Pathophysiology FINAL questions (CH. 54)

Which of the following sexually active women most likely faces the highest risk of developing an ectopic pregnancy? A) A 14-year-old who experienced menarche 2 years prior. B) A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed. C) A 27-year-old who stopped using medroxyprogesterone contraceptive injection (Depo-Provera) several months ago. D) A 22-year-old who has a history of anorexia nervosa and who has a body mass index (BMI) of 12.0 (normal weight = 18.5 to 24.9).

B) a 42 year old who has decided to try to have one more child and has had her tubal ligation reversed

Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20-year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis? A) "Are you using tampons during your period or do you normally use pads?" B) "What does your daily hygiene routine usually consist of?" C) "How many sexual partners have you had?" D) "Have you ever had a therapeutic abortion in the past?"

C) "how many sexual partners have you had?"

A college student has come to the health clinic complaining of heavy bleeding during and between her menstrual periods. The nurse practitioner will document this as A) dyspareunia. B) amenorrhea. C) polymenorrhea. D) menometrorrhagia.

D) menometorrhagia

A 23-year-old woman has been referred to a fertility clinic after 1 year of attempting to become pregnant. Her diagnostic workup has resulted in a diagnosis of polycystic ovary syndrome (PCOS). What will the first line of treatment most likely consist of? A) Estrogen-progesterone hormone therapy and the administration of clomiphene B) Surgical resection of the ovaries using laparoscopy C) Lifestyle modifications to include weight loss by lowering calories and fat consumption D) Temporary use of oral contractive agents

c) lifestyle modifications to include weight loss by lowering calories and fat consumption

A 57-year-old woman has been diagnosed with atrophic vaginitis and has expressed surprise to her care provider, citing a lifetime largely free of gynecological health problems. She has asked what may have contributed to her problem. How can the care provider best respond? A) "The lower levels of estrogen since you've begun menopause make your vagina prone to infection." B) "Vaginitis is not usually the direct result of any single problem, but rather an inevitability of the vaginal dryness that accompanies menopause." C) "This type of vaginitis is most commonly a symptom of a latent sexually transmitted infection that you may have contracted in the distant past." D) "The exact cause of this problem isn't known, but it can usually be resolved with a diet high in probiotic bacteria."

A) "the low levels of estrogen since you've begun menopause make your vagina prone to infection"

While teaching a class on female cancers, the instructor emphasizes to the nursing students that many patients with ovarian cancer may display A) abdominal pain, bloating, feeling full quickly after ingesting food. B) pain after intercourse, bleeding irregularities, perineal tenderness. C) colicky low abdominal pain, adnexal mass present without palpation. D) lower abdominal pain localized to one side, referred shoulder pain.

A) abdominal pain, bloating, feeling full quickly after ingesting food

A 70-year-old woman who delivered four children during her reproductive years has weakened pelvic floor muscles. Which of her following anatomical structures is least susceptible to inappropriate herniation into her vagina? A) Peritoneum B) Uterus C) Bladder D) Rectum

A) peritoneum

A nurse who works on a urology-gynecology ward of a hospital is coming on shift and will be caring for a 34-year-old woman who has been admitted overnight for the treatment of a large endometriosis. What interventions should the nurse most realistically anticipate providing over the course of the shift and the next several days? A) Providing pain control; preparing the client for a laparoscopic procedure or hysterectomy. B) Administration of packed red blood cells to compensate for low hemoglobin; administering hormone therapy. C) Assisting with a Pap smear; administration of high-dose corticosteroids. D) Administration of male androgens to minimize endometrial hyperplasia; facilitating a dilation and curettage.

A) providing pain control, preparing the client for a laparoscopic procedure or hysterectomy

A 31-year-old woman and her husband have presented to their family physician due to their inability to conceive a child after trying for the last 18 months. Which of the following will the nurse practitioner want to specifically rule out as potential contributing factors? Select all that apply. A) Cryptorchidism in the husband B) Slow maturation of the endothelial lining after ovulation C) Low levels of LH and FSH in the wife D) Large amounts of clear, stretchy cervical mucus E) Sexually transmitted diseases like gonorrhea or chlamydial infection.

A, B, C, E

Prior to performing a laparoscopy, a patient exhibiting which of the following clinical manifestations would be treated with oral antibiotic therapy for suspected pelvic inflammatory disease (PID)? Select all that apply. A) Lower abdominal pain. B) Tenderness when cervix is touched during bimanual exam. C) Feeling of fullness and bloating in abdomen. D) Purulent cervical drainage noted on tissue after voiding. E) Elevated white cell count.

A, B, D, E

Following a workup that included endocrine studies (FSH/LH, prolactin, testosterone, DHEAS levels), a 22-year-old college student complaining of abnormal bleeding has been diagnosed with dysmenorrhea due to alterations in her hormone levels. The nurse should anticipate that she will likely be prescribed: Select all that apply. A) oral contraceptives. B) estrogen only. C) prostaglandin synthetase inhibitors. D) anxiolytic medications. E) androgens.

A, C

A 60-year-old woman who is 11 years menopausal has presented to the emergency department stating, "I haven't had my period in years, but lately I've been bleeding again, and quite heavily in the last few days." The care team needs to rule out endometrial cancer. How should they best explain the most accurate plan for confirming or ruling out the diagnosis? A) "We're going to book a CT scan for you as soon as possible so that we can see what is inside your uterus." B) "We're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus." C) "We are going to order blood work that will measure your hormone levels." D) "We can do a Pap smear right now, and we will get the results as soon as we can."

B) "we're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus"

After a long and frustrating course of constant vaginal pain, a 38-year-old woman has diagnosed with generalized vulvodynia by her gynecologist. What treatment plan is her physician most likely to propose? A) Alternative herbal therapies coupled with antifungal medications B) Antidepressant and antiepileptic medications C) Lifestyle modifications aimed at accommodating and managing neuropathic pain D) Narcotic analgesia and nonsteroidal anti-inflammatory medications

B) antidepressant and antiepieptic medications

A 31-year-old patient with breast cancer is concerned about being prescribed a hormonal medication to help block the effects of estrogen on the growth of breast cancer cells. The nurse should provide education about which of the following likely medications? A) Trastuzumab (Herceptin), a biologic therapy B) Nolvadex (Tamoxifen), a nonsteroidal antiestrogen C) Progesterone, a hormone. D) Arimidex (anastrozole), an aromatase inhibitor.

B) nolvadex, a nonsteroidal antiestrogen

While educating a mother about the benefits of giving her child the human papilloma virus (HPV) vaccine, gardisil, which of the following statements will the nurse need to clarify for the parent? Select all that apply. The vaccine is A) best administered before the child becomes sexually active. B) 100% effective against development of cervical cancer for her life span. C) effective against the two most common strains of genital warts. D) only recommended for females between the ages of 9 and 26. E) recommended prior to exposure to HPV, and if the child has genital warts, they are already exposed.

B, D

A patient who is still breast-feeding her infant has arrived at the clinic complaining of sore breasts. The physician has diagnosed mastitis. Which of the following statements made by the patient will require correction by the nurse? A) "They tell me this is usually caused by a Staph infection." B) "I need to make sure to wash my hands thoroughly before touching my breasts." C) "I need to stop breast-feeding until all my antibiotics have been taken." D) "A clogged duct in my breast has become clogged."

C) "i need to stop breast-feeding until all my antibiotics have been taken"

A 15-year-old female has presented to her family physician complaining of frequent discomfort around the time of her period. She has subsequently been diagnosed with primary dysmenorrhea. Which of the following treatments is most likely to be effective? A) Investigation and resolution of her hypothalamic-pituitary-ovarian disorder B) Hormone therapy aimed at resolving her estrogen deprivation C) Pain control with prostaglandin synthetase inhibitors D) Dilation and curettage

C) pain control with prostaglandin synthetase inhibitors

Staff at a women's health center are being briefed by their supervisor on the latest recommendations for breast cancer screening. Which of the following guidelines should staff pass on to their clients? A) "Breast self-exam should be ideally performed around the time of the month that you think you're ovulating." B) "The most important thing you can do to identify breast cancer early is to perform regular, systematic self-exams." C) "All postmenarche females should get a clinical exam by a trained professional on an annual basis." D) "Screening mammography and clinical exams are the cornerstones of breast cancer screening."

D) "screening mammography and clinical exams are the cornerstones of breast cancer screening"

Which of the following women is most likely to have a sexually transmitted infection as a contributing factor to her health problem? A) A 29-year-old woman with a diagnosis of localized vulvodynia B) A 40-year-old who is being treated for vaginal cancer C) A 32-year-old who is undergoing diagnostics to rule out endometriosis D) A 41-year-old with a diagnosis of mucopurulent cervicitis

D) a 41 year old with a diagnosis of mucopurulent cervicitis

A 28-year-old female has been told she has atypical glandular cells following Pap smear. The physician will likely recommend which procedure that can be performed in his office to remove the abnormal zone and provide a specimen for further histological evaluation? A) Cone biopsy B) Intracavitary irradiation C) Trachelectomy D) Loop electrosurgical excision procedure (LEEP)

D) loop electrosurgical excision procedure (LEEP)