Chapter 52 (test 2)

Question 1

Which condition would prevent the use of a vaginal hysterectomy?
a. A woman with more than four pregnancies
b. Large uterine fibroids
c. Menorrhagia for over 6 months
d. Women over the age of 50

Answer 1

ANS: B

Question 2

On the second postoperative day, a patient who has had an abdominal hysterectomy complains of gas and abdominal distention. Which intervention would be most appropriate to stimulate a bowel movement?
a. Offering carbonated beverages
b. Encouraging ambulation at least four times per day
c. Administering a 1000-mL soapsuds enema
d. Applying an abdominal binder

Answer 2

ANS: B

Question 3

The young husband of a patient who has been scheduled for a hysterectomy because of the discovery of ovarian cancer in both ovaries says to the nurse, “Please go talk to my wife. She is real upset and says she won’t be a ‘woman’ anymore.” Which response from the nurse is most therapeutic?
a. “Don’t be concerned. All young women get upset before this kind of surgery.”
b. “Certainly, I will be glad to tell her about hormone replacement.”
c. “She will get over this feeling soon.”
d. “No matter what I may say to her, it is you that needs to listen to her concerns and
assure her.”

Answer 3

ANS: D

Question 4

A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She asks the nurse if she will have “hot flashes.” Knowledge of which fact will guide the nurse’s response?
a. Only the uterus was removed, and the ovaries are still producing estrogen and she
will not have hot flashes.
b. The patient is too young to have hot flashes associated with menopause.
c. The uterus, ovaries, and fallopian tubes were removed, and she will have surgically induced menopause and may have hot flashes.
d. The uterus and fallopian tubes were removed, and she will not experience “hot
flashes.”

Answer 4

ANS: C

Question 5

On the fourth postoperative day after a modified radical mastectomy, the nurse finds the patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore. The nurse recognizes the interventions in the plan of care will be based which patient problem?
a. Difficulty accepting the change in body image
b. Fear, due to inadequate preoperative education
c. Mood swings, due to inability to interact with others
d. Fear of dying, due to the diagnosis of breast cancer

Answer 5

ANS: A

Question 6

For which reason will the nurse encourage the patient who is recovering from a modified radical mastectomy to exercise the affected arm?
a. To reduce pain.
b. To stimulate appetite.
c. To reduce lymphedema.
d. To increase muscle tension.

Answer 6

ANS: C

Question 7

A 20-year-old patient presents in the emergency room with a temperature of 103°F, blood pressure of 92/58, headache, and desquamation of both palms. Which question will the nurse make sure to ask about during the interview?
a. Any recent traveling outside the country
b. Immunization against influenza
c. Method of birth control
d. Use of tampons

Answer 7

ANS: D

Question 8

At which stage of life should a male be taught testicular self-examination (TSE)?
a. childhood
b. pre-adolescent
c. puberty
d. middle age adult

Answer 8

ANS: C

Question 9

Which statement made by a patient who has been taught the technique of testicular self-examination indicates the need for further teaching?
a. “The testes feel smooth and egg-shaped.”
b. “The best time to perform TSE is after a shower.”
c. “I will examine my scrotum after every ejaculation.”
d. “The epididymis feels like a soft tube.”

Answer 9

ANS: C

Question 10

Which patient is most at risk for the infection of epididymitis?
a. 17-year-old athlete who trains for several hours a day
b. 22-year-old who has been exposed to mumps
c. 45-year-old who was circumcised at the age of 10
d. 50-year-old who has smoked for 30 years

Answer 10

ANS: A

Question 11

A patient, age 26, has had a tubal insufflation (Rubin test) to ascertain whether her fallopian tubes are patent. She complains of pain in her right shoulder. Which response is most appropriate?
a. “Don’t worry, that is a normal reaction.”
b. “I’ll report the findings immediately to the head nurse.”
c. “That is a symptom that resulted from your position on the operating table.”
d. “That is from the carbon dioxide passing from the fallopian tubes into your
abdomen.”

Answer 11

ANS: D

Question 12

The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy. Which statement by her indicates to the nurse that the teaching has been successful?
a. “I should sleep on the side opposite my mastectomy.”
b. “I should keep my right arm supported in a sling when I am up and around until my incision is healed.”
c. “I can do whatever exercises and activities I want as long as I don’t elevate my right hand above my head.”
d. “I should take aspirin before moving or exercising my arm to prevent pain during the exercises.”

Answer 12

ANS: A

Question 13

A female patient, age 48, is undergoing a routine physical examination for the first time in 5 years. Which procedure would be included in this examination?
a. Culdoscopy
b. Colposcopy
c. Cervical biopsy
d. Papanicolaou smear

Answer 13

ANS: D

Question 14

Which is the recommended age range foran annual option for a mammogram?
a. 25 and 30 years
b. 31 and 34 years
c. 35 and 39 years
d. 40 and 44 years

Answer 14

ANS: C

Question 15

Which situation does the diagnosis of secondary infertility refer to?
a. Has never conceived.
b. Is infertile because of repeated infection.
c. Has conceived but is now unable to do so.
d. Is over the age of 38.

Answer 15

ANS: C

Question 16

Which instruction will a nurse give a patient with genital herpes who does not have lesions at the present?
a. “Continued use of acyclovir will prevent reinfection by the virus.”
b. “Condoms should be used during all sexual activity to prevent transmission of the
virus, even when lesions are not present.”
c. “Acyclovir ointment should be applied to the lesions to increase comfort and speed
healing.”
d. “Recurrent genital herpes is promoted by any sexual stimulation.”

Answer 16

ANS: B

Question 17

The patient reports that she is free of gonorrhea and can now engage in sexual activity. Which response is most appropriate?
a. “If you have been free of symptoms for 2 weeks you are cured.”
b. “You should get a rapid plasma reagin (RPR) just to make sure.”
c. “No case is considered cured until you have had three consecutive negative cervical smears.”
d. “To confirm your cure, you should get a Venereal Disease Research Lab (VDRL).”

Answer 17

ANS: C

Question 18

A Gram stain smear of the patient’s discharge reveals the presence of Neisseria gonorrhoeae. He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease. Which information will the nurse include in response to his comment?
a. “Women do not develop gonorrhea infections but can serve as carriers to spread
the disease to males.”
b. “When gonorrhea infections occur in women, the disease affects only the ovaries
and not the other genital organs.”
c. “Many women are not aware that they have gonorrhea because they often do not
have symptoms of infection.”
d. “Women develop subclinical cases of gonorrhea that do not cause tissue damage or
symptoms.”

Answer 18

ANS: C

Question 19

The patient who had a colporrhaphy for the repair of a cystocele and rectocele asks that the catheter be removed as it is bothersome to her. In which way will the nurse explain the reason for the catheter?
a. It replaces uncomfortable gauze packing.
b. It will prevent adhesions and will be in place for about 2 weeks.
c. It allows for quick urine sample collection.
d. It keeps the bladder empty and prevents stress on the sutures.

Answer 19

ANS: D

Question 20

Why is a mammogram the most useful method of diagnosing breast cancer?
a. It is the most reliable method of detecting breast cancer before it becomes
palpable.
b. It is inexpensive and covered by most medical insurance plans.
c. It involves no radiation and takes only a few minutes.
d. It involves no pain or discomfort and is readily available.

Answer 20

ANS: A

Question 21

The patient, age 52, is recovering from a modified radical mastectomy. For which reason will the nurse ensure postoperative elevation of the patient’s arm after thisprocedure?
a. To prevent vascular and lymph stasis, thus lymphedema.
b. To prevent drainage accumulation at the incisional site.
c. To prevent wound infection and dehiscence.
d. To prevent pleural effusion and respiratory distress.

Answer 21

ANS: A

Question 22

A patient, age 46, is recovering from an abdominal hysterectomy. Postoperative nursing assessment findings include a urinary output of 100 mL in 4 hours. Which action will the nurse take?
a. Force fluids.
b. Report urinary retention to the charge nurse.
c. “Milk” the urinary catheter.
d. Turn the patient onto her right side.

Answer 22

ANS: B

Question 23

When should postmenopausal women be instructed to perform breast self-examination (BSE)?
a. On the same date of their choice each month
b. Every 3 months
c. Every day, because they are at high risk for breast cancer
d. Whenever they begin to take estrogen supplements

Answer 23

ANS: A

Question 24

Which statement indicates that the patient who has had an abdominal hysterectomy needs further home teaching?
a. “I understand I can lift as much as 20 lb.”
b. “I’m leaving today to stay with my daughter, who lives 20 miles away. My
husband plans to drive the family car.”
c. “The health care provider said I can’t have sexual intercourse for 4 to 6 weeks.”
d. “I’m going to miss wearing my girdle or knee-high hose.”

Answer 24

ANS: A

Question 25

The patient with a swollen scrotum is amazed that diagnosis of the condition of hydroceleis diagnosed in which simple way?
a. placing the scrotum on a warm pad.
b. shining light through scrotum.
c. squatting and letting the scrotum hang dependently.
d. packing the scrotum in ice.

Answer 25

ANS: B

Question 26

A patient, age 36, is scheduled for a right modified radical mastectomy. She is withdrawn and does not initiate interaction with the nurse. Which activity is the most appropriate nursing action at this time?
a. Carefully explain the postoperative activity restrictions.
b. Show her a diagram of what the orchiectomy will accomplish.
c. Assure her that she will have adequate future sexual functioning.
d. Assess her concerns related to her diagnosis and treatment.

Answer 26

ANS: D

Question 27

Which statement is TRUE regarding diagnostic tests for cervical cancer?
a. All persons who have a cervix remaining should be screened up to the age of 75.
b. Cervical cancer screening should begin at 25 years of age
c. Traditional Pap tests are less than 30% accurate in screening for cervical cell
abnormalities
d. False-positive and false-negative results rarely occur with traditional Pap
diagnostic tests.

Answer 27

ANS: B

Question 28

A male patient, age 23, seeks care at the health clinic because he has developed a profuse, purulent urethral discharge, and urination is painful. When assisting with data collection from the patient, it is most important that the nurse gather information related which aspect of his history?
a. recent urinary infections.
b. episodes of prostatitis.
c. contagious diseases like mumps.
d. present and past sexual partners and notify them to get treatment.

Answer 28

ANS: D

Question 29

A 25-year-old woman comes to the clinic with a yellowish-green malodorous vaginal discharge. She says it makes her itch and makes it hard to urinate. After a microscopic examination that confirms trichomoniasis, the patient is placed on metronidazole for 7 days. Which advice will the nurse give to the patient?
a. Avoid alcohol while on metronidazole
b. Be aware that her urine may turn blue and will stain clothing.
c. Wear snug underwear during treatment.
d. Be aware that she need not notify her sexual partners as trichomoniasis is not
contagious.

Answer 29

ANS: A

Question 30

The young woman comes to the free clinic for the complaint of stomach cramps. During the examination, the nurse recommends that she be tested for chlamydia. The woman says “I don’t need any test…I don’t have any symptoms for a sexual infection…I just came for irregular bleeding.” Which response is most informative?
a. “Well, if you get more symptoms come back for testing.”
b. “The health care provider may have to order medicine for syphilis and chlamydia.
You probably have that too. You need to be tested today!”
c. “Testing is not mandatory…I probably wouldn’t bother either since you have no
symptoms.”
d. “ The irregular bleeding may be part of a chlamydia infection.”

Answer 30

ANS: D

Question 31

Which factor influences older women’s reluctance to seek medical care for problems of the reproductive system?
a. Embarrassment and cultural factors
b. Denial
c. Religious convictions
d. Lack of free time

Answer 31

ANS: A

Question 32

Although menopause is a normal part of aging, why do some women enter menopause at an earlier age?
a. Having become sexually active at an early age
b. Living at high altitudes
c. Excessive use of alcohol
d. Morbid obesity

Answer 32

ANS: B

Question 33

Why do false-negative results in mammography occur in specific age-groups?
a. Older women have greater density of breast tissue.
b. Older women have less density of breast tissue.
c. Younger women have greater density of breast tissue.
d. Younger women have less density of breast tissue.

Answer 33

ANS: C

Question 34

Which action is the sixth step in the process of the menstrual cycle to produce menses?
a. Egg matures in the graafian follicle.
b. Corpus luteum is formed from old follicle.
c. Estrogen from the maturing follicle causes vascularization of the uterine lining.
d. Anterior pituitary releases luteinizing hormone (LH), releasing the ovum.
e. Anterior pituitary releases follicle-stimulating hormone (FSH).
f. Corpus luteum releases estrogen and progesterone.
g. Corpus luteum disintegrates causing a decrease in progesterone.
h. Lining of uterus is shed as menses.

Answer 34

ANS: F

Question 35

The nurse gives discharge instructions to a person who has had a modified radical mastectomy of the right side to perform the “elbow pull-in.” Which step is the first step of the exercise?
a. Pull elbows forward until they touch.
b. Lower and straighten the arms.
c. Extend arms sideways to shoulder level.
d. Bring elbows back and extend arms.
e. Clasp hands behind neck.

Answer 35

ANS: C

Question 36

mult resp

Vaginal fistulas are caused by an ulcerating process resulting from which cause? (Select all that apply.)
a. cancer.
b. radiation.
c. poor hygiene.
d. multiple sexual partners.
e. weakening of tissue from pregnancies.
f. surgical interventions.

Answer 36

ANS: A, B, E, F

Question 37

mult resp

Select the intervention that should be performed with caution, in the affected arm, on patients who have undergone a modified radical mastectomy. (Select all that apply.)
a. Vaccinations
b. Taking of blood pressure or samples
c. Insertion of IV line
d. Physical therapy on uninvolved arm
e. Wear watch and jewelry on involved arm
f. Carry purse on involved arm or shoulder

Answer 37

ANS: A, B, C

Question 38

mult resp

Which factor is an advantage of a vaginal hysterectomy over the abdominal hysterectomy?
(Select all that apply.)
a. Less postoperative discomfort
b. Reduced hospital stay
c. Less expensive
d. Better visualization of the intrapelvic area
e. Faster recovery

Answer 38

ANS: A, B, C, E

Question 39

mult resp

The nurse instructs a group of women who attend the health clinic that persons who are particularly at risk for cervical cancer are persons who have which risk factor? (Select all that apply.)
a. smoke.
b. wear tampons.
c. have been sexually active since their teens.
d. have multiple sexual partners.
e. had chickenpox as a child.
f. have a history of sexually transmitted infections (STI).

Answer 39

ANS: A, C, D, F

Question 40

mult resp

Which statement is true of the Gardasil vaccine? (Select all thatapply.)
a. It requires two more immunizations at 6 months after the firstdose.
b. It reduces incidence of cervical cancer.
c. It reduces the incidence of human papilloma virus (HPV).
d. It can be given only to females.
e. It should be given before a person becomes sexually active.
f. It is safe for people as young as 8 years of age.

Answer 40

ANS: A, B, C, E