Exemplar 19.B - Menopause
A client who is experiencing menopause expresses an interest in using alternative and complementary therapies to manage her symptoms. Which initial response by the nurse is most appropriate? A) "What types of therapies are of interest to you?" B) "Those therapies seldom work." C) "Have you discussed this with your physician?" D) "Many women report success with these measures."
A
A client who is postmenopausal confides in the nurse that she has been experiencing pain during intercourse. What should the nurse instruct the client to do? A) Use vaginal lubricants during intercourse. B) Avoid intercourse. C) Tolerate this problem because it is a normal part of aging. D) Decrease the frequency of intercourse to decrease the pain.
A
A nurse is evaluating the care provided to a client who is experiencing menopause. Which observation indicates that the client is successfully managing her menopausal symptoms? A) The client has lost 5 pounds in 4 months after starting an exercise program. B) The client reports consuming about 800 mg of calcium per day. C) The client has gained 8 pounds in 3 months despite regularly engaging in non-weight-bearing exercise. D) The client states that she is "doing fine" so there's no need for her to keep talking about menopause.
A
The nurse is assessing a postmenopausal client. Which client statement indicates the need for further assessment by the nurse? A) "I use water-soluble lubricant to treat my vaginal dryness." B) "For some reason, I have more sexual desire than ever." C) "Sex certainly takes longer than it used to, but I'm getting used to that." D) "I am so glad that I don't need to worry about sex anymore."
D
Which of the following clients would be described as experiencing premature ovarian failure? A) A 29-year-old woman who is receiving chemotherapy that damages her ovaries B) A 43-year-old woman who has irregular periods as a result of ovarian dysfunction C) A 35-year-old woman who recently underwent an oophorectomy D) A 32-year-old woman who does not ovulate because of an abnormally low number of ovarian follicles
D
A client with a history of breast cancer who is entering menopause is seeking information about how to manage hot flashes. Which of information should the nurse provide to the client? A) Soy may be useful in reducing hot flashes, but researchers are still gathering evidence. B) Hot flashes will continue until menopause is complete. C) Estrogen is the only reliable treatment for hot flashes. D) Black cohosh is effective in the management of hot flashes.
A
A premenopausal client tells the nurse that she is not looking forward to menopause because it means her life is over. When the nurse asks what she means by this statement, the client says, "I can't imagine that anyone will have much use for an old woman who can't have children anymore." Based on this statement, which nursing diagnosis would most likely be appropriate for the client at this time? A) Ineffective Sexuality Pattern B) Deficient Knowledge C) Situational Low Self-Esteem D) Disturbed Body Image
C
A nurse is caring for a client who is perimenopausal who states that she has recently had frequent bacterial vaginal infections. Which reason for these infections should the nurse include in the response to the client? A) Decreased vaginal pH B) Increased vaginal pH C) Increased estrogen level D) Decreased vasomotor stability
B
Which of the following statements is true with regard to surgical menopause and oophorectomy? A) Natural conception is not an option for women who have undergone single oophorectomy. B) Surgical menopause may be successfully treated with hormone replacement therapy. C) Onset of surgical menopause is usually gradual. D) Oophorectomy is always accompanied by either hysterectomy or salpingectomy.
B
A nurse is caring for a client in menopause. When discussing hormone replacement therapy (HRT) with the client, the nurse should include which of the following statements? A) "Most healthy, recently menopausal women should not use HRT for relief of hot flashes and vaginal dryness." B) "HRT is the least effective treatment of menopausal hot flashes and vaginal dryness." C) "If vaginal dryness and painful intercourse are the only symptoms, then low-dose vaginal estrogen is preferred." D) "The risk of blood clots in the legs or lungs is further increased by using transdermal patches, gels, or sprays."
C
A client who is approaching menopause is interested in oral hormone replacement therapy (HRT) to manage her symptoms. Which of the following points should the nurse include in this client's teaching plans? A) HRT decreases a woman's risk for deep vein thrombosis. B) HRT helps protect women against stroke and congestive heart failure. C) HRT is often useful for women who are at increased risk for osteoporosis. D) HRT is associated with a reduced incidence of breast cancer and pulmonary embolism.
C
A female client asks what causes the symptoms of menopause. On which hormonal function should the nurse focus when responding to this client's question? A) Increased estradiol levels B) Increased progesterone levels C) Decreased estrogen levels D) Increased luteinizing hormone levels
C