Surg 2 Reproductive System
Which method of contraception works in conjunction with spermicide and must be left in for 6 hours after sex?
Contraceptive Sponge
The nurse working on a cancer treatment floor assesses her assigned clients. It is most important for the nurse to report which assessment finding?
Coolness and mottling of a newly constructed breast site
A patient diagnosed with endometriosis asks for an explanation of the disease. What should the nurse explain to the patient?
Tissue from the lining of the uterus has implanted in areas outside the uterus.
A(n) _______ is a solid, benign breast mass composed of connective and glandular tissues
fibroadenoma
A patient informs the nurse that she believes she has premenstrual syndrome and is having physical symptoms as well as moodiness. What physical symptoms does the nurse recognize are consistent with PMS?
fluid retention, low back pain, headache
A client is experiencing symptoms associated with menopause. What is a likely recommendation to increase the client's interest in sexual activity?
low-dose androgens
Sentinel lymph node mapping is done to validate the lack of lymph node metastasis. Which complication does this technique help avoid?
lymphedema
___ is inflammation of breast tissue, which can occur in one or both breasts
mastitis
What is the main cause of anemia in a client with active uterine leiomyoma?
menorrhagia
____ is the migration of cancer cells from one part of the body to another
metastasis
_____ is vaginal bleeding at a time other than a menstrual period
metrorrhagia
Removal of the ovaries is called
oophorectomy
A client who came to the clinic after finding a mass in the breast is scheduled for a diagnostic breast biopsy. During the nurse's admission assessment, the nurse observes that the client is distracted and tense. What is the nurse's best action?
Acknowledge the fear the client is likely experiencing.
A client has been diagnosed with stage II breast cancer. The client tells the nurse that the primary health care provider has recommended breast conservation surgery followed by radiation. The client's husband has done some online research and is asking why his wife does not have a modified radical mastectomy "to be sure all the cancer is gone." The nurse knows that breast conservation surgery was recommended for which reason?
"According to current guidelines, breast conservation combined with radiation is as effective as a modified radical mastectomy."
A client has had a right modified radical mastectomy and axillary lymph node dissection. The nurse is teaching the client about measures to reduce the risk of complications. The client demonstrates understanding of the instructions when she states which of the following?
"I need to use an electric shaver when shaving my right armpit."
The nurse instructs a client on self-care after having a mastectomy with lymph node removal. Which client statement indicates that teaching has been effective?
"I will shave under my arms with an electric razor."
A woman with a 3-cm breast tumor is scheduled for a lumpectomy followed by 5 to 7 weeks of radiation therapy. The patient asks the nurse if this procedure would cure her. What is the nurse's best response?
"Lumpectomy, followed by radiation, has the same predicted long-term survival rates as a mastectomy."
The nurse is caring for a 52-year-old client whose aunt and mother died of breast cancer. The client states, "My doctor and I talked about tamoxifen to help prevent breast cancer. Do you think it will work?" What would be the nurse's best response?
"Tamoxifen is known to be a highly effective protective measure."
A middle-aged female client has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the client is visibly surprised and embarrassed by this offer. How should the nurse best respond?
"This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history.
A client has been diagnosed with endometriosis. When planning this client's care, the nurse should prioritize what nursing diagnosis?
Acute pain related to misplaced endometrial tissue
A client is being discharged to home following a modified radical mastectomy. The nurse is providing discharge instructions and making arrangements for home care. Which interventions will be included in the instructions?
-Advise the client that blood pressure measurements, injections, blood donations, and IV infusions are lifelong restrictions on the side of the mastectomy. -Recommend wearing gloves while doing yard or housework.
A client has just returned to the postsurgical unit from postanesthetic recovery after breast surgery for removal of a malignancy. What is the most likely major nursing diagnosis to include in this client's immediate plan of care?
Acute pain related to tissue manipulation and incision
A client has been diagnosed with cancer of the cervix. In what age group would the nurse expect the client to be?
35 to 50 years
Which client has the highest risk of ovarian cancer?
45-year-old woman who has never been pregnant
The nurse is educating a patient about the best time to perform breast self-examination (BSE). When does the nurse inform her is the best time after menses to perform BSE?
5 to 7 days
A client has fibrocystic breast disease. Assuming that there are no sudden or unusual changes, the nurse would suggest that the client have follow-up appointments with her physician every ____ months. Record your answer with a whole number.
6
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 42-year-old client tells the nurse that they have found a painless lump in the right breast during a monthly self-examination. The client notes being afraid of having cancer. Which assessment finding would most strongly suggest that this client's lump is cancerous?
A nonmobile mass with irregular edges
The history of a female patient reveals the following:First coitus at age 16 yearsFirst pregnancy at age 28 yearsSexual intercourse with circumcised partnerWeight appropriate for heightWhich of the following would alert the nurse to a possible risk factor for developing cervical cancer?
Age at first coitus
A client reports stress incontinence, pelvic pain, and a feeling like "something is dropping out of my vagina." The client is diagnosed as having a pelvic organ prolapse and the treatment plan includes using a pessary. Which instructions will the nurse include in client education?
Apply a sterile lubricant to the pessary before it is reinserted.
A client is postoperative day 1 following a vaginal hysterectomy. The nurse notes an increase in the client's abdominal girth and the client reports "bloating." What is the nurse's most appropriate action?
Apply warm compresses to the client's lower abdomen.
A client returns to the recovery room following a mastectomy. An initial postoperative assessment is performed by the nurse. What is the nurse's priority assessment?
Assessing the vital signs and oxygen saturation levels.
A community health nurse is leading a health education session addressing menopause and other aspects of women's health. What dietary supplements should the nurse recommend to prevent morbidity associated with osteoporotic fractures?
Calcium and vitamin D
While taking a health history on a 20-year-old female client, the nurse learns that the client is taking miconazole. The nurse is justified in presuming that this client has what medical condition?
Candidiasis
A client who underwent an anterior colporrhaphy 6 hours ago has not voided. She reports some discomfort in her suprapubic area. Which of the following would the nurse expect to do?
Catheterize the client.
A 31-year-old client has returned to the postsurgical unit following a hysterectomy. The client's care plan addresses the risk of hemorrhage. How should the nurse best monitor the client's postoperative blood loss?
Count and inspect each perineal pad that the client uses
Which method of contraception works as a physical barrier and may need to be refitted if the patient has a 20% weight fluctuation?
Diaphragm
An adolescent patient comes to the clinic with complaints of "terrible pain" during menstruation. What should the nurse document this subjective data as?
Dysmenorrhea
Which of the following diseases or disorders is most likely an indication for tamoxifen?
ER-positive breast cancer
Which of the following is the descent of the small intestine into the vaginal vault?
Enterocele
A nurse advises a client scheduled for external beam radiation that side effects are minimal and usually well tolerated. What are side effects should the nurse include in the teaching? Select all that apply.
Erythema, Fatigue, Breast edema
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
Douching is not recommended for with vaginitis TRUE OR FALSE
FALSE
A client has just received a diagnosis of premature ovarian failure. How would this diagnosis be confirmed
FSH level determination
Bleeding is a late symptom of both endometrial and cervical cancer True or False
False
A female client is being evaluated due to increased menstrual bleeding and dysmenorrhea. A history and physical suggest the diagnosis of endometriosis rather than uterine fibroids. What finding would support the diagnosis of endometriosis?
Familial predisposition
During a routine sports physical examination, the nurse practitioner recommends HPV vaccination for an 11-year-old girl. Which statements by the client's mother demonstrates understanding of HPV vaccinations?
I will track follow-up appointments in my smartphone so she receives all three injections.
The nurse is assessing the breast of a female patient and observes a prominent venous pattern on the left breast. What does the nurse understand that this can be indicative of?
Increased blood supply required by a tumor
A patient is told that she has a common form of breast cancer where the tumor arises from the duct system and invades the surrounding tissues, often forming a solid irregular mass. What type of cancer does the nurse prepare to discuss with the patient?
Infiltrating ductal carcinoma
Which method of contraception is administered every 12 weeks?
Injectable Progestins
A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the client's history that his father was treated for breast cancer. What should the nurse provide to the client before he leaves the clinic?
Instructions about breast self-examination (BSE)
Which method of contraception has both hormonal and non-hormonal formulations?
Intrauterine Device (IUD)
A patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which information in teaching the patient about this type of fibroid?
It grows within the wall of the uterine muscle.
A patient is taking oral danazol (Danocrine), 800 mg/day, for 9 months for the treatment of endometriosis. How does the nurse describe this medication to the patient?
It is an antigonadotropin that decreases pituitary and ovarian stimulations.
A client has been referred to the breast clinic after the most recent mammogram revealed the presence of a lump. The lump is found to be a small, well-defined nodule in the right breast. The oncology nurse should recognize the likelihood of what treatment?
Lumpectomy and radiation
Which method of contraception can prevent both sexually transmitted infections and pregnancy?
Male Condom
Which of the following is a term used to describe excessive menstrual bleeding?
Menorrhagia
Which term is used to describe removal of breast tissue and axillary lymph node dissection leaving muscular structure intact as surgical treatment of breast cancer?
Modified radical mastectomy
A client has returned to the postsurgical unit after vulvar surgery. What intervention should the nurse prioritize during the initial postoperative period?
Monitoring the integrity of the surgical site
A client is being treated for trichomoniasis. The client has received instructions about the prescribed drug therapy. The nurse determines that the client needs additional teaching when she states which of the following?
My partner will not need any treatment.
A patient has undergone surgery for breast cancer and the findings of the surgery are as follows:Invasive undifferentiated tumorSize 2.2 cmAxillary lymph nodes negativeHigh ERBB2 expressionWhich of these findings would suggest a favorable prognosis?
Negative lymph nodes
Which method of contraception works by suppressing FSH & LH secretion and may be contraindicated in patients with a history of thromboembolism?
Oral Contraceptive
A nurse providing prenatal care to a pregnant client is addressing measures to reduce postpartum risk of cystocele, rectocele, and uterine prolapse. What action should the nurse recommend?
Performance of pelvic muscle exercises
While caring for a client who is being treated for severe pelvic inflammatory disease (PID), which nursing action minimizes transmission of infection?
Performing hand hygiene when entering the room
What best describes the purpose of contraception?
Preventing Unplanned Pregnancies
A nurse is caring for a client who has just had a modified radical mastectomy with immediate reconstruction. She's in her 30s and has two young children. Although she's worried about her future, she seems to be adjusting well to her diagnosis. What should the nurse do to support her coping?
Refer the client to the American Cancer Society's Reach for Recovery program or another support program.
The nurse is caring for a client with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this client's analgesic regimen be best managed
Scheduled analgesia should be administered around-the-clock to prevent pain.
A perimenopausal woman informs the nurse that she is having irregular vaginal bleeding. What should the nurse encourage the patient to do?
See her gynecologist as soon as possible
A patient has had a pessary inserted for long-term treatment of a prolapsed uterus. As part of the teaching plan, what should the nurse advise the patient to do?
See her gynecologist to remove and clean the pessary at regular intervals
Which method of contraception works by primarily preventing sperm motility?
Spermicides
A nurse is assisting with obtaining a specimen of breast milk from a mother with suspected mastitis. What organism would the nurse most expect to be found in the milk that would be consistent with a diagnosis of mastitis?
Staphylococcus aureus
Which is one of the most important prognostic factors in breast cancer?
Status of lymph nodes
A client scheduled for a simple mastectomy in 1 week is having preoperative education provided by the clinic nurse. What educational intervention will be of primary importance to prevent hemorrhage in the postoperative period?
Stop taking aspirin.
If hormone replacement therapy is indicated for menopause, it is prescribed in the lowest appropriate dose for a relatively short time TRUE OR FALSE
TRUE
The nurse is providing preoperative education for a client diagnosed with endometriosis. A hysterectomy has been scheduled. What education topic should the nurse be sure to include for this client?
The bladder must be emptied prior to surgery and a catheter may be placed during surgery.
A female client has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this client?
The warts may require surgical removal or cryotherapy
A client has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the client?
Treatment is aimed at relieving symptoms
A female client tells the nurse that they think they have a vaginal infection because the client has noted inflammation of the vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infection?
Trichomonas vaginalis
A patient has been diagnosed with a vaginal infection and received a prescription for metronidazole (Flagyl). The nurse knows that this is the recommended treatment for a vaginal infection caused by what organism?
Trichomonas vaginalis
Cancer of the vagina is rare and usually seen in woman older than 40 years of age True or False
True
A group of students are reviewing the anatomy and physiology of the breasts. The students demonstrate understanding of breast structure when they identify the tail of Spence as an extension of which quadrant?
Upper outer
What is the most common location for breast cancer?
Upper outer quadrant of the breast
During a teaching demonstration on breast self-examination (BSE), the nurse should always explain that the majority of breast cancers are found in the:
Upper, outer quadrant.
A nurse is using a diagram to educate a client with a pelvic organ prolapse. Which condition would the client have based on the illustration?
Uterine prolapse
Which term describes an opening between the bladder and the vagina?
Vesicovaginal fistula
A client with HIV has recently completed a 7-day regimen of antibiotics. She reports vaginal itching and irritation. In addition, the client has a white, cheese-like vaginal discharge. Which condition is the client most likely experiencing?
Vulvovaginal candidiasis
Tamoxifen is most likely associated with which of the following mechanisms of action?
antagonist on breast tissue
Which method of contraception works as a physical barrier and must remain in place for at least 6 hours after sex?
cervical cap
A client is concerned about the lumps that have developed in her breasts and is fearful of cancer. The client reports variability in the size of the lumps. What could be causing this condition?
cyclical hormonal changes
A(n) _____ is the bulging of the bladder into the vagina
cystocele
Which of the following is most likely associated with tamoxifen?
decreased risk of osteoporosis
____ is painful menstruation
dysmenorrhea
____ is a condition in which tissue with a cellular structure and function resembling that of the endometrium is found outside the uterus
endometriosis
While caring for a client who is being treated for severe pelvic inflammatory disease (PID), the nurse insists on keeping the client in a semi-sitting position. The nurse advises this in order to:
facilitate pelvic drainage and minimize the upward extension of the infection.
Which of the following side effects is most likely to be seen with the use of tamoxifen?
increased risk of endometrial cancer, increased risk of venous thromboembolism (VTE)
A school nurse at a middle school finds that students are typically surprised to hear the role of women's breasts. What is their primary function?
lactation
A client is very concerned about possibly having breast cancer, especially after caring for a close family member who recently died from the disease. The nurse informs the client that the primary and most common sign of breast cancer is a:
painless mass in the breast, most often in the upper outer quadrant.
A(n) ____ is an overnight surgical procedure in which glandular breast tissue, fat, and skin are removed bilaterally to decrease the size of large, pendulous breasts
reduction mammoplasty
Tamoxifen most likely belongs to which of the following types of drugs?
selective estrogen receptor modulator (SERM)
On discharge, a client who underwent left modified radical mastectomy expresses relief that "the cancer" has been treated. When discussing this issue with the client, the nurse should stress that she:
should continue to perform breast self-examination on her right breast.
