ch. 27 maternity

A nurse is caring for a client for whom estrogen replacement therapy has been recommended for pelvic organ prolapse. Which nursing intervention is the most appropriate for the nurse to implement before the start of the therapy? Discuss the dietary modifications following therapy. Discuss the cost of estrogen replacement therapy. Evaluate the client to validate her risk for complications. Discuss the effective dose of estrogen required to treat the client.

Evaluate the client to validate her risk for complications.

The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which suggestions should the nurse include in the teaching plan? Select all that apply. Increase exercise and physical activity. Use heating pads or take warm baths. Increase water consumption. Avoid keeping legs elevated while lying down. Increase intake of salty foods.

Increase exercise and physical activity. Use heating pads or take warm baths. Increase water consumption.

A client is diagnosed with a leiomyoma. The client asks the nurse what this is. The nurse describes this as a: fistula. fibroid. cyst. pelvic organ prolapse.

fibroid.

A 47-year-old woman is being seen at the local clinic reporting irregular menstrual cycles. The nurse would explain to the client that the irregularity is most likely due to: pregnancy. an underlying endocrine problem. menopause. hormonal fluctuations.

menopause.

A woman who has been trying to conceive has been diagnosed with multiple uterine fibroids (uterine myomas). What option is available for the woman to be able to conceive? appendectomy salpingo-oophorectomy myomectomy hysterectomy

myomectomy

A nursing student correctly identifies that a person's outward appearance or expression of genes is referred to as the: allele. genome. genotype. phenotype

phenotype

A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct? "Human papillomavirus is the cause of essentially all cases of cervical cancer." "STIs can't be transmitted through oral sexual intercourse." "At least antibiotics will cure a sexually transmitted infection." "Gonorrhea and syphilis are infections seen only in men."

"Human papillomavirus is the cause of essentially all cases of cervical cancer."

What should the nurse include when explaining endometriosis as a cause for a female client's infertility? "You do not ovulate because of endometrial implants on the ovaries." "Your uterine cervix fails to close because it is engorged with tissue." "Ovulation does not take place because misplaced endometrial tissue interferes with transport of the ovum." "Menstrual sloughing does not occur, so there is never a new base for embryo growth."

"Ovulation does not take place because misplaced endometrial tissue interferes with transport of the ovum."

Which of the following teenage girls is most likely to have secondary amenorrhea? 12-year-old, breast buds present and pubic hair 17-year-old, gymnast preparing for competition 15-year-old, 15 percent above desired body weight 14-year-old, at desired body weight

17-year-old, gymnast preparing for competition

A client asks a nurse to review the process of menopause and the physical changes that accompany it. The client wants to know if others will know she is going through menopause. What are external indicators of menopause that the nurse should share with the client? 1. Tendency to gain weight 2. Thinning of hair 3. Loss of eyebrows 4. Dry itchy skin 1, 2, 4 1, 3, 4 1, 2, 3 2, 3, 4

2, 3, 4

A nurse is collecting assessment data on a new patient. The patient states that she does not have menses. What term will the nurse use in her documentation to describe the absence of menstrual flow? Amenorrhea Metrorrhagia Dysmenorrhea Menorrhagia

Amenorrhea

he nurse is conducting a routine well-visit on a 43-year-old client who is concerned about developing breast cancer, although no family members have experienced it. What is the best advice for this client at this time? Ask the health care provider for recommendations based on family history. Have a yearly mammogram as part of a comprehensive screening. Inspect your nipples every day for discharge or bleeding. Be aware of the normal appearance and feel of your breasts.

Be aware of the normal appearance and feel of your breasts.

The nurse is reviewing the laboratory test results of a client with dysfunctional uterine bleeding (DUB). Which finding would be of concern? Negative pregnancy test Prothrombin time of 60 seconds Hemoglobin level of 10.1 g/dL Serum cholesterol of 140 mg/dL

Hemoglobin level of 10.1 g/dL

A patient you are caring for has returned to her room after vulvar surgery. What would be an important intervention during the initial postoperative period? Sitz baths are recommended Placing the patient in high Fowler's position Monitoring the surgical site for signs of infection Analgesics will be administered on a prn basis

Monitoring the surgical site for signs of infection

A 55-year-old client presents to the clinic with persistent vulvar pruritus, burning, and a lump. She states she has had the symptoms for 5 months and has been trying to treat them with over-the-counter creams. She has a history of multiple sexual partners and HPV and is a smoker. What should the nurse do next? Assess how much the client smokes daily. Schedule the client for cryosurgery. Prepare the client for a biopsy of the lesion. Determine what creams the client has used.

Prepare the client for a biopsy of the lesion.

A nurse is caring for a 45-year-old client using a pessary to help decrease leakage of urine and support a prolapsed vagina. Which recommendation is most commonly provided to a client regarding pessary care? Douche the vaginal area with diluted vinegar or hydrogen peroxide. Remove the pessary twice weekly, and clean it with soap and water. Use estrogen cream to make the vaginal mucosa more resistant to erosion. Remove the pessary before sleeping or intercourse.

Remove the pessary twice weekly, and clean it with soap and water.

The nurse is assessing a 52-year-old perimenopausal female who is concerned about the changes occurring in her body. When questioned about the most serious changes, which effect should the nurse point out? bone mineral density decreases dense breast tissue is replaced with adipose tissue the uterus and ovaries decrease in size pelvic support muscles lose tone

bone mineral density decreases

hich symptom is an early symptom of vulvar cancer? headache pruritus with genital burning fever accompanied by chills severe abdominal pain

pruritus with genital burning

A client with polycystic ovary syndrome (PCOS) is receiving oral contraceptives as part of her treatment plan. When discussing this treatment with the client, the nurse would discuss which rationale for this therapy? improve insulin uptake induce ovulation alleviate hirsutism restore menstrual regularity

restore menstrual regularity

After teaching a local woman's group about incontinence, the nurse determines that the teaching was successful when the group identifies which characteristic of stress incontinence? passing a large amount of urine developing most often in women in their 30s sneezing as an initiating stimulus feeling a strong need to void

sneezing as an initiating stimulus

Which action would the nurse emphasize when teaching postmenopausal women about ways to reduce the risk of osteoporosis? using hormone replacements swimming daily taking vitamin A taking calcium supplements

taking calcium supplements

The nurse is reviewing with a new client the diagnosis of polycystic ovary syndrome (PCOS). Which long-term health problems would the nurse review as a risk with this syndrome? celiac disease migraine cellulitis type 2 diabetes

type 2 diabetes

A client was in labor for more than 36 hours and now reports urine leaking from her vagina. On examination the nurse would be inspecting for: urge incontinence fistula. urethrovaginal fistula. rectovaginal fistula. vesicovaginal fistula.

urethrovaginal fistula.

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? "I get really irritable and moody about a week before my period." "I get sharp pain in my lower abdomen usually starting soon after my period comes." "I've been having bleeding off and on that's irregular and sometimes heavy." "My periods have been unusually long and heavy lately."

"I've been having bleeding off and on that's irregular and sometimes heavy."

A nurse is assessing a 20-year-old female. Which data finding taken during the history would indicate endometrial cancer? diagnosis of diabetes mellitus diagnosis of liver disease severe back pain vaginal bleeding that is painless and abnormal

vaginal bleeding that is painless and abnormal

A postmenopausal client is told at her routine gynecological exam that the primary care provider has found a cyst on her right ovary. The nurse notices that this does not cause worry for this client. What should the nurse and/or care provider tell this client? "You are correct not to be concerned; after all, it is only a cyst." "We will keep a eye on it and recheck it at your next yearly appointment." "You may get a second opinion if you would like." "After menopause a mass on an ovary is not a cyst and should be considered cancerous until proven otherwise."

"After menopause a mass on an ovary is not a cyst and should be considered cancerous until proven otherwise."

A nurse is teaching a client how to use a pessary. The nurse determines that the teaching was successful based on which statement? "I need to clean the pessary with soap and water." "I will use petroleum jelly to help make the insertion easier." "I will remove the pessary every night before I go to bed." "I will have follow up examinations every month for the first year."

"I need to clean the pessary with soap and water."

client is to have a vaginal hysterectomy to repair her stage IV uterine prolapse. The nurse realizes she needs more education when she states: "I have already picked up the stool softeners." "The leg bag will be covered by my clothes, once I am home." "My husband is not crazy about the six weeks of pelvic rest." "I'm not going home with a Foley catheter in place."

"I'm not going home with a Foley catheter in place."

A woman experiencing menopausal symptoms asks the nurse about herbal remedies for managing her symptoms. Which response by the nurse would be most appropriate? "Herbal remedies have been proven quite reliable in alleviating the symptoms of menopause." "Your symptoms are not severe enough to warrant any treatment or therapy." "You should avoid herbal remedies and ask your primary care provider for hormone replacement therapy." "Most of the information about herbal therapies is based on reports by those who have used them, not scientific studies."

"Most of the information about herbal therapies is based on reports by those who have used them, not scientific studies."

The nursing instructor is teaching a student about urinary incontinence and realizes that the student needs further instruction when she makes which statement? "For many women with urge incontinence simple reassurance and lifestyle interventions might help." "Urinary incontinence is an inevitable problem of aging." "Urinary incontinence is not an inevitable problem of aging." "There are many effective treatments for urinary incontinence."

"Urinary incontinence is an inevitable problem of aging."

When working in a local community health care center, a nurse is frequently asked about cervical cancer and ways to prevent it. Which information should the nurse provide? Select all that apply. Encourage prevention of sexually transmitted infections (STIs) to reduce risk factors. Encourage cessation of smoking and drinking. Avoid stress and high blood pressure. Counsel teenagers to avoid early sexual activity. Encourage the use of an intrauterine device (IUD) for contraception.

Encourage cessation of smoking and drinking. Encourage prevention of sexually transmitted infections (STIs) to reduce risk factors. Counsel teenagers to avoid early sexual activity.

A 47-year-old woman was just diagnosed with a cancer of her reproductive tract. The public health nurse is aiding in counseling. Which nursing interventions would be supportive in counseling this woman? Select all that apply. Give postoperative care and instructions when prescribed. Be judgmental of the women's previous lifestyle. Give care based on all women diagnosed with cancer. Use sincere, basic communication techniques. Validate the client's feelings and provide realistic hope.

Give postoperative care and instructions when prescribed. Use sincere, basic communication techniques. Validate the client's feelings and provide realistic hope.

The mother of four small children comes to the clinic and has just been diagnosed with an enterocele. What should the nurse teach the client about her diagnosis? Her rectum is protruding into the back wall of the vagina. Her small intestine and peritoneum are jutting downward between the uterus and the rectum. Her uterus has prolapsed and is causing this bulge. Her bladder is bulging into the front wall of the vagina.

Her small intestine and peritoneum are jutting downward between the uterus and the

The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which information is important for the nurse to include? High-grade dysplasia progresses to invasive cervical cancer in about 4 years. High-grade dysplasia progresses to invasive cervical cancer in about 7 years. High-grade dysplasia progresses to invasive cervical cancer in about 2 years. High-grade dysplasia progresses to invasive cervical cancer in about 9 years.

High-grade dysplasia progresses to invasive cervical cancer in about 2 years.

When explaining what will occur during the first prenatal visit physical examination, a pregnant client asks why a Papanicolaou test is being done at this time. What should the nurse respond to the client? It detects if uterine cancer is present. It helps to date the pregnancy. It predicts whether cervical cancer will occur. It detects cancer cells of the cervix, vulva, or vagina.

It detects cancer cells of the cervix, vulva, or vagina.

The nurse notes that a patient has a history of "fibroids" and is aware that this term refers to a benign tumor of the uterus. What is a more appropriate term for a fibroid? Hydatidiform mole Bartholin's cyst Leiomyoma Dermoid cyst

Leiomyoma

A client with abnormal uterine bleeding is diagnosed with small ovarian cysts. The nurse has to educate the client on the importance of routine checkups. Which assessment is most appropriate for this client's condition? Monitor blood sugar level every 15 days. Monitor gonadotropin level every month. Schedule periodic Papanicolaou tests. Schedule an ultrasound every 3 to 6 months

Schedule an ultrasound every 3 to 6 months.

The nurse is developing a presentation about urinary incontinence for a local women's group. Which of the following would the nurse be least likely to include in the discussion? Urinary incontinence can often be cured. Urinary incontinence can be treated. Urinary incontinence is a normal part of aging. Urinary incontinence can be prevented.

Urinary incontinence is a normal part of aging.

The nurse would expect which client to be at a high risk for developing a pelvic support disorder? a 29-year-old mother of one son a 30-year-old who just gave birth to twin girls a 60-year-old mother with four children an 18-year-old college freshman

a 60-year-old mother with four children

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for: a pelvic X-ray. an MRI. an ultrasound. a DEXA scan.

a DEXA scan.

A 36-year-old was diagnosed with uterine fibroids (uterine myomas). The nurse teaches the client to expect which clinical manifestation? diarrhea decrease in fibroid size if pregnancy occurs acute abdominal pain abnormal uterine bleeding

abnormal uterine bleeding

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as: herniation of the rectum into the vagina. downward displacement of the cervix. protrusion of intestinal wall into the vagina. bulging of the bladder into the vagina.

bulging of the bladder into the vagina.

A nurse is caring for a 30-year-old woman who was just diagnosed with cervical cancer. Which psychosocial need would be the priority for the nurse with her client? clear information on the disease, management, and treatment touching the client's hand for comfort remaining cheerful through all of the interactions offering words of hope to the client

clear information on the disease, management, and treatment

A client is suspected of having endometrial cancer. The nurse would most likely prepare the client for which procedure to confirm the diagnosis? transvaginal ultrasound Papanicolaou test colposcopy endometrial biopsy

endometrial biopsy

A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which disorder? Select all that apply. enterocele urinary incontinence rectocele fecal incontinence cystocele

enterocele rectocele cystocele

The nurse is providing care to a client with abnormal uterine bleeding. Treatment with medications has been unsuccessful, and surgical intervention is being considered. The nurse identifies which technique as being the last resort? uterine artery embolization endometrial ablation dilatation and curettage (D&C) hysterectomy

hysterectomy

The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease: has metastasized to distant sites. is limited to the ovary. has spread to the lymph nodes and other organs within the abdomen. involves one or both ovaries and extends into the pelvis.

involves one or both ovaries and extends into the pelvis.

The nurse reviews the medical record of a woman diagnosed with ovarian cancer, stage II. The nurse interprets this information, understanding that the disease: has spread to the lymph nodes and other organs within the abdomen. involves one or both ovaries and extends into the pelvis. is limited to the ovary. has metastasized to distant sites.

involves one or both ovaries and extends into the pelvis.

A nurse is conducting a session on education about cancers of the reproductive tract and is explaining the importance of visiting a health care professional if certain unusual symptoms appear. Which symptoms that merit a visit to a health care professional for further evaluation should the nurse discuss? Select all that apply. increase in urinary frequency irregular vaginal bleeding elevated or discolored vulvar lesions persistent low backache not related to standing irregular bowel movements

irregular vaginal bleeding persistent low backache not related to standing elevated or discolored vulvar lesions

When preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects that the lesion would most likely be located at which area? labia minora clitoris prepuce labia majora

labia majora

Which measure would the nurse include in the teaching plan for a woman to reduce the risk of osteoporosis after menopause? eating high-fiber, high-calorie foods taking vitamin supplements participating in regular daily exercise restricting fluid to 1,000 ml daily

participating in regular daily exercise

The nurse working in the genitourinary clinic understands that the most common cause for women suffering from urinary incontinence is: estrogen replacement therapy (ERT). urinary tract infection (UTI). pelvic organ prolapse (POP). obesity.

pelvic organ prolapse (POP).

A nurse is conducting a presentation for a local women's group about pelvic organ prolapse. When describing the different types, which information would the nurse incorporate into the description of a cystocele? downward movement of the uterus through the pelvic floor and into the vagina bulging of the small intestine through the posterior vaginal wall sagging of the rectum, pushing against or into the posterior vaginal wall protrusion of the bladder wall through the anterior vaginal wall

protrusion of the bladder wall through the anterior vaginal wall

After teaching a group of young women how to reduce their risk for ovarian cancer, the nurse determines that additional teaching is needed when the group identifies which element as a way to reduce risk? use of feminine hygiene sprays pregnancy breastfeeding use of oral contraceptives

use of feminine hygiene sprays

A nurse is caring for a client who has been prescribed gonadotropin-releasing hormone (GnRH) medication for uterine fibroids (uterine myomas). For which side effect of GnRH medications should the nurse monitor the client? increased vaginal discharge vaginitis urinary tract infections vaginal dryness

vaginal dryness

An elderly woman is seen in the clinic reporting a lesion on her labia majora and states that she has experienced some bleeding and itching as well. She states that this has been going on for approximately three months. She tells the nurse that she has not been to a health care provider in over 10 years. What diagnosis would the nurse expect the primary care provider to make? polyps vaginal cancer cervical cancer vulvar cancer

vulvar cancer

The plan of care for a woman diagnosed with a suspected reproductive cancer includes a nursing diagnosis of disturbed body image related to suspected reproductive tract cancer and impact on sexuality as evidenced by the client's statement that she is worried that she will not be the same. Which outcome would be appropriate for this client? Client will exhibit positive coping strategies related to diagnosis. Client will identify misconceptions related to her diagnosis. Client will verbalize positive statements about self and sexuality. Client will demonstrate understanding of the condition and associated treatment.

Client will verbalize positive statements about self and sexuality.

A woman with polycystic ovary syndrome (PCOS) tells the nurse, "I hate this disease. Just look at me! I have no hair on the front of my head, but I've got hair on my chin and upper lip. I don't feel like a woman anymore." Further assessment reveals breast atrophy and increased muscle mass. Which nursing diagnosis would the nurse identify as the priority? ineffective peripheral tissue perfusion related to effects of disease on vasculature risk for suicide related to effects of condition and fluctuating hormone levels situational low self-esteem related to masculinization effects of the disease social isolation related to feelings about appearance

situational low self-esteem related to masculinization effects of the disease