Deck 6: Reproductive Health

Question 1

While interviewing a 31-year-old woman before her routine gynecological examination,the nurse collects data about the patient's recent menstrual cycles.The nurse should collect additional information when the woman makes which of the following statements?

A) The woman says her menstrual flow lasts 5 to 6 days.
B) She describes her flow as very heavy.
C) She reports that she has had a small amount of spotting midway between her periods for the past 2 months.
D) She says the length of her menstrual cycle varies from 26 to 29 days.

Answer 1

She describes her flow as very heavy.

Question 2

What should the nurse be aware of with regard to dysfunctional uterine bleeding ( DUB )?

A) It is most commonly caused by anovulation.
B) It most often occurs in middle age.
C) DUB should be the initial consideration for abnormal menstrual bleeding.
D) The most effective medical treatment involves steroids.

Answer 2

It is most commonly caused by anovulation.

Question 3

What are the two primary areas of risk for sexually transmitted infections (STIs)?

A) Sexual orientation and socioeconomic status
B) Age and educational level
C) Large number of sexual partners and race
D) Risky sexual behaviours and inadequate preventive health behaviours

Answer 3

Risky sexual behaviours and inadequate preventive health behaviours

Question 4

Nurses should be aware that which statement is true with regard to dysmenorrhea?

A) It is more common in older women.
B) It is more common in leaner women who exercise strenuously.
C) Symptoms can begin at any point in the ovulatory cycle.
D) Pain usually occurs in the suprapubic area or lower abdomen.

Question 5

Nafarelin (Synarel)200 mg BID per nasal spray currently is used as a treatment for mild-to-severe endometriosis.What should the nurse tell the woman who is taking this medication?

A) It stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity.
B) It should be sprayed into one nostril every other day.
C) It should be injected into subcutaneous tissue BID.
D) It can cause her to experience some hot flashes and vaginal dryness.

Question 6

When planning care for a 36-year-old woman who has been diagnosed as having uterine fibroids,what is important for the nurse to know?

A) Fibroids are malignant tumours of the uterus that require radiation or chemotherapy.
B) Fibroids will increase in size during the perimenopausal period.
C) Menorrhagia is a common finding in women with uterine fibroids.
D) The woman is unlikely to become pregnant as long as the fibroids are in her uterus.

Question 7

Which medication does the Public Health Agency of Canada recommend for the treatment of patients with human papillomavirus (HPV)?

A) Miconazole ointment
B) Topical podofilox 0.5% solution or gel
C) Penicillin given intramuscularly (IM) for two doses
D) Metronidazole by mouth

Question 8

Management of primary dysmenorrhea often requires a multifaceted approach.What is the optimal pharmacological therapy for pain relief for dysmenorrhea?

A) Acetaminophen
B) Oral contraceptives (OCPs)
C) Nonsteroidal anti-inflammatory drugs (NSAIDs)
D) Aspirin

Question 9

What symptom described by a woman is characteristic of premenstrual syndrome (PMS)?

A) "I feel irritable and moody when my period is supposed to start."
B) "I have lower abdominal pain beginning the third day of my menstrual period."
C) "I have nausea and headaches after my period starts, and they last 2 to 3 days."
D) "I have abdominal bloating and breast pain after a couple days of my period."

Question 10

During her annual gynecological checkup,a 17-year-old woman states that recently she has been experiencing cramping and pain during her menstrual periods.The nurse would use which term to document this complaint?

A) Amenorrhea
B) Dysmenorrhea
C) Dyspareunia
D) Premenstrual syndrome (PMS)

Question 11

When a nurse is counselling a woman for primary dysmenorrhea,which nonpharmacological intervention might be recommended?

A) Increase the intake of red meat and simple carbohydrates.
B) Reduce the intake of diuretic foods, such as peaches and asparagus.
C) Temporarily substitute physical activity for a sedentary lifestyle.
D) Use a heating pad on the abdomen to relieve cramping.

Question 12

Nurses should be aware of which of the following statements in relation to endometriosis?

A) It is characterized by the presence and growth of endometrial tissue inside the uterus.
B) It is found more often in Black women than in White or Asian women.
C) It may worsen with repeated cycles or remain asymptomatic and disappear after menopause.
D) It is unlikely to affect sexual intercourse or fertility.

Question 13

When evaluating a patient for sexually transmitted infections (STIs),the nurse should be aware that which one of the following STIs is on the rise in Canada?

A) Chancroid
B) Candidiasis
C) Chlamydia
D) Herpes simplex virus (HSV) type 2

Question 14

A woman has a thick,white,lumpy,cottage cheese-like discharge,with patches on her labia and in her vagina.She complains of intense pruritus.The nurse practitioner would order which preparation for treatment?

A) Fluconazole
B) Tetracycline
C) Clindamycin
D) Acyclovir

Question 15

A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years.She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months.What are these symptoms most likely related to?

A) Endometriosis
B) PMS
C) Primary dysmenorrhea
D) Secondary dysmenorrhea

Question 16

When evaluating a patient whose primary complaint is amenorrhea,the nurse must be aware that lack of menstruation is most often the result of which of the following?

A) Stress
B) Excessive exercise
C) Pregnancy
D) Eating disorders

Question 17

What is the viral sexually transmitted infection (STI)that affects most people in Canada today?

A) Herpes simplex virus type 2 (HSV-2)
B) Human papillomavirus (HPV)
C) Human immunodeficiency virus (HIV)
D) Cytomegalovirus (CMV)

Question 18

Which statement concerning cyclic perimenstrual pain and discomfort ( CPPD )is accurate?

A) Premenstrual dysphoric disorder ( PMDD ) is a milder form of premenstrual syndrome ( PMS ) and more common in younger women.
B) Secondary dysmenorrhea is more intense and medically significant than primary dysmenorrhea.
C) Premenstrual syndrome is a complex, poorly understood condition that may include many symptoms.
D) The causes of PMS have been well established.

Question 19

Which term refers to an alteration in cyclic bleeding that occurs between periods of menstruation?

A) Oligomenorrhea
B) Menorrhagia
C) Leiomyoma
D) Metrorrhagia

Question 20

When assessing the patient for amenorrhea,the nurse should be aware that which of the following may cause amenorrhea?

A) Alcohol use
B) Type 1 diabetes mellitus
C) Lack of exercise
D) Cessation of oral contraception use

Question 21

Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes?

A) Herpes simplex virus (HSV)-2
B) Human papillomavirus (HPV)
C) Human immunodeficiency virus (HIV)
D) Cytomegalovirus (CMV)

Question 22

The nurse must watch for what common complications in a patient who has undergone a transverse rectus abdominis myocutaneous (TRAM)flap?

A) Axillary edema and tissue necrosis
B) Delayed wound healing and muscle contractions
C) Delayed wound healing and axillary edema
D) Delayed wound healing and hematoma

Question 23

A patient has been prescribed adjuvant tamoxifen therapy.What common adverse effects might she experience?

A) Nausea, hot flashes, and vaginal bleeding
B) Vomiting, weight loss, and hair loss
C) Nausea, vomiting, and diarrhea
D) Hot flashes, weight gain, and headaches

Question 24

On vaginal examination of a 30-year-old woman,the nurse documents the following findings: profuse,thin,greyish white vaginal discharge with a "fishy" odour; complaint of pruritus.These findings lead the nurse to which diagnosis?

A) Bacterial vaginosis (BV)
B) Candidiasis
C) Trichomoniasis
D) Gonorrhea

Question 25

A 25-year-old single female comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap)smear.The test revealed that the patient has human papillomavirus (HPV).The patient asks,"What is that? Can you get rid of it?" What is the nurse`s best response?

A) "It's just a little lump on your cervix. We can freeze it off."
B) "HPV stands for 'human papillomavirus.' It is a sexually transmitted infection (STI) that may lead to cervical cancer."
C) "HPV is a type of early human immunodeficiency virus (HIV). This disease is usually fatal."
D) "You probably caught this from your current boyfriend. He should get tested for this."

Question 26

After a mastectomy,a woman should be instructed to perform which of the following?

A) Empty surgical drains twice a day and as needed.
B) Avoid lifting more than 5 kg or reaching above her head until given permission by her surgeon.
C) Wear clothing with snug sleeves to support the tissue of the arm on the operative side.
D) Expect mild signs of inflammation at the incision site or in the affected arm.

Question 27

When teaching a group of women about breast cancer,which fact would the nurse point out to them?

A) Risk factors identify more than 50% of women who will develop breast cancer.
B) Nearly 90% of lumps found by women are malignant.
C) One in 10 women in Canada will develop breast cancer in her lifetime.
D) The exact cause of breast cancer is unknown.

Question 28

The nurse should know that once human immunodeficiency virus (HIV)enters the body,seroconversion to HIV positivity usually occurs within which time frame?

A) 6 to 10 days
B) 2 to 4 weeks
C) 6 to 12 weeks
D) 6 months

Question 29

A patient's oncologist has just finished explaining the diagnostic workup results to her,and she still has questions.The woman states,"The doctor says I have a slow-growing cancer.Very few cells are dividing.How does she know this?" What is the name of the test that gave the physician this information?

A) Tumour ploidy
B) S-phase index
C) Nuclear grade
D) Estrogen receptor assay

Question 30

What is the recommended treatment for the prevention of human immunodeficiency virus (HIV)transmission to the fetus during pregnancy?

A) Acyclovir
B) Ofloxacin
C) Podophyllin
D) Zidovudine

Question 31

Which of the following should the nurse explain when providing education regarding breast care and fibrocystic changes in breasts?

A) Fibrocystic changes are a disease of the milk ducts and glands in the breasts.
B) Fibrocystic changes are a premalignant disorder characterized by lumps found in the breast tissue.
C) Fibrocystic changes describe lumpiness with pain and tenderness in the breast tissue of healthy women during menstrual cycles.
D) Fibrocystic changes include lumpiness accompanied by tenderness after menses.

Question 32

What would most likely be included for the care management of a woman diagnosed with acute pelvic inflammatory disease ( PID )?

A) Oral antiviral therapy
B) Bed rest in a semi-Fowler position
C) Antibiotic regimen continued until symptoms subside
D) Frequent pelvic examination to monitor the progress of healing

Question 33

A nurse practitioner performs a clinical breast examination on a woman diagnosed with fibroadenoma.The nurse knows that fibroadenoma is characterized by which of the following?

A) Fibroadenoma is an inflammation of the milk ducts and glands behind the nipples.
B) Fibroadenoma is a thick, sticky discharge from the nipple of the affected breast.
C) Fibroadenoma is lumpiness in both breasts that develops 1 week before menstruation.
D) Fibroadenoma is a single lump in one breast that can be expected to shrink as the woman ages.

Question 34

What do most laboratory tests focus on to detect the human immunodeficiency virus (HIV)?

A) HIV virus
B) HIV antibodies
C) CD₄ counts
D) CD₈ counts

Question 35

What does a woman most likely have when she experiences a breast mass that is not well delineated and is nonpalpable,immobile,and nontender?

A) Fibroadenoma
B) Lipoma
C) Intraductal papilloma
D) Mammary duct ectasia

Question 36

Which statement about the various forms of hepatitis is accurate?

A) A vaccine exists for hepatitis C , but not for hepatitis B .
B) Hepatitis A is acquired by eating contaminated food or drinking polluted water.
C) Hepatitis B is less contagious than human immunodeficiency virus ( HIV ).
D) The incidence of hepatitis C is decreasing.

Question 37

An essential component of counselling women on safe sex practices includes discussion about avoiding the exchange of body fluids.The physical barrier promoted for the prevention of sexually transmitted infections (STIs)and human immunodeficiency virus (HIV)is the condom.What is the most important aspect of a discussion related to health promotion and condom use that the nurse should be aware of?

A) Strategies to enhance condom use
B) Choice of colours and special features
C) Leaving the decision up to the male partner
D) Places to safely carry condoms

Question 38

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?

A) Mammogram
B) Ultrasound
C) Fine-needle aspiration ( FNA )
D) CA 15-3

Question 39

What important,immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

A) The blood pressure (BP) cuff should not be applied to the affected arm.
B) Venipuncture for blood work should be performed on the affected arm.
C) The affected arm should be used for intravenous (IV) therapy.
D) The affected arm should be held down close to the woman's side.

Question 40

A healthy 60-year-old Black Canadian woman regularly receives her health care at the clinic in her neighbourhood.She is due for a mammogram.At her first clinic visit her physician,concerned about the 3-week wait at the neighbourhood clinic,made an appointment for her to have a mammogram at a teaching hospital across town.She did not keep her appointment and returned to the clinic today to have the nurse check her blood pressure.What would be the most appropriate statement for the nurse to make to this patient?

A) "Do you have transportation to the teaching hospital so that you can get your mammogram?"
B) "I'm concerned that you missed your appointment; let me make another one for you."
C) "It's very dangerous to skip your mammograms; your breasts need to be checked."
D) "Would you like me to make an appointment for you to have your mammogram here?"

Question 41

Fibrocystic changes in the breast most often appear in women in their 20s and 30s.The etiology is not known,but it may be an imbalance of estrogen and progesterone.The nurse who cares for these patients should be aware that treatment modalities are conservative.Which of the following is a modality that may provide relief?

A) Diuretic administration
B) Including caffeine daily in the diet
C) Increased vitamin C supplementation
D) Application of cold packs to the breast as necessary

Question 42

The Jarisch-Herxheimer reaction is an acute febrile reaction associated with treatment for which one of the following STIs?

A) Syphilis
B) Gonorrhea
C) Herpes simplex virus type 2
D) Human immunodeficiency virus