Reproductive Disorder

22.A patient, age 46, is recovering from an abdominal hysterectomy. Postoperative nursing assessment findings include a urinary output of 100 mL in 4 hours. What should the nurse do?

Report urinary retention to the charge nurse

8.At what age should a male be taught testicular self-examination (TSE)?

15

10.Which patient is most at risk for the infection of epididymitis?

17-year-old athlete who trains for several hours a day

A 23-year-old man is diagnosed with gonorrhea. Because of statements made in his patient interview, the nurse has established a nursing diagnosis of noncompliance. Which is the most effective way to overcome noncompliance for this patient?

3. Single-dose treatment of ceftriaxone (Rocephin) IM

14.What is the recommended age range for a baseline mammogram?

35 and 39 years

26.A patient, age 36, is scheduled for a unilateral orchiectomy for treatment of testicular cancer. He is withdrawn and does not initiate interaction with the nurse. What is the most appropriate nursing action at this time?

Assess his concerns related to his diagnosis and treatment.

29.A 25-year-old woman comes to the clinic with a yellowish-green malodorous vaginal discharge. She says it makes her itch and makes it hard to urinate. After a microscopic examination that confirms trichomoniasis, the patient is placed on metronidazole (Flagyl) for 7 days. How should the nurse advise the patient?

Avoid alcohol while on Flagyl

2.On the second postoperative day, a patient who has had an abdominal hysterectomy complains of gas and abdominal distention. Which intervention would be most appropriate to stimulate a bowel movement?

Encouraging ambulation at least four times per day

46.The nurse gives discharge instructions to a person who has had a modified radical mastectomy of the right side to perform the elbow pull-in. Place the steps of the exercise in appropriate order. (Separate letters by a comma and space as follows: A, B, C, D) a. Pull elbows forward until they touch b. Lower and straighten the arms c. Extend arms sideways to shoulder level d. Bring elbows back and extend arms e. Clasp hands behind neck

C, E, A, D, B

16.What instruction should a nurse give a patient with congenital herpes who does not have lesions at the present?

Condoms should be used during all sexual activity to prevent transmission of the virus, even when lesions are not present.

41._____________ are the most benign tumors of the uterus and arise from the uterine muscle tissue.

Fibroids

5.On the fourth postoperative day after a modified radical mastectomy, the nurse finds the patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore. The nurse bases subsequent nursing interventions on what diagnosis?

Disturbed body image related to removal of her breast

45.Arrange the process of the menstrual cycle in order of their function to produce menses. (Separate letters by a comma and space as follows: A, B, C, D) a. Egg matures in the graafian follicle b. Corpus luteum is formed from old follicle c. Estrogen from the maturing follicle causes vascularization of the uterine lining d. Anterior pituitary releases luteinizing hormone (LH), releasing the ovum e. Anterior pituitary releases follicle-stimulating hormone (FSH) f. Corpus luteum releases estrogen and progesterone g. Corpus luteum disintegrates causing a decrease in progesterone h. Lining of uterus is shed as menses

E, A, C, D, B, F, G, H

31.What factor influences older womens reluctance to seek medical care for problems of the reproductive system?

Embarrassment and cultural factors

15.What does the diagnosis of secondary infertility refer to?

Has conceived but is now unable to do so

12.The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy. Which statement by her indicates to the nurse that the teaching has been successful?

I should sleep on the side opposite my mastectomy.

24.Which statement indicates that the patient who has had an abdominal hysterectomy needs further home teaching?

I understand I can lift as much as 20 lb.

9.Which statement made by a patient who has been taught the technique of testicular self-examination indicates the need for further teaching?

I will examine my scrotum after every ejaculation.

20.Why is a mammogram the most useful method of diagnosing breast cancer?

It is the most reliable method of detecting breast cancer before it becomes palpable.

19.The patient who had a colporrhaphy for the repair of a cystocele and rectocele asks that the catheter be removed as it is bothersome to her. How should the nurse explain the reason for the catheter?

It keeps the bladder empty, and prevents stress on the sutures

1.Which condition would prevent the use of a vaginal hysterectomy?

Large uterine fibroids

32.Although menopause is a normal part of aging, why do many women enter menopause at an earlier age?

Living at high altitudes

18.A Gram stain smear of the patients discharge reveals the presence of N. gonorrhoeae. He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease. Which information should the nurse include in response to his comment?

Many women are not aware that they have gonorrhea because they often do not have symptoms of infection.

17.The 10-year-old clinic patient reports that she is free of gonorrhea and can now engage in sexual activity. Which response is most appropriate?

No case is considered cured until you have had three consecutive negative cervical smears.

3.The young husband of a patient who has been scheduled for a hysterectomy because of the discovery of ovarian cancer in both ovaries says to the nurse, Please go talk to my wife. She is real upset and says she wont be a woman anymore. What is the nurses most therapeutic response?

No matter what I may say to her, it is you that needs to listen to her concerns and assure her.

23.When should postmenopausal women be instructed to perform breast self-examination (BSE)?

On the same date of their choice each month

13.A female patient, age 48, is undergoing a routine physical examination for the first time in 5 years. Which procedure would be included in this examination?

Papanicolaou smear

11.A patient, age 26, has had a tubal insufflation (Rubin test) to ascertain whether her fallopian tubes are patent. She complains of pain in her right shoulder. Which response is most appropriate?

That is from the carbon dioxide passing from the fallopian tubes into your abdomen.

30.The young woman comes to the free clinic for the complaint of stomach cramps. During the examination, the nurse recommends that she be tested for chlamydia. The woman says I dont need any testI dont have any symptoms for a sexual infectionI just came for my stomach. Which response is most informative?

That stomachache may be part of a chlamydia infection. Many women do not have a discharge, but are carriers.

4.A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She asks the nurse if she will have hot flashes. What knowledge will guide the nurses response?

The uterus, ovaries, and fallopian tubes were removed, and she will have surgically induced menopause and may have hot flashes.

21.The patient, age 52, is recovering from a modified radical mastectomy. Why is postoperative elevation of the patients arm important after this procedure?

To prevent vascular and lymph stasis, thus lymphedema

6.Why would the nurse encourage the patient who is recovering from a modified radical mastectomy to exercise the affected arm?

To reduce lymphedema

7.A 20-year-old patient presents in the emergency room with a temperature of 103 F, blood pressure of 92/58, headache, and desquamation of both palms. What should the nurse make sure to ask about during the interview?

Use of tampons

27.The 69-year-old patient laughs at the nurse when the nurse suggests that she should have a Pap smear and says, I had my uterus removed except for the cervix 30 years ago and I am almost 70. Why in the world would I want to get a Pap smear at my age? What is the nurses most informative reply?

Well, you have one more year to go to get a Pap smear.

33.Why do false-negative results in mammography occur in specific age groups?

Younger women have greater density of breast tissue.

34.Vaginal fistulas are caused by an ulcerating process resulting from (select all that apply): a. Cancer b. Radiation c. Poor hygiene d. Multiple sexual partners e. Weakening of tissue from pregnancies f. Surgical interventions

a. Cancer b. Radiation e. Weakening of tissue from pregnancies f. Surgical interventions

38.Which of the following are true of the Gardasil vaccine? (Select all that apply.) a. It requires two more immunizations at 6 months after the first dose b. It reduces incidence of cervical cancer c. It reduces the incidence of human papilloma virus (HPV) d. It can be given only to females e. It should be given before a person becomes sexually active f. It is safe for people as young as 8 years of age

a. It requires two more immunizations at 6 months after the first dose b. It reduces incidence of cervical cancer c. It reduces the incidence of human papilloma virus (HPV) e. It should be given before a person becomes sexually active

36.What are some advantages of a vaginal hysterectomy over the abdominal hysterectomy? (Select all that apply.) a. Less postoperative discomfort b. Reduced hospital stay c. Less expensive d. Better visualization of the intrapelvic area e. Faster recovery

a. Less postoperative discomfort b. Reduced hospital stay c. Less expensive e. Faster recovery

37.The nurse instructs a group of women who attend the health clinic that persons who are particularly at risk for cervical cancer are persons who (select all that apply): a. Smoke b. Wear tampons c. Have been sexually active since their teens d. Have multiple sexual partners e. Had chickenpox as a child f. Have a history of sexually transmitted diseases (STD)

a. Smoke c. Have been sexually active since their teens d. Have multiple sexual partners f. Have a history of sexually transmitted diseases (STD)

35.Select the interventions that should be performed with caution, in the affected arm, on patients who have undergone a modified radical mastectomy. (Select all that apply.) a. Vaccinations b. Taking of blood pressure or samples c. Insertion of IV line d. Physical therapy on uninvolved arm e. Wear watch and jewelry on involved arm f. Carry purse on involved arm or shoulder

a. Vaccinations b. Taking of blood pressure or samples c. Insertion of IV line

39.A ___________ is performed to evaluate living tissue to establish or confirm a diagnosis or to follow the course of a disease.

biopsy

40.The nurse is assisting the physician in removing a small sample of tissue from the patients cervix to have it evaluated. This procedure is called a cervical _______________.

conization

28.A male patient, age 23, seeks care at the health clinic because he has developed a profuse, purulent urethral discharge, and urination is painful. During assessment of the patient, it is most important that the nurse gather information related to his history of:

present and past sexual partners, and notify them to get treatment.

25.The patient with a swollen scrotum is amazed that diagnosis of the condition of hydrocele is such a simple thing as:

shining a flashlight through the scrotum.

42.________are produced in the seminiferous tubules and stored in the epididymis.

sperm

44.When the veins in the scrotum become dilated, and the scrotum becomes enlarged and dilated, the condition is called a __________.

varicocele

43.An alternative remedy, ____________ , is used by men for the treatment of impotence.

yohimbine, Pausinystalia yohimbe