Chapter 53: Female Reproductive and Genital Problems

A nurse is caring for a patient who has premenstrual syndrome (PMS). The nurse should assess the patient for which symptoms? Select all that apply. A. Anxiety B. Hair loss C. Back pain D. Headaches E. Breast discomfort F. Abdominal bloating

A. Anxiety C. Back pain D. Headaches E. Breast discomfort F. Abdominal bloating

The diagnostic reports of a patient who has infertility problems indicate the presence of tubal obstruction due to the growth of endometrial tissue. Which medication would be most beneficial for the patient? Select all that apply. A. Pergonal B. Nafarelin C. Repronex D. Humegon E. Leuprolide

B. Nafarelin E. Leuprolide

The nurse is preparing a patient for a procedure that will stage ovarian cancer. For what procedure will the nurse ensure that the patient is prepared? A. OVA1 test B. Abdominal ultrasound C. Exploratory Laparotomy D. Papanicolaou (Pap) test

C. Exploratory Laparotomy

The nurse is educating a female patient who is experiencing menopausal symptoms about conditions at which the patient will now be at a greater risk. For which conditions will the nurse monitor this patient? Select all that apply. A. Blood clots B. Depression C. Osteoporosis D. Bladder infections E. Endometrial cancer F. Coronary artery disease

B. Depression C. Osteoporosis D. Bladder infections F. Coronary artery disease

A patient is diagnosed with polycystic ovary syndrome and asks the nurse how she could have developed this disorder. What is the best response by the nurse? A. "The disorder may result from hormonal abnormalities." B. "Taking immunosuppressive medications can cause it." C. "Obesity is an associated factor in the development of the disorder." D. "Contracting an infection caused by the human papillomavirus (HPV) is the cause."

A. "The disorder may result from hormonal abnormalities."

The nurse is educating a patient regarding the risk factors for ovarian cancer after the patient states that she is concerned because her sister died with the disease. What is the best response by the nurse? A. "Some forms of hormonal therapy may be a risk factor." B. "Oral contraceptive use is a risk factor for ovarian cancer." C. "Multiple pregnancies will place you at risk for ovarian cancer." D. "Breastfeeding is a risk factor for the development of ovarian cancer."

A. "Some forms of hormonal therapy may be a risk factor."

What instruction does the nurse give to the patient with cystocele who undergoes an anterior colporrhaphy to ensure effective treatment after surgery? Select all that apply. A. "You should eat a low-residue diet." B. "You should avoid voiding frequently." C. "You should take a stool softener every night." D. "You should avoid frequent change of positions." E. "You should avoid intercourse until the follow up visit."

A. "You should eat a low-residue diet." C. "You should take a stool softener every night." E. "You should avoid intercourse until the follow up visit."

A patient is diagnosed with a cervical polyp. What information should the nurse give this patient? Select all that apply. A. A malignant change may occur. B. Polyps may be excised or cauterized on an outpatient basis. C. A single polyp is usually benign; multiple polyps are malignant. D. Polyps are due to infection and a course of antibiotics is needed. E. Polyps are due to aggressive intercourse, and intercourse should be avoided for two weeks.

A. A malignant change may occur. B. Polyps may be excised or cauterized on an outpatient basis.

A patient is admitted to the hospital with severe pain due to a tuboovarian abscess caused by pelvic inflammatory disease (PID). Which nursing interventions are appropriate for the patient? Select all that apply. A. Administer IV fluids. B. Give a sitz bath to the patient. C. Provide bed rest in a prone position. D. Administer analgesics to relieve pain. E. Apply a cold compress to the lower abdomen.

A. Administer IV fluids. B. Give a sitz bath to the patient. D. Administer analgesics to relieve pain.

The nurse is caring for a patient who has experienced a tubal rupture as the result of an ectopic pregnancy. Which nursing interventions will help reduce the patient's risk for hypovolemia? Select all that apply. A. Administering intravenous fluid B. Preparing for blood transfusions C. Applying heat to the lower abdomen D. Recording the characteristics of the vaginal discharge E. Asking the patient to sleep in the semi-Fowler's position

A. Administering intravenous fluid B. Preparing for blood transfusions

A couple who have experienced a spontaneous abortion before eight weeks of gestation visit a nurse for information about increasing their chances for successful future pregnancies. What information should the nurse provide? Select all that apply. A. Advise the couple that any bleeding should be reported immediately. B. Inform the couple that the abortion may have been due to chromosomal defects. C. Inform the couple that the abortion may have been due to cervical incompetence. D. Advise the couple that serial monitoring of serum follicular stimulating hormone (FSH) levels should be done. E. Advise the couple that absolute bed rest and abstention from intercourse can reduce the chance of spontaneous abortion.

A. Advise the couple that any bleeding should be reported immediately. B. Inform the couple that the abortion may have been due to chromosomal defects.

A patient is scheduled to have a hysterectomy and informs the nurse that after previous abdominal surgery, she had gas pains. What can the nurse educate the patient about that will reduce the occurrence of gas pains? A. Ambulating after surgery B. Performing leg exercises C. Changing position frequently D. Avoiding pressure under knees

A. Ambulating after surgery

A patient informs the nurse that she has not menstruated in several months. How will the nurse document this finding? A. Amenorrhea B. Dysmenorrhea C. Ectopic pregnancy D. Heavy menstrual bleeding

A. Amenorrhea

The nurse suspects that the tumor of a patient with cervical cancer has enlarged, resulting in heavy bleeding. Which other late stage symptoms does the nurse expect in this patient? Select all that apply. A. Anemia B. Cachexia C. Weight loss D. Heavy bleeding E. Abdominal girth

A. Anemia B. Cachexia C. Weight loss

The nurse is caring for a patient that underwent colporrhaphy. Which nursing intervention would provide the most comfort to this patient? Select all that apply. A. Apply ice locally in the area of swelling. B. Provide sitz bath regularly to the patient. C. Administer cleansing enema in the morning. D. Apply vaginal cream after shaving perineal area. E. Ask the patient to perform perineal care twice daily.

A. Apply ice locally in the area of swelling. B. Provide sitz bath regularly to the patient. E. Ask the patient to perform perineal care twice daily.

A patient is being discharged from the hospital after having a hysterectomy for a malignant uterine growth performed vaginally or via an incision. What instruction should the nurse give to the patient for rehabilitation? Select all that apply. A. Avoid dancing for several months. B. Avoid swimming for several months. C. Avoid lifting heavy weights for two months. D. Avoid sex for six days after the wound has healed. E. Avoid sex for six weeks after the wound has healed.

A. Avoid dancing for several months. C. Avoid lifting heavy weights for two months.

A patient is reporting various symptoms of premenstrual syndrome (PMS). Which medication does the nurse anticipate discussing with the patient for the relief of these symptoms? A. Buspirone for anxiety B. Vitamin B 6 for cramping pain C. Spironolactone for negative mood D. Ibuprofen for premenstrual dysphoric disorder

A. Buspirone for anxiety

A patient reports abdominal pain, urinary urgency, and difficulty eating, and has a positive CA-125 tumor test. Which medications does the nurse anticipate administering? A. Cisplatin and paclitaxel B. Docetaxel and metformin C. Carboplatin and tamoxifen D. Altretamine and progesterone HT

A. Cisplatin and paclitaxel

A patient is suspected to have vulvar cancer. For which diagnostic study does the nurse prepare the patient? A. Colposcopy B. Laparotomy C. CA-125 test D. Papanicolaou (Pap) test

A. Colposcopy

A female college student presents at the campus clinic reporting a headache and increased lethargy with difficulty concentrating on studying. Which of the following questions should the nurse include during the focused assessment? Select all that apply. A. Does the patient practice birth control? B. When was the patient's last self-breast exam? C. Does the patient wear contact lenses or glasses? D. Does the patient have a history of menstrual cramps? E. Did the patient bump or receive any hits to her head?

A. Does the patient practice birth control? C. Does the patient wear contact lenses or glasses? E. Did the patient bump or receive any hits to her head?

A patient with premenstrual syndrome is on medication therapy. On a follow up visit, the nurse observes that the patient's cholesterol level is 200 mg/dL, and her blood pressure is 140/90 mm Hg. Which medication does the nurse report may be responsible for this condition? A. Estrogen B. Methotrexate C. Tranexamic acid D. Medroxyprogesterone

A. Estrogen

Normal vaginal pH is typically lower than 4.5 as a result of sufficient levels of which combined substances? A. Estrogen and lactobacillus B. Estrogen and progesterone C. Progesterone and lactobacillus D. Testosterone and lactobacillus

A. Estrogen and lactobacillus

A pregnant patient with abdominal pain and irregular vaginal bleeding has had morning sickness, breast tenderness, and syncope since the sixth week of pregnancy. For which complication should the nurse monitor the patient? Select all that apply. A. Hemorrhage B. Peripheral edema C. Migraine headache D. Hypovolemic shock E. Thyroid dysfunction

A. Hemorrhage D. Hypovolemic shock

When teaching a group of postmenopausal women about the risk of osteoporosis, what information should the nurse include? Select all that apply. A. Inform that raloxifene prevents bone loss. B. Emphasize the need for estrogen replacement. C. Inform that Bisphosphonates enhance bone mineral density. D. Emphasize the need for adequate intake of calcium and vitamin E. E. Encourage avoidance of weight-bearing exercises, because they can cause bone loss.

A. Inform that raloxifene prevents bone loss. B. Emphasize the need for estrogen replacement. C. Inform that Bisphosphonates enhance bone mineral density.

A postmenopausal woman is on combined hormone therapy with estrogen and progesterone. What information should the nurse provide to this patient regarding advantages of hormonal therapy? Select all that apply. A. It reduces the risk of hip fractures and colorectal cancer. B. The therapy is very beneficial in women without a uterus. C. The therapy decreases the risk of stroke and heart disease. D. It may cause breast enlargement, which is a common side effect. E. The therapy helps to treat hot flashes and vaginal atrophic changes.

A. It reduces the risk of hip fractures and colorectal cancer. D. It may cause breast enlargement, which is a common side effect. E. The therapy helps to treat hot flashes and vaginal atrophic changes.

The nurse is examining the diagnostic reports of a patient who has had a spontaneous abortion. The ultrasound reports indicate the presence of products of conception in the uterus. Which procedure does the primary health care provider perform? A. Hysterotomy B. Dilation and curettage C. Hypertonic saline solution D. Methotrexate with misoprostol

B. Dilation and curettage

A patient with polycystic ovary syndrome (PCOS) is prescribed metformin. The patient seeks an explanation, as the drug is usually prescribed for diabetes. What explanation should the nurse provide to this patient? Select all that apply. A. It restores ovulation. B. It reduces ovarian cysts. C. It reduces plasma insulin. D. It increases plasma insulin. E. It improves hyperandrogenism.

A. It restores ovulation. C. It reduces plasma insulin. E. It improves hyperandrogenism.

A pregnant patient reports occasional spotting and severe pain in the abdomen. The ultrasonography reports reveal the absence of an intrauterine fetus and serum β-hCGof 1,500 mIU per mL. For which procedure that may prevent complications does the nurse prepare the patient? A. Laparoscopy B. Myomectomy C. Hysterectomy D. Balloon thermotherapy

A. Laparoscopy

Which nonhormonal measures should the nurse teach to a postmenopausal patient experiencing hot flashes to decrease heat production and increase heat loss? Select all that apply. A. Limit intake of alcohol. B. Increase intake of caffeine. C. Use heavy quilts when sleeping. D. Promote air circulation in the room. E. Avoid wearing clothes with tight necks.

A. Limit intake of alcohol. D. Promote air circulation in the room. E. Avoid wearing clothes with tight necks.

The normal physiologic cessation of menses associated with declining ovarian function is referred to as which condition? A. Menopause B. Amenorrhea C. Dysmenorrhea D. Perimenopause

A. Menopause

The nurse is caring for a patient with an ectopic pregnancy of more than 3 cm in size. What nursing interventions should the nurse perform for this patient? Select all that apply. A. Monitor vital signs around the clock to identify signs of shock. B. Prepare the patient for either laparoscopic or laparotomy surgery. C. Assure the patient that with proper care she may continue the pregnancy. D. Inform the patient that laparotomies are associated with fewer repeated ectopic pregnancies. E. Inform the patient that increasing pain and vaginal bleeding indicate dislodgement of the ectopic pregnancy.

A. Monitor vital signs around the clock to identify signs of shock. B. Prepare the patient for either laparoscopic or laparotomy surgery.

While interviewing a patient, the nurse finds that the patient uses superabsorbent tampons during the menstrual cycle. For which symptoms should the nurse tell the patient to be observant? Select all that apply. A. Myalgia B. Vomiting C. Diarrhea D. Low fever E. Dizziness

A. Myalgia B. Vomiting C. Diarrhea

A patient has been diagnosed with a few small leiomyomas, and she has informed the health care provider that she would like to preserve her uterus. Regarding which procedure should the nurse prepare to educate the patient? A. Myomectomy B. Hysteroscopy C. Dilation and curettage D. Laparoscopic hysterectomy

A. Myomectomy

For which treatment does the nurse prepare the patient with leiomyomas whose pelvic examination reveals uterine fibroids? Select all that apply. A. Myomectomy B. Hysteroscope C. Laser resection instruments D. Uterine artery embolization E. Magnetic resonance imaging (MRI)-guided focused ultrasound

A. Myomectomy C. Laser resection instruments E. Magnetic resonance imaging (MRI)-guided focused ultrasound

The nurse is performing an assessment for a patient with secondary dysmenorrhea. Which findings support the patient's diagnosis? Select all that apply. A. Nausea B. Fatigue C. Headache D. Weight gain E. Constipation F. Painful menses

A. Nausea B. Fatigue C. Headache F. Painful menses

The nurse is caring for a patient who has polycystic ovary syndrome (PCOS). When preparing to teach this patient, the nurse should know that which classic manifestation is associated with the severity of symptoms, including infertility? A. Obesity B. Hirsutism C. Amenorrhea D. Irregular menstrual periods

A. Obesity

The nurse is obtaining a history and performing an assessment of a patient with polycystic ovarian syndrome (PCOS). Which clinical manifestations does the nurse anticipate observing in this patient? Select all that apply. A. Obesity B. Hirsutism C. Amenorrhea D. Hypertension E. Endometriosis F. Irregular menstrual periods

A. Obesity B. Hirsutism C. Amenorrhea F. Irregular menstrual periods

A newly married couple is interested in using a combined oral contraceptive containing both estrogen and progesterone. What information should the nurse include when explaining about combined oral contraceptives to this couple? Select all that apply. A. Oral contraceptives increase risk of breast cancer. B. Oral contraceptives increase risk of ovarian cancer. C. Oral contraceptives decrease the risk of liver cancer. D. Oral contraceptives need to be taken after sexual intercourse. E. Oral contraceptives increase blood pressure and serum cholesterol.

A. Oral contraceptives increase risk of breast cancer. E. Oral contraceptives increase blood pressure and serum cholesterol.

The nurse is performing an assessment for a patient in menopause. What symptoms does the patient likely report having? Select all that apply. A. Osteoporosis B. Constipation C. Vision changes D. Loss of skin elasticity E. Hot flashes and irregular menses

A. Osteoporosis D. Loss of skin elasticity E. Hot flashes and irregular menses

When teaching a group of young women about pelvic inflammatory disease (PID), what information should the nurse include? Select all that apply. A. PID is associated with a higher risk of ectopic pregnancy. B. Old age and multiple sex partners are risk factors for PID. C. Causative organisms reach the pelvic organs through blood. D. PID is an infectious condition of the fallopian tubes, ovaries, and uterus. E. Causative organisms reach the pelvic organs through the cervix in an ascending manner.

A. PID is associated with a higher risk of ectopic pregnancy. E. Causative organisms reach the pelvic organs through the cervix in an ascending manner.

A registered nurse is evaluating the care plan drafted by a nurse for four patients in the health care unit. Which patient's care plan needs correction? A. Patient A B. Patient B C. Patient C D. Patient D

A. Patient A

The nurse is educating a patient about decreasing the risk of developing deep vein thrombosis (DVT). What should the nurse be sure to include when discussing this with the patient? Select all that apply A. Perform leg exercises B. Change position frequently C. Maintain high-Fowler's position D. Avoid pressure under the knees E. Massage legs when they get stiff in bed

A. Perform leg exercises B. Change position frequently D. Avoid pressure under the knees

A female patient is admitted to the nursing unit with dehydration related to frequent nausea and emesis. She was seen in the emergency department (ED) three weeks ago for a concussion and discharged home with instructions for physical and cognitive rest. Patient education and preparation should be done for which of the following tests? A. Pregnancy test B. Incentive spirometry C. 12-lead electrocardiogram (EKG) D. Magnetic resonance imaging (MRI) scan of the brain

A. Pregnancy test

A patient has been admitted for dilation and evacuation (D&E). What nursing interventions should the nurse perform for this patient? A. Prepare the patient both physically and emotionally for the procedure. B. Counsel the patient that she may fail to conceive in the future due to this procedure. C. Instruct the patient that postprocedure she has to avoid sexual intercourse for two months. D. Inform the patient that this procedure is associated with the possibility of multiple pregnancies in the future.

A. Prepare the patient both physically and emotionally for the procedure.

A female patient is admitted to the fertility clinic newly diagnosed with polycystic ovarian syndrome (PCOS). Which nursing action should be the priority? A. Provide emotional support for infertility. B. Address patient concerns about hirsutism. C. Explain why a lipid profile will be collected. D. Begin teaching about weight management.

A. Provide emotional support for infertility.

A couple married for two years has failed to conceive. What advice should the nurse give to the couple? Select all that apply. A. Provide information regarding physiology of reproduction and explain various factors which result in infertility. B. Instruct the couple that because they have failed to conceive within two years after their marriage, it will be difficult for them to conceive. C. Inform the couple that infertility management is very expensive and ask them to obtain insurance coverage before they begin routine testing. D. Inform the couple they should directly go for assisted reproductive technologies such as in vitro fertilization and zygote intrafallopian transfer. E. Encourage the couple to identify the psychological problems, emotional disturbances, social distress, and frustration and anger associated with infertility and to address these issues accordingly.

A. Provide information regarding physiology of reproduction and explain various factors which result in infertility. E. Encourage the couple to identify the psychological problems, emotional disturbances, social distress, and frustration and anger associated with infertility and to address these issues accordingly.

A female patient was admitted to the hospital after her mother found her sobbing in the bathroom, washing blood from her clothing and bandaging a laceration from a split eyebrow. Which health care team member would the nurse anticipate the health care provider to consult? Select all that apply. A. Psychiatrist B. Social worker C. Physical therapist D. Occupational therapist E. Speech and hearing specialist F. Sexual assault nurse examiner (SANE)

A. Psychiatrist B. Social worker F. Sexual assault nurse examiner (SANE)

The nurse is caring for a patient who has been sexually assaulted. What nursing actions are appropriate for this patient? Select all that apply. A. Refer to crisis center. B. Provide privacy and emotional support. C. Train her about self-defense techniques. D. Provide the primary care and admit the patient in hospital. E. Discuss the possibility of pregnancy and offer effective emergency contraceptive pills.

A. Refer to crisis center. B. Provide privacy and emotional support. E. Discuss the possibility of pregnancy and offer effective emergency contraceptive pills.

The nurse is giving discharge instructions to a woman that had an induced abortion. What should the nurse include in the education to avoid complications related to the procedure? Select all that apply A. Report fever B. Report feelings of sadness C. Report abnormal vaginal bleeding D. Report severe abdominal cramping E. Report any foul smelling discharge

A. Report fever C. Report abnormal vaginal bleeding D. Report severe abdominal cramping E. Report any foul smelling discharge

The nurse is educating a group of adolescent girls about cervical cancer. What should the nurse include in the discussion? Select all that apply. A. Smoking is a risk factor for cervical cancer. B. Limiting sexual activity is recommended during adolescence. C. Taking oral contraceptive pills lowers the risk of cervical cancer. D. Doing regular Pap tests is important to screen for cervical cancer. E. Using condoms provides protection if they have multiple sexual partners.

A. Smoking is a risk factor for cervical cancer. B. Limiting sexual activity is recommended during adolescence. D. Doing regular Pap tests is important to screen for cervical cancer.

The nurse is providing education to a group of perimenopausal women. Which herbs or supplements would the nurse include in a discussion regarding effective alternative therapies for menopausal symptoms? Select all that apply. A. Soy B. Garlic C. Ginkgo D. Vitamin A E. Black cohosh

A. Soy E. Black cohosh

A patient is determined to have a second-degree uterine prolapse. Which assessment finding by the nurse correlates with this diagnosis? A. The cervix is at the vaginal opening. B. The cervix is at lower part of the vagina. C. The vagina and rectum have no support. D. The uterus protrudes through the introitus.

A. The cervix is at the vaginal opening.

After assessing a pregnant patient, the nurse anticipates that the patient has a risk of spontaneous abortion. Which advice given by the nurse is beneficial for the patient? A. "You should move frequently." B. "You should avoid intercourse." C. "You should avoid high-fiber foods." D. "You should increase folic acid supplements."

B. "You should avoid intercourse."

Human chorionic gonadotropin is prescribed to an infertile patient. What explanation will the nurse provide when the patient asks why they will be taking this? A. To induce ovulation B. To promote the development of follicles C. To suppress the release of follicle-stimulating hormone D. To prevent the premature release of luteinizing hormone

A. To induce ovulation

While caring for a patient with irritability, abdominal bloating, breast discomfort, and edema, the nurse administers spironolactone. What rationale does the nurse give to the patient for administration of the medication? A. To reduce fluid retention B. To reduce cramping pain C. To improve negative mood D. To alleviate physiologic symptoms

A. To reduce fluid retention

A patient has been scheduled to receive external radiotherapy of the bladder. What instruction should the nurse give to this patient? A. Urinate before the treatment is initiated. B. Tell visitors to stay six feet away from the bed and not to visit as often. C. Drink adequate water so that the bladder is full before initiating therapy. D. Consult the primary health care provider if symptoms of enteritis or cystitis occur.

A. Urinate before the treatment is initiated.

The nurse is assisting the health care provider with a routine vaginal exam on a female patient. The patient has erythema of the vulva, and during the breast exam, scratches were noted. The patient is withdrawn and reluctant to answer many questions about her health history except to volunteer she is tired after attending a party the previous night. Which of the following is acceptable without patient consent? A. Using an unlubricated speculum B. Sending a cervical culture for gonorrhea C. Clipping a pubic hair sample to send to the lab D. Sending a blood specimen for a pregnancy test

A. Using an unlubricated speculum

A patient newly diagnosed with leiomyomas becomes very anxious regarding the diagnosis. What information should the nurse give to this patient to alleviate anxiety? Select all that apply. A. Uterine fibroids may result in abortion or infertility. B. Uterine fibroids are benign tumors with a good prognosis. C. Uterine fibroids are slow-growing malignant tumors with a good prognosis. D. Uterine fibroids are benign tumors but may undergo malignant transformation. E. Uterine fibroids are slow-growing benign tumors that undergo atrophy after menopause.

A. Uterine fibroids may result in abortion or infertility. B. Uterine fibroids are benign tumors with a good prognosis. E. Uterine fibroids are slow-growing benign tumors that undergo atrophy after menopause.

The nurse is providing education to a postmenopausal patient regarding nutritional therapy. What information provided by the nurse will have the best outcome? Select all that apply. A. Vitamin E helps to reduce hot flashes. B. Daily calorie intake should be 60 cal/kg of body weight. C. Calcium supplements must be taken two hours after meals. D. Adequate intake of calcium and vitamin D helps to maintain healthy bones. E. Women on estrogen replacement need a maximum of 1000 mg of calcium per day.

A. Vitamin E helps to reduce hot flashes. D. Adequate intake of calcium and vitamin D helps to maintain healthy bones.

A patient reports to the nurse that they have feelings of "being full quickly", weight gain, menstrual changes. The nurse assesses an increase in abdominal girth from a previous visit last month. What does the nurse infer from these findings? A. Vulvar cancer B. Cervical cancer C. Ovarian cancer D. Endometrial cancer

C. Ovarian cancer

The nurse collects a health history from a patient with a suspected malignancy. What finding is considered significant? A. Obesity since childhood B. Annual influenza vaccination C. Varicose veins from an early age D. History of human papillomavirus

D. History of human papillomavirus

A patient is scheduled to have a myomectomy. What statement made by the patient indicates to the nurse that the patient understands the procedure? A. "I am having an ovary removed" B. "I am having uterine fibroids removed" C. "I am having a fallopian tube removed" D. "I am having a portion of my vagina removed"

B. "I am having uterine fibroids removed"

The nurse is educating a teenage patient about risk factors for cancer of the reproductive system. Which patient statements demonstrate understanding of the education? Select all that apply. A. "I will avoid alcohol." B. "I will avoid smoking." C. "I will increase my intake of dietary fiber." D. "I will use condoms for sexual intercourse." E. "I will limit sexual activity in my adolescent years." F. "I will urinate as soon as sexual intercourse is over."

B. "I will avoid smoking." D. "I will use condoms for sexual intercourse." E. "I will limit sexual activity in my adolescent years."

A patient confides in the nurse that she has started experiencing dyspareunia and asks, "Is there anything I can do about this?" What is the nurse's best response? A. "No, it is part of the aging process." B. "Water-soluble vaginal lubricants may provide relief." C. "You need to be evaluated for a sexually transmitted infection (STI)." D. "You may have vaginal scar tissue that is producing the discomfort."

B. "Water-soluble vaginal lubricants may provide relief."

Along with the Papanicolaou (Pap) test, which test is used to screen for cervical cancer? A. CA-125 test B. Colposcopy C. Cervical biopsy D. Human papillomavirus (HPV) test

D. Human papillomavirus (HPV) test

A patient states, "I'm sure that I am suffering from premenstrual syndrome (PMS). How can I get my primary health care provider to take this seriously?" What is the nurse's best response? A. "Men are not usually sympathetic to PMS sufferers." B. "You should keep a daily record of the occurrence and severity of your symptoms for three months." C. "Because you feel certain you are right, you should just treat yourself with overthe- counter medications." D. "You are probably right. You should remind your primary health care provider of your symptoms every time you visit."

B. "You should keep a daily record of the occurrence and severity of your symptoms for three months."

The term "child sexual abuse" is used for children under what age? A. 12 years B. 14 years C. 18 years D. 21 years

B. 14 years

The nurse is assessing four patients receiving sertraline. Which patient may benefit from the administration of this medication? A. A patient with uterine fibroids and endometrial polyps B. A patient with migraine headache before menstruation C. A patient with abdominal pain radiating to the lower back D. A patient with candidiasis with thick curdlike vaginal discharge

B. A patient with migraine headache before menstruation

A patient reports radiating lower abdominal pain associated with nausea, diarrhea, and fatigue even on the fourth day of menstruation. Which is the best nursing intervention for this patient? A. Advise the patient to use superabsorbent tampons. B. Apply warm compresses to the lower abdomen and back. C. Encourage the patient to perform daily aerobic exercise. D. Advise the patient to eat a hot meal and wear warm clothes.

B. Apply warm compresses to the lower abdomen and back.

Which is an early clinical sign of cervical cancer? A. Pain B. Asymptomatic C. Heavy, frequent vaginal bleeding D. Dark, foul-smelling vaginal discharge

B. Asymptomatic

A patient is diagnosed with a vesicovaginal fistula and is to be discharged. What instructions should the nurse give to this patient? Select all that apply. A. Reduce fluid intake. B. Change perineal pads frequently. C. Take a warm sitz bath once a day. D. Cleanse the perineum every four hours. E. Perform Kegel exercises several times a day.

B. Change perineal pads frequently. D. Cleanse the perineum every four hours.

After assessing a patient with premenstrual syndrome (PMS), the nurse anticipates that the primary health care provider will prescribe ibuprofen to the patient. Which symptom of PMS does the nurse inform the patient that this will alleviate? A. Anxiety B. Cramping pain C. Fluid retention D. Negative mood

B. Cramping pain

The nurse administers mifepristone to the patient in the seventh week of pregnancy to induce abortion. Which medication would the nurse administer intravaginally to the patient after two days? A. Carboplast B. Misoprostol C. Methotrexate D. Dinoprostone

B. Misoprostol

A patient with premenstrual syndrome (PMS) approaches the nurse for advice on conservative ways of managing the condition. What should the nurse advise? Select all that apply. A. Drink coffee daily. B. Exercise on a regular basis. C. Practice relaxation techniques. D. Increase intake of refined carbohydrates. E. Increase consumption of pork, milk, and legumes.

B. Exercise on a regular basis. C. Practice relaxation techniques. E. Increase consumption of pork, milk, and legumes.

A patient at the clinic reports abdominal bloating, depression, and irritability related to her premenstrual syndrome. What education does the nurse provide? Select all that apply. A. Take diuretics B. Exercise regularly C. Take antidepressants D. Take antianxiety agents E. Increase pork, chicken, and milk intake

B. Exercise regularly E. Increase pork, chicken, and milk intake

A patient with cervical cancer asks the nurse about various treatment modalities. What information should the nurse provide to this patient? Select all that apply. A. Hormone-based chemotherapy regimens B. External radiotherapy or internal radiotherapy or both C. Surgery or radiation, or chemotherapy as single treatments based on patient's choice D. Management depends on stage of the tumor, patient's age, and general state of health E. Surgical procedures include hysterectomy and radical hysterectomy (involving adjacent structures)

B. External radiotherapy or internal radiotherapy or both D. Management depends on stage of the tumor, patient's age, and general state of health E. Surgical procedures include hysterectomy and radical hysterectomy (involving adjacent structures)

Recurrent vaginitis may be classified as severe when a patient experiences more than how many episodes per year? A. Two B. Four C. Five D. Six

B. Four

The nurse is preparing a patient for external pelvic radiation treatment. What nursing action is essential prior to this treatment? A. Assessing for enteritis B. Having the patient empty the bladder C. Avoiding activities that increase pelvic congestion D. Applying an abdominal binder to prevent distention

B. Having the patient empty the bladder

The nurse admits a female patient of childbearing age who reports severe abdominal pain, abnormal uterine bleeding, and constipation. For which diagnostic tests should the nurse anticipate preparing the patient? Select all that apply. A. Myomectomy B. Hysteroscopy C. Hysterectomy D. Pelvic exam and ultrasound E. Complete blood count (CBC) F. Uterine artery embolization (UAE)

B. Hysteroscopy D. Pelvic exam and ultrasound E. Complete blood count (CBC)

During which stage of cervical cancer is the cancer confined to the cervix? A. 0 B. I C. II D. III

B. I

The nurse is talking with a couple that are unable to have children. What information should the nurse include? Select all that apply. A. Tobacco and illicit drug use do not cause infertility. B. In certain cases, the cause for infertility may be unidentified. C. The cause for infertility may occur either in the male or the female. D. Assisted reproductive technologies (ARTs) can be used to bear children. E. Presence of infection such as cervicitis may cause infertility even if treated.

B. In certain cases, the cause for infertility may be unidentified. C. The cause for infertility may occur either in the male or the female. D. Assisted reproductive technologies (ARTs) can be used to bear children.

A young woman with polycystic ovary syndrome (PCOS) is on clomiphene therapy. Which is the rationale for use of this medication in this patient? A. Manage insulin resistance B. Induce ovulation C. Manage weight gain D. Reduce cardiovascular risk

B. Induce ovulation

A postmenopausal patient wishes to initiate hormone replacement therapy. What instructions should the nurse give to this patient? Select all that apply. A. Instruct the patient about the maximum effective dose. B. Inform the patient that estrogen and progestin use leads to fewer hip fractures. C. Inform the patient that estrogen and progestin use increases risk of stroke and emboli. D. Instruct the patient that estrogen alone preparations decrease the risk of hip fractures. E. Inform the patient that estrogen alone preparations increase breast and colorectal cancer.

B. Inform the patient that estrogen and progestin use leads to fewer hip fractures. C. Inform the patient that estrogen and progestin use increases risk of stroke and emboli. D. Instruct the patient that estrogen alone preparations decrease the risk of hip fractures.

Which condition is characterized as a benign, noncancerous, smooth muscle uterine tumor? A. Fistula B. Leiomyoma C. Endometriosis D. Ectopic pregnancy

B. Leiomyoma

A patient is concerned about the development of cervical cancer because her mother had it. What clinical manifestations does the nurse instruct the patient to immediately report to the primary health care provider? A. Bloating and difficulty in eating B. Leukorrhea and intermenstrual bleeding C. Irregular menstrual periods and amenorrhea D. Abnormal uterine bleeding and bladder discomfort

B. Leukorrhea and intermenstrual bleeding

A patient has a vulvectomy wound, and the nurse is concerned about prevention of fecal contamination of the wound. Which dietary intervention would best aid in the prevention of fecal contamination? A. High-fiber diet B. Low-residue diet C. Increased fat intake D. Increased dairy intake

B. Low-residue diet

A patient reports abnormal vaginal bleeding and wants to know what could be causing these symptoms since she never had them before. What is the best response by the nurse? Select all that apply. A. Oligomenorrhea is an absence of menstruation. B. Menorrhagia is excessive or prolonged duration of menstrual bleeding. C. Secondary amenorrhea is cessation of the menstrual cycle once it is established. D. Primary amenorrhea is failure of menstrual cycles to begin in a woman of 17 years of age. E. Primary amenorrhea is failure of menstrual cycles to begin in a woman of 14 years of age with presence of secondary sexual characteristics.

B. Menorrhagia is excessive or prolonged duration of menstrual bleeding. C. Secondary amenorrhea is cessation of the menstrual cycle once it is established. E. Primary amenorrhea is failure of menstrual cycles to begin in a woman of 14 years of age with presence of secondary sexual characteristics.

A patient seen in the clinic reports a fishy-smelling, thin, white, watery vaginal discharge and is diagnosed with bacterial vaginosis (BV). The patient reports an allergy to sulfa. Which medication does the nurse expect to administer? A. Doxycycline 100 mg PO BID for one week. B. Metronidazole 500 mg PO BID for one week. C. Penicillin G, 2 million units intramuscularly (IM) one time. D. Azithromycin 1 gram by mouth (PO) twice a day (BID) for two weeks.

B. Metronidazole 500 mg PO BID for one week.

A patient presents with primary dysmenorrhea. The nurse is likely to find which clinical presentations during the physical examination? Select all that apply. A. Unilateral pain B. Onset of pain 12-24 hours before menstruation C. Colicky lower abdominal pain radiating to the thighs D. Constant intense pain which lasts for more than two days E. Most severe pain on the first day which subsides within two days

B. Onset of pain 12-24 hours before menstruation C. Colicky lower abdominal pain radiating to the thighs E. Most severe pain on the first day which subsides within two days

The nurse is reviewing the medical reports of four patients with reproductive problems. Which patient does the nurse suspect to have cervical cancer? A. Patient 1 B. Patient 2 C. Patient 3 D. Patient 4

B. Patient 2

When educating a group of teenagers about premenstrual syndrome (PMS), what information should the nurse include? Select all that apply. A. Premenstrual symptoms are similar during each menstrual cycle. B. Premenstrual symptoms can be severe enough to impair interpersonal relationships. C. Premenstrual symptoms occur cyclically in the luteal phase just before menstruation. D. Premenstrual symptoms occur cyclically in the follicular phase just before menstruation. E. Premenstrual symptoms may vary, but breast discomfort is seen in all patients experiencing PMS.

B. Premenstrual symptoms can be severe enough to impair interpersonal relationships. C. Premenstrual symptoms occur cyclically in the luteal phase just before menstruation.

The nurse is working in the emergency department (ED) and caring for a woman admitted for reports of terrible nightmares and nausea accompanied by frequent diarrhea. She has a history of rape during a street mugging. Which of the following would most likely explain the patient's signs and symptoms? A. Contraction of H1N1 B. Rape trauma syndrome C. Experience of an additional rape D. Gastroesophageal reflux disease

B. Rape trauma syndrome

The nurse is preparing to administer medication for a patient who is experiencing premenstrual dysphoric disorder (PMDD). Which medication will the nurse anticipate administering? A. Natazia B. Sertraline C. Ibuprofen D. Methotrexate

B. Sertraline

A patient with a subdural hematoma is being admitted to the unit from the emergency department (ED). The ED nurse reports that there is a suspicion of sexual abuse. Given this information, what is the most likely reason for a subdural hematoma? A. Bleed from previous injury B. Shoving that resulted in a fall C. Arteriovenous (AV) malformation D. Family history of spontaneous bleeds

B. Shoving that resulted in a fall

The nurse is performing an educational session for a group of women regarding cervical cancer. Which risk factors for cervical cancer should the nurse include in the presentation? Select all that apply. A. Infertility B. Smoking C. Dysmenorrhea D. Caucasian race E. Chlamydia infection F. Low socioeconomic class

B. Smoking E. Chlamydia infection F. Low socioeconomic class

A patient has a condition as depicted in the image. Which clinical manifestation does the nurse expect? A. Dyspareunia B. Difficulty voiding C. Protruding cervix D. Incomplete defecation

D. Incomplete defecation

What advice should the nurse give to postmenopausal patients about sexuality? Select all that apply. A. Inform the patient that femininity and libido disappear with menopause. B. Teach the patient that the use of moisturizing soaps and body lotions may help improve dry skin. C. Inform the patient that water-soluble lubricants are effective for atrophic changes in the vagina. D. Inform the patient that cessation of menstruation should be equated with cessation of sexual desire. E. Inform the patient that vaginal atrophic changes are normal after menopause and often are permanent.

B. Teach the patient that the use of moisturizing soaps and body lotions may help improve dry skin. C. Inform the patient that water-soluble lubricants are effective for atrophic changes in the vagina.

A patient approaches the nurse expressing concerns about her impending menopause. What information should the nurse give to this patient to alleviate anxiety? Select all that apply. A. Menopause is a sudden event occurring in life. B. The age of menopause ranges from 44 to 55 years. C. Cigarette smoking may lead to early menopause. D. The age of menopause is affected by number of pregnancies. E. Menopause usually occurs as a result of illness, chemotherapy, or radiotherapy.

B. The age of menopause ranges from 44 to 55 years. C. Cigarette smoking may lead to early menopause.

A patient has been prescribed tranexamic acid for Heavy Menstrual Bleeding (HMB). What instructions should the nurse give to the patient? Select all that apply. A. The drug cures the HMB. B. The drug only addresses blood loss. C. The drug may cause clots in the blood. D. The drug may also be used for body aches. E. The drug acts by facilitating the action of platelets.

B. The drug only addresses blood loss. C. The drug may cause clots in the blood.

Which diagnostic test does the nurse question when it is prescribed for a patient diagnosed with pelvic inflammatory disease (PID)? A. Rapid plasma reagin (RPR) B. Throat culture for streptococcus A C. Vaginal culture for Neisseria gonorrhea D. Complete blood count (CBC) with differential

B. Throat culture for streptococcus A

The nurse administers ibuprofen to a patient with premenstrual syndrome. What information does the nurse include when explaining the reasons for this prescription? A. To reduce anxiety B. To reduce cramping pain C. To reduce mood swings D. To reduce appetite

B. To reduce cramping pain

The nurse is providing care to a patient with symptoms of perimenopause. Which findings does the nurse anticipate when performing the health history and physical assessment for this patient? Select all that apply. A. Breast firmness B. Urge incontinence C. Cessation of menses D. Uterine atrophy E. Hot flashes

B. Urge incontinence D. Uterine atrophy E. Hot flashes

A postmenopausal woman states that she has painful sexual intercourse. What advice should the nurse give to this patient? Select all that apply. A. Avoid sexual intercourse. B. Use local hormonal creams. C. Use systemic hormone therapy. D. Ask the male partner to use condoms. E. Use lubricants during sexual intercourse.

B. Use local hormonal creams. C. Use systemic hormone therapy. E. Use lubricants during sexual intercourse.

The nurse is caring for a patient who has had a hysterectomy. Which nursing action is useful in preventing strain on the suture line? A. Ambulating the patient B. Using a indwelling catheter C. Restricting foods and fluids D. Avoiding the high-Fowler's position

B. Using a indwelling catheter

The nurse is performing an assessment on an older adult female patient. Which symptom does the nurse teach her to report to the primary health care provider? A. Dyspareunia B. Vaginal bleeding C. Skin becomes thinner D. Breasts become smaller

B. Vaginal bleeding

Which of the following factors may increase the severity of injuries a woman experiences following a sexual assault? Select all that apply. A. Location of the assault B. Woman's age at time of assault C. Season in which assault occurred D. Use of a weapon during the assault E. Type of clothing the woman was wearing F. The perpetrator being known to the victim

B. Woman's age at time of assault D. Use of a weapon during the assault F. The perpetrator being known to the victim

A patient has undergone induced abortion. The nurse is evaluating the patient after teaching about necessary interventions to avoid complications. Which statement made by the patient indicates effective learning? A. "I should perform vaginal douching." B. "I should avoid oral contraceptive pills." C. "I should avoid intercourse for two weeks." D. "I should perform exercise for one hour every day."

C. "I should avoid intercourse for two weeks."

The nurse is educating a patient about care after a hysterectomy. Which statement indicates to the nurse that the patient needs further education? A. "I will avoid dancing for several months." B. "I will avoid swimming for 8 weeks." C. "I will avoid sexual intercourse for 2 weeks." D. "I will avoid heavy lifting for 2 months."

C. "I will avoid sexual intercourse for 2 weeks."

A nurse in a family planning clinic is completing the admission intake on a woman who has decided to get an abortion for an unwanted pregnancy. The patient tells the nurse that she is struggling with her decision because she is concerned that God will punish her for this decision and that she will not be able to reconcile this decision as she continues with life. What is the most appropriate response from the nurse? A. "God is forgiving; forgiveness will be given and your spirit will heal over time." B. "I understand why you feel that way, but this is the best decision at this point." C. "Would you like to speak with someone about these concerns before the procedure?" D. "Spirituality concerns should have been considered before scheduling of the appointment."

C. "Would you like to speak with someone about these concerns before the procedure?"

Which instruction should the nurse provide regarding clomiphene, prescribed for a patient with ovarian cysts? A. "You should contact the primary health care provider if you gain weight." B. "You should contact the primary health care provider if you get irregular menses." C. "You should contact the primary health care provider if lower abdominal pain occurs." D. "You should contact the primary health care provider if you find abnormal hair on your body."

C. "You should contact the primary health care provider if lower abdominal pain occurs."

A patient has pelvic organ prolapse and is instructed to perform Kegel exercises. What does the nurse instruct the patient about Kegel exercises for an effective outcome? A. "You should perform exercise once a day." B. "You should avoid voiding before performing the exercises." C. "You should pull in as if you are trying to stop the urine flow." D. "You should breathe continuously while performing the exercises."

C. "You should pull in as if you are trying to stop the urine flow."

The nurse is educating a postmenopausal woman who is not receiving hormone replacement therapy (HRT) about calcium supplementation. How many milligrams (mg) per day is the recommended dose? A. 500 mg B. 1,000 mg C. 1,500 mg D. 2,000 mg

C. 1,500 mg

Spontaneous abortion is the term used to describe the natural loss of a pregnancy prior to how many weeks of gestation? A. 10 B. 12 C. 20 D. 25

C. 20

The risk of infertility increases in a woman after what age? A. 20 B. 30 C. 40 D. 50

C. 40

Which patient will the nurse educate about oral contraceptives? A. A 17-year-old patient with vaginal discharge that smells fishy B. A 34-year-old patient with implantation of a fetus in her ovaries C. A 46-year-old patient with irregular menses for the past two years D. A 21-year-old patient with unknown abdominal bleeding and pain

C. A 46-year-old patient with irregular menses for the past two years

A pregnant female is experiencing amenorrhea, morning sickness, and breast tenderness. In the ninth week after her last menstrual period she is rushed to the hospital with severe left shoulder pain, blood pressure of 90/60 mm Hg, and heart rate of 112 beats/minute. What is the best diagnostic test to determine the cause of her problem? A. Serum hemoglobin B. 12-lead electrocardiogram C. A transvaginal ultrasound D. Serial β-human chorionic gonadotropin levels

C. A transvaginal ultrasound

The nurse is educating a patient regarding a new medication regimen that may lead to amenorrhea. Which medication will the nurse discuss with this patient? A. Clonidine B. Raloxifene C. Amitriptyline D. Norethindrone

C. Amitriptyline

A patient has a speculum examination that reveals bright cherry-red pedunculated lesions on the cervix. Which condition is associated with these assessment findings? A. Leiomyomas B. Cervical cancer C. Cervical polyps D. Endometrial cancer

C. Cervical polyps

A patient is diagnosed with cancer that has spread beyond the cervix. For which type of therapy should the nurse prepare the patient? A. Cautery B. Cryosurgery C. Cisplatin-based chemotherapy D. Tamoxifen and progesterone therapy

C. Cisplatin-based chemotherapy

The nurse is preparing a nutritional plan for a postmenopausal woman. What does the nurse include in the patient's dietary plan? Select all that apply. A. A low-carbohydrate diet B. A reduction in vitamin D C. Daily intake of vitamin E D. Adequate intake of calcium E. Adequate intake of sunflower seeds

C. Daily intake of vitamin E D. Adequate intake of calcium E. Adequate intake of sunflower seeds

Because of the risks associated with hormone therapy (HT), a female patient does not want to take HT and asks the nurse how she can tolerate the perimenopausal symptoms of hot flashes and sweating at night. What is the best response by the nurse? A. Increase warmth to avoid chills. B. Maintain good nutrition to avoid osteoporosis. C. Decrease heat production and increase heat loss. D. Take vitamin B complex and use vaginal lubrication.

C. Decrease heat production and increase heat loss.

The nurse finds that a patient reporting infertility has polycystic ovary syndrome (PCOS) that has been left untreated. About which complications does the nurse anticipate educating the patient? Select all that apply. A. Leukorrhea B. Cervical stenosis C. Diabetes mellitus D. Cardiovascular disease E. Hematogenous metastases

C. Diabetes mellitus D. Cardiovascular disease

A nurse is caring for a 36-year-old woman who has induced menopause. The nurse informs the patient that induced menopause can be attributed to which factors? Select all that apply. A. Age B. Diet C. Drugs D. Surgery E. Chemotherapy F. Radiation therapy

C. Drugs D. Surgery E. Chemotherapy F. Radiation therapy

Which condition does the nurse suspect in a patient with a history of hereditary nonpolyposis colorectal cancer (HNPCC) who reports abnormal uterine bleeding? A. Leiomyomas B. Ovarian cancer C. Endometrial cancer D. Polycystic ovary syndrome

C. Endometrial cancer

Which is the biggest risk factor for endometrial cancer? A. Obesity B. Pregnancy C. Estrogen exposure D. Use of oral contraceptives

C. Estrogen exposure

A woman is scheduled for an induced abortion on her 40th day of gestation. What instructions should the nurse give to the patient about the procedure? Select all that apply. A. Contraception can be started a month after the procedure. B. The abortion drugs must be given within the first 59 days of pregnancy. C. Fever and foul-smelling drainage postprocedure may indicate complications. D. Abnormal vaginal bleeding and severe abdominal cramping need to be reported to the health care provider. E. Intercourse and vaginal insertions should be avoided until postprocedure reexamination, which needs to be in two weeks.

C. Fever and foul-smelling drainage postprocedure may indicate complications. D. Abnormal vaginal bleeding and severe abdominal cramping need to be reported to the health care provider. E. Intercourse and vaginal insertions should be avoided until postprocedure reexamination, which needs to be in two weeks.

A patient suspects she is having symptoms related to menopause. Which diagnostic study will the nurse tell the patient is used to confirm the diagnosis of menopause? A. Ultrasound B. Endometrial biopsy C. Follicle-stimulating hormone (FSH) D. Human chorionic gonadotropin (HCG)

C. Follicle-stimulating hormone (FSH)

A patient arrives at the clinic to have a Papanicolaou (Pap) test done. What information should the nurse give to this patient? Select all that apply. A. Get this test done annually until the age of 65 years. B. Get this test done three times a year until the age of 65 years. C. Get this test done once in three years until the age of 65 years. D. This test is not required for women who have undergone hysterectomy. E. After 65 years, this test is not required if two or three consecutive negative Pap tests are received in two years.

C. Get this test done once in three years until the age of 65 years. D. This test is not required for women who have undergone hysterectomy. E. After 65 years, this test is not required if two or three consecutive negative Pap tests are received in two years.

The nurse is providing care for a patient who is experiencing irregular vaginal bleeding. How does the nurse document this occurrence in the patient's medical record? A. Amenorrhea B. Oligomenorrhea C. Intermenstrual bleeding D. Heavy Menstrual Bleeding (HMB)

C. Intermenstrual bleeding

A patient reports discomfort in the rectal and abdominal area and also having uterine bleeding not related to menstruation. The ultrasound reveals an enlarged uterus with nodular masses. What medication does the nurse anticipate to be administered to this patient? A. Cisplatin B. Flutamide C. Leuprolide D. Clomiphene

C. Leuprolide

A patient has been diagnosed with pelvic inflammatory disease (PID). What is a priority topic that the nurse should discuss with the patient? A. The importance of contraception B. Benefits of hormone therapy (HT) C. Manifestations of further infection D. The importance of maintaining hygiene

C. Manifestations of further infection

A patient with polycystic ovary syndrome (PCOS) is being treated to restore ovulation. What medication does the nurse administer to the patient? A. Flutamide B. Megestrol C. Metformin D. Clomiphene

C. Metformin

The nurse is caring for a patient who has an unruptured ectopic pregnancy located in the fallopian tube. What treatment option does the nurse anticipate administering? A. Leuprolide B. Nortriptyline C. Methotrexate D. Metronidazole

C. Methotrexate

A patient with uterine fibroids causing Heavy Menstrual Bleeding (HMB) informs the nurse that she wants to become pregnant. About what treatment will the nurse educate the patient that will have the best outcome? A. Cryotherapy B. Hysterectomy C. Myomectomy D. Microwave energy

C. Myomectomy

A patient reports back pain after a hysterectomy, and the nurse observes that urine output is less than 30 mL/hr. What is the priority intervention provided by the nurse? A. Administering analgesics B. Monitoring other signs and symptoms C. Notifying the primary health care provider D. Documenting the condition as normal observation

C. Notifying the primary health care provider

A patient expresses concern over her risk factors for developing ovarian cancer since her mother and sister died from the disease. What should the nurse include when teaching about early detection of ovarian cancer? A. Report any pelvic or vaginal bleeding soon B. Use estrogen with progestin for menopause C. Obtain annual bimanual pelvic examinations D. Receive a preventive bilateral oophorectomy

C. Obtain annual bimanual pelvic examinations

A nurse is educating a patient on abnormal uterine bleeding. The nurse should encourage the patient to report which symptoms to her healthcare provider? Select all that apply. A. Insomnia B. Weight gain C. Passing clots D. Excessive bleeding E. Spotting between regular menstrual cycles F. Unusually long duration of menstrual cycles

C. Passing clots D. Excessive bleeding F. Unusually long duration of menstrual cycles

Menopause is the result of a decrease in which hormone? A. Estrogen B. Progesterone C. Prostaglandin D. Human chorionic gonadotropin (HCG)

C. Prostaglandin

Primary dysmenorrhea is most commonly caused by overproduction of which hormone? A. Estrogen B. Progesterone C. Prostaglandin D. Human chorionic gonadotropin (HCG)

C. Prostaglandin

A female patient reports severe back pain and abdominal cramping during her menstrual cycle, and the nurse educates the patient about taking nonsteroidal antiinflammatory drugs (NSAIDS) and using heat to relieve her discomfort. What explanation does the nurse give for how NSAIDs offer relief from this type of pain? A. Progesterone stimulates an increase in the uterine pain receptors. B. Increased estrogen results in a decrease in prostaglandin production. C. Prostaglandin production increases due to estrogen and progesterone. D. Prostaglandin production is below normal, triggering cramping in the uterus.

C. Prostaglandin production increases due to estrogen and progesterone.

The nurse is caring for a patient who is postoperative after undergoing a vulvectomy. What is the priority nursing action to prevent wound contamination? A. Administering analgesics B. Using indwelling catheter C. Providing low residue diet D. Administering anticoagulants

C. Providing low residue diet

A patient is scheduled to have a surgical procedure involving dissection of lymph nodes in the pelvis. About what surgical procedure should the nurse educate the patient? A. Vulvectomy B. Vaginectomy C. Radical hysterectomy D. Vaginal hysterectomy

C. Radical hysterectomy

A patient that left a tampon in for several days is suspected of having developed toxic shock syndrome. What does the nurse recognize are clinical manifestations of this syndrome? A. Hypotension B. Hemorrhage C. Rapid onset of high fever D. Sudden sharp abdominal pain

C. Rapid onset of high fever

A patient with primary dysmenorrhea inquires as to what interventions may be used in order to relieve the discomfort. What is the best response by the nurse? Select all that apply. A. Steroids B. Hysterectomy C. Regular exercises D. Nonsteroidal antiinflammatory drugs E. Application of heat to lower abdomen and back

C. Regular exercises D. Nonsteroidal antiinflammatory drugs E. Application of heat to lower abdomen and back

A patient is scheduled to have a surgical procedure to remove a fallopian tube after an ectopic pregnancy. What procedure should the nurse ensure is scheduled on the consent? A. Vulvectomy B. Hysterectomy C. Salpingectomy D. Oophorectomy

C. Salpingectomy

The nurse is providing care to a patient who has been admitted for surgical removal of the fallopian tubes. How does the nurse document this surgical procedure in the patient's medical record? A. Hysterectomy B. Myomectomy C. Salpingectomy D. Oophorectomy

C. Salpingectomy

A college student accompanied by a roommate presents to the emergency department (ED) to seek treatment for worsening depression. What further assessment from the nurse should be considered as a cause of the depression? Select all that apply. A. Conflicts with roommate B. Week-long sinus infection C. Sexual assault on campus D. Difficulty in college courses E. Family history of depression

C. Sexual assault on campus D. Difficulty in college courses E. Family history of depression

The nurse is caring for a patient with a diagnosis of cervical cancer spreading to the pelvic wall and lower vagina. Which advanced stage of cervical cancer does the nurse suspect in this patient? A. Stage I B. Stage II C. Stage III D. Stage IV

C. Stage III

A patient has a third-degree uterine prolapse but denies observing anything unusual. The patient's husband recently passed away from pancreatic cancer and was cared for at home by the patient. What are the most plausible reasons the nurse identifies for this lack of self-awareness? Select all that apply. A. The cervix was only at the vaginal opening. B. The patient didn't attend to hygiene of the urogenital area. C. The patient was overwhelmed by caring for her husband. D. The cervix was only resting in the lower part of the vagina. E. The patient was embarrassed about not having noticed the prolapsed uterus.

C. The patient was overwhelmed by caring for her husband. E. The patient was embarrassed about not having noticed the prolapsed uterus.

A patient with excessive bleeding for more than a week is on tranexamic acid therapy. Which outcome in the patient does the nurse recognize indicates effective treatment? A. The patient will not experience anxiety. B. The patient will not experience migraine headache. C. The patient will not experience heavy menstrual bleeding. D. The patient will not experience bacterial and fungal infection. The nurse is reviewing the medical history of few patients in the unit.

C. The patient will not experience heavy menstrual bleeding.

A couple who failed to conceive under infertility management has been asked to go for in vitro fertilization (IVF). When explaining the procedure, what information should the nurse include? Select all that apply. A. The procedure requires two to three hours. B. The procedure cannot be done if the partner has low sperm count. C. This procedure is done for patients with tubal obstruction and diminished sperm count. D. This procedure is financially costly, but a single attempt provides successful implantation. E. With this procedure, the embryo develops outside the body and is later transplanted into the patient's uterus.

C. This procedure is done for patients with tubal obstruction and diminished sperm count. E. With this procedure, the embryo develops outside the body and is later transplanted into the patient's uterus.

A patient with Heavy Menstrual Bleeding (HMB) is concerned about her condition. When explaining HMB to this patient to alleviate her anxiety, what information should the nurse include? Select all that apply. A. Ovulatory cycles are commonly associated with HMB. B. Unopposed progesterone action on endometrium results in HMB. C. Uterine fibroid and endometrial polyps are commonly associated with HMB. D. Menstrual bleeding either lasts more than seven days, amounts to more than 80 mL, or both. E. Menstrual bleeding either lasts for more than seven days or amounts to more than 80 mL, but never both.

C. Uterine fibroid and endometrial polyps are commonly associated with HMB. D. Menstrual bleeding either lasts more than seven days, amounts to more than 80 mL, or both.

The sexual assault nurse examiner (SANE) has been asked to facilitate a college campus orientation breakout session. Which item would the SANE cover during this breakout session? A. Do not leave your laptop open and unattended. B. Exercise daily to promote blood flow to the brain. C. Yell "Fire" if you are attacked, and run toward a lit area. D. Eat protein-rich snacks and vegetables during exam week.

C. Yell "Fire" if you are attacked, and run toward a lit area.

The primary health care provider has prescribed metronidazole for a woman diagnosed with trichomoniasis. Which statement should be included in the nurse's instructions? A. "It will turn your urine orange." B. "Alcohol does not need to be avoided." C. "This medication may produce drowsiness." D. "Both partners must be treated with the medication."

D. "Both partners must be treated with the medication."

The nurse is educating a patient with abnormal uterine bleeding. Which statement made by the patient indicates the needs for further instruction? A. "I should regularly change my tampon." B. "I should record the degree of pad saturation daily." C. "I should get my blood pressure checked regularly." D. "I should apply heat on my lower back and abdomen."

D. "I should apply heat on my lower back and abdomen."

A nurse is educating a patient with a diagnosis of menopause who is not receiving hormone replacement therapy about strategies to prevent or reduce the risk of osteoporosis. Which patient statement is most important for the nurse to determine that the education is understood? A. "Exercise will keep me and my bones strong." B. "I will go outside to make sure I get enough vitamin D." C. "Good nutrition is important to reduce my risk of osteoporosis." D. "I should have an intake of at least 1,500 mg of calcium every day."

D. "I should have an intake of at least 1,500 mg of calcium every day."

A patient with premenstrual syndrome (PMS) states, "My PMS symptoms get so bad sometimes. I feel like my boyfriend thinks it is all in my head." What is the most therapeutic response from the nurse? A. "PMS symptoms are different for everyone." B. "I can totally relate. You shouldn't worry about what your boyfriend thinks." C. "There are a lot of different medications you can take to treat your symptoms." D. "PMS symptoms are physiological. Let's talk about different ways you can manage your symptoms."

D. "PMS symptoms are physiological. Let's talk about different ways you can manage your symptoms."

A patient has a vesicovaginal fistula and undergoes colporrhaphy to prevent further complications. What instruction should the nurse provide to the patient after the procedure? A. "You should avoid taking stool softeners." B. "You should reduce fluid intake throughout the day." C. "You should avoid taking a warm sitz bath frequently." D. "You should ensure that a catheter is in place for 10 days."

D. "You should ensure that a catheter is in place for 10 days."

A patient who is postmenopausal comes to the clinic reporting unexpected vaginal bleeding. What should the nurse tell the patient about diagnosing the cause of this bleeding? A. "It is probably only the end of menopause." B. "You will need a hysterectomy to treat this bleeding." C. "You will need a Pap smear to see if you have endometrial cancer." D. "You will need an endometrial biopsy to determine the cause of bleeding."

D. "You will need an endometrial biopsy to determine the cause of bleeding."

The nurse is providing an educational program to a group of young women about the importance of Papanicolaou (Pap) testing for cervical cancer. Which information should the nurse include? A. Pap tests are 100 percent accurate in screening for cervical cell abnormalities. B. A Pap test should be conducted in women who have had a total hysterectomy. C. Regular Pap testing should begin at the age the woman becomes sexually active. D. A Pap test should be conducted every 3 years in women aged 21 to 29 years.

D. A Pap test should be conducted every 3 years in women aged 21 to 29 years.

An older adult female patient taking hormone replacement therapy (HRT) is admitted to the unit with unexplained weight loss and ascites of her abdomen. The health care provider drains 500 mL of ascites fluid from the abdominal cavity using ultrasound-guided aspiration. What assessment questions should the nurse include in the documentation? Select all that apply. A. Has the patient ever had gallstones? B. When was the patient's last physical exam? C. Did the patient have her appendix removed? D. At what age did the patient begin menstruation? E. What type of diet does the patient follow at home? F. Does the patient have a family history of breast cancer?

D. At what age did the patient begin menstruation? E. What type of diet does the patient follow at home? F. Does the patient have a family history of breast cancer?

A patient has a history of familial sexual abuse and was the victim of a sexual assault three weeks prior. This week, the patient misses an appointment. Which of the following is the priority nursing intervention? A. Ask the health care provider how to handle this situation. B. Call the patient during break to offer verbal support by phone. C. Ensure the patient is scheduled for an appointment the following week. D. Call the patient expediently to assess why they missed the appointment.

D. Call the patient expediently to assess why they missed the appointment.

A patient is diagnosed with stage III cervical cancer. Which is the most beneficial treatment that the nurse anticipates to be prepared for the patient? A. Cryosurgery B. Cervical conization C. Radical hysterectomy D. Cisplatin-based chemotherapy

D. Cisplatin-based chemotherapy

Upon assessment, the nurse suspects a patient on a medication therapy for polycystic ovary syndrome (PCOS) may be pregnant. Which medication does the nurse determine may have contributed to the pregnancy? A. Cervarix B. Flutamide C. Leuprolide D. Clomiphene

D. Clomiphene

A known sex worker is brought into the emergency department (ED). She had been working and arrived with facial trauma including a laceration to the lip and eyebrow, and swelling of the right eye. What is the most appropriate nursing action? A. Cleanse and treat the facial injuries. B. Obtain fresh clothing and discard clothing she is wearing. C. Call the patient's boyfriend to transport her upon discharge. D. Consult sexual assault nurse examiner (SANE) for rape examination.

D. Consult sexual assault nurse examiner (SANE) for rape examination.

The nurse is preparing to provide teaching to a patient who has been diagnosed with endometrial cancer. Which information does the nurse include in the teaching plan? A. Metastasis is very rare. B. Pain occurs at the early stages of the disease. C. Endometrial cancer can be cured with partial hysterectomy. D. During distant metastasis, the lungs, bones, and brain are involved.

D. During distant metastasis, the lungs, bones, and brain are involved.

A patient had a surgical repair of a fistula. What education should the nurse provide to the patient to avoid complications related to the surgical procedure? A. Douche daily to prevent postoperative infection B. Remove and cleanse her pessary on a daily basis C. Resume normal activity to prevent adhesion formation D. Ensure that she does not place stress on the repaired area

D. Ensure that she does not place stress on the repaired area

A patient informs the nurse that she is having heavy menstrual cycles and also would like to avoid pregnancy at this time. What medication does the nurse anticipate educating the patient about? A. Sertraline B. Paroxetine C. Alendronate D. Estradiol valerate

D. Estradiol valerate

The nurse is providing care to a female patient that experienced a sexual assault. What is the priority nursing action for this patient? A. Administering a pregnancy test B. Close monitoring of the patient's vital signs C. Ensuring the patient is left alone when possible D. Informing the patient about possible financial support

D. Informing the patient about possible financial support

A patient is concerned regarding some of the symptoms being experienced after menopause. What information given by the nurse would explain this process? A. This condition will cause libido to disappear. B. This condition will cause femininity to disappear. C. It is a condition in which increased menstrual bleeding occurs. D. It is a condition in which atrophic changes in the reproductive tissues are observed.

D. It is a condition in which atrophic changes in the reproductive tissues are observed.

A patient is diagnosed with an unruptured ectopic pregnancy. What medication does the nurse anticipate educating the patient about to treat this condition? A. Tamoxifen B. Leucovorin C. Gemcitabine D. Methotrexate

D. Methotrexate

Which is the most common noninvasive modality of treatment for a leiomyoma? A. Hysterectomy B. Oophorectomy C. Radiation therapy D. Oral contraceptive pill (OCP)

D. Oral contraceptive pill (OCP)

The nurse is reviewing medication charts of four patients. About which patient's treatment should the nurse question the primary health care provider? A. Patient A B. Patient B C. Patient C D. Patient D

D. Patient D

A patient is being evaluated for dysmenorrhea. The healthcare provider just finished a complete health history. Which action does the nurse anticipate the healthcare provider will perform next? A. Lab work B. Ultrasound C. Pregnancy test D. Pelvic examination

D. Pelvic examination

The nurse is caring for a postoperative ovarian cancer patient the day after she had a tumor debulking. The patient is crying and refusing to allow her husband of 25 years to visit. What is the most likely reason for the patient's refusal to allow her husband to visit? A. Experiencing too much abdominal pain for visitors B. Emotional and overly tired due to a noisy care environment C. Concerned about privacy when the nurse performs the dressing change D. Perceived perception of the husband's feelings about this type of surgery

D. Perceived perception of the husband's feelings about this type of surgery

What is the term for multiple small ovarian follicles that are produced as a result of ovulatory dysfunction? A. Ovarian cysts B. Ovarian cancer C. Cervical polyps D. Polycystic ovarian syndrome (PCOS)

D. Polycystic ovarian syndrome (PCOS)

A patient reports the absence of menstruation, abnormal growth of hair of the body, weight gain, and infertility problems. What does the nurse infer from these clinical manifestations? A. Leiomyomas B. Cervical polyps C. Cervical cancer D. Polycystic ovary syndrome

D. Polycystic ovary syndrome

Which term is used to describe premenstrual syndrome (PMS) associated with severe mood changes? A. Menarche B. Depression C. Perimenopause D. Premenstrual dysphoric disorder (PMDD)

D. Premenstrual dysphoric disorder (PMDD)

A patient has a diagnosis of endometriosis after having symptoms for several years and not knowing what the problem was. What nursing action is appropriate for this patient? A. Reassure the patient that it is not a life-threatening condition, but a hysterectomy will be necessary. B. Explain to the patient that weight management and exercises are important components of treatment. C. Inform the patient that it is a very complicated disease, and she should be prepared for vigorous medical and surgical management. D. Reassure the patient that it is not a life-threatening condition, but she should be prepared for a conservative and progressive treatment approach.

D. Reassure the patient that it is not a life-threatening condition, but she should be prepared for a conservative and progressive treatment approach.

A patient reports cessation of her menstrual cycle to the nurse. Which condition does the nurse suspect in the patient after learning that the patient had menarche 15 years ago? A. Endometriosis B. Oligomenorrhea C. Primary amenorrhea D. Secondary amenorrhea

D. Secondary amenorrhea

A patient with total cholesterol of 210 mg/dL and cessation of menstruation one year ago reports easy fatigue, generalized weakness, joint pain, and night sweats. Which treatment strategy that may provide comfort will nurse educate the patient about? A. Hormonal therapy with estradiol B. Tricyclic antidepressants with spironolactone C. Nonsteroidal antiinflammatory agents with danazol D. Selective estrogen receptor modulators with risedronate

D. Selective estrogen receptor modulators with risedronate

A patient diagnosed with polycystic ovarian syndrome (PCOS) is experiencing hirsutism. About which medication does the nurse anticipate educating the patient? A. Flutamide B. Leuprolide C. Clomiphene D. Spironolactone

D. Spironolactone

The nurse is assessing a patient with polycystic ovary syndrome who has excessive body hair. Which medication does the nurse anticipate to be most beneficial for the patient? A. Orlistat B. Metformin C. Clomiphene D. Spironolactone

D. Spironolactone

The nurse is caring for a patient with polycystic ovarian syndrome. What nursing interventions are appropriate for this patient? A. Advise absolute bed rest. B. Instruct to take diet rich in carbohydrates and fat. C. Explain the advantages of early surgical intervention. D. Suggest use of a depilating agent or electrolysis to remove unwanted hair.

D. Suggest use of a depilating agent or electrolysis to remove unwanted hair.

A patient is diagnosed with endometriosis after having pain for many years. After having 2 children via in vitro, she is seeking a cure for this problem. What treatment should the nurse educate the patient regarding? A. Danazol B. Leuprolide C. Nonsteroidal antiinflammatory drugs D. Surgical removal of endometrial implants

D. Surgical removal of endometrial implants

A patient with newly diagnosed ovarian cancer states to the nurse, "I don't understand how the cancer spread so fast." What is the best response by the nurse? A. Ovarian cancer is symptom free. B. The ovaries are highly vascular organs. C. Cell division in ovarian cancer is rapid and uninhibited. D. The pelvic lymphatics and blood vessels are intermingled.

D. The pelvic lymphatics and blood vessels are intermingled.

A patient diagnosed with leiomyomas asks the nurse why she is having discomfort in the lower abdominal area. What is the best response by the nurse? A. There is twisting of the tumor pedicle. B. There is a lack of blood flow to the lower abdomen. C. Blood vessels are being compressed by the tumors. D. There is pressure on surrounding organs from the leiomyomas.

D. There is pressure on surrounding organs from the leiomyomas.

The nurse is caring for a patient with pelvic inflammatory disease. The nurse knows that positioning the patient into supine position with the head of the bed to 30 degrees is known to do what? A. To promote circulation B. To prevent dehydration C. To reduce pelvic inflammation D. To promote drainage of the pelvic cavity

D. To promote drainage of the pelvic cavity

The nurse is educating an adolescent female about the use of tampons. Which condition will the nurse inform the patient can result from the prolonged use of superabsorbent tampons? A. Dyspareunia B. Dysmenorrhea C. Abnormal uterine bleeding D. Toxic shock syndrome (TSS)

D. Toxic shock syndrome (TSS)

The nurse is providing care to a patient with frothy greenish and grey vaginal discharge. A pelvic examination reveals hemorrhagic spots on the cervix and vaginal walls. On the basis of these assessment data, which diagnosis does the nurse anticipate? A. Cervicitis B. Bacterial vaginosis C. Vulvovaginal candidiasis D. Trichomonas vaginitis infection

D. Trichomonas vaginitis infection

The nurse at a women's clinic is providing education to a woman with a history of a cystocele. Which symptom does the nurse include as a reason to contact the primary health care provider? A. Backache B. Constipation C. Urinary stress incontinence D. Urinary frequency and dysuria

D. Urinary frequency and dysuria