Gynecologic Health:Menstrual Cycle & Common Diseases lecture 14

Question 1

External Female Reproductive Organs:Anatomy

Answer 1

Sure, here’s the information formatted as bullet points with corrected spelling, grammar, and accurate information:

• Mons Pubis: Fatty tissue over the symphysis pubis (pubic bone of the pelvis).
• Labia: Majora (outer) & Minora (inner).
• Vestibule: The area inside the inner labia.
• Clitoris.
• Perineum: The area between the vagina and anus.
• Vulva: A collective term for the labia, the head of the clitoris, urethral and vaginal openings; EXTERNAL, but the vagina is actually inside.

Question 2

• Cervix: Has the internal os and the external os, which become the same during labor.
• Ovary:
  • Size: Approximately 3 cm long, 2 cm wide, and 1 cm thick.
  • Function: Ovulation and production of estrogen, progesterone, and androgen.

Answer 2

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Question 3

Internal Female Reproductive Organs

Answer 3

• Vagina: A rugated (containing folds like scrotum) muscular organ that stretches and increases surface area to accommodate delivery.
• Sulcus Tear: Tears that occur in the spaces between the rugae in the vagina, often happening after birth, and can sometimes cause bleeding. They are challenging to see.
• Uterus: A hollow muscular organ.
• Cervix: Often referred to as the “neck” of the uterus, it effaces (thins out) and dilates (opens up) to allow the fetus to pass into the vagina during labor.
• Fundus: The superior muscular portion of the uterus.
• Corpus: The body of the uterus.
• Uterine Layers: Consist of the endometrium (inside lining), myometrium (muscular layer), and perimetrium (outer layer).
• Fallopian Tubes: The location of fertilization and the tube that transports ova (eggs) to the uterus. It has a narrow lumen that can be easily scarred.
• Ovary: Each ovary contains around 400,000 immature oocytes (eggs) from birth . It can go up to 1 million eggs between the two ovaries, but typically, only one matures each month. If more than one matures, it can lead to twins or triplets. Ovaries do not take turns ovulating; they compete to mature first.
• Ovaries: Produce estrogen, progesterone, and androgens.

Question 4

Puberty

Answer 4

EXAM: Puberty is a broad term that denotes the entire transitional stage between childhood and sexual maturity.

Question 5

Female Puberty

Answer 5

• Puberty Onset: Typically occurs between 8-13 years old, with a marked increase in changes by ages 8-11.
• Trigger: Puberty is triggered by the production of GnRH (gonadotropin-releasing hormone) in the hypothalamus.
• Three Phases of Puberty:
  
  1. Thelarche: Development of breast buds. Tetas
  2. Adrenarche: Growth of axillary and pubic hair. Adrenal glands/top kidneys
  3. Menarche: The first occurrence of menstruation. The average age for menarche in the U.S. is 12 years old. This marks the last event in the pubertal process.
• Pubertal Initiation: Initiated by the hypothalamus, which sends signals to the anterior pituitary gland and the ovaries (the female gonad).
• Estrogen: Responsible for the development of female secondary sexual characteristics during puberty.

Question 6

Female Reproductive Cycle check slide

Answer 6

Ovarian Cycle is not always 28 days

Endometrial aka Uterine Cycle

Regulating Hormonal Cycle

Cyclic Breast Changes that happen simultaniously

Question 7

Female Reproductive Cycle Hormones

Answer 7

• GnRH (Gonadotropin-Releasing Hormone): Released as part of a feedback system that can vary in response to other conditions and signals in the body. It is released by the hypothalamus and targets the anterior pituitary gland to stimulate the release of FSH (Follicle-Stimulating Hormone) and LH (Luteinizing Hormone). Indirectly, GnRH stimulates the production of progesterone and estrogen.
• FSH (Follicle-Stimulating Hormone): Produced by the anterior pituitary gland, FSH is responsible for promoting egg maturation in the ovary.
• Follicle: Refers to an immature egg in the ovary.
• Ovulation Day: Typically occurs around day 14 in the menstrual cycle, when the mature egg is released from the ovarian follicle.
• LH (Luteinizing Hormone): At midcycle, LH is responsible for triggering the release of the egg from the ovarian follicle into the fallopian tube, a process known as ovulation.
• Estrogen (Estradiol): Produced by the ovaries, estrogen is responsible for maintaining the uterine lining.
• Progesterone: Progesterone is responsible for maintaining the uterine lining. It typically has low levels in the follicular phase (the first part of the menstrual cycle) and rises in the luteal phase (the second part of the menstrual cycle). It is produced in the ovary, specifically in the corpus luteum (meaning “yellow body” or “yellow shell”), which forms after the egg is released, and also by the adrenal glands.

Question 8

Hypothalamic-Pituitary-Ovarian Axis

Answer 8

Here’s the information formatted as bullet points with corrected spelling, grammar, and accurate information:

• Hypothalamus: Releases GnRH (Gonadotropin-Releasing Hormone), which stimulates the…
• Anterior Pituitary: First releases FSH (Follicle-Stimulating Hormone), which stimulates the maturation of Graafian primordial follicles.
• Anterior Pituitary: Then releases LH (Luteinizing Hormone), which triggers the release of the ovum (egg) from one of the follicles.
• Empty Follicle: The follicle from which the egg is released then becomes the corpus luteum.

Question 9

Ovarian Cycle:
3 Phases

Answer 9

• Follicular Phase (Phase 1): Occurs from Day 1 to Day 14 of the menstrual cycle. During this phase, the follicle/egg matures in response to FSH (Follicle-Stimulating Hormone) released from the pituitary gland. If a patient has a long menstrual cycle, this phase is usually the longest.
• Ovulatory Phase (Phase 2): Ovulation typically occurs around Day 14 of the menstrual cycle, lasting for about 24-48 hours (though it can vary by individual).
• Luteal Phase (Phase 3): Post-ovulatory, occurring from Day 14 to Day 28 of the menstrual cycle.

Question 10

Endometrial aka Uterine Cycle happens simultaneously to the the Ovarian Cycle.
4 Phases

Answer 10

• Menstrual Phase 1:
  
  • Duration: 1-5 days.
  • During this phase, endometrial cells shed.
• Proliferative Phase 2 :
  
  • Endometrial growth increases by 6-8 times.
  • Glands within the endometrium enlarge due to estrogen.
  • Cervical mucus becomes thin, watery, alkaline, and elastic.
• Secretory Phase 3:
  
  • Begins with ovulation.
  • Endometrial growth continues, driven by estrogen.
  • An increase in progesterone supports endometrial and gland growth.
  • Increased vascularity is observed.
  • If pregnancy occurs during this phase, the process stops and supports the pregnancy.
• Ischemic Phase (Phase 4, if no fertilization):
  
  • Occurs if fertilization does not take place.
  • The corpus luteum degenerates and becomes corpus albicans (white body).
  • There is a decrease in estrogen and progesterone.
  • Ischemia (tissue death) occurs under the epithelial lining, leading to the rupture of small blood vessels and constriction of arteries.
  • This phase marks the return to the menstrual phase as the endometrium is shed from the body.
• hCG (Human Chorionic Gonadotropin):
  
  • In case of pregnancy of the woman and at about 8-10 weeks, the corpus luteum ceases to be responsible for releasing the hormones that maintain the pregnancy.
    
    • Human chorionic gonadotropin takes over the functions of the corpus luteum. (hCG) is produced by the chorion (placenta) and takes over the role of maintaining the pregnancy.

Question 11

• The hypothalamus releases Gonadotropin-Releasing Hormone (GnRH).
• The pituitary secretes FSH and LH.
• The FSH and LH stimulate follicle growth.
• The follicles start to make estradiol.
  Several follicles begin to grow with each cycle, but usually only one matures.
• Around day 12 estradiol levels rise steeply.
  Rising estradiol stimulates a LH surge by positive feedback.
• The LH surge triggers ovulation: the follicle ruptures, releasing the secondary oocyte.
• The follicle left in the ovary forms the corpus luteum, which secretes progesterone and estradiol.
• Rising progesterone and estradiol levels stimulate thickening of the uterine wall, or endometrium.

If pregnancy occurs, the corpus luteum continues secreting progesterone and estradiol to maintain the endometrium

Otherwise, it disintegrates, and hormone levels drop, resulting in the loss of endometrial tissue as menstrual flow.

Question 12

Prostaglandins and the Menstrual Cycle

Answer 12

• Note: If someone experiences fertility issues or recurrent miscarriages, they may be prescribed progesterone.
• Prostaglandins are Lipids with Hormone-like Action:
  
  • These lipids can raise body temperature and may cause fever.
  • They are not classified as hormones because they are not released by glandular tissue and are present throughout the body.
• MISO-PROSTOL:
  
  • It is prostaglandin-based and is used to:
    
    • Ripen the cervix.
    • May cause hemorrhaging.
    • Can be used to induce abortion. (Prostaglandins act on the smooth muscle cells of the uterine wall, causing them to contract.)
  • Side effects may include diarrhea when too many prostaglandins are administered.
• Hemabate:
  
  • Also prostaglandin-based.
  • May cause even worse diarrhea, and in such cases, Imodium may be given to alleviate the symptoms.
  • Prostaglandins have various roles in body functions, including immune and clotting actions.
  • They are released by tissues throughout the body and respond to hormonal changes in the menstrual cycle.
  • Prostaglandins also play a role in causing muscle contractions during the menstrual cycle.
  • They can be used to alleviate cramping post-birth or during the menstrual period, and they may be administered to induce labor if necessary.

Question 13

Cancers of the Reproductive Tract
Women 50-60 years old

Answer 13

Ovarian Cancer

Uterine/Endometrial Cancer

Cervical Cancer

Vaginal Cancer

Vulvar Cancer

Question 14

Incidence/Mortality of GYN Cancers:

Breast cancer is the most prevalent (numero 1) in women cancers but not the deadliest.

Answer 14

• Incidence/Mortality of GYN Cancers:
  • 1. Breast cancer is the most prevalent cancer in women, but it is not the deadliest.
  1. 1 Breast Cancer: Most prevalent among women.
  2. 2 Endometrial Cancer:
  3. 3 Ovarian Cancer: Despite being less common than breast and endometrial cancer, ovarian cancer has a higher mortality rate. It is often referred to as the “silent cancer” because it tends to remain asymptomatic until it reaches an advanced stage. Screening for ovarian cancer is limited, and it is often discovered accidentally or at a late stage.
  4. 4 Cervical Cancer

Question 15

• Ovarian Cancer:
  
  • Often remains undetected until it has spread within the pelvis and abdomen.
  • At this late stage, ovarian cancer becomes difficult to treat and is often fatal.
  • Ovarian cancer accounts for approximately 3% of all cancers among women, but it causes more deaths than any other cancer of the female reproductive system.
• BRCA (BReast CAncer) gene mutations: These mutations are related to the risk of developing prostate, ovarian, and breast cancer.
• Prophylactic Oophorectomy: This surgical procedure involves the removal of the ovaries to prevent cancer from developing, particularly in the context of a high genetic risk such as BRCA mutations.

“Oophoro-“ is derived from the Greek word “oophoros,” which means “ovary.” In Greek, “oo” (ᾠόν) means “egg,” and “phoros” (φορός) means “bearing” or “carrying.

Answer 15

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Question 16

Ovarian Cancer BRCA

Answer 16

• Ovarian Cancer and BRCA (Breast Cancer) Genes:
  
  • Genetic Predisposition: A small percentage of ovarian cancers are caused by inherited gene mutations, such as BRCA mutations. These genetic mutations can increase the risk of developing ovarian cancer.

Yes, it is true that a small percentage of ovarian cancers are caused by inherited gene mutations, including BRCA mutations. Here’s some more information about the connection between ovarian cancer and BRCA genes:

1. BRCA Gene Mutations: BRCA1 and BRCA2 are genes that are associated with an increased risk of breast and ovarian cancers when they are mutated. Individuals who inherit a mutated BRCA1 or BRCA2 gene from one of their parents have an increased risk of developing these cancers.
2. Increased Ovarian Cancer Risk: Women who carry a mutation in the BRCA1 or BRCA2 gene have a higher risk of developing ovarian cancer compared to those without these mutations. The exact level of risk varies depending on the specific mutation and other factors, but it’s generally higher than the risk in the general population.
3. Hereditary Ovarian Cancer Syndrome: The presence of BRCA mutations is associated with a condition known as hereditary ovarian cancer syndrome. This syndrome includes an increased risk of both breast and ovarian cancers.
4. Genetic Testing: Genetic testing can identify the presence of BRCA mutations in individuals and their families. Women with a family history of breast or ovarian cancer or who belong to certain ethnic groups with a higher prevalence of these mutations may consider genetic testing to assess their risk.

Question 17

*Ovarian Cancer Symptoms:“Silent Stalker”

Answer 17

• Ovarian Cancer Symptoms:
  
  • Ovarian cancer is often called the “Silent Stalker” because there is no routine screening for it, and it is not typically suspected until it has advanced.
  • Symptoms may include:
    
    • General abdominal discomfort or pain
    • Gastrointestinal disturbances like nausea, diarrhea, or constipation
    • Frequent urination
    • Feeling of fullness
    • Unexplained weight loss or gain
    • Vaginal bleeding outside of period
    • Back pain and fatigue
    • Painful intercourse

Question 18

Slide 26

Answer 18

Only a few people are familiar with ovarian cancer and its symptoms

Question 19

Ovarian Cancer: Risk Factors

Answer 19

• Ovarian Cancer Risk Factors:
  
  • Advancing age
  • Early onset of menstruation (menarche) and late menopause (xk you have more periods and hormonal fluctuations in this life)
  • Giving birth to a first child after the age of 30
  • Personal or family history of breast or colon cancer
  • History of using fertility drugs
  • Significant exposure to hormones either indrognoues or supplements anna
  • High-fat diet
• Androgens: These are male hormones.
• Danazol: A drug that increases androgen levels. Some small studies have linked it to an increased risk of ovarian cancer.
• Clomiphene Citrate (Clomid®): Some research suggests that using the fertility drug clomiphene citrate for longer than one year may increase the risk of developing ovarian tumors.

Question 20

Nursing Care: Ovarian Cancer

Answer 20

• Help
  
  • Help identify women at the highest risk for ovarian cancer.
• Encourage
  
  • Encourage regular GYN health assessments.
• Provide
  
  • Provide emotional and psychosocial support to individuals facing ovarian cancer.
• Educate and Prepare
  
  • Educate and prepare individuals for surgery as part of their treatment plan.
• Post
  
  • Post-surgery follow-up care to ensure the best possible outcomes for patients.

Question 21

Endometrial cancer happens more than cervical cancer but has a better prognosis : women 50-65 yo

Answer 21

• Endometrial Cancer:
  
  • Occurs more frequently than cervical cancer.
  • Has a better prognosis, particularly when diagnosed in women between 50-65 years old.
  • It is the most common malignancy of the reproductive system.
  • Endometrial cancer is typically slow-growing and has a favorable prognosis when detected at a localized stage.
  • Common symptoms include abnormal uterine bleeding, which occurs outside of a regular menstrual cycle. Most significative

Question 22

Endometrial cancer

Answer 22

• Risk Factors for Endometrial Cancer:
  
  • Obesity
  • Nulliparity (having never given birth)
  • Late onset of menopause
  • Infertility
  • Diabetes mellitus (DM)
  • Hypertension (HTN)
  • Family history of endometrial or related cancers
  • Hormone imbalance, particularly unopposed estrogen in postmenopausal women

Question 23

Endometrial Cancer:
Signs and Symptoms

Answer 23

• Early Signs of Endometrial Cancer:
  
  • Abnormal uterine bleeding.
• Late Signs of Endometrial Cancer:
  
  • Vaginal discharge
  • Low back pain
  • Pelvic pain

Question 24

Endometrial Cancer:
Diagnosis & Treatment

Answer 24

• Endometrial Biopsy:
  
  • Involves sampling the lining of the uterus.
  • Often performed with the patient in stirrups.
• Total Abdominal Hysterectomy (TAH):
  
  • Surgical removal of the uterus and cervix.
• Bilateral Salpingo-Oophorectomy (BSO):
  
  • Surgical removal of the fallopian tubes and ovaries.
• Radiation:
  
  • A treatment option for endometrial cancer.
• Radical Hysterectomy:
  
  • Surgical removal of the uterus, cervix, ligaments, part of the vagina, and surrounding tissue.
• Chemotherapy:
  
  • A treatment option that may be used depending on the staging of the cancer.
• Treatment Decision:
  
  • The choice of treatment depends on the staging of the cancer, and the patient plays a significant role in deciding on the treatment plan.

Question 25

Cervical cancer

Answer 25

• Cervical Cancer:
  
  • A type of cancer that occurs in the cells of the cervix.
  • Most cases of cervical cancer are caused by various strains of the human papillomavirus (HPV).
• Pap Smear:
  
  • A screening test used to detect abnormal changes in the cells of the cervix.
  • It is an important tool for the early detection and prevention of cervical cancer.

Question 26

Human Papilloma Virus (HPV)

Answer 26

STI, Condylomata acuminata (genital warts)

• Most Common STI:
  
  • Condylomata acuminata (genital warts) is one of the most common sexually transmitted infections (STIs).
• Variety of Types:
  
  • There are more than 100 types of human papillomavirus (HPV).
  • Five of these types cause warts (papilloma), and eight of them may potentially lead to cancer.
  • Importantly, the types that cause cancer do not typically cause warts.
• Cervical Cancer and HPV:
  
  • Types 16 and 18 of HPV are responsible for nearly all cases of cervical cancer.
• Spontaneous Resolution:
  
  • In many cases, HPV infections can resolve spontaneously as the immune system can clear or shed the virus.

Question 27

• HPV Vaccination Recommendations:
  
  • The CDC recommends routine HPV vaccination for adolescents at the age of 11 or 12 years old.
  • Vaccination can begin as early as 9 years old.
  • The vaccine is called Gardasil and requires three doses.
• Recommended Age Groups for HPV Vaccination:
  
  • Males ages 13 through 21 years.
  • Females ages 13 through 26 years.
  • Gay, bisexual, and other men who have sex with men.
  • Transgender individuals.
  • Persons with certain immunocompromising conditions ages 22 through 26 years.
• Protection Against HPV:
  
  • Ideally, people should be vaccinated as adolescents before they are exposed to HPV.
  • However, individuals who have already been infected with one or more HPV types can still get protection from other HPV types covered by the vaccine. Condom can’t help with HPV
• Risk Factors for Cervical Cancer:
  
  • HPV types 16 and 18, responsible for 70-80% of cervical cancers.
  • Being sexually active during adolescence.
  • Having multiple sexual partners.
  • History of sexually transmitted infections (STIs).
  • Using birth control for more than 5 years.
  • Having HIV.
  • Smoking, which may slow helpful immune responses and potentially speed up the process by which HPV-16 causes cancer.
• Smoking and Cervical Cancer:
  
  • Smoking is associated with an increased risk of cervical cancer.
  • It is suggested to avoid smoking for overall health and reducing cancer risk, including cervical cancer.

Question 28

• Signs and Symptoms of Cervical Cancer:
  
  • Cervical cancer may be asymptomatic in its early stages.
  • Common symptoms may include:
    
    • Abnormal vaginal discharge.
    • Bleeding, especially after sexual intercourse.
  • Regular Pap smear screenings are important as they can detect up to 90% of early cervical changes, even before symptoms become apparent.

Question 29

Yearly pap smears.

There is also a blood test for the HPV.

Question 30

Nursing Care:Preparation for Pap Smear

Answer 30

• Nursing Care: Preparation for Pap Smear
  
  • A Pap smear should be scheduled between menstrual periods.
  • Within 48 hours prior to the Pap smear, the RN advises the woman not to:
    
    • Have sexual intercourse.
    • Use tampons.
    • Use intravaginal medication.
    • Douche.

Question 31

cervical cancer screening recommendations EXAM

Answer 31

cervical cancer screening recommendations

• Recommended Screening Methods:
  
  • Age 21-24: No screening because the disconfort of the procedure outweighs the risk. Plus this new generation has been getting the vaccine .
  • Age 25-29: HPV test every 5 years (preferred) or Pap test every 3 years (acceptable).
  • Age 30-65: HPV test every 5 years (preferred) or HPV/Pap co-test every 5 years (acceptable) or Pap test every 3 years (acceptable).
  • Age 65 & older: No screening if a series of prior tests were normal.
  • After hysterectomy: No screening.
  • After HPV vaccination: No change in age-specific recommendations.

Question 32

The Nurse is teaching a sex education class to teenage girls. The nurse informs them that which age group should receive a vaccination to prevent HPV infection?
13-29
12-26
9-26
7-20

Answer 32

9-26

Question 33

The nurse taught a class on HPV and cervical cancer. Which statement by the student indicates a need for further teaching?
Most HPV infections resolve on their own within 1 to 2 years
I can get the HPV vaccination to prevent the most common types of HPV that could cause cervical cancer.
Genital warts cause cervical cancer

A persistent infection of HPV type 16 or 18 can lead to cervical cancer

Answer 33

Genital warts cause cervical cancer:
NOT TRUE

Question 34

The nurse teaches the patient that she can enhance the accuracy of her Pap test screening by:

• Avoiding intercourse for 48 hours before the test
• Douching 24 hours before the test
• Scheduling the appointment to occur during menstruation
• Using lubricants with intercourse 24 hours before the test

Answer 34

Avoiding intercourse for 48 hours before the test

Question 35

PID is an acute infection of the reproductive organs, generally caused by STIs.

Answer 35

• PID (Pelvic Inflammatory Disease):
  
  • PID is an acute infection of the reproductive organs, typically caused by sexually transmitted infections (STIs).
  • It primarily affects the reproductive organs, especially the fallopian tubes.
• Common Causes of PID:
  
  • The most common causes of PID are Chlamydia and Gonorrhea infections.
  • Chlamydia is the most common STI in the US responsible for causing PID.
• Mechanism of Infection:
  
  • The infection typically ascends or moves up the reproductive tract, leading to inflammation and scarring of the reproductive tissues.
• Consequences of PID:
  
  • PID can lead to infertility due to scarring and damage to the reproductive organs and structures.

Question 36

Pelvic Inflammatory Disease

Answer 36

• Pelvic Inflammatory Disease (PID):
  
  • Affects approximately 1 million women annually.
• Incidence of PID:
  
  • One incidence of PID can lead to approximately 20% of women becoming infertile.
• Increased Incidence of Ectopic Pregnancy:
  
  • PID is associated with an increased incidence of ectopic pregnancy, which occurs outside of the uterus (referred to as tubal pregnancy or in the peritoneal cavity).
• Formation of Scar Tissue:
  
  • PID can result in the formation of scar tissue both outside and inside the fallopian tubes.
  • This scar tissue can lead to tubal blockage, affecting fertility.
• Long-term Consequences:
  
  • PID can cause long-term pain in the pelvic and abdominal regions.

Question 37

Predisposing Factors for PID

Answer 37

• Predisposing Factors for PID:
  
  • History of untreated sexually transmitted diseases (STDs).
  • Previous history of PID, especially when reexposed to PID due to a partner with gonorrhea or chlamydia.
  • Chronic vaginal infections.
  • Intravenous drug use.
  • Having multiple sexual partners or having a partner with multiple sexual partners.
  • Increased incidence in young women, especially those who are sexually active and 25 years old or younger.
  • Douching, which can introduce bacteria into the reproductive tract.
  • Risk may be increased in the first three weeks after intrauterine device (IUD) placement.

Question 38

Signs and Symptoms of PIDVary according to severity

Answer 38

• Common Symptoms of PID:
  
  • Elevated temperature (> 38.3°C or 100.9°F).
  • Abnormal vaginal discharge.
  • Lower abdominal tenderness or pain.
  • Increased menstrual cramping.
  • Dyspareunia (vaginal pain during intercourse).
  • Foul-smelling menstrual flow.
  • Malaise (fatigue).
• Subacute PID Symptoms:
  
  • In subacute cases, symptoms may include dull and intermittent cramping.
• Variation in Symptoms:
  
  • The symptoms of PID can vary in severity from mild to severe, and subacute cases may present with dull and intermittent cramping.

Question 39

Nursing Care

Answer 39

• Management of PID:
  
  • Antibiotics for the patient.
  • Treatment of sexual partner(s) to prevent reinfection.
  • Comfort measures to alleviate symptoms.
  • Good perineal care and hygiene.
  • Semi-Fowler’s position for improved drainage.
  • Patient education on PID and prevention strategies.
• Prevention of PID:
  
  • Practicing safer sex by using barrier methods like condoms.
  • Considering avoiding intrauterine device (IUD) contraception if the patient has a history of PID to reduce the risk of recurrence.

Question 40

The Nurse is teaching a sex education class to teenage girls. The nurse informs them that which age group should receive a vaccination to prevent HPV infection?
13-29
12-26
9-26
7-20

Answer 40

9-26

Question 41

The nurse taught a class on HPV and cervical cancer. Which statement by the student indicates a need for further teaching:

Most HPV infections resolve on their own within 1 to 2 years

I can get the HPV vaccination to prevent the most common types of HPV that could cause cervical cancer.

A persistent infection of HPV type 16 or 18 can led to cervical cancer

Answer 41

Genital warts cause cervical cancer

Question 42

The nurse teaches the patient that she can enhance the accuracy of her Pap test screening by:

Avoiding intercourse for 48 hours before the test
Douching 24 hours before the test
Scheduling the appointment to occur during menstruation
Using lubricants with intercourse 24 hours before the test

Answer 42

Avoiding intercourse for 48 hours before the test

Question 43

A male with the diagnosis of chlamydia will first experience dysuria as the primary symptom. The other symptoms listed do not correlate to men with the diagnosis of chlamydia.

Answer 43

Trichomoniasis symptoms are vulvar itching and a malodorous foamy yellow vaginal discharge.

Question 44

Chlamydia is a common sexually transmitted infection (STI) in men and women. The client indicates an understanding of the education when stating not being legally obligated to tell the partner. The nurse would inform the client, however, of the benefit of telling partners. Health Insurance Portability and Accountability Act (HIPAA)/Personal Information Protection and Electronic Document Act (PIPEDA) laws protect the client’s privacy in this case. The client will be prescribed an antibiotic and, if taken properly, will resolve the infection and prevent the newborn from being exposed during the birthing process. The client would not require a cesarean birth. Only a condom and abstinence can prevent future STI exposure, not a cervical cap or diaphragm. Clients do not produce antibodies against future exposure to chlamydia; therefore, the client can contract it repeatedly.

Question 45

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection?

trichomoniasis

Question 46

A male client appears in the walk-in clinic and requests treatment for trichomoniasis as his girlfriend was recently diagnosed with it. What medication would the health care provider most likely prescribe?

You Selected:
metronidazole
Correct response:
metronidazole
Explanation:
Trichomoniasis is a common vaginal infection with the therapeutic management of metronidazole or tinidazole for both partners. Trichomoniasis is a common, curable sexually transmitted infection (STI) caused by a parasitic protozoa called Trichomonas.

Answer 46

A client reports genital ulcers and a diagnosis of syphilis. Which nursing interventions should the nurse implement when caring for the client? Select all that apply.

Have the client urinate in water if urination is painful.
Suggest the client apply ice packs to the genital area for comfort.
Instruct the client to wash her hands with soap and water after touching lesions.
Instruct the client to wear nonconstricting, comfortable clothes.
Instruct the client to abstain from sex during the latency period.
Correct response:
Incorrect response:
Your selection:
Explanation:
The nurse should instruct the client to wear nonconstricting clothes and to wash her hands with soap and water after touching lesions to avoid autoinoculation. If urination is painful because of the ulcers, instruct the client to urinate in water but to avoid extremes of temperature such as ice packs or hot pads to the genital area. The client should abstain from intercourse during the prodromal period and when lesions are present. The ulcer disappears during the latency period.

Question 47

A 45-year-old female client tells the nurse she has a dimpling of the right breast that has occurred in the past 2 weeks. What action will the nurse take next?

You Selected:
Perform an examination of both of the client’s breasts.
Correct response:
Perform an examination of both of the client’s breasts.
Explanation:
It would be most important for the nurse to palpate the breast to determine the presence of a mass and compare it to the left. Edema and pitting of the skin may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance (peau d’orange), a classic sign of advanced breast cancer. Determining if the client has a family history will not change the course of action and is not a priority. Before notifying the health care provider, the nurse will assess the client as the client is stable. The client will be assessed before additional procedures are completed to determine the best procedures, if any, for the client.

A nurse is educating a client on the technique for performing breast self-examination. Which instruction should the nurse include in the teaching plan with regard to the different degrees of pressure that need to be applied on the breast?

You Selected:
hard pressure applied down to the ribs
Correct response:
hard pressure applied down to the ribs
Explanation:
When performing the breast self-examination, the nurse should instruct the client to apply hard pressure down to the ribs. Light, not medium, pressure should be applied when moving the skin without moving the tissue underneath. Medium, not light, pressure should be applied midway into the tissue. The client need not specifically palpate the areolar area during breast self-examination.

The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which complication?

You Selected:
lymphedema
Correct response:
lymphedema
Explanation:
Lymphedema occurs in some women after breast cancer surgery. It causes disfigurement and increases the lifetime potential for infection and poor healing. Fibrocystic breast disease and fibroadenoma are two benign breast conditions that occur usually in premenopausal woman. Breast abscess is the infectious and inflammatory breast condition that is common among breastfeeding mothers.