RICCI Chapter 8

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."

The nursing instructor is teaching a class on gynecologic (GYN) malignancies and realizes a need for further instruction when a student makes which statement?

"Cervical cancer is the most common GYN malignancy."

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 45-year-old woman comes to the clinic for a routine check up. During the assessment, the woman asks the nurse, "I had a friend who developed ovarian cancer and she just died from it because it was diagnosed late. I know there is screening available for colon cancer and cervical cancer, but is there anything for ovarian cancer?" Which response by the nurse would be most appropriate?

"There really isn't any routine screening used for ovarian cancer."

A client asks the nurse if she can recommend a screening test for ovarian cancer. Which response by the nurse would be most appropriate?

"Unfortunately, there aren't any routine screening methods currently."

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 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.

1. Hispanics 2. African Americans 3. Asian and Pacific Islanders 4. Caucasians

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 conducting a class at a women's clinic about reproductive cancers. When describing the incidence of reproductive tract cancers in pregnant women, which information would the nurse include?

Cervical cancer is more common in the pregnant population than other reproductive cancers.

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.

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

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 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

The endometrial biopsy of a client reveals cancerous cells, and the primary health care provider has diagnosed it as endometrial cancer. Which responsibilities of the nurse are part of the treatment of the client? Select all that apply.

Make sure the client understands all the available treatment options. Inform the client about the possible advantages of a support group. Offer the family explanations and emotional support throughout the treatment.

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 Pap smear should be scheduled about 2 weeks (10 to 18 days) after the first day of the woman's last menstrual period to increase the chance of getting the best sample of cervical cells without menses. In this case, the date would be May 17.

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

The nursing instructor is teaching the student about cervical cancer and tells her that it is the one cancer whose incidence and mortality rates have greatly decreased in the past several decades. This can be attributed to which factor?

Pap tests

A nurse is educating a 25-year-old client with a family history of cervical cancer. Which test should the nurse inform the client about to detect cervical cancer at an early stage?

Papanicolaou test

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 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.

A nurse is preparing a discussion for a group of women at the clinic. When describing vaginal cancer, the nurse wouldmost likely integrate which statement into the discussion?

Pulmonary metastasis is common with adenocarcinomas of the vagina.

A 30-year-old woman had a Pap smear 4 weeks ago. The results of the test are classified as ASC-H, as per the Bethesda System. Which therapeutic management intervention should the nurse expect the health care provider to prescribe?

Refer for a colposcopy with 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 28-year-old woman had a Pap smear 4 weeks ago. The results of the test are classified as ASC-US as per the Bethesda System. Which therapeutic management intervention should the nurse expect the health care provider to prescribe?

Repeat the Pap smear in 4 to 6 months, or refer for a colposcopy.

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.

A woman has been referred for laser therapy for her diagnosis of cervical cancer. The client wants to know more about the procedure. Which information regarding laser therapy should the nurse give to the client?

The client may experience a watery brown discharge for a few weeks.

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

The malignancy is localized.

A young woman has been referred for a colposcopy by the health care provider. The nurse is educating the woman on the procedure. Which information about the colposcopy should the nurse provide?

The results of the Pap smear were abnormal; therefore, this procedure must be done.

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 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 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 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 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

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

Which risk factors are associated with vaginal cancer? Select all that apply.

advancing age HIV infection smoking

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 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 preparing a presentation for a group of women who are of age to have children about the risk for cancer during pregnancy. When describing the risk, which cancer would the nurse most likely include as being the most common cancer occurring during pregnancy?

breast

A nurse is preparing a presentation about vaginal cancer for a group of women at the local community clinic. The nurse plans to include information about metastatic forms of vaginal cancer. Which cancers would the nurse most likely include as commonly metastasizing to the vagina? Select all that apply.

breast cervical skin colon

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

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 nurse is trying to assist her client with dealing with her newly diagnosed cervical cancer, but the client is not wanting to discuss it. The nurse needs to understand that this may be due to:

cultural background.

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 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 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 assesses and suspects vulvar cancer based on which assessment finding?

fleshy, ulcerated mass on the labia majora

As a class project a group of student nurses are developing a care plan for clients being screened for cervical cancer. When teaching clients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?

human papillomavirus (HPV)

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

hysterectomy and salpingo-oophorectomy

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

infertility

A nurse is providing care to a female client just diagnosed with cervical cancer. When developing this client's plan of care, the nurse would focus interventions on which client needs as the priority at this time? Select all that apply.

information emotional support

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.

The women's health clinic nurse is giving a presentation on cancers of the reproductive tract. Which signs and symptoms are abnormal and, if present, should result in notification of a health care provider? Select all that apply.

irregular vaginal bleeding vulvar lesions of abnormal color that are raised continuous low back pain

The Obstetric Educator Nurse is reviewing vulvar cancer with nursing staff as part of their continuing education seminar. Which risk factor for vulvar cancer would the nurse list?

lichen sclerosus

A nurse is reviewing the medical history of a client just diagnosed with stage III ovarian cancer. Which findings would the nurse identify as placing this client at risk? Select all that apply:

never been pregnant positive BRCA1 and BRCA2 gene mutations use of perineal hygiene sprays

The nurse is educating a female client about lifetime risk for developing cancer. The nurse determines that the teaching was successful when the woman states that regardless of her risk factors, her chances for developing cancer are:

one-in-three.

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 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 nursing student correctly identifies vaginal cancer as one of the rarest forms of genital cancers. It is mostly asymptomatic, which makes the diagnosis even harder. What does she identify to be symptoms of this disease? Select all that apply.

painless vaginal bleeding abnormal vaginal discharge dysuria constipation pelvic pain

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 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

Health clinic nurses are presenting a health fair at a local women's shelter. They are discussing the topic of cervical cancer. Which preventions should be included? Select all that apply.

smoking cessation and prohibiting of alcohol consumption encouraging teens to refrain from early sexual activity

A nurse is working as part of a group of health care providers implementing a community health initiative for primary prevention of cervical cancer. The nurse would focus educational efforts on which areas? Select all that apply.

steps to prevent sexually transmitted infections (STIs) consistent use of barrier contraceptives immunization with the HPV vaccine

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

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 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 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 client presents at a community health care center for a routine check up. The client wants to know about any tests that can effectively detect ovarian cancer early. The nurse should inform the client about which test that aids in the detection of ovarian cancer?

yearly bimanual pelvic examinations