Assessment of Reproductive System Questions

Question 1

A patient has been informed that she has a specific BRCA 1 and BRCA 2 gene mutations. Which brochure would the nurse prepare for the patient?
A. “Role of nutrition therapy in reproductive health”
B. “Risk factors and treatments for infertility”
C. “Risk factors and treatments for breast cancer”
D. “ Colposcopy and other tests for cervical cancer”

Answer 1

Answer: C
Having gene mutation/strong fam history get tested for gene mutation; gene increases risk for breast cancer and ovarian cancer

Question 2

A 79 year old man is being seen for difficulty voiding and blood in urine. Which is the first screening test likely to be done?
A. Cytology culture
B. Prostate specific antigen
C. Serum testosterone level
D. Serological studies

Answer 2

Answer: B (PSA)

Question 3

PSA–Prostate-specific antigen (PSA) test
Definitive tool to diagnose prostate cancer - biopsy
Early prostate cancer antigen (EPCA-2) and Serum acid phosphatase
Alpha-fetoprotein (AFP), Beta human chorionic gonadotropin (hCG), and Lactate dehydrogenase (LDH)

Answer 3

Assessment-lab (Male)

Question 4

Normal < 2.5 ng/mL for age <50 and increases with age (possibly up to 6.5 ng/mL)
Used as a screening lab for prostate cancer because other prostate problems can increase the level
Some variance on the PSA value and how it is affected by age
As men age normal to be little higher than 2.5 - typ around 4
Just because have elevated PSA not automatically mean have prostate cancer
Elevated move onto other tests

Answer 4

PSA–Prostate-specific antigen (PSA) test

Question 5

Elevations indicative of prostate cancer
EPCA-2 is very sensitive and can detect early; typ after PSA

Answer 5

Early prostate cancer antigen (EPCA-2) and Serum acid phosphatase

Question 6

Elevations indicative of testicular cancer
Indicative of testicular cancer

Answer 6

Alpha-fetoprotein (AFP), Beta human chorionic gonadotropin (hCG), and Lactate dehydrogenase (LDH)

Question 7

Which test detects cancerous and precancerous cells of the cervix?
A. Serologic studies
B. Vaginal cultures
C. Pap smear
D. Human papilloma virus (HPV) test

Answer 7

Answer: C

Question 8

Pap smear
Human papilloma virus (HPV)
Vaginal cultures
Alpha fetoprotein (AFP)
Cancer antigen 125 (CA 125)
Ovarian cancer - not always caught early; symp very vague; not caught until later stages because symptoms vague

Answer 8

Assessment - Female labs

Question 9

Cytologic study effective in detecting precancerous and cancerous cells from the cervix
Annual Pap test starting at age 21
Checking for cervical cancer

Answer 9

Pap smear

Question 10

Used to identify many high-risk types of HPV associated with the risk of development of cervical cancer
HPV - cells collected same time of pap test
Cells are collected from the cervix at the same time a Pap test is completed

Answer 10

Human papilloma virus (HPV)

Question 11

Used to detect bacterial, viral, fungal, and parasitic disorders

Answer 11

Vaginal cultures

Question 12

Elevated with ovarian cancer

Answer 12

Alpha fetoprotein (AFP)

Question 13

Elevated with ovarian cancer

Answer 13

Cancer antigen 125 (CA 125)

Question 14

Which test is used to assess tubal anatomy and patency, and uterine problems?
A. CT scan
B. Laparoscopy
C. Colposcopy
D. Hysterosalpingography

Answer 14

Answer: D
HSG
What screening needs to be done prior to this test?
use contrast dye to look at tubal anatomy and patency, and uterine problems and fallopian tubes
Contrast dye allergy - big safety thing

Question 15

Metastasized to other areas
Evaluate for metastasis with different reproductive cancers to see if metastasized to other areas
Evaluate for ovarian cancer

Answer 15

CT

Question 16

Breast - people with high risk factors
Evaluation for breast cancer for women with high risk factors

Answer 16

MRI

Question 17

Transvaginal ultrasound-ovarian and endometrial cancer
Transrectal ultrasound-prostate cancer
Ultrasound-evaluate for testicular masses versus fluid; See if mass vs fluid
Also used for breast cancer evaluation

Answer 17

US

Question 18

X-ray that uses an injection of a contrast dye/medium to visualize the cervix, uterus, and fallopian tubes
Used to evaluate tubal anatomy and patency and uterine problems such as fibroids, tumors, and fistulas
Pre: Assess for allergies to contrast dye
Post: mighthave Some pelvic and referred shoulder pain - could be possibility to have that and let them know that

Answer 18

HSG–Hysterosalpingography

Question 19

The nurse is caring for a patient who had a laparoscopy. What is included in the postoperative care for this patient?
A. Notify the HCP of postoperative shoulder pain
B. Reassure the patient that most painful sensations disappear within 4-6 weeks
C. Teach the patient to observe the incision for signs of infection or hematoma
D. Remind the patient to avoid strenuous activity for 4-6 weeks after procedure

Answer 19

Answer: C
Anytime have any incision want them: look at area, see signs of infection (warmth redness), bleeding, abnormal discharge, hematoma - beeling underneath skin

Question 20

What post procedure instructions would the nurse give to a patient who just had a colposcopy?
A. Do not drive or operate heavy machinery while taking prescribed pain medication
B. Do not use tampons and abstain from sexual intercourse for at least a week
C. Wear a perineal pad and expect bleeding with small clots for the first 24 hours
D. Perform breast self examinations every month and report changes to provider

Answer 20

Answer: B

Question 21

Colposcopy
Laparoscopy
Hysteroscopy

Answer 21

Endoscopic studies

Question 22

Examination of the cervix and vagina using a colposcope
Allows three-dimensional magnification and intense illumination of epithelium with suspected disease
Locate exact site of precancerous and malignant lesions for biopsy
Look if suspected disease

Answer 22

Colposcopy

Question 23

Direct examination of the pelvic cavity through a endoscope
Performed under anesthesia
Pre: NPO - Under gen anesthesia
Post:
Some pelvic and referred shoulder pain
Observe incision sites for infection
Post-surgically look for signs bleeding, infection; make sure waking up from anesthesia appropriately

Answer 23

Laparoscopy

Question 24

Block off area where cannot feel it - diff when wake up
Use of Fibroptic camera that is inserted into the vagina to look at cervix and uterus
Examines the cervix and uterus
Performed with regional nerve block - block off area where cannot feel it; diff when wake up
Post: Some pelvic and referred shoulder pain

Answer 24

Hysteroscopy

Question 25

What pre-procedural instructions would the nurse give the patient about a mammogram?
A. Do not eat or drink anything 6 to 7 hours prior
B. Abstain from sex prior to test
C. Do not use lotions, creams or powders on breasts
D. Wear a supportive bra and bring a breast pad for after testing

Answer 25

Answer: C
Messes with imaging and cause them to see something that not actually there and may have come back if see something that actually not there
What does the mammogram screen for?
Breast cancer
Diagnose breast cancer early to increase treatment success and decrease mortality
What are the screening recommendations?
40; yearly; higher generic risk earlier
Annually for women over 40
May need MRI or ultrasound for women with higher genetic risk - also may do mammogram earlier

Question 26

x-ray of the soft tissue of the breast
Now have 3-D mammograms that allow visualization of the layers of breast tissue
3-D mammograms - allow look further at layers breast tissue and get better pics; experience some pain/discomfort during test; imp to do self breast exams and get clinical breast exams
Pre: no creams, lotions, powders or deodorant on breast on under arms
May experience discomfort during procedure
Post: reinforce continued self breast exams and clinical breast exams

Answer 26

Mammography

Question 27

The nurse is helping a patient schedule a cervical biopsy. When does the nurse advise the patient that the procedure should be done?
A. 5 days after menses has ceased
B. 5 days before the beginning of menses
C. During the menstrual cycle
D. Whenever she can get 3-4 days off work

Answer 27

Answer: A
Cervix is vascular so want to decrease/less risk of bleeding
Do 5 days into/after cycle
Less vascular so decrease risk of bleeding

Question 28

Cervical
Endometrial
Breast

Answer 28

Biopsy studies

Question 29

Cervical tissue is removed for cytologic study
Early in menstrual cycle so less vascular
Remove tissue
Pre:
Depends on type anesthesia used
Address anxiety - anytime screening for cancer likely have anxiety so big deal
Post:
Monitor for bleeding and infections
Nothing in vagina for 2 weeks
No heavy lifting

Answer 29

Cervical

Question 30

Used to obtain cells directly from the lining of the uterus to assess for cancer of the endometrium
Assess menstrual disturbancesand infertility
Endometrial cancer - also assess for infertility and irregularirity in menstrual cycle
Less invasive and less time precautions
Post:
Some cramping may occur
Monitor for bleeding and infections
Spotting for 1-2 days
Nothing in vagina for 1-2 days
Less invasive and less precautions after

Answer 30

Endometrial

Question 31

Tissue aspirated through a large bore needle or through small incision
local anesthetic
Aspirated fluid from benign cysts may appear clear to dark green-brown
Bloody fluid suggests cancer
Aspirat tissue from breast
Pre:
Depends on anesthesia used
Address anxiety
Post:
Mild pain alleviated with mild analgesics, ice or heat
Monitor incision for bleeding and s/s infection
Some Numbness may occur around biopsy site
Wear a supportive bra for 1 week

Answer 31

Breast

Question 32

What post procedure instructions would the nurse give to a patient who had a prostate biopsy?
A. Light rectal bleeding and blood in the urine or stools is expected for a few days
B. Swelling of the biopsy area and difficulty urinating are expected for 1 week
C. Low grade fever and bright red penile discharge are normal for several days
D. Return to see the health care provider in 1 week for recheck of biopsy site

Answer 32

Answer: A
Light bleeding expected; not lots bleeding is not expected

Question 33

Lying on diff sides or on back depending on what doing
Light rectal bleeding for sev days
Prophylacitally antibiotic so no infection
Definitive diagnostic tool for prostate cancer
Transurethral biopsy
Transrectal biopsy
Pre:
Discuss positioning and discomfort during procedure - lie on left side, flat with legs in air depending on what doing
Address anxiety
Post:
Educate regarding about possible soreness and light rectal bleeding, blood in urine and stool for a few days in addition to rust colored semen for several weeks - need to know about this
Monitor for signs of excessive bleeding, infection and any sort urinary retention
Also get Post biopsy antibiotic - prophylactically so not get an infection

Answer 33

Prostate - biopsy studies

Question 34

Insert a needle through the area of skin between the anus and scrotum

Answer 34

Transurethral biopsy

Question 35

Passing the needle through the wall of the rectum

Answer 35

Transrectal biopsy