Chapter 33: Preventive Care for Women

Chapter 33: Preventive Care for Women

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which piece of the usual equipment setup for a pelvic examination is omitted with a Pap smear?

a.	Lubricant
b.	Speculum
c.	Fixative agent
d.	Gloves and eye protectors

 

 

ANS:  A

Lubricants interfere with the accuracy of the cytology report. A speculum is needed to see the cervix. A fixative agent is applied to the slide to prevent drying or disruption of the specimen. The examiner should always use standard precautions.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   722

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Health Promotion and Maintenance

 

2. A 45-year-old client asks how often she should have a mammogram. The most appropriate answer is:

a.	whenever she feels a lump.
b.	every year beginning at age 40.
c.	they are unnecessary until age 50.
d.	every year if you have risk factors.

 

 

ANS:  B

The American Cancer Society recommends that women have an annual mammogram after 40 years of age. Mammography should be done routinely following the American Cancer Society guidelines. Mammograms are necessary when a woman is in her 40s. Women with high-risk factors may need them more often.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   722

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Health Promotion and Maintenance

 

3. While performing a self-breast exam, the client notes an area on the right breast that is nodular, with some associated tenderness. This is a new onset finding because the exams were not problematic in the past,. The left breast examination is unremarkable. The client calls to report her findings to the clinical nurse because this is not her typical result. What action should the nurse take next?

a.	Refer the client to an oncologist because the results sound suspicious.
b.	Ask the client to come in for an office visit so that the findings can be validated but tell her that this information is within the normal range of presentation.
c.	Have the client wear a tight-fitting bra and tell her that the tenderness is associated with ovulation and will pass.
d.	Have the client repeat the self-breast exam in 2 weeks and call back with findings to provide a basis for comparison.

 

 

ANS:  B

Although these findings are within the normal range of presentation for breast tissue, they are not in the normal presentation for this client. The client has called to express concern; therefore, the nurse should have the client schedule an appointment for assessment and evaluation. There is no need for referral to a specialist at this time. Wearing a tight fitting bra may help provide support but does not address the physical findings and concern of the client. Repeating the self-breast exam may be required but it does not address the client’s current concerns; therefore, the client should be seen by a health care provider.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   720, 721

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Health Promotion and Maintenance

 

4. Findings of a Pap smear exam denote atypical cells of undetermined significance (ASCUS). The Pap test is repeated at 6 months and the same finding of ASCUS are reported. Which therapeutic treatment option would the nurse expect the practitioner to order?

a.	Mammography
b.	Bone scan
c.	Transvaginal ultrasound
d.	Biopsy

 

 

ANS:  D

Based on the standard of care, a colposcopy or biopsy of the cervix is indicated. A Pap smear is done to evaluate the cervix. There is no indication that mammography, which is used to assess and evaluate breast tissue, is required. There is no evidence to warrant a bone scan. Although a transvaginal ultrasound might be included in the treatment plan, the Pap smear indicates cervical pathology so a colposcopy or biopsy is indicated.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   724

OBJ:   Nursing Process Step: Planning        MSC:  Client Needs: Health Promotion and Maintenance