client?
Vaginal estrogen preparation
Which clinical manifestation is most likely to accompany a diagnosis of vulvodynia?
Vulvar pain
The nurse planning care for a menopausal woman should include interventions to decrease risk for:
atherosclerosis.
An adult client reports persistent vaginal irritation and recurrent infections. In her history the physician notices that she recently has been prescribed antibiotics for a respiratory infection and concludes that it has affected her normal flora by:
causing the vaginal environment to be more alkaline than normal.
When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by:
elevated LH."
A client has been diagnosed with breast cancer following a suspicious mammogram followed by biopsy. The nurse who is planning this client's care should recognize that her prognosis is primarily dependent on the:
extent to which lymph nodes are involved.
A client is experiencing oligomenorrhea. The nurse interprets this as:
infrequent menstruation with periods more than 35 days apart.
A 51 year-old woman who has been receiving estrogen therapy (ET) for the last 5 years has visited her care provider because her peers have told her about the risks of heart disease, stroke, and breast cancer that could accompany hormone therapy (HT). How should her care provider respond to her concerns?
"ET demonstrated no increased risk of heart disease when compared with HT, but there was similar increased risk for stroke."
After seeking care due to recent history of testicular enlargement and scrotal pain, a 22-year-old college student has been diagnosed with testicular cancer. Which statement by the client indicates the need for further teaching?
"I can't shake this feeling like I've received a death sentence."
What should the nurse teach the client about assessing for possible breast cancer?
"Perform monthly self-breast exams after menses."
In teaching a client about genital warts, which statement is correct for the nurse to say?
"The incubation period is 6 weeks to 3 months."
A client asks the health care provider to, "Explain brachytherapy, which is recommended for my cervical cancer." Which response by the nurse is most accurate?
"They will insert a radioactive device into your vagina and position it next to the cervix, so that curative levels of radiation are directly on the cancer site."
Which instruction is essential for the nurse to include in the care plan for a client with herpes simplex virus-1 (HSV-1)?
"This disease is transmitted by oral secretions."
The nurse is teaching a female client who has been prescribed hormone therapy. The client asks, "What does this medication do?" Which statement is an appropriate response by the nurse?
"This medication will help relieve hot flashes and other adverse symptoms of menopause."
A young woman has contracted the human papillomavirus (HPV) and has developed genital warts. The client is eager to receive an HPV vaccine, citing the large number of television advertisements she has seen. How should the nurse best respond?
"Unfortunately, these vaccines are not effective once you have HPV."
A client is diagnosed with trichomoniasis. Which information is appropriate for the nurse to tell the client?
"We need to contact your sexual partners."
A female client with uterine leiomyomas asks the nurse about her risk of uterine cancer. Which statement best answers the question?
"Your leiomyomas may cause heavy periods but will not become cancerous."
What will the nurse assess in a client diagnosed with Paget disease as a cause of breast cancer?
A lesion of the nipple on the affected breast
The nurse suspects which female client may be at risk for infertility?
A long distance runner
An asymptomatic client who is worried about developing breast cancer due to the fact that it runs in her family asks the nurse if she could have a mammogram to see if she has any lumps. The nurse informs the client that a tumor usually is undetectable until it has doubled 30 times and contains more than 1 billion cells. This means that at this point it measures approximately which size?
1 cm
After inoculation with HPV, genital warts may begin to grow. They usually manifest as soft, raised fleshy lesions on the external genitalia of either male or female. What is the incubation period for HPV-induced genital warts?
6 weeks to 8 months
The client has a Bartholin cyst that has developed into an abscess. The nurse explains to the client the plan of care, including which treatments?
A catheter may be inserted to drain the cyst for several weeks.
Which client is at highest risk of developing trichomoniasis?
A client who is sexually active
A 32-year-old is being treated for an abnormal menstrual cycle with excessive bleeding, endometrial hyperplasia, and fertility problems. Which is a possible cause of these symptoms?
A granulosa cell tumor
A client has been diagnosed with syphilis after seeking care for a penile lesion. The nurse should anticipate which intervention?
Administration of injectable penicillin
A nurse notes that the incidence of sexually transmitted infections (STIs) are increasing. To which reason does the nurse attribute this?
Advanced technology to screen for infections
What should the nurse do when a woman who stopped breast-feeding her infant 3 months ago complains of occasional milk leakage from her breasts?
Advise the woman that this is a normal occurrence after stopping breast-feeding
The nurse is caring for a client recently diagnosed with testicular cancer. The nurse evaluates the medical record for which of these diagnostic tests, typically altered in this type of malignancy?
Alpha fetoprotein test
The nurse is administering a phenothiazine derivative with the understanding that this medication puts the client at risk for hyperprolactinemia, which may produce which manifestations? Select all that apply.
Amenorrhea Oligomenorrhea Anovulation
A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last 6 months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of medication is most likely to resolve her symptoms?
An azole antifungal agent
Which client is at highest risk for developing acute bacterial prostatitis?
An older adult male diagnosed with frequent urinary tract infections testing positive for Gram-negative rods
The nurse is explaining ovulation to a female client. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are important hormones needed to ovulate and are secreted by which gland?
Anterior pituitary
Select the structure primarily responsible for the secretions of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin.
Anterior pituitary gland
When caring for the client with acute bacterial prostatitis, the nurse plans for which intervention?
Antibiotics
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed:
Atrophic vaginitis
A nurse is attempting to culture a lesion to determine if a client has genital herpes. What is the nurse's best action?
Attempt to culture a lesion as soon as it develops.
A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:
Atypical cervix cellular changes
A woman of child-bearing age asks the nurse about a natural method to avoid pregnancy. What is an appropriate response?
Avoid sex when cervical mucus is most stretchy.
A client has been diagnosed with a chlamydial infection. Select the pharmacologic treatment of choice.
Azithromycin
A nurse is caring for a client being treated for chlamydial infection. Which medication would the nurse anticipate being prescribed?
Azithromycin
The nurse provides prophylactic treatment for a neonate to prevent conjunctival gonorrhea. The nurse is aware that the intervention will reduce the risk of:
Blindness
A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of hormone therapy. What is the goal of this pharmacologic treatment?
Blocking effects of estrogen on the growth of malignant cells
What can a female client with a palpable breast lump expect as the next diagnostic step if the mass does not appear on mammography?
Breast ultrasound
The human ovary is fully developed at what age?
By the third month of fetal life
Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has:
C. albicans
Epididymitis can be sexually transmitted, or it can be caused by a variety of other reasons, including abnormalities in the genitourinary tract. What are the most common causes of epididymitis in young men without underlying genitourinary disease?
Chlamydia trachomatis and Neisseria gonorrhoeae
The nurse is reviewing the uses and side effects of azithromycin. For which infection is azithromycin the antibiotic of choice?
Chlamydial
A couple presents to an infertility clinic. The health care provider will focus testing on which sexually transmitted infection (STI) that is very damaging to the reproductive system but rarely exhibits symptoms of infection?
Chlamydial infection
Which risk factor is associated with erectile dysfunction (ED) and considered preventable?
Cigarette smoking
Which female client is exhibiting signs of untreated polycystic ovary syndrome (PCOS)?
Client age 34, states excess body hair and menstrual cycles are irregular
A client with polycystic ovary syndrome (PCOS) visits a fertility clinic. Which intervention will best improve the chance for a successful pregnancy?
Clomiphene
The vulva area is especially prone to skin infections. The nurse knows that this occurs because of:
Constant exposure to secretions and moisture
Which assessment is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)?
Digital rectal examination
Cryptorchidism, left untreated, is a high risk for testicular cancer and infertility. What is one of the treatment goals for boys with cryptorchidism?
Easier cancer detection
A client who has been diagnosed with premenstrual syndrome (PMS) asks if there is anything to help alleviate the symptoms. The best response would be:
Eat a diet low in simple sugars and high in protein.
The nurse in the ER is caring for a client with lower abdominal pain that is greater on the right side and who has light vaginal spotting. When the client's human chorionic gonadotropin (hCG) level is lower than normal, the nurse plans care for a client with:
Ectopic pregnancy
The nurse working in a fertility clinic is assessing a client's risk for fallopian tube obstruction. Which disorder places the woman at greatest risk for fallopian tube obstruction?
Endometriosis
The ovarian follicle becomes luteinized once ovulation has taken place. As the corpus luteum, the now empty follicle produces what?
Estrogen and progesterone
The nurse is reviewing the history of an older adult female client who was recently diagnosed with coronary heart disease. What factors are known to contribute to this condition? Select all that apply.
Has hypertension for 15 years Used hormone therapy for 5 years Smoked 1 pack/day for 20 years
A client comes to the clinic and informs the nurse that he was playing soccer and was kicked in the scrotal area on the right side. The nurse observes that the scrotal skin on the right side is dark red. What should the nurse suspect this client may have?
Hematocele
A nurse educator is describing the changes in cervical mucus as they related to changes in hormone levels. Long, stretchy cervical mucus that exhibits ferning on a microscope slide is characteristic of which hormonal change?
High estrogen levels.
The community health nurse is providing men's health education on prostate cancer. Which risk factors for prostate cancer should the nurse include in the discussion? Select all that apply.
High fat diet from processed meat Consuming high fat dairy items
A 38-year-old woman with proliferative breast changes of papilloma asks the nurse about her risk for breast cancer. Which statement of risk is correct?
Higher because of your papilloma
Select the factor that would increase a male's risk for the development of testicular cancer.
History of cryptorchidism
A client presents with priapism. The nurse interviews the client about which potential risk factors? Select all that apply.
History of erectile dysfunction Hematologic disorders Recent intake of alcohol
A female client is found to have genital warts during a routine pelvic examination. Which sexually transmitted infection will the nurse prepare to test for?
Human papillomavirus
A female client with blocked fallopian tubes seeks assistance at a fertility clinic. Which assisted reproductive technology will bring the greatest chance for conception?
In vitro fertilization (IVF)
Select the treatment of choice for syphilis.
Long-acting penicillin in a single injection
The nurse is taking the history of a 30-year-old female client with amenorrhea. What factors does the nurse identify as contributing to the condition? Select all that apply.
Long-distance running Anorexia nervosa Pituitary tumor
The nurse is reviewing laboratory values of a 70-year-old female client and observes the client's low-density lipoprotein (LDL) level is elevated. The nurse understands a possible reason for this is:
Long-term estrogen deprivation
For which STI should the nurse anticipate a prescription for antibiotics such as erythromycin or doxycycline since this infection will respond to antibiotic treatment?
Lymphogranuloma venereum (LGV)
A woman reports to the primary healthcare provider that she experiences monthly changes before her menstrual cycle. Which statement demonstrates understanding of premenstrual disorders?
Many women report premenstrual emotional or physical changes.
Polycystic ovary syndrome is an endocrine disorder and a common cause of chronic anovulation. In addition to the clinical manifestations of PCOS, long-term health problems, including cardiovascular disease and diabetes, have been linked to PCOS. What drug has emerged as an important part of PCOS treatment?
Metformin
A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?
Metronidazole
A client has developed a 5-cm Bartholin cyst and is experiencing pain, tenderness, and dyspareunia. Which treatment regimen is commonly prescribed for this condition? Select all that apply.
Moist heat applications Drainage of cyst Antibiotics
Polycystic ovary syndrome (PCOS) is a common endocrine disorder. The nurse understands that about 50% of the women who are diagnosed with PCOS have which problem?
Obesity
Select the correct statement regarding herpes simplex virus.
Only two strains of the virus are considered sexually transmittable.
A 24-year-old client with a body mass index (BMI) of 35 has been diagnosed with polycystic ovary syndrome (PCOS) and is exploring treatment options. What treatment options should the nurse share with the client? Select all that apply.
Oral contraceptives A calorie-reduced diet Biguanide medication
A 27-year-old male developed mumps and was ill for several days. The client suddenly developed a fever and painful enlargement of the testes approximately 4 days after recovering. The nurse should suspect that the client has developed:
Orchitis
A client develops Reiter's syndrome. Which symptoms will the nurse assess? Select all that apply.
Pain in the joints Conjunctivitis
A client has been diagnosed with a Bartholin gland cyst. The nurse expects the client may experience which symptoms if this becomes infected?
Pain, tenderness, and dyspareunia
A nurse is assessing a male who is reporting nonspecific symptoms of prostate and periurethral gland pain. Which characteristic discharge makes the nurse suspect gonorrhea?
Purulent exudates
A client presents with a rash on the palms of his hands, mucous membranes, and stomach. He is reporting a sore throat and nausea. Which conditions is the nurse concerned about?
Syphilis
A female client presents to the clinic with a rash on the palms of her hands, symptoms of hair loss, and the development of elevated, red-brown lesions that have begun to ulcerate and produce a foul discharge. Based on these symptoms, the nurse plans to test the client for which sexually transmitted infection?
Syphilis
What is the most important discharge instruction for a female client with pelvic inflammatory disease (PID)?
Take all of the antibiotic
Which client will the nurse determine is a candidate for continuous antiviral suppressive therapy for genital herpes?
The client with more than six outbreaks this year
The nurse is assessing the genitalia of a 42-year-old female client diagnosed with a genitourinary disorder. The nurse recognizes that which finding does not describe the normal anatomy of the female genitalia.
The clitoris is located posterior to the urethra.
Leiomyomas are smooth-muscle fibroid tumors that usually develop in which part of the reproductive system?
The corpus of the uterus
A 40-year-old woman has been identified to have a deficiency in estrogen. Which physiologic phenomenon is most likely to remain unaffected?
The synthesis and release of adrenal glucocorticoids.
A woman has gone to her gynecologist complaining of pain during intercourse. The physician orders a maturation index on her vaginal scrapings. The results return an index of 75-25-0. The nurse can interpret this to mean:
The woman is experiencing postmenopausal vaginal dryness.
An older female client is diagnosed with uterine prolapse. Which factors in her history increase her risk for this condition? Select all that apply.
Three living children Diabetic neuropathy Colon cancer
What is the primary reason that the nurse urges clients to be seen by their health care provider when they have genital warts?
To be informed of the risk of premalignant and malignant changes
A sexually active 22-year-old woman is visiting her nurse practitioner for a yearly physical. The nurse is performing a Pap smear to assess the potential of cervical cancer. When focusing on the region most susceptible to cancerous transformation, the nurse should prioritize which area?
Transformation zone
A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the health care provider is thinking this client most likely has:
Trichomoniasis
A nurse is interviewing a client about issues with infertility. Which condition contributes to the risk of infertility in both men and women?
Trichomoniasis
Select the condition that contributes to the risk of infertility in males.
Trichomoniasis
Ectopic pregnancies are true gynecologic emergencies and are considered the leading cause of maternal death in the first trimester. What diagnostic test would the nurse expect to have ordered for a suspected ectopic pregnancy?
Ultrasonography followed by serial hCG tests
A client has an ectopic pregnancy. Which factor(s) in the client's history could contribute to the condition? Select all that apply.
pelvic inflammatory disease (PID) smokes one pack per day
The nurse is teaching a client with polycystic ovary syndrome (PCOS) about the condition. Which statement by the client indicates a need for further instruction?
"I developed this as a result of a sexually transmitted infection."
The nurse has taught a 30-year-old female client to perform breast self-evaluation (BSE). Which statement by the client indicates correct understanding?
"I will palpate my breasts for lumps a few days after my period."
A client comes to the clinic and is diagnosed with genital herpes. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?
"I will take the acyclovir every 8 hours for the next week."
The nurse is discussing the physical changes related to menopause with a 48-year-old woman. The client asks, "How long will it take before I am through these changes and finally reach menopause?" Which statement is an appropriate response by the nurse?
"Most women experience symptoms for about 4 years."
A female client is diagnosed with chlamydia during a routine pelvic examination. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?
"My partner will need to take antibiotics at the same time I do."
A female client informs the nurse that she is having hot flashes on occasion, has trouble sleeping, and thinks that she is having some symptoms of menopause. The client asks the nurse how long these symptoms will last prior to experiencing menopause. What is the best response?
"Perimenopause can precede menopause by approximately 4 years."
What will the nurse teach the client who has a cervical polyp?
"Polyps typically are asymptomatic"
In a client suspected of having gonorrhea with active symptoms, what does the nurse tell the client about confirming the diagnosis?
"Since you have discharge, we can perform a culture."
A woman asks "Why do I have to tell my sexual partner about chlamydia? I thought this was a "female" disease." What is the nurse's best response?
"The condition is transmittable to men and may cause infertility."
A client with vulvodynia tells the nurse, "This is not getting better. I just can't live like this." What is the best response by the nurse?
"What bothers you the most about your condition?"
The nurse is caring for a 48-year-old female client who asks, "How do you know when you have reached menopause?" Which statement is an appropriate response by the nurse?
"You are considered to be menopausal when you have not menstruated for a full year and the hormone that fluctuates with menstruation no longer fluctuates."
The nurse is reviewing findings from the maturation index with an understanding that the test indicates:
Estrogen levels
How often do most women in the middle reproductive years menstruate?
Every 28 to 30 days
The nurse is caring for a client with cancer of the scrotum. When performing a health history, which of these does the nurse explore as a risk for this type of malignancy?
Exposure to tar and soot
The endocrine system is highly involved in the female reproductive system. Which hormones are used to stimulate the primordial follicles?
FSH and LH
During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation?
Fallopian tube damage
A nurse educator is explaining the process of sexual intercourse, fertilization, and fetal development to a high school biology class. What process should the nurse describe?
Fertilization in the outer portion of the fallopian tube
A female client informs the nurse that she had intercourse yesterday evening and is wondering if she could become pregnant. She asks the nurse where the fertilization (implantation) currently would be located if she was indeed pregnant. What should the nurse tell the client?
Fertilization normally occurs in the middle to outer portion of the Fallopian tube.
Which statement about gonorrhea is correct?
Gonorrhea is a reportable sexually transmitted infection.
The nurse is caring for a client with lichen simplex chronicus. What assessment finding does the nurse expect?
Gray-white plaques with an irregular surface
Bacterial vaginosis is the most common vaginal infection seen by health care providers. What is the predominant symptom of bacterial vaginosis?
Grayish white discharge with a fishy odor
A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be:
HPV vaccine before becoming sexually active
Mastitis is an inflammation of the breast that can occur at any time. What is the treatment for mastitis? Select all that apply.
Nonsteroidal anti-inflammatory drugs Application of heat or cold
A newly pregnant woman reports to the nurse that her breasts are excessively tender and that her areolae and nipples are becoming darker and more prominent. The nurse should describe which cause of these changes?
Normal changes of pregnancy due to increased levels of estrogen and progesterone
A female client is being seen in the ED with complaints of lower abdominal pain, dyspareunia, back pain, purulent cervical discharge, and the presence of adnexal tenderness and painful cervix on bimanual pelvic examination. The nurse suspects the client has pelvic inflammatory disease (PID), and will assess the client for:
Number of sexual partners
Which treatment intervention is recommended for infants who have a severe case of hypospadias?
surgical repair
The nurse caring for a client with syphilis notes the Venereal Disease Research Laboratory (VDRL) test result is elevated. Which stage of syphilis is this client likely experiencing?
Secondary
A 23-year-old diagnosed with syphilis presents with palmar rash, sore throat, fever, and a red-brown lesion on the genital area. The symptoms have been present for 3 weeks. Select the stage of syphilis this client is currently in.
Secondary
Which assessment finding is most clearly suggestive of initial genital herpes (herpes simplex virus, HSV) in a male client?
Itching, pain, and the emergence of pustules on the penis
A client requests a prescription for sildenafil to assist him with achieving and maintaining an erection. Which type of medication would contraindicate the use of sildenafil?
Nitrate
A client is complaining to the health care provider about several vague signs/symptoms. Which sign/symptom raises a "red flag" indicating the client may have developed endometrial cancer?
Painless abnormal bleeding
A 75-year-old man presents at the clinic complaining of pain during intercourse and an upward bowing of his penis during erection. The client's history mentions an inflammation of the penis that was treated 3 months ago. The physician's physical examination of the client notes beads of scar tissue along the dorsal midline of the penile shaft. What would be the suspected diagnosis of this client?
Peyronie disease
The provider is assessing a client with a history of erectile dysfunction (ED) who is requesting a prescription for treatment. When assessing for additional information related to causes of ED, which information should the provider solicit from the client?
Presence of arterial occlusive disease
The nurse is caring for a client with acute superficial balanoposthitis. The nurse assesses for which of these signs or symptoms consistent with the diagnosis?
Redness of the glans penis and malodorous discharge
The nurse is performing an assessment on a newborn, 12 hours old. The newborn has right cryptorchidism as documented in the health records and assessed by the nurse. Where will the nurse assess for this disorder?
Scrotum
What role do Montgomery tubercles play in breast health?
Secrete a lubricant that keeps the nipple soft and elastic
A female client experiencing hot flashes during perimenopause asks the nurse about hormone therapy (HT). What is the appropriate response by the nurse?
Short term HT can be used to reduce symptoms.
Priapism (a prolonged painful erection not associated with sexual excitement) can occur at any age. In boys, ages 5 to 10, what are the most common causes of priapism?
Sickle cell disease or neoplasms
The nurse is assessing a female client who is being seen at the clinic for a yearly pelvic and Pap smear. Upon assessment, which sign is consistent with the facilitation of movement of intravascular fluid into the extracellular space related to estrogen levels before menstruation?
Slight edema of the feet and ankles
Specific actions of estrogen include which actions on the body? Select all that apply.
Stimulate development of vagina, uterus, and fallopian tubes Promote growth of ovarian follicles
The nurse has just completed the admission assessment of a client diagnosed with invasive penile cancer. The most likely plan of treatment will be:
Surgical removal of the affected area
When caring for a group of clients, the nurse recognizes which of these individuals has increased risk for balanitis?
Client with a sexually transmitted infection
An older adult female client had an oophorectomy before menopause. Which current symptoms could result from early loss of estrogen? Select all that apply.
Cognitive decline Hyperlipidemia
The mother of a 5-year-old boy brings him into the clinic because there is a firm feeling and swelling around one of his testes. What would the suspected diagnosis be?
Hydrocele
Which chronic health issues increase a man's risk for developing erectile dysfunction? Select all that apply.
Hypertension Diabetes mellitus Hyperlipidemia
The nurse is performing a newborn assessment on a 2-day-old male infant. Assessment reveals the presence of the urethral opening on the ventral side of the penis. The nurse would document this finding as being:
Hypospadias
A client calls the clinic and informs the nurse that he has sustained an erection for 3 hours and that it is extremely painful. The client has a history of sickle cell disease and this has not happened to him in the past. Which instruction should the nurse give to the client?
If the client does not seek medical attention, impotence may result.
An adult male has been diagnosed with mumps orchitis. The nurse should educate the client regarding which complication associated with mumps orchitis?
Impaired spermatogenesis
A client has developed priapism. For which outcome is this client at risk?
Impotence
The community health nurse is conducting a men's health class. Which of these does the nurse relate as the major role of the prostate?
It increases sperm motility.
If not treated urgently, testicular torsion can result in which complication?
Loss of testicular perfusion
What are the small bumps or projections on the areolar surface called?
Montgomery tubercles or glands
A postmenopausal client reports painful intercourse. Which information should the nurse provide the client?
"Decreased estrogen levels can lead to vaginal dryness after menopause which can lead to painful intercourse."
A client is admitted with secondary orchitis. Which assessment question is most relevant?
"Have you ever had mumps?"
While working with a client with a fairly recent spinal cord injury, the partner asks about the couple's ability to maintain a sexual relationship. Which response by the nurse is most accurate?
"If the parasympathetic impulses can pass from the sacral segments of spinal cord through pelvic nerves, an erection should be possible."
The nurse is discussing the menstrual cycle with a female client. The client asks, "Why do my hands get puffy and I gain weight right before my periods?" Which statement is an appropriate response by the nurse?
"The level of estrogen increases in your body before your period, and this causes fluid retention."
An adult male reports painful urination, rectal pain, fever/chills, general malaise and myalgia. Vital signs are: temperature, 101.7°F (38.7°C); blood pressure, 105/74 mm Hg; pulse, 98 bpm; respiration, 22 breaths/min. What condition should the health care provider suspect?
Acute bacterial prostatitis
Which client is most at risk for experiencing erectile dysfunction (ED)?
A 54-year-old with history of smoking one pack of cigarettes per day for 30 years
An adolescent male comes to the urgent care clinic. Upon assessment, the following is noted: history of circumcision, erythema of the glans, and prepuce with a malodorous discharge. Based on symptoms, the probable diagnosis would be:
Acute superficial balanoposthitis
Which statement about screening for prostate cancer is most accurate?
BPH and prostatitis can confound prostate screening results.
Benign prostatic hyperplasia (BPH) and prostatic adenocarcinomas present differently. The nurse is aware of which difference?
BPH is commonly located in the periurethral zone of the prostate, while prostate cancers are commonly located in the peripheral zones of the prostate.
The environment of the vagina is moist with a pH 4.0 to 4.5. The major purpose of the acidic environment is:
Bacteriostatic
A male client reports frequent urination, difficulty starting to urinate, and dribbling after he has finished urinating. Which diagnosis correlates with this client's manifestations?
Benign prostatic hyperplasia (BPH)
Based on the group that statistically has the greatest risk, the health care provider should assess which ethnic group for prostate cancer?
Black
A client on the urology floor who has BPH asks the nurse how the pharmacologic agent finasteride will help decrease the size of his prostate. Which principle explains the mechanism of action?
Blocking effects of androgens on the prostate
A client asks the nurse what can cause, or contributes to the development of, benign prostatic hyperplasia (BPH). The best response would be:
Dihydrotestosterone (DHT) proliferates the growth of prostatic stromal cells, leading to a reduction in the death of the epithelial cells.
The mother requests that a circumcision be performed on a newborn with hypospadias. Which information related to treatment of hypospadias should the nurse convey?
Circumcision is avoided as the foreskin will be used to repair the urinary opening.
Erectile dysfunction is the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. The nurse knows that there may be many causes of erectile dysfunction, and a psychogenic cause would include which of the following?
Depression
The fallopian tubes are narrow tubes that attach bilaterally to the uterus. Within the fallopian tube, fertilization of the ovum takes place. The end of the fallopian tube nearest the ovary is funnel-like. What are the fringed, finger-like projections around the funnel-shaped opening of the fallopian tube called?
Fimbriae
A client has just become pregnant and there is a consequent increase in secretions from the columnar epithelium of her endocervix. What effect will this have?
Formation of a mucoid plug to protect her uterus
A woman with a regular 28-day menstrual cycle wishes to become pregnant. At which point in the menstrual cycle is the optimal time for intercourse to end in fertilization of the ovum?
Fourteenth day after menses begins
A client in the urology clinic asks the nurse how the doctor will determine if his prostate lesion is due to benign prostatic hyperplasia (BPH) or prostate cancer. Which response should the nurse convey?
Presence of cancers are determined through a biopsy.
Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation?
Progesterone
A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be:
Psychosexual counseling and PDE-5 inhibitor medications
The lactating mother of a 3-month-old infant reports to the nurse that she experiences milk leakage if she hears the child cry when it has been more than 2 hours since the last feeding. How should the nurse respond?
Reassure her that this is a normal physiologic response.
A nurse is performing a genital examination on a male client who develops an erection. Which action is the nurse's most appropriate intervention?
Reassure the client that this is a normal response and continue with the examination
The nurse is caring for a client with significant benign prostatic hyperplasia (BPH) and hydronephrosis who is fearful of having corrective surgery. Which information is important for the nurse to convey?
The obstruction is causing urine to flow backward and cause kidney dysfunction.
The nurse is caring for an infant with an undescended testis. Which of these does the nurse teach the parents is the appropriate treatment?
The surgical placement of the testis in the scrotum is needed.
Which factor places a male client at risk for balanitis?
Uncircumcised penis
The nurse working on an inpatient adolescent pediatric unit must prioritize which parents to teach first. Which diagnosis directs the nurse to provide teaching for the parents first due to the need for prompt treatment to prevent long-term complications?
Undescended testis
A client asks, "What caused my acute prostatitis?" Which response by the nurse explains the most common cause of acute prostatitis?
Urethral infection with Escherichia coli
Which complication is associated with prostatic hyperplasia?
Urine retention
The connecting tube between the cervix and the vestibule is referred to as:
Vagina
A client is suspected to have small varicoceles in his left scrotum. Which assessment technique may help accentuate small varicosities?
Valsalva maneuver
A client is admitted with a prolonged and painful erection that has lasted longer than 4 hours. The nurse knows that this is a true urologic emergency, and that the cause is:
impaired blood flow in the corpora cavernosa of the penis.
The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs:
in the middle to outer portion of the fallopian tube.
The nurse is checking the pH of a client's vaginal tissue and finds the pH to be 4.3. The nurse interprets this finding as:
normal.
The nurse in the urology unit is teaching about medication to treat erectile dysfunction. The mechanism of action of most of these medications is that the medication:
promotes increase in blood flow to the corpora cavernosa.
The nurse on the urology unit teaches the nursing student that which test assists in detecting a recurrence of prostate cancer after prostatectomy?
prostate-specific antigen (PSA) level
