Exam 2 ( Ch. 72, 74) Flashcards
0
Q
True or False
The amounts of glycogen and lubricating fluid secreted by the vaginal cells are influenced by ovarian hormones. The normal vaginal bacteria interact with the secretions to produce lactic acid and maintain an acidic pH (3.5-5)
A
True
1
Q
What is a vestibule?
A
A vestibule is a longitudinal area between the labia minora, the clitoris, and the vagina that contains the Bartholin glands and the openings of the urethra, Skenes glands (paraurethral glands), and vagina. The two Bartholins glands, located deeply toward the back on both sides of the vaginal opening, secrete lubrication fluid during sexual excitement. Their ductal opening are not usually visible
2
Q
The female breasts are a pair of mammary glands that develop in response to secretions from where?
A
The hypothalamus, pituitary gland and ovaries
3
Q
What are the major reproductive organs of a male?
A
The testes and the prostate gland
4
Q
What do the testes produce?
A
The testes produce sperm and testosterone
5
Q
What is the spermatic cord?
A
Each testis is suspended in the scrotum by the spermatic cord, which provides blood, lymphatic, and nerve supply to the testis.
6
Q
What is the epididymis?
A
The epididymis is the first portion of a ductal system that transports sperm from the testes to the urethra and is a site of sperm maturation.
7
Q
What is the Vas Deferns?
A
The Vas Deferns, or ductus deferens, is a firm muscular tube that continues from the tail of each epididymis. The end of each vas deferns is a reservoir for sperm and tubular fluids. They merge with ducts from the seminal vesicle to form ejaculatory ducts at the base of the epididymis. Sperm from the vas deferns and secretions from the seminal vesicles move through the ejaculatory duct to mix with the prostatic fluids in the prostatic urethra.
8
Q
What is the prostate gland?
A
The prostate gland is a large accessory gland of the male reproductive system. It secretes a milky alkaline fluid that adds bulk to the semen, enhances sperm movement, and neutralizes acidic vaginal secretions.
9
Q
Prostate gland and the aging process
A
The prostate gland can be palpated through the rectum and should not project more than 3/8 inch (1 cm) into the rectal lumen. Prostate function depends on adequate levels of testosterone. Men older than 50 commonly have an enlarged prostate (benign prostatic hyperplasia) which can cause problems such as overflow incontinence and nocturia.
10
Q
What causes Orchitis?
A
Orchitis is painful inflammation and swelling of the testes and can lead to testicular atrophy and sterility. It can be caused by mumps.
11
Q
True of false
Failure of ovulation is associated with with a greater risk of endometrial cancer
A
True
12
Q
What can cause reproductive system dysfunction?
A
It can result from irradiation, prolonged use of corticosteroids, internal or external estrogen, testosterone and chemotherapy drugs
13
Q
What is Salpingitis?
A
Salpingitis is a uterine tube infection usually caused by chlamydial infection and can result in female infertility
14
Q
True or False
Breast cancer is more common in women who have NOT experienced childbearing
A
True
15
Q
What is the PSA test?
A
The prostate specific antigen test is used to screen for cancer and to monitor disease after treatment. PSA levels less than 4ng/ml are normal. Elevated PSA levels especially above 10 ng/ml are associated with prostate cancer
16
Q
What is a hysterosalpingogram?
A
It is an xray of the cervix, uterus, and Fallopian tubes
17
Q
Progesterone levels in men and women
A
Men: 10-50 ng/dl
Women: luteal phase 300-2500 ng/dl
18
Q
Testosterone levels in men and women
A
Men: 280-1080 ng/dl
Women: <70 ng/dl
19
Q
Total estrogens in men and women
A
Men: 4-25 mcg
Women: 4-60 mcg
20
Q
What is a colposcopy used for?
A
Colposcopy is suited for inspection of the cervical epithelium, vagina, and vulvar epithelium
21
Q
What is a Laparoscopy?
A
Its a direct examination of the pelvic cavity through an endoscope. This procedure can rule out ectopic pregnancy, pelvic masses, and aid in diagnoses of infertility
22
Q
What are the most common gynecologic manifestations?
A
Pain, vaginal discharge, and bleeding
23
Q
What is endometriosis?
A
It is an endometrial tissue implantation outside the uterine cavity. The tissue typically appears on the ovaries and posterior rectovaginal wall and less commonly on other pelvic organs.It progresses slowly and regresses during pregnancy and menopause. Rarely does it become cancerous
24
What is the most common symptom of endometriosis?
Pain
Other symptoms include dyspareunia (painful intercourse), painful defecation, low back pain and infertility
25
What is DUB?
Dysfunctional uterine bleeding is excessive and frequent bleeding (more than every 21 days)
26
What is endometrial ablation?
Removal of the built up uterine lining, it stops the blood flow to fibroids that are causing the excessive bleeding
27
What is vulvovaginitis?
It is inflammation of the lower genital tract resulting from a disturbance of the balance of hormones and flora in the vagina and vulva.
28
What is a cystocele?
A cystocele is a protrusion of the bladder through the vaginal wall, which can lead to stress urinary incontinence and UTIs
29
What is the purpose of a anterior colporrhaphy?
It tightens the pelvic floor muscles for better bladder support
A posterior colporrhaphy reduces rectal bulging
30
What are Leiomyomas?
Leiomyomas, also called fibroids or myomas, are benign, slow growing solid tumors of the uterine myometrium (muscle layer) They are classified according to their position in the layers of the uterus.
31
What are the most common types of Leiomyomas?
Intramural: contained in the uterine wall within the myometrium
Submucosal: protrude into the cavity of the uterus and can cause bleeding and disrupt pregnancy
Subserosal: protrude through the outer surface of the uterine wall and may extend to the broad ligament pressing other organs
32
What is the most common reason for hysterectomy?
Leiomyomas are the most common reason for hysterectomys
33
What is a common disorder of the vulva?
A Bartholin cyst, which results from the obstruction of the duct of the bartolin gland. The secretory function of the gland continues, and the fluid fills the obstructed duct. The main causes of the obstruction are infection, thickened mucous or truama.
34
How is a Bartholin cyst treated?
Marsupialization, which is formation of a pouch that is the new duct opening.
35
What are cervical polyps?
Cervical polyps are pedunculated (on stalks) tumors that arise from the mucosa and extend through the opening of the cervical OS. They result from hyperplasia of the endocervical epithelium in response to hormonal stimulation
36
What is the main symptom of endometrial cancer?
Postmenopausal bleeding
37
When a patient has a rectal exam to evaluate the prostate, it can be palpated through the rectum. How far into the rectal lumen does the prostate normally project?
No more than 3/8 inches
38
What is the site for a Papanicolaou (PAP) test?
The Cervix
39
The nurse is interviewing a 52 year old woman reporting irregular and decreased flow of menses for several months. Which question does the nurse ask the patient?
Are you having any discomfort during intercourse?
40
Which statements about what is included in a hysteroscopy procedure are true?
1. The patient is placed in the lithotomy position
2. Removal of an intrauterine device can be done with this procedure
3. The exam can reveal the cause of any abnormal bleeding
41
A laparoscopy can be used for which purpose?
1. Rule out ectopic pregnancy
2. Evaluate ovarian disorders
3. Diagnose infertility
4. Evaluate pelvic masses
42
A laparoscopy is used to perform which procedures?
1. Cyst aspiration
2. Ovarian biopsy
3. Tubal sterilization
4. Retrieval of lost intrauterine devices
43
A male patient reports that he has a decreased libido. The nurse assesses for which factors related to this condition?
1. Tobacco use
2. Alcohol consumption
3. Illicit drug use
44
A male patient had mumps as a child which caused orchitis. This patient is likely to have which potential complications?
1. Testicular atrophy
| 2. Sterility
45
Which statements about prostate specific antigen (PSA) testing are true?
1. It is used to screen for prostate cancer
| 2. PSA levels less than 4 ng/ml are normal
46
Failure of ovulation in women is associated with an increased risk __________?
endometrial cancer
47
Most diseases that alter a womans metabolism or nutrition can result in which condition?
Amenorrhea
48
Females who fail to ovulate are associated with a greater risk for what complication?
Endometrial cancer
49
A 30 year old female informs the nurse that she has been a diabetic for 10 years. What gynecologic change will the patient likely experience as a result?
Vaginal dryness
50
What is the normal pH of the vagina?
3.5-5
51
Men with ____ degree relatives with prostate cancer are at a greater risk for the disease than men in the general population
First degree
52
A delayed or early development of secondary sex characteristics can be related to a _______ pattern?
Familial pattern
53
Penile erection can result from _____ stimulation and ______ mechanisms
Penile erection can result from tactile and psychogenic mechanism
54
THe prostate gland secretes a milky alkaline fluid that enhances sperm_____ and neutralizes acidic ____secretions
enhances sperm movement and neutralizes acidic vaginal secretions
55
A _____ diet may increase the risk for cancer of the breast, ovary, and prostate gland
High fat diet
56
A patient taking oral contraceptives will have an increased need for which elements in her diet?
1. Folic acid
2. Vitamin B6 and B12
3. Vitamin C
57
A certain level of body fat and weight is essential to which factors regarding the female reproductive system?
1. The onset of menses
| 2. Maintenance of regular menstrual cycle
58
AN insufficient estrogen level is related to which condition?
Osteoporosis
59
A patient with chronic congestive heart failure and chronic obstructive pulmonary disease can have alterations of which factor?
Decreased sexual response
60
an adult 29 year patient has strictures and adhesions in her Fallopian tubes. This may be the result of which conditions?
1. Ruptured appendix followed by peritonitis
| 2. Pelvic inflammatory disease
61
Young women who have intercourse as teenagers and have multiple sex partners are at high risk for which disease?
Cervical cancer
62
A 37 yr old patient reports abnormal bleeding not related to her menstrual cycle. About what associated symptoms would the nurse ask the patient?
1. Pain
2. Change in bowel habits
3. Abdominal fullness
4. Urinary difficulties
63
The nurse is assigned to a patient who reports a discharge from his penis that started 3 days ago. About what associated characteristics does the nurse ask the patient regarding the discharge?
1. Pain
2. Odor
3. Amount
4. Consistency
64
In a patient with a reproductive health problem, what health and lifestyle habits would the nurse assess?
1. Diet
2. Exercise pattern
3. Sleep pattern
65
Other than determining pregnancy or infertility, a pelvic examination is indicated to assess for which conditions?
1. Rape trauma
2. Menstrual irregularities
3. Vaginal discharge or itching
66
Which imaging is used to differentiate solid tissue masses from cystic or hemorrhagic structures in the abdomen and pelvis?
Hysterosalpingography
67
What imaging is selected to assess for pelvic masses, calcified tumors or fibroids, metastatic bone changes, and demoid cysts?
X ray of kidneys, ureters, and bladder
68
Which test detects cancerous and precancerous cells of the cervix?
Pap smear
69
A 79 year old man is being seen for difficulty voiding and some blood in the urine. Which is the first screening test likely to be done?
PSA
70
When Prostate cancer is suspected in a man, what does the nurse suggest the next step may be?
You will need to have a needle biopsy of the prostate gland
71
A 23 year old female has a decreased level of follicle stimulating hormone (FSH). What may this finding indicate?
1. Anorexia nervosa
2. Infertility
3. Neoplasm
72
What test is used to asses tubal anatomy and patency, and uterine problems?
Hysterosalpingography
73
In recalling dietary intake, patients who eat a high fat diet are at increased risk for What?
Cancer of the breast and ovaries
74
A 40 year old woman has heavy vaginal bleeding. Which question is the priority in evaluating the patients chief complaint?
Are you feeling weak, dizzy, or light headed
75
A young woman reports that she has vaginal discharge causing irritation and odor. She feels embarrassed, but insists that she has not had recent sexual relations. What does the nurse assess for?
1. Current use of antibiotic medications
2. Type of clothing and undergarments
3. Presence of genital or orifice lesions
4. Chronic presence of the discharge
76
The nurse is teaching a patient about the contraindications for hysteroscopy. What does the nurse tell the patient?
During the procedure, normal or abnormal cells can be pushed through Fallopian tubes and into your pelvic cavity, therefore pregnancy is contraindicated
77
Low levels of body fat or poor nutrition causes....
Ovarian dysfunction
78
Mumps causes...
Orchitis
79
Substance abuse can cause...
Decreased spermatogenesis, libido, or impotence
80
Endocrine disorders can cause....
Vaginal dryness, increased yeast infections, impotence
81
Chronic disorders of nervous, respiratory, or cardiovascular system...
Altered sexual response
82
Associated with a greater risk for endometrial cancer...
Failure of ovulation
83
A 31 year old woman is being seen for a follow up of salpingitis. What possible complication can this patient develop?
infertility
84
The nurse explains to a patient that the american cancer society advises to begin annual pap testing for woman who meet which criteria?
no later than 21 years of age if not sexually active and within 3 years of becoming sexually active
85
The nurse is caring for a patient who had a laparoscopy. What does postoperative care for this patient include?
Administer oral analgesics for incisional pain, instruct the patient to change the small adhesive bandage as needed, teach the patient to observe the incision for signs of infection or hematoma.
86
The nurse is helping a patient schedule an appointment for a hysteroscopy. When does the nurse advise the patient that the procedure should be done?
5 days after menses have ceased.
87
In which patients is hysteroscopy contraindicated?
Patients with suspected cervical cancer, infection of the reproductive tract, pregnant, suspected of endometrial cancer
88
What serum levels are typically obtained to help diagnose male or female reproductive tract disorder?
Follicle stimulating hormone, prolactin, Luteinizing hormone.
89
A [ ] allows for the three dimensional magnification and intense illumination of epithelium that has suspected disease of cervical, vaginal, and vulvular epithelium.
Colposcopy
90
Protrusion of the bladder through the vaginal wall?
Cystocele
91
Painful sexual intercourse
Dyspareunia
92
Protrusion of the rectum through the vaginal wall?
Rectocele
93
Inflammation of the lower genital tract?
Vulvovaginitis
94
A common disorder of the vulva?
Bartholin cyst
95
Weakened pelvic floor muscles and a full feeling in the vagina?
Uterine prolapse
96
Uterine muscle?
Myometrium
97
Slow growing solid tumor of the uterus?
Fibroid
98
Most common benign neoplastic growth of the cervix?
Polyp
99
[ ]Is the most common symptom of endometriosis .
Pain
100
Teach the patient who is receiving [ ] therapy for menopausal symptoms that fibroids may continue to grow because of estrogen stimulation.
Hormone
101
In endometriosis, the monthly cyclic bleeding occurs at an [ ] site of implantation, which irritates and scars the surrounding tissue.
Ectopic
102
Without [ ] prolonged estrogen stimulation causes the endometrium to grow, causing disordered shedding of the uterine lining.
Progesterone
103
Management of symptoms for endometriosis include which medications or supplements?
1. Oral progestins
2. Injectable progestins
3. Calcium
4. Magnesium
104
A 20 year old woman is being seen for possible toxic shock syndrome. Which conditions could be the cause?
1. Surgical wound infection
2. Non surgical wound infection
3. Internal contraceptives
4. Tampon use for prolonged times
105
A patient with endometriosis is likely to have what manifestation from this disorder?
Chocolate cyst
106
A 22 year old patient reports pain associated with her menstrual periods. What questions does the nurse ask when taking the patients history?
1. How old were you when you started menstruation?
2. When did you first start having pain?
3. What is a typical menstrual period for you?
4. Have you ever been pregnant?
5. What kind of contraceptives do you use?
107
What non-pharmacologic therapy may be recommended to a patient to prevent vulvovaginitis?
Avoid wearing tight fitting clothing
108
A current treatment of non emergent dysfunctional uterine bleeding includes which medications?
Oral or patch contraceptives
109
The nurse is taking care of a 39 year old woman who is 2 days postoperative for an abdominal hysterectomy. What complications may occur after surgery?
1. Pneumonia
2. Atelectasis
3. Intestinal obstruction
4. Hemorrhage
110
What types of examinations are done to reveal the presence of uterine enlargement related to fibroids?
1. Abdominal examination
2. Vaginal examination
3. Rectal examination
4. Transvaginal ultrasound with saline infusion
111
Which woman is at greatest for dysfunctional uterine bleeding?
45 year old attorney with a stressful life
112
Which woman is at greatest risk for developing pelvic organ prolapse?
48 year old mother of four who is recently divorced
113
Following a uterine embolization using a vascular closure device, the nurse must provide what patient care?
1. Assist the patient to ambulate 2 hours after the procedure
2. Assess the patients pain level and administer analgesics as needed
3. Raise the head of the bed
114
An obese 54 year old patient describes excessive menstrual bleeding that occurs approximately every 10 days. The nurse prepares the patient for which diagnostic test that is used to evaluate for endometrial cancer?
Endometrial biopsy
115
A 25 year old patient is diagnosed with dysfunctional uterine bleeding. During the pelvic exam, the health care provider determines that the bleeding is acute and heavy. What is the nurses priority action?
Prepare to administer combination hormonal therapy
116
A patient who is very upset asks the nurse, My doctor says I have endometriosis. That sounds so horrible. What does it mean. What is the nurses best response?
A special type of tissue, called endometrial tissue, is outside your uterus
117
Dysfunctional uterine bleeding is classified into which types?
1. Anovulatory
| 2. Ovulatory
118
What signs/symptoms does the nurse assess in a patient with dysfunctional uterine bleeding?
1. Male hair patterns
2. Thyroid enlargement
3. Abdominal pain
4. Abdominal masses
119
What is the primary treatment for dysfunctional uterine bleeding in perimenopausal women?
Progestins
120
A Patient has excessive bleeding from uterine fibroids. Which therapy stops the blood flow to the fibroids?
Endometrial ablation
121
What is the major reason for the onset of menopause and resulting atrophy of the vulvar organs?
Decrease in levels of estrogen
122
A patient has undergone a total hysterectomy with vaginal repair. The nurse advises her to use which over the counter product to decrease sexual discomfort related to intercourse?
Water soluble jelly
123
Potential complications following hysteroscopic surgery can include which conditions?
1. Hemorrhage
2. Embolism
3. Perforation of uterus
124
Which is a common cause of vulvovaginitis?
Taking antibiotics
125
The nurse is advising a patient about self care for vulvovaginits, which is caused by a non pathologic condition. What info does the nurse provide?
1. Take a sitz bath for 30 min several times a day
2. Apply a prescribed topical drug, such as estrogens or lidocaine
3. Remove any irritants or allergens
4. Apply wet compress
126
A patient with a high fever, headache, flu like symptoms, and fainting is admitted with the diagnoses of toxic shock syndrome. What additional clinical manifestations does the nurse assess for.
Sunburn like rash with peeling of palms
127
The nurse is teaching a group of women about prevention of toxic shock syndrome. What preventive measures does then nurse include?
1. Avoid use of tampons
2. Use sanitary napkins at night
3. Avoid using internal contrceptives
128
A Patient is admitted with toxic shock syndrome. What organism is frequently associated with this syndrome when it occurs as a menstrually related infection.
Staphylococcus aureus
129
A patient reports the sensation of feeling as if "something is falling out" along with painful intercourse, backache, and of feeling of heaviness or pressure in the pelvis. which question does the nurse ask to assess for cystocele?
Are you having urinary frequency or urgency?
130
A patient is recovering from a pair of cystocele. What postprocedure intervention does the nurse teach the patient?
Perform perineal floor exercises
131
A patient has had a posterior colporrhaphy. What is included in the nursing care of this patient.
Administer pain medication before having a bowel movement, avoid straining during bowel movement, provide sitz baths, promote a low residue {low fiber} diet.
132
A patient reports a feeling of heaviness in her vagina.Upon examination the nurse observes that the uterus is bulging into the vagina and the cervix is protruding through the entrance to the vagina. the assessment finding would be grades as which type of uterine prolapse?
Grade 2
133
May extend the broad ligament pressing other organs
subserosal leiomyomas
134
Contained in the uterine wall within the myometrium.
Intramural Leiomyomas
135
Occasionally breaks off and attaches to other tissues.
Parasitic fibroid
136
Can cause bleeding and disrupt pregnancy
Submucosal leiomyomas
137
Attached by a stalk to the outside of the uterus
Pendunculated leiomyomas
138
A patient is diagnosed with a uterine leiomyomas. What does the nurse expect to see in the documentation for this patient as the chief presenting complaint?
Heavy vaginal bleeding
139
A patient with uterine leiomyomas reports a feeling of pelvic pressure, constipation, urinary frequency, and says " i cant button my pants anymore" What does the nurse asses for to further evaluate the patients symptoms.
Abdominal distention or enlargement.
140
A patient has had a pelvic examination and needs an additional diagnostic test for possible uterine Leiomyomas. The nurse prepares the patient for which first choice diagnostic test.
Transvaginal ultrasound
141
What is the priority nursing care most commonly seen preoperatively in a patient with leiomyomas?
Monitoring for adequate tissue perfusion.
142
What disease is strongly associated with prolonged exposure to estrogen without the protective effects of progesterone?
Endometrial cancer
143
The main symptom of endometrial cancer is [ ] bleeding.
Postmenopausal
144
[ ] women most often get endometrial cancer in the U.S.
White
145
A patient with cancer has also been diagnosed with uterine leiomyomas. Which procedure does the nurse prepare the patient for?
Hysterectomy
146
A patient who had a total abdominal hysterectomy is anxious to resume her activities because she has young children at home. What postprocedure information does the nurse provide to the patient.
Avoid sitting for prolonged periods, do not lift anything heavier than 5 to 10 pounds, when sitting do not cross legs
147
A patient who had a total hysterectomy comes to the clinic for a 6 week follow up appointment. Which patient demeanor is the strongest indicator that there is a need for psychological referral?
Disheveled and lackluster but answers correctly with repeated prompting.
148
What does discharge teaching for a woman who ad a local cervical ablation include?
Refrain from sexual intercourse for 3 weeks, showering is permitted but no baths, avoid lifting heavy objects for 3 weeks.
149
A patient reporting swelling in the perineal area is diagnosed with a bartholian cyst. Non surgical management is recommended. What does the nurse instruct the patient to do?
Apply moist heat sitz baths or hot wet packs to the vulva
150
What gold standard tests are done to determine the presence of endometrial thickening and cancer.
Transvaginal ultrasound, endometrial biopsy
151
The surgical procedure for stage 1 disease of endometrial cancer involves removal of which components.
Uterus, Fallopian tubes, ovaries
152
The nurse is caring for a patient with a radioactive implant. Which task can be delegated to unlicensed assistive personel?
Save linens until radioactive source is removed, than dispose of linens as usual.
153
A patient is receiving external radiation therapy for treatment of endometrial cancer. What task does the nurse delegate to UAP.?
Assist the patient to ambulate if she feels fatigue or tiredness
154
A patient recieving chemotherapy treatments reeports fatigue, loss of energy, and experiencing "emotional crisis everyday and my hair is falling out" What does the nurse do first to help the patient adapt to body changes?
Encourage the patient to ventilate feelings.
155
A nurse encourages a female patient to receive the HPV vaccine gardasil because it protects against which type of cancer?
Cervical cancer
156
Which statement about pelvic examinations and Pap smears is correct?
Begin screening precautions within 3 years after having sexual activity or by the age of 21.
157
Which classic symptom is indicative of invasive gynecological cancer in an older patient?
Painless vaginal bleeding.
158
The nurse is taking a history on a patient with a probable gynecological cancer. Which clinical manifestation is a sign of metastasis?
Dysuria and hematuria.
159
A patient had a loop electrosurgical excision procedure for treatment and diagnosis of cervical cancer. In the discharge instructions what does the nurse tell the patient to expect after the procedure.
Spotting
160
The nurse is teaching several patients being discharged after having total abdominal hysterectomy.
which conditions does the nurse tell each patient to report to the surgeon immediately?
Vaginal discharge that becomes thicker or foul smelling, temperature of 100.5, burning during urination
161
A patient had a total abdominal hysterectomy. which patient behavior is the best indicator that she is coping and adapting successfully?
Asking questions about wound care but reluctant to do self care
162
A patient has undergone surgery for ovarian cancer and will be receiving chemotherapy. Which drugs may be part of the patients therapy?
Cisplatin{Platinol}, Carboplatin{Paraplatin},taxanes.
163
The nurse is giving instructions to a patient who is undergoing brachytherapy for cervical cancer. What information does the nurse include?
You are not radioactive between treatments, report any blood in the urine or severe diarrhea immediately, you will be on bedrest during the treatment session.
165
A patient undergoing which procedure has the greatest need for referral to sexual counseling because of the nature of the surgery?
Vaginectomy
166
```
A client with endometriosis asks a nurse where to find a support group. What resource does the nurse suggest?
American Cancer Society (ACS)
American Endometrial Society (AES)
Endometrial United Association (EUA)
RESOLVE
```
RESOLVE
167
A client with newly diagnosed gynecologic cancer is being discharged home. Which health care team member does the nurse contact to coordinate nursing care at home for this client?
Case manager
168
Which client history places a woman at highest risk for developing endometrial (uterine) cancer?
Nulliparity, smoking, uterine polyps, hypertension
169
A nurse is teaching a local young women's group about health promotion and maintenance measures for prevention of gynecologic cancers. Which preventive factors does the nurse stress? Select all that apply.
Annual Pap test and cervical examination
Safe sex
Well-balanced diet
170
A client is scheduled for a total hysterectomy with a laparoscopic vaginal approach after a diagnosis of microinvasive cervical cancer. What psychological and/or social changes does the nurse expect this client to experience?
Sexual counseling may be needed, especially if the client has doubts about her ability to feel like a woman and engage in sexual activities.
171
A nurse is teaching a client how to adapt to physical and psychological changes after surgery for ovarian cancer. What is included in the teaching plan? Select all that apply.
Encouraging the use of support groups and counseling
Encouraging the expression of grief and fears
Offering vaginal dilators
Suggesting alternatives to vaginal intercourse
172
A nurse is teaching a group of clients with endometriosis about complementary and alternative therapies that may bring relief to them. What does the nurse suggest? Select all that apply.
Low-level heat applications
Massage
Relaxation techniques
Yoga
173
A client is being treated for endometriosis with medrodroxyprogesterone (Depo-Provera). Which client statement indicates correct understanding of this drug therapy?
"It is an injection that I will receive monthly."
174
A nurse is teaching a client how to prevent vaginal inflammation and itching. What information does the nurse include?
Do not have unprotected sex with multiple partners.
175
A nurse is discussing transvaginal repair for pelvic organ prolapse (POP) using surgical vaginal mesh with a client who plans to have the procedure. What teaching does the nurse include? Select all that apply.
Manufacturer's labeling and information
Signs and symptoms of infection
When to contact the surgeon after the procedure
176
A client who had an anterior colporrhaphy is being discharged. What does the nurse tell the client before her discharge?
"Take a hot bath or use a moist heating pad for discomfort."
177
A nurse is doing discharge teaching for a client who is recovering from a total abdominal hysterectomy (TAH). Which client statement indicates a need for clarification?
"I will need to find a new form of birth control."
178
A client has gynecologic cancer. Which client statement demonstrates correct understanding of her treatment options?
"External beam radiation therapy (EBRT) may be used after my cancer surgery."
179
A nurse is teaching care principles to a client who plans uterus-sparing surgery to remove uterine fibroids. Which client statement needs clarification?
"It is important to avoid having sexual intercourse for 3 weeks after surgery."
180
A client is being discharged after having an abdominal hysterectomy (TAH). What principle guides the nurse who is providing discharge planning and instructions for her?
No special home equipment will be necessary for the client.
181
A 52-year-old client has been diagnosed with endometrial (uterine) cancer. She says to her nurse, "I was told that my cancer is stage II. What does that mean?" How does the nurse respond?
"Your cancer has spread from your uterus to your cervix."
182
A nurse is reviewing laboratory results on a 34-year-old client who is suspected of having endometrial (uterine) cancer. Which laboratory tests does the nurse expect to see? Select all that apply.
Alpha-fetoprotein (AFP) test
CA (cancer antigen)-125 test
Human chorionic gonadotropin (hCG)
level Testing for hereditary nonpolyposis colon cancer (HNPCC)
183
A nurse is teaching a group of young boy and girl clients about getting vaccinated for HPV (human papilloma virus). Which statement by one of the girls needs to be clarified?
"The vaccine is for girls; a different one is available for boys."
184
A 32-year-old client has a laparoscopic removal of endometrial adhesions at a same-day surgery center. What does the nurse tell her to expect postprocedure?
"You may have some referred pain in your chest and shoulders because of the carbon dioxide (CO2) used."
185
Which client does the RN assess first after receiving change-of-shift report?
54-year-old with an anterior and posterior colporrhaphy who has an elevated heart rate and an oral temperature of 101.2° F
186
What action does the RN delegate to unlicensed assistive personnel (UAP) working on the medical-surgical unit?
Assisting with a sitz bath for a client with ulcerative vulvitis
187
Four women phone the Gynecology Clinic about having new-onset vaginal bleeding. Which call does the RN decide to return first?
62-year-old with no previous gynecologic problems
188
An 18-year-old female is diagnosed with possible toxic shock syndrome (TSS) and has these vital signs: T 103.2° F (39.6° C), P 124, R 36, BP 84/30. Which health care provider request does the nurse implement first?
Administer O2 at 6 L/min
189
Which gynecologic clients does a charge nurse assign to an LPN/LVN? Select all that apply
23-year-old who is nauseated after her laparotomy and needs to receive antiemetic drugs
42-year-old who had an abdominal hysterectomy whose health care provider wants to remove sutures at her bedside
190
Situation: A nurse is caring for a 42-year-old woman with an intramural leiomyoma (myomas or fibroids). She has been taking estrogen replacement therapy for menopausal symptoms. What does the nurse tell her about estrogen replacement therapy and how it relates to her fibroids?
"The fibroids may continue to grow."
191
Situation: A nurse is caring for a 42-year-old woman with an intramural leiomyoma (myomas and fibroids). She has been taking estrogen replacement therapy for menopausal symptoms. She had a total abdominal hysterectomy (TAH) 2 days ago and is to be discharged on antibiotics. What does the nurse include in her discharge teaching about antibiotics?
"It is important to take them as directed until all are gone."
192
Situation: A client who is being treated for dysfunctional uterine bleeding (DUB) reports heavy vaginal bleeding, abdominal pain, and anemia. She is started on a gonadotropin-releasing hormone (GnRH) agonist, leuprolide (Lupron). What side effects may be of concern to this client? Select all that apply.
Breast swelling or tenderness
Decreased interest in sex
Hot flashes
Skin problems or acne
193
Situation: A client who is being treated for endometriosis reports abdominal pain, dyspareunia, low back pain, and infertility. She had heard that various vitamins and minerals might relieve muscle cramping but cannot remember which ones. What vitamins and minerals that are known to help relieve muscle cramping does the nurse suggest?
Calcium and magnesium
194
What type of diet should you have after a Rectocele ?
Low fiber diet right after surgery to promote healing, but a high fiber diet after that
195
What can cause diarrhea during your period?
Prostaglandins, they relax the GI tract
