Chapter 51: Nursing Assessment: Reproductive System My Nursing Test Banks

Lewis: Medical-Surgical Nursing, 8th Edition

Chapter 51: Nursing Assessment: Reproductive System

Test Bank

MULTIPLE CHOICE

1. Which question should the nurse ask when assessing a patient who has a history of benign prostatic hyperplasia (BPH)?

a.

Have you noticed any unusual discharge from your penis?

b.

Has there been any change in your sex life in the last year?

c.

Has there been a decrease in the force of your urinary stream?

d.

Have you been experiencing any difficulty in achieving an erection?

ANS: C

Enlargement of the prostate blocks the urethra, leading to urinary changes such as a decrease in the force of the urinary stream. The other questions address possible problems with infection or sexual difficulties, but would not be helpful in determining whether there were functional changes caused by BPH.

DIF: Cognitive Level: Application REF: 1296

TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

2. After a patient has been treated for pelvic inflammatory disease, the nurse will plan to implement teaching about

a.

irregularities in the menstrual cycle.

b.

changes in secondary sex characteristics.

c.

possible difficulty with becoming pregnant.

d.

use of hormone replacement therapy (HRT).

ANS: C

Pelvic inflammatory disease may cause scarring of the fallopian tubes and result in difficulty in fertilization or implantation of the fertilized egg. Because ovarian function is not affected, the patient will not require HRT, have irregular menstrual cycles, or experience changes in secondary sex characteristics.

DIF: Cognitive Level: Application REF: 1297-1298 TOP: Nursing Process: Planning

MSC: NCLEX: Physiological Integrity

3. While the nurse is assessing a 62-year-old man, the patient says that he does not respond to sexual stimulation the way he did when he was younger. The nurses best response to the patients comment is,

a.

Many men need more sexual stimulation with aging.

b.

Interest in sex frequently decreases as men get older.

c.

Erectile dysfunction is a common problem with older men.

d.

Tell me more about how your sexual response has changed.

ANS: D

The initial response by the nurse should be further assessment of the problem. The other statements by the nurse are accurate but might not respond to the patients concerns.

DIF: Cognitive Level: Application REF: 1294-1295 | 1298

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

4. When scheduling a pelvic examination and Pap test for a patient, the nurse instructs the patient that she should

a.

shower, but not take a tub bath, before the examination.

b.

not have sexual intercourse the day before the Pap test.

c.

plan to have the Pap test just after her menstrual period.

d.

avoid douching for at least 24 hours before the examination.

ANS: D

The results of a Pap test may be affected by douching, and so the patient should not douche before the examination. The exam may be scheduled without regard to the menstrual period. The patient may shower or bathe before the examination. Sexual intercourse does not affect the results of the examination or Pap test.

DIF: Cognitive Level: Application REF: 1301-1304

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

5. A 19-year-old patient who is being assessed for amenorrhea at the clinic makes all of the following statements to the nurse. Which one indicates a need for patient teaching?

a.

I run at least 8 miles every day to keep in shape.

b.

I drink at least 3 glasses of non-fat milk every day.

c.

I am not sexually active but currently I have an IUD [intrauterine device].

d.

I was recently treated for a sexually transmitted disease.

ANS: A

Excessive exercise can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs.

DIF: Cognitive Level: Application REF: 1296

TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance

6. When the nurse is assessing the sexual-reproductive functional health pattern for a 34-year-old man, which question is most useful in determining the patients sexual orientation and risk factors?

a.

Do you have sex with men, women, or both?

b.

Which gender do you prefer to have sex with?

c.

What types of sexual activities do you prefer?

d.

Are you heterosexual, homosexual, or bisexual?

ANS: A

This question is the most simply stated and will increase the likelihood of obtaining the relevant information about sexual orientation and possible risk factors associated with sexual activity. A patient who prefers intercourse with women also may have intercourse at times with men. The types of sexual activities engaged in may not indicate sexual orientation. Many patients who have intercourse with both men and women do not identify themselves as homosexual or bisexual.

DIF: Cognitive Level: Application REF: 1296-1298 | 1301-1304

TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance

7. When preparing a patient for colposcopy with a cervical biopsy, the nurse explains to the patient that the procedure

a.

involves dilation of the cervix and biopsy of the tissue lining the uterus.

b.

will take place in a same-day surgery center so that local anesthesia can be used.

c.

requires that the patient have nothing to eat or drink for 6 hours before the procedure.

d.

is similar to a speculum examination of the cervix and should result in little or no pain.

ANS: D

Colposcopy involves visualization of the cervix with a binocular microscope and is similar to a speculum examination. A cervical biopsy may cause a minimal amount of pain.

DIF: Cognitive Level: Application REF: 1301-1304

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

8. A couple who has not been able to conceive is scheduled for a Huhner test for infertility. In preparation for the test, the nurse will instruct the couple about

a.

possible shoulder pain after the procedure.

b.

sedative medications used during the procedure.

c.

ways to determine the estimated time of ovulation.

d.

how long to refrain from intercourse before the test.

ANS: C

For the Huhner test, the couple should have intercourse at the estimated time of conception and then arrive for the test 2 to 8 hours after intercourse. The other instructions would be used for other types of fertility testing.

DIF: Cognitive Level: Application REF: 1301-1304

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

9. A patient in the sexually transmitted disease clinic has a positive Venereal Disease Research Laboratory (VDRL) test, but no chancre is noted. The nurse will plan to send specimens for

a.

gram stain.

b.

cytologic studies.

c.

rapid plasma reagin (RPR) agglutination.

d.

fluorescent treponemal antibody absorption (FTA-ABS).

ANS: D

Since false positives are common with VDRL and RPR testing, FTA-ABS testing is recommended to confirm a diagnosis of syphilis. Gram staining is used for other sexually transmitted diseases (STDs) such as gonorrhea and chlamydia and cytologic studies are used to detect abnormal cells (such as neoplastic cells).

DIF: Cognitive Level: Application REF: 1300-1301 TOP: Nursing Process: Planning

MSC: NCLEX: Physiological Integrity

10. Which information about a 22-year-old who wants to start using oral contraceptives is most important to report to the health care provider?

a.

The patient quit smoking 6 months previously.

b.

The patients blood pressure is 164/90 mm Hg.

c.

The patient has not been vaccinated for rubella.

d.

The patient has chronic iron-deficiency anemia.

ANS: B

Since hypertension increases the risk for morbidity and mortality in women taking oral contraceptives, the patients blood pressure should be controlled before oral contraceptives are prescribed. The other information also will be reported but will not affect the choice of contraceptive.

DIF: Cognitive Level: Application REF: 1295

TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance

11. A 42-year-old man who is taking the following medications tells the nurse that he has had difficulty in achieving an erection. Which of the following medications may cause erectile dysfunction (ED)?

a.

atorvastatin (Lipitor) for hyperlipidemia

b.

metformin (Glucophage) for type 2 diabetes

c.

propranolol (Inderal) for high blood pressure

d.

ranitidine (Zantac) for gastroesophageal reflux

ANS: C

Some antihypertensives may cause erectile dysfunction, and the nurse should anticipate a change in antihypertensive therapy. The other medications will not affect erectile function.

DIF: Cognitive Level: Application REF: 1295 TOP: Nursing Process: Planning

MSC: NCLEX: Physiological Integrity

12. A patient calls the clinic and tells the nurse, My menstrual period is very heavy. I have to change my tampon every 4 hours. Which action should the nurse take next?

a.

Tell the patient that her flow is not unusually heavy.

b.

Schedule the patient for an appointment later that day.

c.

Ask the patient how heavy her usual menstrual flow is.

d.

Have the patient call again if the heavy flow continues.

ANS: C

Because a heavy menstrual flow is usually indicated by saturating a pad or tampon in 1 to 2 hours, the nurse should first assess how heavy the patients usual flow is. There is no need to schedule the patient for an appointment that day. The patient may need to call again, but this is not the first action that the nurse should take. Telling the patient that she does not have a heavy flow implies that the patients concern is not important.

DIF: Cognitive Level: Application REF: 1293

TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance

13. A patient with a possible ovarian cyst is scheduled for ultrasound. The nurse will teach the patient that she should

a.

discontinue taking aspirin before the procedure.

b.

receive IV contrast solution during the procedure.

c.

expect mild abdominal cramps after the procedure.

d.

drink several glasses of fluids before the procedure.

ANS: D

A full bladder is needed for many ultrasound procedures, so the nurse will have the patient drink fluids before arriving for the ultrasound. The other instructions are not accurate for this procedure.

DIF: Cognitive Level: Application REF: 1301-1304

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity

14. A 52-year-old man is scheduled for an annual physical exam. The nurse will plan to teach the patient about

a.

increased risk for testicular cancer.

b.

possible changes in erectile function.

c.

normal decreases in testosterone level.

d.

annual prostate specific antigen (PSA) testing.

ANS: D

PSA testing should be done annually for all men, starting at age 50. There is no indication that the other patient teaching topics are appropriate for this patient.

DIF: Cognitive Level: Application REF: 1295-1296 TOP: Nursing Process: Planning

MSC: NCLEX: Health Promotion and Maintenance

15. A 22-year-old female patient who has been admitted to the emergency department after an automobile accident is scheduled for abdominal x-rays. Which information is most important to report to the health care provider before the x-rays are obtained?

a.

Abdominal pain

b.

Positive hCG testing

c.

Temperature 102.1 F (38.9 C)

d.

Blood pressure 172/88 mm Hg

ANS: B

Positive hCG testing indicates that the patient is pregnant and that unnecessary abdominal x-rays should be avoided. The other information also is important to report, but it will not affect whether the x-rays should be done.

DIF: Cognitive Level: Application REF: 1299-1300

TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

16. The following patients call the outpatient clinic. Which phone call should the nurse return first?

a.

A patient who has severe breast tenderness following a breast biopsy

b.

A patient who has bloody discharge after a hysteroscopy earlier today

c.

A patient who is complaining of dyspnea after a pelvic computed tomography (CT) with contrast

d.

A patient who is experiencing shoulder pain after a laparoscopy yesterday

ANS: C

The patients dyspnea suggests a delayed reaction to the iodine dye used for the CT scan. The other patients symptoms are not unusual after the procedures they had done.

DIF: Cognitive Level: Analysis REF: 1301-1304

OBJ: Special Questions: Multiple Patients

TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment

17. A woman calls the clinic because she is having an unusually heavy menstrual flow. She tells the nurse that she has saturated two tampons in the past 2 hours. The nurse estimates that the amount of blood loss is

a.

10 to 20 mL.

b.

20 to 30 mL.

c.

30 to 40 mL.

d.

40 to 60 mL.

ANS: D

The average tampon absorbs 20 to 30 mL.

DIF: Cognitive Level: Comprehension REF: 1293

TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity

18. When performing a physical assessment on a male patient, the nurse obtains this information. Which finding is most important to report to the health care provider?

a.

One testis hangs lower than the other.

b.

Inguinal lymph nodes are nonpalpable.

c.

Genital hair distribution is diamond shaped.

d.

Clear penile discharge is present at the meatus.

ANS: D

Clear penile discharge may be indicative of a sexually transmitted disease (STD). The other findings are normal and do not need to be reported.

DIF: Cognitive Level: Application REF: 1301-1304

OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

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