21 minute read
Chapter 19: Alterations in Women’s Health
from TEST BANK for Maternal-Newborn Nursing: The Critical Components of Nursing Care, 3rd Ed, Robert Durh
by ACADEMIAMILL
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is assessing a 70-year-old female patient in the family practice clinic. The patient states that she has been experiencing sudden heavy vaginal bleeding the past 3 months. What is the expected diagnostic procedure for this patient?
1. Cervical conization
2. Colposcopy
3. Dilation and curettage
4. Endometrial biopsy
2. A 32-year-old female patient arrives to the emergency department with heavy uterine bleeding. The nurse finds that the patient had a positive pregnancy test 1 month prior to the visit. What is the potential medical management for this patient’s issue?
1. Endometrial biopsy
2. Dilation and curettage
3. Colposcopy
4. Laparoscopy
3. The telephone triage nurse receives a call from a patient who is 5 days postoperative total abdominal hysterectomy. The patient states that her pain is not relieved with the medications and that she has noticed blood in her urine. The nurse instructs the patient to report immediately to the emergency department. What does the nurse suspect as the surgical complication?
1. Possible complication related to the anesthesia
2. Possible injury to the ureters or bladder
3. Possible hemorrhage from the internal incision
4. Possible peritoneal venous thromboembolism
4. The nurse is providing preoperative education on the laparoscope-assisted vaginal hysterectomy. Which statement by the patient verifies understanding of the procedure?
1. “I will use a mild douche solution to keep the surgical area clean.”
2. “I’m relieved that I won’t have any visible scars on my abdomen.”
3. “I understand that there will be some light vaginal bleeding for several days.”
4. “I understand that I must remain on bedrest until cleared by the surgeon.”
5. The nurse is providing care to the 24-year-old patient in the OB/GYN clinic. The patient states that she thinks she may be pregnant because she has missed three menstrual cycles. The patient says, “This couldn’t be happening at a worse time. I have been training heavily for a triathlon in 4 months.” Which response by the nurse is most appropriate?
1. “Secondary amenorrhea, or no menses for 3 months, is not always a sign of pregnancy; it may be due to your heavy athletic activity.”
2. “Pregnancy during times of stress such as heavy athletic activity can occur when precautions are not followed.”
3. “If the pregnancy test is negative, the physician will need to perform a diagnostic
Copyright © 2019 F. A. Davis Company laparoscopy to rule out a neoplasm.”
4. “Amenorrhea may occur at times of nutritional disturbances. Are you eating a well-balanced diet?”
6. The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient’s oral contraceptives. What is the rationale for this treatment?
1. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.
2. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control.
3. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives.
4. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.
7. The nurse is assessing the 19-year-old female patient in the women’s health clinic. She reports that for the past several months, she has had lower abdominal pain, elimination issues, and mood swings, and her acne is worse the week before menstruation. The health care provider has prescribed oral contraceptives. The patient asks the nurse for the reason for the prescription. Which response by the nurse is appropriate?
1. “Pregnancy should be avoided because the hormonal shift would place the fetus at risk for birth defects.”
2. “The hormones in the oral contraceptives can maintain estrogen–progesterone hormones to alleviate discomfort.”
3. “Oral contraceptives may provide an increase in the hormones to help with your possible infertility issues.”
4. “Oral contraceptives may balance the chemical changes in your brain to alleviate the depression symptoms.”
8. The nurse is preparing a teaching plan for a polycystic ovary syndrome (PCOS) support group. One of the teaching points will include diet and weight loss to decrease hirsutism and acne. What is the reasoning for this rationale?
1. Diet and exercise will promote weight loss, which will decrease hyperandrogenemia.
2. Diet and exercise will decrease the risk of type 2 diabetes and gestational diabetes.
3. Diet and exercise will decrease serum lipid levels and lower the risk for cardiovascular disease.
4. Diet and exercise will increase the frequency of ovulation and menstruation and increase fertility.
9. The nurse is providing care to a 35-year-old female patient who complains of low back pain, pain with defecation, pelvic pressure, and premenstrual spotting. The health care provider has prescribed the hormonal therapy Lupron for this condition. What is the goal of this prescription?
1. To prevent pregnancy at this time to promote healing
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2. To suppress menstruation and further growth of the tissue
3. To prevent retrograde menstruation outside the uterine cavity
4. To increase blood flow to decrease the endometrial lining
10. The nurse is caring for a 33-year-old female patient who has just undergone laparoscopic removal of endometrial lesions. Which statement by the patient illustrates her understanding of the disease process and prognosis?
1. “I realize that this is not a cure for the issue, but I want to have more children within the next year.”
2. “I’m happy to know that the surgeon has been able to cure me of this disease without a hysterectomy.”
3. “I realize that my type 2 diabetes will be cured now that I have those lesions removed.”
4. “I understand that I will not have to have a colostomy now that the growths were removed from my bowels.”
11. The nurse is assessing a 16-year-old sexually active patient in the family practice clinic. The patient’s symptoms include breakthrough vaginal bleeding, abdominal pain, nausea, and fever. The health care provider obtains cultures of the cervical epithelial cells during a Pap smear and orders doxycycline 100 mg orally twice a day for 7 days for her and her partner. The nurse understands that this prescription is consistent with the treatment of which medical diagnosis?
1. Herpes
2. Condylomas
3. Chlamydia
4. Gonorrhea
12. The nurse is assessing a 22-year-old female patient who arrives at the family clinic. The patient has finished her prescription for a urinary tract infection and now reports a milky discharge from her vagina and has a fishy odor. After microscopic examination of the vaginal discharge, the health care provider prescribed metronidazole gel to be inserted vaginally. What is the suspected medical diagnosis for this patient?
1. The patient has gonorrhea due to lowered immunity after antibiotic therapy.
2. The patient has bacterial vaginosis due to recent disruption of normal vaginal flora.
3. The patient has genital condylomas due to the recent UTI treatment.
4. The patient has candida vaginitis due to recent disruption of normal vaginal flora.
13. The nurse is assessing a 64-year-old female patient. The patient states that she is able to reduce the risk of urinary tract infections (UTIs) by drinking a quart of cranberry juice a day. Which health condition, if present in this patient, contraindicates the use of cranberry juice?
1. Hypertension, managed with lisinopril
2. Diabetes type 1, managed with insulin
3. Atrial fibrillation, managed with warfarin
4. COPD, managed with inhaled steroids Copyright © 2019 F. A. Davis Company
14. The nurse is assessing a 72-year-old female patient in the women’s health clinic. The mildly obese patient’s history includes 7 vaginal births, 2 of which necessitated forceps deliveries, type 2 diabetes, and hypertension. The patient states that she has become incontinent of urine, has a history of frequent urinary tract infections (UTIs), and has a sense of fullness “down there.” What would be an appropriate nursing intervention to help the patient with her symptoms?
1. Instruct the patient to stop urinating midstream at least twice a day.
2. Instruct the patient to eat a high-fiber diet and increase fluid intake.
3. Instruct the patient to add probiotics to their diet while taking antibiotics.
4. Instruct the patient to bear down effectively while having a bowel movement.
15. The nurse at a family practice clinic is providing care to a 47-year-old obese patient. The patient states that she realizes that she has put on extra weight but is reluctant to go to any exercise classes. She states that she often has to cross her legs when she sneezes and cannot do any exercises with her legs crossed. The health care provider has prescribed tolterodine (Detrol). What is the rationale for this medication?
1. Tolterodine is used to treat overactive bladders and to decrease urinary frequency, urgency, and urge incontinence.
2. Tolterodine is used to improve the tone and tissue in the urethral and vaginal areas.
3. Tolterodine is used to facilitate weight loss by acting as an appetite suppressant.
4. Tolterodine is used to improve blood flow to the pelvic muscles to decrease urinary tract infections.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
16. The nurse is providing postoperative care to a patient who underwent a total abdominal hysterectomy 12 hours ago. Which of the following are appropriate nursing interventions? Select all that apply.
1. Assist the patient with ambulation.
2. Maintain the Foley catheter for 48 to 72 hours postoperatively.
3. Monitor intake and output and characteristics of urine.
4. Maintain bedrest while taking narcotic pain medications.
5. Initiate antiembolism therapy as ordered.
17. The nurse is educating a 24-year-old female patient who was newly diagnosed with polycystic ovary syndrome (PCOS). The patient was prescribed an antidiabetic medication. Which medication effects should the nurse educate the patient about? Select all that apply.
1. A period of initial weight gain
2. A change in her integumentary system
3. Low blood sugar until her hormones stabilize
4. Decreased likelihood of pregnancy
5. A decrease in abdominal obesity and weight
Copyright © 2019 F. A. Davis Company
18. The nurse is assessing a 42-year-old patient who presents to the gynecology office with complaints of pelvic pressure, backaches, menorrhagia, and urinary frequency. The health care provider has diagnosed the patient with leiomyoma of the uterus. What are the treatment options for this condition? Select all that apply.
1. Routine pelvic examinations to assess rate of disease process
2. Oral contraceptives to control the bleeding and pain
3. Myomectomy for women who desire pregnancy
4. Hysterectomy for women who do not desire pregnancy
5. Antibiotic therapy with NSAIDS for symptom management
19. The nurse is assessing a 25-year-old female patient when the patient becomes tearful. The patient states that she has thin milky discharge from her nipples and two small masses on her left breast. She has lost over 40 pounds in the past year due to intensive exercises and finds that she needs to wear a sports bra during her sessions. The patient states that she is afraid that she will become the first member of her family to have breast cancer. Besides a negative mammogram, what other symptoms would correlate with this being a benign finding? Select all that apply.
1. Milky discharge from nipples
2. Extensive weight loss
3. Painful masses
4. Mood swings
5. Multiple masses
20. The nurse is preparing to teach the community about risk factors for the second most common cancer of the female reproductive system. Which of the following groups of women are at higher risk for this cancer? Select all that apply.
1. Menopausal women with an intact uterus who receive hormonal therapy
2. Women who have undergone treatment for breast cancer
3. Women who have many pregnancies and nursed their infants
4. Women who smoke and have many sexual partners
5. Women with a long-standing history of polycystic ovarian syndrome
Copyright © 2019 F. A. Davis Company
Chapter 19: Alterations in Women’s Health
Answer Section
Multiple Choice
1. ANS: 4
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 1. Describe diagnostic procedures commonly used in women’s health care.
Page: 576
Heading: Table 19-1: Common Diagnostic Procedures
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Coordinated Care.
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
Feedback
1 This is incorrect. Cervical conization would be indicated for an abnormal Pap smear, but there is no indication of any cervical intraepithelial lesions.
2 This is incorrect. There is no indication of dysplasia or an abnormal Pap smear. This would be used to rule out cancer of the cervix.
3 This is incorrect. Although this could be used to detect uterine malignancy or to evaluate dysfunction uterine bleeding, this would not be indicated as a first step in diagnostics.
4 This is correct. The patient will need to have an endometrial biopsy to determine the cause of postmenopausal bleeding. The patient’s age is past the average age of menopause.
PTS: 1 CON: Patient-Centered Care
2. ANS: 2
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 576
Heading: Table 19-1: Common Diagnostic Procedures
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Coordinated Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Moderate
1 This is incorrect. This diagnostic procedure would be appropriate to determine the cause of the uterine bleeding.
2 This is correct. The patient may be experiencing an incomplete abortion and will need the remnants of the pregnancy removed.
3 This is incorrect. A colposcopy is a procedure to rule out cancer of the cervix after an abnormal Pap smear.
4 This is incorrect. Although this patient may need a laparoscopic procedure if the dilation and curettage (D&C) is not indicated, the D&C is often first in treatment of an incomplete abortion.
PTS: 1 CON: Patient-Centered Care
3. ANS: 2
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 578
Heading: Hysterectomy > Risks Related to Surgical Procedure
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Safety
Difficulty: Moderate Feedback
1 This is incorrect. A complication from anesthesia often effects the cardiovascular or pulmonary systems, not the urinary system.
2 This is correct. Bloody urine and unmanaged pain could indicate a ureter injury from the surgery.
3 This is incorrect. Although unmanaged pain would indicate a buildup of blood in the peritoneal cavity, the bloody urine is a cue that the ureters may be injured and the patient is bleeding within the bladder.
4 This is incorrect. A venous thromboembolism would occur in the calves as a result of the surgical procedure.
PTS: 1 CON: Safety
4. ANS: 3
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 579
Heading: Hysterectomy > Postoperative Care for Abdominal Hysterectomy > Nursing Actions
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1 This is incorrect. Although there will be small abdominal incisions, anything introduced into the vagina can cause an infection.
2 This is incorrect. Although the incisions will be small, they may be visible. The laparoscopic procedure includes several small “stab-like” incisions in the abdomen to guide the surgical removal of the uterus.
3 This is correct. There will be some light bleeding for several days, and the patient should be instructed to notify the surgeon if bleeding increases.
4 This is incorrect. Walking is important to prevent postoperative complications, such as constipation and blood clots. Walking can facilitate the patient’s gradual return to her presurgery activity level.
PTS: 1 CON: Patient-Centered Care
5. ANS: 1
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 2. Discuss various causes of menstrual disorders.
Page: 580
Heading: Table 19-2: Menstrual Disorders
Integrated Processes: Communication and Documentation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1 This is correct. Heavy athletic activity may cease ovulation and menstrual cycles.
2 This is incorrect. Stress may cause secondary amenorrhea, not pregnancy, and there is no indication that the patient has not taken precautions to prevent pregnancy.
3 This is incorrect. A laparoscopy is not indicated at this time. If the patient is not pregnant, the health care provider may order other diagnostics, such as an ultrasound.
4 This is incorrect. Although nutritional disturbances can often cause amenorrhea, there is no indication that this is the case with this patient.
PTS: 1 CON: Patient-Centered Care
6. ANS: 1
Chapter: Chapter 19 Alterations in Women’s Health
Copyright © 2019 F. A. Davis Company
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 581
Heading: Table 19-2: Menstrual Disorders
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacologic Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Sexuality
Difficulty: Moderate
Feedback
1 This is correct. Metrorrhagia is the most significant form of menstrual disorder. If not caused by endometrial cancer, it is typically associated with use of an IUD and use of oral contraceptives.
2 This is incorrect. This is not associated with type 2 diabetes. PCOS is associated with type 2 diabetes, not metrorrhagia.
3 This is incorrect. Hyperplasia of endometrial tissue was ruled out with the biopsy.
4 This is incorrect. Metrorrhagia may be associated with ovarian cysts, and oral contraceptives may decrease ovulation or further trauma to the ovaries.
PTS: 1 CON: Sexuality
7. ANS: 2
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 581
Heading: Table 19-2: Menstrual Disorders
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate
Feedback
1 This is incorrect. This treatment plan is based on the patient’s symptoms, which correlate with premenstrual syndrome (PMS).
2 This is correct. PMS may be controlled, with oral contraceptives, as PMS might be related to hormonal changes related to the menstrual cycle. Estrogen–progesterone hormones found in oral contraceptives may provide relief from the symptoms.
3 This is incorrect. The patient did not claim any issues with fertility. The fertility issues may occur due to the patient’s sexual dysfunction, which was not listed in
Copyright © 2019 F. A. Davis Company her statement.
4 Incorrect. Although some of the symptoms of PMS can include mental health/mood disorders, the chemical changes in the brain are only part of the patient’s symptoms. The health care provider may include antidepressants or antianxiety medications along with oral contraceptives.
PTS: 1 CON: Health Promotion
8. ANS: 1
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 583
Heading: Polycystic Ovary Syndrome > Medical Management
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate
Feedback
1 This is correct. Hyperandrogenemia can lower testosterone levels, which can reduce the degree of acne and hirsutism.
2 This is incorrect. Hyperandrogenemia is a condition of high testosterone, not of abnormal blood sugars.
3 This is incorrect. Although weight loss can lower serum lipid levels, it does not directly affect testosterone levels.
4 This is incorrect. Although diet and exercise can increase frequency of ovulation and menstruation, the focus of the question is the level of testosterone.
PTS: 1 CON: Health Promotion
9. ANS: 2
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 584
Heading: Endometriosis > Medical Management
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate
1 This is incorrect. This patient has the classic symptoms of endometriosis. Infertility is often a problem for patients with endometriosis.
2 This is correct. This is the goal of GnRH agonists, which suppresses menstruation and further growth of tissue.
3 This is incorrect. Although this medication is used to suppress menstruation, one theory for the cause of endometriosis is retrograde menstruation, which transports endometrial tissue outside the uterine cavity.
4 This is incorrect. The goal is to suppress menstruation, not increase blood flow and thinning of the endometrial tissue.
PTS: 1 CON: Health Promotion
10. ANS: 1
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 584
Heading: Endometriosis > Medical Management
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate
Feedback
1 This is correct. Endometriosis may recur after surgical interventions, but the laparoscopic surgery is used for women with severe symptoms who are infertile and desire pregnancy.
2 This is incorrect. Endometriosis may recur after surgical interventions, but the laparoscopic surgery is used for women with severe symptoms who are infertile and desire pregnancy
3 This is incorrect. Type 2 diabetes is associated with polycystic ovarian syndrome, not endometriosis.
4 This is incorrect. There is no indication that the patient would have had to incur a colostomy for endometriosis.
PTS: 1 CON: Health Promotion
11. ANS: 3
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 586
Heading: Table 19-3: Sexually Transmitted Infections
Integrated Processes: Nursing Process
Copyright © 2019 F. A. Davis Company
Client Need: Physiological Integrity: Pharmacological Therapies
Cognitive Level: Application [Applying]
Concept: Infection
Difficulty: Difficult
Feedback
1 This is incorrect. The signs and symptoms of genital herpes vary from no symptoms to lesions in the area of virus entry. Treatment for herpes includes antiviral mediations such as acyclovir.
2 This is incorrect. Genital warts/condylomas are caused by human papillomavirus. They are a painless warty growth in the vagina, vulva, perineum, or anal areas. Treatment for this disease is topical application of trichloroacetic acid, cryotherapy, or surgical removal.
3 This is correct. Chlamydia is the most common bacterial STI in the United States and the leasing cause of preventable infertility. This is diagnosed by cultures of cervical epithelial cells and is treated with antibiotics. The partner needs to be treated to prevent reinfection.
4 This is incorrect. The symptoms for this disease vary from being absent to painful sexual intercourse and bleeding. It is treated with a single intramuscular dose of ceftriaxone with azithromycin or doxycycline, and the partner should be treated to prevent reinfection.
PTS: 1 CON: Infection
12. ANS: 2
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 588
Heading: Table 19-3: Sexually Transmitted Infections (STI)
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacological Therapies
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Moderate
Feedback
1 This is incorrect. Although gonorrhea may have vaginal discharge, it is not caused by lowered immunity after antibiotic therapy.
2 This is correct. Disruption of normal vaginal flora can increase the likelihood of bacterial vaginosis, and the symptoms are often described as milky vaginal discharge with a distinct “fishy” odor.
3 This is incorrect. Genital condylomas (genital warts) are caused by the human papillomavirus (HPV), not bacterial or fungal infections.
Copyright © 2019 F. A. Davis Company
4 This is incorrect. Although some of the symptoms are the same, such as vaginal discharge, the key term in this answer is the “fishy odor.”
PTS: 1 CON: Health Promotion
13. ANS: 3
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 590
Heading: Vaginitis > Urinary Tract Infections > Nursing Actions
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Concept: Infection
Difficulty: Moderate
Feedback
1 This is incorrect. Although there is no evidence that cranberry juice will prevent UTIs, it does not interact with lisinopril.
2 This is incorrect. Although cranberry juice may be high in sugar content and increase blood glucose levels, it is not contraindicated with insulin.
3 This is correct. Studies have shown that cranberry juice can affect the liver and interfere with warfarin (Coumadin) levels. Cranberry juice should not be taken with warfarin (Coumadin), aspirin, or medications that effect the liver.
4 This is incorrect. Inhaled steroids affect the pulmonary system, not hepatic.
PTS: 1 CON: Infection
14. ANS: 1
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 592
Heading: Pelvic Organ Prolapse > Cystocele and Rectocele > Nursing Actions
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation.
Cognitive Level: Application [Applying]
Concept: Elimination
Difficulty: Moderate
Feedback
1 This is correct. This is the Kegel exercise, which helps improve pelvic muscle strength for a mild cystocele. Key words in this question are frequent UTIs, urinary incontinence, multiple births, two of which were forceps deliveries,
Copyright © 2019 F. A. Davis Company which further traumatizes the pelvic floor.
2 This is incorrect. This would be a teaching for a rectocele, not a cystocele.
3 This is incorrect. This measure would help prevent yeast infections while taking antibiotics, not a cystocele.
4 This is incorrect. This would exacerbate a rectocele and is not beneficial for a cystocele.
PTS: 1 CON: Elimination
15. ANS: 1
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 593
Heading: Urinary Incontinence > Medical Management
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Pharmacological Therapies
Cognitive Level: Application [Applying]
Concept: Elimination
Difficulty: Moderate
Feedback
1 This is correct. Tolterodine (Detrol) inhibits cholinergic bladder contractions, thereby decreasing urinary frequency, urgency, and urge incontinence.
2 This is incorrect. Estrogen cream is applied to the genital tissues to improve tone and tissue in the urethral and vaginal areas.
3 This is incorrect. There is no indication that this would facilitate weight loss or suppress appetites.
4 This is incorrect. This does not decrease urinary tract infections, nor does it increase the blood blow to the pelvic muscles.
PTS: 1 CON: Elimination
Multiple Response
16. ANS: 1, 3, 5
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 578
Heading: Hysterectomy> Postoperative Care for Abdominal Hysterectomy
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Application [Applying]
Copyright © 2019 F. A. Davis Company
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1 This is correct. Ambulation decreases the risk for deep vein thrombosis and facilitates return of peristalsis, which decreases the amount of gas buildup.
2 This is incorrect. The Foley catheter is typically removed 12 to 24 hours after surgery.
3 This is correct. Monitoring intake and output, as well as the characteristics of the urine, will facilitate monitoring for signs/symptoms of fluid imbalances and injury to the ureters or bladder.
4 This is incorrect. Although this patient may be at risk for falls due the narcotic pain control, it usually does not impede ambulation. Ambulation decreases risk for deep vein thrombosis and facilitates return of peristalsis, which decreases the amount of gas buildup.
5 This is correct. A risk related to surgical procedures is deep vein thrombosis or venous thromboembolism. This may include antiembolism stockings, ambulation, and/or anticoagulant therapy.
PTS: 1 CON: Patient-Centered Care
17. ANS: 2, 3, 5
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 584
Heading: Polycystic Ovary Syndrome > Medical Management
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
Feedback
1 This is incorrect. The patient may experience a weight loss due to the decreased blood glucose levels.
2 This is correct. The patient may notice loss of hirsutism and acne while taking the antidiabetic medication. This is because this medication decreases testosterone levels.
3 This is correct. The nature of the antidiabetic medication can cause lower blood sugar, and the patient will need to take the proper precautions.
4 This is incorrect. This medication is actually used to treat infertility.
5 This is correct. This may lower the testosterone level, which may decrease the degree of acne, hirsutism, and abdominal obesity.
PTS: 1 CON: Patient-Centered Care Copyright © 2019 F. A. Davis Company
18. ANS: 1, 3, 4
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 590
Heading: Leiomyoma of the Uterus > Medical Management
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Cellular Regulation
Difficulty: Moderate
Feedback
1 This is correct. Routine pelvic examinations may be performed to assess the rate of growth of the leiomyomas (fibroids). A pelvic ultrasound to confirm the diagnosis of tumors and rule out pregnancy is another option of diagnosis.
2 This is incorrect. This would be an option for another diagnosis such as PMS, not fibroids, which could increase the growth due to increase levels of estrogen and progesterone.
3 This is correct. A myomectomy may be a surgical intervention to remove the fibroids, while leaving the uterus intact for those that desire pregnancy.
4 This is correct. Hysterectomy is recommended for women who do not desire pregnancy and who are experiencing excessive bleeding. Leiomyomas are the main indicator for hysterectomy.
5 This is incorrect. This may be a treatment for an infection not of fibroids of the uterus.
PTS: 1 CON: Cellular Regulation
19. ANS: 1, 3, 5
Chapter: Chapter 19 Alterations in Women’s Health
Chapter Learning Objective: 3. Describe common alterations in women’s health, including medical management and nursing actions.
Page: 595
Heading: Breast Disorders
Integrated Processes: Teaching and Learning
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate
Feedback
1 This is correct. Discharge from nipples that are milky may be due to the elicited response from compression (resulting from the sports bra).
2 This is incorrect. The patient’s weight loss is likely from intensive exercises. Copyright © 2019 F. A. Davis Company
