Patho Final - CH 45

The vulva area is especially prone to skin infections. The nurse knows that this occurs because of:

Constant exposure to secretions and moisture

Which condition would the nurse expect a female client with human papillomavirus (HPV) to exhibit?

Cervical intraepithelial neoplasia

Leiomyomas are smooth-muscle fibroid tumors that usually develop in which part of the reproductive system?

The corpus of the uterus

A 21-year-old college student has sought care because of the vaginal burning, itching, and redness that have become worse in recent weeks. Which assessment question by the clinician is most likely to apply to a diagnosis of vaginitis?

"Have you ever had a sexually transmitted infection?"

After an office visit with her primary health provider, a female client with an elevated CA-125 test result asks the nurse if that means she has ovarian cancer. What is the nurse's best response?

"This test is not specific for ovarian cancer but suggest further evaluation to find the elevation"

A client with vulvodynia tells the nurse, "This is not getting better. I just can't live like this." What is the best response by the nurse?

"What bothers you the most about your condition"

A female client with uterine leiomyomas asks the nurse about her risk of uterine cancer. Which statement best answers the question?

"Your leiomyomas may cause heavy periods but will not become cancerous"

An asymptomatic client who is worried about developing breast cancer due to the fact that it runs in her family asks the nurse if she could have a mammogram to see if she has any lumps. The nurse informs the client that a tumor usually is undetectable until it has doubled 30 times and contains more than 1 billion cells. This means that at this point it measures approximately which size?

1cm

Which sexually active woman most likely faces the highest risk of developing an ectopic pregnancy?

A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed

Which woman will the nurse encourage to have annual Papanicolaou (Pap) smears? Select all that apply.

Client age 63 postmenopausal for 10 years, client age 44 has multiple sexual partners, client age 27 history of human papillomavirus (HPV)

A client has been diagnosed with breast cancer following a suspicious mammogram followed by biopsy. The nurse who is planning this client's care should recognize that her prognosis is primarily dependent on the:

Extent to which lymph nodes are involved

An 18-year-old woman presents at the clinic complaining of new-onset breakthrough bleeding, even though she is taking contraceptives. What contraceptive use, along with new-onset breakthrough bleeding, has been associated with pelvic inflammatory disease?

Intrauterine device

A client reporting low abdominal pain, purulent cervical discharge, and painful intercourse is diagnosed with pelvic inflammatory disease (PID). The provider educates the client about this disease mentioning which statement?

Is a polymicrobial infection of the upper reproductive tract

A woman reports to the primary healthcare provider that she experiences monthly changes before her menstrual cycle. Which statement demonstrates understanding of premenstrual disorders?

Many women report premenstrual emotional or physical changes

A female client is being seen in the ED with complaints of lower abdominal pain, dyspareunia, back pain, purulent cervical discharge, and the presence of adnexal tenderness and painful cervix on bimanual pelvic examination. The nurse suspects the client has pelvic inflammatory disease (PID), and will assess the client for:

Number of sexual partners

Which disorder of the female genitourinary system is most likely to result from a disruption in normal endocrine function?

Polycystic ovary syndrome (PCOS)

What is the most important discharge instruction for a female client with pelvic inflammatory disease (PID)?

Take all of the antibiotic

A female client reports to the health care provider that she has noticed a release of urine when she laughs or sneezes. Which interventions should the provider implement first?

Teach the client to do pelvic floor exercises

A female client reports that her mother-in-law was just diagnosed with cervical cancer and asks the nurse about her own risk. Which response by the nurse is correct?

"If you had the HPV vaccine, your risk is greatly reduced"

A client diagnosed with endometriosis asks the nurse how it is that she did not know about this when she had it for so long. What is the nurse's best response?

"It's symptoms mimic those of other disorders"

What should the nurse teach the client about assessing for possible breast cancer?

"Perform monthly self-breast exams after menses"

A client asks the health care provider to, "Explain brachytherapy, which is recommended for my cervical cancer." Which response by the nurse is most accurate?

"They will insert a radioactive device into your vagina and position it next to the cervix, so that curative levels of radiation are directly on the cancer site"

The client has a Bartholin cyst that has developed into an abscess. The nurse explains to the client the plan of care, including which treatments?

A catheter may be inserted to drain the cyst for several weeks"

The nurse is caring for a client with lichen simplex chronicus. What assessment finding does the nurse expect?

Gray-white plaques with an irregular surface

What is a primary intervention for the nurse to implement for a client with pelvic inflammatory disease ?

Administer antibiotic therapy

A client who has a history of untreated cervicitis tells the nurse that she is concerned about the risk of experiencing problems with fertility. The nurse explains that problems may result from:

Ascending infection of the fallopian tubes

A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:

Atypical cervix cellular changes

A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of hormone therapy. What is the goal of this pharmacologic treatment?

Blocking effects of estrogen on the growth of malignant cells

There are many cancers of the female reproductive system. The nursing student knows that the most readily detected and most easily cured cancer—if detected early—is:

Cervical

A female client is admitted for lesions on her vulva, which has become infected. The nurse understands that diseases of the external genitalia are similar to which other lesions elsewhere in the body?

Hair-bearing skin

Which factor in a client's history is most likely related to the diagnosis of cervical squamous dysplasia?

Human papillomavirus (HPV) infection

A female client with blocked fallopian tubes seeks assistance at a fertility clinic. Which assisted reproductive technology will bring the greatest chance for conception?

In vitro fertilization (IVF)

A client is experiencing oligomenorrhea. The nurse interprets this as:

Infrequent menstruation with periods more than 35 days apart

An examination of the external genitalia of a female would concentrate on which structures? Select all that apply.

Labia minora, Clitoris

The health care provider suspects a diagnosis of endometriosis. Which procedure provides a definitive diagnosis?

Laparoscopy

The ovaries have a dual function. The nurse is able to explain to the client that any problems with the ovaries frequently cause which problem?

Menstrual and fertility problems

Polycystic ovary syndrome is an endocrine disorder and a common cause of chronic anovulation. In addition to the clinical manifestations of PCOS, long-term health problems, including cardiovascular disease and diabetes, have been linked to PCOS. What drug has emerged as an important part of PCOS treatment?

Metformin

The nurse is caring for a client who had a recent miscarriage. Which past history could be the cause of this recent failed pregnancy?

Past infection with chlamydia

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis, which may develop into which potential complication?

Pelvic adhesions

A nurse who works on a urology-gynecology ward of a hospital is coming on shift and will be caring for a 34-year-old woman who has been admitted overnight for the treatment of endometriosis. Which interventions should the nurse most realistically anticipate providing over the course of the shift and the next several days?

Providing pain control; preparing the client for a laparoscopic procedure or hysterectomy

Fibrocystic changes in the breast are not uncommon. How is the diagnosis of fibrocystic changes made?

The mass is round, the mass is freely movable, the mass changes in size with menses

Which clinical manifestation is most likely to accompany a diagnosis of vulvodynia?

Vulvar Pain

For which cancers is a client infected with human papillomavirus (HPV) at increased risk? Select all that apply.

Vulvar, Cervical, Vaginal

The nurse has taught a 30-year-old female client to perform breast self-evaluation (BSE). Which statement by the client indicates correct understanding?

"I will palpate my breasts for lumps a few days after my period"

A nurse who works in a fertility clinic is conducting a program on options for various fertility issues. The nurse judges that the participants understand the education when they identify that donor eggs are the best option for which woman?

A 42-year-old

A 45-year-old client reports "needing to bear down with urination," frequency, and occasional loss of urine when coughing. Based on symptoms, which diagnosis is most appropriate for this client?

Cystocele

A client who has been diagnosed with premenstrual syndrome (PMS) asks if there is anything to help alleviate the symptoms. The best response would be:

Eat a diet low in simple sugars and high in protein.

In assessing a client with a fibroadenoma of the breast, what will the nurse find?

Firm, rubbery masses

A client has been diagnosed with a Bartholin gland cyst. The nurse expects the client may experience which symptoms if this becomes infected?

Pain, tenderness, and dyspareunia

An adult client reports persistent vaginal irritation and recurrent infections. In her history the physician notices that she recently has been prescribed antibiotics for a respiratory infection and concludes that it has affected her normal flora by:

Causing the vaginal environment to be more alkaline than normal"

A female client reports a grayish-green nipple discharge in one breast. Which additional manifestation corresponds with a diagnosis of ductal ectasia?

Ductal inflammation with thickening

When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by:

Elevated LH

The nurse working in a fertility clinic is assessing a client's risk for fallopian tube obstruction. Which disorder places the woman at greatest risk for fallopian tube obstruction?

Endometriosis

What is the term for the condition that involves dyspareunia and widespread vaginal burning in the absence of bacterial presence?

Generalized vulvodynia

A client has been diagnosed with acute cervicitis caused by Chlamydia trachomatis. Which clinical manifestation correlates to this diagnosis?

Mucopurulent drainage

A 38-year-old woman with proliferative breast changes of papilloma asks the nurse about her risk for breast cancer. Which statement of risk is correct?

Higher because of your papilloma

When educating a group of teenagers about sexually transmitted infections (STIs), the school nurse also mentions that cervical cancer has been associated with which viral infection?

Human papillomavirus

The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine. Which instructions are appropriate for the nurse to provide? Select all that apply.

It should be given before the child is sexually active, it prevents a common cause of cervical cancer, it can be given to boys and girls

A client is diagnosed with vulvar carcinoma, which appears as an inconspicuous thickening of the skin resembling eczema or dermatitis and may produce few symptoms other than pruritus, local discomfort, and exudation. The nurse understands that the cancer metastasizes readily through which mode?

Multiple lymph channels

When one of the mucosal glands becomes blocked and traps mucus in the deeper glands, what kind of cyst forms within the cervix?

Nabothian cysts