Question 1

The nurse is caring for an adolescent girl with primary dysmenorrhea.The girl's mother reports that her daughter has been absent from school at least 1 day during her last four periods.She anticipates that the health care provider will likely prescribe which treatment?

Accepted Answer

Seasonale is a popular oral contraceptive that provides delayed menstruation.Since this patient is accruing multiple short-term school absences over a period of months,Seasonale would provide longer periods of pain-free amenorrhea by allowing only four menstrual periods per year.Aromatherapy,dietary modification,and effleurage may also help relieve discomfort when present but extend pain-free intervals.

Question 2

The nurse is educating a patient with premenstrual dysphoric disorder (PMDD)about potential triggers.Which nutritional change should the nurse suggest to help reduce symptoms?

Accepted Answer

Strategies for self-care of PMDD may include stress management exercises,some lifestyle changes,and maintaining a healthy diet rich in complex carbohydrates and fiber (like whole-grain breads and pastas or lentils).Alcohol,red meat,and sugar exacerbate the symptoms of PMDD.

Question 3

How does the body benefit from the normal acidic pH of the vaginal vault?

Accepted Answer

The acidic pH of the vagina,provided by lactic acid,is a defense against infection.The low pH is a hostile environment for pathogens.Muscle tone in the vagina is not affected by the pH level.The vagina is not a hostile environment to the sperm.

Question 4

A copper intrauterine device (IUD)can be used as an emergency contraceptive measure if it is inserted within what time frame after unprotected sex?

Accepted Answer

A copper IUD can be inserted up to 7 days after unprotected sexual intercourse to prevent implantation of the zygote in women who prefer long-term contraception.

Question 5

The nurse educates a patient about differences between primary infertility and secondary infertility.Which statement accurately describes primary infertility?

Accepted Answer

Primary infertility is defined as inability to conceive after 1 year of active unprotected sex.Secondary infertility is the inability to conceive after having once conceived,or the inability to maintain a pregnancy long enough to deliver a viable infant.Approximately 10% to 20% of U.S.couples have infertility,and today more couples are seeking medical intervention.

Question 6

Which change is a possible benefit of oral contraceptives?

Accepted Answer

Decreased breast tenderness is a benefit of oral contraceptives.Oral contraceptives do not cause weight loss,heightened sexual pleasure,or decreased incidence of vaginitis.

Question 7

When should a patient conduct breast self-examinations (BSE)?

Accepted Answer

The examination should be performed 1 week after the period has begun,or on a specific date if menses has stopped.

Question 8

An infertile couple considering zygote intrafallopian transfer (ZIFT)asks how it differs from in vitro fertilization (IVF).Which information about ZIFT is most important for the nurse to include?

Accepted Answer

The ZIFT refers to the placement of the fertilized ovum into the fallopian tube at the zygote stage of development.During IVF-ET,the woman's eggs are collected from the ovary,fertilized in the laboratory,and transferred into the uterus at the embryo stage of development.

Question 9

The nurse is caring for a patient taking long-term estrogen replacement for osteoporosis prevention.The nurse recommends that the patient undergo which type of examination annually?

Accepted Answer

Estrogen therapy increases the incidence of endometrial cancer and breast cancer.An annual pelvic examination is recommended,as well as monthly breast self-examinations (BSE).

Question 10

The patient complains to the nurse about a sharp pain in the lower quadrants every month at midcycle that lasts for several hours.This description is consistent with which underlying pathophysiological process?

Accepted Answer

Mittelschmerz is a pain in either lower quadrant associated with ovulation.There is no stretching of the round ligaments during the midcycle period.Premenstrual uterine changes do not produce discomfort.

Question 11

Which statement accurately describes BRCA1 and BRCA2?

Accepted Answer

BRCA1 and BRCA2 are genes that are involved in the inherited form of breast cancer.It should be noted that not all people who have a BRCA gene get cancer,and people without it may get cancer.

Question 12

Which statement indicates that the patient requires additional teaching related to emergency contraception?

Accepted Answer

The emergency contraceptive Uliprisal (Ella)requires a prescription.It prevents pregnancy by prolonging ovulation and can be taken up to 5 days after unprotected sex.The woman is advised to take an antiemetic prior to each dose to minimize nausea and vomiting.Antiemetics are not necessary before levonorgestrel."Plan B one-step" is one tablet of levonorgestrel only,taken within 72 hours of unprotected sex; the tablet was approved in July 2009 and is available without prescription to women over 17 years of age.After using any emergency contraception,the patient should be referred for counseling and follow-up care.

Question 13

The nurse is caring for a menopausal patient who is experiencing hot flashes.The nurse suggests that the patient increase intake of which foods?

Accepted Answer

During menopause,decreasing estrogen levels may cause hot flashes.Cherries,yams,and black beans are foods rich in phytoestrogens,substances found in plants that may act like normally produced estrogen.Red meat and leafy greens are rich in iron,carrots,and asparagus are rich in beta carotene.Yogurt and cheese are rich in calcium.Iron,beta carotene,and calcium are not known to impact estrogen levels.

Question 14

The nurse is caring for a female patient who reports using an estrogen cream as a lubricant for sexual intercourse.The nurse should caution the patient about which potential negative effect?

Accepted Answer

Using estrogen cream as a lubricant for sexual intercourse is discouraged as the cream may damage latex condoms and require a backup method of contraception.Estrogen cream will not exacerbate hot flashes.Estrogen cream is used to increase vaginal tissue elasticity.While the partner can absorb estrogen from estrogen cream for sexual intercourse,contact dermatitis is not likely.

Question 15

The nurse is educating a speaking to a group of junior high girls about reproductive health.Which information is most important to include?

Accepted Answer

Hormonal changes during the midportion of the cycle may increase breast tenderness.The onset of the menstrual cycle completes puberty and usually occurs between ages 9 and 17.During the first year following menarche,the menstrual cycle may be somewhat irregular,but by the second year a regular cycle of approximately 28 days is normally established.Irregular periods may be a benign finding,but late or absent periods could also be a cause for concern (including a potential sign of pregnancy).Menstrual bleeding occurs about 14 days after ovulation and lasts between 2 and 8 days.

Question 16

Unresolved primary dysmenorrhea may cause the young female to develop which negative perception?

Accepted Answer

Unresolved dysmenorrhea in the young woman can cause negative attitudes related to sexuality and self-worth.

Question 17

When does premenstrual syndrome (PMS)occur?

Accepted Answer

PMS occur during the luteal stage,which lasts from day 15 to day 28 of a 28-day cycle.The uterus prepares to receive a fertilized ovum during this phase.The follicular phase includes the first 14 days of a 28-day cycle.During this dismantling stage,the endometrial layer sloughs away and menstrual flow begins.During the proliferative stage of the menstrual cycle,the follicle grows and the egg matures.

Question 18

After having a right total mastectomy,the patient confides that her husband has voiced concern about her "disfigurement." Which response is most appropriate for the nurse to make? The nurse's most therapeutic response would be:

Accepted Answer

Using open-ended and matter-of-fact tactful questions will help the patient express feelings.Characterizing the husband's statement as terrible renders an inappropriate judgment without exploring how the patient feels.Informing the patient about others' feelings or offering empty reassurance that her husband will change over time is inappropriate and ineffective.

Question 19

The nurse is caring for a patient with a tentative diagnosis of polycystic ovarian syndrome (PCOS).When reviewing the patient's health history,which finding supports this diagnosis?

Accepted Answer

PCOS is a congenital condition in which many cysts develop on one or both ovaries and produce excess estrogen.High levels of testosterone and luteinizing hormone (LH)and low levels of follicle-stimulating hormone (FSH)occur.A manifestation of PCOS includes problems with glucose tolerance,which would result in elevated serum glucose levels.Other signs and symptoms include excessive body hair (hirsuitism),irregular menstruation,and infertility.Cold intolerance could be indicative of hypothyroidism,anemia,Raynaud syndrome,or other underlying medical issues.

Question 20

During a family planning session,a young couple confides that they are hoping to conceive.Which action should the nurse suggest to potentially enhance conception?

Accepted Answer

Water-soluble lubricant has no spermicidal properties as compared to other lubricants that may damage sperm and decrease chances of conception.Heat to the scrotum depresses spermatogenesis and could decrease chance of conception.Foreplay and vibrators do not increase spermatogenesis and will not increase the chances of conception.

Quiz 38: Care of Women with Reproductive Disorders