Chapter 27: PrepU - Common Reproductive Conditions

A nurse assesses and suspects vulvar cancer based on which assessment finding? 1- vulvar itching that responds to creams 2- fleshy, ulcerated mass on the labia majora 3- vulvar bleeding 4- dysuria

2

A nurse is caring for a client who has been prescribed gonadotropin-releasing hormone (GnRH) medication for uterine fibroids. For which side effect of GnRH medications should the nurse monitor the client? 1- increased vaginal discharge 2- vaginal dryness 3- urinary tract infections 4- vaginitis

2

The nurse is providing care to a client with abnormal uterine bleeding. Treatment with medications has been unsuccessful, and surgical intervention is being considered. The nurse identifies which technique as being the last resort? 1- endometrial ablation 2- dilation and curretage 3- uterine artery embolization 4- hysterectomy

4

A nurse is assisting with the pelvic exam of a woman who has come to the clinic with reports of abnormal vaginal bleeding. The client is diagnosed with an endocervical polyp. The nurse understands that the pelvic exam most likely revealed a polyp appearing as: 1- cherry red. 2- grayish-white. 3- purplish-blue. 4- pinkish-gray.

1

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? 1- clear information on the disease, management, and treatment 2- touching the client's hand for comfort 3- remaining cheerful through all of the interactions 4- offering words of hope to the client

1

The nurse is assessing the laboratory test results of a client with abnormal uterine bleeding (AUB). Which finding should the nurse prioritize? 1- negative pregnancy test 2- hemoglobin level of 10.1 g/dL 3- prothrombin time of 40 seconds 4- serum cholesterol of 140 mg/dL

2

A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct? 1- "Human papillomavirus is the cause of essentially all cases of cervical cancer." 2- "At least antibiotics will cure a sexually transmitted infection." 3- "Gonorrhea and syphilis are an infection seen only in men." 4- "STIs can't be transmitted through oral sexual intercourse."

1

A nurse is assessing a 20-year-old female. Which data finding taken during the history would indicate endometrial cancer? 1- vaginal bleeding that is painless and abnormal 2- diagnosis of diabetes mellitus 3- diagnosis of liver disease 4- severe back pain

1

A nurse is conducting an in-service program for a group of staff nurses. After teaching the group about ovarian cysts, the nurse determines that the teaching was successful when the group identifies which type of cyst as being associated with hydatidiform mole? 1- theca-lutein cyst 2- corpus luteum cyst 3- follicular cyst 4- polycystic ovarian syndrome

1

A nurse is providing teaching about lifestyle modifications to address a client's pelvic organ prolapse. The nurse understand that the majority of these changes focus on: 1- reducing intra-abdominal pressure. 2- increasing muscle tone. 3- providing mechanical support. 4- preventing incontinence.

1

A nurse is reviewing the various treatment options with a client diagnosed with uterine fibroids. The nurse determines that the teaching was successful based on which statement? 1- "If I use hormone therapy, my fibroids may grow back when I stop the medication." 2- "A myomectomy will not allow me to keep my uterus." 3- "Uterine artery embolization is associated with minimal pain." 4- "Laser surgery won't affect my ability to have children."

1

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? 1- High-grade dysplasia progresses to invasive cervical cancer in about 2 years. 2- High-grade dysplasia progresses to invasive cervical cancer in about 9 years. 3- High-grade dysplasia progresses to invasive cervical cancer in about 4 years. 4- High-grade dysplasia progresses to invasive cervical cancer in about 7 years.

1

The plan of care for a woman diagnosed with a suspected reproductive cancer includes a nursing diagnosis of disturbed body image related to suspected reproductive tract cancer and impact on sexuality as evidenced by the client's statement that she is worried that she will not be the same. Which outcome would be appropriate for this client? 1- Client will verbalize positive statements about self and sexuality. 2- Client will demonstrate understanding of the condition and associated treatment. 3- Client will exhibit positive coping strategies related to diagnosis. 4- Client will identify misconceptions related to her diagnosis.

1

A nurse is caring for a 45-year-old client using a pessary to help decrease leakage of urine and support a prolapsed vagina. Which recommendation is most commonly provided to a client regarding pessary care? 1- Douche the vaginal area with diluted vinegar or hydrogen peroxide. 2- Remove the pessary twice weekly, and clean it with soap and water. 3- Use estrogen cream to make the vaginal mucosa more resistant to erosion. 4- Remove the pessary before sleeping or intercourse.

2

The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease: 1- is limited to the ovary. 2- involves one or both ovaries and extends into the pelvis. 3- has spread to the lymph nodes and other organs within the abdomen. 4- has metastasized to distant sites.

2

The nursing instructor asks the student how genital prolapses are classified in regard to their extent. The correct response would be which of the following? 1- primary, secondary, and tertiary 2- first, second, and third degree 3- small, medium, and large 4- micro, macro, and maxo

2

After teaching a group of young women how to reduce their risk for ovarian cancer, the nurse determines that additional teaching is needed when the group identifies which element? 1- pregnancy 2- oral contraceptives 3- feminine hygiene sprays 4- breastfeeding

3

A nurse is caring for a 32-year-old client for whom pessary usage is recommended for uterine prolapse. Which instruction should the nurse include in the teaching plan for the client concerning the pessary? 1- Avoid jogging and jumping. 2- Wear a girdle or abdominal support. 3- Report any discomfort with urination and defecation. 4- Avoid lifting heavy objects.

3

A nurse is preparing a client for discharge following an abdominal hysterectomy for fibroids. After providing discharge teaching, the nurse determines that the teaching was successful based on which client statement? 1- "I can resume using tampons in about 3 weeks." 2- "I don't have any restrictions on what I can lift or carry." 3- "I should shower rather than take a tub bath." 4- "I should limit my intake of foods that are high in fiber for about 2 weeks."

3

A 30-year-old client asks the nurse about risk factors for ovarian cancer. Which risk factor should be included in client education? 1- infertility 2- less than 40 years of age 3- menopause before age 50 4- breastfeeding

1

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? 1- Prepare the client for a biopsy of the lesion. 2 -Determine what creams the client has used. 3- Assess how much the client smokes daily. 4- Schedule the client for cryosurgery.

1

A client has just been diagnosed with ovarian cancer. The nurse understands that among women, this type of cancer ranks as: 1- ninth most common. 2- fifth most common. 3- seventh most common. 4- third most common.

1

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for: 1- DEXA scan. 2- ultrasound. 3- MRI. 4- pelvic X-ray.

1

A client was in labor for more than 36 hours and now reports urine leaking from her vagina. On examination the nurse would be inspecting for: 1- urethrovaginal fistula. 2- vesicovaginal fistula. 3- urge incontinence fistula. 4- rectovaginal fistula.

1

A client with large uterine fibroids is scheduled to undergo a hysterectomy. Which intervention should the nurse perform as a part of the preoperative care for the client? 1- Teach turning, deep breathing, and coughing. 2- Instruct the client to reduce activity level. 3- Educate the client on the need for pelvic rest. 4- Instruct the client to avoid a high-fat diet.

1

A client with pelvic organ prolapse is using lifestyle modifications and working to lose weight. The client asks the nurse, "Which type of exercise would be best?" The nurse would most likely suggest which exercise? 1- brisk walking 2- high impact aerobics 3- jogging 4- repeated jumping

1

A nurse is collecting assessment data on a new patient. The patient states that she does not have menses. What term will the nurse use in her documentation to describe the absence of menstrual flow? 1- Amenorrhea 2- Dysmenorrhea 3- Menorrhagia 4- Metrorrhagia

1

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? 1- Highest incidence of cervical cancer is in women 40 to 49 years of age. 2- It rarely develops in women over 60. 3- It is 10 times more common in women affected with HIV or AIDS. 4- Early detection with a colposcopy improves the chances of survival.

1

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: 1- cultural background. 2- acceptance of the diagnosis. 3- she wants her family there to discuss it. 4- she does not see the need to discuss it.

1

A patient in the second trimester of pregnancy is diagnosed with cervical cancer. For which treatment should the nurse instruct the patient as causing the least harm to the developing fetus? 1- Chemotherapy 2- Chelation therapy 3- Radiation therapy 4- Anticoagulant therapy

1

A postmenopausal woman is seen in the clinic and reports vaginal bleeding that has lasted for the past 3 to 4 weeks. A pelvic exam is performed and shows no abnormalites. Which test does the nurse anticipate the primary care provider will prescribe next for this client? 1- endometrial biopsy 2- colposcopy 3- endoscopy 4- colonoscopy

1

A young couple have presented to the office with concerns of possible infertility. A physical examination and complete history of the woman reveals type 2 diabetes mellitus, obesity, sleep apnea, and hypertension. The nurse would suspect: 1- polycystic ovary syndrome. 2- irregular menses. 3- leiomyomas. 4- hormonal imbalance.

1

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? 1- "I've been having bleeding off and on that's irregular and sometimes heavy." 2- "I get sharp pain in my lower abdomen usually starting soon after my period comes." 3- "I get really irritable and moody about a week before my period." 4- "My periods have been unusually long and heavy lately."

1

A nurse is caring for a woman who has just been diagnosed with uterine prolapse. Which symptoms may interfere with her daily activities? Select all that apply. 1- urinary frequency 2- low back pain 3- pelvic pressure 4- sinus pressure 5- diarrhea

1,2,3

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. 1- breast 2- cervical 3- skin 4- liver 5- colon

1,2,3,5

The nursing instructor is teaching the students about pelvic organ prolapse (POP). The nurse understands that teaching has been successful when the students identify which different types of POP? Select all that apply. 1- cystocele 2- rectocele 3- hydrocele 4- enterocele 5- uterine prolapse

1,2,4,5

A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? Select all that apply. 1- rectocele 2- fecal incontinence 3- cystocele 4- urinary incontinence 5- enterocele

1,3,5

A 47-year-old woman is being seen at the local clinic reporting irregular menstrual cycles. The nurse would explain to the client that the irregularity is most likely due to: 1- pregnancy. 2- menopause. 3- hormonal fluctuations. 4- an underlying endocrine problem.

2

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? 1- pelvic organ prolapse (POP) 2- ovarian cancer 3- breast cancer 4- fibroids

2

The nurse has assessed several clients who have arrived for routine appointments. The nurse predicts the health care provider will prioritize a bone density scan for which client? 1- a 40-year-old Black client, 5 ft 4 in (1.62 m) tall, 172 lbs (78 kg), inactive lifestyle 2- a 25-year-old Asian client, 5 ft 7 in (1.7 m) tall, 129 lbs (58.5 kg), with two children 3- a 55-year-old White client who smokes and has family history of osteoporosis 4- a 45-year-old Hispanic client with a vitamin D deficiency

3

A 36-year-old was diagnosed with uterine fibroids (leiomyomas). The nurse teaches the client to expect which clinical manifestation? 1- decrease in fibroid size if pregnancy occurs 2- diarrhea 3- acute abdominal pain 4- abnormal uterine bleeding

4

A client is to be examined for the presence and extent of endometriosis. For which test should the nurse prepare the client? 1- tissue biopsy 2- hysterosalpingogram 3- clomiphene citrate challenge test 4- laparoscopy

4

A client with abnormal uterine bleeding is diagnosed with small ovarian cysts. The nurse has to educate the client on the importance of routine check-ups. Which assessment is most appropriate for this client's condition? 1- Monitor gonadotropin level every month. 2- Monitor blood sugar level every 15 days. 3- Schedule periodic Papanicolau tests. 4- Schedule an ultrasound every 3 to 6 months.

4

A nurse is assessing a female client and suspects that the client may have endometrial polyps based on which clinical manifestation? 1- bleeding after intercourse 2- vaginal discharge 3- bleeding between menses 4- metrorrhagia

4

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as: 1- herniation of the rectum into the vagina. 2- protrusion of intestinal wall into the vagina. 3- downward displacement of the cervix. 4- bulging of the bladder into the vagina.

4

The nurse notes that a patient has a history of "fibroids" and is aware that this term refers to a benign tumor of the uterus. What is a more appropriate term for a fibroid? 1- Bartholin's cyst 2- Dermoid cyst 3- Hydatidiform mole 4- Leiomyoma

4

When explaining what will occur during the first prenatal visit physical examination, a pregnant client asks why a Papanicolaou test is being done at this time. What should the nurse respond to the client? 1- It helps to date the pregnancy. 2- It detects if uterine cancer is present. 3- It predicts whether cervical cancer will occur. 4- It detects cancer cells of the cervix, vulva, or vagina.

4

When reviewing the history of a woman diagnosed with endometrial cancer, the nurse would identify which factor as increasing the woman's risk? 1- vaginal birth of 4 children 2- menarche at age 14 years 3- menopause at age 47 years 4- use of tamoxifen

4

The nurse is conducting a presentation about urinary incontinence for a local women's group. During the presentation, which statement by a member of the group would the nurse need to clarify? 1- "It's normal for a woman to develop incontinence as she ages." 2- "There are ways to prevent urinary incontinence." 3- "Urinary incontinence is a treatable condition." 4- "Incontinence can be cured in some cases."

1

The nurse is conducting a routine well-visit on a 43-year-old client who is concernd about developing breast cancer, although no family members have experienced it. What is the bestadvice for this client at this time? 1- Conduct regular breast self-examination. 2- Inspect her nipples for discharge. 3- Ask health care provider for recommendations based on family history. 4- Have a yearly mammogram as part of a comprehensive screening.

1

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? 1- ultrasound 2- Papanicolau test 3- CA-125 test 4- endometrial biopsy

1

When assessing a woman with pelvic organ prolapse, the nurse notes the uterus is approximately 1 cm below the hymenal ring. The nurse documents this finding as which stage of prolapse? 1- stage II 2- stage 0 3- stage I 4- stage III

1

When preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects that the lesion would most likely be located at which area? 1- labia majora 2- labia minora 3- clitoris 4- prepuce

1

Which symptom is an early symptom of vulvar cancer? 1- pruritus with genital burning 2- fever accompanied by chills 3- severe abdominal pain 4- dyspareunia

1

A nurse is caring for a client for whom estrogen replacement therapy has been recommended for pelvic organ prolapse. Which nursing intervention is the most appropriate for the nurse to implement before the start of the therapy? 1- Discuss the effective dose of estrogen required to treat the client. 2- Evaluate the client to validate her risk for complications. 3- Discuss the dietary modifications following therapy. 4- Discuss the cost of estrogen replacement therapy.

2

A nursing student correctly identifies that a person's outward appearance or expression of genes is referred to as the: 1- allele. 2- phenotype. 3- genotype. 4- genome.

2

A woman is scheduled for diagnostic testing to evaluate for endometrial cancer. The nurse would expect to prepare the woman for which procedure? 1- CA-125 testing 2- transvaginal ultrasound 3- Papanicolau test 4- mammography

2

After undergoing diagnostic testing, a woman is diagnosed with a corpus luteum cyst. The nurse anticipates that the woman will require: 1- biopsy. 2- no treatment. 3- oral contraceptives. 4- metformin.

2

Kegel exercises are recommended for a client with pelvic organ prolapse. Which information about the exercises should the nurse give the client? 1- They should be performed after food intake. 2- They alleviate mild prolapse symptoms. 3- They are not recommended after surgery. 4- They increase blood pressure.

2

The nursing instructor is teaching a class on gynecologic (GYN) malignancies and realizes a need for further instruction when a student makes which statement? 1- "Endometrial cancer is also known as uterine cancer." 2- "Cervical cancer is the most common GYN malignancy." 3- "Endometrial cancer usually has a better prognosis than cervial cancer." 4- "Endometrial cancer is the most common GYN malignancy."

2

When working in a local community health care center, a nurse is frequently asked about cervical cancer and ways to prevent it. Which information should the nurse provide? Select all that apply. 1- Encourage the use of an intrauterine device (IUD) for contraception. 2- Encourage cessation of smoking and drinking. 3- Encourage prevention of sexually-transmitted infections (STIs) to reduce risk factors. 4- Avoid stress and high blood pressure. 5- Counsel teenagers to avoid early sexual activity.

2,3,5

A nurse is assessing a client with polycystic ovary syndrome for metabolic syndrome. Which findings would the nurse assess? Select all that apply. 1- waist circumference 32 inches 2- triglyceride level 175 mg/dL 3- HDL 60 mg/dL 4- elevated C-reactive protein 4- hypotension

2,4

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. 1- Be judgmental of the women's previous lifestyle. 2- Use sincere, basic communication techniques. 3- Give care based on all women diagnosed with cancer. 4- Validate the client's feelings and provide realistic hope. 5- Give postoperative care and instructions when prescribed.

2,4,5

The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which suggestions should the nurse include in the teaching plan? Select all that apply. 1- Increase intake of salty foods. 2- Increase water consumption. 3- Avoid keeping legs elevated while lying down. 4- Use heating pads or take warm baths. 5- Increase exercise and physical activity.

2,4,5

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? 1- A genital exam should be completed by the health care provider only. 2- A genital exam should be done by the woman herself only. 3- The woman should avoid tight undergarments. 4- The woman should take OTC drugs to self-medicate and treat lesions. 5- The woman should use oral contraceptives instead of using barrier methods.

3

A nurse is preparing a presentation for a group of women which will cover various dietary and lifestyle changes to help avoid future pelvic structure changes. Which key point should the nurse point out in this presentation to the women? 1- Limit fiber intake to less than 25 grams daily. 2- Eat more refined, processed foods. 3- Drink plenty of fluids each day. 4- Engage in vigorous exercise.

3

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? 1- I 2- II 3- III 4- IV

3

A patient you are caring for has returned to her room after vulvar surgery. What would be an important intervention during the initial postoperative period? 1- Placing the patient in high Fowler's position 2- Sitz baths are recommended 3- Monitoring the surgical site for signs of infection 4- Analgesics will be administered on a prn basis

3

A woman experiencing menopausal symptoms asks the nurse about herbal remedies for managing her symptoms. Which response by the nurse would be most appropriate? 1- "Herbal remedies have been proven quite reliable in alleviating the symptoms of menopause." 2- "You should avoid herbal remedies and ask your primary care provider for hormone replacement therapy." 3- "Most of the information about herbal therapies is based on reports by those who have used them, not scientific studies." 4- "Your symptoms are not severe enough to warrant any treatment or therapy."

3

Which measure would the nurse include in the teaching plan for a woman to reduce the risk of osteoporosis after menopause? 1- taking vitamin supplements 2- eating high-fiber, high-calorie foods 3- restricting fluid to 1,000 mL daily 4- participating in regular daily exercise

4