NCLEX - Reproductive Questions
A client with a history of ovarian cysts is seen by the primary health care provider (PHCP). The client has had 2 previous surgeries related to this condition. Her PHCP recommends an exploratory laparoscopic procedure for the current ovarian cyst, which has persisted for several months. The client states that the prior ovarian cysts were benign and questions the need for this procedure. Which response is best for the nurse to provide? 1."A prolonged ovarian abnormality should be evaluated thoroughly." 2."With your recurrent history, one of these times the cyst will be malignant." 3."The surgical procedure is minimal, and you will not have to be concerned after you learn the results." 4."I appreciate your concern regarding another surgical procedure. Would you like to discuss your concerns?"
1 Rationale:An ovarian cyst is considered an abnormal occurrence, and it should be thoroughly evaluated. Not all ovarian cysts are malignant, and this client may never experience a malignancy. Any surgical procedure has some risk and pain associated with it. The nurse cannot promise the procedure will be minimal and that there will be no reason for concern after learning the results. Discussing the concerns does involve therapeutic communication but is not the best response given the situation. In addition, it is nontherapeutic for the nurse to tell the client that he or she appreciates the client's concern.
A female client is suspected of having a vaginal infection caused by the organism Candida albicans. Which assessment question would elicit data associated with this infection? 1."Have you had any vaginal discharge?" 2."Do you have any blood in your urine?" 3."Have you had any flank pain or headaches?" 4."Have you noticed any swelling in your feet?"
1 Rationale:Clinical manifestations of a Candida infection include vaginal pain, itching, and a thick white vaginal discharge. Hematuria, edema, flank pain, and headache are clinical manifestations associated with urinary tract infections.
The clinic nurse has provided instructions regarding home care measures to a female client diagnosed with pelvic inflammatory disease (PID). Which statement, if made by the client, indicates an understanding of these measures? 1."I need to avoid tight-fitting clothing." 2."I need to douche once in the morning and once in the evening." 3."I need to see a primary health care provider to get an intrauterine device for birth control." 4."I need to wear tampons instead of sanitary pads when I have my menstrual period."
1 Rationale:The client who has been diagnosed with PID should avoid frequent douching because this decreases the normal flora that controls the growth of infectious organisms. The client should wear cotton undergarments, and clothes should not fit tightly. Tampons, if worn, should be changed frequently but should not be used during an acute infection. In fact, many primary health care providers recommend avoiding the use of tampons indefinitely. Intrauterine devices increase the client's susceptibility to PID.
The nurse presents a seminar on sexually transmitted infections. Which information about syphilis should the nurse include in this presentation? Select all that apply. 1.A blood test will confirm the diagnosis. 2.Syphilis signs and symptoms are divided into stages. 3.Syphilis can be spread through vaginal, anal, or oral sex. 4.Having syphilis once provides lifelong immunity from repeat infection. 5.Syphilis will always be present in a chronic state, as there is no cure for this illness.
1,2,3 Rationale:Syphilis can be cured with the initiation of prompt treatment. A blood test can confirm this diagnosis. Syphilis is staged in relation to signs and symptoms and the length of the infection. Syphilis may be transmitted via vaginal, anal, or oral sex. An individual may be positive for syphilis more than once. Syphilis can be cured by early treatment.
A preadolescent client asks the nurse about the onset of puberty. The nurse describes which changes as indicating puberty? Select all that apply. 1.Mood swings occur. 2.Pubic hair will develop. 3.Breast development begins. 4.Uterus matures to adult size. 5.Height will increase due to a growth spurt.
1,2,3,5 Rationale:During puberty, a number of body changes will occur. These changes include mood swings, the beginning development of pubic hair, breast bud development, and growth spurt. The uterus does not reach full maturity until approximately 17 years of age.
The instructor asks a nursing student to identify the phases of the ovarian cycle. Which phases identified by the nursing student indicate an understanding of the ovarian cycle? Select all that apply. 1.Luteal phase 2.Follicular phase 3.Menstrual phase 4.Ovulatory phase 5.Proliferative phase
1,2,4 Rationale:The ovarian cycle consists of 3 phases: follicular, ovulatory, and luteal. The menstrual and proliferative phases are phases of the endometrial cycle.
The nurse is performing an assessment on a client who asks how she might recognize when she is ovulating. The nurse should explain that which occurs at ovulation? Select all that apply. 1.Breast tenderness 2.Decreased sex drive 3.Small amount of vaginal spotting 4.Slight decrease in basal body temperature 5.Lower abdominal pain known as Mittelschmerz 6.Presence of spinnbarkeit-thin and clear mucous discharge
1,3,5,6 Rationale:While ovulation predictors may be individual in nature, the most common predictors are breast tenderness, increase in libido, small amount of vaginal bleeding, slight elevation in basal body temperature, the presence of Mittelschmerz (middle pain), and spinnbarkeit.
A nursing student is doing a presentation on human papillomavirus (HPV) for a young adult group aged 18 to 20 years old. What information should the nursing student include in this presentation? Select all that apply. 1."Some forms of HPV can lead to cervical cancer." 2."You cannot get HPV if you have had only 1 sex partner." 3."There are no vaccinations available to protect against HPV." 4."HPV is most commonly spread during vaginal or anal sexual contact." 5."In some types, HPV will go away on its own and does not cause health issues."
1,4,5 Rationale:HPV has now become the most common sexually transmitted infection. Some types of HPV have been found to have a strong link to cervical cancer, while other types of HPV may resolve without any intervention. HPV may be contracted with any sexual partner. There is a vaccine for the known strains that may lead to cervical cancer, which can be administered to females from ages 9 to 26 years. HPV is spread through vaginal or anal sexual contact.
A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse should determine whether this method of family planning would be most appropriate? 1."Have you ever had surgery?" 2."Do you plan to have any other children?" 3."Do either of you have diabetes mellitus?" 4."Do either of you have problems with high blood pressure?"
2 Rationale:Sterilization is a method of contraception for couples who have completed their families. It should be considered a permanent end to fertility, because reversal surgery is not always successful. The nurse would ask the couple about their plans for having children in the future. Options 1, 3, and 4 are unrelated to this procedure.
55-year-old male client confides in the nurse that he is concerned about his sexual function. What is the nurse's best response? 1."How often do you have sexual relations?" 2."Please share with me more about your concerns." 3."You are still young and have nothing to be concerned about." 4."You should not have a decline in testosterone until you are in your 80s."
2 Rationale:The nurse needs to establish trust when discussing sexual relationships with men. The nurse should open the conversation with broad statements to determine the true nature of the client's concerns. The frequency of intercourse is not a relevant first question to establish trust. Testosterone declines with the aging process.
The nurse employed in a fertility clinic is providing information to a couple considering in vitro fertilization. The nurse's explanation should most appropriately include which information? Select all that apply. 1.Embryo transfer occurs through an abdominal incision. 2.A fertilized ovum is transferred into the woman's uterus. 3.Mild spotting or cramping may occur following egg removal. 4.A medication protocol for follicle development will be prescribed. 5.Ova and sperm are collected and immediately transferred into the woman's uterus.
2,3,4 Rationale:In vitro fertilization is a method of medically assisted reproduction for women with nonpatent, diseased, or missing fallopian tubes or with infertility of unknown cause. Ova and sperm are obtained from potential parents or donors, placed in a nutrient medium, and allowed to incubate for approximately 18 hours; then the fertilized ovum is transferred into the woman's uterus via vaginal catheter insertion. The woman houses the pregnancy throughout gestation and gives birth. No abdominal incision is made during this procedure. Mild spotting or cramping may occur following egg removal. A medication protocol including daily injectable gonadotropins for follicle development will be prescribed.
The nursing student is asked to discuss information related to the uterus with female high school students. Which statements by the nursing student are accurate? Select all that apply. 1."The uterus consists mostly of skeletal muscle." 2."The uterus is a pelvic organ when not pregnant." 3."The uterus weighs approximately 2.2 lb (1000 g) at term pregnancy." 4."The uterus weighs approximately 2 oz (60 g) in the nonpregnant state." 5."The uterus is composed of 3 layers: endometrium, myometrium, and perimetrium."
2,3,4,5 Rationale: Before conception, the uterus is a small, pear-shaped cavity contained entirely in the pelvic cavity. Before pregnancy, the uterus weighs approximately 2 oz (60 g) and has a capacity of about ⅓ oz (10 mL). At the end of pregnancy, the uterus weighs approximately 2.2 lb (1000 g) and has sufficient capacity for the fetus, placenta, and amniotic fluid. The uterus mostly consists of smooth muscle and is composed of 3 layers. The innermost layer is the endometrium, the middle layer is the myometrium, and the outer layer is the perimetrium.
The nurse is interviewing a middle-aged woman with a history of fibrocystic disorder of the breasts. Which statements made by the client indicate a need for further teaching? Select all that apply. 1. "I might experience pain in my underarm region." 2. "My symptoms will decrease just before menstruation." 3. "After I experience menopause, my symptoms may lessen." 4. "Taking oral contraceptives now will increase my symptoms." 5. "Upon self-breast examination, I may detect lumpiness in the upper, outer area of my breasts."
2,4 Rationale:The nurse assesses the client with fibrocystic breast disorder for worsening symptoms (breast lumps, painful breasts extending into the underarm region, and possible nipple discharge) before the onset of menses. This is associated with cyclical hormonal changes. Taking oral contraceptive pills and experiencing menopause may also help to decrease the signs and symptoms of fibrocystic disease.
An adolescent seen in the health care clinic has been diagnosed with endometriosis. The client asks the clinic nurse to describe this condition. Which response should the nurse provide? 1."It always causes infertility." 2."It causes the cessation of menstruation." 3."It is the presence of tissue outside the uterus." 4."It is also known as primary dysmenorrhea."
3 Rationale:Endometriosis is defined as the presence of tissue outside the uterus that resembles the endometrium in both structure and function. The response of this tissue to the stimulation of estrogen and progesterone during the menstrual cycle is identical to that of the endometrium. Endometriosis can lead to pelvic scarring, pain, and possible infertility. Amenorrhea is the cessation of menstruation for a period of at least 3 cycles or 6 months in a woman who has established a pattern of menstruation and can be due to a variety of causes. Primary dysmenorrhea refers to menstrual pain without identified pathology.
he client has a regular 32-day cycle. She asks on which day she most likely ovulates. How should the nurse reply? 1.Day 14 2.Day 16 3.Day 18 4.Day 20
3 Rationale:Ovulation typically occurs 14 days prior to day 1 of the next menstrual cycle. Subtracting 14 days from 32 results in day 18 being the most likely time of ovulation.
The nurse is performing an assessment on a client admitted to the hospital who was diagnosed with toxic shock syndrome (TSS). Which assessment question would assist in eliciting the most specific data regarding the cause of this syndrome? 1."Did you start your menses at an early age?" 2."Have your menstrual periods been irregular?" 3."Do you use tampons during your menstrual period?" 4."Have you been consuming a high intake of green leafy vegetables?"
3 Rationale:TSS is caused by infection and is often associated with tampon use. Disseminated intravascular coagulation is a complication of TSS. Options 1, 2, and 4 are unrelated to the etiology of TSS.
The nurse is caring for a client with a diagnosis of endometriosis. The client asks the nurse to describe this condition. How should the nurse respond? Select all that apply. 1."It causes the cessation of menstruation." 2."It is pain that occurs during ovulation." 3."It is the presence of tissue outside the uterus that resembles the endometrium." 4."It is also known as primary dysmenorrhea and causes lower abdominal discomfort." 5."Major symptoms of endometriosis are pelvic pain, dysmenorrhea, and dyspareunia."
3,5 Rationale:Endometriosis is defined as the presence of tissue outside the uterus that resembles the endometrium in both structure and function. Major symptoms include pelvic pain, dysmenorrhea, and dyspareunia (painful intercourse). The response of this tissue to the stimulation of estrogen and progesterone during the menstrual cycle is identical to that of the endometrium. Amenorrhea is the cessation of menstruation for at least 3 cycles or 6 months in a woman who has an established pattern of menstruation. Amenorrhea can be caused by a variety of factors. Mittelschmerz refers to pelvic pain that occurs midway between menstrual periods. Primary dysmenorrhea refers to menstrual pain without identified pathology.
