Chapter 74: Care of Patients with Gynecologic Problems

Chapter 74: Care of Patients with Gynecologic Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A client is in the clinic reporting stress incontinence. Which other assessment is the priority for the nurse to perform?

a.	Ask the client about vaginal discharge or bleeding.
b.	Have the client perform a 24-hour fluid recall.
c.	Inquire about fever, chills, and burning on urination.
d.	Obtain the client’s reproductive history.

 

 

ANS:  A

Gynecologic problems are often accompanied by urinary symptoms. Because women are often hesitant or embarrassed to discuss gynecologic problems, the nurse should specifically assess for them in clients reporting urinary issues. The other assessments are important as well but are not the priority.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

2. A woman reports cyclical abdominal pain, and her pelvic examination reveals tender nodules in the posterior vagina. The nurse plans to educate the woman about which treatment?

a.	Medroxyprogesterone (Depo-Provera)
b.	Radiation therapy
c.	Doxycycline (Vibramycin)
d.	Endometrial ablation

 

 

ANS:  A

This client has manifestations of endometriosis, and menstrual cycle control is a common therapy. Oral contraceptives or injectables such as Depo-Provera are often used. Radiation therapy is used for cancer. Doxycycline is an antibiotic used for bacterial infection. Endometrial ablation is a treatment used for dysfunctional uterine bleeding.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Illness Management)  MSC:           Integrated Process: Nursing Process (Implementation)

 

3. A woman has endometriosis and is visibly upset. She tells the nurse that she just got married and wants to have children but is distressed because now she will be infertile. Which response by the nurse is most appropriate?

a.	“Treatment for endometriosis often causes infertility; I can refer you to a support group.”
b.	“Endometriosis is more common in infertile women, but not all treatments cause infertility.”
c.	“You shouldn’t worry about fertility until after we know that this didn’t cause cancer.”
d.	“Unfortunately, you will have to take birth control pills for the rest of your life.”

 

 

ANS:  B

Endometriosis is more common among infertile women than in the general population. However, treatments can be chosen on the basis of symptoms, extent of the disease, and the woman’s desire to remain fertile. Menstrual cycle control with hormones is often a choice and would not leave the woman infertile. Endometriosis only rarely causes cancer. The woman would not have to take birth control pills for the rest of her life.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Health Promotion and Maintenance (Principles of Teaching/Learning)

MSC:  Integrated Process: Teaching/Learning

 

4. A 48-year-old woman reports to the nurse about new “flooding” with her periods. Which other complaint is the nurse prepared to investigate more thoroughly?

a.	Hot flashes and sweating episodes
b.	Fatigue during typical activity
c.	More frequent periods than usual
d.	Abdominal cramping with periods

 

 

ANS:  B

A description of “flooding” during the menstrual cycle indicates heavy bleeding, which may be due to dysfunctional uterine bleeding (DUB). DUB usually occurs at the beginning or at the end of a woman’s reproductive years. Because this woman is 48, she might be entering the perimenopausal period. Fatigue during usual activities can indicate anemia. Hot flashes with sweating are a manifestation of menopause. More frequent menstrual bleeding also occurs in DUB. Abdominal cramping may be normal for this client.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Analysis)