Chapter 58: Drugs for Disorders in Womens Health, Infertility, and Sexually Transmitted Infections Nursing School Test Banks

Chapter 58: Drugs for Disorders in Womens Health, Infertility, and Sexually Transmitted Infections
Test Bank

MULTIPLE CHOICE

1. The parent of a 16-year-old female tells the nurse that the child has not had a menstrual period in spite of having breast and pubic hair development. The nurse recognizes this as characteristic of which condition?
a. Dysmenorrhea
b. Hypothyroidism
c. Primary amenorrhea
d. Secondary amenorrhea
ANS: C
Females who have never had a period have primary amenorrhea, which is defined as no menses by age 14 without secondary sex characteristics, or no menses by age 16 with secondary sex characteristics. Dysmenorrhea refers to painful cramping with periods. Hypothyroidism can contribute to secondary amenorrhea, which is characterized by cessation of periods for at least 6 months once menses have begun.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 886
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pathophysiology

2. A young woman reports not having a period for 7 months. Which test will the provider likely order first to evaluate the cause of amenorrhea in this patient?
a. Pelvic ultrasound
b. Pregnancy test
c. Progestational challenge test
d. Serum insulin levels
ANS: B
When secondary amenorrhea occurs, pregnancy must be ruled out prior to performing other tests. A progestational challenge test will be performed if the patient is not pregnant. If polycystic ovarian syndrome is suspected, serum insulin levels and possibly a pelvic ultrasound will be performed.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 886
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pathophysiology

3. A woman is diagnosed with polycystic ovarian disease (PCOS) after being unable to conceive. Her provider has ordered metformin (Glucophage) and clomiphene citrate (Clomid). The nurse will explain that metformin is given for which purpose?
a. To increase androgen levels
b. To induce ovulation
c. To promote a dominant follicle
d. To regulate menstrual periods
ANS: D
Metformin decreases androgen levels, which helps to regulate periods. It does not induce ovulation but increases the possibility of ovulation by its antiandrogenic effects. Clomiphene citrate promotes a dominant follicle.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 887
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A 30-year-old woman describes having periods every 30 days, lasting 8 days, with heavy bleeding. The nurse understands that these are signs of which condition?
a. Menometrorrhagia
b. Menorrhagia
c. Menorrhea
d. Metrorrhagia
ANS: B
Menorrhagia is defined as regular uterine bleeding lasting more than 7 days with heavy bleeding. Metrorrhagia is irregular uterine bleeding lasting more than 7 days with heavy bleeding. Menorrhea is normal uterine bleeding. Menometrorrhagia is a combination of menorrhagia and metrorrhagia.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 887
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pathophysiology

5. A woman who has menorrhagia is prescribed ibuprofen, and she asks the nurse how a pain medication can decrease uterine bleeding. The nurse will explain that this is most likely explained by ibuprofens effects on
a. estrogen levels.
b. platelet aggregation.
c. prostaglandin production.
d. uterine endometrium.
ANS: C
Ibuprofen blocks prostaglandin production, which decreases uterine bleeding and cramps. Ibuprofen does not affect estrogen levels. Its effects on platelet aggregation would most likely increase bleeding. It does not have effects on the uterine endometrium.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 888
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A woman is diagnosed with bacterial vaginosis and will begin taking metronidazole (Flagyl). What will the nurse teach the patient about this medication?
a. Abstain from sexual intercourse while taking this medication.
b. Do not consume alcohol while taking this drug and for 48 hours after stopping.
c. Take this medication on an empty stomach to increase absorption.
d. Topical preparations are ineffective for treating bacterial vaginosis.
ANS: B
Metronidazole can cause a disulfiram-like reaction when taken with alcohol, so patients should be cautioned against using foods or drug products that contain alcohol. There is no need to abstain from sexual intercourse. Metronidazole should be taken with food. The topical preparation is effective against bacterial vaginosis.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 891
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. A woman who is infertile has taken 50 mg of clomiphene citrate (Clomid) from days 5 through 9 of a cycle and has not ovulated. The nurse will anticipate that the provider will perform which action?
a. Begin recombinant follicle-stimulating hormone therapy.
b. Increase the dose to 100 mg on days 5 through 9 of her next cycle.
c. Order clomiphene citrate to be given throughout her next cycle.
d. Repeat the 50 mg of clomiphene citrate for 2 more cycles.
ANS: B
If clomiphene is unsuccessful, the provider may increase the dose by 50-mg increments for 2 each cycles up to 250 mg until ovulation occurs. Recombinant FSH may be used if this fails. It is not correct to administer the drug throughout the cycle or to continue with the initial dose.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 895
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. The nurse performs a history on a woman who will begin taking clomiphene citrate (Clomid) to induce ovulation. Which aspect of this patients history is of concern?
a. Anovulation
b. Dysmenorrhea
c. Sexually transmitted infection
d. Uterine fibroids
ANS: D
Patients with a history of uterine fibroids should not take clomiphene. Anovulation is the indication for clomiphene. Dysmenorrhea and sexually transmitted infections are not contraindications.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 896
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The nurse is teaching the parent of an 11-year-old girl about the Gardasil vaccine. What will the nurse include in teaching?
a. Gardasil is given to females and not to males.
b. Gardasil protects against cervical dysplasia.
c. Gardasil reduces the need for routine Pap smears.
d. Gardasil will be given as a single injection.
ANS: B
Gardasil protects against human papillomavirus, which is a cause of cervical dysplasia and cancer. It is offered to both females and males. The vaccine does not decrease the need for regular cervical cancer screening. It is given in a 3-vaccine series, with the second dose in 2 months and the third dose in 6 months.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 900
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

10. A woman who is 6 weeks pregnant develops a vaginal yeast infection and asks the nurse what she can use to treat it. The nurse will make which recommendation?
a. Apply over-the-counter Gyne-Lotrimin cream.
b. Ask her provider about nystatin vaginal tablets.
c. Request a prescription for oral fluconazole (Diflucan).
d. Use over-the-counter Monistat-3 suppositories.
ANS: B
Nystatin vaginal tablets are the safest to use during pregnancy. Monistat-3 is contraindicated during the first trimester of pregnancy. Oral fluconazole will have systemic side effects and is pregnancy category C or D.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 892
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A patient is taking azithromycin to treat a chancroid infection. What nonpharmacologic measures will the nurse recommend as adjunct therapy to treat this infection?
a. Apply a bacteriostatic ointment to the lesions twice daily.
b. Avoid washing the lesions to prevent spread of the infection.
c. Cover the lesions with gauze at all times to minimize discomfort.
d. Use compresses to remove necrotic material and clean the lesions 3 times daily.
ANS: D
Patients should be counseled to cleanse the lesions 3 times daily and to use compresses to remove necrotic material. It is not necessary to apply bacteriostatic ointment or to cover the lesions with gauze. Washing the lesions is recommended.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 901
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A woman is diagnosed with gonorrhea and receives ceftriaxone intramuscularly in clinic and a prescription for doxycycline to be taken twice daily for 7 days. She asks the nurse why she needs to take medicine since she has had a shot. How will the nurse respond?
a. Both medications are required to fully treat the gonorrheal infection.
b. Doxycycline helps prevent spread of gonorrhea to your sexual partners.
c. Patients with gonorrhea are always treated for chlamydia as well.
d. The second medication decreases your chances of disease recurrence.
ANS: C
Patients with gonorrhea should be treated for chlamydia empirically. Doxycycline is used to treat chlamydia. Ceftriaxone does not prevent spread of gonorrhea to sexual partners or decrease the risk of relapse.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 902
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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