575 Women's Health Practice Questions

4 phases of the menstrual cycle

1 *menstrual( shedding of the endometrium top layer) 2 *prolifetive ( beginning on the 5h day of ovulation, repid regrowth of endometrium) 3 *secretory ( from ovulation to 3 days before next period- endometrium thickens with anticipation of fertilized egg) 4 *if no fertilization, hormone levels drop and ischemia ( loss of blood ) occurs so endometrium is shedded.

A 22-year-old nulligravid client tells the nurse that she and her husband have been considering using condoms for family planning. Which of the following instructions would the nurse include about the use of condoms as a method for family planning? A) Using a spermicide with the condom offers added protection against pregnancy. B) Natural skin condoms protect against sexually transmitted diseases. C) The typical failure rate for couples using condoms is about 25%. D) Condom users frequently report penile gland sensitivity

A) Using a spermicide with the condom offers added protection against pregnancy. The typical failure rate of a condom is approximately 12% to 14%. Adding a spermicide can decrease this potential failure rate because it offers additional protection against pregnancy. Natural skin condoms do not offer the same protection against sexually transmitted diseases caused by viruses as latex condoms do. Unlike latex condoms, natural skin (membrane) condoms do not prevent the passage of viruses. Most condom users report decreased penile gland sensitivity. However, some users do report an increased sensitivity or allergic reaction (such as a rash) to latex, necessitating the use of another method of family planning or a switch to a natural skin condom.

The nurse educator knows that teaching about reproduction has been effective when a student states, "Once the ovum has entered the fallopian tube, movement of the ovum through the fallopian tube and toward the Uterus is facilitated by: A. "Estrogen-induced tubal peristalsis" B. "Progesterone-induced cervical mucus changes" C. "Motions of the sphincters at the fallopian tubes" D. "Movements of the corona radiata of the ovum"

A. "Estrogen-induced tubal peristalsis"

A woman, who wishes to use the calendar method for contraception, reports that her last 6 menstrual cycles were 28, 32, 29, 36, 30, and 27 days long, respectively. In the future, if used correctly, she should abstain from intercourse on which of the following days of her cycle? A. Days 9-25 B. Days 10-15 C. Days 11-20 D. Days 12-17

A. Days 9-25 Subtract 18 from the shortest cycle and 11 from the longest cycle.

Four women who use super absorbent tampons during their menses are being seen in the medical clinic. The woman with which of the following findings would lead the nurse to suspect that the woman's complaints are related to her use of tampons rather than to an unrelated medical problem? A. Diffuse rash with fever B. Angina C. Hypertension D. Thrombocytopenia with pallor

A. Diffuse rash with fever A sign of Toxic Shock Syndrome

Genetic testing on an embryo shows two X chromosomes. This infant will be: A. Female. B. Male.

A. Female.

A woman has contracted herpes simplex 2 for the first time. Which of the following signs/symptoms is the client likely to complain of? A. Flu-like symptoms B. Metrorrhagia C. Amenorrhea D. Abdominal cramping

A. Flu-like symptoms

The phase of the ovarian cycle that begins with the first day of menstruation and ends about 14 days later is called the: A. Follicular phase. B. Ovulatory phase. C. Luteal phase.

A. Follicular phase. The follicular phase is the period during which an ovum matures. It lasts from the first day of menstruation until about day 14.

When a nurse is teaching a woman about her menstrual cycle, which of the following is the most important change that happens during the follicular phase of the menstrual cycle? A. Maturation of the graafian follicle B. Multiplication of the fimbriae C. Secretion of human chrionic gonadotropin D. Proliferation of the endometrium

A. Maturation of the graafian follicle Due to the elevation of FSH

A woman is being issued a new prescription for a low-dose combination birth control pill. What advice should the nurse give the woman if she ever forgets to take a pill? A. Take it as soon as she remembers, even if that means taking two pills in one day. B. Skip that pill and refrain from intercourse for the remainder of the month C. Wear a pad for the next week because she will experience vaginal bleeding D. Take an at-home pregnancy test at the end of the month to check for a pregnancy

A. Take it as soon as she remembers, even if that means taking two pills in one day.

A genetic counselor's report states, "The genetic nomenclature for this fetus is 46, XX." How should the nurse who reads this report interpret the cytogenetic results? A. The baby is female with a normal number of chromosomes B. The baby is hermaphroditic male with female chromosomes C. The baby is male with an undisclosed genetic anomaly D. There is insufficient information to answer this question

A. The baby is female with a normal number of chromosomes

During a counseling session on natural family planning techniques, how should the nurse explain the consistency of cervical mucus at the time of ovulation? A. Thin and elastic B. Opaque and acidic C. It contains numerous leukocytes to prevent vaginal infections D. It decreases in quantity in response to the body temperature changes.

A. Thin and elastic

Four women with significant health histories wish to use the diaphragm as a contraceptive method. The nurse should counsel the woman with which of the following histories that the diaphragm may lead to a recurrence of her problem? A. Urinary tract infections B. HSV C. DVT D. HPV

A. Urinary tract infections

A man has been diagnosed with a chlamydial infection. The nurse would expect the client to complain of pain at which of the following times? A. When urinating B. When ejaculating C. When the penis becomes erect D. When the testicles are touched

A. When urinating Women are often asymptomatic

It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long Which of the following is an appropriate reply by the nurse? A. You're probably ovulating B. Your hormone levels should be checked C. You will probably menstruate early D. Your breast changes are a worrisome sign

A. You're probably ovulating Usually women ovulate 14 days before menstruation

Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse would assess the client for signs and symptoms of which of the following? A) Anemia. B) Hypertension. C) Dysmenorrhea. D) Acne vulgaris.

B) Hypertension. Before advising a client about oral contraceptives, the nurse needs to assess the client for signs and symptoms of hypertension. Clients who have hypertension, thrombophlebitis, obesity, or a family history of cerebral or cardiovascular accident are poor candidates for oral contraceptives. In addition, women who smoke, are older than 40 years of age, or have a history of pulmonary disease should be advised to use a different method. Iron-deficiency anemia, dysmenorrhea, and acne are not contraindications for the use of oral contraceptives. Iron-deficiency anemia is a common disorder in young women. Oral contraceptives decrease the amount of menstrual flow and thus decrease the amount of iron lost through menses, thereby providing a beneficial effect when used by clients with anemia. Low-dose oral contraceptives to prevent ovulation may be effective in decreasing the severity of dysmenorrhea (painful menstruation). Dysmenorrhea is thought to be caused by the release of prostaglandins in response to tissue destruction during the ischemic phase of the menstrual cycle. Use of oral contraceptives often improves facial acne

A 23-year-old nulliparous client visiting the clinic for a routine examination tells the nurse that she desires to use the basal body temperature method for family planning. The nurse should instruct the client to do which of the following? A) Check the cervical mucus to see if it is thick and sparse. B) Take her temperature at the same time every morning. C) Document ovulation when the temperature decreases at least 1°F. D) Avoid coitus for 10 days after a slight rise in temperature.

B) Take her temperature at the same time every morning. The basal body temperature method requires that the client take her temperature each morning before arising, preferably at the same time each day before eating or any other activity. Just before the day of ovulation, the temperature falls by 0.5°F. At the time of ovulation, the temperature rises 0.4° to 0.8°F because of increased progesterone secretion in response to the luteinizing hormone. The temperature remains higher for the rest of the menstrual cycle. The client should keep a diary of about 6 months of menstrual cycles to calculate "safe" days. There is no mucus for the first 3 or 4 days after menses, and then thick, sticky mucus begins to appear. As estrogen increases, the mucus changes to clear, slippery, and stretchy. This condition, termed spinnbarkeit, is present during ovulation. After ovulation, the mucus decreases in amount and becomes thick and sticky again until menses. Because the ovum typically survives about 24 hours and sperm can survive up to 72 hours, couples must avoid coitus when the cervical mucus is copious and for about 3 to 4 days before and after ovulation to avoid a pregnancy.

A woman who has been abused for a number of years asks the nurse for assistance in leaving the relationship. What response by the nurse is most appropriate? A. Comment that she should have left long ago. B. Assist the patient to develop a safety plan. C. Remind the patient that the fault was not likely all attributes to her abuser. D. Encourage her to be sure with her decision, as he abuser will be difficult to deal with.

B. Assist the patient to develop a safety plan.

A nurse is explaining to a client about monthly hormonal changes. Starting with day 1 of the menstrual cycle, please place the following four hormones in the chronological order in which they elevate during the menstrual cycle. A. FSH B. GRH C. LH D. Progesterone

B. GRH A. FSH C. LH D. Progesterone

A woman has been diagnosed with primary syphilis. Which of the following physical findings would the nurse expect to see? A. Cluster of vesicles B. Pain-free lesion C. Macular rash D. Foul-smelling discharge

B. Pain-free lesion Chancre is seem with primary syphilis. Stage 2 there is a reddish brown rash

A woman's temperature has just risen 0.4F and will remain elevated during the remainder of her cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the change? A. Estrogen B. Progesterone C. LH D. FSH

B. Progesterone

A woman is using the contraceptive sponge as a birth control method. Which of the following actions is it important for her to perform to maximize the sponge's effectiveness? A. Insert the sponge at least one hour before intercourse B. Thoroughly moisten the sponge with water before interesting C. Spermicidical jelly must be inserted at the same time the sponge is inserted D. A new sponge must be inserted every time a couple has intercourse

B. Thoroughly moisten the sponge with water before interesting

Assessment of a 16-year-old nulligravid client who visits the clinic and asks for information on contraceptives reveals a menstrual cycle of 28 days. The nurse formulates a nursing diagnosis of Deficient Knowledge related to ovulation and fertility management. Which of the following would be important to include in the teaching plan for the client? A) The ovum survives for 96 hours after ovulation, making conception possible during this time. B) The basal body temperature falls at least 0.2°F after ovulation has occurred. C) Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle. D) Most women can tell they have ovulated because of severe pain and thick, scant cervical mucus.

C) Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle. For a client with a menstrual cycle of 28 days, ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle. Stated another way, the menstrual period begins about 2 weeks after ovulation has occurred. Ovulation does not usually occur during the menses component of the cycle when the uterine lining is being shed. In most women, the ovum survives for about 12 to 24 hours after ovulation, during which time conception is possible. The basal body temperature rises 0.5° to 1.0°F when ovulation occurs. Although some women experience some pelvic discomfort during ovulation (mittelschmerz), severe or unusual pain is rare. After ovulation, the cervical mucus is thin and copious.

The nurse is aware that which woman should NOT be given a birth control method that contains estrogen: A. A woman who is 40 years old B. A woman whose mother has high blood pressure C. A woman who had a DVT in her last pregnancy D. A woman with a history of chlamydia

C. A woman who had a DVT in her last pregnancy

A client who has been taking birth control pills for 2 months calls the clinic with the following complaint "I had a bad headache for the past couple of days and I now have pain in my right leg." Which of the following responses should the nurse make? A. Continue taking the pill, but take one aspirin tablet with it each day from now on B. Stop taking the pill, and start using a condom for contraception C. Come to the clinic this afternoon so that we can see what is going on D. Those are common side effects that should disappear in a month or so

C. Come to the clinic this afternoon so that we can see what is going on Could be a clot, side effect of birth control

Fertilization occurs in which structure? A. Cervix B. Uterus C. Fallopian tubes D. Ovaries

C. Fallopian tubes

The OB-GYN nurse knows the most common shape for the female pelvis is: A. Platypoid B. Android C. Gynecoid D. Anthropoid

C. Gynecoid

The nurse is talking with a young woman who has an STI that puts her at higher risk for cervical cancer. The STI that this young woman has is: A. Molleseum Contagiosum B. Bacterial Vaginosis C. HPV (Human Papilloma Virus) D. HSV (Herpes Simplex Virus)

C. HPV (Human Papilloma Virus)

The nurse teaches a couple that the diaphragm is an excellent method of contraception providing that the woman does which of the following? A. Does not use any cream or jelly with it B. Douches promptly after its removal C. Leaves it in place for 6 hours following intercourse D. Inserts it at least 5 hours prior to having intercourse

C. Leaves it in place for 6 hours following intercourse

A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. This is most likely due to a lack of which hormone? A. FSH B. LH C. Progesterone D. Estrogen

C. Progesterone

The nurse teaching a high school class explains that during the menstrual cycle, following ovulation, the vascularity of the uterus increases and the endometrium becomes prepared for a fertilized ovum. In which phase of the menstrual cycle does this occur? A. Menstrual B. Secretory C. Proliferative D. Ischemic

C. Proliferative

Which of the following sexually transmitted infections is characterized by a foul-smelling, yellow-green discharge that is often accompanied by vaginal pain and dyspareunia? A. Syphilis B. Herpes Simplex C. Trichomoniasis D. Condylomata acuminata

C. Trichomoniasis Caused by a protozoan.

After being examined and fitted for a diaphragm, a 24-year-old client receives instructions about its use. Which of the following client statements indicates a need for further teaching? A) "I can continue to use the diaphragm for about 2 to 3 years if I keep it protected in the case." B) "If I get pregnant, I will have to be refitted for another diaphragm after the delivery." C) "Before inserting the diaphragm I should coat the rim with contraceptive jelly." D) "If I gain or lose 20 pounds, I can still use the same diaphragm."

D) "If I gain or lose 20 pounds, I can still use the same diaphragm." A client would need additional instructions when she says that she can still use the same diaphragm if she gains or loses 20 pounds. Gaining or losing more than 15 pounds can change the pelvic and vaginal contours to such a degree that the diaphragm will no longer protect the client against pregnancy. The diaphragm can be used for 2 to 3 years if it is cared for and well protected in its case. The client should be refitted for another diaphragm after pregnancy and delivery of a newborn because weight changes and physiologic changes of pregnancy can alter the pelvic and vaginal contours, thus affecting the effectiveness of the diaphragm. The client should use a spermicidal jelly or cream before inserting the diaphragm.

A nurse teaches a woman who wishes to become pregnant that if she assesses for spinnbarkeit she will be able to closely predict her time of ovulation. Which technique should the client be taught to assess for spinnbarkeit? A. Take her temperature each morning before rising B. Carefully feel her breasts for glandular development C. Monitor her nipples for signs of tingling and sensitivity D. Assess her vaginal discharge for elasticity and slipperiness

D. Assess her vaginal discharge for elasticity and slipperiness It changes in response to estrogen levels

A woman is menstruating. If hormonal studies were to be done at this time, which of the following hormonal levels would the nurse expect to see? A. Both estrogen and progesterone are high B. Estrogen is high, progesterone is low C. Estrogen is low, progesterone is high D. Both estrogen and progesterone are low

D. Both estrogen and progesterone are low When the egg is not fertilized both estrogen and progesterone drop, and it is followed by menstruation.

When planning care for a patient who has undergone an episiotomy, it would be important to include a goal that addresses the need for pain relief of the: A. Labia Minora B. Hymen C. Mons pubis D. Perineum

D. Perineum

A woman, seen in the ER, is diagnosed with pelvic inflammatory disease (PID). Before discharge, the nurse should provide the woman with health teaching regarding which of the following? A. Endometriosis B. Menopause C. Ovarian hyperstimulation D. STIs

D. STIs PID commonly occurs as a complication of STIs - gonorrhea and chlamydia

A female client asks the nurse about treatment for human papilloma viral warts. The nurse's response should be based on which of the following? A. An antiviral injection cures approximately fifty percent of cases B. Aggressive treatment is required to cure warts C. Warts often spread when an attempt is made to remove them surgically D. Warts often recur a few months after a client is treated

D. Warts often recur a few months after a client is treated

A nurse is reviewing a basal body temperature chart with a couple. Which change would indicate probable ovulation? a) A decrease in temperature followed by an increase for several days b) An increase in temperature followed by a decrease for several days c) A decrease in temperature that remains until menses begins d) A steadily increasing temperature over seven days

a) A decrease in temperature followed by an increase for several days At ovulation body temperature drops, then rises sharply and remains elevated for several days.

Estrogen, one of the hormones regulating cyclic activities in female reproductive system is responsible for which effect? a. Increases the quantity and pH of cervical mucus, causing it to become thin and watery and can be stretched to a distance of 10-13 cm. b. Inhibits the production of LH c. Increases endometrial tortuosity d. All of the above

a. Increases the quantity and pH of cervical mucus, causing it to become thin and watery and can be stretched to a distance of 10-13 cm. Effects of estrogen: • Inhibits the production of FSH • Causes hypertrophy of the myometrium • Increases the quantity and pH of cervical mucus, causing it to become thin and watery and can be stretched to a distance of 10-13 cm. Effects of Progesterone • Inhibits the production of LH • Increases endometrial tortuosity • Increased endometrial secretions • Facilitates transport of the fertilized ovum through the fallopian tubes

Jessa, 17 years old, is bleeding between periods of less than two weeks. This condition is an abnormality in the menstrual cycle known as: a. Metrorrhagia b. Menorrhagia c. Amenorrhea d. Dysmenorrheal

a. Metrorrhagia Abnormalities of Menstruation 1. Amenorrhea - absence of menstrual flow 2. Dysmenorrhea - painful menstruation 3. Oligomenorrhea - scanty menstruation 4. Menorrhagia -excessive menstrual bleeding 5. Metrorrhagia - bleeding between periods of less than 2 weeks

A 19-year-old nulligravid client visiting the clinic for a routine examination asks the nurse about cervical mucus changes that occur during the menstrual cycle. Which of the following statements would the nurse expect to include in the client's teaching plan? a) About midway through the menstrual cycle, cervical mucus is thick and sticky. b) During ovulation, the cervix remains dry without any mucus production. c) As ovulation approaches, cervical mucus is abundant and clear. d) Cervical mucus disappears immediately after ovulation, resuming with menses.

c) As ovulation approaches, cervical mucus is abundant and clear. As ovulation approaches, cervical mucus is abundant and clear, resembling raw egg white. Ovulation generally occurs 14 days (plus or minus 2 days) before the beginning of menses. During the luteal phase of the cycle, which occurs after ovulation, the cervical mucus is thick and sticky, making it difficult for sperm to pass. Changes in the cervical mucus are related to the influences of estrogen and progesterone. Cervical mucus is always present.

Which of the following would the nurse expect to include in the teaching plan for a 30-year-old multiparous client who will be using an intrauterine device (IUD) for family planning? a) Amenorrhea is a common side effect of IUDs. b) The client needs to use additional protection for conception. c) IUDs are more costly than other forms of contraception. d) Severe cramping may occur when the IUD is inserted.

d) Severe cramping may occur when the IUD is inserted. Severe cramping and pain may occur as the device is passed through the internal cervical os. The insertion of the device is generally done when the client is having her menses, because it is unlikely that she is pregnant at that time. Common side effects of IUDs are heavy menstrual bleeding and subsequent anemia, not amenorrhea. Uterine infection or ectopic pregnancy may occur. The IUD has an effectiveness rate of 98%. Therefore, additional protection is not necessary to prevent pregnancy. IUDs generally are less costly than other forms of contraception because they do not require additional expense. Only one insertion is necessary, in comparison to daily doses of oral contraceptives or the need for spermicides in conjunction with diaphragm use.

dyspareunia

pain during sex