Female Repro- Brunner Chapter 51

Question 1

While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition?
A) Bacterial vaginosis
B) Human papillomavirus (HPV)
C) Candidiasis
D) Toxic shock syndrome (TSS)

Answer 1

C) Candidiasis

Question 2

A patient with genital herpes is having an acute exacerbation. What medication would the nurse expect to be ordered to suppress the symptoms and shorten the course of the infection?
A) Clotrimazole (Gyne-Lotrimin)
B) Metronidazole (Flagyl)
C) Podophyllin (Podofin)
D) Acyclovir (Zovirax)

Answer 2

D) Acyclovir (Zovirax)

Question 3

A patient with trichomoniasis comes to the walk-in clinic. In developing a care plan for this patient the nurse would
know to include what as an important aspect of treating this patient?
A) Both partners will be treated with metronidazole (Flagyl).
B) Constipation and menstrual difficulties may occur.
C) The patient should perform Kegel exercises 30 to 80 times daily.
D) Care will involve hormone therapy to control the pain.

Answer 3

A) Both partners will be treated with metronidazole (Flagyl).

Question 4

A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea who has presented at the clinic. The student should include which of the following in the care plan for this patient?
A) The patient may benefit from oral contraceptives.
B) The patient must avoid use of tampons.
C) The patient is susceptible to urinary incontinence.
D) The patient should also be treated for chlamydia.

Answer 4

D) The patient should also be treated for chlamydia.

Question 5

When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?
A) Late childbearing
B) Human papillomavirus (HPV)
C) Postmenopausal bleeding
D) Tobacco use

Answer 5

B) Human papillomavirus (HPV)

Question 6

The nurse is providing preoperative education for a patient diagnosed with endometriosis. A hysterectomy has been scheduled. What education topic should the nurse be sure to include for this patient?
A) Menstrual periods will continue to occur for several months, some of them heavy.
B) Normal activity will be permitted within 48 hours following surgery.
C) After a hysterectomy, hormone levels remain largely unaffected.
D) The bladder must be emptied prior to surgery and a catheter may be placed during surgery.

Answer 6

D) The bladder must be emptied prior to surgery and a catheter may be placed during surgery.

Question 7

A patient has returned to the post-surgical unit after vulvar surgery. What intervention should the nurse prioritize during the initial postoperative period?
A) Placing the patient in high Fowlers position
B) Administering sitz baths every 4 hours
C) Monitoring the integrity of the surgical site
D) Avoiding analgesics unless the patients pain is unbearable

Answer 7

C) Monitoring the integrity of the surgical site

Question 8

A patient comes to the free clinic complaining of a gray-white discharge that clings to her external vulva and vaginal walls. A nurse practitioner assesses the patient and diagnoses Gardnerella vaginalis. What would be the most appropriate nursing action at this time?
A) Advise the patient that this is an overgrowth of normal vaginal flora.
B) Discuss the effect of this diagnosis on the patients fertility.
C) Document the vaginal discharge as normal.
D) Administer acyclovir as ordered.

Answer 8

A) Advise the patient that this is an overgrowth of normal vaginal flora.

Question 9

A female patient with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is
most appropriate for the nurse to tell this patient?

A) This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.
B) The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days.
C) The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
D) The human papillomavirus (HPV), which causes condylomata acuminata, cannot be transmitted during oral sex.

Answer 9

A) This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually

Question 10

The nurse is teaching a patient preventative measures regarding vaginal infections. The nurse should include which of the following as an important risk factor?
A) High estrogen levels
B) Late menarche
C) Nonpregnant state
D) Frequent douching

Answer 10

D) Frequent douching

Question 11

A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following?
A) Babies delivered vaginally may become infected with the virus.
B) Recommended treatment is excision of the herpes lesions.
C) Pain generally does not occur with a herpes outbreak during pregnancy.
D) Pregnancy may exacerbate the mothers symptoms, but poses no risk to the infant.

Answer 11

A) Babies delivered vaginally may become infected with the virus.

Question 12

A patient with ovarian cancer is admitted to the hospital for surgery and the nurse is completing the patients health history. What clinical manifestation would the nurse expect to assess?
A) Fish-like vaginal odor
B) Increased abdominal girth
C) Fever and chills
D) Lower abdominal pelvic pain

Answer 12

B) Increased abdominal girth

Question 13

A 30-year-old patient has come to the clinic for her yearly examination. The patient asks the nurse about ovarian cancer. What should the nurse state when describing risk factors for ovarian cancer?
A) Use of oral contraceptives increases the risk of ovarian cancer.
B) Most cases of ovarian cancer are attributed to tobacco use.
C) Most cases of ovarian cancer are considered to be random, with no obvious causation.
D) The majority of women who get ovarian cancer have a family history of the disease.

Answer 13

C) Most cases of ovarian cancer are considered to be random, with no obvious causation.

Question 14

A student nurse is caring for a patient who has undergone a wide excision of the vulva. The student should know that what action is contraindicated in the immediate postoperative period?
A) Placing patient in low Fowlers position
B) Application of compression stockings
C) Ambulation to a chair
D) Provision of a low-residue diet

Answer 14

C) Ambulation to a chair

Question 15

A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and the presence of a frothy, yellow-green discharge. The nurse recognizes that the clinical
manifestations described are typical of what vaginal infection? A) Trichomonas vaginalis
B) Candidiasis
C) Gardnerella
D) Gonorrhea

Answer 15

A) Trichomonas vaginalis

Question 16

The nurse notes that a patient has a history of fibroids and is aware that this term refers to a benign tumor of the uterus. What is a more appropriate term for a fibroid?
A) Bartholins cyst
B) Dermoid cyst
C) Hydatidiform mole
D) Leiomyoma

Answer 16

D) Leiomyoma

Question 17

A nurse practitioner is examining a patient who presented at the free clinic with vulvar pruritus. For which assessment finding would the practitioner look that may indicate the patient has an infection caused by Candida albicans?
A) Cottage cheese-like discharge
B) Yellow-green discharge
C) Gray-white discharge
D) Watery discharge with a fishy odor

Answer 17

A) Cottage cheese-like discharge

Question 18

The nurse is planning health education for a patient who has experienced a vaginal infection. What guidelines should the nurse include in this program regarding prevention?
A) Wear tight-fitting synthetic underwear.
B) Use bubble bath to eradicate perineal bacteria.
C) Avoid feminine hygiene products, such as sprays.
D) Restrict daily bathing.

Question 19

The nurse is planning health education for a patient who has experienced a vaginal infection. What guidelines should the nurse include in this program regarding prevention?
A) Wear tight-fitting synthetic underwear.
B) Use bubble bath to eradicate perineal bacteria.
C) Avoid feminine hygiene products, such as sprays.
D) Restrict daily bathing.

Answer 19

C) Avoid feminine hygiene products, such as sprays.

Question 20

A patient has herpes simplex 2 viral infection (HSV2). The nurse recognizes that which of the following should be included in teaching the patient?
A) The virus causes cold sores of the lips.
B) The virus may be cured with antibiotics.
C) The virus, when active, may not be contracted during intercourse.
D) Treatment is aimed at relieving symptoms.

Answer 20

D) Treatment is aimed at relieving symptoms.

Question 21

You are caring for a patient who has been diagnosed with genital herpes. When preparing a teaching plan for this
patient, what general guidelines should be taught?
A) Thorough handwashing is essential.
B) Sun bathing assists in eradicating the virus.
C) Lesions should be massaged with ointment.
D) Self-infection cannot occur from touching lesions during a breakout.

Answer 21

A) Thorough handwashing is essential.

Question 22

A patient comes to the clinic complaining of a tender, inflamed vulva. Testing does not reveal the presence of any known causative microorganism. What aspect of this patients current health status may account for the patients symptoms of vulvitis?
A) The patient is morbidly obese.
B) The patient has type 1 diabetes.
C) The patient has chronic kidney disease.
D) The patient has numerous allergies.

Answer 22

B) The patient has type 1 diabetes.

Question 23

A 14-year-old is brought to the clinic by her mother. The mother explains to the nurse that her daughter has just started using tampons, but is not yet sexually active. The mother states I am very concerned because my daughter is having a lot of stabbing pain and burning. What might the nurse suspect is the problem with the 14-year-old?
A) Vulvitis
B) Vulvodynia
C) V aginitis
D) Bartholins cyst

Answer 23

B) Vulvodynia

Question 24

A patient has been diagnosed with polycystic ovary syndrome (PCOS). The nurse should encourage what health
promotion activity to address the patients hormone imbalance and infertility?

A) Kegel exercises
B) Increased fluid intake
C) Weight loss
D) Topical antibiotics as ordered

Answer 24

C) Weight loss

Question 25

A patient has been diagnosed with endometriosis. When planning this patients care, the nurse should prioritize what nursing diagnosis?
A) Anxiety related to risk of transmission
B) Acute pain related to misplaced endometrial tissue
C) Ineffective tissue perfusion related to hemorrhage
D) Excess fluid volume related to abdominal distention

Answer 25

B) Acute pain related to misplaced endometrial tissue

Question 26

When reviewing the electronic health record of a female patient, the nurse reads that the patient has a history of adenomyosis. The nurse should be aware that this patient experiences symptoms resulting from what pathophysiologic process?
A) Loss of muscle tone in the vaginal wall
B) Excessive synthesis and release of unopposed estrogen
C) Invasion of the uterine wall by endometrial tissue
D) Proliferation of tumors in the uterine wall

Answer 26

C) Invasion of the uterine wall by endometrial tissue

Question 27

Following a recent history of dyspareunia and lower abdominal pain, a patient has received a diagnosis of pelvic inflammatory disease (PID). When providing health education related to self-care, the nurse should address which of the following topics? Select all that apply.

A) Use of condoms to prevent infecting others
B) Appropriate use of antibiotics
C) Taking measures to prevent pregnancy
D) The need for a Pap smear every 3 months
E) The importance of weight loss in preventing symptoms

Answer 27

A) Use of condoms to prevent infecting others
B) Appropriate use of antibiotics

Question 28

A middle-aged female patient has been offered testing for HIV/AIDS upon admission to the hospital for an unrelated health problem. The nurse observes that the patient is visibly surprised and embarrassed by this offer. How should the nurse best respond?

A) Most women with HIV dont know they have the disease. If you have it, its important we catch it early.
B) This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history.
C) The rationale for this testing is so that you can begin treatment as soon as testing comes back, if its positive.
D) Youre being offered this testing because you are actually in the prime demographic for HIV infection.

Answer 28

B) This testing is offered to every adolescent and adult regardless of their lifestyle, appearance or history.

Question 29

A patient with a genital herpes exacerbation has a nursing diagnosis of acute pain related to the genital lesions. What nursing intervention best addresses this diagnosis?
A) Cover the lesions with a topical antibiotic.
B) Keep the lesions clean and dry.
C) Apply a topical NSAID to the lesions.
D) Remain on bed rest until the lesions resolve.

Answer 29

B) Keep the lesions clean and dry.

Question 30

The nurse is caring for a patient who has just been told that her ovarian cancer is terminal and that no curative options remain. What would be the priority nursing care for this patient at this time?
A) Provide emotional support to the patient and her family.
B) Implement distraction and relaxation techniques.
C) Offer to inform the patients family of this diagnosis.
D) Teach the patient about the importance of maintaining a positive attitude.

Answer 30

A) Provide emotional support to the patient and her family.

Question 31

A public health nurse is participating in a campaign aimed at preventing cervical cancer. What strategies should the nurse include is this campaign? Select all that apply.
A) Promotion of HPV immunization
B) Encouraging young women to delay first intercourse
C) Smoking cessation
D) Vitamin D and calcium supplementation
E) Using safer sex practices

Answer 31

A) Promotion of HPV immunization
B) Encouraging young women to delay first intercourse
C) Smoking cessation
E) Using safer sex practices

Question 32

A patient is being discharged home after a hysterectomy. When providing discharge education for this patient, the nurse has cautioned the patient against sitting for long periods. This advice addresses the patients risk of what surgical complication?

A) Pudendal nerve damage
B) Fatigue
C) Venous thromboembolism
D) Hemorrhage

Answer 32

C) Venous thromboembolism

Question 33

A 27-year-old female patient is diagnosed with invasive cervical cancer and is told she needs to have a hysterectomy. One of the nursing diagnoses for this patient is disturbed body image related to perception of femininity. What intervention would be most appropriate for this patient?

A) Reassure the patient that she will still be able to have children.
B) Reassure the patient that she does not have to have sex to be feminine.
C) Reassure the patient that you know how she is feeling and that you feel her anxiety and pain.
D) Reassure the patient that she will still be able to have intercourse with sexual satisfaction and orgasm.

Answer 33

D) Reassure the patient that she will still be able to have intercourse with sexual satisfaction and orgasm.

Question 34

A patient is post-operative day 1 following a vaginal hysterectomy. The nurse notes an increase in the patients abdominal girth and the patient complains of bloating. What is the nurses most appropriate action?

A) Provide the patient with an unsweetened, carbonated beverage.
B) Apply warm compresses to the patients lower abdomen.
C) Provide an ice pack to apply to the perineum and suprapubic region.
D) Assist the patient into a prone position.

Answer 34

B) Apply warm compresses to the patients lower abdomen.

Question 35

A 31-year-old patient has returned to the post-surgical unit following a hysterectomy. The patients care plan addresses the risk of hemorrhage. How should the nurse best monitor the patients postoperative blood loss?

A) Have the patient void and have bowel movements using a commode rather than toilet.
B) Count and inspect each perineal pad that the patient uses.
C) Swab the patients perineum for the presence of blood at least once per shift.
D) Leave the patients perineum open to air to facilitate inspection.

Answer 35

B) Count and inspect each perineal pad that the patient uses.

Question 36

A patient diagnosed with cervical cancer will soon begin a round of radiation therapy. When planning the patients subsequent care, the nurse should prioritize actions with what goal?
A) Preventing hemorrhage
B) Ensuring the patient knows the treatment is palliative, not curative
C) Protecting the safety of the patient, family, and staff
D) Ensuring that the patient adheres to dietary restrictions during treatment

Answer 36

C) Protecting the safety of the patient, family, and staff

Question 37

The nurse is caring for a 63-year-old patient with ovarian cancer. The patient is to receive chemotherapy consisting of Taxol and Paraplatin. For what adverse effect of this treatment should the nurse monitor the patient?
A) Leukopenia
B) Metabolic acidosis
C) Hyperphosphatemia
D) Respiratory alkalosis

Answer 37

A) Leukopenia

Question 38

The nurse is caring for a patient with a diagnosis of vulvar cancer who has returned from the PACU after undergoing a wide excision of the vulva. How should this patients analgesic regimen be best managed?

A) Analgesia should be withheld unless the patients pain becomes unbearable.
B) Scheduled analgesia should be administered around-the-clock to prevent pain.
C) All analgesics should be given on a PRN, rather than scheduled, basis.
D) Opioid analgesics should be avoided and NSAIDs exclusively provided.

Answer 38

B) Scheduled analgesia should be administered around-the-clock to prevent pain.

Question 39

A 45-year-old woman has just undergone a radical hysterectomy for invasive cervical cancer. Prior to the surgery the physician explained to the patient that after the surgery a source of radiation would be placed near the tumor site to aid in reducing recurrence. What is the placement of the source of radiation called?
A) Internal beam radiation
B) Trachelectomy
C) Brachytherapy
D) External radiation

Answer 39

C) Brachytherapy

Question 40

A 25-year-old patient diagnosed with invasive cervical cancer expresses a desire to have children. What procedure might the physician offer as treatment?
A) Radical hysterectomy
B) Radical culposcopy
C) Radical trabeculectomy
D) Radical trachelectomy

Answer 40

D) Radical trachelectomy

Question 41

A nurse providing prenatal care to a pregnant woman is addressing measures to reduce her postpartum risk of cystocele, rectocele, and uterine prolapse. What action should the nurse recommend?

A) Maintenance of good perineal hygiene
B) Prevention of constipation
C) Increased fluid intake for 2 weeks postpartum
D) Performance of pelvic muscle exercises

Answer 41

D) Performance of pelvic muscle exercises