Chapter 37: Assessment of the Reproductive System Nursing School Test Banks

Black & Hawks: Medical-Surgical Nursing, 8th Edition

Test Bank

Chapter 37: Assessment of the Reproductive System

MULTIPLE CHOICE

1. A nurse palpates a small lump in a womans breast. The most appropriate action by the nurse is to

a.

ask the client if any relatives have had breast cancer.

b.

document its characteristics and the position of the client.

c.

refer the client for a same-day mammography.

d.

tell the client to return next month for a repeat examination.

ANS: B

The nurse should note the lumps characteristics and the position of the client when palpated. The areola can be used as a reference point. History should precede physical examination. The client may or may not need mammography, depending on many factors, including if the lump has been noted and examined previously and is unchanged. Returning next month for follow-up, again, may or may not be appropriate.

DIF: Application/Applying REF: p. 859 OBJ: Intervention

MSC: Physiological Integrity Reduction of Risk Potential-System Specific Assessments

2. When obtaining a sexual history from a female client, a nurse should first

a.

ask general questions regarding current sexual activity.

b.

ask the client if she would like to talk about her sex life.

c.

share his or her own feelings about sexuality.

d.

tell the client that she should not be embarrassed.

ANS: A

The nurse should begin with general questions about whether the client is satisfied and comfortable with her current sexual activity.

DIF: Application/Applying REF: p. 854 OBJ: Assessment

MSC: Health Promotion and Maintenance Growth and Development Through the Lifespan-Human Sexuality

3. During history-taking on a client considering pregnancy, the nurse should inquire whether the client has ever had

a.

diphtheria.

b.

mumps.

c.

rubella.

d.

typhoid fever.

ANS: C

Maternal rubella during the first trimester increases the fetal risk for congenital disorders. The nurse should ask the client if she has had rubella or has immunity to it. The nurse can suggest a rubella titer to confirm immunity. If immunity is lacking, the client can be vaccinated, but must wait at least 3 months before becoming pregnant.

DIF: Application/Applying REF: p. 856 OBJ: Assessment

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Immunizations

4. The nurse informs a client that the factor that places her at risk for cancer of the cervix is

a.

a mother who took diethylstilbestrol when pregnant with the client.

b.

having a mother of Mediterranean heritage.

c.

riding horseback since the client was a child.

d.

using herbal remedies for her fertility problems.

ANS: A

If the womans mother received diethylstilbestrol (DES) during her pregnancy with the client, the client may be at risk for cancer or for structural and functional changes in the reproductive tract.

DIF: Comprehension/Understanding REF: p. 857 OBJ: Assessment

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health and Wellness

5. The nurse instructs a client that a normal observation during breast self-examination (BSE) is

a.

contour changes.

b.

dimpling.

c.

nipple deviation.

d.

variation in breast size.

ANS: D

Breasts are symmetrical, although it is not unusual for one breast to be slightly larger than the other. Breast contour should be even without dimpling or deviation in nipple appearance.

DIF: Comprehension/Understanding REF: p. 857 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Self Care

6. The nurse notices that a client performing a BSE is failing to palpate her breast and axillae completely. To improve her technique, the nurse should teach the client to

a.

compress the nipple downward.

b.

gently slide her fingers over the breast tissue.

c.

palpate the breast using a systematic approach.

d.

start her examination when standing.

ANS: C

The breast and areola may be palpated in concentric circles, in a wheel-and-spokes pattern, or back and forth from superior to inferior. However the nurse or client chooses to proceed, they should use a systematic approach so as to not forget to examine all the breast tissue.

DIF: Application/Applying REF: pp. 858-859 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Self Care

7. When calling a woman to inform her that the results of her Pap smear are suspicious, the nurse should first

a.

interpret the cytologic findings for the client.

b.

provide an opportunity to discuss concerns and ask questions.

c.

refer the client for further diagnostic evaluation by a physician.

d.

schedule immediate retesting to validate the findings.

ANS: A

Careful interpretation of cytologic findings is very important to the client, and results can be very difficult to interpret. So the client needs the nurse to assist her in understanding the results. The client also needs ample opportunity to ask questions, discuss concerns and feelings, and participate in follow-up care planning. However, the first action by the nurse is to interpret the findings and make sure the client understands them.

DIF: Application/Applying REF: p. 863 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health Screening

8. A female client scheduled for her first mammography needs the information that

a.

no pain or discomfort is involved.

b.

results are available within 60 days.

c.

she cannot wear deodorant on the day of the test.

d.

the procedure takes 15 to 30 minutes.

ANS: C

The procedure takes 15 to 30 minutes, and results are available in 1 to 21 days. Discomfort may be experienced because of breast compression during the procedure. No body powder, creams, or deodorant should be used on the torso before the procedure.

DIF: Knowledge/Remembering REF: pp. 860-861 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health Screening

9. In discussing mammography with a client, the nurse would include the current recommendation that

a.

all females should have a baseline mammogram at menarche.

b.

all females should have a baseline mammogram when they are 21.

c.

mammograms should be done semi-annually in women over age 35.

d.

mammograms should be done yearly in women over age 40.

ANS: D

The American Cancer Society recommends a baseline mammogram for all women by age 40 and mammography screening every year for women age 40 and over.

DIF: Comprehension/Understanding REF: p. 861 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health Screening

10. The nurse obtaining a health history from a male client with a history of hypertension should ask the client about

a.

renal functioning.

b.

sexual functioning.

c.

testicular problems.

d.

voiding problems.

ANS: B

Hypertension is one of several medical conditions that can cause erectile dysfunction (ED). Other medical problems related to ED include diabetes, stroke, heart attack, spinal cord injuries, and back problems.

DIF: Application/Applying REF: p. 866 OBJ: Assessment

MSC: Physiological Integrity Physiological Adaptation-Pathophysiology

11. While physical examination of his reproductive system is being conducted, the client has an erection. The most appropriate action by the nurse is

a.

advise the client to breathe through his mouth to relax.

b.

leave the room and return when the exam is completed.

c.

say nothing and stay while the exam is being conducted.

d.

tell the client this reaction is normal and has no sexual meaning.

ANS: D

If the client does have an erection, the nurse should explain that this is normal and has no sexual connotation. This will help ease the anxiety the man may be having about this event.

DIF: Application/Applying REF: p. 868 OBJ: Intervention

MSC: Psychosocial Integrity Coping and Adaptation-Therapeutic Communication

12. During palpation of a clients testes, the nurse notes a small, hard lump on the anterior aspect of one testis. The nurses most appropriate action would be to

a.

do nothing, since this is a normal finding.

b.

palpate the groin for an associated hernia.

c.

perform transillumination of the scrotum.

d.

recommend the client take antibiotics.

ANS: C

A small (pea-sized) hard lump located on either the anterior or the lateral aspect of a testis suggests a malignancy. After transillumination by the nurse to confirm the nodule, the client is referred to the physician for follow-up.

DIF: Application/Applying REF: pp. 869-870 OBJ: Assessment

MSC: Physiological Integrity Reduction of Risk Potential-System Specific Assessments

13. The nurse observes a red glow during transillumination of a clients scrotum. The nurse would interpret this finding as

a.

a hematoma.

b.

a scrotal mass.

c.

normal findings.

d.

serous fluid.

ANS: D

Serous fluid appears as a red glow on transillumination of the scrotum.

DIF: Application/Applying REF: pp. 869-870 OBJ: Assessment

MSC: Physiological Integrity Reduction of Risk Potential-System Specific Assessments

14. The client who has a prostate-specific antigen (PSA) density of 0.13 ng/ml is considered to have

a.

a contaminated specimen.

b.

the presence of cancer cells.

c.

the need for a follow-up examination.

d.

no risk for prostate cancer.

ANS: D

Clients with PSA density less than 0.15 ng/ml are considered at low risk for prostate cancer.

DIF: Knowledge/Remembering REF: p. 871 OBJ: Assessment

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health Screening

15. The nurse is teaching a client to perform testicular self-examination (TSE). The nurse is aware that this procedure is an example of

a.

primary prevention.

b.

quaternary prevention.

c.

secondary prevention.

d.

tertiary prevention.

ANS: C

Secondary prevention (detecting and treating a problem early) includes screening activities, such as serum PSA levels in men over age 50 and TSE.

DIF: Knowledge/Remembering REF: p. 866 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health Screening

16. The nurse teaches a client scheduled for semen examination that in order to provide an adequate sample, the client should

a.

abstain from ejaculating 2 to 5 days before the test.

b.

drink plenty of liquids for 24 hours before the test.

c.

get plenty of sleep the night before the test.

d.

increase intake of red meat 3 days before the test.

ANS: A

To provide an adequate sample, the client should abstain from ejaculation for 2 to 5 days before the test.

DIF: Comprehension/Understanding REF: p. 872 OBJ: Intervention

MSC: Physiological Integrity Reduction of Risk Potential-Diagnostic Tests

MULTIPLE RESPONSE

1. The nurse explains to a client undergoing her first gynecologic examination that the American Cancer Society recommends an annual Pap test for women (Select all that apply)

a.

every year until the woman experiences menopause.

b.

once the woman reaches the age of 16.

c.

starting at the age of 21 unless sexually active earlier.

d.

who are or who have been sexually active.

e.

who have been exposed to a sexually transmitted disease.

ANS: C, D

Guidelines from the American Cancer Society are an annual Pap test for women who are or who have been sexually active or who have reached the age of 21. Once three negative tests results in a row are obtained, the Pap smear can be performed less often at the discretion of the health care provider. Women should continue having Pap tests even after menopause. Exposure to an STD requires specific testing for STDs; the Pap test is for cervical cancer.

DIF: Comprehension/Understanding REF: p. 863 OBJ: Intervention

MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health Screening

Elsevier items and derived items 2009 by Saunders, an imprint of Elsevier Inc.

Some material was previously published.

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