Reproductive System Questions (Book, Practice, Study Guide, Class Review and Evolve)
28. What are the major goals of treatment of vaginal infections? (1801)
(a) Cure the infection, (b) prevent reinfection, (c) prevent complications, and (d) prevent infection of the sexual partner(s)
27. What are the most common disturbances related to menstruation? (1788)
(a) Amenorrhea: absence of menstrual flow (b) Dysmenorrhea: painful menstruation (c) Dysfunctional uterine bleeding (DUB), abnormal uterine bleeding (d) Menorrhagia: excessive bleeding in amount and duration (e) Metrorrhagia: bleeding between menstrual periods
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) e. No pill-free days
progestin-only pill
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) m. Requires periodic abstinence during fertile portion of menstrual cycle
rhythm method
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) f. Double-ring system fitted into vagina up to 8 hours before intercourse
female condom
20. The nurse is assisting the health care provider with a Pap test. What condition will be diagnosed by this diagnostic study? 1. Cervical cancer 2. Breast cancer 3. Pelvic inflammatory disease 4. Ovarian cancer
1
19. All pregnancy tests, regardless of method, are based on the detection of _______________________________, which secerted in the urine after fertilization of the ovum (1787).,
human chorionic gonadotropin (HCG)
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) n. Surgical removal uterus; 100% effective
hysterectomy
14. While discussing breast cancer with a group of women, what should the nurse stress as the greatest risk factor for breast cancer? 1. Being a woman over the age of 50 years 2. Experiencing menstruation for 40 years or more 3. Using estrogen replacement therapy during menopause 4. Having a paternal grandmother with postmenopausal breast cancer
4
15. A patient diagnosed with breast cancer has been offered the treatment choice of breast conservation surgery with radiation or a modified radical mastectomy. Which statement by the patient concerning the lumpectomy with radiation indicates understanding of the procedure? 1. "It preserves the normal appearance and sensitivity of the breast." 2. "It provides a shorter treatment period with fewer long-term complications." 3. "It has about the same 10-year survival rate as the modified radical mastectomy." 4. "It has a much higher survival rate than the modified radical mastectomy."
1
26. Nurses may intervene in sexual problems among patient populations through what four strategies? (1783)
(a) Educating patient groups likely to have sexual concerns (b) providing anticipatory guidance throughout the life cycle, (c) promoting a milieu conducive to sexual health, and (d) validating normalcy about sexual concerns
29. What are the four main factors that contribute to STIs being among the world's most common commu- nicable diseases? (1832)
(a) Unprotected sex, (b) antibiotic resistance, (c) treatment delay, and (d) sexual behavior patterns and permissiveness
1. A patient visits her health care provider because of an increase in her abdominal girth and dyspnea during the past month as a result of pressure on her diaphragm. She is diagnosed as having ovarian cancer. The cause for these manifestations can be explained by what physiological occurrence? 1. Development of ascites 2. Metastasis to the bowel 3. Dilation of the alveoli 4. Bladder distention
1
11. A 73-year-old patient comes to the health care provider's office with a complaint of constant seepage of feces from her vagina, causing her embarrassment due to soilage and odor. These manifestations are most consistent with what condition? 1. Rectovaginal fistula 2. Vesicovaginal fistula 3. Urethrovaginal fistula 4. Rectocele
1
19. A 40-year-old patient has a history of multiple births in the past 15 years. Her health care provider is concerned she has a cystocele. (Could have possibly meant rectocele, book is unclear) What manifestations provide support to the diagnosis? 1. Rectal pressure 2. Dysmenorrhea 3. Hemorrhoids 4. Urinary frequency
1
8. A 20-year-old patient goes to the health care provider's office with vaginal pruritus, burning, dull pelvic pain, and purulent vaginal discharge. A diagnostic test reveals she has chlamydia. What nursing intervention would best promote a successful patient outcome? 1. Encourage her to have her sexual partner(s) seek medical care as soon as possible to avoid reinfection of the patient. 2. Recommend she abstain from sexual contact while lesions are present. 3. Provide social and emotional support because the edematous, draining lymph nodes may be disturbing to the patient's self-image. 4. Educate the patient that the causative organism is a spirochete that gains entrance into the body during intercourse.
1
21. A patient has reported to the emergency department. The health care provider suspects toxic shock syndrome. What manifestations confirm this suspicion? (Select all that apply.) 1. Sudden high fever 2. Vaginal hemorrhage 3. Diarrhea 4. Sudden hypertension 5. Headache
1,3,5
10. The nurse is teaching a group of teenagers about contraception and sexually transmitted infections (STIs). The nurse asks the students if they know which is the most prevalent STI. Which response by the participants is correct? 1. Syphilis 2. Chlamydial infection 3. Gonorrhea 4. Genital herpes
2
18. On the second postoperative day, a 63-year-old patient who underwent an abdominal hysterectomy complains of gas pains and abdominal distention. The patient has not had a bowel movement since surgery. Which nursing intervention will best stimulate peristalsis and relieve distention? 1. Offering carbonated beverages 2. Encouraging ambulation at least four times daily 3. Administering a 1000-mL soapsuds enema 4. Applying an abdominal binder
2
2. The nurse is discussing breast self-examination with a 30-year-old premenopausal patient. When should the nurse advise is the best time for the patient to perform her monthly self-examination of the breasts? 1. During her menstruation 2. 7 to 8 days after conclusion of the menstrual period 3. The same day each month 4. The 26th day of the menstrual cycle
2
24. Which woman is most likely to develop toxic shock syndrome? 1. The woman with multiple sexual contacts 2. The woman who inserts tampons with her fingers 3. The woman with untreated chronic PID 4. The woman who has undergone multiple abortions
2
25. A patient is scheduled to have a Pap smear. The nurse can provide correct information about preparing for the examination by including what information? 1. Use a mild vinegar douche the night before the test. 2. Abstain from intercourse 24 hours before the test. 3. Take a warm tub bath the night before the test. 4. Save a first-voided morning urine specimen.
2
7. A 49-year-old obese diabetic patient has had a total abdominal hysterectomy. On the second postoperative day, the patient complains of increased pain in the operative site. She states, "It feels like something suddenly popped." With the symptoms presented, it would be likely that when the nurse removes the abdominal dressing she may note what occurrence? 1. The wound has a purulent exudate. 2. Dehiscence has occurred. 3. The wound is indurated and tender. 4. The wound is well approximated.
2
17. The nurse plans early and frequent ambulation for a patient who has undergone an abdominal hysterectomy to: (Select all that apply.) 1. prevent urinary retention. 2. prevent deep-vein thrombosis. 3. relieve abdominal distention. 4. maintain a sense of normalcy. 5. reduce postoperative nausea.
2,3
23. The nurse is reviewing the health history of an assigned patient. The patient was treated for pelvic inflammatory disease. What conditions may be noted in the patient's history as a result of the condition? (Select all that apply.) 1. Vaginal discharge 2. Infertility 3. Hemorrhage 4. Dyspareunia 5. Dysmenorrhea
2,4
25. Identify three functions of the organs of the male reproductive system. (1776)
25. (a) Producing and storing sperm, (b) depositing sperm for fertilization, and (c) developing the male secondary sex characteristics
12. The American Cancer Society recommends that women have an annual screening mammography beginning at what age? 1. 21 years 2. 35 years 3. 40 years 4. 52 years
3
17. By ____ years of age, children are aware that they will remain boys or girls and that no outward change in their appearnce will alter this.
3
22. Lower abdominal and lower back pain that increases in severity during menstruation may signal which condition? 1. Cervical polyp 2. Ovarian tumor 3. Endometriosis 4. Uterine cancer
3
3. A 52-year-old patient has ductal cell carcinoma of the left breast. After a modified radical mastectomy, a Davol drain is placed in the left axillary region. What is the primary purpose of this drain? 1. To control numbness of her left incisional site 2. To improve her ability to perform range-of-motion exercises on her affected side 3. To facilitate drainage and to prevent formation of a hematoma 4. To prevent postoperative phlebitis in her affected arm
3
5. A 44-year-old patient is admitted for an abdominal hysterectomy. She is instructed that she will have a Foley catheter in place postoperatively. She asks the nurse how many days she will have the catheter in place. What is the best response by the nurse? 1. "The indwelling catheter will probably remain in place for 1 week." 2. "The indwelling catheter will be removed after you are fully awake from the anesthesia." 3. "The indwelling catheter will generally be removed on the first postoperative day." 4. "The indwelling catheter will remain in place for a few days postdischarge."
3
9. A 23-year-old man is diagnosed with gonorrhea. Because of statements made in his patient interview, the nurse has established a nursing diagnosis of noncompliance. Which is the most effective way to overcome noncompliance for this patient? 1. Telephone follow-up 2. Case finding 3. Single-dose treatment of ceftriaxone (Rocephin) IM 4. Extensive patient education program
3
13. The first lymph node most likely to drain the cancerous site in a patient with breast cancer is known as the: 1. axillary node. 2. contaminated node. 3. primary node. 4. sentinel node.
4
26. A patient's husband tells the nurse that his wife, who has been diagnosed with inoperable ovarian cancer, is talking about dying and her fear of death. He asks the nurse for suggestions to help his wife. Which response by the nurse would be most helpful? 1. "Your wife will probably die of another disease before she dies of ovarian cancer." 2. "Talk of death is normal at this time, but will diminish in the future." 3. "Your wife is expressing acceptance of the need for hospice care." 4. "It is perfectly normal to want to talk about death. It is most helpful to support her by listening."
4
4. A 35-year-old patient has undergone a vasectomy. Teaching for this patient should include what information? 1. The procedure is reversible if he later changes his mind. 2. He should abstain from sexual intercourse until the incision is completely healed. 3. He should apply warm compresses to the scrotum four times a day. 4. He should return to the health care provider at regular intervals for sperm counts.
4
16. The nurse is educating a patient who has undergone a modified radical mastectomy in ways to prevent lymphedema. What should the nurse include in the information provided? (Select all that apply.) 1. Use a sling for the first 2 weeks after the procedure. 2. Expose the arm to sunlight to increase circulation. 3. Wrap the arm with elastic bandages during the night. 4. Avoid unnecessary trauma (e.g., venipuncture, blood pressure) to the arm on the operative side. 5. Elevate the hand and arm above the level of the chest.
4,5
6. A 60-year-old patient underwent a vaginal hysterectomy for a prolapsed uterus. The nurse is aware that patients undergoing pelvic surgery are more susceptible to what postoperative complications? (Select all that apply.) 1. Wound dehiscence 2. Postoperative loss of libido 3. Atelectasis 4. Venous stasis 5. Thrombophlebitis
4,5
16. Prostate enlargement is increasingly common with each decade after _______ years of age. (1781)
40
20. The appearance of the male climacteric phase is gradual and occurs between _______ and _______ years of age. (1796
55;70
18. It is believed that the average breast tumor is present for _______ years before it is palpable. (1786
9
5. On the fourth postoperative day after a modified radical mastectomy, the nurse finds the patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore. The nurse bases subsequent nursing interventions on what diagnosis? a. Disturbed body image related to removal of her breast b. Deficient knowledge related to inadequate education c. Impaired social interaction related to depression d. Fear related to the cancer diagnosis and surgical intervention
ANS: A After losing a breast, many patients experience grief over the loss of a body part. The process of grieving is essential for personal adaptation to the loss. The nurse can assist the patient to find helpful coping mechanisms. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1824 OBJ: 18 TOP: Mastectomy KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity
20. Why is a mammogram the most useful method of diagnosing breast cancer? a. It is the most reliable method of detecting breast cancer before it becomes palpable. b. It is inexpensive and covered by most medical insurance plans. c. It involves no radiation and takes only a few minutes. d. It involves no pain or discomfort and is readily available.
ANS: A Mammography is radiography of the soft tissue of the breast to allow identification of various benign and neoplastic processes, especially those not palpable on physical examination. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1817 OBJ: 5 TOP: Diagnostic procedures KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance
10. Which patient is most at risk for the infection of epididymitis? a. 17-year-old athlete who trains for several hours a day b. 22-year-old who has been exposed to mumps c. 45-year-old who was circumcised at the age of 10 d. 50-year-old who has smoked for 30 years
ANS: A Symptoms can occur after trauma to the genital area, after instrumentation of the urethra and cystoscopy, and after physical exertion or prolonged sexual activity. PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 1828 OBJ: 20 TOP: Epididymitis KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
12. The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy. Which statement by her indicates to the nurse that the teaching has been successful? a. "I should sleep on the side opposite my mastectomy." b. "I should keep my right arm supported in a sling when I am up and around until my incision is healed." c. "I can do whatever exercises and activities I want as long as I don't elevate my right hand above my head." d. "I should take aspirin before moving or exercising my arm to prevent pain during the exercises."
ANS: A The patient should be instructed to avoid sleeping on the involved arm. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1823-1824, Box 51-7 OBJ: 18 TOP: Mastectomy KEY: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity
2. On the second postoperative day, a patient who has had an abdominal hysterectomy complains of gas and abdominal distention. Which intervention would be most appropriate to stimulate a bowel movement? a. Offering carbonated beverages b. Encouraging ambulation at least four times per day c. Administering a 1000-mL soapsuds enema d. Applying an abdominal binder
ANS: B Early ambulation is very helpful to return the bowel to normal function. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1813 OBJ: 14 TOP: Hysterectomy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity
1. Which condition would prevent the use of a vaginal hysterectomy? a. A woman with more than four pregnancies b. Large uterine fibroids c. Menorrhagia for over 6 months d. Women over the age of 50
ANS: B In the case of large uterine fibroids, a vaginal hysterectomy is not an option. PTS: 1 DIF: Cognitive Level: Application REF: Page 1813 OBJ: 14 TOP: Hysterectomy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity
16. What instruction should a nurse give a patient with congenital herpes who does not have lesions at the present? a. "Continued use of acyclovir (Zovirax) will prevent reinfection by the virus." b. "Condoms should be used during all sexual activity to prevent transmission of the virus, even when lesions are not present." c. "Acyclovir ointment should be applied to the lesions to increase comfort and speed healing." d. "Recurrent genital herpes is promoted by any sexual stimulation."
ANS: B Sexual transmission of HSV (genital herpes, a virus) has been documented even in the absence of clinical lesions, and the use of condoms should be encouraged. Acyclovir does not cure the disease but makes the attacks less virulent. PTS: 1 DIF: Cognitive Level: Application REF: Page 1831, Safety Alert OBJ: 23 TOP: Genital herpes KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance
4. A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She asks the nurse if she will have "hot flashes." What knowledge will guide the nurse's response? a. Only the uterus was removed, and the ovaries are still producing estrogen and she will not have hot flashes. b. The patient is too young to have hot flashes associated with menopause. c. The uterus, ovaries, and fallopian tubes were removed, and she will have surgically induced menopause and may have hot flashes. d. The uterus and fallopian tubes were removed, and she will not experience "hot flashes."
ANS: C A total abdominal hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, fallopian tubes, and ovaries. If the ovaries are removed in these surgeries, the surgery will induce menopause and hot flashes may occur. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1813 OBJ: 14 TOP: Hysterectomy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity
6. Why would the nurse encourage the patient who is recovering from a modified radical mastectomy to exercise the affected arm? a. To reduce pain b. To stimulate appetite c. To reduce lymphedema d. To increase muscle tension
ANS: C An exercise regimen, built up gradually, can help reduce lymphedema following a modified radical mastectomy. PTS: 1 DIF: Cognitive Level: Application REF: Page 1823-1824, Box 51-7 OBJ: 19 TOP: Postmastectomy exercises KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
9. Which statement made by a patient who has been taught the technique of testicular self-examination indicates the need for further teaching? a. "The testes feel smooth and egg-shaped." b. "The best time to perform TSE is after a shower." c. "I will examine my scrotum after every ejaculation." d. "The epididymis feels like a soft tube."
ANS: C It is not recommended for a patient to perform a testicular self-examination after every ejaculation. Perform testicular self-examination after a bath or shower when the scrotum is warm and most relaxed. The testes should feel smooth and be firm to the touch. The epididymis feels like a soft tube. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1830, Figure 51-16 OBJ: 22 TOP: Testicular self-examination KEY: Nursing Process Step: Evaluation MSC: NCLEX: Health Promotion and Maintenance
18. A Gram stain smear of the patient's discharge reveals the presence of N. gonorrhoeae. He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease. Which information should the nurse include in response to his comment? a. "Women do not develop gonorrhea infections but can serve as carriers to spread the disease to males." b. "When gonorrhea infections occur in women, the disease affects only the ovaries and not the other genital organs." c. "Many women are not aware that they have gonorrhea because they often do not have symptoms of infection." d. "Women develop subclinical cases of gonorrhea that do not cause tissue damage or symptoms."
ANS: C Most women remain asymptomatic but may show a greenish-yellow discharge from the cervix. PTS: 1 DIF: Cognitive Level: Application REF: Page 1834 OBJ: 23 TOP: Infectious diseases KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
17. The 10-year-old clinic patient reports that she is free of gonorrhea and can now engage in sexual activity. Which response is most appropriate? a. "If you have been free of symptoms for 2 weeks you are cured." b. "You should get a rapid plasma reagin (RPR) just to make sure." c. "No case is considered cured until you have had three consecutive negative cervical smears." d. "To confirm your cure, you should get a Venereal Disease Research Lab (VDRL)."
ANS: C No case of gonorrhea is considered cured until you have had three consecutive negative cervical smears. The RPR and the VDRL are tests for syphilis. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1835 OBJ: 8 TOP: Pelvic inflammatory disease (PID) KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
15. What does the diagnosis of secondary infertility refer to? a. Has never conceived b. Is infertile because of repeated infection c. Has conceived but is now unable to do so d. Is over the age of 38
ANS: C Secondary infertility refers to a woman who has conceived in the past and now is unable to do so. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1797 OBJ: 7 TOP: Infertility KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity
14. What is the recommended age range for a baseline mammogram? a. 25 and 30 years b. 31 and 34 years c. 35 and 39 years d. 40 and 45 years
ANS: C The American Cancer Society recommends that mammograms be performed on women between 35 and 39, and annually for women 40 years of age and older. PTS: 1 DIF: Cognitive Level: Knowledge REF: Pages 1816-1817 OBJ: 5 TOP: Routine examination KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance
8. At what age should a male be taught testicular self-examination (TSE)? a. 10 b. 13 c. 15 d. 20
ANS: C Young men should be taught to perform TSE monthly beginning at 15 years of age. PTS: 1 DIF: Cognitive Level: Application REF: Page 1830 OBJ: 22 TOP: Testicular self-examination KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance
19. The patient who had a colporrhaphy for the repair of a cystocele and rectocele asks that the catheter be removed as it is bothersome to her. How should the nurse explain the reason for the catheter? a. It replaces uncomfortable gauze packing b. It will prevent adhesions and will be in place for about 2 weeks c. It allows for quick urine sample collection d. It keeps the bladder empty, and prevents stress on the sutures
ANS: D A retention catheter is usually inserted into the bladder to keep it empty and prevent pressure on sutures. PTS: 1 DIF: Cognitive Level: Analysis REF: Page 1806 OBJ: 14 TOP: Postoperative care KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
3. The young husband of a patient who has been scheduled for a hysterectomy because of the discovery of ovarian cancer in both ovaries says to the nurse, "Please go talk to my wife. She is real upset and says she won't be a 'woman' anymore." What is the nurse's most therapeutic response? a. "Don't be concerned. All young women get upset before this kind of surgery." b. "Certainly, I will be glad to tell her about hormone replacement." c. "She will get over this feeling soon." d. "No matter what I may say to her, it is you that needs to listen to her concerns and assure her."
ANS: D Assisting patients with recognizing and clarifying fears and with developing coping strategies for those fears by listening is helpful. PTS: 1 DIF: Cognitive Level: Application REF: Page 1822, Nursing Care Plan OBJ: 12 TOP: Ovarian cancer KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity
13. A female patient, age 48, is undergoing a routine physical examination for the first time in 5 years. Which procedure would be included in this examination? a. Culdoscopy b. Colposcopy c. Cervical biopsy d. Papanicolaou smear
ANS: D The American Cancer Society recommends that all women who are or have been sexually active or who are at least 18 years of age have an annual Pap smear for 3 consecutive years and then every 3 years until middle age. PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 1783 OBJ: 5 TOP: Routine examination KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance
11. A patient, age 26, has had a tubal insufflation (Rubin test) to ascertain whether her fallopian tubes are patent. She complains of pain in her right shoulder. Which response is most appropriate? a. "Don't worry, that is a normal reaction." b. "I'll report the findings immediately to the head nurse." c. "That is a symptom that resulted from your position on the operating table." d. "That is from the carbon dioxide passing from the fallopian tubes into your abdomen."
ANS: D The Rubin insufflation test determines tubal patency. Carbon dioxide escapes into the abdominal cavity through the patent left fallopian tube. PTS: 1 DIF: Cognitive Level: Application REF: Page 1786 OBJ: 4 TOP: Diagnostic procedures KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
7. A 20-year-old patient presents in the emergency room with a temperature of 103° F, blood pressure of 92/58, headache, and desquamation of both palms. What should the nurse make sure to ask about during the interview? a. Any recent traveling outside the country b. Immunization against influenza c. Method of birth control d. Use of tampons
ANS: D These are signs of toxic shock frequently brought on by leaving a tampon in place too long. The nurse should inquire about tampon use, headache, muscle pain, and fatigue. PTS: 1 DIF: Cognitive Level: Application REF: Page 1802 OBJ: 6 TOP: Toxic shock syndrome (TSS) KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
36. The nurse is interviewing a patient ***** ports that her menstrual periods seem heavier than usual. Which question(s) would the nurse ask? (Select all that apply.) (1792) 1."How many days have you had menstrual flow?" 2."How many days would your period typically last?" 3."How many pads or tampons are you saturating per day?" 4."How frequently would you normally change a pad/tampon?" 5."Do you take aspirin or other anticoagulant medications?" 6."Have you recently started a rigorous exercise program?"
Answer 1, 2, 3, 4, 5: The nurse is assessing for menorrhagia or abnormally excessive bleeding. Comparing flow and pad/tampon use to regular periods is one way to determine amount of blood loss. Aspirin and anticoagulants could potentiate blood loss. Rigorous exercise is more likely to be associated with amenorrhea.
50. Tamoxifen has been ordered to manage a patient diagnosed with breast cancer. Which characteristics are associated with tamoxifen? (Select all that apply.) (1821) 1. Inhibits the growth-stimulating effects of estrogen 2. Hormonal agent of choice for postmenopausal women 3. Used to manage recurrent breast cancer 4. Used to prevent breast cancer in high-risk individuals 5. Used for women desiring continued fertility
Answer 1, 2, 3, 4: Tamoxifen is not used for women who desire continued fertility. The other statements apply to tamoxifen.
31. Which illnesses can result in actual inabilities to function sexually? (Select all that apply.) (1783) 1. Diabetes mellitus 2. End-stage renal disease 3. Primary syphilis 4. Hypertension 5. Spinal cord injuries
Answer 1, 2, 4, 5: Many illnesses—such as diabetes mellitus, end-stage renal disease, hypertension, cancer, certain types of prostate surgery, spinal cord injuries, organ transplants, chronic obstructive pulmonary disease, and heart disease or heart surgery—may cause patients concern or may result in actual inabilities with sexual function. In primary syphilis, there may be a rash or painless chancre, but sexual function is not impaired; thus, the risk to infect others continues.
49) Anemia is a side effect associated with chemo- therapy. Which medications may be ordered to manage this complication? (1821) 1. Epoetin alfa (Procrit) 2.Prochlorperazine(Compazine) 3. Granisetron (Kytril) 4. Ondansetron (Zofran)
Answer 1: Epoetin alfa (Procrit) is helpful in raising erythrocyte counts to help correct anemia. The other drugs could be ordered to control the nausea and vomiting associated with chemotherapy.
41. The woman is undergoing a tubal insufflation test. Which outcome suggests that the fallopian tubes are blocked? (1787) 1.No pain or other symptoms are experienced during the test. 2.The patient experiences shoulder pain during the test. 3.A high-pitched bubbling is auscultated over the abdomen.
Answer 1: If the patient doesn't experience any pain, it means that the tubes are occluded, so the gas is not passing through.
54. What is the treatment of choice for primary syphilis? (1834) 1. Penicillin 2. Acyclovir 3. Valtrex 4. Tetracycline
Answer 1: Parenteral benzylpenicillin (penicillin G) remains the treatment of choice for all stages of syphilis. In patients who have an allergy to penicillin, tetracycline, erythromycin and ceftriaxone are prescribed.
37. Which disorder is most likely to be treated with an antidepressant medication? (1793) 1.Premenstrual dysphoric disorder 2.Premenstrual syndrome 3.Pelvic inflammatory syndrome 4. Polycystic ovarian syndrome
Answer 1: Premenstrual dysphoric disorder is a severe mood disorder that may be treated with antidepressants.
43. The nurse is reviewing the medication lists for several patients. Which combination of medi- cations must be immediately brought to the at- tention of the health care provider? (1798) 1). Sidenafil citrate (Viagra and nitrates (nitrotroglycerin tablets) 2. Vitamin B6 supplement and ibuprofen (Motrin) 3.Cefoxitin (Mefoxin) and steroids (Prednisone) 4.Danazol (Danocrine) and vitamin E supplement
Answer 1: Sildenafil citrate (Viagra) can potentiate the hypotensive effects of nitrates (nitroglycerin tablets). The nurse would alert the health care provider so the patient can be properly advised. Vitamin B6 supplement and ibuprofen (Motrin) could be prescribed for dysmenorrhea. Cefoxitin (Mefoxin) and corticosteroids are prescribed to treat PID. Danazol (Danocrine) and vitamin E supplement could be prescribed to treat fibrocystic breast disease.
32. Which woman needs to be advised to have an annual Pap smear? (1784) 1. A 17-year-old who has been sexually active since age 14 2. A 19-year-old who has never been sexually active 3. A 31-year-old who had three normal consecutive Pap smears 4. A 25-year-old who had a hysterectomy for traumatic injury
Answer 1: The American Cancer Society recommends that every woman begin annual Pap tests within 3 years after becoming sexually active or no later than 21 years of age. Women age 30 years or older who have had three normal Pap tests in a row may be screened every 2 to 3 years instead of annually. Women who have had a hysterectomy may stop having cervical cancer screenings (unless their surgery was done as a treatment for cervical cancer or precancerous cells).
52. A 22-year-old woman who has a history of cervical dysplasia is scheduled for a conization procedure to remove a small eroded area on her cervix. What nursing care is appropriate for this procedure? (1784) 1. Assess for allergies to seafood or iodine. 2. Monitor for bleeding after the procedure. 3. Encourage fluids prior procedure 4. Remind to refrain from using deodorants.
Answer 2: A cone-shaped section will be cut from the cervix; thus, it is important to monitor for bleeding after the procedure. Schiller's iodine test is used for the early detection of cancer cells and to guide the health care provider in doing a biopsy. Encouraging fluids is done prior to ultrasound. Refraining from powders, deodorants, or ointments is an instruction given for mammography
51. An autologous bone marrow transplant is planned for a patient with breast cancer. Which statement is correct? (1822) 1. Radiation is administered before the transplant to reduce the cancerous growth. 2. Patient will donate bone marrow, form which stem cells will be harvested. 3. Chemotherapy administration reduces success for the bone marrow transplant. 4. Plasmapheresis is performed on the donor stem cells before transplantation.
Answer 2: Autologous indicates originating within self; thus, the patient donates the bone marrow. Chemotherapy is performed prior to the transplant. Radiation and plasmapheresis are not used.
45. What is an early manifestation of toxic shock syndrome? (1803) 1. Decreased urine output 2. Flulike symptoms 3. Desquamation of palms 4. Hypotension
Answer 2: Flulike symptoms often occur in the first 24 hours. The other symptoms will occur later.
39. What is the physiologic rationale that supports use of calcium and vitamin D supplements for postmenopausal women? (1795) 1. These supplements are an alternative to hormone replacement therapy to relieve hot flashes 2. Decreased bone density occurs with meno- pause; calcium and vitamin D support bone health. 3. Calcium and vitamin D mimic estrogen and progesterone in their structure and function in the body. 4. Postmenopausal women are more likely to decrease active exercises that contribute to bone health.
Answer 2: The hormonal changes that accompany menopause lead to decreased bone density. Calcium and vitamin D should be encouraged throughout life to support bone
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) d. Device inserted into uterus; flexible object made of plastic
intrauterine device
35. For which condition is the nurse most likely to use a heat application as a comfort measure? (1790) 1. Amenorrhea 2. Dysmenorrhea 3. Menorrhagia 4. Metrorrhagia
Answer 2: The pain of "menstrual cramps" that are characteristic of dysmenorrhea can be relieved with local heat applications or warm showers. In the other conditions, abdominal pain is not anticipated; in addition for excessive bleeding or irregular bleeding, heat applications could worsen the bleeding.
48) An advantage of brachytherapy over traditional radiation therapy is that brachytherapy: (1821) 1. is more cost-effective. 2. will take less time to complete. 3. is associated with fewer side effects. 4. uses a lower dosage of radiation
Answer 2: The technique uses a balloon catheter to insert radioactive seeds into the breast after the tumor is removed (at the time of the lumpectomy or shortly thereafter into the tumor resection cavity). In brachytherapy, an internal radiation therapy, the patient is hospitalized for 48 hours. For external radiation, the treatments are usually done 5 days a week for 5-6 weeks
40. For most menopausal women, which symptom/condition could be relieved by the use of a water-soluble lubricant , such as KY (1796) 1. Pruritus 2. Phimosis 3. Dyspareunia 4. Procidentia
Answer 3: Dyspareunia is pain with sexual intercourse. For postmenopausal women, this could be related to dryness in the vaginal vault. Pruritus is itching. Procidentia is another term for uterine prolapse. Phimosis is a condition in which the prepuce (foreskin) is too small to allow it to be retracted over the glans.
42) A 57-year old male patient confides in the nurse that he doesn't feel as productive or sexually powerful as he used to. What should the nurse say first? (1797) 1. "I understand how you feel; aging makes us feel like time is slipping away" 3. "What factors are contributing to the changes that you see in yourself 4. "Let's talk about ways that you can cope with your loss of sexual power"
Answer 3: First the nurse tries to help the patient identify what things, events, or factors are making him experience this sense of losing power. After initial assessment, the nurse may decide to discuss with the patient feelings about aging, review past accomplishments, or talk about coping strategies.
44. The nurse places the patient with pelvic inflammatory disease in a fowler's position. What is the rationale for using this position for this patient? (1802) 1. Facilitate respiratory effort 2. Prevent aspiration 3. Facilitate vaginal drainage 4. Decrease strain on the abdomen
Answer 3: For patients with PID, the Fowler's position facilitates the flow of vaginal drainage.
33. In caring for men who have had diagnostic testing of the reproductive system, the nurse would provide the comfort measures of scrotal support and an ice application for which diagnostic test? (1787) 1. Semen analysis 2. Prostatic smear 3. Testicular biopsy 4. Prostate specific antigen
Answer 3: In testicular biopsy, a sample is obtained by aspiration or through an incision into the testes. For semen analysis, the semen can be obtained by manual stimulation, or by using a condom. The prostatic smear is obtained by massaging the prostate via the rectum. The prostate-specific antigen is a blood test.
53. When teaching a patient about the rationale for prescribing oral contraceptives to treat dysmenorrhea, the nurse's statement is based on the understanding that oral contraceptives will: (1790) 1. suppress ovulation by increasing prostaglandin levels. 2. suppress ovulation by increasing estrogen levels. 3. suppress ovulation by inhibiting prostaglandin levels. 4. promote ovulation by increasing estrogen levels.
Answer 3: Oral contraceptives may be usedto suppress ovulation by inhibiting prostaglandin levels. A recent theory proposes that dysmenorrhea may be caused by hypercontractility of the uterus resulting from higherthan- normal levels of prostaglandins.
56. A patient who has a pessary reports foul smelling discharge, baginal irritation, and difficulty with sexual intercourse. Which question should the nurse ask? (1807) 1. Have you been using vaginal douching? 2. Are you having burning with urination? 3. How long has it been since it was cleaned? 4. Do you use spermicidals for birth control?
Answer 3: Pessaries are placed for uterine support. They should be removed and cleaned every 3-4 months. Unattended pessaries can cause erosion, fistula, and carcinoma
34. Following a cystoscopy, which finding would be considered normal? (1787) 1. Elevated temperature 2.Decreased urinary output 3. Pink-tinged urine 4. Low-back pain
Answer 3: Pink-tinged urination, urinary frequency, and burning with urination are considered normal because of the mechanical irritation caused the scope. The other findings are not expected and could signal infection or other complications.
47. Radiation has been scheduled for a patient diagnosed with breast cancer. When developing the plan of care, when should the nurse anticipate radiation will take place? (1821) 1. Radiation will begin within 72 hours after surgery. 2. Radiation will begin within 1 week after surgery. 3. Radiation will begin 2 to 3 weeks after surgery. 4. Radiation will begin 4 to 6 weeks after surgery.
Answer 3: Radiation therapy is usually started 2-3 weeks after surgery, when the wound is completely healed and the patient can comfortably raise her arm over her head.
38. A 55-year-old woman reports that she went through menopause 3 years ago, but has started to have a menstrual flow again and she wonders if she should start using birth control again. What should the nurse say? (1812) 1. "Resuming birth control is a good idea if don't want to get pregnant?" 2. "Pregnancy is probably not likely since you went through menopause three years ago." 3. "Vaginal bleeding after menopause is not expected. see your health care provider"
Answer 3: This patient should be referred to the provider, because the bleeding could be a signal of cancer.
55. A 22-year-old man comes to the clinic with complaints of urethritis, dysuria, and purulent penile discharge. What medical diagnosis should be anticipated? (1835) 1. Genital herpes 2. Syphilis 3. Chlamydia 4. Gonorrhea
Answer 4: In the male signs and symptoms of gonorrhea are mild to severe transient urethritis, dysuria, frequent urination, pruritus, and purulent exudate. Genital herpes is characterized by recurrent episodes of acute, painful, erythematous, vesicular eruptions (blisters) on or in the genitalia or rectum. The first sign of primary syphilis is a painless erosion or papule that ulcerates superficially with a scooped-out appearance. In men, signs and symptoms of chlamydia may include a scanty white or clear exudate, burning or pruritus around the urethral meatus, urinary frequency, and mild dysuria.
46. What advice does the nurse give about tampon use in order to prevent toxic shock syndrome? (1803) 1. Use an applicator to insert super-absorbent tampons. 2. Wash hands thoroughly after inserting a tampon. 3. Tampons should be changed every 8 hours. 4. Alternate the use of tampons with use of pads.
Answer 4: Tampons and pads should be alternated. The use of super-absorbent tampons is not recommended. Tampons should be changed every 4 hours. The hands should be washed after insertion, but washing them before is the key to preventing toxic shock.
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) j. Thin rubber sheath fitting over erect penis
male condom
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) h. Only drug given be injection every 3 months
medroxyprogesterone (Depo-Provera)
23. CA-125 can detect primary ovarian cancer. (1787)
False: CA-125 has been touted as a way to detect primary ovarian cancer, but unfortunately it does not do so. CA-125 is useful mainly to signal a recurrence of ovarian cancer and to follow the response to chemotherapy treatment.
21. The hymen can only be ruptured during sexual intercourse. (1779)
False: Rigorous exercise or the insertion of a tampon may tear the hymen. If the hymen does remain intact, it is ruptured by coitus (intercourse).
22. In giving patient information about sexuality, the implication is that the nurse agrees with specific beliefs (1782)
False: The goal of patient education is to provide information without influencing patient choices, regardless of the nurse's personal beliefs
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) b) Consists of a thin flexible rod, which is inserted subdermally
Implanon
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) c. Rubber thimble-shaped shield covering cervix, held place suction
cervical cap
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) g) Contains both estrogen and progesterone
combination pill
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) i. Dome- shaped latex cap with flexible metal ring
diaphragm
24. Delaying childbearing by women with endometriosis is not recommended as worsening of the condition may result in a loss of fertility. (180
True
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) a. Take two within 72 hours of coitus; repeat if vomiting occurs; take second dose 12 hours later
morning-afterpill
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) l. Crushing, ligating, clipping, or plugging of Fallopian tubes
tubal sterilization
Directions: Match the birth control method with the description. Indicate your answers in the spaces provided. (1839- 1841) k. Bilateral surgical ligation and resection of the ductus deferens
vasectomy
