Ricci Chapter 7 - Test Bank - 4th Edition || 100% Faultless
Answers.
1. A woman is admitted for repair of cystocele and rectocele. She has nine living children. In
taking her health history, what would the nurse expect to find?
A. sporadic vaginal bleeding accompanied by chronic pelvic pain
B. heavy leukorrhea with vulvar pruritus
C. menstrual irregularities and hirsutism on the chin
D. stress incontinence with feeling of low abdominal pressure Correct Answer: D
Rationale: Cystocele and rectocele are examples of pelvic organ prolapse. Manifestations
typically include stress incontinence and lower abdominal pressure or pain. Complaints of
sporadic vaginal bleeding and chronic pelvic pain are associated with uterine fibroids.
Leukorrhea and vulvar pruritus commonly are associated with an infection. Menstrual
irregularities and hirsutism are associated with polycystic ovarian syndrome.
2. To assist the woman in regaining control of the urinary sphincter after bladder surgery, the
nurse should teach the client to perform which action?
A. Perform Kegel exercises daily.
B. Void every hour while awake.
C. Limit the intake of fluid.
D. Take a laxative every night. Correct Answer: A
Rationale: After bladder surgery, the client should perform Kegel exercises daily to strengthen
the pelvic floor muscles. Bladder training with voiding every 3 to 5 hours helps to establish
normal voiding intervals. Fluids should not be limited; however, the woman should avoid fluids
that are irritants, such as caffeinated fluids, soda, and alcohol. Constipation is to be avoided, but
a high-fiber diet rather than daily laxative use is recommended.
3. When developing the plan of care for a woman who has had an abdominal hysterectomy, the
nurse would identify which action as contraindicated?
A. ambulating the client
B. massaging the client's legs
C. applying elasticized stockings
D. encouraging range-of-motion exercises Correct Answer: B
Rationale: After an abdominal hysterectomy, massaging the client's legs would be
contraindicated because the woman is at risk for venous stasis, thrombophlebitis, and
thromboembolism. Ambulation, elasticized stockings, and range-of-motion exercises would be
appropriate to reduce the woman's risk for thrombophlebitis.
4. A nurse is conducting a presentation for a local women's group about pelvic floor disorders.
Which instruction would the nurse include about preventing pelvic support disorders?
A. performing Kegel isometric exercises
B. consuming low-fiber diets
C. using hormone replacement
D. voiding every 2 hours Correct Answer: A
Rationale: Kegel exercises are an effective preventive measure for pelvic support disorders. They
may limit the progression of a mild prolapse and alleviate mild prolapse symptoms. High-fiber
, rather than low-fiber diets are appropriate to reduce straining associated with constipation.
Hormone replacement therapy must be highly individualized and is not an appropriate option for
every woman. Normal voiding patterns typically are every 3 to 5 hours. Too frequent or too
infrequent voiding can lead to problems.
5. A client is diagnosed with an enterocele. The nurse interprets this condition as:
A. protrusion of the posterior bladder wall downward through the anterior vaginal wall.
B. sagging of the rectum with pressure exerted against the posterior vaginal wall.
C. bulging of the small intestine through the posterior vaginal wall.
D. descent of the uterus through the pelvic floor into the vagina. Correct Answer: C
Rationale: An enterocele occurs when the small intestine bulges through the posterior vaginal
wall, especially when straining. A cystocele is a protrusion of the posterior bladder wall
downward through the anterior vaginal wall. A rectocele occurs when the rectum sags and
pushes against or into the posterior vaginal wall. Uterine prolapse occurs when the uterus
descends through the pelvic floor and into the vaginal canal.
6. A woman is scheduled for an anterior and posterior colporrhaphy as treatment for a cystocele.
When the nurse is explaining this treatment to the client, which description would be most
appropriate to include?
A. "This procedure helps to tighten the vaginal wall in the front and back so that your bladder
and urethra are in the proper position."
B. "Your uterus will be removed through your vagina, helping to relieve the organ that is putting
the pressure on your bladder."
C. "This is a series of exercises that you will learn to do so that you can strengthen your bladder
muscles."
D. "These are plastic devices that your primary care provider will insert into your vagina to
provide support to the uterus and keep it in the proper position." Correct Answer: A
Rationale: An anterior and posterior colporrhaphy tightens the anterior and posterior vaginal
wall, and the supportive tissue between the vagina and bladder is folded and sutured to bring the
bladder and urethra into proper position. Removal of the uterus through the vagina refers to a
vaginal hysterectomy. Exercises to strengthen the bladder muscles are called Kegel exercises.
Plastic devices inserted to provide support are called pessaries.
7. A client is diagnosed with uterine fibroids. When reviewing the client's health history, the
nurse would identify which finding as associated with the client's condition?
A. diarrhea
B. chronic pelvic pain
C. amenorrhea
D. upper back pain Correct Answer: B
Rationale: Findings associated with uterine fibroids include chronic pelvic pain, constipation,
dysmenorrhea, and lower back pain.
8. A client with polycystic ovarian syndrome (PCOS) is receiving oral contraceptives as part of
her treatment plan. When discussing this treatment with the client, the nurse would discuss which
rationale for this therapy?
A. restore menstrual regularity
Answers.
1. A woman is admitted for repair of cystocele and rectocele. She has nine living children. In
taking her health history, what would the nurse expect to find?
A. sporadic vaginal bleeding accompanied by chronic pelvic pain
B. heavy leukorrhea with vulvar pruritus
C. menstrual irregularities and hirsutism on the chin
D. stress incontinence with feeling of low abdominal pressure Correct Answer: D
Rationale: Cystocele and rectocele are examples of pelvic organ prolapse. Manifestations
typically include stress incontinence and lower abdominal pressure or pain. Complaints of
sporadic vaginal bleeding and chronic pelvic pain are associated with uterine fibroids.
Leukorrhea and vulvar pruritus commonly are associated with an infection. Menstrual
irregularities and hirsutism are associated with polycystic ovarian syndrome.
2. To assist the woman in regaining control of the urinary sphincter after bladder surgery, the
nurse should teach the client to perform which action?
A. Perform Kegel exercises daily.
B. Void every hour while awake.
C. Limit the intake of fluid.
D. Take a laxative every night. Correct Answer: A
Rationale: After bladder surgery, the client should perform Kegel exercises daily to strengthen
the pelvic floor muscles. Bladder training with voiding every 3 to 5 hours helps to establish
normal voiding intervals. Fluids should not be limited; however, the woman should avoid fluids
that are irritants, such as caffeinated fluids, soda, and alcohol. Constipation is to be avoided, but
a high-fiber diet rather than daily laxative use is recommended.
3. When developing the plan of care for a woman who has had an abdominal hysterectomy, the
nurse would identify which action as contraindicated?
A. ambulating the client
B. massaging the client's legs
C. applying elasticized stockings
D. encouraging range-of-motion exercises Correct Answer: B
Rationale: After an abdominal hysterectomy, massaging the client's legs would be
contraindicated because the woman is at risk for venous stasis, thrombophlebitis, and
thromboembolism. Ambulation, elasticized stockings, and range-of-motion exercises would be
appropriate to reduce the woman's risk for thrombophlebitis.
4. A nurse is conducting a presentation for a local women's group about pelvic floor disorders.
Which instruction would the nurse include about preventing pelvic support disorders?
A. performing Kegel isometric exercises
B. consuming low-fiber diets
C. using hormone replacement
D. voiding every 2 hours Correct Answer: A
Rationale: Kegel exercises are an effective preventive measure for pelvic support disorders. They
may limit the progression of a mild prolapse and alleviate mild prolapse symptoms. High-fiber
, rather than low-fiber diets are appropriate to reduce straining associated with constipation.
Hormone replacement therapy must be highly individualized and is not an appropriate option for
every woman. Normal voiding patterns typically are every 3 to 5 hours. Too frequent or too
infrequent voiding can lead to problems.
5. A client is diagnosed with an enterocele. The nurse interprets this condition as:
A. protrusion of the posterior bladder wall downward through the anterior vaginal wall.
B. sagging of the rectum with pressure exerted against the posterior vaginal wall.
C. bulging of the small intestine through the posterior vaginal wall.
D. descent of the uterus through the pelvic floor into the vagina. Correct Answer: C
Rationale: An enterocele occurs when the small intestine bulges through the posterior vaginal
wall, especially when straining. A cystocele is a protrusion of the posterior bladder wall
downward through the anterior vaginal wall. A rectocele occurs when the rectum sags and
pushes against or into the posterior vaginal wall. Uterine prolapse occurs when the uterus
descends through the pelvic floor and into the vaginal canal.
6. A woman is scheduled for an anterior and posterior colporrhaphy as treatment for a cystocele.
When the nurse is explaining this treatment to the client, which description would be most
appropriate to include?
A. "This procedure helps to tighten the vaginal wall in the front and back so that your bladder
and urethra are in the proper position."
B. "Your uterus will be removed through your vagina, helping to relieve the organ that is putting
the pressure on your bladder."
C. "This is a series of exercises that you will learn to do so that you can strengthen your bladder
muscles."
D. "These are plastic devices that your primary care provider will insert into your vagina to
provide support to the uterus and keep it in the proper position." Correct Answer: A
Rationale: An anterior and posterior colporrhaphy tightens the anterior and posterior vaginal
wall, and the supportive tissue between the vagina and bladder is folded and sutured to bring the
bladder and urethra into proper position. Removal of the uterus through the vagina refers to a
vaginal hysterectomy. Exercises to strengthen the bladder muscles are called Kegel exercises.
Plastic devices inserted to provide support are called pessaries.
7. A client is diagnosed with uterine fibroids. When reviewing the client's health history, the
nurse would identify which finding as associated with the client's condition?
A. diarrhea
B. chronic pelvic pain
C. amenorrhea
D. upper back pain Correct Answer: B
Rationale: Findings associated with uterine fibroids include chronic pelvic pain, constipation,
dysmenorrhea, and lower back pain.
8. A client with polycystic ovarian syndrome (PCOS) is receiving oral contraceptives as part of
her treatment plan. When discussing this treatment with the client, the nurse would discuss which
rationale for this therapy?
A. restore menstrual regularity
