Chapter 69: Assessment of the Reproductive System

Chapter 69: Assessment of the Reproductive System

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse is developing a teaching plan for a client who is scheduled for her first Papanicolaou test. What instruction by the nurse is the most accurate?
   1. “The timing of the Pap smear does not matter.”
   2. “Sexual intercourse will not interfere with the results.”
   3. “Results can be interpreted immediately in the office.”
   4. “Results are best if you do not douche 24 hours before the test.”

ANS:   D

In order to prevent false interpretation, the client must not douche or have sexual intercourse for at least 24 hours before the Pap smear. Timing is important, with the test scheduled between the client’s menstrual periods so that the menstrual flow does not interfere with laboratory analysis. The specimens are placed on a glass slide and sent to the laboratory for examination and cannot be interpreted immediately.

DIF:     Understanding/Comprehension         REF: 1454                   KEY: Health promotion| cancer screening Pap smear                                       MSC: Integrated Process: Teaching/Learning           NOT:   Client Needs Category: Health Promotion and Maintenance

2. The nurse is assessing the reproductive history of a 68-year-old postmenopausal woman. Which finding is cause for immediate action by the nurse?
   1. Vaginal dryness
   2. Need for a Papanicolaou test if none for 3 years
   3. Bleeding from the vagina
   4. Leakage of urine

ANS:   C

Vaginal bleeding is not normal for the postmenopausal woman. Vaginal dryness and leakage of urine are common findings in adults of this age range. Pap tests may not be needed for women over 65 who have had regular cervical cancer testing with normal results.

DIF:     Applying/Application                         REF: 1453                   KEY: Adult life stages| older adult| nursing assessment                                MSC:                         Integrated Process: Nursing Process: Evaluation                                         NOT:                          Client Needs Category: Physiological Integrity: Physiological Adaptation

3. The nurse is reviewing discharge instructions with a client who has just experienced an endometrial biopsy. Which finding should be reported to the health care provider immediately?
   1. Mild cramping
   2. Slight chills and fever
   3. Spotting of blood on a perineal pad
   4. Fatigue after anesthesia

ANS:           B

Chills and fever could indicate an infection and should be reported immediately to the health care provider. Mild cramping, spotting, and fatigue are normal findings after an endometrial biopsy.

DIF:            Applying/Application                         REF:    1458                 KEY: Infection control| wound infection| discharge teaching                                  MSC: Integrated Process: Teaching/Learning                               NOT:                                                 Client Needs Category: Physiological Integrity: Reduction of Risk Potential

4. A client is concerned about her irregular menstrual periods since she has increased her daily workouts at the gym to 2 hours each day. What is the nurses’ best response?
   1. “Do you want to talk about the need for that much exercise?”
   2. “Exercise is healthy but can decrease body fat and cause irregular periods.”
   3. “Bingeing and purging can cause electrolyte problems in your body.”
   4. “Anorexic behavior can result in decreased estrogen levels.”

ANS:           B

There needs to be a certain level of body fat and weight to maintain regular menstrual cycles. The client has only indicated that she has increased her workouts. There is no indication that she has anorexic or bingeing and purging behaviors.

DIF:            Applying/Application                         REF:    1453

KEY:          Exercise| health promotion| lifestyle choices

MSC:          Integrated Process: Communication and Documentation

NOT:          Client Needs Category: Psychosocial Integrity

5. A nurse and unlicensed assistive personnel (UAP) are helping a client during a hysterosalpingogram. Which action by the nurse is best delegated to the UAP?
   1. Witnessing of the consent form
   2. Assisting the client into a lithotomy position
   3. Asking about allergies to iodine or shellfish
   4. Assessing for pelvic or shoulder pain after the study

ANS:           B

The UAP would be able to position the client for the procedure. Only the nurse has the ability to witness the consent form and assess allergies and pain within the nursing scope of practice.

DIF:            Applying/Application                         REF:    1456                 KEY: Management| delegation| intraoperative nursing| unlicensed assistive personnel (UAP) MSC:       Integrated Process: Nursing Process: Implementation NOT:                             Client Needs Category: Safe and Effective Care Environment: Management of Care