Chapter 71: Care of Pt with Gynecological Problems EAQ

A patient underwent a total abdominal hysterectomy. Which patient activity would lead to a complication after surgery? A. Lifting an object of 4 lbs B. Sitting for 3 hours at a time C. Gradually increasing walking D. Climbing stairs 2 times daily

B. Sitting for 3 hours at a time

What action does the RN delegate to the unlicensed assistive personnel (UAP) working on the medical-surgical unit? A. Assisting with a sitz bath for a patient with ulcerative vulvitis B. Inserting a catheter in a patient who has a history of uterine prolapse C. Giving a report to a receiving nurse about a patient who is being transferred D. Providing discharge teaching for a patient who is scheduled for brachytherapy

A. Assisting with a sitz bath for a patient with ulcerative vulvitis

The nurse is caring for a patient with vulvovaginitis. What intervention does the nurse teach the patient? A. Change detergents. B. Use cold compresses. C. Use dry heat application. D. Have sitz baths for 10 minutes once a day.

A. Change detergents.

The nurse is caring for a patient who just returned from hysteroscopic surgery. What complications should the nurse observe for? Select all that apply. A. Embolism B. Renal failure C. Fluid overload D. Perforation of the uterus E. Syndrome of inappropriate antidiuretic hormone (SIADH)

A. Embolism C. Fluid overload D. Perforation of the uterus

Which is related to the growth of leiomyomas? Select all that apply. A. Estrogen B. Pregnancy C. Menopause D. Progesterone E. Growth hormone

A. Estrogen D. Progesterone E. Growth hormone

What is the other name for leiomyomas? A. Fibroids B. Intramural C. Subserosal D. Submucosal

A. Fibroids

What instructions should be included when teaching about the prevention of toxic shock syndrome? Select all that apply. A. Insert tampons gently. B. Use sanitary napkins at night. C. Avoid tampons if you have diarrhea. D. Change tampons every 1 to 2 hours. E. Do not use super absorbent tampons.

A. Insert tampons gently. D. Change tampons every 1 to 2 hours. E. Do not use super absorbent tampons.

The nurse is caring for a patient who underwent a uterine artery embolization without a closure device. What action does the nurse take? A. Instruct the patient to report any flu-like illness. B. Recommend that the patient lie on the right side. C. Suggest keeping the legs immobilized for 2 hours. D. Advise the patient that cramping will last only for a day.

A. Instruct the patient to report any flu-like illness.

The nurse is caring for a patient with a new diagnosis of a leiomyoma. Which are classifications of this benign tumor? Select all that apply. A. Intramural B. Subserosal C. Endometrial D. Submucosal E. Colporrhaphy

A. Intramural B. Subserosal D. Submucosal

A patient reports an itching sensation in the vagina and thick, white vaginal discharge. Upon further assessment, the nurse finds that the patient has pediculosis pubis and scabies . The nurse anticipates that what medication will be prescribed? A. Lindane B. Leuprolide C. Medroxyprogesterone acetate D. Estrogen, progestin combination pills

A. Lindane

The nurse is providing postoperative care for a patient after a total abdominal hysterectomy. What are the postoperative priorities for the nurse? Select all that apply. A. Monitor vaginal bleeding. B. Monitor dressing and drains. C. Provide oral fluids 2 hours after surgery. D. Monitor and record urine output for 24 hours. E. Ask the patient to use incentive spirometry from the second day.

A. Monitor vaginal bleeding. B. Monitor dressing and drains. D. Monitor and record urine output for 24 hours.

A patient is being discharged after having a total abdominal hysterectomy (TAH). What principle guides the nurse who is providing discharge planning and instructions for her? A. No special home equipment will be necessary for the patient. B. Psychological reactions should be evident by the time of discharge. C. The patient will be able to return to normal activities upon discharge. D. Patients generally adapt better if they are still in their childbearing years.

A. No special home equipment will be necessary for the patient.

The nurse is caring for a patient 24 hours after uterine artery embolization for treatment of fibroids. The patient complains of muscle aches. What action by the nurse is priority? A. Notify the health care provider B. Encourage increased fluid intake C. Perform a neurologic assessment D. Reassure the patient this is normal

A. Notify the health care provider

Which are risk factors for ovarian cancer? Select all that apply. A. Obesity B. Infertility C. Late menarche D. Older than 20 years E. Family history of breast cancer

A. Obesity B. Infertility E. Family history of breast cancer

A postoperative patient who underwent laparoscopic removal of endometrial implants and adhesions reports pain in the chest and shoulders. Which is the most appropriate nursing response? A. "It is a common consequence from this surgery." B. "This may indicate a need for cardiac diagnostic tests." C. "This may be a result of improper positioning during the surgery." D. "We may have to evaluate you further for retained endometrial tissue."

A. "It is a common consequence from this surgery."

Which symptom should the patient report immediately to the primary health care provider after undergoing total abdominal hysterectomy? A. A burning sensation while urinating B. A small amount of abdominal bleeding after the surgery C. A small amount of vaginal leakage 4 days after the surgery D. A persistent temperature of 99.5°F 4 days after the surgery

A. A burning sensation while urinating

Which statement about uterine fibroids is correct? A. Fibroids often regress in size during pregnancy. B. Subserosal leiomyomas protrude into the uterine cavity. C. The incidence of fibroids increases as women get older. D. The most common type of fibroids is pedunculated leiomyomas.

C. The incidence of fibroids increases as women get older.

Which stage of endometrial cancer is confined to the endometrium? A. Stage I B. Stage II C. Stage III D. Stage IV

A. Stage I

Where is the intramural fibroid located? A. Within the wall of the uterus B. In the wall of the cervix (neck of the uterus) C. In the muscle beneath the endometrium of the uterus D. Underneath the mucosal (peritoneal) surface of the uterus

A. Within the wall of the uterus

The nurse is caring for a patient diagnosed with noninfectious vulvovaginitis. What are the possible causes of noninfectious vulvovaginitis? Select all that apply. A. Candidiasis B. Lichen planus C. Herpes genitalis D. Atrophic vaginitis E. Urinary incontinence

B. Lichen planus D. Atrophic vaginitis E. Urinary incontinence

The nurse is providing health education to a group of women regarding measures to prevent vulvovaginitis. Which patient actions may increase the risk of vulvovaginitis? Select all that apply. A. The patient wears loose cotton underwear. B. The patient uses lemon-based perineal spray. C. The patient douches twice a week during menses. D. The patient wipes from front to back after a bowel movement. E. The patient washes the inner labial mucosa with soap and water.

B. The patient uses lemon-based perineal spray. C. The patient douches twice a week during menses. E. The patient washes the inner labial mucosa with soap and water.

How many layers of classification are there for the leiomyomas in the uterus? A. 5 B. 8 C. 3 D. 6

C. 3

How are the uterus, cervix, adjacent lymph nodes, and the surrounding tissues (parametrium) removed? A. Panhysterectomy B. Total hysterectomy C. Radical hysterectomy D. Bilateral salpingo-oophorectomy

C. Radical hysterectomy

A patient has a pelvic organ prolapse. What symptom indicates the possibility of a cystocele? A. Constipation B. Fecal impaction C. Feelings of vaginal fullness D. Difficulty in emptying the bladder

D. Difficulty in emptying the bladder

The nurse is caring for a patient diagnosed with fibroids. What information provided by the patient indicates that twisting of the fibroid at the stalk has occurred? A. Anuria B. Difficulty breathing C. Flu-like symptoms D. Heavy vaginal bleeding

D. Heavy vaginal bleeding

Which is the most common type of sexually transmitted infection (STI) in the United States? A. Gonorrhea B. Pediculosis pubis C. Herpes simplex virus D. Human papilloma virus (HPV)

D. Human papilloma virus (HPV)

What factor would increase a patient's risk for cervical cancer? A. Presence of uterine polyps B. No childbirths or nulliparity C. Tamoxifen therapy for breast cancer D. Infection with the human papilloma virus (HPV)

D. Infection with the human papilloma virus (HPV)

Which patient history places a woman at highest risk for developing endometrial (uterine) cancer? A. Nulliparity, smoking, uterine polyps, hypertension B. Oral contraceptive use, smoking, localized pain in the thigh C. Multiparity, human papilloma virus (HPV), smoking, and African-American ethnicity D. Nulliparity, endometriosis, diabetes mellitus, first pregnancy at older than 20 years

A. Nulliparity, smoking, uterine polyps, hypertension

What statement by the patient supports the diagnosis of toxic shock syndrome? A. "I had sex while I had my period." B. "I started my period about four days ago." C. "I began having discharge about 10 days ago." D. "My mom had toxic shock syndrome when I was a child."

B. "I started my period about four days ago."

A patient is being discharged from the hospital after a total vaginal hysterectomy. Which self-management measures does the nurse teach the patient? A. Avoid climbing stairs. B. Walk for exercise until fatigued. C. Participate in aerobic exercises after a week. D. Avoid crossing legs at the knees when sitting.

D. Avoid crossing legs at the knees when sitting.

Which tumor arises from the glandular part of the endometrium and usually follows endometrial hyperplasia? A. Melanoma B. Adenocarcinoma C. Leiomyosarcoma D. Squamous cell carcinoma

B. Adenocarcinoma

The nurse is caring for an obese patient who reports pain and bleeding upon defecation and a feeling of rectal fullness. The nurse expects that the patient's plan of care will include what intervention? A. Administering lindane lotion B. Administering stool softeners C. Recommending bladder training D. Recommending the practice of biofeedback

B. Administering stool softeners

What interventions should the nurse include when teaching a patient diagnosed with vaginal prolapse? Select all that apply. A. A pessary B. Bladder training C. A high-fiber diet D. Kegel exercises E. Progestin treatment

A. A pessary D. Kegel exercises

A 42-year-old woman with an intramural leiomyoma (myomas or fibroids) has been taking estrogen replacement therapy for menopausal symptoms. What does the nurse tell her about estrogen replacement therapy and how it relates to her fibroids? A. "The fibroids may continue to grow." B. "Estrogen will help shrink your fibroids." C. "Your estrogen dosage will not change." D. "Increasing the amount of estrogen you are taking will be necessary."

A. "The fibroids may continue to grow."

What is to be performed to help diagnose abnormalities of the uterus? A. Lung biopsy B. Breast biopsy C. Endometrial biopsy D. Bone marrow biopsy

C. Endometrial biopsy

What is a cardinal sign of toxic shock syndrome (TSS)? A. Hypertension B. Low-grade fever C. Sunburn-like rash D. Increased urine output

C. Sunburn-like rash

Which patient does the RN assess first after receiving a change-of-shift report? A. 54-year-old with an anterior and posterior colporrhaphy who has an elevated heart rate and an oral temperature of 101.2°F B. 48-year-old who is reporting abdominal pain and light vaginal spotting after an endometrial biopsy C. 50-year-old who is receiving morphine through a patient-controlled analgesia (PCA) device after a hysterectomy and who rates her pain at a level 3 (0 to 10 scale) D. 45-year-old with a history of hypothyroidism who is scheduled for a hysterectomy and bladder suspension

A. 54-year-old with an anterior and posterior colporrhaphy who has an elevated heart rate and an oral temperature of 101.2°F

What instructions should be included when teaching about the prevention of vulvovaginitis? Select all that apply. A. Avoid tight clothing. B. Douche after menses. C. Avoid cotton underwear. D. Do not use feminine hygiene sprays. E. Do not use soap near the inner labial mucosa.

A. Avoid tight clothing. D. Do not use feminine hygiene sprays. E. Do not use soap near the inner labial mucosa.

What does the nurse teach a patient about preventing vulvovaginitis? A. Avoid wearing pantyhose or tight jeans. B. Cleanse the inner labial mucosa with soap. C. Wipe back to front after a bowel movement. D. Use safety precautions if the patient's partner has an infection.

A. Avoid wearing pantyhose or tight jeans.

The nurse is caring for a patient diagnosed with vulvovaginitis from a secondary infection. Which conditions are the potential causes of the vulvovaginitis? Select all that apply. A. Candidiasis B. Lichen planus C. Pediculus pubis D. Herpes genitalis E. Condylomata acuminata

A. Candidiasis C. Pediculus pubis

What is the most common type of tumor? A. Melanoma B. Adenocarcinoma C. Leiomyosarcoma D. Squamous cell carcinoma

B. Adenocarcinoma

Which self-care intervention will the nurse recommend to the patient who has undergone local cervical ablation therapy? A. Use douches B. Insert tampons C. Take showers instead of baths D. Lift heavy weights to build muscle tone

C. Take showers instead of baths

What is a key assessment finding in a patient with uterine prolapse? A. Dyspareunia B. Hemorrhoids C. Stress urinary incontinence D. Difficulty in emptying the bladder

A. Dyspareunia

What complication causes pain in women with fibroids? A. Constipation B. Pelvic pressure C. Heavy vaginal bleeding D. Twisting of the fibroid on its stalk

D. Twisting of the fibroid on its stalk

Which is the priority concern for a patient diagnosed with lichen planus? A. Infection B. Social isolation C. Impaired skin integrity D. Ineffective health management

A. Infection

The nurse is teaching a group of young boys and girls about getting vaccinated for HPV (human papilloma virus). Which statement by one of the girls needs to be clarified? A. "The vaccine is for girls; a different one is available for boys." B. "Having the vaccine will help keep me from getting cancer of my cervix." C. "I will need to have all three injections to be protected from the disease." D. "It is better to have the vaccination before I start having sexual relations."

A. "The vaccine is for girls; a different one is available for boys."

The nurse is caring for a patient diagnosed with toxic shock syndrome. What are the potential causes of this diagnosis? Select all that apply. A. Tampon use B. Sexual intercourse C. Urinary incontinence D. Hormonal dysfunction E. Internal contraceptives

A. Tampon use E. Internal contraceptives

During a review of family medical history, the nurse learns that a patient's mother had a cystocele when she was the patient's age. The patient voices concerns that this will happen to her if she is not careful and wants to know how to prevent it. What is the best response by the nurse? A. "Avoid using muscle relaxants to prevent a cystocele." B. "Performing Kegel exercises will help prevent a cystocele." C. "Preventing a cystocele is not possible, but early treatment helps." D. "Using progesterone supplements after menopause will help prevent a cystocele."

B. "Performing Kegel exercises will help prevent a cystocele."

The patient with urinary elimination problems reports urgency, a urinary tract infection, and stress urinary incontinence. What condition should the nurse suspect and assess for? A. Rectocele B. Cystocele C. Vulvovaginitis D. Vaginal prolapse

B. Cystocele

What nonsurgical methods of treatment does the nurse teach a patient with pelvic organ prolapse? Select all that apply. A. Avoid use of laxatives. B. Practice Kegel exercises. C. Use pessaries or spheres. D. Practice bladder training. E. Use oral hormone replacement therapy.

B. Practice Kegel exercises. C. Use pessaries or spheres. D. Practice bladder training.

The nurse is discussing transvaginal repair for pelvic organ prolapse (POP) using surgical vaginal mesh with a patient who plans to have the procedure. What teaching does the nurse include? Select all that apply. A. Incisional care instructions B. Signs and symptoms of infection C. Manufacturer's labeling and information D. When to contact the surgeon after the procedure E. Statements from women who have had successful outcomes

B. Signs and symptoms of infection C. Manufacturer's labeling and information D. When to contact the surgeon after the procedure

The nurse teaches the patient who is scheduled for a total hysterectomy about changes to expect after surgery. What does the nurse tell the patient to expect postoperatively? Select all that apply. A. Decreased breast size B. Increased weight gain C. No menstrual periods D. Need for birth control E. Menopausal symptoms

C. No menstrual periods E. Menopausal symptoms

The nurse administers intravenous antibiotics to a patient with toxic shock syndrome (TSS). The patient is also receiving prednisolone to treat an associated skin rash. What is the priority assessment finding that indicates that further treatment is needed? A. Body temperature of 101°F B. Blood pressure of 110/80 mm Hg C. Platelet count of 50,000 per microliter D. Serum creatinine phosphatase level of 120 mcg/L

C. Platelet count of 50,000 per microliter

The nurse is providing discharge instructions to a patient diagnosed with a rectocele. What instruction is priority? A. Pessary care B. A low-fiber diet C. Stool softeners D. Bladder training

C. Stool softeners

The nurse suspects that a patient has a cystocele based on what assessment finding? A. Constipation B. Bleeding from rectum C. Urine loss when laughing D. Acute respiratory distress syndrome (ARDS)

C. Urine loss when laughing

What teaching does the nurse provide to the community during a class on prevention of toxic shock syndrome (TSS)? A. Wash hands before inserting a tampon. B. Use superabsorbent tampons during the day. C. Change tampons at least once every 8 hours. D. Use tampons instead of sanitary napkins at night.

A. Wash hands before inserting a tampon.

The nurse is providing teaching to a patient on hormone replacement therapy who is experiencing pain related to fibroids. What statement by the patient indicates an understanding of the teaching provided? A. "I am going to need a hysterectomy very soon." B. "I will need to stop taking my hormone replacement therapy." C. "The hormones are probably making my fibroids grow larger." D. "My fibroids should start to shrink now that I have reached menopause."

C. "The hormones are probably making my fibroids grow larger."

The nurse receives a call from a patient who has been discharged after a total vaginal hysterectomy. The patient reports vaginal discharge. What action by the nurse is priority? A. Instruct the patient to go to the emergency room B. Inform the patient that she may need to be checked for STDs C. Let the patient know this is a normal finding for a few days after surgery D. Ask the patient if she has continued to take the postoperative antibiotics

C. Let the patient know this is a normal finding for a few days after surgery

The nurse is assessing a patient who reports pain in the lower abdomen before the onset of menstruation. The patient also experiences nausea, diarrhea, and pain during defecation. A pelvic examination reveals limited movement of the uterus and tenderness. Which diagnostic test will help rule out the presence of pelvic masses? A. Sonohysterography B. Endometrial ablation C. Transvaginal ultrasound D. Serum cancer antigen CA-125

C. Transvaginal ultrasound

A patient with a prolapsed uterus is scheduled for anterior colporrhaphy surgery. What should the patient expect with this procedure? Select all that apply. A. Driving should be avoided for 6 weeks after surgery. B. Anterior colporrhaphy is a minimally invasive surgery. C. Vaginal hysterectomy may accompany anterior colporrhaphy. D. Sutures of the anterior colporrhaphy will not need to be removed. E. It is important to avoid sexual intercourse for 4 weeks after the surgery. F. It is important to avoid lifting anything heavier than 5 pounds after the surgery.

C. Vaginal hysterectomy may accompany anterior colporrhaphy. D. Sutures of the anterior colporrhaphy will not need to be removed. F. It is important to avoid lifting anything heavier than 5 pounds after the surgery.

A patient asks the nurse about preventive measures for toxic shock syndrome (TSS). The nurse instructs the patient about the safe use of tampons. Which statement made by the patient indicates effective learning? A. "I should use superabsorbent tampons." B. "I should insert the tampon firmly into the vagina." C. "I should change the tampon every 6 to 12 hours." D. "I should use sanitary napkins instead of tampons at night."

D. "I should use sanitary napkins instead of tampons at night."

The patient is undergoing a laparoscopic myomectomy. What statement indicates that the patient has an accurate understanding of the teaching? A. "I won't be able to get pregnant after this procedure." B. "I'll be at higher risk of spontaneous uterine rupture." C. "This procedure may cause me to miscarry if I'm pregnant." D. "I'll need to give birth by cesarean section if pregnancy occurs."

D. "I'll need to give birth by cesarean section if pregnancy occurs."

The nurse is caring for a patient who has had a posterior repair for a rectocele. The patient reports feeling the urge to have a bowel movement. What action by the nurse is priority? A. Prepare saline enema B. Encourage the patient to ambulate C. Encourage the patient to splint her abdomen D. Provide pain medication prior to the bowel movement

D. Provide pain medication prior to the bowel movement

A 32-year-old patient has a laparoscopic removal of endometrial adhesions at a same-day surgery center. What does the nurse tell her to expect postprocedure? A. "You may have referred pain in your chest and shoulders due to the carbon dioxide (CO 2) used in the procedure." B. "This procedure will guarantee that you and your partner will be able to get pregnant within the next year." C. "Do not expect to get your menstrual period for at least 3 months; this procedure really gets your hormones out of balance." D. "You will likely have a fever and a strong-smelling vaginal discharge for several days after the procedure."

A. "You may have referred pain in your chest and shoulders due to the carbon dioxide (CO 2) used in the procedure."

Which gynecologic patients does the charge nurse assign to an LPN/LVN? Select all that apply. A. 23-year-old who is nauseated after her laparotomy and needs to receive antiemetic drugs B. 34-year-old who had a total hysterectomy for invasive cervical cancer and has a blood pressure of 88/54 mm Hg C. 42-year-old who had an abdominal hysterectomy whose health care provider wants to remove sutures at her bedside D. 48-year-old who is receiving IV chemotherapy to treat stage II cervical cancer E. 52-year-old who just returned to the unit following a total abdominal hysterectomy

A. 23-year-old who is nauseated after her laparotomy and needs to receive antiemetic drugs C. 42-year-old who had an abdominal hysterectomy whose health care provider wants to remove sutures at her bedside

What are the symptoms that may result when an enlarged fibroid presses on other organs? Select all that apply. A. Constipation B. Pelvic pressure C. Swollen breasts D. Urinary retention E. Nausea with or without vomiting

A. Constipation B. Pelvic pressure D. Urinary retention

What differentiates an intramural leiomyoma from a submucosal leiomyomas? A. Intramural leiomyomas are contained in the myometrium. B. Intramural leiomyomas protrude into the cavity of the uterus. C. Intramural leiomyomas grow as a single line of smooth muscle cells. D. Intramural leiomyomas are benign, and submucosal leiomyomas are malignant.

A. Intramural leiomyomas are contained in the myometrium.

What are risk factors for the development of uterine cancer? Select all that apply. A. Obesity B. Smoking C. Multiple sex partners D. Diabetes mellitus E. Low socioeconomic status

A. Obesity B. Smoking D. Diabetes mellitus

Which are risk factors for endometrial cancer? Select all that apply. A. Obesity B. Smoking C. Multiparity D. Uterine polyps E. Diabetes mellitus

A. Obesity B. Smoking D. Uterine polyps E. Diabetes mellitus

What nursing interventions are appropriate when caring for a patient diagnosed with vulvovaginitis? Select all that apply. A. Providing reassurance B. Assessing for erythema C. Obtaining vaginal smears D. Bimanual pelvic examination E. Performing Papanicolaou test

A. Providing reassurance B. Assessing for erythema

Which are common parasitic infestations of the skin of the vulva that can be sexually transmitted? Select all that apply. A. Scabies B. Litchen planus C. Pediculosis pubis D. Candida albicans E. Bacterial vaginosis

A. Scabies C. Pediculosis pubis

The nurse is providing information to a patient about risk factors for cervical cancer. What should the nurse include in this teaching? Select all that apply. A. Smoking B. Hypertension C. Human papilloma virus (HPV) infection D. Multiple sex partners E. Use of oral contraceptives

A. Smoking C. Human papilloma virus (HPV) infection D. Multiple sex partners E. Use of oral contraceptives

The nurse is reviewing a care plan for a patient with vulvovaginitis. The care plan includes wet compresses, sitz baths, and use of estrogens and lidocaine. What is the expected outcome? A. The patient will report less itching in a week. B. The patient will report control over voiding in a week. C. The patient will report painless sexual intercourse in a week. D. The patient will report absence of abdominal pain in a week.

A. The patient will report less itching in a week.

Which statement about cervical cancer vaccines is accurate? A. Cervarix is also given to boys and men. B. Gardasil is given as three injections over 6 months. C. Gardasil provides longer-lasting protection than Cervarix. D. Cervarix protects against human papilloma virus (HPV) strains 6 and 11.

B. Gardasil is given as three injections over 6 months.

The nurse is assessing a woman who reports abdominal distention and indigestion over the past several months. Which question by the nurse is priority? A. "Have you ever had a tubal ligation?" B. "Have you had any unexplained weight loss?" C. "Do you have a family history of breast cancer?" D. "Have you had any excessive vaginal bleeding?"

B. "Have you had any unexplained weight loss?"

A patient has undergone a total vaginal hysterectomy without removal of the ovaries. What statement by the patient indicates a need for further teaching? A. "I will no longer have a period." B. "I may experience hot flushes and night sweats." C. "I will no longer need to use birth control methods." D. "I may need more sleep and rest for a few weeks."

B. "I may experience hot flushes and night sweats."

A 52-year-old patient has been diagnosed with endometrial (uterine) cancer. She says to the nurse, "I was told that my cancer is stage II. What does that mean?" How does the nurse respond? A. "The spread of your cancer is beyond your pelvic area." B. "Your cancer has spread from your uterus to your cervix." C. "It means that your cancer remains confined to your uterus." D. "Vaginal and lymph nodes are areas of involvement with your cancer."

B. "Your cancer has spread from your uterus to your cervix."

The nurse is caring for a patient who has just returned from hysteroscopic surgery. The patient reports soaking two pads an hour. What action should the nurse take first? A. Document the findings B. Assess the patient's vital signs C. Contact the health care provider D. Place the patient in supine position

B. Assess the patient's vital signs

The nurse is caring for a pregnant patient who has been diagnosed with fibroids. What hormones are common causes of this condition? Select all that apply. A. Oxytocin B. Estrogen C. Lactogen D. Progesterone E. Human chorionic gonadotropin

B. Estrogen D. Progesterone

The nurse who is teaching a patient about ovarian cancer asks the patient to repeat the risk factors to ensure she has learned the information. Which patient response indicates a need for further teaching? A. Having diabetes B. Having multiple sexual partners C. Eating a high fat-diet and being obese D. Being older than 30 at the time of a first pregnancy

B. Having multiple sexual partners

What are the risk factors for endometrial (uterine) cancer? Select all that apply. A. HIV/AIDS B. Hypertension C. Uterine polyps D. Late menopause E. Diabetes mellitus F. Oral contraceptive use

B. Hypertension C. Uterine polyps D. Late menopause E. Diabetes mellitus

What symptoms should the nurse assess in a patient diagnosed with toxic shock syndrome? Select all that apply. A. Pruritus B. Myalgias C. Sore throat D. Hypotension E. Vaginal discharge

B. Myalgias C. Sore throat D. Hypotension

The nurse is providing education to a young woman and her parents regarding human papilloma virus (HPV) vaccinations. What information should the nurse include in the teaching plan? Select all that apply. A. Vaccinations will prevent HPV. B. Possible side effects are vomiting and headache. C. The medication will be given in three injections over 6 months. D. Vaccination should be administered after sexual activity has begun. E. The immunization may cause irritation at the area of the injection site.

B. Possible side effects are vomiting and headache. C. The medication will be given in three injections over 6 months. E. The immunization may cause irritation at the area of the injection site.

What discharge instructions should be provided to a patient who underwent an abdominal hysterectomy? A. Encourage stair climbing. B. Refrain from lifting heavy objects. C. Refrain from being in a standing position. D. Encourage the patient to jog and do aerobics.

B. Refrain from lifting heavy objects.

While assessing a febrile patient admitted with toxic shock syndrome (TSS), the nurse discovers that the patient regularly uses tampons. What other assessment findings would support this diagnosis? Select all that apply. A. Constipation B. Severe body aches C. Excessive urination D. Reddening of the mucosa of the throat E. Reddening of the conjunctiva of the eyes

B. Severe body aches D. Reddening of the mucosa of the throat E. Reddening of the conjunctiva of the eyes

What measures regarding the proper use of tampons help to prevent toxic shock syndrome (TSS)? Select all that apply. A. Use superabsorbent tampons. B. Use sanitary napkins at night. C. Change tampons 2 to 3 times daily. D. Report sudden vomiting or diarrhea. E. Wash hands before inserting tampons.

B. Use sanitary napkins at night. D. Report sudden vomiting or diarrhea. E. Wash hands before inserting tampons.

What instructions should the nurse include when teaching a patient who has just had transvaginal mesh implant for repair of a pelvic organ prolapse? Select all that apply. A. Avoid using heat on your abdomen. B. You should take stool softeners daily. C. Avoid lifting anything over 5 pounds. D. You may resume sexual intercourse in 4 weeks. E. Smoking should be avoided to allow proper healing.

B. You should take stool softeners daily. C. Avoid lifting anything over 5 pounds. E. Smoking should be avoided to allow proper healing.

The nurse is caring for a patient who is scheduled for a magnetic resonance-guided focused ultrasound for treatment of a fibroid. What statement by the patient indicates a need for further teaching? A. "Ultrasound is going to destroy the fibroid." B. "I will have to lie on my stomach for this procedure." C. "I will be given pain medication prior to the procedure." D. "I will still be able to have kids after having this procedure."

C. "I will be given pain medication prior to the procedure."

The nurse is performing discharge teaching for a patient who is recovering from a total abdominal hysterectomy (TAH). Which patient statement indicates a need for clarification? A. "I cannot jog for 2 to 6 weeks." B. "I will no longer have menstrual periods." C. "I will need to find a new form of birth control." D. "I must take my temperature twice a day for the first 3 days after surgery."

C. "I will need to find a new form of birth control."

The nurse is providing instructions to a patient being discharged after an anterior and posterior colporrhaphy for repair of a cystocele and rectocele. The patient asks the nurse why she is being placed on a low-residue diet. What statement by the nurse is most appropriate? A. "It will allow your stool to bulk." B. "It will reduce the chance of infection." C. "It will decrease your bowel movements." D. "It will decrease your chances of dehydration."

C. "It will decrease your bowel movements."

Following a transvaginal repair for vaginal prolapse, a patient calls the health care provider's office to inquire when her sutures will be removed. What statement by the nurse is appropriate? A. "They will be removed at your follow-up appointment." B. "You do not need sutures with this type of procedure." C. "They do not need to be removed; they are absorbable." D. "The doctor will discuss that with you at your two week follow-up."

C. "They do not need to be removed; they are absorbable."

A patient is scheduled for a transvaginal repair for pelvic organ prolapse using a vaginal mesh sling procedure. The patient asks the nurse when she will be discharged. What statement by the nurse is most appropriate? A. "It's normally about 2 to 3 days." B. "Sometimes it can be up to a week." C. "Usually you're discharged the same day." D. "You usually need to stay in the hospital overnight for observation."

C. "Usually you're discharged the same day."

Four women phone the gynecology clinic about having new-onset vaginal bleeding. Which call does the RN decide to return first? A. 23-year-old using medroxyprogesterone acetate B. 34-year-old with a history of multiple leiomyomas C. 62-year-old with no previous gynecologic problems D. 48-year-old who had an endocervical curettage yesterday

C. 62-year-old with no previous gynecologic problems

The nurse is reviewing laboratory results on a 34-year-old patient who is suspected of having endometrial (uterine) cancer. Which laboratory tests does the nurse expect to see? Select all that apply. A. Serum electrolytes B. Liver function tests (LFTs) C. Alpha-fetoprotein (AFP) test D. CA (cancer antigen)-125 test E. Human chorionic gonadotropin (hCG) level F. Hereditary nonpolyposis colon cancer (HNPCC) test

C. Alpha-fetoprotein (AFP) test D. CA (cancer antigen)-125 test E. Human chorionic gonadotropin (hCG) level F. Hereditary nonpolyposis colon cancer (HNPCC) test

How are leiomyomas defined? A. The reduction of a rectal bulge B. Tightening of the pelvic muscles for better bladder support C. Benign, slow-growing solid tumors of the uterine myometrium D. An alternative to surgery for a woman who does not want to become pregnant

C. Benign, slow-growing solid tumors of the uterine myometrium

The nurse is caring for a patient experiencing dyspareunia. What action by the nurse is priority? A. Measure urine output B. Assess bowel sounds C. Discuss sexuality issues D. Administer PRN pain medication

C. Discuss sexuality issues

The nurse is teaching a patient how to adapt to physical and psychological changes after surgery for ovarian cancer. What is included in the teaching plan? Select all that apply. A. Offering vaginal dilators B. Suggesting the use of oil-based lubricants C. Encouraging the expression of grief and fears D. Encouraging the use of support groups and counseling E. Suggesting alternatives to vaginal intercourse for 6 weeks

C. Encouraging the expression of grief and fears D. Encouraging the use of support groups and counseling E. Suggesting alternatives to vaginal intercourse for 6 weeks

What are the gold standard tests that can be done to determine the presence of endometrial thickening and cancer? Select all that apply. A. Pap tests B. Genetic testing C. Endometrial biopsy D. Transvaginal ultrasound E. Intravenous pyelography test

C. Endometrial biopsy D. Transvaginal ultrasound

Which is the most common female reproductive malignancy? A. Vulvovaginitis B. Ovarian cancer C. Endometrial cancer D. Human papilloma virus (HPV)

C. Endometrial cancer

The nurse is providing teaching for a group of women regarding symptoms of endometrial cancer. The nurse recognizes the teaching has been effective when the women identify what main symptom of endometrial cancer? A. Pelvic pain B. Low back pain C. Heavy vaginal bleeding D. Watery vaginal discharge

C. Heavy vaginal bleeding

What is the name of the surgery in which a very small incision is made and an organ can be removed such as an ovary, gallbladder, or appendix? A. Liposuction surgery B. Craniofacial surgery C. Laparoscopic surgery D. Oophorectomy surgery

C. Laparoscopic surgery

A patient has been prescribed brachytherapy for gynecologic cancer. What does the nurse teach the patient? A. Low-grade fever below 100°F. B. Report for the procedure once a week. C. Maintain bed rest and avoid excessive movement in bed. D. Avoid interaction with others between treatment sessions.

C. Maintain bed rest and avoid excessive movement in bed.

Which gynecologic surgery involves the removal of the uterus, cervix, adjacent lymph nodes, the upper third of the vagina, and the surrounding tissues? A. Panhysterectomy B. Total hysterectomy C. Radical hysterectomy D. Bilateral salpingo-oophorectomy

C. Radical hysterectomy

A patient underwent a magnetic resonance imaging (MRI) diagnostic exam of the abdomen that reveals a fibroid tumor larger than the size of a 16-week pregnancy. The recommended treatment is removal of uterus and cervix. Which gynecologic surgery is appropriate for this patient? A. Panhysterectomy B. Radical hysterectomy C. Total abdominal hysterectomy D. Bilateral salpingo-oophorectomy

C. Total abdominal hysterectomy

Which surgery is performed for leiomyomas larger than the size of a 16-week pregnancy? A. Panhysterectomy B. Radical hysterectomy C. Total abdominal hysterectomy D. Bilateral salpingo-oophorectomy

C. Total abdominal hysterectomy

The nurse is planning education for a patient diagnosed with stage I endometrial cancer. Which common treatments for this stage of the disease does the nurse include in the teaching plan? Select all that apply. A. Radiation B. Chemotherapy C. Total hysterectomy D. Radical hysterectomy E. Bilateral salpingo-oophorectomy

C. Total hysterectomy E. Bilateral salpingo-oophorectomy

Which organs are removed in a panhysterectomy? A. Uterus and cervix B. Fallopian tubes and ovaries C. Uterus, ovaries, and fallopian tubes D. Uterus, cervix, adjacent lymph nodes, the upper third of the vagina, and parametrium

C. Uterus, ovaries, and fallopian tubes

A patient reports new onset of vulvar burning, redness, and pruritus and is diagnosed with vulvovaginitis. The patient asks the nurse how to prevent future occurrences. Which response by the nurse is best? A. "You can use a douche monthly." B. "Switch to soft nylon undergarments." C. "Use a sitz bath for 30 minutes several times a day." D. "During a bath or shower, clean your labia with water only."

D. "During a bath or shower, clean your labia with water only."

A patient has gynecologic cancer. Which patient statement demonstrates a correct understanding of her treatment options? A. "The purpose of brachytherapy will be to dissolve the cancer." B. "Chemotherapy will be used to shrink my cancer before I have my operation." C. "Brachytherapy is given on an outpatient basis for 4 to 6 weeks before surgery." D. "External beam radiation therapy (EBRT) may be used after my cancer surgery."

D. "External beam radiation therapy (EBRT) may be used after my cancer surgery."

The nurse is teaching a patient about post-surgical care following a total vaginal hysterectomy. Which statement made by the patient indicates a need for further teaching? A. "I won't need to use birth control methods anymore." B. "I will avoid lifting anything heavier than 5 or 10 lb." C. "I will need someone to drive me to my post-surgical appointments." D. "I will monitor my temperature every other day for the first week after surgery."

D. "I will monitor my temperature every other day for the first week after surgery."

The registered nurse is teaching a patient who underwent a total abdominal hysterectomy about self-care when discharged. Which statement made by the patient indicates the need for further teaching? A. "I will start ambulating." B. "I will drink lots of water." C. "I will refrain from doing any strenuous activities." D. "I will refrain from coughing and deep breathing exercises."

D. "I will refrain from coughing and deep breathing exercises."

The nurse is teaching care principles to a patient who plans uterus-sparing surgery to remove uterine fibroids. Which patient statement needs clarification? A. "I will be able to return to my usual activities in about 2 weeks." B. "Probably I will be able to go home on the day of the surgery." C. "Fewer complications occur with this procedure than with hysterectomies." D. "It is important to avoid having sexual intercourse for 3 weeks after surgery."

D. "It is important to avoid having sexual intercourse for 3 weeks after surgery."

A patient who had an anterior colporrhaphy is being discharged. What does the nurse tell the patient before her discharge? A. "Avoid lifting more than 25 pounds." B. "Return to the clinic in 6 weeks for suture removal." C. "Do not have sexual intercourse for at least 2 weeks." D. "Take a hot bath or use a moist heating pad for discomfort."

D. "Take a hot bath or use a moist heating pad for discomfort."

The registered nurse asked the student nurse to explain post-operative physical changes that occur to a patient who underwent a total abdominal hysterectomy. Which statement made by the student nurse indicates effective learning? A. "You will have to use condoms." B. "You may suffer from sleep disturbances." C. "You will not have periods or vaginal discharge after you go home." D. "You may have hot flushes, night sweats, and vaginal dryness, if your ovaries are removed."

D. "You may have hot flushes, night sweats, and vaginal dryness, if your ovaries are removed."

Which surgery requires the removal of the fallopian tubes and ovaries? A. Panhysterectomy B. Total hysterectomy C. Radical hysterectomy D. Bilateral salpingo-oophorectomy

D. Bilateral salpingo-oophorectomy

How is painful intercourse documented in a patient's medical record? A. Dysuria B. Alopecia C. Hematuria D. Dyspareunia

D. Dyspareunia

A patient presents to the hospital with a high fever and diffuse sunburn-like rash on skin. The nurse reviews the assessment findings and notes a history of tampon use, blood pressure of 80/60 mm Hg, and Staphylococcus aureus in the blood sample. Which intervention is most beneficial for this patient? A. Performing a hysterectomy B. Performing a transvaginal repair C. Encouraging the use of superabsorbent tampons D. Encouraging the patient to change tampons every 3 to 6 hours

D. Encouraging the patient to change tampons every 3 to 6 hours

Which is a benign, slow-growing solid tumor of the uterine myometrium? A. Erythema B. Rectocele C. Cystocele D. Leiomyoma

D. Leiomyoma

The nurse is caring for a patient with a vaginal infection secondary to pediculosis. What instruction should the nurse provide to the patient? A. Tepid sitz baths B. Topical estrogen C. Cool compresses D. Lindane lotion application

D. Lindane lotion application

A patient is scheduled for a total hysterectomy with a laparoscopic vaginal approach after a diagnosis of microinvasive cervical cancer. What psychological and/or social changes does the nurse expect this patient to experience? A. The patient will be actively involved in her own care in the immediate postoperative period. B. The patient should demonstrate reality testing and should experience a grief reaction immediately after her surgery. C. Because the surgery does not affect a visible site, altered body image issues will be fewer in number. D. Sexual counseling may be needed, especially if the patient has doubts about her ability to feel like a woman and engage in sexual activities.

D. Sexual counseling may be needed, especially if the patient has doubts about her ability to feel like a woman and engage in sexual activities.

Which condition can be caused by menstruation and tampon use? A. Vulvovaginitis B. Ovarian cancer C. Pelvic organ prolapse D. Toxic shock syndrome

D. Toxic shock syndrome

The nurse is caring for a patient who underwent an anterior colporrhaphy. What does the nurse tell the patient about postoperative care? A. Avoid lifting any weight heavier than 2 pounds. B. Start routine activities, including driving, within a week. C. Report to the outpatient department to have sutures removed. D. Use a moist heating pad or apply warm compresses to the abdomen.

D. Use a moist heating pad or apply warm compresses to the abdomen.

The nurse performs the initial gynecologic assessment for a 40-year-old female who denies any pain but reports heavy vaginal bleeding, increased abdominal size, urinary frequency, constipation, and dyspareunia for the last six months. What does the nurse know is the most likely diagnosis for the patient? A. Endometriosis B. Ovarian cancer C. Endometrial cancer D. Uterine leiomyoma

D. Uterine leiomyoma