CH 50: Assessment and Management of Patients with Female Physiologic Processes
The opening into the vagina on the perineum is called the B) introitus. C) hymen. D) adnexa. E) cervix.
B
Hormone therapy decreases the risk of A) blood clots. B) stroke. C) hot flashes. D) heart attack.
C
A 52-year-old client asks the nurse how she is to remember when to schedule her clinical breast examination. Which response by the nurse is most correct? A) "The clinical breast evaluation will be completed with annual gynecologic examination." B) "The office staff can schedule your clinical breast examination twice a year." C) "You can complete the examination at home and report if you found anything abnormal." D) "The diagnostic center will send you a reminder card to complete the annual examination."
A
A patient has been diagnosed with a Trichomoniasis vaginal infection. The nurse would expect which color of discharge? A) Yellow-green B) White C) White, curd-like D) Gray
A
The nurse is providing care to a client scheduled to undergo an elective abortion that involves the use of medications. Which of the following medications could be used during this procedure? Select all that apply. A) Methotrexate B) Misoprostol C) Bromocriptine D) Mifepristone E) Clomiphene
A, B, and D
A patient informs the nurse that she believes she has premenstrual syndrome and is having physical symptoms as well as moodiness. What physical symptoms does the nurse recognize are consistent with PMS? Select all that apply. A) Low back pain B) Fever C) Fluid retention D) Headache E) Hypotension
A, C, and D
A client comes to the clinic reporting dysmenorrhea and is diagnosed with primary dysmenorrhea. Which medication would the nurse most likely suggest for pain relief? A) Acetaminophen B) Ibuprofen C) Calcium D) Cholecalciferol
B
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? A) It calls for a repeat Pap test in 6 weeks. B) It calls for a biopsy as soon as possible. C) It calls for a repeat Pap test in 3 months. D) It's normal and requires no action.
B
A client is scheduled to undergo a Papanicolaou test. The nurse should advise the client of which preparation? A) Avoid consuming food that contains iodine 48 hours before the procedure B) Make sure the procedure is scheduled during menstruation C) Do not douche before the procedure D) Avoid intercourse for 7 days before the procedure
C
A nurse is caring for a client who is being evaluated for a lump found on the lateral aspect of the right breast. The client is anxious and asks the nurse if the next step is to have a mastectomy. Which is the nurse's best response? A) "The doctor will answer your questions when he or she arrives." B) "The doctor will need a biopsy first to see if the lump is cancerous." C) "Many times, an ultrasound is done to distinguish between a tumor and cyst." D) "Yes, breast lumps are abnormal and will need to be removed."
C
The nurse is conducting a health history when a middle-aged client states that her last menstrual period was 6 months ago. Upon further questioning, the client also states that symptoms of hot flashes and mood fluctuations. Which question should the nurse ask next? A) "When was your first menstrual period?" B) "Are you finished having children?" C) "Do you feel like hurting yourself?" D) "Are you taking any hormone replacement therapy?"
D
Which structure is referred to as the vulva? A) clitoris B) mons pubis C) vagina D) external female genitalia
D
Which term describes a procedure in which cervical tissue is removed because abnormal cells are detected? A) Cryotherapy B) Colporrhaphy C) Perineorrhaphy D) Cone biopsy (conization)
D
Which of the following diagnostic tests is used as a therapeutic measure for incomplete miscarriage? A) Dilation and curettage (D & C) B) Laparoscopy C) Endometrial ablation D) Endometrial biopsy
A
A new client has come to the clinic seeking an appropriate method of birth control. What would the nurse teach this client about a diaphragm? A) The diaphragm should be removed 1 hour following intercourse. B) A diaphragm eliminates the need for spermicidal jelly. C) One size fits all females. D) The diaphragm may be cleaned with soap and water after use.
D
Which of the following positions may be utilized for a patient who is unable to maintain the supine lithotomy position? A) Sims' B) Prone C) Semi-Fowler's D) Trendelenburg
A
A client is diagnosed with hypertension. The client also reports skin discoloration, weight gain, and nausea. Which contraceptive preparations would the nurse practitioner recommend for this client? A) Progestin-only B) Biphasic C) Triphasic D) Monophasic
A
A client reports experiencing vulvar pruritus. Which assessment factor may indicate that the client has an infection caused by Candida albicans? A) Cottage cheese-like discharge B) Gray-white discharge C) Discharge with a fishy odor D) Yellow-green discharge
A
A nurse is obtaining health history from a young adult woman. Which of the following would alert the nurse to a possible problem? A) Menstrual cycle averaging 28 to 29 days B) Mucus-like vaginal discharge C) Reports of dyspareunia D) Age of 13 years at menarche
C
A postmenopausal patient is experiencing dyspareunia. What methods can the nurse recommend she use to diminish the discomfort? A) Petroleum jelly B) Ibuprofen C) Water-based lubricant D) Aspirin
C
A nurse practitioner is conducting a history and physical on a 42-year-old woman. One of the questions asked of someone in this age group is the type of medications that the patient's mother took during her pregnancy. The nurse is assessing for a past history of ______ use. A) Cancer drugs B) Diethylstilbestrol C) Antibiotics D) Immunosuppressive agents
B
A postmenopausal patient is experiencing dyspareunia. What methods can the nurse recommend she use to diminish the discomfort? A) Aspirin B) Water-based lubricant C) Ibuprofen D) Petroleum jelly
B
During physical examination of the male reproductive system, which method would best provide the nurse information about the prostate's size as well as evidence of tumor? A) inspection of the size of the scrotum B) digital rectal examination C) transillumination D) scrotal radiography
B
Menopause marks the end of a woman's reproductive capacity. Which of the following is a common complaint that may be due to a cystocele? A) Decreased pH of the vagina B) Dyspareunia C) Irregular menses D) Atrophic vaginitis
B
A woman comes to the clinic complaining of vaginal itching and a discharge. Inspection reveals a thick curd-like white discharge. The nurse suspects which of the following? A) Trichomonas infection B) Bacterial vaginosis C) Candida infection D) Atrophic vaginitis
C
A 30-year-old woman comes to the clinic for a routine examination. During the visit, the nurse would least likely recommend which of the following as important for health screening? A) Pap smear every 3 years B) Yearly clinical breast examination C) Annual pelvic examination D) Mammography
D
A nurse practitioner is preparing to perform a client's scheduled Pap smear, and the client asks the nurse to ensure that the speculum is well lubricated. How should the nurse proceed with assessment? A) Reassure the client that a water-based lubricant or warm water will be used. B) Reassure the client that she will probably not feel the insertion and opening of the speculum. C) Reassure the client that ample petroleum jelly will be used. D) Explain to the client why the speculum must be introduced without lubricant.
A
A patient asks the nurse if there are any available nonsurgical options to terminate a pregnancy if she is only 2 weeks pregnant. What information should the nurse provide to the patient about a medication that blocks progesterone? A) Mifepristone (RU-486, Mifeprex) is used only in early pregnancy to terminate a pregnancy nonsurgically. B) Methotrexate is used only in early pregnancy to terminate a pregnancy nonsurgically. C) Clomiphene (Clomid) is used only in early pregnancy to terminate a pregnancy nonsurgically. D) Birth control pills can be used to terminate the pregnancy.
A
During an internal vaginal examination, the nurse practitioner notes a frothy and malodorous discharge. The nurse suspects the odor is caused by which bacteria? A) Trichomonas B) Pseudomonas C) Escherichia coli D) Candida
A
During physical examination of the male reproductive system, which method would best provide the nurse information about the prostate's size as well as evidence of tumor? A) digital rectal examination B) inspection of the size of the scrotum C) transillumination D) scrotal radiography
A
Fertility studies for men include a semen analysis to determine sperm count, sperm motility, and abnormal sperm. Which test can also be performed to determine infertility? A) Blood test for luteinizing hormone (LH) B) Needle biopsy of prostatic tissue C) Cystoscopy D) Prostate-specific antigen (PSA) assay test
A
Nursing students are reviewing information about natural family planning methods in preparation for a quiz the next day. The students demonstrate a need for additional study when they identify which of the following as an example? A) Spermicide B) Basal body temperature C) Symptothermal method D) Calendar method
A
The nurse is caring for a client who has been admitted to hospital for uterine bleeding after incomplete miscarriage. The nurse knows what will be included in this client's treatment? A) Dilation and curettage B) Ultrasonography C) Endometrial ablation D) Hysteroscopy
A
The nurse is documenting the results of a pelvic examination on a client's medical record. Which of the following would alert the nurse to the need for additional follow up? A) Positive cervical motion tenderness B) Uterus tipped toward abdominal wall C) Ovaries slightly tender on palpation D) Cervix uniformly firm on palpation
A
The nurse is instructing clients at a prenatal class. Which term does the nurse state as the medical name of what is removed during this procedure? A) The prepuce B) The shaft C) The glans D) The corpora cavernosa
A
Which of the following would be most important for the nurse to include to ensure a thorough baseline history related to the reproductive system? A) Age of menarche B) Cultural history C) Nutritional history D) Exercise and fitness routine
A
The nurse instructs a female client about contraceptive options. The nurse explains that the intrauterine device (IUD) is a good contraceptive option for women who: A) Have had a history of ectopic pregnancies. B) Are in a monogamous relationship. C) Desire short-term use of a contraceptive. D) Have a history of sexually transmitted diseases (STDs).
B
A nurse is reviewing the medical record of a client who has come to the clinic for contraception. What condition would hormonal contraceptives be contraindicated for in a client? A) An irregular menstrual cycle B) History of thrombophlebitis C) Controlled hypertension D) Severe acne
B
The nurse educator is teaching a group of nursing students in a reproductive health class. The students are correct in identifying that a woman is most likely to be unable to become pregnant at what age? A) 18 years old B) 49 years old C) 40 years old D) 35 years old
B
The nurse is preparing a client for a pelvic examination. Which nursing question is essential for the nurse to ask? A) "Do you have any sexually transmitted diseases?" B) "Would you like to void at this time?" C) "Are you sexually active?" D) "Would you like to have assistance to get in position for the exam?"
B
When preparing a woman for a gynecologic examination, which of the following would the nurse explain as being done at the end of the examination? A) Vaginal-abdominal palpation B) Palpation of the posterior uterus via the rectum C) Inspection of the vaginal wall D) Inspection of the external genitalia
B
Which statement is true regarding hormonal contraception? A) It increases risk for benign breast cancer. B) It increases risk for venous thromboembolism. C) It increases risk for uterine cancer. D) Fetal anomalies are a concern.
B
A client presents with symptoms of menstrual difficulties and infertility. Which hormone is essential in the maintenance of the endometrium? A) Testosterone B) Prolactin C) Estrogen D) Progesterone
D
A client is prescribed a combination hormonal contraceptive. What condition would the nurse instruct the client to report to the healthcare provider immediately? A) Difficulty hearing B) Mood changes C) Nausea D) Pregnancy
D
Which test is an x-ray study of the uterus and the fallopian tubes after injection of a contrast agent? A) Endometrial ablation B) Hysteroscopy C) Laparoscopy D) Hysterosalpingography
D
A client is scheduled for an abdominal ultrasound as a follow up to her pelvic examination. Which action by the nurse would be most appropriate? A) Checking that it has been 5 days since the end of her menses B) Ensuring that the client has a full bladder C) Administering laxatives and an enema prior to the procedure D) Giving the client a mild sedative before the procedure
B
A group of students are reviewing the female reproductive system in preparation for a test. Which of the following if identified by the students as an internal structure indicates successful learning? A) Vulva B) Vagina C) Mon pubis D) Labia majora
B
A newly pregnant client is being assessed in an obstetric clinic. The client states that she has been experiencing intense abdominal pain and the nurse anticipates that the client will be assessed for ectopic pregnancy. In addition to ultrasonography, what diagnostic test should the nurse anticipate? A) Estrogen and progesterone testing B) Human chorionic gonadotropin (hCG) testing C) Abdominal x-ray D) Computed tomography
B
A 55-year-old client has hypertension. She admits to her physician that she stopped taking her regular medications about 3 months ago and started an alternative, new-age therapy. When the client asks about herbal remedies to treat her hot flashes, which natural estrogen is the physician likely to recommend? A) Soy milk B) Bitter gourd tea C) Turmeric powder D) Ginkgo biloba
A
The nurse is providing information at the local YMCA about screenings for breast and cervical cancer. The nurse should inform young women that they should begin their screenings at what time? A) Annual breast and pelvic examinations are important for all women 21 years of age or older and for those who are sexually active, regardless of age. B) Annual breast and pelvic examinations should begin at age 14 years old. C) Annual breast and pelvic examinations should be performed when a woman begins taking birth control. D) Annual breast and pelvic examinations should begin when a woman becomes sexually active.
A
The nurse is relating health education to male students when asked where sperm is actually made. Which location is most correct? A) In the testes within the scrotum B) In the seminiferous tubules C) In the male reproductive system D) Sperm are present from birth.
A
The nurse is seeing a client who has been told her Papanicolaou smear results are abnormal. The client states, "I can't believe I have cancer." What is the nurse's best response? A) "Abnormal results happen for many different reasons, not just cancer." B) "Cervical cancer has a very good prognosis." C) "Most of the time there has been a mistake in the cell sample." D) "You were probably menstruating when the sample was taken."
A
The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new client. According to this model, the nurse should begin with what action? A) Asking the client's permission to discuss sexuality B) Assessing for physiologic problems C) Addressing the client's psychosocial status D) Conducting a preliminary assessment
A
While examining the introitus, the nurse practitioner asks the client to "bear down." The nursing student observing the examination knows that the nurse practitioner is assessing the client for which condition? A) Uterine prolapse B) Human papillomavirus C) Female genital mutilation D) Colorectal cancer
A
A nurse is discussing contraception with a client interested in transdermal contraceptives. What should the nurse inform the client is the most common side effect of transdermal contraceptives? A) Thrombophlebitis B) Application site allergic reactions C) Withdrawal bleeding D) Breast cancer
B
Cone biopsy describes a procedure in which cervical tissue is removed as result of detection of abnormal cells. Which statements by the client demonstrates that the client undergoing a cone biopsy understands the discharge instructions? A) "I require a repeat conization in 2 weeks after the edema subsides." B) "I will avoid having sexual relations until I see the doctor again." C) "I will use a Sitz bath to relieve pain caused by the sutures." D) "I will need to use a menstrual pad to capture the moisture as my cervix unfreezes."
B
The nurse is assisting a patient in preparing for a pelvic examination. What position will the nurse place the patient in for the examination? A) Jackknife B) Lithotomy C) Left lateral D) Prone
B
The nurse is caring for a client who is being supplemented with the hormone responsible for developing and maintaining the female reproductive organs. This client is being treated with what hormone? A) Progesterone B) Estrogen C) Androgens D) Follicle-stimulating hormone
B
The nurse is scheduling an appointment for Pap test with a client. What information should the nurse provide to the client to ensure the test is accurate? Select all that apply. A) "Ensure you have used any vaginal medication creams prior to the test." B) "Avoid sexual intercourse for at least 2 days prior to the test." C) "It is best if you come during your menstrual period." D) "Use a sanitary pad instead of tampon 2 to 3 days prior to the test." E) "Use vaginal cleansers such as douche to prepare for the test."
B and D
Nursing students are reviewing information about the various structures of the female reproductive system. The students demonstrate understanding of the material when they identify which of the following about the uterus? Select all that apply. A) The fallopian tubes extend outward from the cervix. B) Ligaments hold the uterus in place. C) The bladder is located behind the uterus. D) The uterus is a pear-shaped muscular organ. E) The fundus and cervix comprise the uterus.
B, D, and E
The nurse, who is conducting a Papanicolaou (Pap) smear, performs which actions to promote client comfort during the procedure? Select all that apply. A) Flush away any purulent material at the cervical os B) Ensure warming of the speculum C) Use a quick motion to open the speculum once inserted D) Explain to the client that some discomfort is normal E) Lubricate the blades of the speculum
B, D, and E
A nurse is providing care to a client who was just admitted with a diagnosis of ectopic pregnancy. When reviewing the client's history, which of the following would the nurse identify as a major risk factor for this client? A) Habitual abortions B) Use of in vitro fertilization C) Pelvic inflammatory disease (PID) D) Combined hormonal contraceptive use
C
A patient who is scheduled for a gynecologic examination and Pap smear informs the nurse that she just began her menstrual cycle. What is the best response by the nurse? A) "We will proceed with the examination and reschedule your Pap smear for next week." B) "This will have no bearing on your test today." C) "We will reschedule your examination when you have finished menstruating." D) "We will do the test and take into consideration that you are menstruating."
C
The nurse is caring for a 67-year-old woman in the reproductive health clinic. Which question should the nurse be sure to include during health screening and counseling with this client? A) "Do you experience hot flashes and night sweats?" B) "Have you been tested for gonorrhea recently?" C) "When was your last colonoscopy completed?" D) "Which contraceptive medications are you currently taking?"
C
The nurse is obtaining a history from a male client who states having difficulty achieving and sustaining an erection. When reviewing the medication history, which medication classification does the nurse anticipate? A) Antibiotics B) Cardiac dysrhythmics C) Antihypertensives D) Bronchodilators
C
Which of the following is an age-related functional change of the female reproductive system? A) Decreased pH of vagina B) Hormone level stability C) Decreased ovulation D) Increased vaginal lubrication
C
A 35-year-old African American woman who smokes regularly and had diabetes visits the health care unit with sustained elevated blood levels and is diagnosed with essential hypertension. Which contraceptive method is best for this client? A) Clomiphene therapy B) Menotropins therapy C) Placement of an etonogestrel/ethinyl estradiol vaginal ring D) Cervical cap
D
A nurse has assessed a woman in the hospital emergency department who was struck several times in the face by her intimate partner. As the woman is having her facial injuries assessed, she tells the nurse she does not want to return home. Which action should the nurse take? A) Contact a 24-hour hotline for the client B) Provide the woman with a safety plan C) Call a shelter where the woman can stay D) Provide the woman with a list of phone numbers for shelters
D
A positive chandelier sign is indicative of which of the following? A) Uterine prolapse B) Rectocele C) Endometriosis D) Pelvic infection
D
An older female client reports pain during intercourse, disrupting the intimacy that she and her husband are accustomed to sharing. What might be the cause of her pain? A) increased vascularity B) decreased sensitivity C) lack of desire D) atrophy of Bartholin glands
D
During an internal vaginal examination, the nurse practitioner notes a frothy and malodorous discharge. What bacteria does the practitioner suspect is causing this disorder? A) Eschar B) Candida C) Escherichia coli D) Trichomonas
D
The nurse is providing client education to a 45-year-old female who asks how she can be certain that she has reached menopause. How should the nurse respond? A) "Menopause has been reached if there have been 8 years of menstrual irregularity." B) "Menopause is marked by persistent night sweats and hot flashes." C) "Menopause can be confirmed when a steady increase in estrogen levels is detected." D) "Menopause is likely if you have not menstruated for 12 months."
D
Within the female internal reproductive structures, where is the egg most commonly fertilized? A) cervix B) endometrium C) fundus D) fallopian tubes
D
