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CNUR 303- MATERNITY FLASH CARDS > CHAPTER 7- REPRODUCTIVE HEALTH > Flashcards

CHAPTER 7- REPRODUCTIVE HEALTH Flashcards

1
Q
  1. When assessing a patient for amenorrhea, a nurse should be aware that which may cause amenorrhea?
    a. Alcohol use
    b. Type 1 diabetes mellitus
    c. Lack of exercise
    d. Cessation of oral contraception use
A

ANS: B
Type 1 diabetes may cause amenorrhea. Lack of exercise does not cause amenorrhea. It is the use of oral contraception that may cause amenorrhea. Alcohol use does not cause amenorrhea.

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2
Q
  1. When a nurse is counselling a woman for primary dysmenorrhea, which nonpharmacological intervention might be recommended?
    a. Increase the intake of red meat and simple carbohydrates.
    b. Reduce the intake of diuretic foods, such as peaches and asparagus.
    c. Temporarily substitute physical activity for a sedentary lifestyle.
    d. Use a heating pad on the abdomen to relieve cramping.
A

ANS: D
Heat minimizes cramping by increasing vasodilation and muscle relaxation and minimizing uterine ischemia. Dietary changes such as eating less red meat may be recommended for women experiencing dysmenorrhea. Increasing the intake of diuretics, including natural diuretics such as asparagus, cranberry juice, peaches, parsley, and watermelon, may help ease the symptoms associated with dysmenorrhea. Exercise has been found to help relieve menstrual discomfort through increased vasodilation and subsequent

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3
Q
  1. What symptom described by a person is characteristic of premenstrual syndrome (PMS)?
    a. Irritable and moody prior to menses.
    b. Lower abdominal pain that begins halfway through menstruation.
    c. Nausea and headache after menses begins lasting 2 to 3 days.
    d. Abdominal bloating and breast pain halfway through menstruation.
A

ANS: A
PMS is a cluster of physical, psychological, and behavioural symptoms that begin in the luteal phase of the menstrual cycle and coincide with menses. Concerns with lower abdominal pain, nausea and headaches, and abdominal bloating are all associated with PMS; however, the timing reflected is inaccurate.

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4
Q
  1. A patient states they have severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. The patient also has pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. What are these symptoms most likely related to?
    a. Endometriosis
    b. PMS
    c. Primary dysmenorrhea
    d. Secondary dysmenorrhea
A

ANS: A
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. Although endometriosis may be associated with secondary dysmenorrhea, it is not a cause of primary dysmenorrhea or PMS. In addition, this patient has symptoms of dyspareunia and infertility, which are associated with endometriosis, not with PMS or primary or secondary dysmenorrhea.

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5
Q
  1. Nafarelin (Synarel) 200 mg BID per nasal spray currently is used as a treatment for mild-to-severe endometriosis. What should a nurse teach a patient who is taking this medication?
    a. It stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby
    stimulating ovarian activity.
    b. It should be sprayed into one nostril every other day.
    c. It should be injected into subcutaneous tissue BID.
    d. It can cause the patient to experience some hot flashes and vaginal dryness.
A

ANS: D
Nafarelin is a GnRH agonist, and its adverse effects are similar to those of menopause. The hypoestrogenism effect results in hot flashes and vaginal dryness. Nafarelin is a GnRH agonist that suppresses the secretion of GnRH and is administered twice daily by nasal spray.

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6
Q
  1. While interviewing a 31-year-old patient before their routine gynecological examination, a nurse collects data about the patient’s recent menstrual cycles. The nurse should collect additional information when the patient makes which statement?
    a. They state their menstrual flow lasts 5 to 6 days.
    b. They describe their flow as very heavy.
    c. They report that they had a small amount of spotting midway between periods for the past 2 months.
    d. They describe the length of their menstrual cycle varying from 26 to 29 days.
A

ANS: B
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. A menstrual flow lasting 5 to 6 days is a normal finding. Mittelschmerz, a small amount of bleeding or spotting that occurs at the time of ovulation (14 days before onset of the next menses), is considered normal. During the reproductive years, a patient may have physiological variations in their menstrual cycle. Variations in the length of a menstrual cycle are considered normal.

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7
Q
  1. When evaluating a patient whose primary concern is secondary amenorrhea, a nurse must be aware that lack of menstruation is most often the result of which event?
    a. Stress
    b. Excessive exercise
    c. Pregnancy
    d. Eating disorders
A

ANS: C
Secondary amenorrhea, or the absence of menstrual flow, is most often a result of pregnancy. Although stress, excessive exercise, and eating disorders all may be contributing factors, none is the most common factor associated with amenorrhea.

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8
Q
  1. When planning care for a patient who has been diagnosed as having uterine fibroids, what is important for a nurse to know?
    a. Fibroids are malignant tumours of the uterus that require radiation or
    chemotherapy.
    b. Fibroids will increase in size during the perimenopausal period.
    c. Menorrhagia is a common finding in patients with uterine fibroids.
    d. The patient is unlikely to become pregnant as long as the fibroids are in their
    uterus.
A

ANS: C
Uterine fibroids are a common cause of menorrhagia. Fibroids are benign tumours of the smooth muscle of the uterus, and their etiology is unknown. Fibroids are estrogen sensitive and shrink as levels of estrogen decline. Fibroids occur in 25% of women of reproductive age and are seen in 2% of pregnant women.

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9
Q
  1. During an annual gynecological checkup, a patient states that recently they have been experiencing cramping and pain during their menstrual periods. A nurse would use which term to document this concern?
    a. Amenorrhea
    b. Dysmenorrhea
    c. Dyspareunia
    d. Premenstrual syndrome (PMS)
A

ANS: B
Dysmenorrhea is pain during or shortly before menstruation. Amenorrhea is the absence of menstrual flow. Dyspareunia is pain during intercourse. PMS is a cluster of physical, psychological, and behavioural symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses.

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10
Q
  1. Nurses should be aware that which is true with regard to dysmenorrhea?
    a. It is more common in older women.
    b. It is more common in leaner women who exercise strenuously.
    c. Symptoms can begin at any point in the ovulatory cycle.
    d. Pain usually occurs in the suprapubic area or lower abdomen.
A

ANS: D
Pain is described as sharp and cramping or sometimes as a dull ache. It may radiate to the lower back or upper thighs. Dysmenorrhea is more common in younger women ages 17 to 24 and in women who smoke and who are obese. Symptoms begin with menstruation or sometimes a few hours before the onset of flow.

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11
Q
  1. Which statement is accurate?
    a. Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual
    syndrome (PMS) and more common in younger women.
    b. Secondary dysmenorrhea is more intense and medically significant than primary
    dysmenorrhea.
    c. Premenstrual syndrome is a complex but clearly understood condition that may
    include many symptoms.
    d. The causes of PMS have been well established.
A

ANS: A
PMDD is a more severe variant of PMS. PMS may manifest itself with one or more of many physical, mood, and behavioural symptoms and is poorly understood. Secondary dysmenorrhea is characterized by more muted pain than that seen in primary dysmenorrhea; the medical treatment is much the same. The cause of PMS is unknown. It may be a collection of different problems.

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12
Q
  1. Nurses should be aware of which in relation to endometriosis?
    a. It is characterized by the presence and growth of endometrial tissue inside the
    uterus.
    b. It is found more often in Black patients than in White or Asian patients.
    c. It may worsen with repeated cycles or remain asymptomatic and disappear after
    menopause.
    d. It is unlikely to affect sexual intercourse or fertility.
A

ANS: C
Symptoms vary among patients, ranging from nonexistent to incapacitating. With endometriosis the endometrial tissue is outside the uterus. Endometriosis is found equally in patients from all cultures. Patients can experience painful intercourse and impaired fertility.

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13
Q
  1. Which refers to an alteration in cyclic bleeding that occurs between periods of menstruation? a. Oligomenorrhea
    b. Menorrhagia
    c. Leiomyoma
    d. Metrorrhagia
A

ANS: D
Metrorrhagia is bleeding between periods. It can be caused by progestin injections and implants. Oligomenorrhea is infrequent or scanty menstruation. Menorrhagia is excessive menstruation. Leiomyoma is a common cause of excessive bleeding.

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14
Q
  1. What should a nurse be aware of with regard to abnormal uterine bleeding (AUB)?
    a. Inherited blood disorders may be a cause of AUB.
    b. It most often occurs in middle age.
    c. Acute bleeding episodes require a dilation and curettage.
    d. The most effective medical treatment involves steroids.
A

ANS: A
Inherited bleeding disorders may be an underlying cause of abnormal uterine bleeding, with von Willebrand’s disease present in the majority of cases, and should be considered when other causes cannot be determined. AUB can occur at any age. Acute bleeding episodes do not automatically require a dilation and curettage. The most effective medical treatment is oral or intravenous estrogen, not steroids.

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15
Q
  1. Management of primary dysmenorrhea often requires a multifaceted approach. What is the optimal pharmacological therapy for pain relief for dysmenorrhea?
    a. Acetaminophen
    b. Oral contraceptives (OCPs)
    c. Nonsteroidal anti-inflammatory drugs (NSAIDs)
    d. Aspirin
A

ANS: C
This pharmacological agent has the strongest research results for pain relief. Often if one NSAID is not effective, another one will provide relief. Approximately 80% of women find relief from these prostaglandin inhibitors. Preparations containing acetaminophen are less effective for dysmenorrhea because they lack the antiprostaglandin properties of NSAIDs. OCPs are a reasonable choice for women who also want birth control. The benefit of OCPs is the reduction of menstrual flow and irregularities. OCPs may be contraindicated for some women and have a number of potential adverse effects. NSAIDs are the drug of choice. If a woman is taking an NSAID, she should avoid taking aspirin.

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16
Q
  1. What are the two primary areas of risk for sexually transmitted infections (STIs)?
    a. Sexual orientation and socioeconomic status
    b. Age and educational level
    c. Large number of sexual partners and race
    d. Risky sexual behaviours and inadequate preventive health behaviours
A

ANS: D
Risky sexual behaviours and inadequate preventive health behaviours put a person at risk for acquiring or transmitting an STI. Low socioeconomic status may be a factor in being less able to purchase barrier protection, and sexual orientation does not put one at higher risk. Younger individuals with less education may not be aware of proper prevention techniques: however, these are not the primary areas of risk for STIs. Having a large number of sexual partners is certainly a risk-taking behaviour. Being of a certain race does not increase the risk for STIs.

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17
Q
  1. When evaluating a patient for sexually transmitted infections (STIs), a nurse should be aware that which STI is on the rise in Canada?
    a. Chancroid
    b. Candidiasis
    c. Chlamydia
    d. Herpes simplex virus (HSV) type 2
A

ANS: C
Chlamydia is the one of the three STIs on the rise in Canada; the other two are gonorrhea and syphilis. Candidiasis is caused by a fungus, not by bacteria. Chancroid is not on the rise in Canada. HSV type 2 is common in women; however, it is not cited as one of the three STIs that are on the increase in Canada.

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18
Q
  1. What is the viral sexually transmitted infection (STI) that affects most people in Canada today?
    a. Herpes simplex virus type 2 (HSV-2)
    b. Human papillomavirus (HPV)
    c. Human immunodeficiency virus (HIV)
    d. Cytomegalovirus (CMV)
A

ANS: B
HPV infection, an STI, is the most prevalent viral STI seen in ambulatory health care settings. HSV-2, HIV, and CMV are all viral STIs, but are not the most prevalent viral STI.

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19
Q
  1. What are the two primary functions of the ovary?
    a. Normal female development and sex hormone release
    b. Ovulation and internal pelvic support
    c. Sexual response and ovulation
    d. Ovulation and hormone production
A

ANS: D
The two functions of the ovaries are ovulation and hormone production. The presence of ovaries does not guarantee normal female development. The ovaries produce estrogen, progesterone, and androgen. Ovulation is the release of a mature ovum from the ovary; the ovaries are not responsible for internal pelvic support. Sexual response is a feedback mechanism involving the hypothalamus, anterior pituitary gland, and the ovaries. Ovulation does occur in the ovaries.

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20
Q
  1. A patient has a thick, white, lumpy, cottage cheese-like discharge, with patches on their labia and in their vagina. The patient states symptoms of intense pruritus. A nurse would anticipate which preparation for treatment?
    a. Fluconazole
    b. Tetracycline
    c. Clindamycin
    d. Acyclovir
A

ANS: A
Fluconazole, metronidazole, and clotrimazole are the drugs of choice to treat candidiasis. Tetracycline is used to treat syphilis. Clindamycin is used to treat bacterial vaginosis. Acyclovir is used to treat genital herpes.

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21
Q
  1. What do most laboratory tests focus on to detect the human immunodeficiency virus (HIV)?
    a. HIV virus
    b. HIV antibodies
    c. CD4 counts
    d. CD8 counts
A

ANS: B
The screening tool used to detect HIV is the enzyme immunoassay, which tests for the presence of antibodies to the HIV virus. CD4 counts are associated with the incidence of acquired immunodeficiency syndrome (AIDS) in HIV-infected individuals.

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22
Q
  1. What would most likely be included for the care management of a woman diagnosed with acute pelvic inflammatory disease (PID)?
    a. Oral antiviral therapy
    b. Bedrest in a semi-Fowler position
    c. Antibiotic regimen continued until symptoms subside
    d. Frequent pelvic examination to monitor the progress of healing
A

ANS: B
The woman with acute PID should be on bedrest in a semi-Fowler position. Broad-spectrum antibiotics are used. Antibiotics must be taken as prescribed, even if symptoms subside. Few pelvic examinations should be conducted during the acute phase of the disease.

23
Q
  1. On vaginal examination of a 30-year-old patient, a nurse documents the following findings: profuse, thin, greyish white vaginal discharge with a “fishy” odour; symptoms of pruritus. These findings lead the nurse to which diagnosis?
    a. Bacterial vaginosis (BV)
    b. Candidiasis
    c. Trichomoniasis
    d. Gonorrhea
A

ANS: A
Most patients with BV have a characteristic “fishy” odour. The discharge usually is profuse and thin and has a white, grey, or milky colour. Some patients also may have mild irritation or pruritus. The discharge associated with candidiasis is thick, white, and lumpy and resembles cottage cheese. Trichomoniasis may be asymptomatic, but patients commonly have a characteristic yellowish to greenish, frothy, mucopurulent, copious, and malodorous discharge. Patients with gonorrhea are often asymptomatic. They may have a purulent endocervical discharge, but discharge usually is minimal or absent.

24
Q
  1. The uterus is a muscular, pear-shaped organ that is responsible for which event?
    a. Cyclic menstruation
    b. Sex hormone production
    c. Fertilization
    d. Sexual arousal
A

ANS: A
The uterus is an organ for reception, implantation, retention, and nutrition of the fertilized ovum; it also is responsible for cyclic menstruation. Hormone production and fertilization occur in the ovaries. Sexual arousal is a feedback mechanism involving the hypothalamus, the pituitary gland, and the ovaries.

25
Q
  1. Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes?
    a. Herpes simplex virus (HSV)-2
    b. Human papillomavirus (HPV)
    c. Human immunodeficiency virus (HIV)
    d. Cytomegalovirus (CMV)
A

ANS: A
The initial HSV genital infection is characterized by multiple painful lesions, fever, chills, malaise, and severe dysuria; it may last 2 to 3 weeks. Recurrent episodes of HSV infection commonly have only local symptoms that usually are less severe than those of the initial infection. With HPV infection, lesions are a chronic problem. HIV is a retrovirus. Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has entered the body. Severe depression of the cellular immune system associated with HIV infection characterizes acquired immunodeficiency syndrome (AIDS). AIDS has no cure. In most adults the onset of CMV infection is uncertain and asymptomatic. However, the disease may become a chronic, persistent infection.

26
Q
  1. A nurse should know that once human immunodeficiency virus (HIV) enters the body, seroconversion to HIV positivity occurs in 70% of individuals by what week?
    a. 1 week
    b. 4 weeks
    c. 8 weeks
    d. 12 weeks
A

ANS: D
Seroconversion to HIV positivity usually occurs within 3 to 6 weeks after the virus has entered the body; 70% of individuals will have seroconverted by 12 weeks.

27
Q
  1. A 25-year-old female comes to the gynecologist’s office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the patient has human papillomavirus (HPV). The patient asks, “What is that? Can you get rid of it?” What is the basis for the nurses’ response?
    a. Provide reassurance that it can be frozen and it will fall off.
    b. Explain that HPV stands for “human papillomavirus” and is a sexually transmitted infection (STI).
    c. Explain that HPV is a type of early human immunodeficiency virus (HIV) and is usually fatal.
    d. Explain transmission from the current partner, who needs to be tested as well.
A

ANS: B
It is important to inform the patient about STIs and the risks involved with HPV. The health care team has a duty to provide proper information to the patient, including information related to STIs. HPV and HIV are both viruses that can be transmitted sexually, but they are not the same virus. The onset of HPV can be insidious and it is not fatal. Often STIs go unnoticed. Abnormal bleeding frequently is the initial symptom. The patient may have had HPV before her current boyfriend. The nurse cannot make any deductions from this limited information.

28
Q
  1. Which statement about the various forms of hepatitis is accurate?
    a. A vaccine exists for hepatitis C, but not for hepatitis B.
    b. Hepatitis A is acquired by eating contaminated food or drinking polluted water.
    c. Hepatitis B is less contagious than human immunodeficiency virus (HIV).
    d. The incidence of hepatitis C is decreasing.
A

ANS: B
Contaminated milk and shellfish are common sources of infection with hepatitis A. A vaccine exists for hepatitis B but not for hepatitis C. Hepatitis B is more contagious than HIV. The incidence of hepatitis C is increasing.

29
Q
  1. Which is the most important aspect of a discussion related to health promotion and condom use that a nurse should be aware of?
    a. Strategies to enhance condom use
    b. Choice of colours and special features
    c. Leaving the decision up to the male partner
    d. Places to safely carry condoms
A

ANS: A
When the nurse opens discussion on safer sex practices, it gives the patient permission to clear up any concerns or misapprehensions that they may have regarding condom use. The nurse can also suggest ways that the patient can enhance their condom negotiation and communications skills. These include role-playing, rehearsal, cultural barriers, and situations that put the patient at risk. Although patients can be taught the differences among condoms, such as size ranges, where to purchase them, and price, this is not as important as negotiating the use of safer sex practices. Women must address the issue of condom use with every sexual contact. Some men need time to think about this. If they appear reluctant, the woman may want to reconsider the relationship. Although not ideal, women may safely choose to carry condoms in shoes, wallets, or inside their bra. They should be taught to keep the condom away from heat. This information is important; however, it is not germane if the woman cannot even discuss strategies on how to enhance condom use.

30
Q
  1. Which should a nurse explain when providing education regarding breast care and fibrocystic changes in breasts?
    a. Fibrocystic changes are a disease of the milk ducts and glands in the breasts.
    b. Fibrocystic changes are a premalignant disorder characterized by lumps found in
    the breast tissue.
    c. Fibrocystic changes describe lumpiness with pain and tenderness in the breast
    tissue of healthy patients during menstrual cycles.
    d. Fibrocystic changes include lumpiness accompanied by the appearance of
    tenderness after menses.
A

ANS: C
Fibrocystic changes are palpable thickenings in the breast that are usually associated with pain and tenderness. The pain and tenderness fluctuate with the menstrual cycle. Symptoms usually subside within 1 week of menses, not appear then.

31
Q
  1. When teaching a group of women about breast cancer, which fact would a nurse point out to them?
    a. Risk factors identify more than 50% of women who will develop breast cancer.
    b. Nearly 90% of lumps found by women are malignant.
    c. One in 10 women in Canada will develop breast cancer in their lifetime.
    d. The exact cause of breast cancer is unknown.
A

ANS: D
The exact cause of breast cancer in unknown. Risk factors help to identify fewer than 30% of women in whom breast cancer eventually will develop. Women detect about 90% of all breast lumps. Of this 90%, only 20% to 25% are malignant. One in nine women in Canada will develop breast cancer in her lifetime.

32
Q
  1. Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?
    a. Mammogram
    b. Ultrasound
    c. Fine-needle aspiration (FNA)
    d. CA 15-3
A

ANS: C
When a suspicious mammogram is noted or a lump is detected, diagnosis is confirmed by FNA, core needle biopsy, or needle localization biopsy. Mammography is a clinical screening tool that may aid early detection of breast cancers. Transillumination, thermography, and ultrasound breast imaging are being explored as methods of detecting early breast carcinoma. CA-15 is a serum tumour marker that is used to test for residual disease.

33
Q
  1. Unique longitudinal muscle fibres make the uterine myometrium ideally suited for which event?
    a. Menstruation
    b. Birth process
    c. Ovulation
    d. Fertilization
A

ANS: B
The myometrium is made up of layers of smooth muscle that extend in three directions. These muscles assist in the birth process by expelling the fetus, ligating blood vessels after birth, and controlling the opening of the cervical os. The myometrium has little connection to menstruation. The muscles in the myometrium are not related to ovulation or fertilization.

34
Q
  1. Which hormone is responsible for maturation of mammary gland tissue?
    a. Estrogen
    b. Testosterone
    c. Prolactin
    d. Progesterone
A

ANS: D
Progesterone causes maturation of the mammary gland tissue, specifically acinar structures of the lobules. Estrogen increases the vascularity of the breast tissue. Testosterone has no bearing on breast development. Prolactin is produced after birth and released from the pituitary gland. It is produced in response to infant suckling and emptying of the breasts.

35
Q
  1. Which is true of fibroadenoma?
    a. Fibroadenoma is an inflammation of the milk ducts and glands behind the nipples.
    b. Fibroadenoma is a thick, sticky discharge from the nipple of the affected breast.
    c. Fibroadenoma is lumpiness in both breasts that develops 1 week before
    menstruation.
    d. Fibroadenoma is a single lump in one breast that can be expected to shrink as the
    woman ages.
A

ANS: D
Fibroadenomas are characterized by discrete, usually solitary lumps averaging 2.5 cm in diameter. Fibroadenomas increase in size during pregnancy and shrink as the woman ages. Inflammation of the milk ducts is associated with mammary duct ectasia, not fibroadenoma. A thick, sticky discharge is associated with galactorrhea, not fibroadenoma. Lumpiness before menstruation is associated with fibrocystic changes of the breast.

36
Q
  1. Which myometrial muscle fibres prevent menstrual blood from flowing back into the uterine tubes during menstruation?
    a. Oblique
    b. Circular
    c. Transverse
    d. Longitudinal
A

ANS: B
Circular fibres of the inner myometrium prevent menstrual blood from flowing back into the uterine tubes during menstruation. Oblique fibres do not prevent menstrual blood from flowing back into the uterine tubes during menstruation. Transverse fibres do not prevent menstrual blood from flowing back into the uterine tubes during menstruation. Longitudinal fibres do not prevent menstrual blood from flowing back into the uterine tubes during menstruation.

37
Q
  1. What does a patient most likely have when they experience a breast mass that is not well delineated and is nonpalpable, immobile, and nontender?
    a. Fibroadenoma
    b. Lipoma
    c. Intraductal papilloma
    d. Mammary duct ectasia
A

ANS: C
Intraductal papilloma is the only benign breast mass that is nonpalpable. Fibroadenoma is well-delineated, palpable, and movable. Lipoma is palpable and movable. Mammary duct ectasia is not well delineated and is immobile, but it is palpable and painful.

38
Q
  1. Which is a modality that may provide relief for patients with fibrocystic breast changes?
    a. Diuretic administration
    b. Including caffeine daily in the diet
    c. Increased vitamin C supplementation
    d. Application of cold packs to the breast as necessary
A

ANS: A
Diuretic administration plus a decrease in sodium and fluid intake is recommended. Although not supported by research, some advocate eliminating dimethylxanthines (caffeine) from the diet. Smoking should also be avoided and alcohol consumption reduced. Vitamin E supplements are recommended; however, the patient should avoid megadoses because this is a fat-soluble vitamin. Pain relief measures include applying heat to the breast, wearing a supportive bra, and taking nonsteroidal anti-inflammatory drugs.

39
Q
  1. The Jarisch-Herxheimer reaction is an acute febrile reaction associated with treatment for which sexually transmitted infection?
    a. Syphilis
    b. Gonorrhea
    c. Herpes simplex virus type 2
    d. Human immunodeficiency virus
A

ANS: A
The Jarisch-Herxheimer reaction is an acute febrile reaction associated with syphilis treatment. Other symptoms may include headache, myalgias, and arthralgias that develop within the first 24 hours of treatment.

40
Q
  1. Which both protects the pelvic structures and accommodates the growing fetus during pregnancy?
    a. Perineum
    b. Bony pelvis
    c. Vaginal vestibule
    d. Fourchette
A

ANS: B
The bony pelvis protects and accommodates the growing fetus. The perineum covers the pelvic structures. The vaginal vestibule contains openings to the urethra and vagina. The fourchette is formed by the labia minor.

41
Q
  1. Individual irregularities in the ovarian (menstrual) cycle are most often caused by
    a. variations in the follicular (preovulatory) phase.
    b. an intact hypothalamic-pituitary feedback mechanism.
    c. a functioning corpus luteum.
    d. a prolonged ischemic phase.
A

ANS: A
Almost all variations in the length of the ovarian cycle are the result of variations in the length of the follicular phase. An intact hypothalamic-pituitary feedback mechanism is regular, not irregular. The luteal phase begins after ovulation. The corpus luteum depends on the ovulatory phase and fertilization. During the ischemic phase, the blood supply to the functional endometrium is blocked and necrosis develops. The functional layer separates from the basal layer, and menstrual bleeding begins.

42
Q
  1. The transition phase during which ovarian function and hormone production decline is called
    a. the climacteric.
    b. menarche.
    c. menopause.
    d. puberty.
A

ANS: A
The climacteric is a transitional phase during which ovarian function and hormone production decline. Menarche is the term that denotes the first menstruation. Menopause refers only to the last menstrual period. Puberty is a broad term that denotes the entire transitional stage between childhood and sexual maturity.

43
Q
  1. The body part that both protects the pelvic structures and accommodates the growing fetus during pregnancy is the
    a. perineum.
    b. bony pelvis.
    c. vaginal vestibule.
    d. fourchette.
A

ANS: B
The bony pelvis protects and accommodates the growing fetus. The perineum covers the pelvic structures. The vaginal vestibule contains openings to the urethra and vagina. The fourchette is formed by the labia minor.

44
Q
  1. A fully matured endometrium that has reached the thickness of heavy, soft velvet describes the cycle.
    a. menstrual
    b. proliferative c. secretory
    d. ischemic
A

ANS: C
The secretory phase extends from the day of ovulation to approximately 3 days before the next menstrual cycle. During this phase, the endometrium becomes fully mature. During the menstrual phase, the endometrium is being shed; the endometrium is fully mature again during the secretory phase. The proliferative phase is a period of rapid growth, but the endometrium becomes fully mature again during the secretory phase. During the ischemic phase, the blood supply is blocked, and necrosis develops. The endometrium is fully mature during the secretory phase.

45
Q
  1. The stimulated release of gonadotropin-releasing hormone and follicle-stimulating hormone is part of the
    a. menstrual cycle.
    b. endometrial cycle.
    c. ovarian cycle.
    d. hypothalamic-pituitary cycle.
A

ANS: D
The menstrual, endometrial, and ovarian cycles are interconnected. However, the cyclic release of hormones is the function of the hypothalamus and pituitary glands.

46
Q
  1. A nurse providing care in a women’s health care setting must be aware regarding which sexually transmitted infection that can be successfully treated and cured?
    a. Herpes
    b. Acquired immunodeficiency syndrome (AIDS)
    c. Venereal warts
    d. Chlamydia
A

ANS: D
The usual treatment for infection by the bacterium Chlamydia is doxycycline or azithromycin. Concurrent treatment of all sexual partners is needed to prevent recurrence. There is no known cure for herpes, and treatment focuses on pain relief and preventing secondary infections. Because there is no known cure for AIDS, prevention and early detection are the primary focus of care management. Condylomata acuminata are caused by human papillomavirus. No treatment eradicates the virus.

47
Q
  1. The medication of choice for treatment of gonorrhea is
    a. penicillin G.
    b. tetracycline.
    c. ceftriaxone.
    d. acyclovir.
A

ANS: C
Ceftriaxone is effective for treatment of all gonococcal infections. Penicillin is used to treat syphilis. Tetracycline is prescribed for chlamydial infections. Acyclovir is used to treat herpes genitalis.

48
Q
  1. Which communicable diseases must be reported in all provinces and territories? (Select all that apply.)
    a. Gonorrhea
    b. Human papillomavirus
    c. Human immunodeficiency virus (HIV)
    d. Herpes simplex virus 2 (HSV -2)
    e. Chlamydia
    f. HSV-1
    g. Infectious syphilis
A

ANS: A, C, E, G
Gonorrhea, chlamydia, infectious syphilis, and HIV are reportable communicable diseases in all provinces and territories.

49
Q
  1. Which are viral sexually transmitted infections (STIs)? (Select all that apply.)
    a. Herpes simplex virus (HSV)
    b. Chancroid
    c. Mycoplasmas
    d. Human papillomavirus (HPV)
    e. Trichomoniasis
    f. Syphilis
    g. Cytomegalovirus
A

ANS: A, D, G
Viral STIs include HIV, HSV, cytomegalovirus, viral hepatitis A and B, and HPV. Chancroid, mycoplasms, and syphilis are bacterial STIs. Trichomoniasis is a protozoa STI.

50
Q
  1. Which are symptoms of endometriosis? (Select all that apply.)
    a. Dysmenorrhea
    b. Dysuria
    c. Apnea
    d. Hypertension e. Dyscrasias
A

ANS: A, B
Symptoms of endometriosis include dysmenorrhea, dyspareunia, dysuria, dyschezia, lower back or abdominal discomfort, and chronic pelvic pain.

51
Q
  1. There is little consensus on the management of premenstrual dysphoric disorder (PMDD). However, nurses can advise patients on several self-help modalities that often improve symptoms. A nurse knows that health teaching has been effective when the patient reports that she has adopted a number of lifestyle changes, including (Select all that apply.)
    a. regular exercise.
    b. improved nutrition.
    c. a daily glass of wine.
    d. smoking cessation.
    e. oil of evening primrose.
A

ANS: A, B, D, E
These modalities may provide significant symptom relief in 1 to 2 months. If there is no improvement after these changes have been made, the patient may need to begin pharmacologic therapy. Patients should decrease both their alcohol and caffeinated beverage consumption if they have PMDD.

52
Q
  1. Examples of sexual risk behaviours associated with exposure to a sexually transmitted infection (STI) include (Select all that apply.)
    a. oral sex.
    b. unprotected anal intercourse.
    c. multiple sex partners.
    d. dry kissing.
    e. abstinence.
A

ANS: A, B, C
Engaging in these sexual activities increases the exposure risk and the possibility of acquiring an STI. Dry kissing and abstinence are considered “safe” sexual practices.

53
Q
  1. The exact cause of breast cancer remains undetermined. Researchers have found that there are many common risk factors that increase a woman’s chance of developing a malignancy. It is essential for the nurse who provides care to women of any age to be aware of which of the following risk factors? (Select all that apply.)
    a. Family history
    b. Late menarche
    c. Early menopause
    d. Race
    e. Nulliparity or first pregnancy after age 30
A

ANS: A, D, E
Family history, race, and nulliparity are known risk factors for the development of breast cancer. Other risk factors include age, personal history of cancer, high socioeconomic status, sedentary lifestyle, hormone replacement therapy, recent use of oral contraceptives, never having breastfed a child, and drinking more than one alcoholic beverage per day. Early menarche and late menopause are risk factors for breast malignancy, not late menarche and early menopause.

54
Q

Herbal preparations have long been used for the management of menstrual problems, including dysmenorrhea, cramping and discomfort, and breast pain. For the nurse to counsel adequately the patient who elects to use this alternative modality, it is important to understand the action of these herbal preparations. Match the herbal medicine with the appropriate action.
a. Uterine antispasmodic
b. Uterotonic
c. Anti-inflammatory
d. Estrogen-like luteinizing hormone suppressant
e. Decreases prolactin levels

  1. Fennel, dong quai
  2. Chaste tree fruit
  3. Black cohosh
  4. Valerian, wild yam
  5. Ginger
A
  1. ANS: B
  2. ANS: E
  3. ANS: D
  4. ANS: A
  5. ANS: C

CNUR 303- MATERNITY FLASH CARDS (24 decks)

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