Female Reproductive Disorder Practice Questions NCLEX

The client in the gynecology clinic asks the nurse, "What are the risk factors for developing cancer of the cervix?" Which statement is the nurse's best response? a. "The earlier age of sexual activity and the more partner, the greater the risk." b. "Eating fast food high in fat and taking birth control pills are risk factors" c. "A chlamydia infection can cause cancer of the cervix." d. "Having early pap smears will protect you from developing cancer"

ANS: A Risk factors for cancer of the cervix include sexual activity before the age of 20 years; multiple sexual partner; early childbearing; exposure to HPV; HIV infection; smoking; and nutritional deficits of folates, beta carotene and vitamin C

The nurse is working with a client who is recovering after a cervical biopsy. Which statement by the client indicates a need for further instruction? a. "I can resume vaginal intercourse after 6 weeks." b. "I should report heavy bleeding to the health care provider." c. "I must not lift heavy objects for about 2 weeks." d. "I will use the antiseptic rinse on a regular basis."

ANS: A The client should be instructed to keep the perineum clean and dry by using antiseptic solution rinses (as directed by her health care provider) and changing pads frequently. In addition, the client is instructed not to lift heavy objects for 2 weeks and to report excessive bleeding (more than like a normal period). She can resume intercourse in about 2 weeks, when the site has healed; she does not need to wait 6 weeks.

When scheduling an annual pelvic examination and Pap test, the client asks if she should abstain from intercourse before the test. Which is the nurse's best response? a. "Yes. Avoid having intercourse for 24 hours before the test." b. "Yes. Avoid having intercourse for 2 hours before the test." c. "No. Intercourse does not interfere with this test." d. "No. Intercourse can actually enhance the test results."

ANS: A The woman should not douche, use vaginal medications or deodorants, or have sexual intercourse for at least 24 hours before the test. Such activities may prevent the accurate evaluation of smears, cultures, and cytologic data.

A client tells the nurse she is happy that she never had children because she has less risk of developing cancer. Which response by the nurse is best? a. "Actually, your risk of breast cancer is slightly higher." b. "You're right; your risk of all reproductive cancer is quite low." c. "In reality, smoking is the leading risk factor for all types of cancer." d. "Your risk of uterine cancer is higher because you had no children."

ANS: A Women who have never had children have a slightly higher risk of breast cancer than the general population. Smoking is a major risk factor for many, but not all, cancers. Uterine cancer is not influenced by pregnancy.

A client is in the clinic for an annual examination and questions the need for a pelvic examination and Pap smear because she had a hysterectomy many years ago. Which response by the nurse is most appropriate? a. "Do you still have your cervix?" b. "Are you sexually active?" c. "We can skip it if you like." d. "Let's see what the doctor says."

ANS: A Women who still have their cervix after hysterectomy still need a Pap smear according to the guidelines established for other women. Sexual activity is not relevant. Simply stating that it can be skipped does not help the woman protect her health. Asking the provider does not help the nurse further assess the client.

Which question is most important for the nurse to ask the client with a cystocele who is schedule to have a pessary inserted? a. "Do you know if you are allergic to latex?" b. "When did you started having incontinence?: c. 'When was your last bowel movement?" d. "Are you experiencing any pelvic pressure?"

ANS: A The client should be assessed for allergies to latex as a result of the composition of the pessary

The nurse is teaching high school girls about the female reproductive tract. Which statements by the nurse are accurate? (Select all that apply.) a. The vagina has an acidic environment. b. The cervix is where the Pap smear is taken from. c. The ovum is fertilized in the uterus. d. Ovaries produce sex steroid hormones. e. The breasts contain fat tissue.

ANS: A, B, D, E The acidic environment of the vagina helps protect against infection. The cervix is the site for Pap testing. The ovaries produce sex steroid hormones. The breasts contain fat, glandular, fibrous, and ductal tissue. Ova are fertilized in the fallopian tubes.

The nurse is caring for a client who is day 1 post-op hysterectomy for cancer of the ovary. Which nursing intervention should the nurse implement? Select all the apply. a. Assess for calf enlargement and tenderness b. TCDB every 6 hours c. Assess pain on a 1 to 10 pain scale d. Apply sequential compression devices to legs e. Assess bowel sounds every 4 hours.

ANS: A, C, D, E All client who had surgery are at risk for developing deep vein thrombosis and an enlarged, tender calf is a sign of DVT. Clients who have had surgery should be assessed for pain on a pain scale and by observing for physiological markers indicating pain. Sequential compression hose are used prophylactically to prevent deep vein thrombosis. The client should be assess for the return of bowel sounds.

A young adult client is in the clinic for evaluation of amenorrhea lasting 3 months. She takes birth control pills but is on no other medications. Which actions by the nurse are most appropriate? (Select all that apply.) a. Instruct the client on collecting a urinalysis for a pregnancy test. b. Assess the client's urinary and bowel habits. c. Perform a physical assessment on the client's abdomen. d. Weigh the client and calculate the body mass index. e. Reassure the client that amenorrhea can occur with oral contraception.

ANS: A, D Amenorrhea can be caused by several things, but not by urinary or bowel problems. Pregnancy should always be considered, even if the woman is on birth control of any type. Too little body fat can lead to menstrual irregularities. Simply reassuring the client is not as helpful as conducting further assessment.

The nurse is assessing the client diagnosed with rectocele. Which signs and symptoms should the nurse expect? Select all that apply. a. Rectal Pressure b. Flatus c. Fecal incontinence d. Constipation e. Urinary Frequency

ANS: A,B,C,D A rectocele cause the rectum to be pouched upward, causing rectal pressure. When the recum pushes against the posterior wall of the vagina the result is flatus.Clients with rectocele experience fecal incontinence. Clients with a rectocele frequently are constipated.

Which information should the nurse include in the discharge teaching for the client recovering from an abdominal hysterectomy? a. The client should report any vaginal bleeding or cramping to the surgeon. b. The client should started a vigorous exercise routine to restore her muscle tone. c. The client should continue sitting in the bedside chair at least six hours daily. d. The client should soak in a warm tub bath each night for 1 hour.

ANS: A. The client should report any vaginal bleeding or gastrointestinal changes suchs as distention, cramping, or changes in bowel habits.

The client diagnosed with endometriosis experience pain rated a 5 on a 1 to 10 pain scale during her menses. Which intervention should the nurse teach the client? a. Teach the client to take a stool softener when taking morphine b. Instruct the client to soak in a tepid bath for 30-45 minutes when the pain occurs. c. Explain the needs to take nonsteroidal anti-inflammatory rugs with food. d. Discuss the possibility of a hysterectomy to help relieve the pain.

ANS: C The medication of choice for mild to moderate dysmenorrhea is an NSAID. NSAIDS cause GI upset and should be taken with food.

The nurse is counseling a postmenopausal woman about her new stress incontinence. Which statement by the nurse is most important? a. "You can try a variety of briefs and undergarments." b. "It will be important to keep that area clean and dry." c. "I can refer you to a good incontinence clinic." d. "Unfortunately, incontinence is common in women your age."

ANS: B After menopause, the vagina becomes dry, thinner, and smoother. This atrophy places the vagina at risk for infection. The combination of this fact with the presence of urine places the woman at higher risk for infection. The nurse should teach the client good hygienic practices to reduce the likelihood of infection. Education about briefs/undergarments may be needed, and a referral to an incontinence clinic would be very helpful, but neither takes priority over preventing infection. Stating that incontinence is common is not a helpful strategy.

The nurse is teaching a postmenopausal woman about nutrition. Which statement by the nurse is most appropriate? a. "Be sure to eat cereal fortified with folic acid and B vitamins." b. "Make sure you take a calcium supplement every day." c. "Vitamin C is important for the postmenopausal woman." d. "You can get all the iron you need in two daily meat servings."

ANS: B Calcium is important throughout life, but for the postmenopausal woman, it is vital to help prevent osteoporosis. Folic acid and B and C vitamins are very important for the woman taking oral contraceptives. Iron might be important for this client for other reasons but is especially important for women with heavy menstrual bleeding.

A postmenopausal client says that she is experiencing difficulty with vaginal dryness during intercourse and wonders what might be causing this. Which is the nurse's best response? a. "The less frequently you have intercourse, the drier the vaginal tissues become." b. "Estrogen deficiency causes the vaginal tissues to become drier and thinner." c. "Drinking at least 3 liters of water each day will make all your tissues less dry." d. "Try using a water-soluble lubricant during intercourse."

ANS: B Estrogen deprivation, which occurs as a result of menopause, decreases the moisture-secreting capacity of vaginal cells, thereby making the area drier. The vaginal tissues also become thinner and the rugae become smoother. Reduced frequency of intercourse will not dry out the vaginal tissues. Drinking excess water will not make the tissues less dry. A water-soluble lubricant may make intercourse less difficult. However, the client is asking what causes the problem.

A young woman is not pregnant but has not had a menstrual period for 5 months. Which factors does the nurse explore as a possible cause of the amenorrhea? a. The client's mother having type 2 diabetes mellitus b. Running 10 to 15 miles/day c. Taking aspirin daily d. Having a diet high in protein

ANS: B Excessive exercise, with corresponding loss of body fat, is associated with insufficient estrogen levels for the maintenance of normal ovulatory and menstrual cycles. The other factors are noncontributory.

The client is diagnosed with benign uterine fibroid tumors. Which question should the nurse ask to determine if the client is experiencing a complication? a. "How many period have you missed?" b. "Do you get short of breath easily?" c. "How many times have you been pregnant?" d. "Where is the location of the pain you are having?"

ANS: B Many women delay surgery until anemia has occured from the heavy menstrual flow. A symptom of anemia is shortness of breath

The nurse is preparing a teaching plan for a client who is scheduled to undergo mammography for the first time. What instruction by the nurse is accurate? a. "The test should be carried out even if you are pregnant." b. "Do not use deodorant on breasts or underarms before the test." c. "You will not experience any discomfort because this is just an x-ray." d. "The entire test should not take longer than 1 hour."

ANS: B The client should be reminded not to use creams, powders, or deodorant on breast or underarm areas before mammography because these products can show on the x-ray. The test should be rescheduled if any possibility exists that the client is pregnant. Women can experience discomfort as the breasts are compressed. The test is generally much less than an hour in duration.

The nurse is caring for a client diagnosed with uterine cancer who has been receiving systemic therapy for 6 months. Which intervention should the nurse implement first? a. Determine which antineoplastic medication the client has received. b. Ask the client if she has had any problems with mouth ulcers at home. c. Administer the biologic response modifier filgrastim (Neupogen) d. Encourage the client to discuss feeling about having cancer.

ANS: B The systemic side effects of chemotherapy are not always apparent and the development of stomatitis can be extremely distressing for the client. The nurse should assess the client's tolerance to treatments.

The 50 year old female client complains of bloating and indigestion and tells the nurse she has gained two inches in her waist recently. Which question should the nurse ask the client? a. "What do you have before you feel bloated?" b. "Have you had your ovaries removed?" c. "Are you stools darker in color lately? d. " Is the indigestion worse when you lie down?"

ANS: B Ovarian cancer has vague symptoms of abdominal discomfort, but increasing abdominal girth is the most common symptom. If the client has had the ovaries removed, then the nurse would assess for another cause.

The female client has a mother who died from ovarian cancer and a sister diagnosed with ovarian cancer. Which recommendations should the nurse make regarding early detection of ovarian cancer? a. The client should consider having a prophylactic bilateral oophorectomy. b. The client should have a transvaginal ultrasound and a CA-125 laboratory test every 6 months. c. The client should have yearly magnetic resonance imaging (MRI) scans d. The client should have a biannual gynecological examination with flexible sigmoidoscopy.

ANS: B The transvaginal ultrasound is a sonogram in which the sonogram probe is inserted into the vagina and sound waves are directed toward the ovaries. The CA-125 tumor marker is elevated in several cancers. It is nonspecific but, coupled with the sonogram, can provide information about ovarian cancer for early diagnosis.

The nurse is counseling a mother who wants her teenage daughter to have a Pap smear and pelvic examination. Which statement by the nurse is most accurate? a. "If your daughter is over 18, she needs a pelvic examination and Pap smear." b. "A teenager does not need this examination unless she is sexually active." c. "Teach her to have her first examination by the age of 21 at the latest." d. "It is not needed unless you are worried about sexually transmitted diseases."

ANS: C A woman needs to have her first pelvic examination with Pap smear by the age of 21, or within 3 years of becoming sexually active. The other statements are not accurate.

The nurse is formulating a care place for a client post-abdominal hysterectomy. Which nursing diagnosis is appropriate for the client who has developed a complication? a. Potential for urinary retention. b. Potential for nerve damage c. Potential for intestinal obstruction d. Potential for fluid imbalance

ANS: C Clients who have has a total abdominal hysterectomy are at risk for intestinal obstruction.

The nurse is assessing a client with a history of irregular periods. Which condition does the nurse possibly correlate with this problem? a. Childhood mumps b. Past valve replacement surgery c. Diabetes mellitus d. Mild intermittent asthma

ANS: C Endocrine disorders can affect the hypothalamic-pituitary-gonadal function of both men and women. Mumps would be important to know if the client were male. Past valve replacement surgery would not be contributory. Mild intermittent asthma also would not contribute to this problem. However, a client with more severe asthma who takes steroids on a long-term basis may develop secondary diabetes.

What intervention should the nurse implement for a client diagnosed with rectocele? a. Limit oral intake to decrease voiding. b. Encourage a low-residue diet c. Administer a stool softener daily. d. Arrange for the client to take sitz baths

ANS: C Stool softeners are laxatives are used to prevent and treat constipation, which is common with rectocele. BEcause of the position of the rectum, stool can stay in the rectal pouch, causing constipation.

A client is scheduled for an ultrasound to evaluate for possible uterine fibroids. Which instruction by the nurse is most appropriate? a. "Do not eat or drink anything after midnight." b. "Take these laxatives the morning of the test." c. "Do not urinate an hour before the test; a full bladder will give best results." d. "Have a designated driver because you will be sleepy from the anesthesia."

ANS: C The scan is noninvasive and painless. The abdominal and pelvic organs are better visualized with the bladder full during the scan. The other statements are inaccurate

The nurse is caring for a 30 year old nulliparous client who is complaining of severe dysmenorrhea. Which diagnostic test should the nurse prepare the client to undergo to determine the diagnosis? a. A bimanual vaginal exam. b. A pregnancy test c. An exploratory laparoscopy. d. An ovarian biopsy.

ANS: C There is a high incidence of endometriosis among women who have never had children (nulliparity) and those who have children later in life. The most common way to diagnosed this condition is through an exploratory laparoscopy.

The client has had a total abdominal hysterectomy for cancer of the ovary. Which diet should the nurse discuss when providing discharge instructions? a. A low residue diet without seeds b. A low sodium, low fat diet with skim milk c. A regular diet with fruits and vegetables. d. A full liquid-only diet with mild shake supplements.

ANS: C: The client is not placed on a specific diet, but it is always a good to recommendation to include fruits and vegetables in the diet.

The nurse is conducting a reproductive assessment of a postmenopausal woman. Which assessment finding reported by the client requires immediate intervention by the nurse? a. Urinary incontinence b. Vaginal dryness c. Painful intercourse d. Returning periods

ANS: D All client reports require some action by the nurse, but the priority would be to further investigate and report the "returning periods." In a postmenopausal woman, this can signal cancer.

What specific complication should the nurse assess for in the client with uterine prolapse recovering from a anterior and posterior repair? a. Orthostatic Hypertension b. Atelectasis c. Allen sign d. Deep vein thrombosis.

ANS: D Assessing for deep vein thrombosis (DVT) is performed on all client having a vaginal hysterectomy. After any surgery requiring the client to be placed in the lithotomy position, the client should be assessed for DVT. These clients are at a higher risk for this complication.

The nurse is working with a client who is recovering after a laparoscopy. Which assessment finding is considered a priority by the nurse? a. Slight drainage from the incision site b. Grogginess after the anesthesia c. Discomfort from the catheter d. Reports of shoulder pain

ANS: D Clients should expect mild drainage or blood from the incision site. Grogginess from the anesthesia and discomfort from a catheter are also expected minor occurrences post-laparoscopy. The nurse would not be concerned about these but should intervene and treat the client with shoulder pain. Shoulder pain is referred pain from phrenic nerve irritation and can be expected.

Which states indicates further instruction is needed for the client with cystocele? a. "I need to have a sonogram to diagnosed this problem" b. "I need to practice Kegel exercises to help strengthen my muscles." c. "I lose my urine when I sneeze because of my cystocele." d. "I can never have sexual intercourse again."

ANS: D Clients with cystoceles may have seuxal intercourse unless contraindicated by another medical reason.

A client who has had numerous children is having her annual examination. The nurse wishes to discuss contraception, but the client is not interested. Which action by the nurse is most appropriate? a. Provide education on the value of spacing children. b. Explain the many alternatives from which to choose. c. Ask the client how her husband feels about so many children. d. Assess the client's religious and cultural background.

ANS: D Cultural and religious backgrounds can have a great deal of influence on clients' attitudes toward sexuality and reproduction. Because the client does not seem interested in the topic, the nurse should gently assess for these background influences and respect them. Providing education that the client does not want is not helpful and is disrespectful. Asking about the husband's preferences diminishes the nurse-client relationship, which should be focused on the client.

Which intervention should the nurse include when teaching the client who is having an anterior colporrhaphy to repair a cystocele? a. Discuss the need to perform perineal care every 4 hours b. Discuss the care of an indwelling catheter for at least one month c. Instruct the client how to care for the pessary inserted in surgery d. Teach the client how to perform Kegel exercises.

ANS: D The client should be taught how to perform kegel exercises to strengthen the muscles.

The postmenopausal client reveals it has been several years since her last gynecological examination and states, "Oh I don't need exams anymore. I am beyond having children" Which statement should be the nurse's response? a. "As long as you are not sexually active, you don't have to worry." b. "You should be taking hormone replacement therapy now." c. "You are beyond bearing children. How does that make you feel?" d. "There are situations other than pregnancy that should be checked"

ANS: D The client should have a yearly clinical examination of the breast and pelvic area for the detection of cancer.

The nurse is teaching the client diagnosed with uterine prolapse. Which information should the nurse include in the discussion? a. Increase fluid and daily exercise to prevent constipation. b. Explain there is only one acceptable treatment for uterine prolapse. c. Instruct the client to visually check the uterine prolapse daily. d. Discuss limiting coughing and lifting heavy objects

ANS: D Symptoms can be aggravated by coughing, sneezing, lifting heavy objects, standing for prolonged periods and climbing stairs.