Ch. 71: Female Reproductive (Nurs 309)

After an abdominal hysterectomy the client returns to the unit with an indwelling catheter. The nurse identifies that the urine in the client's collection bag has become increasingly sanguineous. What complications does the nurse suspect? 1. An incisional nick in the bladder. 2. A urinary infection from the catheter. 3. Disseminated intravascular coagulopathy. 4. Uterine relaxation with increased bleeding.

1. An incisional nick in the bladder.

A client has an anterior and posterior surgical repair of a cystocele and rectocele and returns from the PACU with an indwelling catheter in place. WHat should the nurse tell the client about the primary reasons for the catheter? Select All That Apply. 1. Discomfort is minimized. 2. Bladder tone is maintained. 3. Urinary retention is prevented. 4. Pressure on the suture line is relieved. 5. Hourly urine outputs can be easily measured.

1. Discomfort is minimized. 3. Urinary retention is prevented. 4. Pressure on the suture line is relieved.

A client past menopause undergoes an anterior-posterior colporrhaphy. What should the discharge teaching include? 1. Eating a high fiber diet. 2. Limiting daily activities. 3. Reporting signs of urinary retention. 4. Observing for signs of a rectovaginal fistula.

1. Eating a high fiber diet.

A nurse is assessing a client who is being admitted for surgical repair of a rectocele. What signs or symptoms does the nurse expect the client to report? Select All That Apply. 1. Painful intercourse. 2. Crampy abdominal pain. 3. Bearing-down sensations. 4. Urinary stress incontinence. 5. Recurrent urinary tract infections.

1. Painful intercourse. 3. Bearing-down sensations.

Three days after undergoing a pelvic exenteration procedure, a client reports dizziness after experiencing a sudden "giving" sensation along her abdominal incision. The nurse finds that the wound edges are open, and loops of intestine are protruding. Which action should the nurse take first? 1. Notify the surgeon that wound evisceration has occurred. 2. Cover the wound with saline-soaked dressings. 3. Use swabs to obtain aerobic and anaerobic wound cultures. 4. Call for assistance of the Rapid Response Team.

2. Cover the wound with saline-soaked dressings.

What does a nurse expect to be the priority concern of a 28-year old woman who is to undergo a laparoscopic bilateral salpingo-oophorectomy? 1. Acute pain. 2. Risk for hemorrhage. 3. Fear of chronic illness. 4. Loss of childbearing potential.

4. Loss of childbearing potential.

What potential complication does a nurse anticipate when admitting a client with the diagnosis of of severe procidentia (prolapse of the uterus)? 1. Edema 2. Fistulas 3. Exudate 4. Ulcerations

4. Ulcerations

A client who had an abdominal hysterectomy 3 days ago reports burning with urination. Her urine output during the previous shift was 210 mL, and her temperature is 101.3 F. Which of these actions prescribed by the health care provider will the nurse implement first? 1. Insert a straight catheter PRN for outputs of less than 300 ml/8 hr. 2. Administer acetaminophen 650 mg now and every 6 hours PRN. 3. Send a urine specimen to the laboratory for culture and sensitivity testing. 4. Administer ceftizoxime 1 g IV now ad every 12 hours.

1. Insert a straight catheter PRN for outputs of less than 300 ml/8 hr

The nurse is working the emergency department when a client with possible toxic shock syndrome is admitted. Which prescribed intervention will the nurse implement first? 1. Remove client's tampon. 2. Obtain blood specimens for culture. 3. Give acetaminophen 650 mg. 4. Infuse nafcillin 1000 mg IV.

1. Remove client's tampon.

A client is diagnosed with uterine fibroids, and the HCP advises hysterectomy. The client expresses concern about having a hysterectomy at age 45 because she has heard from friends that she will undergo severe symptoms of menopause after surgery. What is the nurse's most appropriate response? 1. "You are correct, but there are medications you can take that will ease the symptoms." 2. "This sometimes occurs in women of your age, but you needn't worry about it at this time." 3. "Perhaps you should talk to your surgeon because I am not allowed to discuss this with you." 4. "Some women may experience symptoms of menopause if their ovaries are removed with their uterus."

4. "Some women may experience symptoms of menopause if their ovaries are removed with their uterus."

The nurse is working on a postanesthesia care unit caring for a 32-year old client who has just arrived after undergoing dilation and curettage to evaluate for infertility. Which assessment finding should be immediately communicated to the surgeon? 1. Blood pressure of 162/90 mmHg. 2. Saturation of the perineal pad after the first 30 minutes. 3. Oxygen saturation of 91% to 95%. 4. Sharp, continuous, level 8 abdominal pain.

4. Sharp, continuous, level 8 abdominal pain.

A 15-year old adolescent tells a school nurse "I have persistent pain during my periods." What should the nurse encourage her to do? 1. Continue daily activities. 2. Have a gynecologic examination. 3. Eat a nutritious diet containing iron. 4. Practice relaxation of abdominal muscles.

2. Have a gynecologic examination.

An 86-year old woman had an anterior and posterior colporrhaphy (A and P repair) several days ago. Her retention catheter was removed 8 hours ago. Which assessment finding requires that the nurse act most rapidly? 1. Her oral temp is 100.7 F. 2. Her abdomen is firm and tender to palpation above her pubic symphysis. 3. Her breath sounds are decreased, with fine crackles audible at both bases. 4. Her apical pulse is 86 bpm and slightly irregular.

2. Her abdomen is firm and tender to palpation above her pubic symphysis.

A client who has a diagnosis of endometriosis is concerned about the side effect of hot flashes from her prescribed medication. She tells the nurse that her mother found them very uncomfortable during her menopause. Which medication causes this side effect? 1. Estrogen 2. Leuprolide 3. Diclofenac 4. Ergonovine

2. Leuprolide

When assessing a client with cervical cancer who had a total abdominal hysterectomy yesterday, the nurse obtains the following data. Which information has the most immediate implications for planning the client's care? 1. Fine crackles are audible at the lung bases. 2. The client's right calf is swollen, and she reports mild-calf tenderness. 3. The client uses patient-controlled-analgesia device every 30 minutes. 4. Urine in the collection bag is amber and clear.

2. The client's right calf is swollen, and she reports mild-calf tenderness.

A client with a third-degree uterine prolapse is scheduled for a vaginoplasty. What should the nurse anticipate the surgeon will order? 1. Encourage ambulation. 2. Elevate the foot of the bed. 3. Apply a moist compress to the uterus. 4. Support the prolapsed uterus with a sanitary pad.

3. Apply a moist compress to the uterus.

The nurse is supervising a student nurse who has an intracavitary radioactive implant in place to treat cervical cancer. Which action by the student requires that the nurse intervene immediately? 1. Standing next to the client for 5 minutes while assisting with her bath. 2. Asking the client how she feels about losing her child-bearing ability. 3. Assisting the client to the bedside commode for a bowel movement. 4. Offering to get the client whatever she would like eat or drink.

3. Assisting the client to the bedside commode for a bowel movement.

After a hysterosalpingo-oophorectomy, a client wants to know whether it would be wise for her to take hormones right away to prevent symptoms of menopause. What is the nurse's most appropriate response? 1. "It is best to wait because you may not have any symptoms." 2. "It is comforting to know that hormones are available if you should ever need them." 3. "You have to wait until symptoms are severe; otherwise, hormones will have no effect." 4. "Discuss this with your HCP, because it is important to know your concerns."

4. "Discuss this with your HCP, because it is important to know your concerns."

When taking the health history of a client who is admitted for repair of cystocele and rectocele, the nurse should expect the client to report the occurrance of: 1. White vaginal discharge and itching. 2. Sporadic bleeding and abdominal pain. 3. Elevated temperature and intractable diarrhea. 4. Stress incontinence and low abdominal pressure.

4. Stress incontinence and low abdominal pressure.

A client at the women's health clinic tells the nurse she has endometriosis. What factors associated with endometriosis does the nurse anticipate the client will report? Select All That Apply. 1. Isomnia 2. Ecchymosis 3. Rectal pressure 4. Abdominal pain 5. Skipped periods 6. Pelvic infections

3. Rectal pressure 4. Abdominal pain