MED SURG 2 CH. 53// EXAM 4
. Which nonhormonal therapies will the nurse suggest for a healthy perimenopausal woman who prefers not to use hormone therapy (HT) (select all that apply)? a. Reduce coffee intake. b. Exercise several times a week. c. Take black cohosh supplements. d. Have a glass of wine in the evening. e. Increase intake of dietary soy products.
A, B, C, E
Postoperative goals in caring for the patient who has undergone an abdominal hysterectomy include (select all that apply): A. monitoring urinary output B. changing position frequently C. restricting all food for 24 hours D. observing perineal pad for bleeding E. encouraging leg exercises to promote circulation
A, B, E
Which factors are associates with endometrial cancer (select all that apply)? A. Obesity B. Smoking C. Family history D. Early sexual activity E. Early menarche and late menopause F. Unopposed estrogen-only replacement therapy
A, B, F
The patient calls the office and says that she thinks she thinks she has a yeast infection. What signs symptoms should the nurse expect in this patient (select all that apply)? A. Intense itching and dysuria B. Hemorrhage cervix and vagina C. Pruritic, frothy greenish or gray discharge D. Thick, white, cottage cheese-like discharge E. Mucopurulent discharge and postcoital spotting
A, D
A woman who has been postmenopausal for 10 years calls the clinic because of vaginal bleeding. the nurse schedules a visit for the patient and informs her expect to have which diagnostic procedures? A. An endometrial biopsy B. Abdominal radiography C. A laser treatment to the cervix D. Only a routine pelvic examination and Pap test
A. An endometrial biopsy
When teaching a patient with problems of pelvic support to perform kegel exercises, what should the nurse tell the patient to do? A. Contract the muscles used to stop rectal gas expulsion B. Tighten the lower abdominal muscles over the bladder area C. Squeeze all of the perineal muscles as if trying to close the vagina D. Lie on the floor and do leg lifts to strengthen the abdominal muscle.
A. Contract the muscles used to stop rectal gas expulsion
Priority Decision: To prepare a woman who has been raped for physical examination, what should the nurse do first? A. Ensure that a signed informed consent is obtained from the patient B. Provide a private place for the patient for the patient to talk about what happened to her. C. Instruct the patient not to wash, eat, drink, or urinate before the examination D. Administer prophylaxis for sexually transmitted infections and tetanus.
A. Ensure that a signed informed consent is obtained from the patient
A patient is diagnosed and treated for a Gardnerealla vaginalis infection at a clinic. For her treatment to be effective, what does the nurse tell the patient? A. Her sexual partner should also be examined and treated B. Her sexual partner must use a condom during intercourse C. She should wear mini pads to prevent reinfection as long as she has vaginal drainage D. The vaginal suppository should be used in the morning so that it will be fighting the infection all day.
A. Her sexual partner should also be examined and treated
What is an appropriate outcome for a patient who undergoes an anterior colporrhaphy? A. Maintain normal bowel patterns B. Adjust to temporary ileal conduit C. Urinate within hours of 8hrs postoperativley D. Experience healing of excoriated vaginal and vulvar tissue.
A. Maintain normal bowel patterns
A couple seeks assistance from an infertility specialist for evaluation of their infertility. The nurse informs the couple that during the initial visit, they can expect? A. Physical and psychological functioning examinations B. Assessment of tubal patency with a hysterosalpingogram C. Pelvic ultrasound for the woman and semen analysis for the men D. Postcoital testing to evaluate sperm numbers and motility in cervical and vaginal secretions
A. Physical and psychological functioning examinations
What should the nurse include when teaching the patient with acute PID how to care for herself? A. Promote rest in Semi-Fowler position B. Perform vaginal irrigation every 4 hours C. Instruct the patient to use tampons to control vaginal discharge D. The patient should ambulate frequently to promote drainage of exudate
A. Promote rest in Semi-Fowler position
During assessment of the patient with vulvar cancer, what should the nurse expect to find? A. Soreness and itching of the vulva B. Labial lesions with purulent exudate C. Severe excoriation of the labia and perineum D. Painless, firm nodules, embedded in the labia
A. Soreness and itching of the vulva
Which cancer is associated with intrauterine exposure to diethylstilbestrol (DES) or metastasis from another gynecologic cancer? A. Vaginal B. Ovarian C. Cervical D. Endometrial
A. Vaginal
The first nursing intervention for the patient who has been sexually assaulted is to: A. treat urgent medical problems B. contact support person for the patient C. provide supplies for the patient to cleanse off D. document bruises and lacerations of the perineum and cervix
A. treat urgent medical problems
Which nursing actions can the nurse working in a womens health clinic delegate to unlicensed assistive personnel (UAP) (select all that apply)? a. Call a patient with the results of an endometrial biopsy. b. Assist the health care provider with performing a Pap test. c. Draw blood for CA-125 levels for a patient with ovarian cancer. d. Screen a patient for use of medications that may cause amenorrhea. e. Teach the parent of a 10-year-old about the human papilloma virus (HPV) vaccine (Gardasil).
B, C
A 20 yr old patient with PID is crying and tells the nurse that she is afraid she will not be able to have children as a result of the infection. What is the nurse best response to this patient? A. "I would not worry about that now. Our immediate concern is to cure the infection you have." B. " PID increases the possibility of infertility. Would you like to talk about what it means to you?" C. "Sterility following PID is possible but not common, and it is too soon to know what the effects will be." D. The infection can cause more serious complications, such as abscesses and shock that you should be more concerned about."
B. " PID increases the possibility of infertility. Would you like to talk about what it means to you?"
A patient with stage 0 cervical cancer identified from a Papanicolaou (Pap) test asks the nurse what this finding means. The nurses response should include which information? A. Malignant cells have extended beyond the cervix to the upper vagina B. Abnormal cells are present but are confined to the epithelial layer of the cervix C. Atypical cells characteristics of inflammation but not necessary malignancy are present D. This is a common finding of Pap testing, and she will be examined frequently to see whether the abnormal cells spread beyond the cervix.
B. Abnormal cells are present but are confined to the epithelial layer of the cervix
Priority Decision: On admission of a victim of sexual assault to the ED, what should be the first priority of the nurse? A. Contact a rape support person for the patient B. Assess the patient for urgent medical problems C. Question the patient about the details of the assault D. Inform the patient what procedures and treatments will be performed.
B. Assess the patient for urgent medical problems
Priority Decision: A patient with abdominal pain and irregular vaginal bleeding is admitted to the hospital with a suspected ectopic pregnancy. Before actual diagnosis , what is the most appropriate action by the nurse? A. Provide analgesics for pain relief B. Monitor vital signs, pain, and bleeding frequently C. Offer support for the patient emotional response to the loss of the pregnancy D. Explain the need for frequent blood samples for B-human chorionic gonadotropin monitoring.
B. Monitor vital signs, pain, and bleeding frequently
A patient has been diagnosed with cancer of ovary. in planning care for the patient, the nurse recognizes that treatment of the patient depends on what? A. Results of a direct needle biopsy of the ovary B. Results of a laparotomy with multiple biopsies C. Whether the patient desires to maintain fertility D. The findings of metastasis by ultrasound and CT.
B. Results of a laparotomy with multiple biopsies
A young woman is admitted to the hospital with acute pelvic inflammatory disease. During the nursing history, the nurse notes which risk factors as being most significant for this patient? A. Lack of any method of birth control B. Sexual activity with multiple partner C. Use of a vaginal sponge for contraception D. Recent antibiotic induced monilial vaginitis
B. Sexual activity with multiple partner
Patient-Centered Care: A 51 year old woman suffered a wrist fracture when she slipped on the ice. She has her uterus and is interested in starting hormone replacement therapy (HRT), as she is also experiencing menopause symptoms. What should the nurse include when discussing the risks and benefits of HRT with the patient? A. Taking only progesterone is suggested for a woman with a uterus B. Taking both estrogen and progesterone may decrease her bone loss C. The risk of breast cancer and cardiovascular disease is decreased with HRT D. Taking estrogen and progesterone will increase the risk of endometrial cancer.
B. Taking both estrogen and progesterone may decrease her bone loss
A patient with a 10-week pregnancy is admitted to the emergency department with vaginal bleeding and abdominal cramping. The nurse recognizes that.. A. The patient will recover quickly when the bleeding stops B. The patient is most likely experiencing a spontaneous abortion C. The patient will be scheduled for an immediate dilation and curettage (D&C) D. Treatment of the patient with bed rest is usually successful in preventing further bleeding.
B. The patient is most likely experiencing a spontaneous abortion
A 44 yr old woman undergoing a total abdominal hysterectomy asks whether she will need to take estrogen until she reaches the age of menopause. What is the best response by the nurse? A. "Yes, it will help to prevent the more intense symptoms caused by surgically induced menopause." B. "You are close enough to normal menopuase that you probably won't need additional estrogen." C. "Because your ovaries won't be removed, they will continue to secrete estrogen until your menopause." D. " There are so many risk associated with estrogen replacement therapy that is best to being menopuase now."
C. "Because your ovaries won't be removed, they will continue to secrete estrogen until your menopause."
The patient arrives at the urgent care facility worried about the fishy smell of her vaginal discharge. What does the nurse suspect will be diagnosed? A. Cervicitis B. Trichomoniasis C. Bacterial vaginosis D. Vulvovaginal candidiasis
C. Bacterial vaginosis
Fertility and normal reproductive function can be maintained when a cancer of the cervix is successfully treated with which therapy? A. External radiation therapy B. Internal radiation implants C. Conization or laser surgery D. Cryotherapy or subtotal hysterectomy
C. Conization or laser surgery
A disturbed body image needing nursing intervention to assist the patient and family to cope may be seen in any patient undergoing gynecologic surgery. With which surgery will this most likely be expected to occur? A. Vaginectomy B. Hemivulvectomy C. Pelvic exenteration D. radical hysterectomy
C. Pelvic exenteration
A young woman who runs vigorously as a form of exercise has not had a menstrual period in more than 6 months. What should the nurse teach her? A. Normal periods will return when she stops running B. Uterine balloon therapy may be necessary to promote uterine sloughing of the overgrown endometrium C. Progesterone or combined oral contraceptives should be used to prevent persistent overgrowth of the endometrium D. Unopposed progesterone production causes overgrowth of the endometrium that increases her risk for endometrial cancer
C. Progesterone or combined oral contraceptives should be used to prevent persistent overgrowth of the endometrium
An infertile couple has used at-home ovulation trusting using basal body temperature without conceiving. The nurse understands that what will be used first to treat this infertile couple? A. Surgery to reduce endometriosis B. Intrauterine insemination with sperm from the husband C. Selective estrogen receptor modulator (clomiphene [Clomid]) D. Assisted reproductive technologies (e.g. in vitro fertilization [IVF])
C. Selective estrogen receptor modulator (clomiphene [Clomid])
A 20-yr-old woman is a college softball player who participates in strenuous practices and a heavy class, schedule. She is describing an absence of menses. What could be contributing to her amenorrhea? A. Decreased sexual activity B. Excess prostaglandin production C. Strenuous exercise or elevated stress D. Endometrial cancer or uterine fibroids
C. Strenuous exercise or elevated stress
When teaching a patient with premenstrual dysphoric (PMDD) about management of the disorder, the nurse includes the need to A. Limit dietary intake of caffeine and refined sugar B. Use estrogen supplements during the luteal phase C. Supplement the diet with vitamin B6, calcium, and magnesium D. Limit exercise and physical activity when symptoms are present
C. Supplement the diet with vitamin B6, calcium, and magnesium
Premenstrual syndrome (PMS) is most likely to be diagnosed in a woman with which occurrence? A. Symptoms can be controlled with the use of progesterone B. The woman has symptoms only when oral contraceptives are used C. Symptoms can be correlated with altered serum levels of estrogen and progesterone D. The woman has consistent syndrome complex with symptoms ending after menses begins.
C. Symptoms can be correlated with altered serum levels of estrogen and progesterone
What is the rationale for the regular use of NSAIDs during the first several days of the menstrual period for women who have primary dysmenorrhea? A. They suppress ovulation and production of prostaglandins that occur with ovulation. B. They cause uterine relaxation and small vessel constriction, preventing cramping and abdominal congestion C. They inhibit the production of prostaglandins believed to be responsible for menstrual pain and associated symptoms D. They block the release of luteinizing hormone, preventing the increase in progesterone associated with maturation of the corpus lutem
C. They inhibit the production of prostaglandins believed to be responsible for menstrual pain and associated symptoms
The patient is suspected of having endometriosis and/or uterine leiomyoma. What best describes what is found with these conditions? A. Endometriosis and uterine leiomyoma are two gynecologic conditions that increase incidence with the onset of menopause B. Danazol and Lupron (GnRH analog) are used to treat endometriosis and leiomyomas to create a psudopregnancy C. Treatment of endometriosis and leiomyomas depends on the severity of symptoms and the woman's to desire to maintain her fertility D. The presence of ectopic uterine tissue that bleeds and causes pelvic and abdominal adhesion, cysts, and pain is known as uterine leiomyoma.
C. Treatment of endometriosis and leiomyomas depends on the severity of symptoms and the woman's to desire to maintain her fertility
he patient is describing a feeling of something coming down her vagina and having a backache. What is most likely the cause of this discomfort? A. Cystocele B. Dysmenorrhea C. Uterine prolapse D. Abdominal distention
C. Uterine prolapse
Nursing responsibilities related to the patient with endometrial cancer Who has a total abdominal hysterectomy and salpingectomy and oophrectomy include include: A. maintaining absolute bedrest B. keeping the patient in a high-fowlers position C. Need for supplemental estrogen after removal of ovaries. D. Encouraging movement and walking as much as tolerated.
D. Encouraging movement and walking as much as tolerated.
A 29-yr-old woman is at the clinic with heavy menstrual period bleeding. What findings would the nurse expect in the patient's assessment? A. Pain with each menstrual period B. Excessive bleeding at irregular intervals C. Bleeding between regular menstrual cycles D. Increased duration or amount of menstrual bleeding
D. Increased duration or amount of menstrual bleeding
Priority Decision: The patient's diagnosis is a large rectocele requiring surgery. What nursing interventions will be the priority postoperatively? A. An ice pack to relieve swelling B. An enema each day to relieve constipation C. Administration of a stool softener each night D. Perineal care after each urination or defecation
D. Perineal care after each urination or defecation
The patient is a perimenopausal woman who has an unexpected and unwanted pregnancy. She wants an abortion. What should the nurse teach her about the effects of an abortion? A. D & C will be needed B. She will feel much better afterward C. The products of conception will pass immediately D. She will need someone to support her through her loss
D. She will need someone to support her through her loss
An 18 year old patient with irregular menstrual periods, hirsutism, and obesity has been diagnosed with polycycstic ovary syndrome. What sis accurate rationale for the expected treatment? A. Hirsutism may be treated with leuprolide to decrease an altered body image B. The medication used will be cure the hormonal abnormality of excess treatment tried. C. The loss of weight will improve all the symptoms so this will be first treatment tried D. The progression of PCOS leads to cardiovascular disease and abnormal insulin resistance if untreated
D. The progression of PCOS leads to cardiovascular disease and abnormal insulin resistance if untreated
What occurs during treatment of the patient with an intrauterine radioactive implant? A. All care should be provided by the same nurse. B. The patient may ambulate in the room as desired C. There can be unlimited number and duration of visitors D. the patient is restricted to bed rest with turning from side to side
D. the patient is restricted to bed rest with turning from side to side
Which manifestations of menopause are related to estrogen deficiency (select all that apply)? A. Cessation of menses B. Breast engorgement C. Vasomotor instability D. Reduction of bone fracture E. Decreased cardiovascular risk
a, c
A 28-year-old patient reports anxiety, headaches with dizziness, and abdominal bloating occurring before her menstrual periods. Which action is best for the nurse to take at this time? a. Ask the patient to keep track of her symptoms in a diary for 3 months. b. Suggest that the patient try aerobic exercise to decrease her symptoms. c. Teach the patient about appropriate lifestyle changes to reduce premenstrual syndrome (PMS) symptoms. d. Advise the patient to use nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (Advil) to control symptoms.
a. Ask the patient to keep track of her symptoms in a diary for 3 months.
A 32-year-old woman brought to the emergency department reports being sexually assaulted. The patient is confused about where she is and she has a large laceration above the right eye. Which action should the nurse take first? a. Assess the patients neurologic status. b. Assist the patient to remove her clothing. c. Contact the sexual assault nurse examiner (SANE). d. Ask the patient to describe what occurred during the assault.
a. Assess the patients neurologic status.
A 19-year-old visits the health clinic for a routine checkup. Which question should the nurse ask to determine whether a Pap test is needed? a. Have you had sexual intercourse? b. Do you use any illegal substances? c. Do you have cramping with your periods? d. At what age did your menstrual periods start?
a. Have you had sexual intercourse?
Which statement by the patient indicates that the nurses teaching about treating vaginal candidiasis has been effective? a. I should clean carefully after each urination and bowel movement. b. I can douche with warm water if the itching continues to bother me. c. I will insert the antifungal cream right before I get up in the morning. d. I will tell my husband that we cannot have intercourse for the next month.
a. I should clean carefully after each urination and bowel movement.
A 48-year-old woman in the emergency department reports that she has been sexually assaulted. Which action by the nurse will be most important in maintaining the medicolegal chain of evidence? a. Labeling all specimens and other materials obtained from the patient. b. Assisting the patient in filling out the application for financial compensation. c. Discussing the availability of the morning-after pill for pregnancy prevention. d. Educating the patient about baseline sexually transmitted infection (STI) testing
a. Labeling all specimens and other materials obtained from the patient.
A 22-year-old tells the nurse that she has not had a menstrual period for the last 2 months. Which action is most important for the nurse to take? a. Obtain a urine specimen for a pregnancy test. b. Ask about any recent stressful lifestyle changes. c. Measure the patients current height and weight. d. Question the patient about prescribed medications.
a. Obtain a urine specimen for a pregnancy test.
Which topic will the nurse include in the preoperative teaching for a patient admitted for an abdominal hysterectomy? a. Purpose of ambulation and leg exercises b. Adverse effects of systemic chemotherapy c. Decrease in vaginal sensation after surgery d. Symptoms caused by the drop in estrogen level
a. Purpose of ambulation and leg exercises
A 50-year-old patient is diagnosed with uterine bleeding caused by a leiomyoma. Which information will the nurse include in the patient teaching plan? a. The symptoms may decrease after the patient undergoes menopause. b. The tumor size is likely to increase throughout the patients lifetime. c. Aspirin or acetaminophen may be used to control mild to moderate pain. d. The patient will need frequent monitoring to detect any malignant changes
a. The symptoms may decrease after the patient undergoes menopause.
A 54-year-old patient is on the surgical unit after a radical abdominal hysterectomy. Which finding is most important to report to the health care provider? a. Urine output of 125 mL in the first 8 hours after surgery b. Decreased bowel sounds in all four abdominal quadrants c. One-inch area of bloody drainage on the abdominal dressing d. Complaints of abdominal pain at the incision site with coughing
a. Urine output of 125 mL in the first 8 hours after surgery
A 56-year-old woman is concerned about having a moderate amount of vaginal bleeding after 4 years of menopause. The nurse will anticipate teaching the patient about a. endometrial biopsy. b. endometrial ablation. c. uterine balloon therapy. d. dilation and curettage (D&C).
a. endometrial biopsy.
The nurse will plan to teach the female patient with genital warts about the a. importance of regular Pap tests. b. increased risk for endometrial cancer. c. appropriate use of oral contraceptives. d. symptoms of pelvic inflammatory disease (PID)
a. importance of regular Pap tests.
A 58-year-old patient who has undergone a radical vulvectomy for vulvar carcinoma returns to the medical-surgical unit after the surgery. The priority nursing diagnosis for the patient at this time is a. risk for infection related to contact of the wound with urine and stool. b. self-care deficit: bathing/hygiene related to pain and difficulty moving. c. imbalanced nutrition: less than body requirements related to low-residue diet. d. risk for ineffective sexual pattern related to disfiguration caused by the surgery.
a. risk for infection related to contact of the wound with urine and stool.
A 28-year-old patient with endometriosis asks why she is being treated with medroxyprogesterone (Depo- Provera), a medication that she thought was an oral contraceptive. The nurse explains that this therapy a. suppresses the menstrual cycle by mimicking pregnancy. b. will relieve symptoms such as vaginal atrophy and hot flashes. c. prevents a pregnancy that could worsen the menstrual bleeding. d. will lead to permanent suppression of abnormal endometrial tissues.
a. suppresses the menstrual cycle by mimicking pregnancy.
A 32-year-old who was admitted to the emergency department with severe abdominal pain is diagnosed with an ectopic pregnancy. The patient begins to cry and asks the nurse to leave her alone to grieve. Which action should the nurse take next? a. Stay with the patient and encourage her to discuss her feelings. b. Explain the reason for taking vital signs every 15 to 30 minutes. c. Close the door to the patients room and minimize disturbances. d. Provide teaching about options for termination of the pregnancy.
b. Explain the reason for taking vital signs every 15 to 30 minutes.
. Which assessment finding in a woman who recently started taking hormone therapy (HT) is most important for the nurse to report to the health care provider? a. Breast tenderness b. Left calf swelling c. Weight gain of 3 lb d. Intermittent spotting
b. Left calf swelling
A healthy 28-year-old who has been vaccinated against human papillomavirus (HPV) has a normal Pap test. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test? a. You can wait until age 30 before having another Pap test. b. Pap testing is recommended every 3 years for women your age. c. No further Pap testing is needed until you decide to become pregnant. d. Yearly Pap testing is suggested for women with multiple sexual partners.
b. Pap testing is recommended every 3 years for women your age.
A 63-year-old woman undergoes an anterior and posterior (A&P) colporrhaphy for repair of a cystocele and rectocele. Which nursing action will be included in the postoperative care plan? a. Encourage a high-fiber diet. b. Perform indwelling catheter care. c. Repack the vagina with gauze daily. d. Teach the patient to insert a pessary.
b. Perform indwelling catheter care.
A 24-year-old patient with pelvic inflammatory disease (PID) is being treated with oral antibiotics as an outpatient. Which instruction will be included in patient teaching? a. Abdominal pain may persist for several weeks. b. Return for a follow-up appointment in 2 to 3 days. c. Instruct a male partner to use a condom during sexual intercourse for the next week. d. Nonsteroidal antiinflammatory drug (NSAID) use may prevent pelvic organ scarring
b. Return for a follow-up appointment in 2 to 3 days.
A 31-year-old patient who has been diagnosed with human papillomavirus (HPV) infection gives a health history that includes smoking tobacco, taking oral contraceptives, and having been treated twice for vaginal candidiasis. Which topic will the nurse include in patient teaching? a. Use of water-soluble lubricants b. Risk factors for cervical cancer c. Antifungal cream administration d. Possible difficulties with conception
b. Risk factors for cervical cancer
A 32-year-old woman is scheduled for an induced abortion using instillation of hypertonic saline solution. Which information will the nurse plan to discuss with the patient before the procedure? a. The patient will require a general anesthetic. b. The expulsion of the fetus may take 1 to 2 days. c. There is a possibility that the patient may deliver a live fetus. d. The procedure may be unsuccessful in terminating the pregnancy.
b. The expulsion of the fetus may take 1 to 2 days.
A 34-year-old woman who is discussing contraceptive options with the nurse says, I want to have children, but not for a few years. Which response by the nurse is appropriate? a. If you do not become pregnant within the next few years, you never will. b. You may have more difficulty becoming pregnant after about age 35. c. You have many years of fertility left, so there is no rush to have children. d. You should plan to stop taking oral contraceptives several years before you want to become pregnant.
b. You may have more difficulty becoming pregnant after about age 35.
A 25-year-old woman has an induced abortion with suction curettage at an ambulatory surgical center. Which instructions will the nurse include when discharging the patient? a. Heavy vaginal bleeding is expected for about 2 weeks. b. You should abstain from sexual intercourse for 2 weeks. c. Contraceptives should be avoided until your reexamination. d. Irregular menstrual periods are expected for the next few months
b. You should abstain from sexual intercourse for 2 weeks.
In telling a patient with infertility what she and her partner can expect, the nurse explains that a. ovulatory studies can help determine tube patency b. a hysterosalpingogram is a common diagnostic study c. the cause will remain unexplained for 40% of couples d. if postcoital studies are normal, infection tests will be done
b. a hysterosalpingogram is a common diagnostic study
When caring for a 58-year-old patient with persistent menorrhagia, the nurse will plan to monitor the a. estrogen level. b. complete blood count (CBC). c. gonadotropin-releasing hormone (GNRH) level. d. serial human chorionic gonadotropin (hCG) results.
b. complete blood count (CBC).
The nurse will plan to teach a 34-year-old patient diagnosed with stage 0 cervical cancer about a. radiation. b. conization. c. chemotherapy. d. radical hysterectomy.
b. conization.
A 29-year-old patient who is trying to become pregnant asks the nurse how to determine when she is most likely to conceive. The nurse explains that a. ovulation is unpredictable unless there are regular menstrual periods. b. ovulation prediction kits provide accurate information about ovulation. c. she will need to bring a specimen of cervical mucus to the clinic for testing. d. she should take her body temperature daily and have intercourse when it drops.
b. ovulation prediction kits provide accurate information about ovulation.
A 32-year-old patient has oral contraceptives prescribed for endometriosis. The nurse will teach the patient to a. expect to experience side effects such as facial hair. b. take the medication every day for the next 9 months. c. take calcium supplements to prevent developing osteoporosis during therapy. d. use a second method of contraception to ensure that she will not become pregnant
b. take the medication every day for the next 9 months.
Postoperative nursing care for the woman with a gynecologic fistula includes (select all that apply): A. ambulation B. bladder training C. warm sitz baths D. perineal hygiene E. stool softner
c, d
The nurse has just received change-of-shift report about the following four patients. Which patient should be assessed first? a. A patient with a cervical radium implant in place who is crying in her room b. A patient who is complaining of 5/10 pain after an abdominal hysterectomy c. A patient with a possible ectopic pregnancy who is complaining of shoulder pain d. A patient in the fifteenth week of gestation who has uterine cramping and spotting
c. A patient with a possible ectopic pregnancy who is complaining of shoulder pain
Which information will the nurse include when teaching a patient who has developed a small vesicovaginal fistula 2 weeks into the postpartum period? a. Take stool softeners to prevent fecal contamination of the vagina. b. Limit oral fluid intake to minimize the quantity of urinary drainage. c. Change the perineal pad frequently to prevent perineal skin breakdown. d. Call the health care provider immediately if urine drains from the vagina.
c. Change the perineal pad frequently to prevent perineal skin breakdown.
A 25-year-old woman who is scheduled for a routine gynecologic examination tells the nurse that she has had intercourse during the last year with several men. The nurse will plan to teach about the reason for a. contraceptive use. b. antibiotic therapy. c. Chlamydia testing. d. pregnancy testing.
c. Chlamydia testing.
The nurse in the infertility clinic is explaining in vitro fertilization (IVF) to a couple. The woman tells the nurse that they cannot afford IVF on her husbands salary. The man replies that if his wife worked outside the home, they would have enough money. Which nursing diagnosis is appropriate? a. Decisional conflict related to inadequate financial resources b. Ineffective sexuality patterns related to psychological stress c. Defensive coping related to anxiety about lack of conception d. Ineffective denial related to frustration about continued infertility
c. Defensive coping related to anxiety about lack of conception
The nurse is caring for a 20-year-old patient with pelvic inflammatory disease (PID) requiring hospitalization. Which nursing intervention will be included in the plan of care? a. Monitor liver function tests. b. Use cold packs PRN for pelvic pain. c. Elevate the head of the bed to at least 30 degrees. d. Teach the patient how to perform Kegel exercises.
c. Elevate the head of the bed to at least 30 degrees.
A 49-year-old woman is considering the use of combined estrogen-progesterone hormone replacement therapy (HT) during menopause. Which information will the nurse include during their discussion? a. Use of estrogen-containing vaginal creams provides most of the same benefits as oral HT. b. Increased incidence of colon cancer in women taking HT requires more frequent colonoscopy. c. HT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast cancer. d. Use of HT for up to 10 years to prevent symptoms such as hot flashes is generally considered safe.
c. HT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast cancer.
A 27-year-old patient tells the nurse that she would like a prescription for oral contraceptives to control her premenstrual dysphoric disorder (PMD-D) symptoms. Which patient information is most important to communicate to the health care provider? a. Bilateral breast tenderness b. Frequent abdominal bloating c. History of migraine headaches d. Previous spontaneous abortion
c. History of migraine headaches
Which action should the nurse take when a 35-year-old patient has a result of minor cellular changes on her Pap test? a. Teach the patient about colposcopy. b. Teach the patient about punch biopsy. c. Schedule another Pap test in 4 months. d. Administer the human papillomavirus (HPV) vaccine.
c. Schedule another Pap test in 4 months.
. An 18-year-old requests a prescription for birth control pills to control severe abdominal cramping and headaches during her menstrual periods. Which should the nurse take first? a. Determine whether the patient is sexually active. b. Teach about the side effects of oral contraceptives. c. Take a personal and family health history from the patient. d. Suggest nonsteroidal antiinflammatory drugs (NSAIDs) for relief.
c. Take a personal and family health history from the patient.
Which patient in the womens health clinic will the nurse expect to teach about an endometrial biopsy? a. The 55-year-old patient who has 3 to 4 alcoholic drinks each day b. The 35-year-old patient who has used oral contraceptives for 15 years c. The 25-year-old patient who has a family history of hereditary nonpolyposis colorectal cancer d. The 45-year-old patient who has had 6 full-term pregnancies and 2 spontaneous abortions
c. The 25-year-old patient who has a family history of hereditary nonpolyposis colorectal cancer
A 47-year-old woman asks whether she is going into menopause if she has not had a menstrual period for 3 months. The best response by the nurse is which of the following? a. Have you thought about using hormone replacement therapy? b. Most women feel a little depressed about entering menopause. c. What was your menstrual pattern before your periods stopped? d. Since you are in your mid-40s, it is likely that you are menopausal.
c. What was your menstrual pattern before your periods stopped?
A nursing diagnosis that is likely to be appropriate for a 67-year-old woman who has just been diagnosed with stage III ovarian cancer is a. sexual dysfunction related to loss of vaginal sensation. b. risk for infection related to impaired immune function. c. anxiety related to cancer diagnosis and need for treatment decisions. d. situational low self-esteem related to guilt about delaying medical care.
c. anxiety related to cancer diagnosis and need for treatment decisions.
The nurse should advise the woman recovering from surgical treatment of an ectopic pregnancy that a. she has an increased risk for salpingitis b. bed rest must be maintained for 12 hours to assist in healing c. having one ectopic pregnancy increases her risk for another d. intrauterine devices and infertility treatments should be avoided
c. having one ectopic pregnancy increases her risk for another
To prevent or decrease age-related changes that occur after menopause in a patient who chooses not to take hormone therapy , the most important self-care measure to teach is a. maintaining usual sexual activity b. increasing the intake of dairy products c. performing regular, aerobic, weight-bearing exercise d. taking vitamin E and B-complex vitamin supplements
c. performing regular, aerobic, weight-bearing exercise
A female patient tells the nurse that she has been having nightmares and acute anxiety around men since being sexually assaulted 3 months ago. The most appropriate nursing diagnosis for the patient is a. anxiety related to effects of being raped. b. sleep deprivation related to frightening dreams. c. rape-trauma syndrome related to rape experience. d. ineffective coping related to inability to resolve incident.
c. rape-trauma syndrome related to rape experience.
An appropriate question to ask the patient with painful menstruation to differentiate primary from secondary dysmenorrhea is a. "does your pain become worse with activity or overexertion?" b. "have you had a recent personal crisis or change in your lifestyle?" c. "is your pain relieved by non steroidal anti-inflammatory medications?" d. "when in your menstrual history did the pain with your period begin?"
d. "when in your menstrual history did the pain with your period begin?"
The nurse in the womens health clinic has four patients who are waiting to be seen. Which patient should the nurse see first? a. 22-year-old with persistent red-brown vaginal drainage 3 days after having balloon thermotherapy b. 42-year-old with secondary amenorrhea who says that her last menstrual cycle was 3 months ago c. 35-year-old with heavy spotting after having a progestin-containing IUD (Mirena) inserted a month ago d. 19-year-old with menorrhagia who has been using superabsorbent tampons and has fever with weakness
d. 19-year-old with menorrhagia who has been using superabsorbent tampons and has fever with weakness
A 49-year-old woman tells the nurse that she is postmenopausal but has occasional spotting. Which initial response by the nurse is most appropriate? a. A frequent cause of spotting is endometrial cancer. b. How long has it been since your last menstrual period? c. Breakthrough bleeding is not unusual in women your age. d. Are you using prescription hormone replacement therapy?
d. Are you using prescription hormone replacement therapy?
A 31-year-old patient has just been instructed in the treatment for aChlamydia trachomatis vaginal infection. Which patient statement indicates that the nurses teaching has been effective? a. I can purchase an over-the-counter medication to treat this infection. b. The symptoms are due to the overgrowth of normal vaginal bacteria. c. The medication will need to be inserted once daily with an applicator. d. Both my partner and I will need to take the medication for a full week.
d. Both my partner and I will need to take the medication for a full week.
. A 19-year-old has been diagnosed with primary dysmenorrhea. How will the nurse suggest that the patient prevent discomfort? a. Avoid aerobic exercise during her menstrual period. b. Use cold packs on the abdomen and back for pain relief. c. Talk with her health care provider about beginning antidepressant therapy. d. Take nonsteroidal antiinflammatory drugs (NSAIDs) when her period starts.
d. Take nonsteroidal antiinflammatory drugs (NSAIDs) when her period starts.
The nurse notes that a patient who has a large cystocele, admitted 10 hours ago, has not yet voided. Which action should the nurse take first? a. Insert a straight catheter per the PRN order. b. Encourage the patient to increase oral fluids. c. Notify the health care provider of the inability to void. d. Use an ultrasound scanner to check for urinary retention.
d. Use an ultrasound scanner to check for urinary retention.
When caring for a patient who has a radium implant for treatment of cancer of the cervix, the nurse will a. assist the patient to ambulate every 2 to 3 hours. b. use gloves and gown when changing the patients bed. c. flush the toilet several times right after the patient voids. d. encourage the patient to discuss needs or concerns by telephone.
d. encourage the patient to discuss needs or concerns by telephone.
To prevent pregnancy in a patient who has been sexually assaulted, the nurse in the emergency department will plan to teach the patient about the use of a. mifepristone (RU-486). b. dilation and evacuation. c. methotrexate with misoprostol. d. levonorgestrel (Plan-B One-Step).
d. levonorgestrel (Plan-B One-Step).
A 28-year-old patient was recently diagnosed with polycystic ovary syndrome. It is most important for the nurse to teach the patient a. reasons for a total hysterectomy. b. how to decrease facial hair growth. c. ways to reduce the occurrence of acne. d. methods to maintain appropriate weight.
d. methods to maintain appropriate weight.
