Chapter 45: Disorders of the Female Reproductive System

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

infrequent menstruation with periods more than 35 days apart.

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."

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

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 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 human papillomavirus (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?

"Its 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."

What will the nurse teach the client who has a cervical polyp?

"Polyps typically are asymptomatic"

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?

"The test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation."

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."

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?"

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

Firm, rubbery masses

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

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

Cervical intraepithelial neoplasia

The nurse is assessing a 24-year-old client who states that she has infrequent menstrual periods that are approximately 40 to 42 days apart. She also states, "My periods are really light. It's almost like I hardly even need to use a pad sometimes." The nurse should document which medical terms associated with this client's menstruation? Select all that apply.

Hypomenorrhea Oligomenorrhea

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

Laparoscopy

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

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

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

Take all of the antibiotic

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

Vulvar pain

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 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

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.

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?

1 cm

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

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 practitioner is reviewing risk factors for the development of pelvic inflammatory disease (PID) with a client. Which information is appropriate to include? Select all that apply.

Multiple sex partners Previous diagnosis of sexually transmitted infection Sexual intercourse before the age of 15 years

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

Polycystic ovary syndrome (PCOS)

A woman comes to the clinic with complains of vague, lower abdominal symptoms. Upon physical exam, the healthcare provider recognizes the woman has symptoms of leiomyomas based on which assessment findings? Select all that apply.

Anemia Urinary frequency Rectal pressure Menorrhagia Abdominal distention

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

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)

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

Constant exposure to secretions and moisture

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.

A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be:

HPV vaccine before becoming sexually active

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

There are two types of vulvar cancer. One type is found in older women, and one type is found in younger women, generally less than 40 years of age. The type found in younger women is thought to be caused by:

Human papillomavirus (HPV)

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 presents to her primary care physician with a report of very heavy bleeding during menstrual cycles. Tests indicate the condition is not from a hormone imbalance. Which intervention option is least invasive?

Oral contraceptives

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

A malignant lesion extending into the endocervical canal was found on the yearly gynecological exam of a 20-year-old woman. Which treatment option would be most appropriate for this client?

Therapeutic conization

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

Ultrasonography and mammography

The nurse in the ER is caring for a client with lower abdominal pain that is greater on the right side and who has light vaginal spotting. When the client's human chorionic gonadroptropin (hCG) level is lower than normal, the nurse plans care for a client with:

Ectopic pregnancy

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)