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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? A) Chronic pelvic inflammatory disease B) Infertility C) Pelvic pain D) Ascending infection
Ans: B
A young, single client reports excessive menstrual flow with menses lasting 10 days each month. Which treatment option will provide symptomatic relief for this client with the least risk? A) Dilation and curettage (D and C) B) Hormonal contraceptives C) Endometrial ablation D) Uterine balloon therapy
Ans: B
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? A) "Symptoms of endometriosis are increased during normal menstrual cycle." B) "Contraceptives will allow blood to be diverted to the peritoneal cavity." C) "Trapping blood causes less pain or discomfort for clients with endometriosis." D) "Endometriosis is usually cured with surgical menopause."
Ans: A
After teaching a client about the use of a pessary, which statement by the client indicates the need for additional instruction? A) "A white or yellow vaginal discharge is expected and normal." B) "I need to apply a sterile lubricant to the pessary before reinserting it." C) "After removal, I should wash the pessary with warm soapy water, rinse, and dry it." D) "I should call the physician if I notice any discomfort with the pessary."
Ans: A
An elderly client, who can void only while standing and pushing upward on the vagina, is ordered a pessary. Which comment from the client indicates a need for further teaching about this device? A) "I will remove and clean it every day." B) "I will report any signs of irritation or bleeding." C) "I should have greater ease of emptying my bladder." D) "I should report any foul odor or drainage."
Ans: A
The nurse is providing an educational presentation on toxic shock syndrome to a group of adolescents. Which preventative measure is a primary focus for this group? A) If using tampons, change frequently. B) Do not use vaginal devices for birth control. C) Toxin is associated with multiple sex partners. D) Use good personal hygiene.
Ans: A
Which of the following is an early symptom of vulvar cancer? A) Pruritus with genital burning B) Fever accompanied by chills C) Severe abdominal pain D) Dyspareunia
Ans: A
Which of the following nursing instructions is essential in the care of a postmenopausal client who is prescribed ibandronate (Boniva)? A) Take with 8 oz of water. B) Take calcium supplements. C) Milk helps with absorption. D) Take at bedtime.
Ans: A
Because ovarian cancer has nonspecific symptoms and can result in lethal outcome, diagnostic testing may be indicated for some women. Which risk factors support the need for screening? Select all that apply. A) Carrying genetic mutation for the disease B) Being nulliparous C) Family history of lung cancer D) Breastfeeding E) Use of oral contraceptives for 5 years or more F) Multiple full-term pregnancies
Ans: A, B
When caring for a client with polycystic ovarian syndrome, the nurse will focus teaching needs in the management of which associated problems? Select all that apply. A) Hypertension B) Hyperlipidemia C) Infertility D) Absence of body hair E) Weight loss F) Decreased Insulin
Ans: A, B, C
Following a laparoscopic-assisted vaginal hysterectomy, which client assessment finding would warrant nursing intervention? Select all that apply. A) Dorsal recumbent positioning with knee bend B) Early ambulation C) Peri-pad changed every shift D) Catheter tube secured to leg E) TED stockings removed and reapplied twice daily F) High-fiber diet
Ans: A, C
While collecting data on reproductive history, the client discloses early menarche, early sexual engagement, chlamydia infection, and treatment for gonorrhea. The nurse knows that this client is at highest risk for the development of which of the following? A) Sexually Transmitted Infections B) Breast cancer C) Fibroid tumor or myoma D) Cervical cancer
Ans: A, D
30. 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? A) "I will not need any further treatment." B) "The cancer has not spread." C) "I will need surgery and chemotherapy to increase my odds for survival." D) "I can wait until I have finished having babies to seek treatment."
Ans: B
A client is prescribed androgen therapy. Which of the following would the nurse explain as a possible adverse effect? A) Severe bleeding from the vagina B) Weight gain C) Decreased libido D) Areolar pigmentation
Ans: B
A client is struggling with symptoms of irritability and "feeling crazy" at times. Which assessment data would provide the most important information needed in the development of a treatment plan for this client? A) Reproductive history B) Menstrual diary C) Vital signs D) Dietary assessment
Ans: B
A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse? A) "Don't worry, every woman goes through this." B) "These are normal, manageable symptoms of menopause." C) "You need to discuss this with your spouse." D) "Hormone replacement therapy can resolve your symptoms."
Ans: B
A female client is diagnosed with carcinoma in situ of the endometrium. The nurse interprets this as which of the following? A) Cancer is confined to the body of the uterus. B) The malignancy is localized. C) Cancer extends outside the uterus. D) The malignancy involves the uterine body and cervix.
Ans: B
A postmenopausal client is receiving alendronate. Which of the following would the nurse include when teaching the client about this drug? A) "Take the drug with milk or milk products to enhance absorption." B) "Drink at least 8 oz of water when you take this drug." C) "Be sure to take the drug just before going to bed at night." D) "Lie down for at least 30 minutes after you've taken the drug."
Ans: B
The nurse is collecting assessment data on a client who is reporting a vaginal discharge that is cottage cheese-like in appearance. Which pathogen is the most likely cause for this symptom? A) Gonococci B) Candida albicans C) Trichomonas vaginalis D) Gardnerella vaginalis
Ans: B
Which assessment finding will most likely influence the treatment regime selected by a client with endometriosis? A) Presence of pain B) Family planning C) Dysmenorrhea D) Presence of chocolate cyst
Ans: B
A client has just been diagnosed with endometriosis. Which of the following would be most appropriate to provide the client with support and guidance about treatment options? A) "Treatment is essential, so you really need to make a decision pretty quickly." B) "If it was me, I would probably choose the medication options." C) "It might help to include your partner in any of the discussions about options." D) "The test results are clear and another physician would tell you the same thing."
Ans: C
A client is admitted to the hospital with the diagnosis of sepsis secondary to pelvic inflammatory disease. Which transmission-based precaution will be initiated by the nurse? A) Standard precautions B) Protective precautions C) Contact precautions D) Droplet precautions
Ans: C
A client with extensive endometriosis is scheduled for a panhysterectomy. Which statement by the client indicates a need for further teaching? A) "I will be having my uterus, tubes, and ovaries removed." B) "I am finished having children." C) "I will not have to deal with symptoms of menopause." D) "I will now have a greater risk for stroke and heart disease."
Ans: C
A client with vaginitis complains of itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms? A) Use a pure vinegar douche daily. B) Use skin protectants containing zinc oxide. C) Take sitz baths frequently. D) Avoid yogurt with active lactobacilli cultures.
Ans: C
Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess? A) Foul foamy discharge B) Thick curdy white discharge C) Fishy smelling watery discharge D) Yellowish white discharge
Ans: C
Following a radical vulvectomy, the nurse is preparing the client for discharge to home. Which care intervention would be considered the priority for this client? A) Relieving edema to lower extremities B) Alterations for sexual function C) Prevention of wound complications D) Care of colostomy site
Ans: C
The client is asking if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy? A) Presence of kyphosis B) Symptoms of hot flashes C) Family history of breast cancer D) History of osteoporosis
Ans: C
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? A) Positive for human papillomavirus (HPV) B) Use of pessary C) Vaginal bleeding D) Urinary stress incontinence
Ans: C
Which of the following would be most important to determine when assessing a client being admitted for suspected toxic shock syndrome (TSS)? A) Existence of menorrhagia B) Psychological trauma C) Use of superabsorbent tampons D) Use of oral contraceptives
Ans: C
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? A) Vulvar cancer B) Breast cancer C) Cervical cancer D) Endometrial cancer
Ans: C
A client is ordered a vaginal cream for the treatment of a yeast infection. As the nurse provides instruction, which step for inserting vaginal medications should be highlighted? A) Do not use once menses begins. B) Eat yogurt daily. C) Lie down for 1 hour after insertion. D) Wash applicator after each use.
Ans: D
A client is to be scheduled for a vesicovaginal fistula repair. Which nursing intervention is focused on preventing complications that may delay the procedure? A) Deodorizing douches as needed B) Use of stool softeners C) Daily perineal care D) Encourage fluid intake
Ans: D
A client who is diagnosed with premenstrual syndrome is ordered a gonadotropin-releasing hormone (GnRH). Which is a priority teaching item in the use of this drug? A) Maintain a menstrual diary B) Reduce sugar intake C) Eat 6 small meals daily D) Increase calcium and vitamin D intake
Ans: D
A young client has just completed the 6-month series of Gardasil vaccine. Which comment by the client would alert the nurse that further teaching is needed? A) "This vaccine lowers my risk for cervical cancer." B) "I will still need to have routine screening for cervical cancer." C) "I am at lower risk for developing cervical warts." D) "This vaccine will prevent human papilloma virus (HPV) from occurring."
Ans: D
Which is the primary assessment finding in identifying the possible cause of repeated episodes of vaginitis in a female client? A) Tub baths preferred over shower B) Healthy sex life C) Occasional use of vinegar douches D) Type 2 diabetes mellitus
Ans: D