Chapter 51 to 54 - Medical-Surgical Nursing Test Bank (8th Ed)

Chapter 51 to 54 - Medical-Surgical Nursing Test Bank (8th Ed) Chapter 51: Female Reproductive System Introduction Linton: Medical-Surgical Nursing, 8th Edition MULTIPLE CHOICE 1. A nurse is instructing a patient on breast self-examination. Which time of the month is best to instruct this patient to perform a breast self-examination? a. Before the menstrual period b. During the menstrual period c. After the menstrual period d. On the first day of the month ANS: C Breast self-examination should be performed at the same time each month, at the end of the menstrual cycle. DIF: Cognitive Level: Knowledge OBJ: 2 TOP: Breast Self-Examination KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. Conjugated estrogen (Premarin) is indicated for treatment of menopause. Which side effects should a nurse explain before administering the medication to a woman who has just had a hysterectomy? a. Breast tenderness b. Hypotension c. Arthralgia d. Skin rash ANS: A A side effect of conjugated estrogen (Premarin) is breast tenderness. DIF: Cognitive Level: Comprehension OBJ: 3 TOP: Drugs Used to Treat Menopause KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 3. A female student, seen in the campus clinic, states that she uses feminine hygiene douches every day and after intercourse. Which is the best response from the nurse? a. “Douching has been used as an effective means of birth control for years.” b. “Commercially prepared douches will neutralize the female vaginal tract.” c. “Douching should only be done when ordered by a physician or nurse practitioner.” d. “Douching protects the vaginal tract from microorganisms.” ANS: C Women should not douche unless it is ordered by a physician or nurse practitioner. DIF: Cognitive Level: Comprehension OBJ: 4 TOP: Douching KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 4. A nurse is demonstrating breast self-examination to a patient. Which body area should the nurse point out as the most common area in the breast for tumors to occur? a. Under the nipple b. Upper outer quadrant c. Six o’clock position d. Axillary lymph nodes ANS: B Nearly half of all malignant breast tumors are located in the upper outer quadrant. DIF: Cognitive Level: Knowledge OBJ: 1 TOP: Breast Self-Examination KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 5. Which medication is used to stimulate or mimic actions of natural pituitary gonadotropins in the treatment of infertility? a. Estrogen only (diethylstilbestrol) b. Danazol (Danocrine) c. Clomiphene citrate (Clomid) d. Raloxifene (Evista) ANS: C Clomid stimulates the actions of natural pituitary gonadotropins. DIF: Cognitive Level: Knowledge OBJ: 3 TOP: Ovulatory Stimulant Drugs KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 6. A woman calls the clinic office and asks the nurse why she is having spotting between her monthly periods when she is taking birth control pills to control the menorrhagia. Which reply is the nurse’s most appropriate response? a. “It is important to take the pill at the same time each day.” b. “Irregular spotting is to be expected with oral contraceptives.” c. “The pills are still safe. Continue to take them, regardless.” d. “Physicians are still uncertain as to how oral contraceptives function.” ANS: A Treatment for menorrhagia consists of taking the birth control pill at the same time each day. DIF: Cognitive Level: Comprehension OBJ: 3 TOP: Menorrhagia KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 7. A patient asks a nurse, “Will the laparoscopy be painful?” Which response is the best reply by the nurse? a. “You will probably have some pain below the rib cage and around the shoulder.” b. “Most patients state that the procedure is painless during and afterward.” c. “You may have some mild to moderate pain around the umbilicus and in the back.” d. “Every person is different. It’s difficult to say whether you’ll have pain.” ANS: A During the immediate postoperative period, the patient tends to experience pain below the rib cage and in the shoulder area from the air injected into the abdominal cavity. The air is absorbed in 24 hours, and the pain disappears. DIF: Cognitive Level: Comprehension OBJ: 2 TOP: Laparoscopy KEY: Nursing Process Step: Implementation 8. Which potential side effect should a nurse caution a patient who is taking danazol (Danocrine), an androgenic steroid, for the treatment of menorrhagia to be prepared for? a. Heavy menses b. Masculinizing c. Acnelike skin eruptions d. Anemia ANS: B Androgenic steroids cause masculinizing. The distressing signs are a deepening voice, development of chest hair, coarsening of the skin, clitoral enlargement, and hot flashes. Many patients reject the drug on the basis of these side effects. DIF: Cognitive Level: Knowledge OBJ: 3 TOP: Androgenic Steroid Therapy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 9. Which instruction should a nurse provide to a patient after a culdoscopy? a. Clean the incision site daily with hydrogen peroxide. b. Avoid vaginal intercourse. c. Return to the clinic for suture removal in 7 days. d. Use tampons. ANS: B Nothing should be inserted into the vagina (e.g., intercourse, tampons) for the time specified by the physician. No incision or sutures are present. DIF: Cognitive Level: Comprehension OBJ: 2 TOP: Culdoscopy KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease Chapter 52: Female Reproductive Disorders Linton: Medical-Surgical Nursing, 8th Edition MULTIPLE CHOICE 1. A patient tells a nurse that she is afraid of getting cervical cancer because her mother died of cervical cancer. Which is the most appropriate response by the nurse? a. “You need to a have a pelvic examination every 6 months because of your history.” b. “If you have regular Pap stain, cervical cancer is usually diagnosed early and cured.” c. “There’s no need to worry so much. Cervical cancer does not run in families.” d. “Cervical cancer is sexually transmitted. Don’t switch partners often, and you don’t have to worry.” ANS: B For patients who have regular annual pelvic examinations and Papanicolaou (Pap) stain, cervical cancer is usually diagnosed and treated in its early stage. DIF: Cognitive Level: Comprehension OBJ: 1 TOP: Cervical Cancer KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. A nurse is caring for a patient after a modified radical mastectomy for a breast tumor that has been determined to be positive for estrogen receptors (ER positive) and has been placed on a protocol of tamoxifen. The patient then asks the nurse, “Do you think I should take this medication?” Which statement is the most appropriate? a. “Tamoxifen will probably not be effective because your tumor was ER positive.” b. “If I were you, I would do what the physician recommends.” c. “I think that you should take tamoxifen, because the tumor was ER positive.” d. “Tamoxifen is an option to consider, because your tumor was ER positive.” ANS: D For tumors that are ER positive, tamoxifen citrate may be prescribed because such drugs interfere with estrogen production. ER-positive tumors need estrogen to grow. DIF: Cognitive Level: Comprehension OBJ: 1 | 2 TOP: Drugs Used in Treatment for Breast Cancer KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 3. A 16-year-old girl seen in the student health clinic has been diagnosed with Trichomonas vaginalis and given medication for the infection. Which information should a nurse provide about treatment of the girl’s sexual partner? a. He will require a 1-day treatment with the same drug. b. He will not develop the infection or require treatment. c. He will be treated, although he is asymptomatic. d. He is required by law to be examined by a physician. ANS: C The woman’s sexual partner(s) may be treated for some infections to avoid reinfection.