Chapter 32: Womens Health Care My Nursing Test Banks

Chapter 32: Womens Health Care

Test Bank

MULTIPLE CHOICE

1. Which piece of the usual equipment setup for a pelvic examination is omitted with a Pap test?

a.

Gloves and eye protectors

b.

Speculum

c.

Fixative agent

d.

Lubricant

ANS: D

Feedback

A

The examiner should always use Standard Precautions.

B

A speculum is needed to see the cervix.

C

A fixative agent is applied to the slide to prevent drying or disruption of the specimen.

D

Lubricants interfere with the accuracy of the cytology report.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 775

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

2. The microscopic examination of scrapings from the cervix, endocervix, or other mucous membranes to detect premalignant or malignant cells is called

a.

Bimanual palpation

b.

Rectovaginal palpation

c.

A Papanicolaou test

d.

DNA testing

ANS: C

Feedback

A

Bimanual palpation is a physical examination of the vagina; the Pap test is a microscopic examination for cancer.

B

Rectovaginal palpation is a physical examination performed through the rectum; the Pap test is a microscopic examination for cancer.

C

The Pap test is a microscopic examination for cancer that should be performed regularly, depending on the patients age.

D

DNA testing for the various types of HPV that cause cervical cancer is now available. Samples are collected in the same way as a Pap test.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 775

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

3. The nurse providing care in a womens health care setting must be aware that which sexually transmitted disease (STD) can be cured?

a.

Herpes

b.

Acquired immunodeficiency syndrome (AIDS)

c.

Venereal warts

d.

Chlamydia

ANS: D

Feedback

A

Because no cure is known for herpes, treatment focuses on pain relief and preventing secondary infections.

B

Because no cure is known for AIDS, prevention and early detection are the main focus.

C

Condylomata acuminata is caused by the human papillomavirus. No treatment eradicates the virus.

D

The usual treatment for chlamydia bacterial infection is doxycycline or azithromycin. Concurrent treatment of all sexual partners is needed to prevent recurrence.

PTS: 1 DIF: Cognitive Level: Knowledge REF: pp. 797-799

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

4. Which statement by a woman diagnosed with premenstrual syndrome indicates that further health teaching is needed?

a.

I will not eat chips or pickles.

b.

Coffee and chocolate can make me more irritable and nervous.

c.

Drinking alcohol makes me more depressed.

d.

Ill eat only three meals per day.

ANS: D

Feedback

A

Less intake of salty foods helps decrease fluid retention.

B

Caffeine consumption increases irritability, insomnia, anxiety, and nervousness.

C

Alcohol consumption aggravates depression.

D

The woman should be encouraged to eat six small meals a day to decrease risk of hypoglycemia.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 787

OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity

5. Which statement by the patient indicates that she understands breast self-examination?

a.

I will examine both breasts in two different positions.

b.

I will perform breast self-examination 1 week after my menstrual period starts.

c.

I will examine the outer upper area of the breast only.

d.

I will use the palm of the hand to perform the examination.

ANS: B

Feedback

A

She should use four positions: standing with arms at her sides, standing with arms raised above her head, standing with hands pressed against hips, and lying down.

B

The woman should examine her breasts when hormonal influences are at a low level.

C

The entire breast needs to be examined, including the outer upper area.

D

She should use the sensitive pads of the middle three fingers.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 772

OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance

6. A benign breast condition that includes dilation and inflammation of the collecting ducts is called

a.

Ductal ectasia

b.

Intraductal papilloma

c.

Chronic cystic disease

d.

Fibroadenoma

ANS: A

Feedback

A

Generally occurring in women approaching menopause, ductal ectasia results in a firm irregular mass in the breast, enlarged axillary nodes, and nipple discharge.

B

Intraductal papillomas develop in the epithelium of the ducts of the breasts; as the mass grows, it causes trauma or erosion within the ducts.

C

Chronic cystic disease causes pain and tenderness. The cysts that form are multiple, smooth, and well delineated.

D

Fibroadenoma is fibrous and glandular tissues. They are felt as firm, rubbery, and freely mobile nodules.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 777

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

7. Which patient is most at risk for fibroadenoma of the breast?

a.

A 38-year-old woman

b.

A 50-year-old woman

c.

A 16-year-old woman

d.

A 27-year-old woman

ANS: C

Feedback

A

Ductal ectasia becomes more common as a woman approaches menopause.

B

Intraductal papilloma develops most often just before or during menopause.

C

Although it may occur at any age, fibroadenoma is most common in the teenage years.

D

Fibrocystic breast changes are more common during the reproductive years.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 777

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

8. Adjuvant treatment with tamoxifen may be recommended for patients with breast cancer if the tumor is

a.

Smaller than 5 cm

b.

Located in the upper outer quadrant only

c.

Contained only in the breast

d.

Estrogen receptive

ANS: D

Feedback

A

Tamoxifen is used depending on age, stage, and hormone receptor status, not size.

B

Location of the cancer does not determine the usefulness of tamoxifen.

C

Stage of the cancer is a consideration, but more important is its sensitivity to estrogen.

D

Tamoxifen is antiestrogen therapy for tumors stimulated by estrogen.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 779

OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity

9. Which statement is true about primary dysmenorrhea?

a.

It occurs in young multiparous women.

b.

It is experienced by all women.

c.

It may be due to excessive endometrial prostaglandin.

d.

It is unaffected by oral contraceptives.

ANS: C

Feedback

A

It occurs in young nulliparous women.

B

It is not experienced by all women.

C

Some women produce excessive endometrial prostaglandin during the luteal phase of the menstrual cycle. Prostaglandin diffuses into endometrial tissue and causes uterine cramping.

D

Oral contraceptives can be a treatment choice.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 785

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

10. In helping a patient manage PMS, the nurse should

a.

Recommend a diet with more body-building and energy food, such as red meat and sugar.

b.

Suggest herbal therapies, and massage.

c.

Tell the patient to push for medications from the physician as soon as symptoms occur so as to lessen their severity.

d.

Discourage the use of diuretics.

ANS: B

Feedback

A

Limiting red meat, refined sugar, caffeinated beverages, and alcohol improves the diet and may mitigate symptoms.

B

Herbal therapies, conscious relaxation and massage have all been reported to have a beneficial effect on PMS.

C

Medication usually is begun only if lifestyle changes fail to provide significant relief.

D

Natural diuretics may help reduce fluid retention.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 787

OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity

11. With regard to endometriosis, nurses should be aware that

a.

It is characterized by the presence and growth of endometrial tissue inside the uterus.

b.

It affects 25% of all women.

c.

It may worsen with repeated cycles or remain asymptomatic and disappear after menopause.

d.

It is unlikely to affect sexual intercourse or fertility.

ANS: C

Feedback

A

With endometriosis, the endometrial tissue is outside the uterus. Symptoms vary among women, ranging from nonexistent to incapacitating.

B

Endometriosis affects 10% of all women and is found equally in Caucasian and African-American women.

C

Symptoms vary among women, ranging from nonexistent to incapacitating.

D

Women can experience painful intercourse and impaired fertility.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 785

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

12. A 49-year-old patient confides to the nurse that she has started experiencing pain with intercourse and asks, Is there anything I can do about this? The nurses best response is

a.

You need to be evaluated for a sexually transmitted disease.

b.

Water-soluble vaginal lubricants may provide relief.

c.

No, it is part of the aging process.

d.

You may have vaginal scar tissue that is producing the discomfort.

ANS: B

Feedback

A

This is a normal occurrence with the aging process and does not indicate STDs.

B

Loss of lubrication with resulting discomfort in intercourse is a symptom of estrogen deficiency.

C

It is part of the aging process, but the use of lubrication will help relieve the symptoms.

D

It is due to loss of lubrication with the decrease in estrogen. Scar tissue problems would have occurred earlier.

PTS: 1 DIF: Cognitive Level: Application REF: p. 790

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

13. A 70-year-old woman should be taught to report what condition to her health care provider?

a.

Vaginal bleeding

b.

Pain with intercourse

c.

Breasts become smaller

d.

Skin becomes thinner

ANS: A

Feedback

A

Vaginal bleeding after menopause should always be investigated. It is highly suggestive of endometrial cancer.

B

Pain with intercourse is an expected change that occurs due to the aging process.

C

Breast shrinkage is an expected change that occurs due to the aging process.

D

Skin thinning is an expected change that occurs due to the aging process.

PTS: 1 DIF: Cognitive Level: Application REF: p. 789

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

14. Which woman is most likely to have osteoporosis?

a.

A 50-year-old woman receiving estrogen therapy

b.

A 60-year-old woman who takes supplemental calcium

c.

A 55-year-old woman with a sedentary lifestyle

d.

A 65-year-old woman who walks 2 miles each day

ANS: C

Feedback

A

Hormone therapy may prevent bone loss.

B

Supplemental calcium will help prevent bone loss, especially when combined with vitamin D.

C

Risk factors for the development of osteoporosis include smoking, alcohol consumption, sedentary lifestyle, family history of the disease, and a high-fat diet.

D

Weight-bearing exercises have been shown to increase bone density.

PTS: 1 DIF: Cognitive Level: Comprehension REF: pp. 791-792

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

15. A woman with a history of a cystocele should contact the physician if she experiences

a.

Involuntary loss of urine when she coughs

b.

Constipation

c.

Backache

d.

Urinary frequency and burning

ANS: D

Feedback

A

Involuntary loss of urine during coughing is stress incontinence and is not an emergency.

B

Constipation may be a problem with rectoceles.

C

Back pain is a symptom of uterine prolapse.

D

Urinary frequency and burning are symptoms of cystitis, a common problem associated with cystocele.

PTS: 1 DIF: Cognitive Level: Application REF: p. 792

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

16. To assist the woman in regaining control of the urinary sphincter, the nurse should teach her to

a.

Practice Kegel exercises.

b.

Void every hour while awake.

c.

Allow the bladder to become distended before voiding.

d.

Drink 8 to 10 glasses of water each day.

ANS: A

Feedback

A

Kegel exercises, tightening and relaxing the pubococcygeal muscle, will improve control of the urinary sphincter.

B

A prescribed schedule may help, but every hour is too frequent.

C

Overdistention of the bladder will cause incontinence.

D

Restricting fluids will cause bladder irritation that increases the problem. Drinking adequate fluids will not help the problem.

PTS: 1 DIF: Cognitive Level: Application REF: p. 794

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

17. The physician diagnoses a 3 cm ovarian cyst in a 28-year-old woman. The nurse expects the initial treatment to include

a.

Beginning hormone therapy

b.

Examining the woman after her next menstrual period

c.

Scheduling a laparoscopy as soon as possible, to remove the cyst

d.

Aspirating the cyst as soon as possible and sending the fluid to pathology

ANS: B

Feedback

A

Cysts in women of childbearing age may decrease within one cycle, so treatment is not necessary at this point.

B

Most ovarian cysts regress spontaneously.

C

It is too early to anticipate removal of the cysts. Most ovarian cysts regress spontaneously within one cycle.

D

A transvaginal ultrasound examination will help determine if the cyst is fluid filled or solid. The cyst can then be removed if warranted.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 795

OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity

18. The drug of choice to treat gonorrhea is

a.

Penicillin G

b.

Tetracycline

c.

Ceftriaxone

d.

Acyclovir

ANS: C

Feedback

A

Penicillin is used to treat syphilis.

B

Tetracycline is used to treat chlamydial infections.

C

Ceftriaxone is effective for treatment of all gonococcal infections.

D

Acyclovir is used to treat herpes genitalis.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 798

OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity

19. When a nurse is counseling a woman for primary dysmenorrhea, which non-pharmacologic intervention might be recommended?

a.

Increasing the intake of red meat and simple carbohydrates

b.

Reducing the intake of diuretic foods, such as peaches and asparagus

c.

Temporarily substituting physical activity for a sedentary lifestyle

d.

Using a heating pad on the abdomen to relieve cramping

ANS: D

Feedback

A

Dietary changes such as eating less red meat may be recommended for women experiencing dysmenorrhea.

B

Increasing the intake of diuretics, including natural diuretics such as asparagus, cranberry juice, peaches, parsley, and watermelon may help ease the symptoms associated with dysmenorrhea.

C

Exercise has been found to help relieve menstrual discomfort through increased vasodilation and subsequent decreased ischemia.

D

Heat minimizes cramping by increasing vasodilation and muscle relaxation and minimizing uterine ischemia.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 785

OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity

20. Nafarelin (Synarel) is currently used as a treatment for mild to severe endometriosis. The nurse should tell the woman taking this medication that the drug

a.

Stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity

b.

Should be sprayed into one nostril every other day

c.

Should be injected into subcutaneous tissue BID

d.

Can cause her to experience some hot flashes and vaginal dryness

ANS: D

Feedback

A

Nafarelin is a GnRH agonist that suppresses the secretion of gonadotrophin-releasing hormone.

B

Nafarelin is administered twice daily by nasal spray.

C

Nafarelin is administered intranasally.

D

Nafarelin is a GnRH agonist, and its side effects are similar to those of menopause. The hypoestrogenism effect results in hot flashes and vaginal dryness.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 786

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

21. The nurse who is teaching a group of women about breast cancer should tell the women that

a.

Risk factors identify almost all women who will develop breast cancer.

b.

African-American women have a higher rate of breast cancer.

c.

One in 10 women in the United States will develop breast cancer in her lifetime.

d.

The exact cause of breast cancer is unknown.

ANS: D

Feedback

A

Risk factors help identify a small percentage of women in whom breast cancer eventually will develop.

B

Caucasian women have a higher incidence of breast cancer; however, African-American women have a higher rate of dying of breast cancer after they are diagnosed.

C

One in eight women in the United States will develop breast cancer in her lifetime.

D

The exact cause of breast cancer in unknown.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 778

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

22. The nurse providing education regarding breast care should explain to the woman that fibrocystic changes in breasts are

a.

A disease of the milk ducts and glands in the breasts

b.

A pre-malignant disorder characterized by lumps found in the breast tissue

c.

Lumpiness with pain and tenderness found in varying degrees in the breast tissue of healthy women during menstrual cycles

d.

Lumpiness accompanied by tenderness after menses

ANS: C

Feedback

A

Fibrocystic changes are palpable thickenings in the breast.

B

Fibrocystic changes are no pre-malignant changes. This information is inaccurate.

C

Fibrocystic changes are palpable thickenings in the breast usually associated with pain and tenderness. The pain and tenderness fluctuate with the menstrual cycle.

D

Fibrocystic changes are palpable thickenings in the breast usually associated with pain and tenderness. Most often tenderness occurs prior to menses.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 777

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

23. Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?

a.

Mammogram

b.

Ultrasound

c.

Core needle biopsy

d.

CA 15-3

ANS: C

Feedback

A

Mammography is a clinical screening tool that may aid early detection of breast cancers.

B

Transillumination, thermography, and ultrasound breast imaging are being explored as methods of detecting early breast carcinoma.

C

When a suspicious mammogram is noted or a lump is detected, diagnosis is confirmed by either a core needle biopsy or needle localization biopsy.

D

CA-15 is a serum tumor marker that is used to test for the presence of breast cancer.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 777

OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity

24. A 36-year-old woman has been diagnosed as having uterine fibroids. When planning care for this patient, the nurse should know that

a.

Fibroids are malignant tumors of the uterus that require radiation or chemotherapy.

b.

Fibroids will increase in size during the perimenopausal period.

c.

Abnormal uterine bleeding is a common finding.

d.

Hysterectomy should be performed.

ANS: C

Feedback

A

Fibroids are benign tumors of the smooth muscle of the uterus, and their etiology is unknown.

B

Fibroids are estrogen-sensitive and shrink as levels of estrogen decline.

C

The major symptoms associated with fibroids are menorrhagia and the physical effects produced by large leimyomas.

D

A hysterectomy may be performed if the woman does not want more children and other therapies are not successful.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 795

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

25. When assessing a woman for menopausal discomforts, the nurse expects the woman to describe the most frequently reported discomfort, which is

a.

Headaches

b.

Hot flashes

c.

Mood swings

d.

Vaginal dryness with dyspareunia

ANS: B

Feedback

A

Headaches may be associated with a decline in hormone levels; however, it is not the most frequently reported discomfort for menopausal women.

B

Vasomotor instability, in the form of hat flashes or flushing, is a result of fluctuating estrogen levels and is the most common disturbance of the perimenopausal woman.

C

Mood swings may be associated with a decline in hormone levels; however, it is not the most frequently reported discomfort for menopausal women.

D

Vaginal dryness and dyspareunia may be associated with a decline in hormone levels; however, it is not the most frequently reported discomfort for menopausal women.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 790

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

26. While evaluating a patient for osteoporosis, the nurse should be aware of what risk factor?

a.

African-American race

b.

Low protein intake

c.

Obesity

d.

Cigarette smoking

ANS: D

Feedback

A

Women at risk for osteoporosis are likely to be Caucasian or Asian.

B

Inadequate calcium intake is a risk factor for osteoporosis.

C

Women at risk for osteoporosis are likely to be small boned and thin. Obese women have higher estrogen levels as a result of the conversion of androgens in the adipose tissue. Mechanical stress from extra weight also helps preserve bone mass.

D

Smoking is associated with earlier and greater bone loss and decreased estrogen production.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 791

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

27. When discussing estrogen replacement therapy (ERT) with a perimenopausal woman, the nurse should include the risks of

a.

Breast cancer

b.

Vaginal and urinary tract atrophy

c.

Osteoporosis

d.

Arteriosclerosis

ANS: A

Feedback

A

Women with a high risk of breast cancer should be counseled against using ERT.

B

Estrogen prevents atrophy of vaginal and urinary tract tissue.

C

Estrogen protects against the development of osteoporosis.

D

Estrogen has a favorable effect on circulating lipids, reducing low density lipoprotein (LDL) and total cholesterol and increasing high density lipoprotein (HDL). It also has a direct antiatherosclerotic effect on the arteries.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 790

OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity

28. During her annual gynecologic checkup, a 17-year-old woman states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse should document this complaint as

a.

Amenorrhea

b.

Dysmenorrhea

c.

Dyspareunia

d.

PMS

ANS: B

Feedback

A

Amenorrhea is the absence of menstrual flow.

B

Dysmenorrhea is pain during or shortly before menstruation. Pain is described as sharp and cramping or sometimes as a dull ache. It may radiate to the lower back or upper thighs.

C

Dyspareunia is pain during intercourse.

D

PMS is a cluster of physical, psychologic, and behavioral symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses.

PTS: 1 DIF: Cognitive Level: Application REF: p. 785

OBJ: Nursing Process: Diagnosis MSC: Client Needs: Health Promotion and Maintenance

29. Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a patient with this condition should be aware that the optimal pharmacologic therapy for pain relief is

a.

Acetaminophen

b.

Oral contraceptives (OCPs)

c.

Nonsteroidal antiinflammatory drugs (NSAIDs)

d.

Aspirin

ANS: C

Feedback

A

Preparations containing acetaminophen are less effective for dysmenorrhea because they lack the antiprostaglandin properties of NSAIDs.

B

OCPs are a reasonable choice for women who also want birth control. The benefit of OCPs is the reduction of menstrual flow and irregularities. OCPs may be contradicted for some women and have a number of potential side effects.

C

This pharmacologic agent has the strongest research results for pain relief. Often, if one NSAID is not effective, another one will provide relief.

D

NSAIDs are the drug of choice. However, if a woman is taking an NSAID, she should avoid taking aspirin as well.

PTS: 1 DIF: Cognitive Level: Application REF: p. 785

OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity

30. A woman is 6 weeks pregnant and has elected to terminate her pregnancy. The nurse knows that the most common technique used for medical termination of a pregnancy in the first trimester is

a.

Administration of prostaglandins

b.

Dilation and evacuation

c.

Intravenous administration of Pitocin

d.

Vacuum aspiration

ANS: A

Feedback

A

The most common technique for medical termination of a pregnancy within the first 7 weeks of pregnancy is administration of prostaglandins.

B

This is the most common method of surgical abortion used if medical abortion fails.

C

Intravenous administration of Pitocin is used to induce labor in a woman with a third trimester fetal demise.

D

Vacuum aspiration is used for abortions in the first trimester.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 788

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

31. The nurse should be aware that a pessary is most effective in the treatment of what disorder?

a.

Cystocele

b.

Uterine prolapse

c.

Rectocele

d.

Stress urinary incontinence

ANS: B

Feedback

A

A pessary is not used for the patient with a cystocele.

B

A fitted pessary may be inserted into the vagina to support the uterus and hold it in the correct position.

C

A rectocele cannot be corrected by the use of a pessary.

D

It is unlikely that a pessary be the most effective treatment for stress incontinence.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 794

OBJ: Nursing Process: Diagnosis MSC: Client Needs: Health Promotion and Maintenance

32. A postmenopausal woman who is 54 years old has been diagnosed with two leiomyomas. What assessment finding is most commonly associated with the presence of leiomyomas?

a.

Abnormal uterine bleeding

b.

Diarrhea

c.

Weight loss

d.

Acute abdominal pain

ANS: A

Feedback

A

Most women are asymptomatic. Abnormal uterine bleeding is the most common symptom of leiomyomas, or fibroids.

B

Diarrhea is not commonly associated with leiomyomas (fibroids).

C

Weight loss does not usually occur in the woman with leiomyomas (fibroids).

D

The patient with leiomyomas (fibroids) is unlikely to experience abdominal pain.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 795

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

MULTIPLE RESPONSE

1. While interviewing a 48-year-old patient during her annual physical examination, the nurse learns that she has never had a mammogram. The American Cancer Society recommends annual mammography screening starting at age 40. Before the nurse encourages this patient to begin annual screening, it is important for her to understand the reasons why women avoid testing. These reasons include (select all that apply)

a.

Reluctance to hear bad news

b.

Fear of x-ray exposure

c.

Belief that lack of family history makes this test unnecessary

d.

Expense of the procedure

e.

Having heard that the test is painful

ANS: A, B, D, E

Feedback

Correct

All of these are reasons for women to avoid having a mammogram done. Although the test is expensive, it is usually covered by health insurance, and many communities offer low-cost or free screening to women without insurance. It is important to acknowledge that some discomfort occurs with screening. Scheduling the test immediately at the end of a period makes it less painful. The risk of radiation exposure is minimal to none. Nurses play a vital role in providing information and reassurance to help women overcome these fears.

Incorrect

Even patients with no family history should have regular screening done. The nurse should emphasize that a combination of breast self-examination and mammography needs to be performed at regular intervals. Women with a family history may need to begin screening at a younger age and have additional testing such as ultrasound performed.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 775

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

2. Which medications can be taken by postmenopausal women to treat and/or prevent osteoporosis? Select all that apply.

a.

Calcium

b.

Evista

c.

Fosamax

d.

Actonel

e.

Vitamin C

ANS: A, B, C, D

Feedback

Correct

All of these medications can be used by postmenopausal women to treat or prevent osteoporosis. Calcitonin is another medication available for treatment of osteoporosis.

Incorrect

Vitamin D is essential for calcium to be absorbed from the intestine. Recommended supplemental vitamin D Intake is 600 international units per day.

PTS: 1 DIF: Cognitive Level: Comprehension REF: pp. 791-792

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

3. The exact cause of breast cancer remains undetermined. Researchers have found that there are a number of common risk factors that increase a womans chance of developing a malignancy. It is essential for the nurse who provides care to women of any age to be aware of which risk factors? Select all that apply.

a.

Family history

b.

Late menarche

c.

Early menopause

d.

Race

e.

Nulliparity or first pregnancy after age 30

ANS: A, D, E

Feedback

Correct

Family history, race, and nulliparity are known risk factors for the development of breast cancer. Others include age, personal history of cancer, high socioeconomic status, sedentary lifestyle, hormone replacement therapy, recent use of oral contraceptives, never having breastfed a child, and drinking more than one alcoholic beverage per day.

Incorrect

Early menarche and late menopause are risk factors for breast malignancy, not late menarche and early menopause.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 774 | Box 32-2

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

TRUE/FALSE

1. The nurse understands that further health teaching is necessary when her young patient who has just had an abortion states, I guess Ill have to wear a tampon for the next week. Is this statement true or false?

ANS: T

Bleeding and cramping are normal after the procedure and will last for 1 to 2 weeks. Sanitary pads should be used rather than a tampon for the first week after an abortion to prevent infection. Other necessary health teaching that should be done includes the following: no intercourse for the first week; no douching for the first week, or perhaps not at all; temperature evaluation twice per day to identify infection; follow-up appointment in 2 weeks; and no strenuous work for a few days.

PTS: 1 DIF: Cognitive Level: Application REF: p. 788

OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity

2. Women in the U.S. are now more likely to die of cardiac disease than all cancers combined. Is this statement true or false?

ANS: T

Heart disease is now the leading cause of death for women in the United States, killing 26% of women who died in 2006. Almost twice as many American women die of heart disease or stroke than any form of cancer including breast cancer.

PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 781

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

Leave a Reply