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Iggy Ch 69 Assessment of the Reproductive System

1. What is the site for a Papanicolaou (Pap) test?
a. Cervix
b. Vaginal wall
c. Uterus
d. Fallopian tubes

a

2. The nurse is interviewing a 52-year-old woman who reports irregular and decreased flow of menses for several months. Which question does the nurse ask the patient?
a. “Is there any chance you could be pregnant?”
b. “Are you having any discomfort during intercourse?”
c. “Do your breasts feel tender or swollen?”
d. “Are you having any problems with urination?”

b

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3. The nurse is assisting a patient to assume the correct position for a hysteroscopy procedure. Which position is correct?
a. Lithotomy position
b. Side-lying position
c. Slight Trendelenburg position
d. Low-Fowler’s position

a

4. An insufficient estrogen level is related to what condition?
a. Osteoporosis
b. Diabetes mellitus
c. Endometriosis
d. Decreased immune function

a

5. A male patient had mumps as a child which caused orchitis. Which potential complication could result?
a. Decreased libido
b. Chronic urinary infection
c. Enlarged prostate gland
d. Testicular atrophy

d

6. A male patient reports that he has a decreased libido. The nurse assesses for which factors related to this condition? (Select all that apply.)
a. Tobacco use
b. Type of exercise
c. Alcohol consumption
d. Occupation
e. Illicit drug use

a,c,e

7. Most diseases that alter a woman’s metabolism or nutrition can result in which condition?
a. Excessive bleeding
b. Endometriosis
c. Amenorrhea
d. Pelvic inflammatory disease

c

8. A 60-year-old female patient informs the nurse that she has experienced some vaginal changes since menopause. What gynecologic change is the patient most likely to report?
a. Thin, white vaginal drainage
b. Vaginal odor
c. Excessive vaginal bleeding
d. Vaginal dryness

d

9. The mother of a 17-year-old adolescent girl tells the nurse that her daughter has been purging, showing anorexic behavior, and continuously exercising. Based on the mother’s report, which question related to the reproductive system would the nurse ask the girl?
a. “When was your last normal menstrual period?”
b. “Are you sexually active?”
c. “Are you having any unusual vaginal discharge?”
d. “Have you had any problems with urination?”

a

10. A 29-year-old patient has strictures and adhesions in her fallopian tubes. This may be the result of which condition?
a. Pelvic inflammatory disease
b. Frequent bouts of colitis
c. Gallbladder disease
d. Frequent urinary tract infections

a

11. In a patient with a reproductive health problem, what health and lifestyle habits would the nurse assess? (Select all that apply.)
a. Diet
b. Socioeconomic status
c. Exercise pattern
d. Occupation
e. Sleep pattern

a,c,e

12. A patient is diagnosed with a chlamydial infection, but is reluctant to spend the money for treatment because she is asymptomatic and does not have a job or health insurance. The nurse advises her that chlamydial infections can result in which condition?
a. Female infertility
b. Male partner infertility
c. Amenorrhea
d. Teratogenic effects

a

13. A 40-year-old woman has heavy vaginal bleeding. Which question is the priority in evaluating the patient’s chief complaint?
a. “Is the bleeding related to the menstrual cycle or intercourse?”
b. “Are you having any sensations of pain or cramping?”
c. “Are you sexually active and do you use oral contraceptives?”
d. “Are you feeling weak, dizzy, or lightheaded?”

d

14. A 37-year-old patient reports abnormal vaginal bleeding not related to her menstrual cycle.
The nurse would ask the patient about which associated symptoms? (Select all that apply.)
a. Pain
b. Change in bowel habits
c. Breast mass
d. Abdominal fullness
e. Urinary difficulties

a,b,d,e

15. According to the American Cancer Society (ACS) recommendations, which healthy woman with no previous history of an abnormal Pap test should be advised to have a Pap test every 3 years?
a. 18-year-old
b. 21-year-old
c. 35-year-old
d. 70-year-old

b

16. The health care provider has just informed the patient about the diagnosis and complications of salpingitis. Which intervention is the nurse most likely to use with this patient?
a. Review nonpharmacologic methods to control chronic pain.
b. Use empathetic listening for feelings related to possible infertility.
c. Inform that annual Pap smears are recommended for salpingitis.
d. Review expected changes that will occur with menstrual flow.

b

17. For a patient with a low testosterone level, which symptom is the patient most likely to report?
a. Increased muscle mass
b. Problems passing urine
c. Change in sexual performance
d. Testicular pain with nausea

c

18. What features would be considered normal findings for the scrotum of a young white male? (Select all that apply.)
a. Suspended below the pubic bone
b. Tenderness with gentle palpation
c. Contracts with exposure to cold
d. Sparse hair follicles
e. Dark cherry-red coloration

a,c,d

19. What is the function of the prostate gland?
a. Production and storage of testosterone
b. Secretes fluid to enhance sperm movement
c. Secretes hormone to increase libido
d. Production of androgen and relaxin

d

20. A 72-year-old patient admitted to the medical-surgical unit tells the nurse that he has benign prostatic hyperplasia. Which question will the nurse ask?
a. “Have you had chemotherapy or radiation treatments?”
b. “Were you recently diagnosed with benign prostatic hyperplasia?”
c. “Would you like to review information about nutrition therapy?”
d. “Are you having urinary incontinence or frequency at night?”

d

21. A young woman reports that she has a genital discharge causing irritation and odor. She feels embarrassed, but insists that she has not had recent sexual relations. Which question is the nurse most likely to ask?
a. “Have you recently taken any antibiotic medications?”
b. “Do you have a family history for cervical cancer?”
c. “How old were you when you first had sexual intercourse?”
d. “Have you had a change of diet or noticed weight loss?”

a

22. The nurse is interviewing a patient who reports a discharge from his penis that started 3 days ago. What does the nurse ask the patient regarding this problem? (Select all that apply.)
a. “Has your sexual partner(s) noticed a discharge?”
b. “Does the discharge have an odor?”
c. “Have you noticed a mass or lump in the scrotum?”
d. “Have you noticed a change in bowel habits?”
e. “What is the consistency of the discharge?”

a,b,e

23. A nurse is working at an ambulatory clinic. Which patient is most likely to need to be prepared for a pelvic examination?
a. 12-year-old whose mother desires a “virgin check”
b. 25-year-old with a possible urinary tract infection
c. 62-year-old who reports resumption of menses
d. 53-year-old who reports decreased libido

c

24. A 31-year-old woman is diagnosed wiith salpingitis. On the figure below, indicate which area of the reproductive system is most affected by this condition.

Fallopian tube (oviduct)

25. Which diagnostic test is used to differentiate solid tissue masses from cystic or hemorrhagic structures in the abdomen and pelvis?
a. Hysterosalpingography
b. Computed tomography
c. Hysteroscopy
d. Colposcopy

c

26. Which test detects cancerous and precancerous cells of the cervix?
a. Serologic studies
b. Vaginal culture
c. Pap smear
d. Human pailloma virus (HPV) test

c

27. A patient calls to make an appointment for a routine pelvic exam which includes a Pap smear. What type of instructions does the nurse give the patient about preparing for the exam?
a. “Do not douche for at least 24 hours before the exam.”
b. “D not eat or drink anything after midnight.”
c. “Clean genitals with mild soap and water before the exam.”
d. “Do not wear a tampon if you are menstruating.”

a

28. A 79-year-old man is being seen for difficulty voiding and some blood in the urine. Which is the first screening test likely to be doen?
a. Cytologic cultures
b. Prostate-specific antigen testing
c. Serum levels for testosterone
d. Serologic studies

b

29. An African-American male patient has a prostate-specific antigen (PSA) level less than 2.5 ng/mL. Which information should the nurse give to the patient?
a. African-American men typically have lower-than-normal PSA levels.
b. Level indicates a need for follow-up for possible prostate cancer.
c. PSA level of less than 2.5 ng/mL is generally considered normal.
d. Test should be repeated on an annual basis to monitor the abnormality.

c

30. A patient received treatment for prostate cancer. Which test is most likely to be ordered to monitor the disease after treatment?
a. Transrectal biopsy
b. PSA test
c. HPV test
d. Routine prostate examination

b

31. The patient reports fatigue and low libido. Based on the patient’s report of symptoms, which laboratory result would the nurse seek out first?
a. Pap smear results
b. Rubella titer
c. Red blood cell count
d. Luteinizing hormone level

c

32. Which patient is most likely to require an iron supplement?
a. 53-year-old woman who is entering menopause and has a breast mass
b. 32-year-old female with heavy menstrual bleeding and an intrauterine device
c. 70-year-old male who is diagnosed with benign prostatic hyperplasia
d. 23-year-old woman who has pelvic inflammatory disease

b

33. The health care provider tells the nurse that the patient is being evaluated for galactorrhea and to please call with the relevant laboratory results. Which laboratory result will the nurse look for?
a. Prolactin level
b. Endometrial biopsy results
c. Follicle-stimulating hormone (FSH) level
d. Progesterone level

a

34. A 23-year-old female has a decreased level of FSH. What may this finding indicate?
a. Midcycle of menses
b. Pregnancy
c. Premature menopause
d. Infertility

d

35. Which statement about PSA testing is true?
a. It is used to screen for prostate cancer.
b. PSA levels above 25 ng/mL are associated with prostate cancer.
c. Older men often have a lower-normal PSA level.
d. It is done on patients over 60 years of age.

a

36. The nurse is teaching a patient about the contraindications for hysteroscopy. What does the nurse tell the patient?
a. “During the procedure, normal or abnormal cells can be pushed through the fallopian tubes and into your pelvic cavity; therefore pregnancy is contraindicated.”
b. “The procedure causes irritation and can be very painful if your vaginal tissue is dry or fragile; therefore, the procedure is not recommended for postmenopausal women.”
c. “The procedure can cause a lot of bleeding so a recent prescription of an anticoagulant is a contraindication.”
d. “During the procedure, an iodine-based dye is used, so allergies to shellfish or iodine are contraindications.”

a

37. What test is used to assess tubal anatomy and patency, and uterine problems?
a. Computed tomography
b. Laparoscopy
c. Colposcopy
d. Hysterosalpingography

d

38. The nurse is caring for a patient who had a laparoscopy. What is included in the postoperative care for this patient? (Select all that apply.)
a. Administer oral analgesics for incisional pain.
b. Notify the health care provider of postoperative shoulder pain.
c. Reassure the patient that most painful sensations disappear within 4 to 6 weeks.
d. Instruct the patient to change the small adhesive bandage as needed.
e. Teach the patient to observe the incision for signs of infection or hematoma.
f. Remind the patient to avoid strenuous activity for 4 to 6 weeks after the procedure.

a,d,e

39. The nurse is helping a patient schedule an appointment for a hysteroscopy. When does the nurse advise the patient that the procedure should be done?
a. 5 days after menses have ceased
b. 5 days before the beginning of menses
c. During the menstrual period
d. Whenever she can take 3 to 4 days off of work

a

40. A patient has just been informed by the health care provider that she has specific BRCA 1 and BRCA2 gene mutations. Which brochure would the nurse prepare for the patient?
a. “Role of Nutrition Therapy in Reproductive Health”
b. “Risk Factors and Treatments for Infertility”
c. “Risk Factors and Treatments for Breast Cancer”
d. “Colposcopy and Other Tests for Cervical Cancer”

c

41. Which man has the greatest risk for developing prostate cancer?
a. Patient’s grandfather, age 82 years, has benign prostatic hyperplasia.
b. Patient’s father was diagnosed and treated for prostate cancer at age 50.
c. Patient’s mother took diethylstilbestrol (DES) to control bleeding during pregnancy.
d. Patient’s brother had delayed development of sexual characteristics.

b

42. The nurse is assisting a patient who needs a pelvic examination. Which action will the nurse perform?
a. Clean perineum with antiseptic solution.
b. Administer a mild analgesic.
c. Assess for allergies to iodine.
d. Instruct to empty the urinary bladder.

d

43. A patient has just been informed that she has an abnormal Pap smear and a positive HPV test. The nurse should be prepared to provide information about which topic?
a. Increased risk for cervical cancer
b. Increased risk for endometrial cancer
c. Increased risk for herpes simplex virus type 2
d. Increased risk for human immunodeficiency virus

a

44. The nurse is talking to a patient who is about to undergo a hysterosalpingogram. The patient discloses information that may not have been available to the health care provider when the test was initially scheduled. Which disclosure could cause the provider to cancel or reschedule the test?
a. Took an over-the-counter acetaminophen 1 hour ago
b. Has fever with malodorous vaginal discharge
c. Has a previous history of uterine fibroids
d. Is on day 10 of the menstrual cycle

b

45. What preprocedural instructions would the nurse give the patient about a mammogram?
a. Do not eat or drink anything 6 to 7 hours before the test.
b. Abstain from sexual relations prior to test to avoid pregnancy.
c. Do not use lotions, creams, or powder on breasts before the study.
d. Wear a supportive bra pad bring a breast pad for use after testing.

c

46. What postprocedure instructions would the nurse give to a patient who just had a colposcopy?
a. Do not drive or operate heavy machinery while taking prescribed pain medication.
b. Do not use tampons and abstain from sexual intercourse for at least 1 week.
c. Wear a perineal pad and expect bleeding with small clots for the first 24 hours.
d. Perform breast self-examination every month and report changes to provider.

b

47. The patient needs to be scheduled for an endometrial biopsy to assess unusually heavy menstrual bleeding.
Which question is the most important to ask, in relation to scheduling the examination?
a. “Have you ever had a spontaneous miscarriage or an elective abortion?”
b. “How many pads per day are you using during the heaviest flow?”
c. “What was the date of your last menstrual period and are you regular?”
d. “Do any unexpected symptoms accompany the heavy menstrual flow?”

c

48. What postprocedure instructions would the nurse give to a patient who had a prostate biopsy?
a. Light rectal bleeding and blood in the urine or stools is expected for a few days.
b. Swelling of the biopsy area and difficulty urinating are expected for 1 week.
c. Low-grade fever and bright-red penile discharge are normal for several days.
d. Return to see the health care provider in 1 week for recheck of biopsy site.

a


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