Chapter 6 Common Gynecologic Problems

Chapter 6   Common Gynecologic Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The nurse is teaching a class to women who were recently diagnosed with benign breast disease (BBD), commonly known as fibrocystic breast disease. One of the participants’ reports increased swelling, pain, and pressure in her breasts just before menstruation. What is the best response by the nurse?

1. “Consider asking your nurse practitioner about adding a mild diuretic to your regimen.”
2. “The pain may be caused by thinning of the normal breast tissue.”
3. “Breast swelling and pressure are expected symptoms, but pain is abnormal and should be evaluated by your physician.”
4. “It’s best to make an appointment with an oncologist.”

Answer:  1

Explanation:  1. Treatment of BBD may include taking a mild diuretic during the week prior to the onset of menses to counteract fluid retention, relieve pressure in the breast, and help decrease pain.

2. The pathology of BBD involves fibrosis, which is a thickening of the normal breast tissue.
3. Common symptoms associated with BBD include cyclical breast pain, tenderness, and swelling.
4. Cyclical breast pain, swelling, and tenderness are common symptoms associated with BBD. Generally fibrocystic changes are not a risk factor for breast cancer.

Page Ref: 94

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and health promotion

Learning Outcome:  LO 6.1-Contrast the contributing factors, signs and symptoms, treatment options, and nursing care management of women with common benign breast disorders.

MNL LO:  Describe the structures and functions of the female reproductive system.

 

2) The nurse is caring for a client diagnosed with endometriosis. Which statement by the client requires immediate follow-up?

1. “I am having many hot flashes since I had the Lupron injection.”
2. “The pain I experience with intercourse is becoming more severe.”
3. “My leg has become painful and swollen since I started taking birth control pills.”
4. “I’ve noticed my voice is lower since I started taking danazol.”

Answer:  3

Explanation:  1. Leuprolide acetate (Lupron) is a GnRH agonist and causes symptoms of a hypo-estrogenic state (hot flashes, vaginal dryness, decreased libido, and bone density loss). Hot flashes are expected and not a complication.

2. Dyspareunia is a common symptom of endometriosis and therefore is not a complication.
3. Combination oral contraceptive pills contain estrogen. A painful, swollen lower extremity can be a sign of deep vein thrombosis, which can cause thromboembolus, which is potentially life threatening. This is a complication and must be addressed immediately.
4. Danocrine (danazol) is a testosterone derivative that suppresses GnRH and has high-androgen and low-estrogen effects. A lowered voice is one side effect of danazol. This client is not experiencing a complication.

Page Ref: 95

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/ Health teaching and health promotion

Learning Outcome:  LO 6.2-Explain the signs and symptoms, medical therapy, and implications for fertility of endometriosis.

MNL LO:  Explain the relationship between pelvic inflammatory disease (PID) and infertility.

 

3) The nurse is creating a care plan for a client who is unable to conceive as a consequence of endometriosis. Which statement accurately reflects a nursing diagnosis that may apply to the care of this client?

1. Acute pain related to dysuria and renal pain secondary to endometriosis
2. Hyperandrogenism related to elevated serum androgen levels secondary to endometriosis
3. Compromised family coping related to depression secondary to infertility
4. Infertility related to endometrial inflammation and adhesions secondary to endometriosis

Answer:  3

Explanation:  1. Pelvic pain is a frequent symptom of endometriosis, while dysuria and renal pain are more commonly associated with conditions such as upper urinary tract infections (UTI).

2. Hyperandrogenism is a medical diagnosis that pertains to elevated serum androgen levels. Hyperandrogenism is associated with polycystic ovarian syndrome (PCOS).
3. Infertility may lead to depression and subsequent compromised family coping, which is a nursing diagnosis.
4. Although associated with the medical condition of endometriosis, infertility is a medical diagnosis.

Page Ref: 95

Cognitive Level:  Analyzing

Client Need&Sub:  Safe and Effective Care Environment

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Diagnosis/Coordination of care

Learning Outcome:  LO 6.2-Explain the signs and symptoms, medical therapy, and implications for fertility of endometriosis.

MNL LO:  Explain the relationship between pelvic inflammatory disease (PID) and infertility.

 

4) The client has been diagnosed with endometriosis. She asks the nurse if there are any long-term health risks associated with this condition. The nurse should include which statement in the client teaching about endometriosis?

1. “There are no other health risks associated with endometriosis.”
2. “Pain with intercourse rarely occurs as a long-term problem.”
3. “You are at increased risk for ovarian and breast cancer.”
4. “Most women with this condition develop fibromyalgia.”

Answer:  3

Explanation:  1. There are long-term health risks associated with endometriosis, including increased risk for cancer of the ovary and breast, melanoma, non-Hodgkin lymphoma, and an increased incidence of fibromyalgia.

2. Dyspareunia is a common symptom of endometriosis.
3. An increased risk for cancer of the ovary and breast is associated with endometriosis.
4. There is a risk of increased incidence of fibromyalgia.

Page Ref: 95

Cognitive Level:  Analyzing

Client Need&Sub:  Physiological Integrity

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 6.2-Explain the signs and symptoms, medical therapy, and implications for fertility of endometriosis.

MNL LO:  Explain the relationship between pelvic inflammatory disease (PID) and infertility.

 

5) A patient diagnosed with polycystic ovarian disease (PCOS) asks her nurse why her treatment regimen includes spironolactone (Aldactone). How should the nurse respond?

1. “Spironolactone may be used to decrease symptoms associated with PCOS, such as excessive hair growth and acne.”
2. “Menstrual irregularities related to polycystic ovarian disease are treated using spironolactone.”
3. “Spironolactone is often used to reduce complications associated with PCOS, including rectocele.”
4. “Condylomata acuminata, which are sometimes caused by polycystic ovarian disease, are treated with spironolactone.”

Answer:  1

Explanation:  1. Spironolactone may be used to treat symptoms of hyperandrogenism that are secondary to PCOS, including excessive hair growth and acne.

2. Combined oral contraceptive (COC) or cyclic progesterone are used to treat menstrual irregularities associated with PCOS.
3. A rectocele, which may develop when the posterior vaginal wall is weakened, is associated with pelvic relaxation.
4. Condylomata acuminata, also called genital or venereal warts, is a sexually transmitted condition unrelated to PCOS.

Page Ref: 96, 97

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  LO 6.4-Discuss the signs and symptoms, diagnosis criteria, treatment options, and health implications of polycystic ovarian syndrome (PCOS).

MNL LO:  Women’s health