Chapter 71: Care of Patients with Gynecologic Problems Ignatavicius

Chapter 71: Care of Patients with Gynecologic Problems Ignatavicius

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which action would the nurse teach to help the client prevent vulvovaginitis?
   1. Wipe back to front after urination.
   2. Cleanse the inner labial mucosa with soap and water.
   3. Use feminine hygiene sprays to avoid odor.
   4. Wear loose cotton underwear.

ANS:   D

To prevent vulvovaginitis, the client should wear cotton underwear. The client should wipe front to back after urination, not back to front. The client should cleanse the inner labial mucosa with water only, and avoid using feminine hygiene sprays.

DIF:     Remembering/Knowledge                 REF: 1485                   KEY: Patient education| hygiene| self-care                                                                       MSC:             Integrated Process: Teaching/Learning                                                      NOT:              Client Needs Category: Health Promotion and Maintenance

2. The nurse is educating a client on the prevention of toxic shock syndrome (TSS). Which statement by the client indicates a lack of understanding?
   1. “I need to change my tampon every 8 hours during the day.”
   2. “At night, I should use a feminine pad rather than a tampon.”
   3. “If I don’t use tampons, I should not get TSS.”
   4. “It is best if I wash my hands before inserting the tampon.”

ANS:   A

Tampons need to be changed every 3 to 6 hours to avoid infection by such organisms as Staphylococcus aureus. All of the other responses are correct: use of feminine pads at night, not using tampons at all, and washing hands before tampon insertion are all strategies to prevent TSS.

DIF:     Applying/Application                         REF: 1485                   KEY: Infection control| patient education| self-care                                                     MSC:             Integrated Process: Teaching/Learning                                                      NOT:              Client Needs Category: Health Promotion and Maintenance

3. A client is admitted to the emergency department with toxic shock syndrome. Which action by the nurse is the most important?
   1. Administer IV fluids to maintain fluid and electrolyte balance.
   2. Remove the tampon as the source of infection.
   3. Collect a blood specimen for culture and sensitivity.
   4. Transfuse the client to manage low blood count.

ANS:   B

The source of infection should be removed first. All of the other answers are possible interventions depending on the client’s symptoms and vital signs, but removing the tampon is the priority.

DIF:            Applying/Application                         REF:    1485

KEY:          Emergency nursing| sepsis| shock

MSC:          Integrated Process: Nursing Process: Implementation           NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

4. A 55-year-old post-menopausal woman is assessed by the nurse with a history of dyspareunia, backache, pelvis pressure, urinary tract infections, and a frequent urinary urgency. Which condition does the nurse suspect?
   1. Ovarian cyst
   2. Rectocele
   3. Cystocele
   4. Fibroid

ANS:           C

Dyspareunia, backache, pelvis pressure, urinary tract infections, and urinary urgency are all symptoms of a cystocele—a protrusion of the bladder through the vaginal wall. Ovarian cysts are rare after menopause. A rectocele is associated with constipation, hemorrhoids, and fecal impaction. Fibroids are associated with heavy bleeding.

DIF:            Remembering/Knowledge                 REF:    1486

KEY:          Pain| reproductive system

MSC:          Integrated Process: Nursing Process: Assessment                 NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation

5. The nurse is caring for a postoperative client following an anterior colporrhaphy. What action can be delegated to the unlicensed assistive personnel (UAP)?
   1. Reviewing the hematocrit and hemoglobin results
   2. Teaching the client to avoid lifting her 4-year-old grandson
   3. Assessing the level of pain and any drainage
   4. Drawing a shallow hot bath for comfort measures

ANS:           D

The UAP  is able to provide comfort through a bath. The registered nurse should review any laboratory results, complete any teaching, and assess pain and discharge.

DIF:            Applying/Application                         REF:    1487                 KEY: Delegation| Unlicensed assistive personnel (UAP)| comfort measures| postoperative nursing MSC:        Integrated Process: Nursing Process: Implementation NOT:                             Client Needs Category: Safe and Effective Care Environment: Management of Care