Deck 12: Care of the Patient With a Reproductive Disorder

Question 1

On the fourth postoperative day after a modified radical mastectomy, the nurse finds the patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore. The nurse bases subsequent nursing interventions on diagnosis?

A) Disturbed body image related to removal of her breast
B) Deficient knowledge related to inadequate education
C) Impaired social interaction related to depression
D) Fear related to the cancer diagnosis and surgical intervention

Answer 1

Disturbed body image related to removal of her breast

Question 2

The discharge instructions should include arm exercises for which postoperative patient?

A) Vaginal hysterectomy
B) Hydrocelectomy
C) Modified radical mastectomy
D) Unilateral orchiectomy

Answer 2

Modified radical mastectomy

Question 3

The nurse provides discharge teaching for a patient regarding her activity level as she recovers from her modified radical mastectomy. Which statement by her indicates to the nurse that the teaching has been successful?

A) "I should sleep on the side opposite my mastectomy."
B) "I should keep my right arm supported in a sling when I am up and around until my incision is healed."
C) "I can do whatever exercises and activities I want as long as I don't elevate my right hand above my head."
D) "I should take aspirin before moving or exercising my arm to prevent pain during the exercises."

Answer 3

"I should sleep on the side opposite my mastectomy."

Question 4

The recommended age for a baseline mammogram is between

A) 25 and 30 years.
B) 31 and 34 years.
C) 35 and 39 years.
D) 40 and 45 years.

Question 5

If severe or chronic pelvic inflammatory disease is present, the complication that may result is

A) metrorrhagia.
B) menorrhagia.
C) infertility.
D) incontinence.

Question 6

On the second postoperative day, a 63-year-old patient who has had an abdominal hysterectomy complains of gas pains and abdominal distention. She has not had a bowel movement since surgery. Which nursing intervention will best stimulate peristalsis and relieve distention?

A) Offering carbonated beverages
B) Encouraging ambulation at least four times per day
C) Administering a 1,000-mL soapsuds enema
D) Applying an abdominal binder

Question 7

A mammogram is the most useful method of diagnosing breast cancer because it

A) is the most reliable method of detecting breast cancer before it becomes palpable.
B) is inexpensive and covered by most medical insurance plans.
C) involves no radiation and takes only a few minutes.
D) involves no pain or discomfort and is readily available.

Question 8

A female patient, age 48, is undergoing a routine physical examination for the first time in 5 years. As a part of this examination she can expect to have a

A) culdoscopy.
B) colposcopy.
C) cervical biopsy.
D) Papanicolaou smear.

Question 9

A Gram-stain smear of the patient's discharge reveals the presence of N. gonorrhoeae. He tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any disease. Which information should the nurse include in response to his comment?

A) "Women do not develop gonorrhea infections but can serve as carriers to spread the disease to males."
B) "When gonorrhea infections occur in women, the disease affects only the ovaries and not the other genital organs."
C) "Many women are not aware that they have gonorrhea because they often do not have symptoms of infection."
D) "Woman develop subclinical cases of gonorrhea that do not cause tissue damage or symptoms."

Question 10

The nurse has taught a 23-year-old patient how to perform a testicular self-examination. Which statement by the patient indicates the need for further teaching?

A) "The testes feel smooth and egg-shaped."
B) "The best time to perform TSE is after a shower."
C) "The best time to perform TSE is just before intercourse."
D) "The epididymis feels like a soft tube."

Question 11

The patient, age 30, was diagnosed with primary genital herpes when she sought care for lesions on her vulva and perineum. Which instructions should the nurse give to her?

A) "Continued use of acyclovir (Zovirax) will prevent reinfection by the virus."
B) "Condoms should be used during all sexual activity to prevent transmission of the virus, even when lesions are not present."
C) "Acyclovir ointment should be applied to the lesions to increase comfort and speed healing."
D) "Recurrent genital herpes is promoted by any sexual stimulation."

Question 12

Female infertility is most often related to

A) systemic disease.
B) abnormal reproductive structures.
C) infections of the reproductive tract.
D) hormonal abnormalities.

Question 13

A 20-year-old college student regularly uses tampons while she is menstruating. She asks the nurse what outstanding sign she should report that might indicate toxic shock syndrome. The most correct response by the nurse would be to observe for

A) sudden hypotension.
B) malodorous vaginal discharge.
C) increased abdominal girth.
D) sudden elevated temperature.

Question 14

A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She asks the nurse if she will have "hot flashes." The nurse's response is based on the knowledge that

A) only the uterus was removed, and the ovaries are still producing estrogen.
B) the patient is too young to have hot flashes associated with menopause.
C) the uterus, ovaries, and fallopian tubes were removed, and she will have surgically induced menopause.
D) the uterus and fallopian tubes were removed, and she will not experience "hot flashes."

Question 15

Epididymitis may occur because of ____ to the testicle.

A) trauma
B) edema
C) removal
D) irritants

Question 16

The nurse admits a patient, age 72, who is scheduled for a vaginal hysterectomy. In what position will this patient be placed in the operating room for her surgery?

A) Lateral
B) Lithotomy
C) Trendelenburg
D) Supine

Question 17

At what age should a male be taught testicular self-exam (TSE)?

A) 10
B) 13
C) 15
D) 20

Question 18

The patient, age 56, is a mother of nine children. She undergoes an anterior and posterior colporrhaphy for repair of a cystocele and rectocele. On her return from the postanesthesia care unit, the nurse would expect which finding on assessment?

A) Gauze vaginal packing
B) Rectal tube
C) Perineal dressings
D) Indwelling catheter

Question 19

A patient, age 26, has had a tubal insufflation (Rubin's test) to ascertain whether her fallopian tubes are patent. She complains of pain in her right shoulder. The nurse's most appropriate response would be

A) "Don't worry, that is a normal reaction."
B) "I'll report the findings immediately to the head nurse."
C) "That is a symptom that resulted from your position on the operating table."
D) "That is from the carbon dioxide passing from the fallopian tubes into your abdomen."

Question 20

A patient tells the nurse that his wife, who has been diagnosed with inoperable ovarian cancer, is talking about dying and fear of death. He asks the nurse for suggestions that will be of assistance to his wife. Which response by the nurse would be most helpful?

A) "Your wife will probably die of another disease before she dies of ovarian cancer."
B) "Talk of death is normal at this time but will diminish in the future."
C) "Your wife is expressing an acceptance of utilizing hospice care."
D) "It is perfectly normal to want to talk about death. It is most helpful to support her by listening."

Question 21

________ are produced in the seminiferous tubules and stored in the epididymis.

Question 22

Select the interventions that should be performed with caution, in the affected arm, on patients who have undergone a modified radical mastectomy. (Select all that apply.)

A) Vaccinations
B) Taking of blood pressure or samples
C) Insertion of IV line
D) Physical therapy on uninvolved arm
E) Wear watch and jewelry on involved arm
F) Carry purse on involved arm or shoulder

Question 23

The nurse realizes that the patient who has had an abdominal hysterectomy needs further home teaching when she states

A) "I understand I can lift anything less than 20 pounds."
B) "I'm leaving today to stay with my daughter, who lives 200 miles away. My husband plans to drive the family car."
C) "The doctor said I can't have sexual intercourse for 4 to 6 weeks."
D) "I'm going to miss wearing my girdle or knee-high hose."

Question 24

A patient, age 23, seeks care at the health clinic because he has developed a profuse, purulent urethral discharge, and urination is painful. During assessment of the patient, it is most important that the nurse gather information related to

A) all of his sexual contacts within the past year.
B) a history of previous similar symptoms.
C) a history of bladder infections or mumps affecting the testicles.
D) a history of recent sexual contact with an individual with a sexually transmitted disease.

Question 25

During a laparoscopy, a small incision is made beneath the umbilicus to view the abdominal cavity. What is the purpose of insertion of a Foley catheter into the bladder?

A) Used to insert carbon dioxide
B) Obtain a small simple sample of cells
C) Irrigate the bladder with normal saline
D) Maintain bladder decompression for an open view

Question 26

A ___________ is performed to evaluate living tissue in order to establish or confirm a diagnosis or to follow the course of a disease.

Question 27

Vaginal fistulas are caused by an ulcerating process resulting from (Select all that apply.)

A) cancer.
B) radiation.
C) poor hygiene.
D) multiple sexual partners.
E) weakening of tissue from pregnancies.
F) surgical interventions.

Question 28

The nurse is assisting the physician in removing a small sample of tissue from the patient's cervix to have it evaluated. This procedure is called a cervical _______________.

Question 29

Which statement by the patient/family indicates that more teaching about HPV is necessary?

A) "I understand I don't need to get the new HPV vaccine unless I am sexually active."
B) "I'm going to make sure my 15-year-old daughter receives the HPV vaccine."
C) "The HPV vaccine is for girls and women ages 9 to 26 years."
D) "The HPV vaccine prevents precancerous changes that lead to cervical cancer."

Question 30

The patient, age 52, is recovering from a modified radical mastectomy. After this procedure, the postoperative elevation of a patient's arm with proper positioning is important to prevent

A) vascular and lymph stasis, thus lymphedema.
B) drainage accumulation at the incisional site.
C) wound infection and dehiscence.
D) pleural effusion and respiratory distress.

Question 31

False negative results in mammography occur in specific age groups because:

A) older women have greater density of breast tissue.
B) older women have less density of breast tissue.
C) younger women have greater density of breast tissue.
D) younger women have less density of breast tissue.

Question 32

Postmenopausal women should be instructed to perform breast self-examination (BSE)

A) on the same date of their choice each month.
B) every 3 months.
C) every day, because they are at high risk for breast cancer.
D) whenever they begin to take estrogen supplements.

Question 33

What factor influences older women's reluctance to seek medical care for problems of the reproductive system?

A) Embarrassment and cultural factors
B) Denial
C) Religious convictions
D) Lack of free time

Question 34

A patient, age 36, is scheduled for a unilateral orchiectomy for treatment of testicular cancer. He is withdrawn and does not initiate interaction with the nurse. Which action by the nurse is most appropriate?

A) Carefully explain the post operative activity restrictions.
B) Set a patient outcome that he will verbalize his understanding of the procedure.
C) Assure him that he will have adequate future sexual functioning.
D) Assess his concerns related to his diagnosis and treatment.

Question 35

During physical assessment of a patient, age 64, which finding would the nurse consider abnormal?

A) Nonpalpable ovaries
B) Serous nipple drainage
C) Pendulous breasts
D) Atrophy of vaginal tissue

Question 36

An appropriate nursing intervention for the patient with a hydrocele is to

A) apply a heating pad.
B) apply ice packs.
C) apply analgesic spray.
D) limit fluid intake.

Question 37

The American Cancer Society recommends that baseline mammograms be performed on women

A) between the ages of 15 and 21.
B) between the ages of 35 and 39.
C) over 40 years of age.
D) over 18 years of age.

Question 38

A patient, age 46, is recovering from an abdominal hysterectomy. Postoperative nursing interventions for her would include

A) monitoring apical pulses.
B) preventing urinary retention.
C) observing for facial distention.
D) assessing for lymphedema.

Question 39

_____________ are benign tumors of the uterus.