Nursing Management: Patients With Breast and Female Reproductive Disorders

After teaching a group of students about the signs and symptoms of breast cancer, the instructor determines that additional teaching is needed when the group identifies which of the following?

Breast symmetry

Which drug is the usual treatment for vulvar dystrophy?

Topical corticosteroids

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.

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

A client is very concerned about possibly having breast cancer, especially after caring for a close family member who recently died from the disease. The nurse informs the client that the primary and most common sign of breast cancer is a:

painless mass in the breast, most often in the upper outer quadrant.

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.

Which is one of the most important prognostic factors in breast cancer?

Status of lymph nodes

A client returns to the recovery room following a mastectomy. An initial postoperative assessment is performed by the nurse. What is the nurse's priority assessment?

Assessing the vital signs and oxygen saturation levels.

A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which of the following would be most appropriate in this situation?

Assist the client to pump the breasts to remove breast milk.

A 50-year-old woman is scheduled for discharge this morning following a left-sided simple mastectomy that was performed yesterday to treat noninvasive breast cancer. When providing this woman's care prior to discharge, what action should the nurse prioritize?

Avoid measuring the woman's blood pressure on her left arm.

A client has been diagnosed with genital herpes. Knowing that education is an essential part of nursing care of the client with a genital herpes infection, the nurse plans to include which method(s) to minimize HIV transmission? Select all that apply.

Avoiding unprotected sexual intercourse Avoiding multiple sexual partners Avoiding IV drug use

A nurse in a campus medical clinic is meeting with a 23-year-old student who states that she has been experiencing malodorous vaginal discharge over the past several days. The nurse should recognize that this patient is describing a sign that is characteristic of:

Bacterial vaginosis (BV)

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

Over the past 2 months, a client has been receiving treatment for multiple ear infections and tonsillitis. The client reports a curdy white vaginal discharge and burning with urination. What is the most likely cause of these symptoms?

Candida albicans

Which type of yeast infection is manifested by white, cheese-like discharge?

Candidiasis

While taking a health history on a 20-year-old woman, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse knows that this medication is used to treat what medical condition?

Candidiasis

A patient is receiving chemotherapy for breast cancer. Her most recent laboratory test results are as follows: Erythrocytes 4,500,000/cu mm Hemoglobin 12.0 gm/dL Hematocrit 35% Leukocytes 4,600 gm/dL Thrombocytes 125,000/cu mm Which results suggests some evidence of bone marrow suppression?

Thrombocyte count

The nurse is caring for a client who will be having artificial implants for breast reconstruction. The client is arriving at the physician's office for which procedure to be completed before the surgery can be done?

Tissue expansion

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.

When a female client reports a frothy, yellow-green vaginal discharge, the nurse suspects the client has a vaginal infection caused by which organism?

Trichomonas vaginalis

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

Use of corticosteroids

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.

A client with HIV has recently completed a 7-day regimen of antibiotics. She reports vaginal itching and irritation. In addition, the client has a white, cheese-like vaginal discharge. Which condition is the client most likely experiencing?

Vulvovaginal candidiasis

A 28-year-old woman is learning about breast self-examination. The nurse teaches the woman that the best time of each month to examine her breasts is during the:

First week after menstruation.

The nurse is planning the care of a woman who is scheduled to begin radiation therapy for the treatment of invasive breast cancer. The nurse is aware that this treatment is often well-tolerated but that it creates a risk of which of the following nursing diagnoses?

Impaired skin integrity

A female patient comes to the clinic with the complaint that she is having a greenish-colored discharge from the nipple and the breast feels warm to touch. What does the nurse suspect these symptoms may indicate?

Infection

A young client presenting at the health clinic with fever and mucopurulent vaginal drainage is diagnosed with acute pelvic inflammatory disease (PID). Which long-term affect is of greatest concern in the care of this client?

Infertility

Several days before admission, a client reports finding a small lump in the left breast near the nipple. What should the nurse tell the client to do?

Inform the physician immediately.

The nurse is obtaining the 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."

During a routine sports physical examination, the nurse practitioner recommends HPV vaccination for an 11-year-old girl. Which statements by the client's mother demonstrates understanding of HPV vaccinations?

"I will track follow-up appointments in my smartphone so she receives all three injections."

A community health nurse is participating in a health forum that has been organized by a local community group. When addressing the topic of breast cancer, what should the nurse teach participants about the risk factors for the disease?

"If your mother, grandmother, or sister had breast cancer, you likely have a higher-than-average risk."

A woman with a 3-cm breast tumor is scheduled for a lumpectomy followed by 5 to 7 weeks of radiation therapy. The patient asks the nurse if this procedure would cure her. What is the nurse's best response?

"Lumpectomy, followed by radiation, has the same predicted long-term survival rates as a mastectomy."

In which stage of breast development does breast budding occur?

2

Atypical hyperplasia increases a woman's risk for breast cancer about how many times compared with that of the general population?

4

Atypical hyperplasia increases a women's risk for breast cancer about how many times compared with that of the general population?

4

Which client has the highest risk of ovarian cancer?

45-year-old woman who has never been pregnant

A patient reports to the nurse that 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

A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which of the following?

A primary function of the female breast is to produce milk.

The nurse is preparing a client for repair of a rectovaginal fistula. Which of the following would the nurse include?

Administering antibiotic to cleanse the bowel

A client with challenging menopausal symptoms has discussed treatment options with the physician and now has some questions for the nurse. The client asks, "What are the potential risks of hormone replacement therapy?" What is the best answer?

All options are correct.

A nurse practitioner 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 condition is a downward displacement of the bladder toward the vaginal orifice?

Cystocele

A nurse is preparing a teaching plan for a client with a vulvovaginal infection. Which teaching would not be appropriate for the nurse to include?

Douche with a dilute vinegar solution twice a day.

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

Enterocele

While caring for a patient who is treated for severe pelvic inflammatory disease (PID), the 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

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.

When a female client demonstrates a wart-like growth near the nipple, causing bloody nipple discharge, the client is exhibiting signs of which disease process?

Intraductal papilloma

A client has a routine Papanicolaou (Pap) test during a yearly gynecologic examination. The result reveals a class V finding. What should the nurse tell the client about this finding?

It calls for a biopsy as soon as possible.

A 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 45-year-old woman has a family history of breast cancer. She herself was diagnosed with breast cancer 2 months ago. During a routine visit, the physician informs her that she has to undergo radiation as soon as possible to avoid spreading of the cancer. Which symptom would prompt radiation therapy?

Massive swelling in her arm

A 26-year-old woman has experienced debilitating pelvic pain accompanied by uterine bleeding for many months and has finally received a diagnosis of uterine fibroids. The nurse is aware that this patient desires to have children in the future. Consequently, the nurse should expect that the patient's health care provider will likely recommend what treatment?

Myomectomy

Which is an early sign of Paget disease?

Nipple erythema

The client is receiving adjuvant chemotherapy for breast cancer. Which is most likely her node status and tumor size?

Node negative, tumor size 1.2 cm

The nurse is completing the admission history for a client who is admitted for a reduction mammoplasty. Which of the following client statements is uncommon when explaining the rationale for the procedure?

Others disapprove

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

Pruritus with genital burning

At a follow-up visit, the client is informed that her breast cancer has recurred. The nurse knows that which situation places the client at risk for developing bone metastases?

Recurrence within 2 years of the original diagnosis

A nurse is caring for a group of breast cancer survivors after mastectomy. Which teaching point should the nurse reinforce about activities 6 weeks after surgery?

Resume light household work.

A patient has had a pessary inserted for long-term treatment of a prolapsed uterus. As part of the teaching plan, what should the nurse advise the patient to do?

See her gynecologist to remove and clean the pessary at regular intervals.

A nurse who works in an oncology practice prepares patients for the side effects of adjuvant hormonal therapy to treat breast cancer. Which of the following is the hormonal agent that has an increased risk of pulmonary embolism and deep vein thrombosis?

Tamoxifen

Students are reviewing information about the use of adjuvant hormonal therapy for breast cancer. They demonstrate understanding of this information when they identify which of the following as an example of a selective estrogen receptor modulator (SERM)?

Tamoxifen

The nurse is doing preoperative teaching with a patient diagnosed with endometriosis. A hysterectomy has been scheduled. What preoperative teaching should the nurse be sure to include for this patient?

The bladder must be emptied prior to surgery, and a catheter may be placed during surgery.

The client arrives at a public health clinic worried that she has breast cancer since finding a lump in her breast. When assessing the breast, which assessment finding is characteristic of fibrocystic disease?

The lump is round and movable.

The nurse is caring for a client who is ordered a sentinel lymph node biopsy. The physician explained the procedure and desired outcome. Which statement, made by the client, indicates a need for further instruction?

The procedure removes all cancer from the body.

A client with breast cancer is scheduled to undergo chemotherapy with aromatase inhibitors. Which of the following best reflects the rationale for using this group of drugs?

They lower the level of estrogen in the body blocking the tumor's ability to use it.

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 Papanicolaou (Pap) smear annually.