Reproductive Assessment

Question 1

changes in the reproductive system related to females

Answer 1

graying and thinning of pubic hair
decreased size of the labia majora and clitoris
drying, smoothing, and thinning of vaginal walls
decrease size of the uterus
atrophy of the endometrium
decrease size and marked convolution of the ovaries
loss of tone and elasticity of the pelvic ligaments and connective tissue
increased flabbiness and fibrosis of the breasts, which hang lower on the chest wall; decreased erection of nipples

Question 2

changes in reproductive system related to males

Answer 2

graying and thinning of pubic hair
increased drooping in the scrotum and loss of rugae
prostate enlargement, with an increased likelihood of urethral obstruction

Question 3

nutrition history assessment collected for reproductive system

Answer 3

high alcohol intake increases risk of ovarian cancer
diet high in fat and low in fruits and vegetables increase risk of reproductive cancers
ex: prostate and ovarian cancer

Question 4

family history and genetic risk assessment collected for reproductive system

Answer 4

daughters of women given diethylstilbestrol (DES) to control bleeding during pregnancy are at increased risk for infertility and reproductive tract cancer
specific BRCA 1 and BRCA 2 gene mutations increase overall risk for breast or ovarian cancer
men with first degree relatives (father, brother) with prostate cancer are at greater risk

Question 5

physical assessment for reproductive system

Answer 5

focused assessment related to specific concerns and needs of the patient
current health problems: pain, bleeding, discharge, masses

Question 6

Labs for female reproductive

Answer 6

Pap smear
HPV
Vaginal cultures
alpha fetoprotein (AFP)
cancer antigen 125 (CA 125)

Question 7

Pap smear

Answer 7

cytologic study effective in detecting precancerous and cancerous cells from the cervix
Annual pap smear starting at age 21

Question 8

HPV

Answer 8

used to identify many high risk types of HPV associated with the development of cervical cancer
cells are collected from the cervix at the same time a pap test is completed

Question 9

vaginal cultures

Answer 9

used to detect bacterial, viral, fungal, and parasitic disorders

Question 10

AFP

Answer 10

elevated with ovarian cancer

Question 11

Cancer antigen CA 125

Answer 11

elevated with ovarian cancer

Question 12

Labs for male reproductive

Answer 12

prostate specific antigen (PSA) test, early prostate cancer antigen (EPCA-2) and serum acid phosphate, alpha fetoprotein (AFP), beta human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH)

Question 13

Prostate specific antigen (PSA) test

Answer 13

normal less than 2.5 ng/ml for age 50 and increases with age (possibly up to 6.5 ng/ml)
used as a screening lab for prostate cancer because other prostate problems can increase the level
some variance on the PSA value and how it is affected by age

Question 14

early prostate cancer antigen (EPCA-2) and serum acid phosphate

Answer 14

elevations indicative of prostate cancer
EPCA-2 is very sensitive and can detect early

Question 15

alpha fetoprotein (AFP), beta human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH)

Answer 15

elevations indicative of testicular cancer

Question 16

Imaging for reproductive system

Answer 16

CT, MRI, Ultrasonography, hysterosalpingography, mammogram

Question 17

CT Reproductive

Answer 17

evaluate for metastasis with different reproductive cancers, evaluate for ovarian cancer

Question 18

MRI reproductive

Answer 18

evaluation for breast cancer for women with high risk factors

Question 19

ultrasonography reproductive

Answer 19

transvaginal- ovarian and endometrial cancer
transrectal- prostate cancer
ultrasound- evaluate for testicular masses versus fluid
also used for breast cancer evaluation

Question 20

hystersalpingography (HSG)

Answer 20

x ray that uses an injection of a contrast medium to visualize the cervix, uterus, and fallopian tubes
used to evaluate tubal anatomy and patency and uterine problems such as fibroids, tumors, and fistulas

Question 21

“pre” considerations for HSG

Answer 21

assess for allergies to contrast dye

Question 22

“post” considerations for HSG

Answer 22

some pelvic and referred shoulder pain

Question 23

mammography

Answer 23

x ray of the soft tissue of the breast
now have 3D mammograms that visualize all layers
annually for women ages 40 and older
may experience discomfort during procedure

Question 24

“pre” consideration for mammogram

Answer 24

no creams, lotions, powders, or deodorant on breast on under arms

Question 25

"post" considerations for mammogram

Answer 25

reinforce continued self breast exams and clinical breast exams

Question 26

endoscopic studies

Answer 26

colposcopy, laparoscopy, hysteroscopy

Question 27

colposcopy reproductive

Answer 27

examination of the cervix and vagina using a colpscope

Question 28

laparoscopy reproductive

Answer 28

direct examination for the pelvic cavity through a endoscope performed under anesthesia

Question 29

"pre" considerations for laparoscopy

Answer 29

NPO

Question 30

"post" considerations for laparoscopy

Answer 30

some pelvic and referred shoulder pain observe incision sites for infection can also used during surgical procedures

Question 31

hysteroscopy

Answer 31

fibroptic camera that is inserted into the vagina examines the cervix and uterus performed with regional nerve block

Question 32

"post" considerations for hysteroscopy

Answer 32

some pelvic and referred shoulder pain

Question 33

biopsy studies for reproductive

Answer 33

cervical, endometrial, breast, prostate

Question 34

cervical biposy

Answer 34

cervical tissue is removed for cytologic study early in menstrual cycle so less vascular

Question 35

"pre" considerations for cervical biopsy

Answer 35

depends on anesthesia used address anxiety

Question 36

"post" considerations for cervical biopsy

Answer 36

monitor for bleeding and infections nothing in vagina for 2 weeks no heavy lifting

Question 37

endometrial biopsy

Answer 37

used to obtain cells directly from the lining of the uterus to assess for cancer of the endometrium assess menstrual disturbances and infertility

Question 38

"post" considerations for endometrial biopsy

Answer 38

some cramping may occur monitor for bleeding and infections spotting for 1-2 days nothing in vagina for 1-2 days

Question 39

breast biopsy

Answer 39

tissue aspirated through a large bore needle or through small incision, local anesthetic, aspirated fluid from benign cysts may appear clear to drank green/brown

Question 40

"pre" considerations for breast biopsy

Answer 40

depends on anesthesia used address anxiety

Question 41

"post" considerations for breast biopsy

Answer 41

mild pain alleviated with analgesics, ice or heat monitor incision for bleeding and infection numbness may occur around biopsy site wear supportive bra for 1 week

Question 42

prostate biopsy

Answer 42

definitive diagnostic tool for prostate cancer

Question 43

transurethral biopsy

Answer 43

insert needle through the area of skin between the anus and scrotum

Question 44

transrectal biopsy

Answer 44

passing the needle through the wall of the rectum

Question 45

"pre" considerations for prostate biopsy

Answer 45

discuss positioning and discomfort during procedure address anxiety

Question 46

"post" considerations for prostate biopsy

Answer 46

educate regarding soreness and light rectal bleeding, blood in urine and stool for a few days in addition to rust colored semen for several weeks monitor for signs of excessive bleeding, infection and urinary retention post biopsy antibiotic

Question 47

A patient has been informed that she has a specific BRCA 1 and BRCA 2 gene mutations. Which brochure would the nurse prepare for the patient? A. “Role of nutrition therapy in reproductive health” B. “Risk factors and treatments for infertility” C. “Risk factors and treatments for breast cancer” D. “ Colposcopy and other tests for cervical cancer”

Answer 47

C

Question 48

A 79 year old man is being seen for difficulty voiding and blood in urine. Which is the first screening test likely to be done? –A. Cytology culture –B. Prostate specific antigen –C. Serum testosterone level –D. Serological studies

Answer 48

B

Question 49

Which test detects cancerous and precancerous cells of the cervix? –A. Serologic studies –B. Vaginal cultures –C. Pap smear –D. Human papilloma virus (HPV) test

Answer 49

C

Question 50

Which test is used to assess tubal anatomy and patency, and uterine problems? –A. CT scan –B. Laparoscopy –C. Colposcopy –D. Hysterosalpingography

Answer 50

D

Question 51

The nurse is caring for a patient who had a laparoscopy. What is included in the postoperative care for this patient? –A. Notify the HCP of postoperative shoulder pain –B. Reassure the patient that most painful sensations disappear within 4-6 weeks –C. Teach the patient to observe the incision for signs of infection or hematoma –D. Remind the patient to avoid strenuous activity for 4-6 weeks after procedure

Answer 51

C

Question 52

What post procedure instructions would the nurse give to a patient who just had a colposcopy? –A. Do not drive or operate heavy machinery while taking prescribed pain medication –B. Do not use tampons and abstain from sexual intercourse for at least a week –C. Wear a perineal pad and expect bleeding with small clots for the first 24 hours –D. Perform breast self examinations every month and report changes to provider

Answer 52

B

Question 53

What pre-procedural instructions would the nurse give the patient about a mammogram? –A. Do not eat or drink anything 6 to 7 hours prior –B. Abstain from sex prior to test –C. Do not use lotions, creams or powders on breasts –D. Wear a supportive bra and bring a breast pad for after testing

Answer 53

C

Question 54

The nurse is helping a patient schedule a cervical biopsy. When does the nurse advise the patient that the procedure should be done? –A. 5 days after menses has ceased –B. 5 days before the beginning of menses –C. During the menstrual cycle –D. Whenever she can get 3-4 days off work

Answer 54

A

Question 55

What post procedure instructions would the nurse give to a patient who had a prostate biopsy? –A. Light rectal bleeding and blood in the urine or stools is expected for a few days –B. Swelling of the biopsy area and difficulty urinating are expected for 1 week –C. Low grade fever and bright red penile discharge are normal for several days –D. Return to see the health care provider in 1 week for recheck of biopsy site

Answer 55

A