Chapter 62Female Reproductive Dysfunction: Nursing Management My Nursing Test Banks

Chapter 62Female Reproductive Dysfunction: Nursing Management

MULTIPLE CHOICE

1.A client tells the nurse that she experiences heavy menstrual bleeding. The nurse would document this condition as being:

1.

dysmenorrhea.

2.

menorrhagia.

3.

metrorrhagia.

4.

polymenorrhea.

ANS: 2

Menorrhagia is heavy menstrual bleeding. Metrorrhagia is bleeding between menses. Dysmenorrhea is pain during the menstrual cycle, and polymenorrhea is having menstrual cycles at 2- to 3-week intervals.

PTS: 1 DIF: Apply REF: Dysmenorrhea; Dysfunctional Uterine Bleeding

2.A client tells the nurse that she has not had menstrual cycles for 2 months since she has been training for a marathon. The nurse would document this clients lack of regular menstrual cycles as being:

1.

dysmenorrhea.

2.

primary amenorrhea.

3.

oligomenorrhea.

4.

secondary amenorrhea.

ANS: 4

Secondary amenorrhea is when a woman has normal menstrual cycles but then stops. Dysmenorrhea is pain during the menstrual cycle, and oligomenorrhea is the absence of menstrual cycles for 3 months or longer. Primary amenorrhea is the lack of a menstrual cycle by age 16.

PTS: 1 DIF: Apply REF: Amenorrhea

3.The nurse is documenting that a female client is menopausal because the client has not had a menstrual cycle in:

1.

6 months.

2.

9 months.

3.

12 months.

4.

15 months.

ANS: 3

Women are considered menopausal if they have not had a menstrual cycle for 12 months. A perimenopausal state may exist prior to actual menopause.

PTS: 1 DIF: Apply REF: Menopause

4.A female client is prescribed estrogen (Alora) for hot flashes associated with menopause. Which of the following should the nurse instruct this client regarding this medication?

1.

Hot flashes can increase.

2.

Weight gain can occur.

3.

Breast tenderness and spotting are side effects.

4.

Abdominal pain is to be expected.

ANS: 3

The nurse should instruct the client prescribed estrogen (Alora) that side effects include breast tenderness, nausea, depression, headache, and spotting (bleeding). Hot flashes do not increase with this medication. Weight gain is not a documented side effect of this medication. Abdominal pain is not an expected side effect of this medication.

PTS:1DIF:Apply

REF:Table 62-1 Medications Used to Treat Menstrual Disorders

5.The nurse is caring for a female client recovering from surgery to remove the uterus, cervix, ovaries, and fallopian tubes using a traditional approach. The nurse realizes this client has had a:

1.

complete hysterectomy.

2.

laparoscopically assisted vaginal hysterectomy.

3.

partial hysterectomy.

4.

total abdominal hysterectomy and bilateral salpingo-oophorectomy.

ANS: 4

Removal of the uterus, ovaries, and fallopian tubes through an abdominal incision is called a total abdominal hysterectomy and bilateral salpingo-oophorectomy. A hysterectomy performed vaginally via laparoscope is a laparoscopically assisted vaginal hysterectomy. A partial hysterectomy removes the body of the uterus without the cervix, and a complete hysterectomy is the removal of the entire uterus.

PTS:1DIF:Analyze

REF: Dysfunctional Uterine Bleeding: Planning and Implementation: Surgery

6.A female client, experiencing vulvar itching and discomfort, is diagnosed with Candida. What would the nurse expect to find when assessing this client?

1.

Foul, fishy odor

2.

Gray, thin, watery discharge

3.

Thick, white discharge

4.

Yellow, green discharge

ANS: 3

Candida typically produces a thick, white discharge. Bacterial vaginosis causes a white or gray, thin, watery discharge and an odor. Trichomoniasis has a frothy, green/yellow/white discharge.

PTS:1DIF:ApplyREF:Infections: Vaginitis

7.A female client who has been menstruating has a temperature of 103.5F, blood pressure 88/56 mmHg, and a diffuse rash. The nurse realizes that this client is most likely experiencing:

1.

pelvic inflammatory disease.

2.

herpes simplex virus.

3.

human papillomavirus.

4.

toxic shock syndrome.

ANS: 4

Toxic shock syndrome is an acute illness associated with menstruation and tampon use. Symptoms include a high fever, a diffuse rash, falling blood pressure, nausea, vomiting, diarrhea, myalgia, disorientation, and coma. Herpes simplex virus usually results in a genital sore or ulcer. The human papillomavirus is associated with genital warts. Pelvic inflammatory disease is an inflammatory condition of the female pelvic organs.

PTS: 1 DIF: Analyze REF: Toxic Shock Syndrome

8.The nurse is teaching a group of young adults about prevention of sexually transmitted infections (STIs). Which of the following instructions would not be included during teaching?

1.

Abstinence is the only way to completely prevent STIs.

2.

Condoms provide some protection against STIs.

3.

Make sure you and your partner finish the entire treatment regimen.

4.

Once one STI is diagnosed, you are less likely to have an infection with another STI.

ANS: 4

Once one STI is diagnosed, an individual is more likely to have an infection with another STI. The person should be tested for all STIs. The other choices would be appropriate for the nurse to instruct regarding STIs.

PTS:1DIF:Apply

REF: Sexually Transmitted Infection: Planning and Implementation: Population-Based Care

9.A 52-year-old female client had been treated for human papillomavirus. After 3 years of testing, the clients Pap smears are normal. The nurse realizes that the clients next Pap smear should be in:

1.

2 years

2.

3 years

3.

5 years

4.

10 years

ANS: 2

If the client is between the ages of 30 to 70 and has three normal Pap smear results, the client does not need to have another Pap smear for 3 years. If the client is between the ages of 21 to 30 and has normal Pap smear results, the client needs another Pap smear in 2 years. If the client is over the age of 70 and the last three Pap smear results were normal, within 10 years, the Pap smears can be discontinued.

PTS: 1 DIF: Analyze REF: Table 62-3 Changes in Pap Smear Guidelines

10.A female client has had a type 1 female circumcision. The nurse realizes that which of the following has been surgically removed on the client?

1.

Clitoris

2.

Clitoris and labia minora

3.

Clitoris, labia minora, inner surface of labia majora, and suturing of the vagina

4.

Clitoris and uterus

ANS: 1

Type 1 female circumcision is the removal of the clitoris. Type II includes the removal of the clitoris and labia minora. Type III is the removal of the clitoris, labia minora, inner surface of the labia majora, and suturing of the labia majora together to cover the urethra and vagina. There is not a type that is the removal of the clitoris and uterus.

PTS:1DIF:AnalyzeREF:Female Circumcision

11.The nurse determines that a female client is at risk for developing a gynecological malignancy because which of the following is assessed?

1.

Alcohol intake of one drink every week

2.

Currently overweight

3.

Smoking history

4.

History of constipation

ANS: 3

Smoking increases the female clients risk of developing gynecological malignancies. Alcohol intake, being overweight, and having a history of constipation do not increase a clients risk of developing the disorder.

PTS:1DIF:AnalyzeREF:Malignancies

12.A female client diagnosed with infertility is prescribed medication. The nurse would provide instruction regarding which of the following medications?

1.

Viagra

2.

Delatestryl

3.

Testim

4.

Clomiphene citrate

ANS: 4

Clomiphene citrate is used to induce ovulation. When used, most pregnancies occur within the first 3 cycles of use and almost all pregnancies occur within 6 months of use. The other medications are used to treat sexual dysfunction and not infertility.

PTS: 1 DIF: Apply REF: Infertility: Pharmacology

MULTIPLE RESPONSE

1.A female client is diagnosed with premenstrual dysphoric disorder. Which of the following will the nurse most likely assess in this client? (Select all that apply.)

1.

Feeling sad or hopeless

2.

Feeling anxious

3.

Mood swings

4.

Increased sleep

5.

Anger

6.

Thirst

ANS: 1, 2, 3, 4, 5

To diagnose premenstrual dysphoric disorder, five or more symptoms must be present most of the time during the last week of the menstrual luteal phase: feeling sad or hopeless; feeling anxious; mood swings; increased sleep; and anger. Thirst is not a symptom of this disorder.

PTS:1DIF:Apply

REFremenstrual Syndrome and Premenstrual Dysphoric Disorder

2.A female client, diagnosed with pelvic inflammatory disease, is being considered for inpatient treatment. Which of the following would indicate that the client should be admitted to the hospital for care of this disorder? (Select all that apply.)

1.

The client is pregnant.

2.

The client will not adhere to the prescribed antibiotic therapy.

3.

The clients temperature is 103 degreesF.

4.

The client is experiencing symptoms of a tubo-ovarian abscess.

5.

The clients blood pressure is 120/80 mmHg.

6.

The client has purulent cervical discharge.

ANS: 1, 2, 3, 4

Criteria for admission to treat pelvic inflammatory disease includes pregnancy, inability to comply with outpatient therapy, failure of outpatient therapy, temperature greater than 102.2F, and suspected tubo-ovarian abscess. Blood pressure and purulent cervical discharge are not criteria for admission to treat pelvic inflammatory disease.

PTS: 1 DIF: Analyze REF: Box 62-1 Criteria for Inpatient Treatment of PID

3.A client is diagnosed with a sexually transmitted infection that the nurse needs to report to the local health department. Which of the following sexually transmitted infections need to be reported by the nurse? (Select all that apply.)

1.

Bacteria vaginitis

2.

HPV

3.

HIV

4.

Chlamydia

5.

Gonorrhea

6.

Syphilis

ANS: 3, 4, 5, 6

Syphilis, gonorrhea, chlamydia, and HIV are infections that need to be reported to the local health department in every state. Bacteria vaginitis and HPV do not need to be reported to the local health department.

PTS: 1 DIF: Apply REF: Health Care Resources

4.A female client is diagnosed with a cystocele. The nurse should prepare to instruct the client on which of the following? (Select all that apply.)

1.

Kegel exercises

2.

Pessary insertion

3.

Use of estrogen cream

4.

Operative repair

5.

Hysterectomy

6.

Antibiotics

ANS: 1, 2, 3

Treatment of a cystocele includes Kegels exercises, insertion of a pessary, and use of estrogen cream. Operative repair, hysterectomy, and antibiotics are not treatments associated with this disorder.

PTS:1DIF:ApplyREFelvic Relaxation

5.A client is diagnosed with uterine fibroids. Which of the following would indicate that surgery is needed for this client? (Select all that apply.)

1.

Abnormal bleeding not responsive to other therapy

2.

Weight gain of 10 lbs over the last 3 months

3.

Growth of fibroids after menopause

4.

Chronic constipation

5.

Client unable to conceive

6.

Diagnosed with iron deficiency anemia

ANS: 1, 3, 5, 6

Indications for surgical management of fibroids include abnormal bleeding that is not responding to medical therapy, growth of fibroids after menopause, infertility, and iron deficiency anemia. Weight gain and chronic constipation are not indications for surgery to remove uterine fibroids.

PTS:1DIF:Analyze

REF:Box 62-2 Indications for Surgical Management of Fibroids

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