PrepU CH. 40
A client who is seeking to become pregnant has made an appointment with a fertility specialist. The clinician is describing the role of the fallopian tubes in response to a question from the client. Which physiologic processes should be explained to the client? Select all that apply.
Facilitating drainage of secretions into the uterus Providing a passageway for ova Acting as a passage for sperm after coitus
The ovaries have a dual function. The nurse is able to explain to the patient that any problems with the ovaries frequently cause which of the following problems?
Menstrual and fertility problems
What are the small bumps or projections on the areolar surface called?
Montgomery tubercles or glands
The nurse is caring for a client with lichen simplex chronicus. What assessment finding does the nurse expect?
Gray-white plaques with an irregular surface
A female client asks her health care provider about guidelines for clinical breast examination (CBE). The most appropriate response would be:
"Between the ages of 20 and 39 years, average-risk women should undergo CBE every 3 years."
Breasts are not functionally related to the female genitourinary system. The role of hormones in breast development is important for the growth of which system related to the breast?
Ductile system
A client who has been diagnosed with premenstrual syndrome (PMS) asks if there is anything to help alleviate the symptoms. The best response would be:
Eat a diet low in simple sugars and high in protein
After hearing daunting reports from her slightly older co-workers and friends, a 44 year-old woman has a number of questions for her physician about what to expect during perimenopause and why. Which of the following teaching points is most accurate?
"Hot flashes are a reality for most women in menopause, and the exact cause of them isn't known yet."
A female patient reports that her mother-in-law was just diagnosed with cervical cancer and asks the nurse about her own risk. Which response by the nurse is correct?
"If you had the human papilloma virus (HPV) vaccine, your risk is greatly reduced."
A client diagnosed with endometriosis asks the nurse how it is that she did not know about this when she had it for so long. What is the nurse's best response?
"Its symptoms mimic those of other disorders "
What should the nurse teach the client about assessing for possible breast cancer?
"Perform monthly self-breast exams after menses."
A female patient informs the nurse that she is having hot flashes on occasion, has trouble sleeping, and thinks that she is having some symptoms of menopause. The patient asks the nurse how long these symptoms will last prior to experiencing menopause. Which of the following is the best response?
"Perimenopause can precede menopause by approximately 4 years."
Staff at a women's health center are being briefed by their supervisor on the latest recommendations for breast cancer screening. Which of the following guidelines should staff pass on to their clients?
"Screening mammography and clinical exams are the cornerstones of breast cancer screening."
During a group prenatal class, the nurse teaching the course is explaining the thinning of the cervix that accompanies the stages of labor leading up to delivery. A participant admits that she is not familiar with either the location or normal role of the cervix. Which of the following responses by the nurse would be most appropriate?
"The cervix is the opening between the uterus and the vagina and so it opens wide during the lead-up to birth."
The nurse is teaching a female client who has been prescribed hormone therapy. The client asks,, "What does this medication do?" Which of the following is an appropriate response by the nurse?
"This medication will help relieve hot flashes and other adverse symptoms of menopause."
A patient with vulvodynia tells the nurse, "This is not getting better. I just can't live like this." What is the best response by the nurse?
"What bothers you the most about your condition?"
The nurse is caring for a forty-eight-year-old female client who asks, "How do you know when you have reached menopause?" Which of the following is an appropriate response by the nurse?
"You are considered to be menopausal when you have not menstruated for a full year and the hormone that fluctuates with menstruation no longer fluctuates."
A female patient with uterine prolapse asks the nurse about treatment options. Which of the following responses by the nurse is appropriate?
"You may need surgery to support your uterus."
A female patient with uterine leiomyomas asks the nurse about her risk of uterine cancer. Which of the following statements best answers the question?
"Your leiomyomas may cause heavy periods but will not become cancerous."
The nurse suspects which of the following female clients may be at risk for infertility?
A long distance runner
Estrogen is an ovarian hormone that plays many roles in the reproductive cycle. The nurse understands that estrogen has which of the following non-reproductive effects on the female?
Accelerates growth of long bones
A female client with anorexia nervosa tells the nurse that she has been experiencing amenorrhea. The nurse is aware that this is a result of:
Alteration of critical body fat-to-muscle ratio needed for menses to occur
The nurse is explaining ovulation to a female client. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are important hormones needed to ovulate and are secreted by which of the following glands?
Anterior Pituitary
Select the structure primarily responsible for the secretions of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin.
Anterior pituitary gland
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed:
Atrophic vaginitis
The environment of the vagina is moist with a pH 4.0 to 4.5. The major purpose of the acidic environment is which of the following?
Bacteriostatic
There are many cancers of the female reproductive system. The nursing student knows that the most readily detected and most easily cured if detected early is which of the following?
Cervical
Which structure supports the breasts while dividing the breast into 15 to 25 lobes?
Cooper's ligaments
A 45-year-old client reports "needing to bear down with urination," frequency, and occasional loss of urine when coughing. Based on symptoms, which diagnosis is most appropriate for this client?
Cystocele
The nurse working in a fertility clinic is assessing a patient's risk for fallopian tube obstruction. Which one of the following places the woman at greatest risk?
Endometriosis
The ovarian follicle becomes luteinized once ovulation has taken place. As the corpus luteum, the now empty follicle produces what?
Estrogen and progesterone
How often do most women in the middle reproductive years menstruate?
Every 28 to 30 days
During menopause, which of the following hormones are elevated? (Select all that apply.)
FSH LH Androstenedione
The endocrine system is highly involved in the female reproductive system. Which hormones are used to stimulate the primordial follicles?
FSH and LH
A nurse educator is explaining the process of sexual intercourse, fertilization, and fetal development to a high school biology class. What process should the nurse describe?
Fertilization in the outer portion of the fallopian tube
A female patient informs the nurse that she had intercourse yesterday evening and is wondering if she could become pregnant. She asks the nurse that if she was pregnant, where it would be located at present. Which of the following should the nurse tell the patient?
Fertilization normally occurs in the middle to outer portion of the Fallopian tube.
The fallopian tubes are narrow tubes that attach bilaterally to the uterus. Within the fallopian tube, fertilization of the ovum takes place. The end of the fallopian tube nearest the ovary is funnel-like. What are the fringed, finger-like projections around the funnel-shaped opening of the fallopian tube called?
Fimbriae
A client has just become pregnant and there is a consequent increase in secretions from the columnar epithelium of her endocervix. What effect will this have?
Formation of a mucoid plug to protect her uterus
Events in the ovulatory cycle progress in a similar manner each month. Place the following events in the ovulatory cycle in the correct chronological order. Use all the options.
Formation of the theca. Formation of the corpus luteum Formation of the antral follicle Development of the zona pellicuda Bursting of the mature follicle
A woman with a regular 28-day menstrual cycle wishes to become pregnant. At which point in the menstrual cycle is the optimal time for intercourse to end in fertilization of the ovum?
Fourteenth day after menses begins
A 38-year-old woman with proliferative breast changes of papilloma asks the nurse about her risk for breast cancer. Which of the following statements of risk is correct?
Higher because of your papilloma
There are two types of vulvar cancer. One type is found in older women, and one type is found in younger women, generally less than 40 years of age. What is the type found in younger women thought to be caused by?
Human papillomavirus
Which of the following factors in a patient's history is most likely related to the diagnosis of cervical squamous dysplasia?
Human papillomavirus (HPV) infection
In primary dysmenorrhea, when contraception is not desired, what is the treatment of choice?
Ibuprofen
The nurse performs a complete physical assessment on a patient with polycystic ovary syndrome (PCOS). Which of the following assessments support this diagnosis? Select all that apply.
Increased dark facial hair Elevated blood glucose Obesity
The ovaries secrete both estrogen and progesterone. What is one function of progesterone in the body?
Increases body temperature at ovulation
A client is experiencing oligomenorrhea. The nurse interprets this as:
Infrequent menstruation with periods more than 35 days apart
An 18-year-old woman presents at the clinic complaining new-onset breakthrough bleeding, even though she is taking contraceptives. What contraceptive use, along with new-onset breakthrough bleeding, has been associated with pelvic inflammatory disease?
Intrauterine device
The nurse is completing patient education on the use of a combination oral contraceptive pill (OCP) to a woman with polycystic ovary syndrome (PCOS). The nurse should include which of the following?
It will reduce hirsutism.
During the female menstrual cycle hormones are produced and excreted by various reproductive organs. The hormone progesterone is secreted and is metabolized in which of the following organs?
Liver
The nurse is reviewing laboratory values of a seventy-year-old female client and observes the client's low-density lipoproteins (LDLs) level is elevated. The nurse understands a possible reason for this is which of the following?
Long-term estrogen deprivation
A 28 year old female has been told she has atypical glandular cells following Pap smear. The physician will likely recommend which procedure that can be performed in their office to remove the abnormal zone and provide a specimen for further histological evaluation?
Loop electrosurgical excision procedure (LEEP).
A 13-year-old patient undergoing puberty is alarmed to find small, white bumps surrounding the areolae on her nipples. You reassure her that these are a normal sign of her sexual maturation and tell her that they are which of the following?
Montgomery's tubercles
A patient is diagnosed with vulvar carcinoma, which appears as an inconspicuous thickening of the skin resembling eczema or dermatitis and may produce few symptoms other than pruritus, local discomfort, and exudation. The nurse understands that the cancer metastasizes readily through which mode?
Multiple lymph channels
Polycystic ovary syndrome (PCOS) is a common endocrine disorder. The nurse understands that about 50% of the women who are diagnosed with PCOS have which of the following problems?
Obesity
A female patient presents to her primary care physician with a report of very heavy bleeding during menstrual cycles. Tests indicate the condition is not from a hormone imbalance. Which of the following intervention options is least invasive?
Oral contraceptives
The nurse providing teaching about the female reproductive system includes which of the following?
Ovaries are responsible for ovulation and hormone production.
The nurse is teaching a class to adolescent girls about puberty. Which health information is accurate for inclusion in the class? Select all that apply.
Ovaries produce hormones that cause growth of reproductive organs. • Estrogen stimulates bone growth and closure of growth plates. • Ovulation usually occurs in the middle of the monthly cycle.
A patient has been diagnosed with a Bartholin gland cyst. The nurse expects the patient may experience which symptoms if this becomes infected?
Pain, tenderness, and dyspareunia
A client has been diagnosed with endometriosis. What assessment finding does the nurse expect? Select all that apply.
Premenstrual pain Back pain Pelvic pain
Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation?
Progesterone
A nurse who works on a urology-gynecology ward of a hospital is coming on shift and will be caring for a 34 year-old woman who has been admitted overnight for the treatment of a large endometriosis. What interventions should the nurse most realistically anticipate providing over the course of the shift and the next several days?
Providing pain control; preparing the client for a laparoscopic procedure or hysterectomy.
A female client experiencing hot flashes during perimenopause asks the nurse about hormone therapy (HT). Which is the appropriate response by the nurse?
Short term HT can be used to reduce symptoms.
Which of the following is the most important discharge instruction for a female patient with pelvic inflammatory disease (PID)?
Take all of the antibiotic
A client with polycystic ovaries is being treated with an oral contraceptive medication. Which change in her condition indicates the treatment is effective?
The client begins a regular menstrual cycle.
The nurse is assessing the genitalia of a forty-two-year-old female client diagnosed with a genitourinary disorder. The nurse recognizes which of the following does not describe the normal anatomy of the female genitalia.
The clitoris is located posterior to the urethra.
The nursing student is studying the structure and function of the female reproductive system. The student wants to know why the urinary system is included in the content. The best reason for inclusion of the information is which of the following?
The urethra and the vagina, although two separate openings, exist in close proximity.
A woman diagnosed with fibrocystic breast disease asks if any foods should be avoided in her diet. The most important information to provide would be:
Xanthines
A 12 year-old girl is experiencing an increase in her FSH and LH levels. This rise in hormone levels will have which effect?
Thickening of her uterine walls
The nurse is reviewing the history of an older adult female client who was recently diagnosed with coronary heart disease. What factors are known to contribute to this condition? Select all that apply.
Used hormone therapy for 5 years Smoked 1 pack/day for 20 years Has hypertension for 15 years
The connecting tube between the cervix and the vestibule is referred to as which of the following?
Vagina
An adult client reports persistent vaginal irritation and recurrent infections. In her history the physician notices that she recently has been prescribed antibiotics for a respiratory infection and concludes that it has affected her normal flora by:
causing the vaginal environment to be more alkaline than normal.
A client has been diagnosed with breast cancer following a suspicious mammogram followed by biopsy. The nurse who is planning this client's care should recognize that her prognosis is primarily dependent on the:
extent to which lymph nodes are involved.
The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs:
in the middle to outer portion of the fallopian tube.
The nurse is checking the pH of a client's vagina tissue and finds the pH to be 4.3. The nurse interprets this finding as:
normal
Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20 year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis?
"How many sexual partners have you had?"
A pregnant patient asks the nurse what is causing her lower leg edema, nausea, and constipation that she is experiencing. Which of the following is the nurse's best response?
"The increase in progesterone during pregnancy is most likely the cause of these discomforts."
A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be:
HPV vaccine before becoming sexually active
The health care provider suspects a diagnosis of endometriosis for a female client. The diagnosis would be confirmed by:
Laparoscopy
Which of the following statements best captures an aspect of the role of progesterone? Progesterone:
Levels peak after ovulation and is present throughout the menstrual cycle.
A 23 year-old woman has been referred to a fertility clinic after one year of attempting to become pregnant. Her diagnostic workup has resulted in a diagnosis of polycystic ovary syndrome (PCOS). What will the first line of treatment most likely consist of?
Lifestyle modifications to include weight loss by lowering calories and fat consumption.
A woman reports to the primary healthcare provider that she experiences monthly changes before her menstrual cycle. Which of the following statements demonstrates understanding of premenstrual disorders?
Many women report premenstrual emotional or physical changes.
A female patient is being seen in the ED with complaints of lower abdominal pain, dyspareunia, back pain, purulent cervical discharge, and the presence of adnexal tenderness and painful cervix on bimanual pelvic examination. The nurse suspects the patient has pelvic inflammatory disease (PID), and will assess the patient for which of the following?
Number of sexual partners
The nurse is discussing the menstrual cycle with a female client. The client asks, "Why does my side hurt half way through my monthly cycle almost every month? The nurse suspects the cause of the pain may be which of the following?
The client has a leakage of blood onto the peritoneal surface after ovulation has occurred.
Which client does the nurse determine is most likely at risk for cancer of the vagina?
The client who is 60 years old or older
Fibrocystic changes in the breast are not uncommon. How is the diagnosis of fibrocystic changes made?
Ultrasonography and mammography
The nurse planning care for a menopausal woman should include interventions to decrease risk for which of the following?
atherosclerosis
What is a primary intervention for the nurse to implement for a client with pelvic inflammatory disease ?
Administer antibiotic therapy.
A college student has come to the health clinic complaining of heavy bleeding during and between their menstrual periods. The nurse practitioner will document this as:
Menometrorrhagia
A 13-year-old client undergoing puberty is alarmed to find small, white bumps surrounding her areolae. The nurse reassures her that these are a normal sign of her sexual maturation and tells her that they are:
Montgomery tubercles
A 20 year old female has come to the clinic complaining of severe menstrual cramps. The clinic nurse practitioner knows that dysmenorrhea occurs when which muscle group contracts?
Myometrium.
A 14-year-old female patient experiences headache and cramping abdominal pain 1 to 2 days before each menstrual period. Which of the following symptoms correlate with a diagnosis of primary dysmenorrhea? Select all that apply.
Nausea Diarrhea Fainting
A 31 year old patient with breast cancer is concerned about being prescribed a hormonal medication to help block the effects of estrogen on the growth of breast cancer cells. The nurse should provide education about which of the following likely medications?
Nolvadex (Tamoxifen), a nonsteroidal antiestrogen
Following a work-up which included endocrine studies (FSH/LH, prolactin, testosterone, DHEAS levels), a 22 year old college student complaining of abnormal bleeding has been diagnosed with dysmenorrhea due to alterations in their hormone levels. The nurse should anticipate that they will likely be prescribed: Select all that apply.
Prostaglandin synthetase inhibitors. Oral contraceptives.
The nurse is screening patients for risk factors associated with ovarian cancer. Which of the following patients has the greatest risk of developing ovarian cancer?
Age 65, one child, postmenopausal, two sisters with breast cancer
A newly pregnant woman reports to the nurse that her breasts are excessively tender and that her areolae and nipples are becoming darker and more prominent. The nurse should describe which cause of these changes?
Normal changes of pregnancy due to increased levels of estrogen and progesterone.
