Chapter 12: Care of the Patient with a Reproductive Disorder
MULTIPLE CHOICE
1. Which condition would prevent the use of a vaginal hysterectomy?
a. A woman with more than four pregnancies
b. Large uterine fibroids
c. Menorrhagia for over 6 months
d. Women over the age of 50
ANS: B
In the case of large uterine fibroids, a vaginal hysterectomy is not an option.
DIF: Cognitive Level: Application REF: Page 588 OBJ: 14
TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. On the second postoperative day, a patient who has had an abdominal hysterectomy complains
of gas and abdominal distention. Which intervention would be most appropriate to stimulate a
bowel movement?
a. Offering carbonated beverages
b. Encouraging ambulation at least four times per day
c. Administering a 1000-mL soapsuds enema
d. Applying an abdominal binder
ANS: B
Early ambulation is very helpful to return the bowel to normal function.
DIF: Cognitive Level: Analysis REF: Page 588 OBJ: 14
TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
3. The young husband of a patient who has been scheduled for a hysterectomy because of the
discovery of ovarian cancer in both ovaries says to the nurse, “Please go talk to my wife. She
is real upset and says she won’t be a ‘woman’ anymore.” What is the nurse’s most therapeutic
response?
a. “Don’t be concerned. All young women get upset before this kind of surgery.”
b. “Certainly, I will be glad to tell her about hormone replacement.”
c. “She will get over this feeling soon.”
d. “No matter what I may say to her, it is you that needs to listen to her concerns and
assure her.”
ANS: D
Assisting patients with recognizing and clarifying fears and with developing coping strategies
for those fears by listening is helpful.
DIF: Cognitive Level: Application REF: Page 597, NCP
OBJ: 12 TOP: Ovarian cancer
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
, 4. A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-
oophorectomy for endometriosis. She asks the nurse if she will have “hot flashes.” What
knowledge will guide the nurse’s response?
a. Only the uterus was removed, and the ovaries are still producing estrogen and she
will not have hot flashes.
b. The patient is too young to have hot flashes associated with menopause.
c. The uterus, ovaries, and fallopian tubes were removed, and she will have surgically
induced menopause and may have hot flashes.
d. The uterus and fallopian tubes were removed, and she will not experience “hot
flashes.”
ANS: C
A total abdominal hysterectomy with bilateral salpingo-oophorectomy is the removal of the
uterus, fallopian tubes, and ovaries. If the ovaries are removed in these surgeries, the surgery
will induce menopause and hot flashes may occur.
DIF: Cognitive Level: Analysis REF: Page 588 OBJ: 14
TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
5. On the fourth postoperative day after a modified radical mastectomy, the nurse finds the
patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is
worried that her husband will not be in love with her anymore. The nurse bases subsequent
nursing interventions on what diagnosis?
a. Disturbed body image related to removal of her breast
b. Deficient knowledge related to inadequate education
c. Impaired social interaction related to depression
d. Fear related to the cancer diagnosis and surgical intervention
ANS: A
After losing a breast, many patients experience grief over the loss of a body part. The process
of grieving is essential for personal adaptation to the loss. The nurse can assist the patient to
find helpful coping mechanisms.
DIF: Cognitive Level: Analysis REF: Page 599 OBJ: 18
TOP: Mastectomy KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity
6. Why would the nurse encourage the patient who is recovering from a modified radical
mastectomy to exercise the affected arm?
a.To reduce pain
b.To stimulate appetite
c.To reduce lymphedema
d.To increase muscle tension
ANS: C
An exercise regimen, built up gradually, can help reduce lymphedema following a modified
radical mastectomy.
DIF: Cognitive Level: Application REF: Pages 598-599, Box 12-7
OBJ: 19 TOP: Postmastectomy exercises
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
MULTIPLE CHOICE
1. Which condition would prevent the use of a vaginal hysterectomy?
a. A woman with more than four pregnancies
b. Large uterine fibroids
c. Menorrhagia for over 6 months
d. Women over the age of 50
ANS: B
In the case of large uterine fibroids, a vaginal hysterectomy is not an option.
DIF: Cognitive Level: Application REF: Page 588 OBJ: 14
TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. On the second postoperative day, a patient who has had an abdominal hysterectomy complains
of gas and abdominal distention. Which intervention would be most appropriate to stimulate a
bowel movement?
a. Offering carbonated beverages
b. Encouraging ambulation at least four times per day
c. Administering a 1000-mL soapsuds enema
d. Applying an abdominal binder
ANS: B
Early ambulation is very helpful to return the bowel to normal function.
DIF: Cognitive Level: Analysis REF: Page 588 OBJ: 14
TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
3. The young husband of a patient who has been scheduled for a hysterectomy because of the
discovery of ovarian cancer in both ovaries says to the nurse, “Please go talk to my wife. She
is real upset and says she won’t be a ‘woman’ anymore.” What is the nurse’s most therapeutic
response?
a. “Don’t be concerned. All young women get upset before this kind of surgery.”
b. “Certainly, I will be glad to tell her about hormone replacement.”
c. “She will get over this feeling soon.”
d. “No matter what I may say to her, it is you that needs to listen to her concerns and
assure her.”
ANS: D
Assisting patients with recognizing and clarifying fears and with developing coping strategies
for those fears by listening is helpful.
DIF: Cognitive Level: Application REF: Page 597, NCP
OBJ: 12 TOP: Ovarian cancer
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
, 4. A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-
oophorectomy for endometriosis. She asks the nurse if she will have “hot flashes.” What
knowledge will guide the nurse’s response?
a. Only the uterus was removed, and the ovaries are still producing estrogen and she
will not have hot flashes.
b. The patient is too young to have hot flashes associated with menopause.
c. The uterus, ovaries, and fallopian tubes were removed, and she will have surgically
induced menopause and may have hot flashes.
d. The uterus and fallopian tubes were removed, and she will not experience “hot
flashes.”
ANS: C
A total abdominal hysterectomy with bilateral salpingo-oophorectomy is the removal of the
uterus, fallopian tubes, and ovaries. If the ovaries are removed in these surgeries, the surgery
will induce menopause and hot flashes may occur.
DIF: Cognitive Level: Analysis REF: Page 588 OBJ: 14
TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
5. On the fourth postoperative day after a modified radical mastectomy, the nurse finds the
patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is
worried that her husband will not be in love with her anymore. The nurse bases subsequent
nursing interventions on what diagnosis?
a. Disturbed body image related to removal of her breast
b. Deficient knowledge related to inadequate education
c. Impaired social interaction related to depression
d. Fear related to the cancer diagnosis and surgical intervention
ANS: A
After losing a breast, many patients experience grief over the loss of a body part. The process
of grieving is essential for personal adaptation to the loss. The nurse can assist the patient to
find helpful coping mechanisms.
DIF: Cognitive Level: Analysis REF: Page 599 OBJ: 18
TOP: Mastectomy KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity
6. Why would the nurse encourage the patient who is recovering from a modified radical
mastectomy to exercise the affected arm?
a.To reduce pain
b.To stimulate appetite
c.To reduce lymphedema
d.To increase muscle tension
ANS: C
An exercise regimen, built up gradually, can help reduce lymphedema following a modified
radical mastectomy.
DIF: Cognitive Level: Application REF: Pages 598-599, Box 12-7
OBJ: 19 TOP: Postmastectomy exercises
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity
