Chapter 49: Female Reproductive Disorders
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. Which potential side effect should a nurse caution a patient who is taking danazol
(Danocrine), an androgenic steroid, for the treatment of menorrhagia to be prepared for?
a.
Heavy menses
b.
Masculinizing
c.
Acnelike skin eruptions
d.
Anemia
2. What instruction should a nurse provide to a patient after a culdoscopy?
a.
Clean the incision site daily with hydrogen peroxide.
b.
Avoid vaginal intercourse.
c.
Return to the clinic for suture removal in 7 days.
d.
Use tampons.
3. A patient asks a nurse, “Will the laparoscopy be painful?” What is the best reply by the nurse?
a.
“You will probably have some pain below the rib cage and around the shoulder.”
b.
“Most patients state that the procedure is painless during and afterward.”
c.
“You may have some mild to moderate pain around the umbilicus and in the
back.”
d.
“Every person is different. It’s difficult to say whether you’ll have pain.”
4. A nurse is teaching a health class for 12- and 13-year-old girls about routine vaginal hygiene.
What should the nurse be sure to include?
a.
Wear clean polyester panties daily and at night.
b.
Douche weekly with a mild vinegar solution.
c.
Wash the external and internal genitalia daily.
d.
Wipe the perineal–anal area from front to back.
5. A nurse is teaching patients with endometriosis. What signs and symptoms of common
complications should be included?
a.
Pelvic inflammatory disease
b.
Obstruction of the bowel and ureters
c.
Cancer of the endometrium
d.
Ovarian cancer
6. After a mastectomy, many patients experience lymphedema. What action can the patient take
to minimize this problem?
a.
Keep the arm elevated as much as possible.
b.
Take Lasix, 20 mg twice daily as ordered.
c.
Use a sling during the day to rest the arm.
d.
Avoid exercising the arm for several weeks.
7. A patient tells a nurse that she is afraid of getting cervical cancer because her mother died of
cervical cancer. What is the most appropriate response by the nurse?
a.
“You need to a have a pelvic examination every 6 months because of your
history.”
b.
“If you have regular Pap smears, cervical cancer is usually diagnosed early and
cured.”
c.
“There’s no need to worry so much. Cervical cancer does not run in families.”
d.
“Cervical cancer is sexually transmitted. Don’t switch partners often, and you
don’t have to worry.”
8. A nurse is instructing a patient on breast self-examination. When is the best time of the month
to instruct this patient to perform a breast self-examination?
a.
Before the menstrual period
b.
During the menstrual period
c.
After the menstrual period
d.
On the first day of the month
9. A nurse is caring for a patient after a modified radical mastectomy for a breast tumor that has
been determined to be positive for estrogen receptors (ER positive) and has been placed on a
protocol of tamoxifen. The patient then asks the nurse, “Do you think I should take this
medication?” Which statement is the most appropriate?
a.
“Tamoxifen will probably not be effective because your tumor was ER positive.”
b.
“If I were you, I would do what the physician recommends.”
c.
“I think that you should take tamoxifen, because the tumor was ER positive.”
d.
“Tamoxifen is an option to consider, because your tumor was ER positive.”
10. Conjugated estrogen (Premarin) is indicated for treatment of menopause. Which side effects
should a nurse explain before administering the medication to a woman who has just had a
hysterectomy?
a.
Breast tenderness
b.
Hypotension
c.
Arthralgia
d.
Skin rash
11. A 16-year-old girl seen in the student health clinic has been diagnosed with Trichomonas
vaginalis and given medication for the infection. What should a nurse explains about
treatment of the girl’s sexual partner?
a.
He will require a 1-day treatment with the same drug.
b.
He will not develop the infection or require treatment.
c.
He will be treated, although he is asymptomatic.
d.
He is required by law to be examined by a physician.
12. A patient makes an appointment with her gynecologist because she is having difficulty
conceiving. Which laboratory test should the nurse anticipate the physician will order?
a.
Complete blood count
b.
Progesterone level
c.
Prothrombin time
d.
Erythrocyte count
13. What action should a nurse implement when assessing for abnormal bleeding in a patient
following a hysterectomy?
a.
Record the number of perineal pads used.
b.
Assess vital signs every 8 hours.
c.
Place the patient’s bed in a high Fowler position.
d.
Apply an abdominal binder.
14. A female student, seen in the campus clinic, states that she uses feminine hygiene douches
every day and after intercourse. What is the best response from the nurse?
a.
“Douching has been used as an effective means of birth control for years.”
b.
“Commercially prepared douches will neutralize the female vaginal tract.”
c.
“Douching should only be done when ordered by a physician or nurse
practitioner.”
d.
“Douching protects the vaginal tract from microorganisms.”
15. A nurse collecting data on the reproductive system from a female patient is told that the
patient has a vaginal discharge that is cottage cheese–like in appearance. What should the
nurse recognize this as a common sign of?
a.
Pelvic inflammatory disease (PID)
b.
Trichomonas vaginalis infection
c.
Atrophic vaginitis
d.
Candida albicans infection
16. A nurse is demonstrating breast self-examination to a patient. What should the nurse point out
as the most common area in the breast for tumors to occur?
a.
Under the nipple
b.
Upper outer quadrant
c.
Six o’clock position
d.
Axillary lymph nodes
17. After months of infertility procedures, a physician informs a 32-year-old patient that she will
never conceive. As the nurse enters the examination room, the patient states, “I guess I’m a
failure as a woman.” Based on this statement, what is the most appropriate nursing diagnosis?
a.
Sexual dysfunction
b.
Ineffective health maintenance
c.
Disturbed body image
d.
Ineffective coping
18. What must be true for a woman to be diagnosed with primary infertility?
a.
She has been unable to conceive after 1 year of regular, unprotected sex.
b.
She conceived once but did not deliver a viable infant.
c.
She conceived once but was unable to conceive again.
d.
She conceived three times in 1 year without a viable birth.
19. A patient is admitted with possible cancer of the ovary. What fact should a nurse know about
malignant tumors of the ovary?
a.
They are frequently advanced and inoperable by the time they are diagnosed.
b.
The respond well to radiation and chemotherapy because of early detection.
c.
They are easily detected because symptoms appear early in a woman’s life.
d.
They are directly related to PID and other infections.
20. A mastectomy care plan should address psychosocial problems of the patient. What should
this be directed toward?
a.
Caring for the wound and dressings
b.
Finding an appropriate support group
c.
Educating for methods for controlling edema
d.
Helping the patient express feelings and concerns
21. Which medication is used to stimulate or mimic actions of natural pituitary gonadotropins in
the treatment of infertility?
a.
Estrogen only (diethylstilbestrol)
b.
Danazol (Danocrine)
c.
Clomiphene citrate (Clomid)
d.
Raloxifene (Evista)
22. A nurse reads that a patient’s breast tumor is a stage II. What should the nurse realize about
this tumor?
a.
It is smaller than 2 cm, with no positive lymph node involvement and no
metastasis evident.
b.
It measures between 2 and 5 cm, with no or one positive lymph node involvement
and no metastasis evident.
c.
It is larger than 5 cm, with no positive lymph node involvement and no metastasis
evident.
d.
It measures between 2 and 5 cm, with positive axillary lymph node involvement
and metastasis evident.
23. A woman calls the clinic office and asks the nurse why she is having spotting between her
monthly periods when she is taking birth control pills to control the menorrhagia. What is the
nurse’s most appropriate response?
a.
“It is important to take the pill at the same time each day.”
b.
“Irregular spotting is to be expected with oral contraceptives.”
c.
“The pills are still safe. Continue to take them, regardless.”
d.
“Physicians are still uncertain as to how oral contraceptives function.”
MULTIPLE RESPONSE
24. A nurse teaching a seminar on breast cancer lists the signs that would alert a woman to the
possibility of a tumor. What should those signs include? (Select all that apply.)
a.
Dimpling
b.
Nipple discharge
c.
Thickening of tissue
d.
Red bruise
e.
Dry rash around nipple
25. What do the causes for menorrhagia include? (Select all that apply.)
a.
Hormonal dysfunction
b.
Tumors
c.
Coagulation disorders
d.
Endometrial hyperplasia
e.
Excessive exercising
COMPLETION
26. A nurse is aware that a tumor determined to be ER positive indicates that the tumor needs
_____ for growth.
27. A nurse points out to a group of young women who are being treated for PID that because of
the effect of this disease on their reproductive organs, they may become _____.
28. Because small non-nodal metastases may be present, _____ is recommended after a
lumpectomy.
29. The nurse recommends that an annual mammogram be performed for women older than
_____ years of age.