Chapter 8

A woman is scheduled to undergo a loop electrosurgical excision procedure (LEEP) as treatment for an abnormal Pap smear. Which instruction would the nurse include in the teaching plan for this client?

"It takes about 10 minutes to do in your healthcare provider's office."

A 25-year-old woman is at the primary care provider for her annual check up. The nurse educated the woman on risks for cervical cancer. Which question would be important to ask as part of a risk screening?

"Were you sexually active at an early age?"

A client presents for her annual Pap test. She wants to know about the risk factors that are associated with cervical cancer. Which risk factor for cervical cancer should the nurse inform the client about?

early age at first intercourse

A nurse is creating a fact sheet for clients at a women's health center about cervical cancer. Which information would be most important for the nurse to include?

Highest incidence of cervical cancer is in women 40 to 49 years of age.

A student in clinical caring for a woman who has been diagnosed with ovarian cancer consults her nursing instructor. The student demonstrates an understanding of ovarian cancer when she states which information?

It is known as the "silent killer."

The nurse is assisting a woman in scheduling an appointment for a Pap smear. The woman's last menstrual period was May 2. Which date would be most appropriate for the appointment?

May 17

A 24-year-old female client with a family history of cervical cancer is in the office. For which test should the nurse prepare the client to detect early stages of cervical cancer?

Papanicolaou test

After conducting a class for college students about cervical cancer prevention, the nurse determines that the class understands that steps can be taken to help prevent cervical cancer based on which statement?

More than 90% of squamous cervical cancers contain HPV DNA.

When preparing a presentation about screening for cervical cancer, the nurse would include which recommendations?

Pap smears every 3 years until age 30

A nurse is preparing a woman for a Pap smear procedure. The nurse has already washed her hands and gathered all necessary equipment (maintaining sterility). What is the next step in the Pap smear procedure?

Position the client in stirrups or foot pedals so that her knees fall outward.

A 55-year-old client presents to the clinic with persistent vulvar pruritus, burning, and a lump. She states she has had the symptoms for 5 months and has been trying to treat them with over-the-counter creams. She has a history of multiple sexual partners and HPV and is a smoker. What should the nurse do next?

Prepare the client for a biopsy of the lesion. A client with ovarian cancer is admitted to the hospital for surgery.

A woman with ovarian cancer has been told that she is in stage III of the cancer. The nurse is reviewing the information with her. Which statement would help in the woman's understanding of stage III ovarian cancer?

The growth has spread to the lymph nodes and other areas/organs in the abdominal cavity.

A 47-year-old woman was just diagnosed with a cancer of her reproductive tract. The public health nurse is aiding in counseling. Which nursing interventions would be supportive in counseling this woman? Select all that apply.

Use sincere, basic communication techniques. Validate the client's feelings and provide realistic hope. Give postoperative care and instructions when prescribed.

A nurse assesses and suspects vulvar cancer based on which assessment finding?

fleshy, ulcerated mass on the labia majora

After teaching a local woman's community group about cervical cancer, the nurse understands that teaching has been successful when the group identifies which condition as a risk factor for cervical cancer?

genital herpes

The nursing student correctly identifies which procedure as the treatment of choice for endometrial cancer?

hysterectomy and salpingo-oophorectomy

The nurse is preparing a woman who is suspected of having endometrial cancer for diagnostic testing. Which test would the nurse most likely prepare the client for first?

ultrasound

While conducting an interview with a 38-year-old client, the nurse recognizes which factor as putting the client at the greatest risk for endometrial cancer?

use of estrogen without progestin for hormone replacement therapy

A nurse is assessing a 20-year-old female. Which data finding taken during the history would indicate endometrial cancer?

vaginal bleeding that is painless and abnormal

A client has been diagnosed with cervical cancer during her second trimester of pregnancy. She decides to delay treatment until after the baby is born. The nurse prepare her for birth by explaining the birth will most likely be:

via cesarean section.

A nurse explains to a client that although HPV infection is more commonly associated with cervical cancer, which cancer would the nurse identify as also a risk?

vulvar cancer

An elderly client who has been seen in the clinic for several months reporting vulvar itching has been prescribed different creams and ointments but none of them have worked. What should the nurse practitioner suspect based solely on this symptom?

vulvar cancer

An elderly woman is seen in the clinic reporting a lesion on her labia majora and states that she has experienced some bleeding and itching as well. She states that this has been going on for approximately three months. She tells the nurse that she has not been to a health care provider in over 10 years. What diagnosis would the nurse expect the primary care provider to make?

vulvar cancer

A nurse is reviewing the symptoms of ovarian cancer with a recently diagnosed 60-year-old woman. Which are common symptoms of ovarian cancer? Select all that apply.

abdominal fullness back pain abdominal pressure

A client with ovarian cancer is admitted to the hospital for surgery. The nurse is completing a health history on the client. What clinical manifestations would the nurse expect to assess?

increased abdominal girth

A female client is diagnosed with carcinoma in situ of the endometrium. The nurse interprets this as which definition?

The malignancy is localized.

A client has been referred for a colposcopy by the primary care provider. The client wants to know more about the examination. Which information regarding a colposcopy should the nurse give to the client?

The test is conducted because of abnormal results in Pap smears.

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?

"After menopause a mass on an ovary is not a cyst and should be considered cancerous until proven otherwise."

A nurse is providing care to a client diagnosed with squamous cell carcinoma of the vagina. The nurse understands that if the cancer metastasizes, which locations would be common sites? Select all that apply.

bladder rectum

A nurse is conducting an in-service program about different female reproductive tract cancers. The nurse explains that of the reproductive tract cancers, which type is the most common?

endometrial

A nurse is conducting a teaching session with a group of adolescent females at a local women's health clinic. When describing appropriate screening guidelines for cervical cancer, at which age would the nurse would instruct the group to have their first Pap smear?

21

A 65-year-old client presents at a local community health care center for a routine check up. While obtaining her medical history, the nurse learns that the client had her menarche when she was 13 years old. She experienced menopause at 51. She is between 5 and 10 lb (2.3 and 4.5 kg) underweight but is otherwise in good physical condition. The nurse should inform the client of which factor that increases the client's risk of getting ovarian cancer?

The client's present age

A middle-aged woman is seen in the OB/GYN clinic and reports abdominal bloating, fatigue, abdominal pain, urinary frequency, and constipation. She also says that she had lost 24 pounds in the last month without trying to lose. For which disease should the primary care provider screen this client?

ovarian cancer

A nurse is assessing a woman who has a history of genital warts (HPV). The nurse understands that this increases the risk of vulvar cancer. The nurse should teach which prevention method to decrease the risk of cancer?

The woman should avoid tight undergarments.

A postmenopausal woman presents to the clinic with painless vaginal bleeding. The health care provider wants to assess for endometrial cancer. The nurse would anticipate the health care provider prescribing which procedure first?

a transvaginal ultrasound

A nurse is reading a journal article about female reproductive cancers. Which malignancy would the nurse expect to be described as a "silent killer"?

ovarian cancer

A group of second year nursing students are planning a community function to teach about ovarian cancer for their group project. Which risk-reduction strategies should they list on their poster board? Select all that apply.

pregnancy use of oral contraceptives breastfeeding avoidance of talc and hygiene sprays on genitals

Which symptom is an early symptom of vulvar cancer?

pruritus with genital burning

The postmenopausal woman who has bleeding and spotting and cannot tolerate a endometrial biopsy in the office would have which test done to rule out endometrial cancer?

transvaginal ultrasound

The nursing student correctly identifies that ovarian cancer occurs more frequently in which age group?

55 to 75 years of age

The nurse works at a cancer treatment center working with clients with a diagnosis of vaginal cancer. The nurse understands that these clients have what percent chance of being diagnosed with another form of cancer?

80%

A nurse is evaluating a female client's risk for cervical cancer and reviewing the client's history. The nurse would be especially alert if the client reported which infection?

HPV

The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which information is important for the nurse to include?

High-grade dysplasia progresses to invasive cervical cancer in about 2 years.

A nurse is reviewing a journal article about cervical cancer which discusses the various groups of women at risk for the disease. Place the groups below in the order from greatest to least risk that the nurse would find as being described by the journal article. All options must be used.

Hispanics African Americans Asian and Pacific Islanders Caucasians

A nurse is reviewing the history, physical exam, and diagnostic test findings for a woman diagnosed with endometrial cancer. The findings reveal that the cancer has spread to the cervix and other parts of the uterus and to nearby lymph nodes. The nurse interprets these findings as suggestive of which stage?

III

A client presents for a routine check-up at a local health care center. One of the client's distant relatives died of ovarian cancer, and the client wants to know about measures that can reduce the risk of ovarian cancer. The nurse informs the client about which measure to reduce the risk of ovarian cancer?

Provide genetic counseling and thorough assessment.

The results of a Pap smear test have been classified as atypical squamous cells with possible HSIL (ASC-H) as per the 2001 Bethesda system. Which interpretation of the result is correct?

Refer for a colposcopy without human papillomavirus (HPV) testing.

A nurse working in the Family Birthing Center is answering the nurse hot line phone. A client calls in to schedule her annual Pap smear procedure. How could the nurse best educate the client before her procedure to make sure results are not affected?

Refrain from sexual intercourse 48 hours before testing to ensure clear results.

A client is waiting for the results of an endometrial biopsy for suspected endometrial cancer. She wants to know more about endometrial cancer and asks the nurse about the available treatment options. Which treatment information should the nurse give the client?

Surgery involves removal of the uterus, fallopian tubes, and ovaries; adjuvant therapy is used if relevant.

An experienced nurse has just read that women have a one-in-three lifetime risk of developing cancer and becomes concerned that she has provided enough education. What should this nurse do to help prevent deaths from cancer? Select all that apply.

Tell women about early symptoms Provide education to all women Focus on screening

A nurse is reviewing the medical record of a female client diagnosed with vaginal cancer. Which factors would the nurse identify as increasing this client's risk? Select all that apply.

age 62 years history of genital warts chronic vaginal discharge

A nurse is participating at a health fair and is presenting information on ways to reduce one's risk for cancer. Which information would the nurse include? Select all that apply.

annual cholesterol level checks starting at age 45 alcohol intake of no more than 1 drink per day blood pressure evaluations at least every 2 years

A nursing student is going to speak at a local high school about women's health. She is planning to talk about sexually transmitted infections (STIs) as well as routine checks, along with guidelines for Pap smears. What should she include in the Pap smear guidelines about when to have a first Pap smear?

at the age of 21 or within three years of first sexual intercourse

A nurse is conducting a class for a group of young women at a women's health center on risk reduction for ovarian cancer. Which information would the nurse most likely include as risk reduction strategies? Select all that apply.

breastfeeding avoidance of feminine hygiene spray use pregnancy before age 30 bilateral tubal ligation

The client has just been diagnosed with cervical cancer, and after discussing her options with her primary care provider and husband she chooses to have cryotherapy. What does this procedure do?

destroys abnormal cervical tissue by freezing it with liquid nitrogen

A 67-year-old Caucasian female comes into the clinic and reports to the nurse that she has started her periods again after 15 years of menopause. After discussing the situation with her, the nurse recognizes that her symptoms are suspicious for:

endometrial cancer.

A 30-year-old female is attending a health fair for women. The nurse at the fair is reviewing risk factors for cervical cancer. Which important risk factor should the nurse include at the fair?

exposure to diethylstilbestrol (DES) in utero

A nurse is preparing a presentation about cervical cancer for a local woman's group. Which risk factor for the development of cervical cancer would the nurse include?

infection with human papilloma virus (HPV)

A 30-year-old client asks the nurse about risk factors for ovarian cancer. Which risk factor should be included in client education?

infertility

The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease:

involves one or both ovaries and extends into the pelvis.

A nursing student is studying gynecological cancers and is excited when she reads that birth control pills can have a positive effect on preventing which disease?

ovarian cancer

The school nurse is teaching middle-school students about cervical cancer and the HPV virus. She is planning on administering the vaccine to protect them from this precursor of cervical cancer. Which vaccine will she administer to the young girls for this purpose?

recombinant human papillomavirus vaccine

The nurse is reviewing information with a client who was just diagnosed with endometrial cancer. Which treatment option should the nurse review for this diagnosis?

removal of uterus, fallopian tubes, and ovaries

While reviewing the history of a client diagnosed with cancer of the vagina, the nurse would expect the client to report which major symptom?

abnormal vaginal bleeding

An elderly woman who has not seen a health care provider in 15 years comes to the gynecology (GYN) clinic with reports of pelvic and back pain, along with weight loss which she attributes to her lack of appetite. She states that she has been very weak and fatigued for the last 12 months and attributes this to depression. What should the nurse expect this client to be diagnosed with?

advanced cervical cancer

A specialty nurse working in the OB-GYN clinic cares for pregnant women who have been diagnosed with cancer during the pregnancy. What is the most common cancer in the pregnant population in regards to reproductive malignancies?

cervical cancer

While obtaining the history, a client reports that her mother was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which cancer?

cervical cancer

A nurse is caring for a woman who has just been diagnosed with cancer (CIS) of the cervix. The nurse should prepare the women for which treatment?

cervical conization with follow-up Pap smears and colposcopy

In a postmenopausal woman with abnormal vaginal bleeding, which diagnostic test would the nurse expect the primary care provider to order to determine whether an endometrial biopsy is needed?

transvaginal ultrasound

A nurse is speaking to a local women's group about the various types of cancer affecting the female reproductive tract. The nurse explains that ovarian cancer is the leading cause of death from gynecologic malignancies based on the understanding that this type of cancer:

typically manifests with vague symptoms resulting in late diagnosis.

A nurse is caring for a 30-year-old woman who was just diagnosed with cervical cancer. Which psychosocial need would be the priority for the nurse with her client?

clear information on the disease, management, and treatment

A nurse prepares a woman with an abnormal Pap smear for further diagnostic evaluation. Which procedure would the nurse expect to be done?

colposcopy

A young woman is seen in the GYN clinic for a follow-up visit and is told that her recent Pap smear has come back abnormal. Which test can the nurse expect the primary care provider to prescribe for this client?

colposcopy