Deck 65: Coordinating Care for Female Patients With Reproductive and Breast Disorders

Question 1

A nurse is caring for a patient who complains of pain with menstruation.What is true regarding the etiology and pathophysiology of this condition?

A) Primary dysmenorrhea is caused by decreased levels of prostaglandins,causing the contractions of the uterus to increase in strength.
B) Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during the teens and 20s of a woman's life.
C) Secondary dysmenorrhea is more common than primary dysmenorrhea.
D) Primary dysmenorrhea causes include endometriosis,tumors,cysts,pelvic adhesions,pelvic inflammatory disease,infections,cervical stenosis,uterine leiomyomas,and adenomyosis.

Answer 1

Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during the teens and 20s of a woman's life.

Question 2

The nurse is caring for a patient with metastatic breast cancer receiving chemotherapy.Even though the prognosis is poor,the patient tells the nurse that the plan is to do everything to survive.How should the nurse respond to this patient?

A) "You have a great attitude,and I am here to support you through education."
B) "It is important to plan for your death,even though there is a chance you will survive."
C) "You should face the reality of the situation.You do not have a good chance of survival."
D) "I am going to speak with your family regarding your unrealistic expectations."

Answer 2

"You have a great attitude,and I am here to support you through education."

Question 3

A patient with a history of breast cancer who is entering menopause is seeking information about how to manage hot flashes.What information can be provided to the patient?

A) Soy and black cohosh can be used to manage the hot flashes associated with menopause.
B) The patient should be advised that she will have to wait until menopause has finished for the hot flashes to cease.
C) Estrogen is the only reliable method of treatment for hot flashes.
D) Olive oil and black cohosh are effective in the management of hot flashes.

Answer 3

Soy and black cohosh can be used to manage the hot flashes associated with menopause.

Question 4

During an assessment,the nurse notes that a patient receiving radiation treatments for breast cancer has excoriated skin.What is the priority nursing diagnosis for this patient?

A) Excess Fluid Volume
B) Ineffective Breathing Pattern
C) Risk for Infection
D) Activity Intolerance

Question 5

A menopausal patient is concerned that intercourse with her spouse has become increasingly painful.What should the nurse explain about the changes in this patient's body after menopause?

A) Cervical mucus is thicker.
B) Estrogen levels increase.
C) Sexual desire diminishes.
D) Vaginal lubrication decreases.

Question 6

A nurse is caring for a patient who is perimenopausal and states that she has recently had frequent bacterial vaginal infections.Which reason for these infections will the nurse include in the response to the patient?

A) Decreased vaginal pH
B) Increased vaginal pH
C) Increased estrogen level
D) Decreased vasomotor stability

Question 7

A female patient asks what causes the symptoms of menopause.On which hormonal function should the nurse focus when responding to this patient's question?

A) Increased estrogen levels
B) Increased progesterone levels
C) Estrone as the major hormone
D) Increased luteinizing hormone levels

Question 8

The nurse is reviewing the plan of care for a patient being treated with brachytherapy for breast cancer.Which assessment finding indicates that the patient's skin integrity has been maintained?

A) Skin intact
B) Skin dry and excoriated
C) Skin stretched
D) Skin damp and sweaty

Question 9

A patient prescribed tamoxifen (Nolvadex)for breast cancer treatment asks the nurse how the medication works.What is the best response by the nurse?

A) "Tamoxifen works by inhibiting the cellular mitosis of breast cancer."
B) "Tamoxifen works by blocking estrogen receptors on breast tissue."
C) "Tamoxifen works by binding to the DNA of breast cancer cells."
D) "Tamoxifen works by inhibiting the metabolism of breast cancer cells."

Question 10

The nurse identifies that a patient is at risk for dysfunctional uterine bleeding.What did the nurse assess in this patient to lead to this clinical diagnosis?

A) Low level of stress
B) Weight gain of 5 lbs in five years
C) Uses birth control pills for contraception
D) Limits intake of high-fat foods

Question 11

The nurse instructs a patient on ways to reduce premenstrual difficulty.Which patient statement indicates the instruction was beneficial?

A) The patient states the need to increase dietary sugar intake to promote energy.
B) The patient states that guided imagery does not help with the symptoms.
C) The patient states the need to increase intake of simple carbohydrates.
D) The patient states that reducing caffeine intake will help.

Question 12

The nurse has identified the diagnosis of Ineffective Coping for a patient with severe premenstrual syndrome.What should be included in this patient's plan of care?

A) Encourage frequent rest periods
B) Suggest four ounces of wine each day
C) Encourage exercise and relaxation techniques
D) Instruct to avoid contraception during menstruation if engaging in sexual intercourse

Question 13

The nurse is instructing a group of women between the ages of 40 and 50 about early detection of breast cancer.What should the nurse include in this teaching?

A) Perform monthly breast self-exams
B) See a health-care provider if there is a strong family history of breast cancer
C) Have a yearly mammogram
D) Have a clinical breast exam performed by a health-care provider every five years

Question 14

A young adolescent patient is concerned about experiencing severe cramps with menstruation.How should the nurse respond to this patient?

A) "This is not normal but is something that can be treated."
B) "You have cramps because you started your periods too early."
C) "Cramps are seen in those who just start having periods and will become less severe as you get older."
D) "You need to see a gynecologist for a pelvic examination."

Question 15

A nurse working in an outpatient women's health clinic is caring for a patient in menopause.When discussing hormone replacement therapy (HRT)with the patient,the nurse should include which statement?

A) "Most healthy,recently menopausal women should not use HRT for relief of hot flashes and vaginal dryness."
B) "HRT is the least effective treatment for menopausal hot flashes and vaginal dryness."
C) "If vaginal dryness and painful intercourse are the only symptoms,then low-dose vaginal estrogen is preferred."
D) "The risk of blood clots in the legs or lungs is further increased by using transdermal patches,gels,or sprays."

Question 16

A female patient is prescribed an androgen medication to treat an estrogen-sensitive type of breast cancer.What should the nurse instruct this patient about the medication?

A) There is an increased risk of multiple births.
B) Monitor weight weekly.
C) Report calf pain or dyspnea.
D) It must be taken with food.

Question 17

The nurse instructs a patient recovering from a mastectomy on ways to prevent lymphedema.Which patient statement indicates that teaching has been successful?

A) "I should do the exercises on my affected arm every day."
B) "I have to take no special precautions."
C) "I should avoid cleansing my skin with soap."
D) "Eating fresh fruits and vegetables will prevent my arm from swelling."

Question 18

A patient recovering from a hysterectomy does not want to take the prescribed estrogen replacement therapy because of the fear of developing breast cancer.Which response by the nurse is the most appropriate?

A) "The risk of breast cancer is slightly increased for women who opt to take estrogen replacement therapy."
B) "Perhaps you should consider an estrogen-progestin combination therapy."
C) "The risk of breast cancer is not increased for women who have had a hysterectomy and take estrogen replacement medications."
D) "Taking estrogen replacement is required after a hysterectomy."

Question 19

The nurse is developing strategies to be used for the relief of menstrual cramping in a teaching session to a group of young women.What should be the focus of these strategies?

A) Minimization of menstrual flow
B) Avoidance of uterine contraction
C) Increase of blood flow to the uterine muscle
D) Decrease in estrogen production

Question 20

A patient who is postmenopausal confides in the nurse about pain experienced during intercourse.What should the nurse instruct the patient to do?

A) Use vaginal lubricants during intercourse
B) Avoid intercourse
C) Tolerate this problem because it is a normal part of aging
D) Decrease the frequency of intercourse to decrease the pain

Question 21

The nurse is caring for a patient recovering from a total hysterectomy.What should the nurse include when instructing this patient prior to discharge?

A) The importance of douching after intercourse for at least 6 weeks
B) Why bed rest is indicated for at least a month after the surgery
C) The risks and benefits of hormone replacement therapy
D) The importance of returning to normal activities of daily living as soon as possible

Question 22

The nurse is assessing a patient who is at risk for endometrial cancer.Which is the priority question for the nurse to include in the health history?

A) "How many times have you been pregnant?"
B) "Do you experience irregular or heavy periods?"
C) "How often do you engage in sexual intercourse?"
D) "Have you ever been diagnosed with a sexually transmitted infection?"

Question 23

The nurse is preparing education for a patient who is diagnosed with endometriosis.Which should the nurse plan to include in the teaching session as a first-line treatment option?

A) Oral contraceptives
B) Aromatase inhibitors
C) Laparoscopy with biopsy
D) Gonadotropin-releasing hormone agonists

Question 24

The nurse is conducting a health history interview for a female patient with a family history of ovarian cancer.Which information noted by the nurse indicates this patient has an increased risk for developing this type of cancer?

A) Two noted pregnancies
B) Long term oral contraceptive use
C) Currently breastfeeding an infant
D) Body mass index indicates obesity

Question 25

Which patient has an increased risk for being diagnosed with cervical cancer in the later stages of the disease process?

A) 35-year-old Hispanic woman with a Pap smear one year ago
B) 45-year-old Caucasian woman with a Pap smear three years ago
C) 50-year-old Native American woman with a Pap smear four years ago
D) 55-year-old African American woman with a Pap smear six years ago