Lewis Ch 50: Assessment of the Reproductive System Flashcards
Which question should the nurse ask when assessing a 60-year-old patient who has a history of benign prostatic hyperplasia (BPH)?
a. “Have you noticed any unusual discharge from your penis?”
b. “Has there been any change in your sex life in the past year?”
c. “Has there been a decrease in the force of your urinary stream?”
d. “Have you been experiencing any difficulty in achieving an erection?”
ANS: c. “Has there been a decrease in the force of your urinary stream?”
Enlargement of the prostate blocks the urethra, leading to urinary changes such as a decrease in the force of the urinary stream. The other questions address possible problems with infection or sexual difficulties, but they would not be helpful in determining whether there were functional changes caused by BPH.
What topic should the nurse plan to teach a 26-year-old patient who has been treated for pelvic inflammatory disease?
a. Use of hormone therapy (HT)
b. Potential complication of infertility
c. Irregularities in the menstrual cycle
d. Changes in secondary sex characteristics
ANS: b. Potential complication of infertility
Pelvic inflammatory disease may cause scarring of the fallopian tubes and result in difficulty in fertilization or implantation of the fertilized egg. Because ovarian function is not affected, the patient will not require HT, have irregular menstrual cycles, or experience changes in secondary sex characteristics.
A 68-year-old male patient tells the nurse that he is worried because he does not respond to sexual stimulation the same way he did when he was younger. Which is the nurse’s best response to the patient’s concern?
a. “You may need additional stimulation with aging.”
b. “Tell me more about how your reaction has changed.”
c. “Interest in sex frequently decreases as men get older.”
d. “Erectile dysfunction is common problem in older men.”
ANS: b. “Tell me more about how your reaction has changed.”
The initial response by the nurse should be further assessment of the problem. The other statements by the nurse are accurate but may not respond to the patient’s concerns.
The nurse is providing teaching by telephone to a woman who is scheduled for a pelvic examination and Pap test next week. What instruction should the nurse give?
a. Do not have sexual intercourse the day before the Pap test.
b. Shower, but not take a tub bath, before the examination.
c. Avoid douching for at least 24 hours before the examination.
d. Schedule to have the Pap test just after her menstrual period.
ANS: c. Avoid douching for at least 24 hours before the examination.
Because the results of a Pap test may be affected by douching, the patient should not douche before the examination. The patient may shower or bathe before the examination. The examination may be scheduled without regard to the menstrual period. Sexual intercourse does not affect the results of the examination or Pap test.
A 22-year-old patient reports her concern about not having a menstrual period for the past 7 months. Which statement by the patient indicates a possible related factor to the amenorrhea?
a. “I drink at least 3 glasses of nonfat milk every day.”
b. “I run 7 to 8 miles every day to manage my weight.”
c. “I am not sexually active but currently I have an IUD.”
d. “I was treated for a sexually transmitted infection 2 years ago.”
ANS: b. “I run 7 to 8 miles every day to manage my weight.”
Intense endurance exercise can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs.
The nurse is assessing the sexual-reproductive functional health pattern of a 32-year-old woman. Which question is most useful in planning for appropriate health screening?
a. “Do you have sex with men, women, or both?”
b. “Which gender do you prefer to have sex with?”
c. “Are you heterosexual, homosexual, or bisexual?”
d. “What types of sexual activities do you engage in?”
ANS: d. “What types of sexual activities do you engage in?”
Asking about activities is the most simply stated question and will increase the likelihood of obtaining the relevant information about possible risk factors associated with sexual activity. Type of activity (genital, anal, oral) is more helpful in determining risk and planning for health screening procedures than asking the gender of the partner. Patients who have sex with both men and women may not identify themselves as homosexual or bisexual.
What should the nurse explain to a patient being prepared for colposcopy with a cervical biopsy?
a. It involves dilation of the cervix and biopsy of the tissue lining the uterus.
b. It will take place in a same-day surgery center so that local anesthesia can be used.
c. It is similar to a speculum examination of the cervix and should cause little discomfort.
d. It requires that the patient have nothing to eat or drink for 6 hours before the procedure.
ANS: c. It is similar to a speculum examination of the cervix and should cause little discomfort.
Colposcopy involves visualization of the cervix with a binocular microscope and is similar to a speculum examination. Anesthesia is not required and fasting is not necessary. A cervical biopsy may cause a minimal amount of pain.
A couple is scheduled to have a Huhner test for infertility. What will the nurse instruct the couple about in preparation for the test?
a. Being sedated during the procedure
b. Determining the estimated time of ovulation
c. Experiencing shoulder pain after the procedure
d. Refraining from intercourse before the appointment
ANS: b. Determining the estimated time of ovulation
For the Huhner test, the couple should have intercourse at the estimated time of ovulation and then arrive for the test 2 to 8 hours after intercourse. The other instructions would be used for other types of fertility testing.
A patient in the sexually transmitted infection clinic has a positive Rapid Plasma Reagin (RPR) test, but no chancre is visible on assessment. For what test should the nurse expect to send specimens?
a. Cytologic studies
b. Culture and Gram stain
c. Herpes Simplex Antibody Test
d. Fluorescent treponemal antibody absorption (FTA-Abs)
ANS: d. Fluorescent treponemal antibody absorption (FTA-Abs)
Because false positives are common with VDRL and RPR testing, FTA-Abs testing is recommended to confirm a diagnosis of syphilis. Gram staining is used for other sexually transmitted infections (STIs) such as gonorrhea and Chlamydia and cytologic studies are used to detect abnormal cells (e.g., neoplastic cells).
A 24-year-old woman says she wants to begin using oral contraceptives. Which information from the nursing assessment is important to report to the health care provider before a prescription is considered?
a. The patient quit smoking 5 months previously.
b. The patient’s blood pressure is 150/86 mm Hg.
c. The patient has not been vaccinated for rubella.
d. The patient has chronic iron-deficiency anemia.
ANS: b. The patient’s blood pressure is 150/86 mm Hg.
Because hypertension increases the risk for morbidity and mortality in women taking oral contraceptives, the patient’s blood pressure should be controlled before oral contraceptives are prescribed. The other information will not affect the choice of contraceptive.
A 49-year-old man who has type 2 diabetes, high blood pressure, hyperlipidemia, and gastroesophageal reflux tells the nurse that he has had recent difficulty in achieving an erection. Which of the following drugs from his current medications list may cause erectile dysfunction (ED)?
a. Ranitidine (Zantac)
b. Atorvastatin (Lipitor)
c. Propranolol (Inderal)
d. Metformin (Glucophage)
ANS: c. Propranolol (Inderal)
Some antihypertensives may cause ED, and the nurse should anticipate a change in antihypertensive therapy. The other medications will not affect erectile function.
A 19-year-old patient calls the school clinic and tells the nurse, “My menstrual period is very heavy this time. I have to change my tampon every 4 hours.” Which action should the nurse
take next?
a. Tell the patient that her flow is not unusually heavy.
b. Schedule the patient for an appointment later that day.
c. Ask the patient how heavy her usual menstrual flow is.
d. Have the patient call again if the heavy flow continues.
ANS: c. Ask the patient how heavy her usual menstrual flow is.
Because a heavy menstrual flow is usually indicated by saturating a pad or tampon in 1 to 2 hours, the nurse should first assess how heavy the patient’s usual flow is. There is no need to schedule the patient for an appointment that day. The patient may need to call again, but this is not the first action that the nurse should take. Telling the patient that she does not have a heavy flow implies that the patient’s concern is not important.
What should the nurse teach the patient who has a possible ovarian cyst and is scheduled for an abdominal and pelvic ultrasound?
a. Expect to receive IV contrast during the procedure.
b. Drink several glasses of fluids before the procedure.
c. Discontinue taking aspirin for 7 days before the procedure.
d. You may have mild abdominal cramps after the procedure.
ANS: b. Drink several glasses of fluids before the procedure.
A full bladder is needed for many ultrasound procedures, so the nurse will have the patient drink fluids before arriving for the ultrasound. The other instructions are not accurate for this procedure.
What should the nurse plan to teach a 57-year-old man who is scheduled for an annual physical examination?
a. Increased risk for testicular cancer
b. Possible changes in erectile function
c. Normal decreases in testosterone level
d. Prostate-specific antigen (PSA) testing
ANS: d. Prostate-specific antigen (PSA) testing
PSA testing may be recommended annually for men, starting at age 50 based on the person’s risk history and discussion with their HCP. There is no indication that the other patient teaching topics are appropriate for this patient.
An 18-year-old female patient admitted to the emergency department after a motor vehicle crash is scheduled for chest and abdominal x-rays. Which information may alter the plans for the x-rays?
a. Report of abdominal pain
b. Positive result of hCG test
c. Blood pressure of 172/88 mm Hg
d. Temperature of 102.1° F (38.9° C)
ANS: b. Positive result of hCG test
Positive hCG testing indicates that the patient is pregnant and that abdominal x-rays should be avoided if possible. The other information is also important to report promptly, but it will not affect whether the x-rays should be done.
Which information obtained by the nurse and shown in the accompanying figure about a 72-year-old man who is complaining of erectile dysfunction is most important to communicate to the health care provider?
a. Recent knee surgery
b. Use of antihypertensives
c. Low position of left testis
d. Pulse and blood pressure level
ANS: b. Use of antihypertensives
Many medications used for hypertension can cause erectile dysfunction. More information is needed regarding the specific medications. The other assessment data will not impact erectile function (recent knee surgery) or are normal for a 70-year-old man (physical examination data and vital signs).
