Commonly Occurring Infections x Womens Health Problems

Abdominal hysterectomy is generally recommended for which condition? 1. Severe endometriosis 2. Removal of the ovaries 3. Suspected or confirmed cancer removal 4. Abnormal uterine bleeding

Answer: 1 Explanation: 1. Abdominal hysterectomy is recommended for severe endometriosis

The nurse is scheduling an ultrasound for a 51-year-old client with a suspected uterine tumor. The nurse includes in the clients teaching that the most common benign uterine tumor seen in women in their 50s is which of the following? 1. Fibroid tumor 2. Fibroadenoma 3. Fibrocystic tumor 4. Lymphoma

Answer: 1 Explanation: 1. By the age of 50, 70% of Caucasian women and 80% of African American women have fibroids.

A pregnant client at 24 weeks gestation is diagnosed with bacterial vaginosis. Her doctor orders Flagyl to treat the problem. What would be appropriate education for the nurse to provide? 1. The client must be careful to observe for signs of preterm labor. 2. The client should advise her partner to seek therapy as soon as possible. 3. The main side effect of the medication is a large amount of vaginal discharge. 4. A repeat culture should be taken 2 weeks after completing the therapy.

Answer: 1 Explanation: 1. Clients with bacterial vaginosis are at risk for preterm labor.

A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be: 1. Oral acyclovir 2. Ceftriaxone IM 3. Azithromycin p.o. 4. Penicillin G IM

Answer: 1 Explanation: 1. Malaise, dysuria, and tingling or painful vesicles are indicative of a primary herpes simplex outbreak. Acyclovir treats herpes.

A client describes breast swelling and tenderness. What piece of data would be most important for the nurse to gather initially? 1. Timing of the symptoms 2. Birth control method 3. Method of breast self-examination 4. Diet history

Answer: 1 Explanation: 1. The breast undergoes regular cyclical changes in response to hormonal stimulation. The nurse will want to determine when the swelling and tenderness occur within the menstrual cycle.

The clinic nurse teaches the pregnant client being treated for trichomoniasis about the risks to her pregnancy due to this infection. Which statement would indicate successful teaching? 1. I am at risk of having a preterm birth because of this infection. 2. I might need to have my membranes ruptured because of this infection. 3. I am at risk of having a baby with a high birth weight. 4. I may have intercourse with my husband while bring treated for this infection.

Answer: 1 Explanation: 1. There is a risk of preterm birth and rupture of membranes with trichomoniasis.

The nurse is evaluating the outcomes of nursing care for a woman with a urinary tract infection. Which of the following does the nurse include in the evaluation? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. The client implements self-care measures for prevention. 2. The client completed the prescribed antibiotics. 3. The client knows self-care measures for worsening symptoms. 4. The client states that UTIs are controlled, not cured. 5. The client knows that cranberry juice can help prevent UTIs.

Answer: 1, 2 Explanation: 1. In the evaluation, the nurse should determine whether the client implements self-care measures to help prevent recurrent UTI as part of her personal routine. 2. Evaluation includes whether the client completed her prescribed course of antibiotic therapy.

The nurse in the emergency department is admitting a 22-year-old woman who complains of watery diarrhea, dizziness, and vomiting. She is in the middle of her period, and has a tampon in place. The nurse suspects toxic shock syndrome, and assesses for the manifestations of which symptom? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Fever 2. Rash 3. Desquamation of skin 4. Bloating 5. Urinary frequency and urgency

Answer: 1, 2, 3 Explanation: 1. A fever presents initially. 2. A rash on the trunk presents initially. 3. The fever and rash on the trunk present initially, followed by desquamation of the skin, especially the palms and soles, which usually occurs 1 to 2 weeks after the onset of symptoms.

The nurse is educating a group of women about the manifestations of benign breast conditions. What information topics will the nurse include? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Masses rapid in appearance or disappearance 2. Galactorrhea is common 3. Galactorrhea is seen with some psychiatric medications 4. Ulcerations or skin erosions are possible 5. An increased breast size with dimpling

Answer: 1, 2, 3 Explanation: 1. Fluctuations in size and rapid appearance or disappearance of breast masses are common in fibrocystic breasts. 2. Galactorrhea is a benign change often associated with hormone therapy. 3. Galactorrhea is often seen in women who have nursed, who have fibrocystic changes in the breast, or are on some types of psychiatric medication.

The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statements indicate that teaching was effective? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. I might have infertility because of this infection. 2. It is important for me to finish my antibiotics. 3. Tubal pregnancy could occur after PID. 4. My PID was caused by a yeast infection. 5. I am going to have an IUD placed for contraception.

Answer: 1, 2, 3 Explanation: 1. Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of PID. 2. Antibiotic therapy should always be completed when a client is diagnosed with any infection. 3. The tubal scarring that occurs from tubal inflammation during PID can prevent a fertilized ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy.

The client with polycystic ovarian syndrome (PCOS) has been prescribed metformin (Glucophage). The nurse tells the client that the medication will do which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Decrease your excessive hair growth. 2. Make it easier to lose weight. 3. Increase your acne. 4. Improve your chances of pregnancy. 5. Make your menstrual periods irregular.

Answer: 1, 2, 4 Explanation: 1. Polycystic ovarian syndrome (PCOS) treatment with metformin decreases hirsutism. 2. Polycystic ovarian syndrome (PCOS) treatment with metformin improves weight loss success. 4. Polycystic ovarian syndrome (PCOS) treatment with metformin increases ovulation and therefore menstrual regularity and fertility.

The nurse is caring for a client in the clinic whom she suspects has vaginosis. Which test best determines whether this sexually active woman has the disorder? 1. The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation 2. The addition of a 10% potassium hydroxide solution to the vaginal secretions 3. A vaginal pH of less than 4.5 4. A Gram stain positive for the fungus

Answer: 2 Explanation: 2. Adding a 10% potassium hydroxide solution to the vaginal secretion of a client with bacterial vaginosis, called a whiff test, produces a fishy smell.

The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority? 1. Encourage oral fluids 2. Administer cefotetan IV 3. Enforce bed rest 4. Remove IUC, if present

Answer: 2 Explanation: 2. Administration of medications to treat the disease is the first priority.

The nurse receives a phone call from a 25-year-old woman experiencing breast tenderness in the week prior to her menses, with palpable breast nodularity, without nipple discharge. What is the best response by the nurse? 1. Please make an appointment at the breast cancer center as soon as possible. 2. How much salty food do you regularly consume? 3. As long as you dont have nipple discharge, it isnt a serious condition. 4. Eliminate caffeine and chocolate from your diet.

Answer: 2 Explanation: 2. The client is describing fibrocystic breast changes. A salt restriction with a mild diuretic taken the week before menstrual bleeding often improves the condition.

The nurse is seeing clients in the womens clinic. Which client should be treated with ceftriaxone IM and doxycycline orally? 1. A pregnant client with gonorrhea and a yeast infection 2. A nonpregnant client with gonorrhea and chlamydia 3. A pregnant client with syphilis 4. A nonpregnant client with chlamydia and trichomoniasis

Answer: 2 Explanation: 2. The combined treatment of ceftriaxone IM and doxycycline orally provides dual treatment for gonorrhea and chlamydia, which frequently occur together.

A client comes to the clinic complaining of a thick, white, tenacious discharge and vulvular soreness. Which medication treatment will the nurse teach the client about? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Silver sulfadiazine 2. Metronidazole 3. Clindamycin cream 4. Ceftriaxone sodium 5. Doxycycline

Answer: 2, 3 Explanation: 2. Metronidazole is the preferred treatment for vulvovaginal candidiasis. 3. Although less effective than metronidazole, clindamycin cream can be used to treat vulvovaginal candidiasis.

The nurse interviews a 28-year-old client with a new medical diagnosis of endometriosis. Which question asked by the nurse is appropriate? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Are you having hot flashes? 2. Are you experiencing pain during intercourse? 3. Is a vaginal discharge present? 4. Are you having pain during your period? 5. Have you noticed any skin rashes?

Answer: 2, 4 Explanation: 2. The primary symptoms of endometriosis include dyspareunia. 4. The primary symptoms of endometriosis include dysmenorrhea.

The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? 1. She could become pregnant. 2. She could have severe vaginal itching. 3. He could get an infection in the tube that carries the urine out. 4. It could cause us to develop a rash.

Answer: 3 Explanation: 3. Chlamydia is a major cause of nongonococcal urethritis (NGU) in men.

The nurse is caring for a client diagnosed with endometriosis. Which statement by the client would require a need for perhaps another treatment option? 1. I am having many hot flashes since I had the Lupron injection. 2. The pain I experience with intercourse is becoming more severe. 3. I have vaginal dryness, reduced libido, and my clitoris has become larger since taking danazol. Is this normal? 4. Ive noticed I have not had my period on a regular basis since being on the GnRH analogs.

Answer: 3 Explanation: 3. Danazol is a testosterone derivative that suppresses ovulation and causes amenorrhea. It is intended for short-term therapy. Because of adverse effects, many clinicians have moved away from danazol to other treatment options.

Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (PID)? 1. CBC (complete blood count) with differential 2. Venereal Disease Research Laboratory (VDRL) 3. Throat culture for Streptococcus A 4. RPR (Rapid Plasma Reagin)

Answer: 3 Explanation: 3. Streptococcus of the throat is not associated with PID.

A client has been diagnosed with bacterial vaginosis. The nurse obtains a sexual history from the client, including contraceptive measures, number of sexual partners, and frequency of intercourse. What is the rationale for the questions? 1. Clients can infect their sexual partners. 2. The nurse is required by law to ask the questions. 3. Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted diseases more easily. 4. The laboratory needs a full client history in order to know for which organisms and antibiotic sensitivities it should test.

Answer: 3 Explanation: 3. The change in normal flora increases the womans susceptibility to other organisms, making the client more vulnerable to sexually transmitted diseases, including HIV.

A client is at a physicians office following the end of treatment for breast cancer. The client is not scheduled to receive any more radiation or chemotherapy at this time. With treatment behind her, the client can now look again to the future. Which phase of psychological adjustment is this client experiencing? 1. Shock 2. Reaction 3. Recovery 4. Reorientation

Answer: 3 Explanation: 3. The recovery phase begins during convalescence following the completion of medical treatment.

The client has been found to have vitiligo on her vulva. Which client statement indicates that the client requires additional teaching on this condition? 1. This can occur in other places on my body. 2. Vitiligo is only a decrease of pigmentation. 3. Other serious health conditions are common with vitiligo. 4. There usually are no other symptoms of this condition.

Answer: 3 Explanation: 3. Vitiligo is an absence of melanin, which results in white patches that are especially noticeable on dark-skinned individuals. It can occur in multiple areas on the body, and has no associated symptoms or health conditions.

The nurse is teaching a client who has been diagnosed with vulvitis. Which statement by the client indicates that the nurses instruction has not been effective? 1. I should stop having sexual intercourse. 2. Non-deodorized tampons could make this condition recur. 3. Wearing pantyhose daily will improve the problem. 4. A different brand of soap might eliminate the irritation.

Answer: 3 Explanation: 3. Vulvitis is inflammation of the vulva. Tight clothing, especially if made of synthetic fibers, can predispose women to the condition. Pantyhose should not be worn.

Women with pyelonephritis during pregnancy are at significantly increased risk for which condition? 1. Foul-smelling discharge 2. Ectopic pregnancy 3. Preterm labor 4. A colicky large intestine

Answer: 3 Explanation: 3. Women with pyelonephritis during pregnancy are at significantly increased risk of preterm labor, preterm birth, development of adult respiratory distress syndrome, and septicemia

The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (VVC), and knows the client understands when she makes which of the following statements? 1. I need to apply the miconazole for 10 days. 2. I need to douche daily. 3. I need to add yogurt to my diet. 4. I need to wear nylon panties.

Answer: 3 Explanation: 3. Yogurt helps reestablish normal vaginal flora.

A nurse is providing a client with instructions regarding breast self-examination (BSE). Which of the following statements by the client would indicate that the teaching has been successful? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. I should perform BSE 1 week prior to the start of my period. 2. When I reach menopause, I will perform BSE every 2 months. 3. Knowing the density of my breast tissue is important. 4. I should inspect my breasts while standing with my arms down at my sides. 5. I should inspect my breasts while in a supine position with my arms at my sides.

Answer: 3, 4 Explanation: 3. The effectiveness of BSE is determined by the womans ability to perform the procedure correctly, by her knowledge of her own breast tissue, and by the density of her breast tissue. 4. The breasts should be inspected while standing with arms at sides.

A nurse is teaching a middle school health class on the different types of viral hepatitis. Which statement made by a student indicates the need for further teaching? 1. Both hepatitis A and E are not chronic infections. 2. Hepatitis A is characterized by symptoms of jaundice, anorexia, nausea, vomiting, malaise, and fever. 3. Hepatitis B, C, and D have symptoms similar to those of hepatitis A, and can also include arthralgias, arthritis and skin eruptions or rash. 4. Both hepatitis B and C have an incubation period of 45-160 days.

Answer: 4 Explanation: 4. Hepatitis B has an incubation period of 45-160 days, but hepatitis C has an incubation period of 14-180 days.

The client is undergoing lab work and ultrasound for a possible diagnosis of polycystic ovarian syndrome (PCOS). Which problem does the nurse expect to find in the clients history? 1. Multiple first-trimester fetal losses 2. Dyspareunia 3. Vulvitis 4. Oligomenorrhea

Answer: 4 Explanation: 4. Irregular menses, ranging from total absence of periods (amenorrhea) to intermittent or infrequent periods (oligomenorrhea) are the hallmarks of PCOS.

The nurse is educating a group of female adolescents regarding sexually transmitted infections. The nurse knows that learning was achieved when an individual states that the most common symptom is which of the following? 1. Menstrual cramps 2. Heavy menstrual periods 3. Flu-like symptoms 4. Usually there are no signs or symptoms

Answer: 4 Explanation: 4. It is common for women to experience no signs or symptoms when they have contracted a sexually transmitted disease.

The client has been diagnosed with hepatitis B. Which statement indicates to the nurse that the client needs more education? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. This infection could be sexually transmitted. 2. I might get jaundiced from this illness. 3. An immunization exists to prevent getting hepatitis B. 4. I might have gotten this infection from food. 5. The incubation period is 15-50 days.

Answer: 4, 5 Explanation: 4. Hepatitis B is found in blood and body fluids, and therefore can be sexually transmitted. Hepatitis A and E are foodborne, and transmitted by fecal-oral contamination. 5. The incubation period for hepatitis B is 45-160 days.