Chapter 50: Assessment of Reproductive System Lewis: Medical-Surgical Nursing, 10th Edition Exam Practice Questions and Answers

Chapter 50: Assessment of Reproductive System Lewis: Medical-Surgical Nursing, 10th Edition Exam Practice Questions and Answers Which question should the nurse ask when assessing a 60-yr-old patient who has a history of benign prostatic hyperplasia (BPH)? a. "Have you noticed any unusual discharge from your penis?" b. "Has there been any change in your sex life in the past year?" c. "Has there been a decrease in the force of your urinary stream?" d. "Have you been experiencing any difficulty in achieving an erection?" - Ans:-ANS: C Enlargement of the prostate blocks the urethra, leading to urinary changes such as a decrease in the force of the urinary stream. The other questions address possible problems with infection or sexual difficulties, but they would not be helpful in determining whether there ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/16 were functional changes caused by BPH. DIF: Cognitive Level: Apply (application) REF: 1194 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity After a 26-yr-old patient has been treated for pelvic inflammatory disease, the nurse will plan to teach about the a. use of hormone therapy (HT). b. potential complication of infertility. c. irregularities in the menstrual cycle. d. changes in secondary sex characteristics. - Ans:-ANS: B Pelvic inflammatory disease may cause scarring of the fallopian tubes and result in difficulty in fertilization or implantation of the fertilized egg. Because ovarian function is not affected, the patient will not require HT, have irregular menstrual cycles, or experience changes in secondary sex characteristics. DIF: Cognitive Level: Apply (application) REF: 1194 ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/16 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity A 68-yr-old male patient tells the nurse that he is worried because he does not respond to sexual stimulation the same way he did when he was younger. Which is the nurse's best response to the patient's concern? a. "Interest in sex frequently decreases as men get older." b. "Many men need additional sexual stimulation with aging." c. "Erectile dysfunction is a common problem with older men." d. "Tell me more about how your sexual response has changed." - Ans:-ANS: D The initial response by the nurse should be further assessment of the problem. The other statements by the nurse are accurate but may not respond to the patient's concerns. DIF: Cognitive Level: Analyze (analysis) REF: 1191 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity The nurse is providing teaching by telephone to a patient who is scheduled for a pelvic examination and Pap test next week. The nurse instructs the patient that she should ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/16 a. not have sexual intercourse the day before the Pap test. b. shower, but not take a tub bath, before the examination. c. avoid douching for at least 24 hours before the examination. d. schedule to have the Pap test just after her menstrual period. - Ans:-ANS: C Because the results of a Pap test may be affected by douching, the patient should not douche before the examination. The examination may be scheduled without regard to the menstrual period. The patient may shower or bathe before the examination. Sexual intercourse does not affect the results of the examination or Pap test. DIF: Cognitive Level: Apply (application) REF: 1199 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity A 22-yr-old patient reports her concern about not having a menstrual period for the past 7 months. Which statement by the patient indicates a possible related factor to the amenorrhea? a. "I drink at least 3 glasses of nonfat milk every day." b. "I run 7 to 8 miles every day to manage my weight." ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/16 c. "I am not sexually active but currently I have an IUD." d. "I was treated for a sexually transmitted infection 2 years ago." - Ans:-ANS: B Intense endurance exercise can cause amenorrhea. The other statements by the patient do not suggest any urgent teaching needs. DIF: Cognitive Level: Apply (application) REF: 1194 TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance The nurse is assessing the sexual-reproductive functional health pattern of a 32-yr-old woman. Which question is most useful in determining the patient's sexual orientation and related risk factors? a. "Do you have sex with men, women, or both?" b. "Which gender do you prefer to have sex with?" c. "What types of sexual activities do you prefer?" d. "Are you heterosexual, homosexual, or bisexual?" - Ans:-ANS: A This question is the most simply stated and will increase the likelihood of obtaining the ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 6/16 relevant information about sexual orientation and possible risk factors associated with sexual activity. A patient who prefers sex with women may also have intercourse at times with men. The types of sexual activities engaged in may not indicate sexual orientation. Many patients who have sex with both men and women do not identify themselves as homosexual or bisexual. DIF: Cognitive Level: Analyze (analysis) REF: 1194 TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance The nurse explains to a patient being prepared for colposcopy with a cervical biopsy that the procedure a. involves dilation of the cervix and biopsy of the tissue lining the uterus. b. will take place in a same-day surgery center so that local anesthesia can be used. c. requires that the patient have nothing to eat or drink for 6 hours before the procedure. d. is similar to a speculum examination of the cervix and should result in little ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 7/16 discomfort. - Ans:-ANS: D Colposcopy involves visualization of the cervix with a binocular microscope and is similar to a speculum examination. Anesthesia is not required and fasting is not necessary. A cervical biopsy may cause a minimal amount of pain. DIF: Cognitive Level: Apply (application) REF: 1201 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity A couple is scheduled to have a Huhner test for infertility. In preparation for the test, the nurse will instruct the couple about a. being sedated during the procedure. b. determining the estimated time of ovulation. c. experiencing shoulder pain after the procedure. d. refraining from intercourse before the appointment. - Ans:-ANS: B For the Huhner test, the couple should have intercourse at the estimated time of ovulation and then arrive for the test 2 to 8 hours after intercourse. The other instructions would be used for ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 8/16 other types of fertility testing. DIF: Cognitive Level: Apply (application) REF: 1194 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity A patient in the sexually transmitted infection clinic has a positive Venereal Disease Research Laboratory (VDRL) test, but no chancre is visible on assessment. The nurse will plan to send specimens for a. Gram stain. b. cytologic studies. c. rapid plasma reagin (RPR) agglutination. d. fluorescent treponemal antibody absorption (FTA-Abs). - Ans:-ANS: D Because false positives are common with VDRL and RPR testing, FTA-Abs testing is recommended to confirm a diagnosis of syphilis. Gram staining is used for other sexually transmitted infections (STIs) such as gonorrhea and Chlamydia and cytologic studies are used to detect abnormal cells (e.g., neoplastic cells). ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 9/16 DIF: Cognitive Level: Apply (application) REF: 1198 TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity A 24-yr-old woman says she wants to begin using oral contraceptives. Which information from the nursing assessment is important to report to the health care provider before a prescription is considered? a. The patient quit smoking 5 months previously. b. The patient's blood pressure is 150/86 mm Hg. c. The patient has not been vaccinated for rubella. d. The patient has chronic iron-deficiency anemia. - Ans:-Because hypertension increases the risk for morbidity and mortality in women taking oral contraceptives, the patient's blood pressure should be controlled before oral contraceptives are prescribed. The other information will not affect the c