Female Repro Disorders MCQ

During a follow-up visit, a female client who underwent a mastectomy presents with an infection that requires an antibiotic. She admits she has been doing some gardening. What further instruction and reinforcement of teaching is needed? Wear gloves and protective clothing to avoid any injuries. Avoid household chores for at least 6 to 9 months. Avoid working in the garden or yard altogether. Increase the frequency of follow-up visits if she does works.

A The nurse should recommend that the client wear gloves when doing backyard work or housework to prevent injuries that may heal slowly or become infected.

The nurse is reviewing care instructions for a client who had a radical mastectomy of the right breast. Which instruction is appropriate for the nurse to include in the teaching​ session? (Select all that​ apply.)​ A. "Sleep with the right arm elevated on a​ pillow."​ B. "You will be able to resume playing golf with your​ friends."​ C. "You should apply hot compresses to the right arm if it is​ aching." D. ​"Do not allow anyone to take your blood pressure in the right​ arm."​ E. "It is okay to carry your purse on your right arm as long as it is not​ heavy."

A,D

A nurse is obtaining health history from a young adult woman. Which of the following would alert the nurse to a possible problem? Age of 13 years at menarche Menstrual cycle averaging 28 to 29 days Reports of dyspareunia Mucus-like vaginal discharge

C Dyspareunia, or pain with intercourse, is an abnormal finding associated with numerous potential problems.

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

D Sitz baths are recommended to relieve the client's itching and burning as well as relieve swelling of the vulva and perineum. It does that by increasing blood flow to the area and cleansing the area. Skin protectants containing zinc oxide promote healing (not symptom relief). Routine douching should be avoided. Taking Lactobacillus acidophilus in capsule form or eating yogurt containing active cultures of lactobacilli can help restore normal vaginal microorganisms.

A​ college-age client asks the nurse about the relationship between breast cancer and alcohol use. Which response by the nurse provides the most accurate information for this​ client?​ A. "Evidence indicates that to decrease your risk for breast​ cancer, you should limit alcohol use to one drink per​ day."​ B. "If you are drinking hard​ liquor, you should limit it to one per​ day, but if you are drinking beer or​ wine, you can have more than one drink per​ day."​ C. "The amount of alcohol that increases risk varies from person to person due to differences in metabolism and alcohol​ tolerance." D. ​"They have not established a firm link between alcohol use and breast cancer. Thus I would not be too​ concerned."

A

The nurse is providing health counseling to a​ 32-year-old woman whose mammogram indicates that she has dense breast tissue. Which information should the nurse provide to this client concerning this finding and breast​ health? The presence of dense breast tissue increases the risk of breast cancer before the age of 45. Dense breast tissue is very common at this age and does not affect breast health. Precancerous cells are found in dense breast​ tissue; thus, she should have further screening done for breast cancer. Dense breast tissue is a protective effect for breast​ cancer, and rates of breast cancer in women with dense breast tissue are very low.

A Dense tissue (fibrous and glandular tissue) makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer

On discharge, a client who underwent left modified radical mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she: should continue to perform breast self-examination on her right breast. is lucky that the cancer was caught in time. should schedule a follow-up appointment in 6 months. will have irregular menses.

A Having breast cancer on her left side puts the client more at risk for cancer on the opposite side and chest wall. Therefore, the nurse should stress the importance of monthly breast self-examinations and annual mammograms.

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following? Lymphedema Breast abscess Fibroadenoma Fibrocystic breast disease

A Lymphedema occurs in some women after breast cancer surgery. It causes disfigurement and increases the lifetime potential for infection and poor healing.

A nurse in a campus medical clinic is meeting with a 23-year-old student who states that she has been experiencing malodorous vaginal discharge over the past several days. The nurse should recognize that this patient is describing a sign that is characteristic of: Bacterial vaginosis (BV) Dysmenorrhea Vulvovaginal candidiasis (VVC) Human papillomavirus (HPV)

A Patients with symptomatic BV will report an increased malodorous, vaginal discharge or leukorrhea that is grayish white in color. Amines commonly found in the vagina become unstable when the pH is altered and release the characteristic "fishy" odor

The nurse is assessing the surgical site of a client who has had a mastectomy. Which of the following would lead the nurse to suspect that the client is developing a seroma? Sloshing of fluid Fever Bruising of the skin Tightness

A Signs and symptoms of a seroma include swelling, heaviness, discomfort, and a sloshing of fluid. Bruising of the skin and tightness would suggest a hematoma. Fever would suggest an infection.

Which intervention promotes optimal circulation after a surgical intervention for breast​ cancer? A. Monitoring surgical drains for amount and color of drainage B. Encouraging​ range-of-motion exercises in the affected arm C. Assessing for manifestations of lymphedema D. Observing the surgical site for redness and swelling

B

A young client presenting at the health clinic with fever and mucopurulent vaginal drainage is diagnosed with acute pelvic inflammatory disease (PID). Which long-term affect is of greatest concern in the care of this client? Ascending infection Infertility Chronic pelvic inflammatory disease Pelvic pain

B About one third of all women who are infertile have lost the ability to conceive due to PID. Early treatment of PID prevents the infection from ascending up the reproductive tract and/or from becoming chronic.

An elderly client, who can void only while standing and pushing upward on the vagina, is ordered a pessary. Which comment from the client indicates a need for further teaching about this device? "I should report any foul odor or drainage." "I will remove and clean it every day." "I should have greater ease of emptying my bladder." "I will report any signs of irritation or bleeding."

B Pessaries should be removed, cleaned, and replaced periodically (at least every 2 months). If the client is unable to manage the pessary, then follow-up appointments should be made with the practitioner. Ill-fitting pessaries can cause irritation and erosion of tissue resulting in irritation, bleeding, or infection. The placement of the pessary should support the uterus in the pelvis and lessen urinary and pelvic symptoms.

Which of the following would the nurse expect to find when assessing the breasts of a client with fibrocystic breast disease? Nipple retraction Soft mass Enlarged lymph nodes Skin dimpling

B The characteristic breast mass of fibrocystic disease is soft to firm, movable, and unlikely to cause nipple retraction. Nipple retraction, enlarged lymph nodes, and skin dimpling are more commonly associated with breast cancer.

After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following? Peau d'orange skin Breast symmetry Nipple retraction Painless mass

B The primary sign of breast cancer is a painless mass in the breast. Other signs of breast cancer include a bloody discharge from the nipple, a dimpling of the skin over the lesion, retraction of the nipple, peau d'orange (orange peel) appearance of the skin, and a difference in size between the breasts.

A suspicious breast lump is noted on a mammogram. The client asks the nurse which diagnostic test confirms if the lump is cancerous or benign. Which response by the nurse is most correct? An ultrasound A biopsy A magnetic resonance imaging (MRI) A clinical breast exam

B To confirm whether a breast lump is cancerous or benign, a tissue sample must be obtained to examine the cells. Although an ultrasound, MRI, and clinical breast exam provides data on the characteristics of the lump, only examining the tissue can specifically identify if and what type of cancer is present.

Which statement demonstrates that a client has understood instructions about breast self-examination? "I should perform the exam on the first day of my menstrual period." "I need to use the pads of three fingers to apply pressure when checking each breast." "I should move the palm of my hand around the breast in a diagonal fashion." "I don't need to check the nipple area of the breast or under my arm."

B When performing breast self-examination, the client should examine the breasts 3 days after the end of her menstrual period, use light medium, and firm pressure applied with the pads of three fingers, move the fingers in circles, spokes of a wheel, or rows, and feel every part of the breast, including the nipple area and the armpit to the collar bone.

The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest? Benign fibrocystic disease Malignant tumor with metastasis to surrounding tissue Malignant tumor Normal finding

C A fast-growing lump, especially on the upper outer quadrant of the breast, is suggestive of a malignant tumor. Metastasis can only be determined by cytology, not by palpation.

During a breast examination, which finding most strongly suggests that a client has breast cancer? Bloody discharge from the nipple Multiple firm, round, freely movable masses that change with the menstrual cycle A fixed nodular mass with dimpling of the overlying skin Slight asymmetry of the breasts

C A fixed nodular mass with dimpling of the overlying skin is common during late stages of breast cancer. Many women have slightly asymmetrical breasts. Bloody nipple discharge is a sign of intraductal papilloma, a benign condition. Multiple firm, round, freely movable masses that change with the menstrual cycle indicate fibrocystic breasts, a benign condition.

The nurse teaches a premenopausal female client to perform breast self-examination (BSE) at which interval? On day 2 to day 4, counting the first day of menses as day 1 With the onset of menstruation On day 5 to day 7, counting the first day of menses as day 1 Any time during the month

C BSE is best performed after menses, when less fluid is retained. Because most women notice increased tenderness, lumpiness, and fluid retention before their menstrual period, BSE is not recommended with the onset of menses. Because these symptoms generally continue through menses, BSE is not recommended during that time. BSE is best performed at a time that takes menses into account.

A 60-year-old woman is postoperative day 2 following a transverse rectus abdominis myocutaneous (TRAM) flap. While assessing the patient near the beginning of the shift, the nurse determines that the skin adjacent to the surgical dressing is pale and cool to the touch. How should the nurse best respond to this assessment finding? Encourage the patient to perform active range of motion exercises to promote circulation. Remove the surgical dressing to more accurately assess the surgical site. Promptly report this assessment finding to the patient's surgeon. Apply warm compresses to the cool regions of the patient's skin.

C Coolness and pallor suggest impaired circulation, which could rapidly result in tissue necrosis; immediate surgical intervention may be required. As a result, this assessment finding should be promptly reported to the patient's surgeon.

Which client has the highest risk of ovarian cancer? 40-year-old woman with three children 30-year-old woman taking hormonal contraceptives 45-year-old woman who has never been pregnant 36-year-old woman who had her first child at age 22

C The incidence of ovarian cancer increases in women who have never been pregnant, are older than age 40, are infertile, or have menstrual irregularities. Other risk factors include a family history of breast, bowel, or endometrial cancer. The risk of ovarian cancer is reduced in women who have taken hormonal contraceptives, have had multiple births, or have had a first child at a young age.

A 32-year-old client has been diagnosed with an ovarian cyst and asks the nurse, "Should I be worried about cancer?" Which response by the nurse would be most appropriate? "Ovarian cysts are just that, cysts and not a cause for concern." "Ovarian cysts can be malignant but this is a rare occurrence." "Most cysts are benign in younger women, but it's good to have it checked out." "Since you don't have any symptoms, the chances of having cancer are really remote."

C The risk of malignancy in postmenopausal women is much greater than in premenopausal women, with almost all pelvic masses in premenopausal women being benign. However, although typically benign, the cyst should be evaluated to exclude ovarian cancer. The most appropriate response would be to provide this information to the client but also reinforce her actions to have the cyst evaluated.

The client arrives at a public health clinic worried that she has breast cancer since finding a lump in her breast. When assessing the breast, which assessment finding is characteristic of fibrocystic disease? One breast is larger than the other. The lump is firm and immovable. The lump is round and movable. Nipple retractions are noted.

C When assessing a breast with fibrocystic disease, the lumps typically are different from cancerous lumps. The characteristic breast mass of fibrocystic disease is soft to firm, circular, movable, and unlikely to cause nipple retraction. A cancerous mass is typically irregular in shape, firm, and immovable.

Hematoma and seroma formation are complications of breast surgery. Which of the following is the indicator that should be reported to the surgeon? Bruising of the skin Pain at the site Tightness of the skin Gross swelling

D The presence of gross swelling or increased bloody output from the drain are abnormal and should be immediately reported to the surgeon.