Chapter 33 - Patients w/ Breast and Female Reproductive Disorders

Atypical hyperplasia increases a women's risk for breast cancer about how many times compared with that of the general population? 4 2 6 8

4

Which client has the highest risk of ovarian cancer? 30-year-old woman taking hormonal contraceptives 36-year-old woman who had her first child at age 22 40-year-old woman with three children 45-year-old woman who has never been pregnant

45-year-old woman who has never been pregnant The incidence of ovarian cancer increases in women who have never been pregnant, are older than age 40, are infertile, or have menstrual irregularities. Other risk factors include a family history of breast, bowel, or endometrial cancer. The risk of ovarian cancer is reduced in women who have taken hormonal contraceptives, have had multiple births, or have had a first child at a young age.

A patient reports to the nurse that she has a sense of pelvic pressure and urinary problems such as incontinence, frequency, and urgency. The problem has gotten much worse since the birth of her third child. What does the nurse suspect the patient is experiencing? A cystocele A rectocele An enterocele A urinary tract infection

A cystocele

A female client is diagnosed with breast abscess. She would like to continue to breast-feed her newborn. Which of the following would be most appropriate in this situation? Encourage the client to include protein content in the diet. Instruct the client to wear a tight-fitting bra. Reduce the frequency of removing and reapplying the dressings. Assist the client to pump the breasts to remove breast milk.

Assist the client to pump the breasts to remove breast milk.

A 50-year-old woman is scheduled for discharge this morning following a left-sided simple mastectomy that was performed yesterday to treat noninvasive breast cancer. When providing this woman's care prior to discharge, what action should the nurse prioritize? Encourage the woman to void in a commode rather than ambulating to the bathroom. Remove the Steri-strips from the woman's incision to assess the incision. Avoid measuring the woman's blood pressure on her left arm. Assess the woman's active and passive range of motion to her left arm

Avoid measuring the woman's blood pressure on her left arm.

A nurse in a campus medical clinic is meeting with a 23-year-old student who states that she has been experiencing malodorous vaginal discharge over the past several days. The nurse should recognize that this patient is describing a sign that is characteristic of: Bacterial vaginosis (BV) Dysmenorrhea Vulvovaginal candidiasis (VVC) Human papillomavirus (HPV)

Bacterial vaginosis (BV)

A client has undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following? Leukopenia Neurotoxicity Bladder dysfunction Clotting deficiencies

Bladder dysfunction

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following? Herniation of the rectum into the vagina Protrusion of intestinal wall into the vagina Downward displacement of the cervix Bulging of the bladder into the vagina

Bulging of the bladder into the vagina

How can breast cancer prevention programs best serve at-risk women from lower socioeconomic backgrounds? Provide access to health insurance. Increase support services. Increase access to health care. Develop screening and educational programs.

Develop screening and educational programs.

Menopause marks the end of a woman's reproductive capacity. Which of the following is a common complaint that may be due to a cystocele? Dyspareunia Irregular menses Decreased pH of the vagina Atrophic vaginitis

Dyspareunia

A nurse is working with a young woman who has been diagnosed with premenstrual syndrome (PMS) to develop a plan to alleviate her symptoms. Which of the following would be most appropriate to include in this plan? Avoiding the intake of whole grains and fruits Engaging in a regular exercise program Planning work during the days of PMS Decreasing water intake

Engaging in a regular exercise program

A patient is having a biopsy that will remove the entire mass, plus a margin of surrounding tissue. What type of biopsy will be documented on the operative permit? Excisional biopsy Incisional biopsy Core biopsy Ultrasound-guided core biopsy

Excisional biopsy

While caring for a patient who is treated for severe pelvic inflammatory disease (PID), the nurse insists on keeping her in a semisitting position. Which of the following is correct rationale for this positioning? Facilitation of pelvic drainage and minimize the upward extension of infection Prevention of nosocomial infections to other patients Prevention movement as it increases pain Facilitation of easy distraction of the patient

Facilitation of pelvic drainage and minimize the upward extension of infection

Hematoma and seroma formation are complications of breast surgery. Which of the following is the indicator that should be reported to the surgeon? Bruising of the skin Pain at the site Tightness of the skin Gross swelling

Gross swelling

As a class project, a group of student nurses are developing a care plan for patients being screened for cervical cancer. When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor? Late childbearing Human papillomavirus (HPV) Postmenopausal bleeding Obesity

Human papillomavirus (HPV)

The nurse is planning the care of a woman who is scheduled to begin radiation therapy for the treatment of invasive breast cancer. The nurse is aware that this treatment is often well-tolerated but that it creates a risk of which of the following nursing diagnoses? Acute pain Unilateral neglect Ineffective thermoregulation Impaired skin integrity

Impaired skin integrity

The nurse is assessing an older adult female who has not seen her physician in 2 years. The nurse is assisting the patient into a gown and notices that the patient has edema and pitting of the skin on the right breast. What does the nurse understand is the significance of this finding? It may result from inflammation due to mastitis while the patient is breastfeeding. This finding is not uncommon and is significant only when of recent origin. It may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance, a classic sign of advanced breast cancer. This finding is most likely related to benign cysts of the breast in the nipple area.

It may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance, a classic sign of advanced breast cancer.

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which of the following? Lymphedema Fibrocystic breast disease Fibroadenoma Breast abscess

Lymphedema

The nurse teaches a premenopausal female client to perform breast self-examination (BSE) at which interval? With the onset of menstruation On day 5 to day 7, counting the first day of menses as day 1 On day 2 to day 4, counting the first day of menses as day 1 Any time during the month

On day 5 to day 7, counting the first day of menses as day 1 BSE is best performed after menses, when less fluid is retained. Because most women notice increased tenderness, lumpiness, and fluid retention before their menstrual period, BSE is not recommended with the onset of menses. Because these symptoms generally continue through menses, BSE is not recommended during that time. BSE is best performed at a time that takes menses into account.

A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do? Stop taking her Premarin (hormonal therapy). See her gynecologist as soon as possible. Disregard this phenomenon because it is common during this life stage. Mention it to her physician during her next annual examination.

See her gynecologist as soon as possible.

A 35-year-old female client is requesting information about mammograms and breast cancer. She isn't considered at high risk for breast cancer. What should the nurse tell this client? She should have had a baseline mammogram before age 30. She should eat a low-fat diet to further decrease her risk of breast cancer. She should perform breast self-examination during the first 5 days of each menstrual cycle. When she begins having yearly mammograms, breast self-examinations will no longer be necessary.

She should eat a low-fat diet to further decrease her risk of breast cancer.

A client with vaginitis reports itching and burning of the perineum. Which suggestion would be most appropriate to relieve the client's symptoms? Use a pure vinegar douche daily. Use skin protectants containing zinc oxide. Take sitz baths frequently. Avoid yogurt with active lactobacilli cultures.

Take sitz baths frequently. Sitz baths are recommended to relieve the client's itching and burning as well as relieve swelling of the vulva and perineum. Skin protectants containing zinc oxide promote healing. Routine douching should be avoided. Taking Lactobacillus acidophilus in capsule form or eating yogurt containing active cultures of lactobacilli can help restore normal vaginal microorganisms.

A 30-year-old woman has stated to the nurse that she experiences significant pain during menses and has asked the nurse's advice on whether to seek further care for the problem. The nurse has suggested that the woman visit her primary care provider and should recommend which of the following pain management measures? Taking nonsteroidal anti-inflammatory drugs (NSAIDs) a day or two before her expected menses Taking low-dose aspirin each morning Taking acetaminophen if the pain becomes unbearable Using acetaminophen suppositories during menses

Taking nonsteroidal anti-inflammatory drugs (NSAIDs) a day or two before her expected menses

The nurse is caring for a client who is ordered a sentinel lymph node biopsy. The physician explained the procedure and desired outcome. Which statement, made by the client, indicates a need for further instruction? The procedure allows for an understanding of the spread of cancer cells. The procedure allows for conservation of breast tissue. The procedure removes all cancer from the body. The procedure includes minimal surrounding tissue damage.

The procedure removes all cancer from the body.

A client complains of having tender and painful breasts, often feeling multiple lumps within her breast tissue. The nurse would need to gather additional information about which of the following? Alcohol and caffeine consumption Client's workplace in relation to the surroundings Timing of symptoms in relation to the menstrual cycle Bathing frequency and living surroundings

Timing of symptoms in relation to the menstrual cycle

A nurse who works in a gynecologist's office frequently cares for patients who are diagnosed with vulvovaginal candidiasis. The nurse should teach the patients how to manage and treat the most common symptom of: Vulvar pruritus. Dysuria. Vaginal pain. Dyspareunia.

Vulvar pruritus.

A nurse is providing breast cancer education at a community facility. The American Cancer Society recommends that women of average risk for breast cancer get mammograms: yearly starting no later than age 45. after the birth of the first child and every 2 years thereafter. after the first menstrual period and annually thereafter. every 3 years between ages 20 and 44 and annually thereafter.

yearly starting no later than age 45.