Chapter 19: Alterations in Womens Health Nursing School Test Banks

Chapter 19: Alterations in Womens Health

Multiple Response

1. Postoperative nursing care for a woman who had a total hysterectomy includes (select all that apply):
a. Administering hormone replacement therapy as per MD orders
b. Informing the woman that she will experience small amounts of vaginal bleeding for several days
c. Instructing the woman to use tampons
d. Instructing the woman to increase her ambulation to facilitate return of normal intestinal peristalsis

ANS: b, d
Feedback
a. Hormone therapy is ordered for women who had a hysterectomy with salpingo-oophorectomy.
b. Women will experience a few days of vaginal bleeding.
c. Women should not put anything into the vagina until the area has healed.
d. Ambulation decreases the risk for deep vein thrombosis and also facilitates intestinal peristalsis.

KEY: Integrated Process: Nursing Process | Cognitive Level: Application and Comprehension | Content Area: Womens Health | Client Need: Safe and Effective Care Environment | Difficulty Level: Hard

2. Menorrhagia may result from (select all that apply):
a. Anovulatory cycle
b. Metritis
c. Anorexia
d. Emotional distress

ANS: a, b
Metritis can be a cause of menorrhagia.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Womens Health | Client Need: Physiological Adaptation | Difficulty Level: Moderate

3. Secondary amenorrhea results from (select all that apply):
a. Polycystic ovary syndrome
b. Diabetes
c. Metritis
d. Pregnancy

ANS: a, b, d
Nutritional disturbances such as anoxia and emotional distress can cause secondary amenorrhea.

KEY: Integrated Process: Knowledge | Cognitive Level: Knowledge | Content Area: Womens Health | Client Need: Physiological Adaptation | Difficulty Level: Moderate

4. During a health visit, a 23-year-old patient shares with her health-care provider that she has been experiencing a yellowish mucus vaginal discharge, pain during sexual intercourse, and burning on urination. A culture of the cervical epithelial cells is obtained. Based on the patient information, the culture is obtained to assist in the diagnosis of which of the following? (Select all that apply.)
a. Chlamydia
b. Gonorrhea
c. Genital herpes
d. Syphilis

ANS: a, b
These are symptoms that can be related to either chlamydia or gonorrhea. Syphilis is diagnosed via blood test. Genital herpes has symptoms similar to the flu, and the person usually has an itching or burning sensation in the genital or anal area.

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Knowledge | Content Area: Diagnostic Tests | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate

5. A woman who is receiving radiation therapy for treatment of stage I cervical cancer is experiencing diarrhea. She contacts the oncology advice nurse. The advice nurse recommends that the woman (select all that apply):
a. Eat five or six small meals a day instead of three large meals
b. Eat cooked vegetables instead of raw vegetables
c. Use baby wipes instead of toilet paper
d. Reduce fluid intake to four glasses of water

ANS: a, b, c
Radiation damages the cells of the intestines. Interventions are aimed at decreasing stress on the intestines such as eating small, frequent meals and foods low in fiber. Baby wipes help reduce irritation to the anal area. A person should increase fluid intake to compensate for fluid loss caused by the diarrhea.

KEY: Integrated Process: Nursing Process | Cognitive Level: Synthesis | Content Area: Health Promotion | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate

Multiple Choice

6. A primary topic for health promotion for a 25-year-old woman with a history of polycystic ovary syndrome is (select the most important topic):
a. The adverse effects of cigarette smoking
b. The adverse effects of excessive alcohol consumption
c. Nutrition
d. Self-esteem issues

ANS: c
Women with PCOS are at higher risk for being obese. Obesity increases the womans risk for type 2 diabetes. Obesity and type 2 diabetes increase the womans risk for cardiovascular disease, hypertension, dyslipidemia, and metabolic syndrome. It is also important to talk about self-esteem issues related to hirsutism and the effects of smoking and drinking, but the long-term effects of obesity are a greater risk to a woman with PCOS.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Analysis | Content Area: Womens Health | Client Need: Reduction of Risk Potential | Difficulty Level: Hard

7. Which of the following is correct regarding endometriosis?
a. The physical symptoms of endometriosis can affect the womans mental health.
b. The abnormal tissue bleeds into surrounding tissue during the secretory stage of the menstrual cycle.
c. Endometriosis causes sterility.
d. Metronidazole is used to treat endometriosis.

ANS: a
Feedback
a. The physical symptoms can have an effect on the womans mental health. The woman may experience anger and grief related to loss of fertility. The pain of endometriosis can interfere with social activities, and dyspareunia can have an effect on intimate relationships.
b. In endometriosis, there is an abnormal tissue response to the changes of hormone levels of the menstrual cycle and the tissue breaks down and bleeds into surrounding areas during the menstrual phase.
c. Endometriosis has an effect on fertility but does not cause sterility.
d. Metronidazole is used to treat trichomoniasis.

KEY: Integrated Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Womens Health | Client Need: Psychological Integrity | Difficulty Level: Moderate

8. The daughter of an 85-year-old woman informs the doctor that her mother has suddenly become disoriented/confused and that she is dizzy and having difficulty with her balance. She is agitated and has fallen twice in the last 24 hours. The patients blood pressure and VS are within normal limits. Her medications include Synthroid, Lisinopril, and Crestor. Based on this data, the woman is most likely experiencing:
a. Stroke
b. Beginning stages of dementia
c. Urinary tract infection
d. Adverse reaction to her medications

ANS: c
These are classic signs/symptoms of a UTI in older women.

KEY: Integrated Process: Critical Thinking | Cognitive Level: Synthesis | Content Area: Potential for Alterations in Body Systems | Client Need: Health Promotion and Maintenance | Difficulty Level: Hard

9. A total hysterectomy is the removal of:
a. The uterus
b. The uterus and cervix
c. The uterus, cervix, fallopian tubes, and ovaries
d. The uterus, cervix, fallopian tubes, ovaries, upper portion of the vagina, and lymph nodes

ANS: b
Feedback
a. This is a supracervical hysterectomy.
b. This constitutes a total hysterectomy.
c. This would be a salpingo-oophorectomy.
d. This is a radical hysterectomy.

KEY: Integrated Process: Knowledge | Cognitive Level: Knowledge | Content Area: Womens Health | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate

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