NURS 317 Unit 4 Chapter 45 Path Point Questions Flashcards
The nurse is teaching the client about risk factors for cervical cancer. What will be included in the plan of care? Select all that apply.
A) Multiple sexual partners
B) History of sexually transmitted infections
C) First intercourse at an early age
D) Smoking
E) Diabetes
F) Alcohol consumption
A) Multiple sexual partners
B) History of sexually transmitted infections
C) First intercourse at an early age
D) Smoking
Rationale:Risk factors for cervical cancer include early age at first intercourse, multiple sexual partners, smoking, and a history of STIs. Diabetes and alcohol consumption are not risk factors.
The nurse performs a complete physical assessment on a client with polycystic ovary syndrome (PCOS). Which assessment findings support this diagnosis? Select all that apply.
A) Decreased luteinizing hormone (LH) level
B) Dysmenorrhea
C) Elevated blood glucose
D) Obesity
E) Increased dark facial hair
C) Elevated blood glucose
D) Obesity
E) Increased dark facial hair
Rationale:PCOS is an endocrine disorder affecting between 5% and 10% of women of childbearing age. Common manifestations include irregular infrequent menstrual periods, signs of hyperandrogenism such as acne and excess body hair, elevated testosterone levels, obesity, insulin resistance, and polycystic ovaries. Also characteristic of the disorder is an imbalance between LH and FSH (follicle-stimulating hormone) where the LH levels are higher in proportion to FSH. This leads to anovulation and infertility.
A 45-year-old client reports “needing to bear down with urination,” frequency, and occasional loss of urine when coughing. Based on symptoms, which diagnosis is most appropriate for this client?
A) Spermatocele
B) Cystocele
C) Enterocele
D) Rectocele
B) Cystocele
Rationale:The symptoms described are commonly found with cystocele, which is the herniation of the bladder into the vagina resulting in urinary symptoms. The bear-down sensation is common in this disorder and not found in the other disorders. Rectocele is the herniation of the rectum into the vagina. Enterocele can be asymptomatic or cause a dull, dragging sensation and occasionally low backache. Spermatocele is a male disorder.
After a long and frustrating course of constant vaginal pain, a 38-year-old woman has diagnosed with generalized vulvodynia by her gynecologist. What treatment plan is most likely to be prescribed by her health care provider?
A) Lifestyle modifications aimed at accommodating and managing neuropathic pain.
B) Alternative herbal therapies coupled with antifungal medications.
C) Tricyclic antidepressants and gabapentin, an antiepileptic medication.
D) Narcotic analgesia and nonsteroidal anti-inflammatory medications.
C) Tricyclic antidepressants and gabapentin, an antiepileptic medication.
Rationale:Treatment of vulvodynia necessitates a long-term, chronic pain approach; antidepressants and antiepileptic medications are often used. Alternative therapies, standard analgesic regimens, and simple lifestyle modifications are less likely to be effective.
A client who has been diagnosed with premenstrual syndrome (PMS) asks if there is anything to help alleviate the symptoms. The best response would be:
A) Limit activities and maintain bed rest as necessary.
B) Increase intake of caffeine products during this period.
C) Decrease intake of fluids to reduce fluid retention.
D) Eat a diet low in simple sugars and high in protein.
D) Eat a diet low in simple sugars and high in protein.
Rationale:Treatment for PMS includes treating various symptoms. A diet low in sugar and high in protein and reduction in caffeine intake are recommended. Other suggestions include diuretics to reduce fluid retention, continue fluid intake as usual, regular exercise, and analgesics for pain
The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine. Which instructions are appropriate for the nurse to provide? Select all that apply.
A) It produces short-term immunity.
B) It should be given before the child is sexually active.
C) It can be given to boys and girls.
D) It prevents sexually transmitted infections.
E) It prevents a common cause of cervical cancer.
B) It should be given before the child is sexually active.
C) It can be given to boys and girls.
E) It prevents a common cause of cervical cancer.
NCLEX-Style Chapter Review Questions1707280572033
Time on Question Exceeded
00:01:15Time on Question Exceeded
Correct
3
Incorrect
2
Unanswered
16
Time on Quiz Exceeded
00:10:51Time on Quiz Exceeded
Question
6 of 21
The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine. Which instructions are appropriate for the nurse to provide? Select all that apply.
Unansweredoption
It produces short-term immunity.
Correctoption
It should be given before the child is sexually active.
Correctoption
It can be given to boys and girls.
Unansweredoption
It prevents sexually transmitted infections.
Correctoption
It prevents a common cause of cervical cancer.
Your Response:It should be given before the child is sexually active., It prevents a common cause of cervical cancer. Correct Response:It should be given before the child is sexually active., It can be given to boys and girls., It prevents a common cause of cervical cancer.
Rationale:The quadrivalent human papillomavirus recombinant vaccine is given to boys and girls between the ages of 9 and 26 years before they begin sexual activity. The vaccine provides long-term immunity from HPV, which is a common cause of cervical cancer. It does not protect against other sexually transmitted diseases.
A nurse monitors for side effects in a female client receiving endometriosis treatment with the gonadotropin-releasing hormone (GnRH) agonist leuprolide. Which adverse effect would be cause to limit duration of treatment?
A) Muscle spasms
B) Decreased bone density
C) Hot flashes and night sweats
D) Nosebleed and cough
B) Decreased bone density
Rationale:The GnRH agonist leuprolide suppresses the release of estrogens from the ovaries. This allows endometrial tissue to shrink and reduces manifestations of endometriosis. Side effects include hot flashes, nosebleed, cough, hypocalcemia, and decreased bone density. Except for bone density, all of these side effects will stop with treatment. A rapid decrease in bone density may be cause to stop treatment because it may not be completely reversed when therapy is ended and could lead to osteoporosis.
The nurse in the ER is caring for a client with lower abdominal pain that is greater on the right side and who has light vaginal spotting. When the client’s human chorionic gonadroptropin (hCG) level is lower than normal, the nurse plans care for a client with:
A) Appendicitis
B) Ectopic pregnancy
C) Cervical cancer
D) Premenstrual syndrome
B) Ectopic pregnancy
Rationale:The symptoms described, and the positive but low hCG, would be most indicative of an ectopic pregnancy. Appendicitis could be suspected with right lower abdominal pain, but would not have a positive hCG and spotting. Neither PMS nor cervical cancer would present with all the above symptomology.
A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be:
A) HPV vaccine before becoming sexually active
B) Use of latex condom with each and every sexual encounter
C) Use of low-dose estrogen oral contraceptive pills or patches
D) Abstinence of sexual activity until in a monogamous relationship
A) HPV vaccine before becoming sexually active
Rationale:Two types of HPV vaccines are currently available to prevent HPV infection: a quadrivalent vaccine to prevent infection by HPV subtypes 16, 18, 6, and 11 and a bivalent vaccine to prevent infection by subtypes 16 and 18. The quadrivalent vaccine has been approved for females and males between the ages of 9 and 26 years, optimally before initiation of sexual activity. Abstinence and condoms may help, but the vaccine is recommended.
What is the term for the condition that involves dyspareunia and widespread vaginal burning in the absence of bacterial presence?
A) Bartholin gland abscess
B) Generalized vulvodynia
C) Localized vulvodynia
D) Vaginitis
B) Generalized vulvodynia
Rationale:The type of vulvodynia that is described is generalized vulvodynia, as opposed to localized, which is not as widespread. Vaginitis would have bacterial involvement. These are not the symptoms associated with a Bartholin gland abscess
Which clinical manifestations would the nurse expect to observe in a female with pelvic inflammatory disease (PID)? Select all that apply.
A) White blood cell (WBC) count of 7500 cells/mL
B) Temperature of 100°F (37.8°C)
C) Elevated C-reactive protein
D) Purulent cervical discharge
E) Lower abdominal pain
C) Elevated C-reactive protein
D) Purulent cervical discharge
E) Lower abdominal pain
Rationale
Manifestations of PID include lower abdominal pain, dyspareunia, purulent cervical discharge, cervix pain with manual examination, temperature greater than 100°F (37.8°C), a WBC greater than 10,000 cells/mL, and elevated C-reactive protein.
The nurse is assessing a 24-year-old client who states that she has infrequent menstrual periods that are approximately 40 to 42 days apart. She also states, “My periods are really light. It’s almost like I hardly even need to use a pad sometimes.” The nurse should document which medical terms associated with this client’s menstruation? Select all that apply.
A) Hypomenorrhea
B) Menometrorrhagia
C) Amenorrhea
D) Oligomenorrhea
E) Polymenorrhea
A) Hypomenorrhea
D) Oligomenorrhea
Rationale:Dysfunctional cycles may take the form of amenorrhea (absence of menstruation), hypomenorrhea (scanty menstruation), oligomenorrhea (infrequent menstruation, periods more than 35 days apart), polymenorrhea (frequent menstruation, periods less than 21 days apart), menorrhagia (excessive menstruation), or metrorrhagia (bleeding between periods). Menometrorrhagia is heavy bleeding during and between menstrual periods. This client exhibits hypomenorrhea and oligomenorrhea.
A 29-year-old female client has been diagnosed with fibrocystic breasts. The nurse should assess the client for which symptoms associated with fibrotic changes? Select all that apply.
A) Breast pain or discomfort
B) Palpable breast masses that change during the menstrual cycle
C) Purulent nipple discharge that is whitish or yellowish in color
D) Breast engorgement
E) Erythema on skin regions within 1 to 2 cm of the areolae
A) Breast pain or discomfort
B) Palpable breast masses that change during the menstrual cycle
Rationale:Fibrocystic changes include nodular granular breast masses that are more prominent and painful during the luteal or progesterone-dominant portion of the menstrual cycle. Discomfort ranges from heaviness to exquisite tenderness, depending on the degree of vascular engorgement and cystic distention. Engorgement, erythema, and discharge are atypical.
A female client is being evaluated for abdominal pain and unusual menstrual bleeding. What factors in her history will the nurse identify as increasing the risk for endometrial cancer? Select all that apply.
A) Diabetes mellitus
B) Trichomonas infection
C) Obesity
D) Estrogen therapy
E) Polycystic ovary syndrome
A) Diabetes mellitus
C) Obesity
D) Estrogen therapy
E) Polycystic ovary syndrome
Rationale:Unopposed estrogen stimulates endometrial hyperplasia, which can lead to cell abnormalities developing into cancers. Obesity, diabetes mellitus, polycystic ovary syndrome, and hormone replacement therapy with unopposed estrogen are all factors that produce a situation with increased estrogen levels that increase risk of endometrial cancer. Sexually transmitted infections such as trichomonas do not change estrogen levels.
A college student presents to the nurse’s office complaining of premenstrual syndrome. Which clinical manifestations would confirm this diagnosis? Select all that apply.
A) Burning during urination
B) Abdominal bloating
C) Thick, cheesy vaginal secretions
D) Painful intercourse
E) Painful, edematous breasts
B) Abdominal bloating
E) Painful, edematous breasts
Rationale:Physical symptoms of PMS include painful and swollen breasts, bloating, abdominal pain, headache, and backache. Burning with urination could be caused by a vaginal or bladder infection. A thick, cheesy, vaginal secretion is usually associated with a yeast infection.
