Chapter 56

A 21-year-old woman has sought care because of heavy periods and has subsequently been diagnosed with menorrhagia. The nurse should recognize which of the following as the most likely cause of the patients health problem?

Hormonal disturbances

A newly pregnant patient is being assessed in an obstetric clinic. The patient states that she has been experiencing intense abdominal pain and the nurse anticipates that the patient will be assessed for ectopic pregnancy. In addition to ultrasonography, what diagnostic test should the nurse anticipate?

Human chorionic gonadotropin (hCG) testing

A nurse presenting an educational event for a local community group is addressing premenstrual syndrome (PMS). What treatment guideline should the nurse teach this group?

Increase the frequency and intensity of exercise.

An adolescent is brought to the clinic by her mother because of abnormal uterine bleeding. The nurse should understand that the most likely cause of this dysfunctional bleeding pattern is what?

Lack of ovulation

The nurse is caring for a couple trying to get pregnant and have not been able to for over a year. The couple asks what kind of problems a man can have that can cause infertility. What should be the nurses response?

Men can have problems that increase the temperature around their testicles and decrease the quality of their semen.

The nurse is working with a patient who expects to begin menopause in the next few years. What educational topic should the nurse prioritize when caring for a healthy woman approaching menopause?

Patient teaching and counseling regarding healthy lifestyles

The nurse is planning the sexual assessment of a new adolescent patient. The nurse should include what assessment components? Select all that apply.

Physical examination findings Laboratory results Health history

A 15-year-old girl is brought to the clinic by her mother to see her primary care provider. The mother states that her daughter has not started to develop sexually. The physical examination shows that the patient has no indication of secondary sexual characteristics. What diagnosis should the nurse suspect?

Primary amenorrhea

A 27-year-old primipara presents to the ED with vaginal bleeding and suspected contractions. The woman relates that she is 14 weeks pregnant and she thinks she is losing her baby. Diagnostic testing confirms a spontaneous abortion. What nursing action would be a priority at this time?

Provide opportunities for the patient to talk and express her emotions.

The nurse is working with a couple who is being evaluated for infertility. What nursing intervention would be most appropriate for this couples likely needs?

Referring them to appropriate community resources

A 51-year-old woman is experiencing perimenopausal symptoms and expresses confusion around the possible use of hormone therapy (HT). She explains that her mother and aunts used HT and she is unsure why few of her peers have been prescribed this treatment. What should the nurse explain to the patient?

Research has shown that significant health risks are associated with HT.

A couple has come to the infertility clinic because they have been unable to get pregnant even though they have been trying for over a year. Diagnostic tests are planned for the woman to ascertain if ovulation is regular and whether her endometrium is adequately supported for implantation. What test would the nurse expect to have ordered for this woman?

Serum progesterone

A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurses best response?

Tampons need to be changed every 4 to 6 hours.

A couple with a diagnosis of ovarian failure discusses their infertility options with their physician. The nurse should recognize which of the following as the treatment of choice for a patient with ovarian failure?

Gamete intrafallopian transfer

The nurse is being trained to perform assessment screenings for abuse on patients who come into the walk-in clinic where the nurse works. Which of the following assessment questions is most appropriate?

Have you ever been forced into sexual activity?

A patient in her late fifties has expressed to the nurse her desire to explore hormone replacement therapy (HRT). Based on what aspect of the patients health history is HRT contraindicated?

History of vascular thrombosis

During the nurses assessment of a female patient, the patient reveals that she experienced sexual abuse when she was a young woman. What is the nurses most appropriate response to this disclosure?

Facilitate appropriate resources and referrals.

A nurse is collecting assessment data from a premenopausal patient who states that she does not have menses. What term should the nurse use to document the absence of menstrual flow?

Amenorrhea

A woman presents at the ED with sharp, colicky pain in her right abdomen that radiates to her right shoulder. She tells the nurse that she has been spotting lightly for the past few days. The patient is subsequently diagnosed with an ectopic pregnancy. What major nursing diagnosis most likely relates to this patients needs?

Anxiety related to potential treatment options and health outcomes

The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new patient. According to this model, the nurse should begin with what action?

Asking the patients permission to discuss sexuality

A womans current health complaints are suggestive of a diagnosis of premenstrual dysphoric disorder (PMDD). The nurse should first do which of the following?

Assess the patient for risk of suicide.

A female patient who has cognitive and physical disabilities has come into the clinic for a routine check- up. When planning this patients assessment, what action should the nurse take?

Avoid equating the patient with her disabilities.

A 48-year-old woman presenting for care is seeking information about hormone therapy (HT) for the treatment of her perimenopausal symptoms. The patients need for relief from hot flashes and other symptoms will be weighed carefully against the increased risks of what complications of HT? Select all that apply.

Breast cancer Cardiovascular disease Venous thromboembolism

A 36-year-old woman comes to the clinic complaining of premenstrual syndrome (PMS) that is disrupting her quality of life. What signs and symptoms are associated with this health problem? Select all that apply.

Breast tenderness Depression Fluid retention Headache

A community health nurse is leading a health education session addressing menopause and other aspects of womens health. What dietary supplements should the nurse recommend to prevent morbidity associated with osteoporotic fractures?

Calcium and vitamin D

A patient who is in the first trimester of pregnancy has experienced an incomplete abortion. The obstetric nurse should prepare the patient for what possible intervention?

Dilation and evacuation

A clinic nurse is meeting with a 38-year-old patient who states that she would like to resume using oral contraceptives, which she used for several years during her twenties. What assessment question is most likely to reveal a potential contraindication to oral contraceptive use?

Do you smoke?

A premenopausal patient is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is 2 weeks late. The nurse should recognize a need for this patient to be investigated for what health problem?

Ectopic pregnancy

A school nurse is presenting information on human development and sexuality. When describing the role of hormones in sexual development, which hormone does the nurse teach the class is the most important one for developing and maintaining the female reproductive organs?

Estrogen

A nurse practitioner is preparing to perform a patients scheduled Pap smear and the patient asks the nurse to ensure that the speculum is well-lubricated. How should the nurse proceed with assessment?

Explain to the patient that water is the only lubricant that can be used.

By initiating an assessment about sexual concerns what does the nurse convey to the patient? Select all that apply.

That sexual issues are valid health issues That it is safe to talk about sexual issues That changes or problems in sexual functioning should be discussed

A new patient has come to the clinic seeking an appropriate method of birth control. What would the nurse teach this patient about a diaphragm?

The diaphragm may be cleaned with soap and water after use.

The nurse is assessing a patient who believes that she has recently begun menopause. What principle should inform the nurses interactions with this patient?

The nurse must carefully assess the patients feelings and beliefs surrounding menopause.

A patient calls the clinic and tells the nurse she has thick white, curd-like discharge from her vagina. How should the nurse best interpret this preliminary data?

The patient may have a Candida species infection.

The school nurse is presenting a class on female reproductive health. The nurse should describe what aspect of Pap smears?

The test can detect early evidence of cervical cancer.

A 51-year-old woman has come to the OB/GYN clinic for her annual physical. She tells the nurse that she has been experiencing severe hot flashes, but that she is reluctant to begin hormone therapy (HT). What potential solution should the nurse discuss with the patient?

Vitamin supplements

The nurse is taking the sexual history of an adolescent who has come into the free clinic. What question best assesses the patients need for further information?

What questions or concerns do you have about your sexual health?