Chapter 4

Question 1

Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI)
include. (Multiple Response)

Answer 1

Fellatio.
Unprotected anal intercourse.
Multiple sex partners.

Question 2

There is little consensus on the management of premenstrual dysphoric disorder (PMDD). However, nurses can advise women on several self-help modalities that often improve symptoms. The nurse knows that health teaching has been effective when the client reports that she has adopted a number of lifestyle changes,
including (Multiple Response)

Answer 2

Regular exercise
Improved nutrition.
Smoking cessation.
Oil of evening primrose.

Question 3

When assessing a patient for amenorrhea, the nurse should be aware that this is unlikely to be caused by

Answer 3

Lack of exercise.

Lack of exercise is not a cause of amenorrhea. Strenuous exercise may cause amenorrhea

Question 4

When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended?

Answer 4

Using a heating pad on the abdomen to relieve cramping

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

Question 5

Which symptom described by a patient is characteristic of premenstrual syndrome (PMS)?

Answer 5

I feel irritable and moody a week before my period is supposed to start.

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.

Question 6

A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to:

Answer 6

Endometriosis.

Symptoms of endometriosis can change over time and may not reflect the extent of the disease. Major symptoms include dysmenorrhea and deep pelvic dyspareunia (painful intercourse). Impaired fertility may result from adhesions caused by endometriosis.

Question 7

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

Answer 7

Can cause her to experience some hot flashes and vaginal dryness.

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

Question 8

While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the clients recent menstrual cycles. The nurse should collect additional information with which statement?

Answer 8

She describes her flow as very heavy.

Menorrhagia is defined as excessive menstrual bleeding, in either duration or amount. Heavy bleeding can have many causes. The amount of bleeding and its effect on daily activities should be evaluated.

Question 9

When evaluating a patient whose primary complaint is amenorrhea, the nurse must be aware that lack of menstruation is most often the result of:

Answer 9

Pregnancy.

Amenorrhea, or the absence of menstrual flow, is most often a result of pregnancy.

Question 10

A 36-year-old woman has been given a diagnosis of uterine fibroids. When planning care for this patient, the nurse should know that:

Answer 10

Menorrhagia is a common finding.

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

Question 11

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

Answer 11

Dysmenorrhea.

Dysmenorrhea is pain during or shortly before menstruation

Question 12

Dysmenorrhea

Answer 12

pain during or shortly before menstruation

Question 13

Amenorrhea

Answer 13

the absence of menstrual flow

Question 14

Dyspareunia

Answer 14

pain during intercourse

Question 15

PMS

Answer 15

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

Question 16

With regard to dysmenorrhea, nurses should be aware that:

Answer 16

Pain usually occurs in the suprapubic area or lower abdomen.

Pain is described as sharp and cramping or sometimes as a dull ache. It may radiate to the lower back or upper thighs

Question 17

Which statement concerning cyclic perimenstrual pain and discomfort (CPPD) is accurate?

Answer 17

Premenstrual syndrome is a complex, poorly understood condition that may include any of a
hundred symptoms

PMS may manifest with one or more of a hundred or so physical and psychological symptoms

Question 18

With regard to endometriosis, nurses should be aware that:

Answer 18

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

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

Question 19

One of the alterations in cyclic bleeding that occurs between periods is called:

Answer 19

Metrorrhagia.

Metrorrhagia is bleeding between periods. It can be caused by progestin injections and implants

Question 20

As relates to dysfunctional uterine bleeding (DUB), the nurse should be aware that:

Answer 20

It is most commonly caused by anovulation.

Anovulation may occur because of hypothalamic dysfunction or polycystic ovary syndrome. DUB most often occurs when the menstrual cycle is being established or when it draws to a close at menopause.

Question 21

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

Answer 21

Nonsteroidal antiinflammatory drugs (NSAIDs).

NSAIDs are prostaglandin inhibitors and show the strongest research results for pain relief. Often if one
NSAID is not effective, another one can provide relief.

Question 22

When evaluating a patient for sexually transmitted infections (STIs), the nurse should be aware that the most common bacterial STI is:

Answer 22

Chlamydia.

Chlamydia is the most common and fastest-spreading STI among American women, with an estimated 3 million new cases each year.

Question 23

The viral sexually transmitted infection (STI) that affects most people in the United States today is:

Answer 23

Human papillomavirus (HPV).