Women's Health - Ch 11: Structural Disorders and Neoplasms of the Reproductive System
The nurse should be aware that a pessary is most effective in the treatment of which disorder?
a.Cystocele
b.Uterine prolapse
c.Rectocele
d.Stress urinary incontinence
ANS: B
A fitted pessary may be inserted into the vagina to support the uterus and hold it in the correct position. Usually a pessary is used for only a short time
and is not used for the client with a cystocele. A rectocele cannot be corrected by the use
A postmenopausal woman has been diagnosed with two leiomyomas (fibroids). Which clinical finding is most commonly associated with the presence of leiomyomas?
a.Abnormal uterine bleeding
b.Diarrhea
c.Weight loss
d.Acute abdominal pain
ANS: A
Most women are asymptomatic. Abnormal uterine bleeding is the most common symptom of leiomyomas. Diarrhea
is not commonly associated with leiomyomas. Weight loss does not usually occur in the woman with leiomyomas, and the client with leiomyomas is
Which woman is at the greatest risk for psychologic complications after hysterectomy?
a.55-year-old woman who has been having abnormal bleeding and pain for 3 years
b.46-year-old woman who has had three children and has just been promoted at work
c.62-yea
ANS: D
The 19-year-old woman is still in her
childbearing years. Often the uterus is related to self-concept in women in this age group, and they may feel that sexual functioning is related to having a uterus. The 55-year-old woman is past her childbearin
A 48-year-old woman has just had a hysterectomy for endometrial cancer. Which statement alerts the nurse that further teaching is needed?
a."I can't wait to go on the cruise that I have planned for this summer."
b."I know that the surgery saved my life, b
ANS: B
Stating that she will miss having sexual intercourse with her husband indicates that further teaching is needed for this client regarding sexual activities after a hysterectomy. Although intercourse may be initially uncomfortable, the use of water-
The nurse provides education to a client about to undergo external radiation therapy. Which statement by the client reassures the nurse that the teaching has been effective?
a."I am using
ointment to keep my skin from drying out."
b."I wash the irradiated
ANS: C
To maintain good nutrition, the woman should eat high-protein meals or use protein supplements and should have a high daily fluid intake of 2 to 3 L. The woman is counseled about good skin care and taught to avoid soaps, ointments, cosmetics, and d
With regard to the treatment plan for a pregnant woman with gynecologic cancer, which statement about timing or type of
treatment is correct?
a.The fetus is most at risk during the first trimester.
b.The fetus is most at risk during the second trimester.
ANS: A
The first trimester is the most vulnerable period for the growing fetus. Women may be faced with making a decision about terminating the pregnancy, depending on the stage and extent of the disease. For advanced disease in the second trimester, alky
Which precaution should the nurse take while caring for
a client who is undergoing internal radiation therapy for cervical cancer?
a.Wear gloves when assessing the cervical intracavity implant.
b.Instruct the client to urinate in the lead-lined bedpan or
ANS: D
Staff and visitor exposure should be limited to 30 minutes or less in an 8-hour period to reduce the risk of overexposure to radiation. Nurses need to protect themselves from overexposure to radiation. Wearing a shield is one method of protection.
What is the most common reproductive tract cancer associated with pregnancy?
a.Cervical
b.Uterine
c.Ovarian
d.Fallopian tube
ANS: A
The incidence of cervical cancer concurrent with pregnancy is reported to be 1 in 2000 pregnancies making it the most common reproductive tract cancer associated with pregnancy. Uterine cancer is rarely diagnosed during pregnancy. Ovarian cancer is
When caring for clients with neoplasms of the reproductive system, the nurse must begin by assessing the woman's knowledge of the disorder, its management, and prognosis. This assessment should be followed by a nursing diagnosis. Which diagnosis fails to
ANS: C
Although risk for injury, related to lack of skill for self-care, is appropriate to this client's condition, this diagnosis is more suited to the client's learning needs than the psychologic effect. Anxiety, related to surgical procedures, is appro
The prevalence of urinary incontinence (UI) increases as women age, with more than one third of the women in the United States suffering from some form of this disorder. The symptoms of mild-to-moderate UI can be successfully decreased by a number of stra
ANS: B
Pelvic muscle exercises, known as Kegel exercises, along with bladder training can significantly decrease or entirely relieve stress incontinence in many women. Pelvic floor support devices, also known as
pessaries, come in a variety of shapes and
A woman exhibits symptoms that may lead to a possible diagnosis of polycystic ovary syndrome (PCOS). While completing the initial assessment of the client, which clinical finding would the nurse not anticipate?
a.Anorexia
b.Hirsutism
c.Irregular menses
d.
ANS: A
These clients often are obese rather than anorexic with weight loss. Approximately 40% of these women also display glucose intolerance
and hyperinsulinemia. Excessive hair growth is often present in women with PCOS. This client is likely to have ir
What information is important for the nurse to include in planning for the care of a woman who has had a vaginal hysterectomy?
a.Expect to be fully recovered in 4 to 6 weeks.
b.Expect no changes in her hormone levels.
c.Expect surgical menopause.
d.Take t
ANS: B
Unless the ovaries were also removed, hormonal levels should
not change. Menses will cease, but the hypothalamus-pituitary-ovarian axis remains intact. The woman should expect to have vaginal discharge for 4 to 6 weeks. Full recovery varies from wo
A woman has preinvasive cancer of the cervix. Which modality would the nurse discuss as an available option for a client with this condition?
a.Cryosurgery
b.Colposcopy
c.Hysterectomy
d.Internal radiation
ANS: A
Cryosurgery, laser surgery, and loop
electrosurgical excision procedure (LEEP) are several techniques used to treat preinvasive lesions. Colposcopy is the examination of the cervix with a stereoscopic binocular microscope that magnifies the view of
Which condition is the most common malignancy of the reproductive system?
a.Endometrial cancer
b.Cervical cancer
c.Ovarian cancer
d.Vulvar and vaginal cancer
ANS: A
Endometrial cancer occurs most frequently in Caucasian women
and after menopause. Certain viral infections and sexually transmitted diseases (STIs) create risks for cervical cancer. Ovarian cancer is the most malignant reproductive system cancer an
A client in late middle age who is certain she is not pregnant tells the nurse during an office visit that she has urinary problems, as well as sensations of bearing down and of something in her vagina. What condition would the nurse suspect based upon th
ANS:
B
Uterine displacement can be caused by congenital or acquired weakness of the pelvic support structures and is known as pelvic relaxation. Cystoceles are protrusions of the bladder downward into the vagina; rectoceles are herniations of the anterior
Which woman has the highest risk for endometrial cancer?
a.Postmenopausal woman with hypertension
b.Woman who has an intrauterine device (IUD)
c.Client who has been on birth control for 15
years
d.Perimenopausal woman who has a cystocele
ANS: A
Endometrial cancer is most often seen in postmenopausal women between the ages of 50 and 65 years. Hypertension is a risk factor associated with the development of this malignancy. The use of an IUD does not increase a woman's risk for endometrial
A client has just returned from a uterine artery embolization (UAE) procedure. Before her discharge, a discussion concerning the symptoms that require a call to the provider postprocedure is very important. Which symptom would reassure the client that the
ANS: D
The physician should be notified if the client is experiencing urinary retention. Urinary frequency is not a complication of UAE. A body temperature of 39� C or higher may indicate the presence of an infectious process, and the physician should be
A woman has arrived for her preoperative testing appointment. She is scheduled for a
myomectomy the following day. What condition would require the client to undergo this procedure for symptom relief?
a.Numerous small fibroid tumors
b.Bartholin cysts
c.Fi
ANS: C
If a fibroid tumor lies near the outer wall of the uterus and the uterine size is no larger than at 12 to 14 weeks of gestation and the symptoms are significant, a myomectomy (i.e., removal of the tumor) may be performed. This procedure leaves the
Which ovarian
neoplasm is described as a growth that contains hair, teeth, and sebaceous secretions?
a.Ovarian fibroma
b.Dermoid cyst
c.Uterine polyp
d.Follicular cyst
ANS: B
Dermoid cysts are germ cell tumors, usually occurring in childhood, that may contain teeth, hair, bones, and sebaceous secretions and may unilaterally or bilaterally develop. Treatment is most often surgical removal. An ovarian fibroma is a solid o
The client is undergoing
treatment for ovarian cancer. Which common nutritional problems are related to gynecologic cancers and the treatment thereof? (Select all that apply.)
a.Stomatitis
b.Constipation
c.Increased appetite
d.Diarrhea
e.Nausea and vomiti
ANS: A, B, D, E
Altered taste, stomatitis, constipation, anorexia, diarrhea, and nausea and vomiting are all possible nutritional complications related to gynecologic cancers and their treatment. The nurse must assess accordingly and
adapt the client's pl
Leiomyomas (also known as fibroid tumors) are benign tumors arising from the muscle tissue of the uterus. Which information related to these tumors is accurate? (Select all that apply.)
a.Are rapid growing
b.Are more common in African-American women
c.Are
ANS: B, C, D
The exact cause of leiomyomas remains unknown, although genetic factors may be involved in their development. Most are found in the body of uterus and
are classified according to their location on the uterine wall. They are benign, slow growi
The client has undergone hysteroscopic uterine ablation to destroy a number of smaller fibroids. The nurse is preparing to provide discharge instructions. Which information is a priority for the patient and should be included in the teaching plan? (Select
ANS: A, D, E
Before discharging the client, the following information should be given: analgesics can be
used for pain relief as needed, normal activities can be resumed within several days, vaginal discharge is to be expected for 4 to 6 weeks, and the us