Chapter 57 - PrepU

A patient had a pessary inserted for long-term treatment of a prolapsed uterus. As part of a teaching plan, the nurse would advise the patient to:

see her gynecologist to remove and clean the pessary at regular intervals

A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do?

see her gyno as soon as possible

A client receives a sealed radiation implant for the treatment of cervical cancer. What should the nurse do when caring for the client?

notify the healthcare provider if the vaginal packing is dislodged

Which abnormality is not considered a structural abnormality?

pelvic inflammatory disease

A client is in isolation after receiving an internal radioactive implant to treat cancer. Two hours later, the nurse discovers the implant in the bed linens. What should the nurse do first?

leave the room and notify the radiation therapy department immediately

Which group represents the fastest-growing segment of the population with AIDS?

women

A patient diagnosed with endometriosis asks for an explanation of the disease. What should the nurse explain to the patient?

Tissue from the lining of the uterus has implanted in areas outside the uterus.

Which drug is the usual treatment for vulvar dystrophy?

Topical corticosteroids

Which of the following is an early symptom of vulvar cancer?

pruritus with genital burning

A client is prescribed androgen therapy. Which of the following would the nurse explain as a possible adverse effect?

weight gain

Which is the earliest and most common symptom of endometrial cancer?

Bleeding

Client reveals evidence of a cystocele. The nurse interprets this as which of the following?

bulging of the bladder into the vagina

A NP suspects patient to have endometriosis. Nurse knows that although a definitive diagnosis could not be made without transvaginal ultrasound, the most frequent symptom is

chronic pelvic pain

Which is the primary assessment finding in identifying the possible cause of repeated episodes of vaginitis in a female client?

type 2 diabetes

Which term describes an opening between the bladder and the vagina?

vesticovaginal fistula

Which of the following is an expected outcome for a client 24 hours after an abdominal hysterectomy?

the client will perform leg exercises hourly

A patient who is diagnosed as having endometriosis asks for an explanation of the disease. What is the nurse's best response?

Tissue similar to the lining of the uterus has implanted in areas outside the uterus.

A client has just received a diagnosis of premature ovarian failure. How would this diagnosis be confirmed?

FSH level determination

What does the nurse recognize are two chief symptoms of early carcinoma that the patient should be questioned about?

Leukorrhea and irregular vaginal bleeding or spotting

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 of the following?

cervical cancer

patient has severe pelvic inflammatory disease, nurse insists on keeping her in a semisitting position. Which of the following is correct rationale for this positioning?

facilitation of pelvic drainage and minimize the upward extension of infection

34 year old client has been diagnosed with endometriosis. What topic should the nurse emphasize during health education?

the importance of reporting a possible pregnancy as soon as it occurs

A nurse is reviewing a client's medical history. Which factor indicates the client is at risk for candidiasis?

use of corticosteroids

client has undergone a total abdominal hysterectomy and bilateral salpingo-oophrectomy as treatment for endometrial cancer. when providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?

Bladder dysfunction

Which client has the highest risk of ovarian cancer?

45-year old woman who has never been pregnant

Patient reports she has a sense of pelvic pressure and urinary problems such as incontinence, frequency and urgency. The problem has gotten much worse since the birth of her third child. What does the nurse suspect the patient is experiencing?

A cystocele

During consultations with the oncologist, a client with cervical cancer is informed that radioactive materials will be inserted in the area of the tumor. She has to undergo these sessions over a period of 3 weeks. Which method of cancer treatment is being described?

Brachytherapy

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following?

Bulging of the bladder into the vagina

Client reports a curdy white vaginal discharge and burning with urination. What is the MOST likely cause of these symptoms?

Candida albicans

While obtaining 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 of the following?

Cervical cancer

Which of the following is the descent of the small intestine into the vaginal vault?

Enterocele

The nurse is obtaining history from a client who is suspected of having pelvic inflammatory disease (PID). Which client statement would help support the suspicion of PID?

I was 15 years old when I first had sex

Elderly client is ordered a pessary. Which comment from the client indicates a need for further teaching about this device?

I will remove and clean it every day

Which statement regarding herpes virus 2 is accurate?

In pregnant women with active herpes, babies delivered vaginally may become infected with the virus

A client is ordered a vaginal cream for the treatment of a yeast infection. What teaching should the nurse include for inserting the vaginal medication?

Insert the medication into the vagina using an applicator.

Which is the preferred medication for bacterial vaginosis?

Metronidazole

Client reports that she has been experiencing some bleeding that occurs suddenly and without a regular pattern in between her normal menstrual periods. The nurse documents this finding as which of the following?

Metrorrhagia

Client with history of dysmenorrhea. During monthly menses, client experiences incapacitating cramping and passes large clots. The client's primary care physician initiates conservative treatment. What interventions would the physician to recommend?

NSAIDs

While caring for a client who is being treated for severe pelvic inflammatory disease (PID), which nursing action minimizes transmission of infection?

Performing hand hygiene when entering the room

To treat cervical cancer, a client has had an applicator of radioactive material placed in the vagina. Which observation by the nurse indicates a radiation hazard?

The client receives a complete bed bath each morning.

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

This condition puts her at a higher risk for cervical cancer; therefore she should have a pap smear annually

A nurse reviewing a client's medical history. Which factor indicates the client is at risk for candidasis?

Use of corticosteroids

The nurse is interviewing a postmenopausal client during an annual gynecologic exam. Which assessment finding presents the greatest concern in the care of this client?

Vaginal bleeding

A patient is receiving chemo with paclitaxel as treatment for ovarian cancer. Patient arrives for lab testings prior to her next dose of chemo. the results are hemoglobin: 12.9 gm/dL WBC: 2,200/ cu mm Platelets: 250,000/cu mm RBC: 4,000,000/cu mm which result would be a cause for concern?

WBC

A client is being seen at the local community-based clinic where you practice nursing. Her healthcare provider has diagnosed the client with candidiasis and prescribed clotrimazole cream once daily for 7 days. You are providing education on how to administer the prescribed treatment. Which of the following techniques will the client use to administer this medication?

administer cream at bedtime high into vaginal canal

A client who wishes to preserve childbearing asks the nurse to explain how taking oral contraceptives will work in the management of endometriosis. Which is the best response by the nurse?

symptoms of endometriosis are increased during normal menstrual cycle

A client complains of itching and burning of the perineum from vaginitis. Which suggestion would be most appropriate to relieve the symptoms?

take sitz baths frequently

A client who had intracavity radiation treatment for cervical cancer 1 month earlier reports small amounts of vaginal bleeding. This finding most likely represents

an expected effect of the radiation therapy

Woman in her late 30s has been having unusually heavy periods combined with occasional urine and stool leakage over the past few weeks. She reveals she has postcoital pain and bleeding. Which diagnosis will the investigation MOST likely lead?

cervical cancer

NP examines a patient suspected of having endometriosis. The nurse knows that although a definitive diagnosis could not be made without diagnostic treatment (transvaginal ultrasound) the most frequent symptom is

chronic pelvic pain

Which group is most important to understand the importance of an annual papanicolaou test?

client infected with the human papillomavirus (HPV)

In which group is it most important for the client to understand the importance of an annual Papanicolaou test?

clients infected with the human papillomavirus (HPV)

Nurse documents following history from female patient No known allergies, douching 2-3 times per week, use of barrier methods, recent viral upper respiratory infection, estrogen levels within acceptable parameters Which of the following would the nurse identify as a risk factor for the patient developing a vulvovaginal infection?

douching

Following a colposcopy, the confirmation of in situ carcinoma of the cervix has been determined. Which comment by the client indicates an appropriate understanding of the diagnosis?

the cancer has not spread

An older client underwent a lumpectomy for a breast lesion that was malignant. Which factors increase the risk for breast cancer?

increased age, obesity, daily alcohol intake, nulliparity

Young client is diagnosed with acute pelvic inflammatory disease (PID). Which long-term affect is of greatest concern in the care of this client?

infertility

A client has just been diagnosed with endometriosis. Which response would be most appropriate in providing support/guidance to the client?

it might help to include your partner in any of the discussions about options

A client is experiencing symptoms associated with menopause. What is a likely recommendation to increase the client's interest in sexual activity?

low - dose androgens

woman comes to the emergency department reporting vaginal discharge and pelvic pain that increases with urination. The client also reports nausea and vomiting, headache, and anorexia. A pelvic examination reveals cervical motion tenderness. The client is diagnosed with acute pelvic inflammatory disease (PID) and is admitted. Which of the following would be most appropriate to include in this client's plan of care?

maintaining bedrest in the semi-fowler's position

A client who has been unable to conceive is intent on discovering the reason. The client has had very scanty, infrequent menses since their onset, and has a history of type 2 diabetes and acne. What could be the reason for this client's menstrual disorder?

polycystic ovarian syndrome

A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The client has a body mass index (BMI) of 30 and reports irregular menstrual cycles and feeling tired all the time. The nurse suspects the client's symptoms to indicate which condition?

polycystic ovary syndrome (PCOS)

During the health history, a client informs the nurse that the client's mother was prescribed DES early in her pregnancy for the client. The nurse must stress the need for frequent gynecological examinations for this client in order to:

prevent onset of cervical cancer

A nurse who works in a gynecologist's office frequently cares for patients who are diagnosed with vulvovaginal candidiasis. The nurse should teach the patients how to manage and treat the most common symptom of:

vulvar pruritus