Chapter 49: Female Reproductive Disorders Nursing School Test Banks

Chapter 49: Female Reproductive Disorders
Linton: Introduction to Medical-Surgical Nursing, 6th Edition

MULTIPLE CHOICE

1. Which potential side effect should a nurse caution a patient who is taking danazol (Danocrine), an androgenic steroid, for the treatment of menorrhagia to be prepared for?
a. Heavy menses
b. Masculinizing
c. Acnelike skin eruptions
d. Anemia
ANS: B
Androgenic steroids cause masculinizing. The distressing signs are a deepening voice, development of chest hair, coarsening of the skin, clitoral enlargement, and hot flashes. Many patients reject the drug on the basis of these side effects.

DIF: Cognitive Level: Knowledge REF: p. 1101 OBJ: 4
TOP: Androgenic Steroid Therapy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

2. What instruction should a nurse provide to a patient after a culdoscopy?
a. Clean the incision site daily with hydrogen peroxide.
b. Avoid vaginal intercourse.
c. Return to the clinic for suture removal in 7 days.
d. Use tampons.
ANS: B
Nothing should be inserted into the vagina (e.g., intercourse, tampons) for the time specified by the physician. No incision or sutures are present.

DIF: Cognitive Level: Application REF: p. 1095 OBJ: 2
TOP: Culdoscopy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

3. A patient asks a nurse, Will the laparoscopy be painful? What is the best reply by the nurse?
a. You will probably have some pain below the rib cage and around the shoulder.
b. Most patients state that the procedure is painless during and afterward.
c. You may have some mild to moderate pain around the umbilicus and in the back.
d. Every person is different. Its difficult to say whether youll have pain.
ANS: A
During the immediate postoperative period, the patient tends to experience pain below the rib cage and in the shoulder area from the air injected into the abdominal cavity. The air is absorbed in 24 hours, and the pain disappears.

DIF: Cognitive Level: Application REF: p. 1096 OBJ: 2
TOP: Laparoscopy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

4. A nurse is teaching a health class for 12- and 13-year-old girls about routine vaginal hygiene. What should the nurse be sure to include?
a. Wear clean polyester panties daily and at night.
b. Douche weekly with a mild vinegar solution.
c. Wash the external and internal genitalia daily.
d. Wipe the perinealanal area from front to back.
ANS: D
Transfer of Escherichia coli from the anus to the vagina or to the urinary system can be avoided by wiping the perinealanal area from front to back.

DIF: Cognitive Level: Comprehension REF: p. 1106 OBJ: 5
TOP: Infections of the Reproductive Tract
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

5. A nurse is teaching patients with endometriosis. What signs and symptoms of common complications should be included?
a. Pelvic inflammatory disease
b. Obstruction of the bowel and ureters
c. Cancer of the endometrium
d. Ovarian cancer
ANS: B
A common complication of endometriosis is obstruction of bowel, ureters, or both, from the endometrial deposits, creating a medical emergency.

DIF: Cognitive Level: Knowledge REF: p. 1112 OBJ: 4
TOP: Endometriosis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

6. After a mastectomy, many patients experience lymphedema. What action can the patient take to minimize this problem?
a. Keep the arm elevated as much as possible.
b. Take Lasix, 20 mg twice daily as ordered.
c. Use a sling during the day to rest the arm.
d. Avoid exercising the arm for several weeks.
ANS: A
To manage lymphedema, the patient should elevate the arm to a height above the level of the heart.

DIF: Cognitive Level: Comprehension REF: p. 1124 OBJ: 5
TOP: Postoperative Care for Mastectomy
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

7. A patient tells a nurse that she is afraid of getting cervical cancer because her mother died of cervical cancer. What is the most appropriate response by the nurse?
a. You need to a have a pelvic examination every 6 months because of your history.
b. If you have regular Pap smears, cervical cancer is usually diagnosed early and cured.
c. Theres no need to worry so much. Cervical cancer does not run in families.
d. Cervical cancer is sexually transmitted. Dont switch partners often, and you dont have to worry.
ANS: B
For patients who have regular annual pelvic examinations and Papanicolaou (Pap) smears, cervical cancer is usually diagnosed and treated in its early stage.

DIF: Cognitive Level: Comprehension REF: p. 1125 OBJ: 4
TOP: Cervical Cancer KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

8. A nurse is instructing a patient on breast self-examination. When is the best time of the month to instruct this patient to perform a breast self-examination?
a. Before the menstrual period
b. During the menstrual period
c. After the menstrual period
d. On the first day of the month
ANS: C
Breast self-examination should be performed at the same time each month, at the end of the menstrual cycle.

DIF: Cognitive Level: Knowledge REF: p. 1097 OBJ: 2
TOP: Breast Self-Examination KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

9. A nurse is caring for a patient after a modified radical mastectomy for a breast tumor that has been determined to be positive for estrogen receptors (ER positive) and has been placed on a protocol of tamoxifen. The patient then asks the nurse, Do you think I should take this medication? Which statement is the most appropriate?
a. Tamoxifen will probably not be effective because your tumor was ER positive.
b. If I were you, I would do what the physician recommends.
c. I think that you should take tamoxifen, because the tumor was ER positive.
d. Tamoxifen is an option to consider, because your tumor was ER positive.
ANS: D
For tumors that are ER positive, tamoxifen citrate may be prescribed because such drugs interfere with estrogen production. ER-positive tumors need estrogen to grow.

DIF: Cognitive Level: Comprehension REF: p. 1122 OBJ: 4
TOP: Drugs Used in Treatment for Breast Cancer
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

10. Conjugated estrogen (Premarin) is indicated for treatment of menopause. Which side effects should a nurse explain before administering the medication to a woman who has just had a hysterectomy?
a. Breast tenderness
b. Hypotension
c. Arthralgia
d. Skin rash
ANS: A
A side effect of conjugated estrogen (Premarin) is breast tenderness.

DIF: Cognitive Level: Comprehension REF: p. 1100 OBJ: 5
TOP: Drugs Used to Treat Menopause KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

11. A 16-year-old girl seen in the student health clinic has been diagnosed with Trichomonas vaginalis and given medication for the infection. What should a nurse explains about treatment of the girls sexual partner?
a. He will require a 1-day treatment with the same drug.
b. He will not develop the infection or require treatment.
c. He will be treated, although he is asymptomatic.
d. He is required by law to be examined by a physician.
ANS: C
The womans sexual partner(s) may be treated for some infections to avoid reinfection.

DIF: Cognitive Level: Comprehension REF: p. 1106 OBJ: 5
TOP: Trichomonas vaginalis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

12. A patient makes an appointment with her gynecologist because she is having difficulty conceiving. Which laboratory test should the nurse anticipate the physician will order?
a. Complete blood count
b. Progesterone level
c. Prothrombin time
d. Erythrocyte count
ANS: B
Evaluation of the female partner includes basal body temperature, serum progesterone level, and endometrial biopsy to assess for infertility.

DIF: Cognitive Level: Comprehension REF: p. 1131 OBJ: 4
TOP: Infertility Diagnostic Tests KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

13. What action should a nurse implement when assessing for abnormal bleeding in a patient following a hysterectomy?
a. Record the number of perineal pads used.
b. Assess vital signs every 8 hours.
c. Place the patients bed in a high Fowler position.
d. Apply an abdominal binder.
ANS: A
Recording the number of pads used and the appearance of the discharge is primary in posthysterectomy care. The abdominal dressing and perineal pad are checked every hour for the first 12 hours. Any excess bleeding is reported. The patient should be placed on her side in a semi-Fowler position. An abdominal binder, if used, has no effect on hemorrhage.

DIF: Cognitive Level: Application REF: p. 1114 OBJ: 5
TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

14. A female student, seen in the campus clinic, states that she uses feminine hygiene douches every day and after intercourse. What is the best response from the nurse?
a. Douching has been used as an effective means of birth control for years.
b. Commercially prepared douches will neutralize the female vaginal tract.
c. Douching should only be done when ordered by a physician or nurse practitioner.
d. Douching protects the vaginal tract from microorganisms.
ANS: C
Women should not douche unless it is ordered by a physician or nurse practitioner.

DIF: Cognitive Level: Comprehension REF: p. 1098 OBJ: 3
TOP: Douching KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

15. A nurse collecting data on the reproductive system from a female patient is told that the patient has a vaginal discharge that is cottage cheeselike in appearance. What should the nurse recognize this as a common sign of?
a. Pelvic inflammatory disease (PID)
b. Trichomonas vaginalis infection
c. Atrophic vaginitis
d. Candida albicans infection
ANS: D
Candida albicans infection has a distinctive odor and a cottage cheeselike appearance.

DIF: Cognitive Level: Comprehension REF: p. 1105 OBJ: 4
TOP: Sexually Transmitted Infections KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. A nurse is demonstrating breast self-examination to a patient. What should the nurse point out as the most common area in the breast for tumors to occur?
a. Under the nipple
b. Upper outer quadrant
c. Six oclock position
d. Axillary lymph nodes
ANS: B
Nearly half of all malignant breast tumors are located in the upper outer quadrant.

DIF: Cognitive Level: Knowledge REF: p. 1121 OBJ: 5
TOP: Breast Self-Examination KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

17. After months of infertility procedures, a physician informs a 32-year-old patient that she will never conceive. As the nurse enters the examination room, the patient states, I guess Im a failure as a woman. Based on this statement, what is the most appropriate nursing diagnosis?
a. Sexual dysfunction
b. Ineffective health maintenance
c. Disturbed body image
d. Ineffective coping
ANS: D
The nurse may be the only person with whom the patient feels comfortable to discuss feelings and to explore coping strategies. The distorted view of herself indicates that, at this time, she is ineffectively coping.

DIF: Cognitive Level: Application REF: p. 1131-1132
OBJ: 5 TOP: Infertility KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

18. What must be true for a woman to be diagnosed with primary infertility?
a. She has been unable to conceive after 1 year of regular, unprotected sex.
b. She conceived once but did not deliver a viable infant.
c. She conceived once but was unable to conceive again.
d. She conceived three times in 1 year without a viable birth.
ANS: A
To be diagnosed with primary infertility, the patient must have been unable to conceive after 1 year of regular, unprotected sex. All other options are definitions of secondary infertility.

DIF: Cognitive Level: Comprehension REF: p. 1130 OBJ: 5
TOP: Infertility KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. A patient is admitted with possible cancer of the ovary. What fact should a nurse know about malignant tumors of the ovary?
a. They are frequently advanced and inoperable by the time they are diagnosed.
b. The respond well to radiation and chemotherapy because of early detection.
c. They are easily detected because symptoms appear early in a womans life.
d. They are directly related to PID and other infections.
ANS: A
The high mortality rate for women with ovarian cancer is due to the fact that a malignant tumor of the ovary is asymptomatic until it is advanced.

DIF: Cognitive Level: Knowledge REF: p. 1127 OBJ: 4
TOP: Ovarian Cancer KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. A mastectomy care plan should address psychosocial problems of the patient. What should this be directed toward?
a. Caring for the wound and dressings
b. Finding an appropriate support group
c. Educating for methods for controlling edema
d. Helping the patient express feelings and concerns
ANS: D
The nurse should gently explore how the patient is feeling about the surgery and encourage her to express her concerns. The other options are significant care concerns but are not psychosocial in nature.

DIF: Cognitive Level: Comprehension REF: p. 1122 OBJ: 5
TOP: Breast Cancer KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

21. Which medication is used to stimulate or mimic actions of natural pituitary gonadotropins in the treatment of infertility?
a. Estrogen only (diethylstilbestrol)
b. Danazol (Danocrine)
c. Clomiphene citrate (Clomid)
d. Raloxifene (Evista)
ANS: C
Clomid stimulates the actions of natural pituitary gonadotropins.

DIF: Cognitive Level: Knowledge REF: p. 1101 OBJ: 4
TOP: Ovulatory Stimulant Drugs KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

22. A nurse reads that a patients breast tumor is a stage II. What should the nurse realize about this tumor?
a. It is smaller than 2 cm, with no positive lymph node involvement and no metastasis evident.
b. It measures between 2 and 5 cm, with no or one positive lymph node involvement and no metastasis evident.
c. It is larger than 5 cm, with no positive lymph node involvement and no metastasis evident.
d. It measures between 2 and 5 cm, with positive axillary lymph node involvement and metastasis evident.
ANS: B
A stage II tumor is between 2 and 5 cm with no or one lymph nodes positive for cancer and no metastases present. All other options are for different stages of tumors.

DIF: Cognitive Level: Comprehension REF: p. 1124 OBJ: 4
TOP: Staging of a Breast Tumor KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. A woman calls the clinic office and asks the nurse why she is having spotting between her monthly periods when she is taking birth control pills to control the menorrhagia. What is the nurses most appropriate response?
a. It is important to take the pill at the same time each day.
b. Irregular spotting is to be expected with oral contraceptives.
c. The pills are still safe. Continue to take them, regardless.
d. Physicians are still uncertain as to how oral contraceptives function.
ANS: A
Treatment for menorrhagia consists of taking the birth control pill at the same time each day.

DIF: Cognitive Level: Comprehension REF: p. 1104 OBJ: 5
TOP: Menorrhagia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

MULTIPLE RESPONSE

24. A nurse teaching a seminar on breast cancer lists the signs that would alert a woman to the possibility of a tumor. What should those signs include? (Select all that apply.)
a. Dimpling
b. Nipple discharge
c. Thickening of tissue
d. Red bruise
e. Dry rash around nipple
ANS: A, B, C, E
Signs of breast cancer that should be investigated are dimpling of the skin of the breast, any discharge from the nipple, any thickening of breast tissue, or a dry rash in the areola. Although it should be investigated, bruising is not a classic sign of breast cancer.

DIF: Cognitive Level: Knowledge REF: p. 1121 OBJ: 4
TOP: Signs of Breast Cancer KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

25. What do the causes for menorrhagia include? (Select all that apply.)
a. Hormonal dysfunction
b. Tumors
c. Coagulation disorders
d. Endometrial hyperplasia
e. Excessive exercising
ANS: A, B, C, D
Common causes for menorrhagia include hormonal dysfunction, tumors (both benign and malignant), coagulation disorders, and endometrial hyperplasia. Excessive exercise is far more likely to cause amenorrhea than menorrhagia.

DIF: Cognitive Level: Knowledge REF: p. 1103 OBJ: 4
TOP: Menorrhagia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

COMPLETION

26. A nurse is aware that a tumor determined to be ER positive indicates that the tumor needs _____ for growth.

ANS:
estrogen
A tumor that is classified as ER positive requires estrogen to grow.

DIF: Cognitive Level: Knowledge REF: p. 1122 OBJ: 4
TOP: ER+ Tumors KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

27. A nurse points out to a group of young women who are being treated for PID that because of the effect of this disease on their reproductive organs, they may become _____.

ANS:
sterile
infertile
Persons who have had repeated episodes of PID are at risk for becoming sterile or infertile.

DIF: Cognitive Level: Comprehension REF: p. 1130 OBJ: 4
TOP: PID and Infertility KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

28. Because small non-nodal metastases may be present, _____ is recommended after a lumpectomy.

ANS:
radiation

Radiation is recommended after a lumpectomy even when no indication of metastasis is evident because of the threat of small metastases without nodal involvement.

DIF: Cognitive Level: Comprehension REF: p. 1122 OBJ: 2
TOP: Radiation KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

29. The nurse recommends that an annual mammogram be performed for women older than _____ years of age.

ANS:
50
Annual mammography is recommended for women age 50 years and older.

DIF: Cognitive Level: Knowledge REF: p. 1096 OBJ: 2
TOP: Mammograms KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

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