Lewis Test Bank
The nurse in the women's health clinic has four patients who are waiting
to be seen.
Which patient should the nurse see FIRST? correct answers a. 22-year-
old with red-brown vaginal drainage 3 days after having balloon
persistent
thermotherapy
b. 42-year-old with secondary amenorrhea who says that her last menstrual
cycle was 3
months
ago
c. 35-year-old with heavy spotting after having a progestin-containing
IUD (Mirena)
inserted a month
ago
D. 19-year-old with menorrhagia who has been using superabsorbent
tampons
fever withand has
weakness
Rational:
The patients history and clinical manifestations suggest possible toxic shock
syndrome,
which will require rapid intervention. The symptoms for the other patients
are
withconsistent
their diagnoses and do not indicate life-threatening
complications.
A healthy 28-year-old who has been vaccinated against human
papillomavirus
has a normal Pap (HPV)
test. Which information will the nurse include in patient
teaching
calling thewhen
patient with the results of the Pap test? correct answers Pap
testing is
recommended every 3 years for women
your age.
To prevent pregnancy in a patient who has been sexually assaulted, the
nurse in thedepartment will plan to teach the patient about the use of
emergency
correct answers(Plan-B One-
levonorgestrel
Step).
Rationa
l:
Plan B One-Step reduces the risk of pregnancy when taken within 72
hours of
intercourse. The other methods are used for therapeutic abortion, but not for
pregnancy
prevention after unprotected
intercourse.
A 22-year-old tells the nurse that she has not had a menstrual period for
the last 2Which action is MOST important for the nurse to take? correct
months.
answersa A.
Obtain urine specimen for a
pregnancy
b. Ask about test.
any recent stressful lifestyle
changes.
c. Measure the patients current height and
d. Question the patient about prescribed medications.
weight.
Rational:
Pregnancy should always be considered a possible cause of amenorrhea in
women of
childbearing age. The other actions are also appropriate, but it is important
to check forin this patient because pregnancy will require rapid
pregnancy
implementation
actions to promote of normal fetal development such as changes in
lifestyle, folic acid
intake,
etc.
Which information will the nurse include when teaching a patient who has
developed
small a
vesicovaginal fistula 2 weeks into the postpartum period? correct
answers
Take stoola.softeners to prevent fecal contamination of the
vagina.
, b. Limit oral fluid intake to minimize the quantity of urinary
drainage.
C. Change the perineal pad frequently to prevent perineal skin
breakdown.
d. Call the health care provider immediately if urine drains from
the vagina.
Rationa
l:
Because urine will leak from the bladder, the patient should plan to use
perineal
and pads
change them frequently. A high fluid intake is recommended to decrease
the risk tract
urinary for infections. Drainage of urine from the vagina is expected with
vesicovaginal
fistulas. Fecal contamination is not a concern with
vesicovaginal fistulas.
The nurse has just received change-of-shift report about the following
four patients.
Which patient should be assessed FIRST? correct answers a. A patient with
a cervical
radium implant in place who is crying in
herAroom
b. patient who is complaining of 5/10 pain after an abdominal
hysterectomy
C. A patient with a possible ectopic pregnancy who is complaining of
shoulder
d. A patientpainin the fifteenth week of gestation who has uterine cramping
and spotting
Rationa
l:
The patient with the ectopic pregnancy has symptoms consistent with
needs
ruptureimmediate
and assessment for signs of hemorrhage and possible transfer
to surgery.
The other patients should also be assessed as quickly as possible but do
not have of life-threatening
symptoms
complications
A 27-year-old patient tells the nurse that she would like a
prescription for to
contraceptives oral
control her premenstrual dysphoric disorder (PMD-D)
symptoms.
Which patient information is MOST important to communicate to the
health carecorrect answers a. Bilateral breast
provider?
tenderness
b. Frequent abdominal
bloating
C. History of migraine
headaches
d. Previous spontaneous
abortion
Rationa
l:
Oral contraceptives are contraindicated in patients with a history
of migraine The other patient information would not prevent the patient
headaches.
from receiving
oral
contraceptives.
The nurse notes that a patient who has a large cystocele, admitted 10
hours
not yetago, has Which action should the nurse take FIRST? correct answers
voided.
a. Insert catheter
straight a per the PRN
b. Encourage the patient to increase oral
order.
fluids.
c. Notify the health care provider of the inability to void. D. Use an ultrasound
scanner
check fortourinary
retention.
Rationa
l:
Because urinary retention is common with a large cystocele, the nurses
first action
should be to use an ultrasound bladder scanner to check for the presence of
urine in the
bladder. The other actions may be appropriate, depending on the
findings with the
bladder
scanner.
The nurse in the women's health clinic has four patients who are waiting
to be seen.
Which patient should the nurse see FIRST? correct answers a. 22-year-
old with red-brown vaginal drainage 3 days after having balloon
persistent
thermotherapy
b. 42-year-old with secondary amenorrhea who says that her last menstrual
cycle was 3
months
ago
c. 35-year-old with heavy spotting after having a progestin-containing
IUD (Mirena)
inserted a month
ago
D. 19-year-old with menorrhagia who has been using superabsorbent
tampons
fever withand has
weakness
Rational:
The patients history and clinical manifestations suggest possible toxic shock
syndrome,
which will require rapid intervention. The symptoms for the other patients
are
withconsistent
their diagnoses and do not indicate life-threatening
complications.
A healthy 28-year-old who has been vaccinated against human
papillomavirus
has a normal Pap (HPV)
test. Which information will the nurse include in patient
teaching
calling thewhen
patient with the results of the Pap test? correct answers Pap
testing is
recommended every 3 years for women
your age.
To prevent pregnancy in a patient who has been sexually assaulted, the
nurse in thedepartment will plan to teach the patient about the use of
emergency
correct answers(Plan-B One-
levonorgestrel
Step).
Rationa
l:
Plan B One-Step reduces the risk of pregnancy when taken within 72
hours of
intercourse. The other methods are used for therapeutic abortion, but not for
pregnancy
prevention after unprotected
intercourse.
A 22-year-old tells the nurse that she has not had a menstrual period for
the last 2Which action is MOST important for the nurse to take? correct
months.
answersa A.
Obtain urine specimen for a
pregnancy
b. Ask about test.
any recent stressful lifestyle
changes.
c. Measure the patients current height and
d. Question the patient about prescribed medications.
weight.
Rational:
Pregnancy should always be considered a possible cause of amenorrhea in
women of
childbearing age. The other actions are also appropriate, but it is important
to check forin this patient because pregnancy will require rapid
pregnancy
implementation
actions to promote of normal fetal development such as changes in
lifestyle, folic acid
intake,
etc.
Which information will the nurse include when teaching a patient who has
developed
small a
vesicovaginal fistula 2 weeks into the postpartum period? correct
answers
Take stoola.softeners to prevent fecal contamination of the
vagina.
, b. Limit oral fluid intake to minimize the quantity of urinary
drainage.
C. Change the perineal pad frequently to prevent perineal skin
breakdown.
d. Call the health care provider immediately if urine drains from
the vagina.
Rationa
l:
Because urine will leak from the bladder, the patient should plan to use
perineal
and pads
change them frequently. A high fluid intake is recommended to decrease
the risk tract
urinary for infections. Drainage of urine from the vagina is expected with
vesicovaginal
fistulas. Fecal contamination is not a concern with
vesicovaginal fistulas.
The nurse has just received change-of-shift report about the following
four patients.
Which patient should be assessed FIRST? correct answers a. A patient with
a cervical
radium implant in place who is crying in
herAroom
b. patient who is complaining of 5/10 pain after an abdominal
hysterectomy
C. A patient with a possible ectopic pregnancy who is complaining of
shoulder
d. A patientpainin the fifteenth week of gestation who has uterine cramping
and spotting
Rationa
l:
The patient with the ectopic pregnancy has symptoms consistent with
needs
ruptureimmediate
and assessment for signs of hemorrhage and possible transfer
to surgery.
The other patients should also be assessed as quickly as possible but do
not have of life-threatening
symptoms
complications
A 27-year-old patient tells the nurse that she would like a
prescription for to
contraceptives oral
control her premenstrual dysphoric disorder (PMD-D)
symptoms.
Which patient information is MOST important to communicate to the
health carecorrect answers a. Bilateral breast
provider?
tenderness
b. Frequent abdominal
bloating
C. History of migraine
headaches
d. Previous spontaneous
abortion
Rationa
l:
Oral contraceptives are contraindicated in patients with a history
of migraine The other patient information would not prevent the patient
headaches.
from receiving
oral
contraceptives.
The nurse notes that a patient who has a large cystocele, admitted 10
hours
not yetago, has Which action should the nurse take FIRST? correct answers
voided.
a. Insert catheter
straight a per the PRN
b. Encourage the patient to increase oral
order.
fluids.
c. Notify the health care provider of the inability to void. D. Use an ultrasound
scanner
check fortourinary
retention.
Rationa
l:
Because urinary retention is common with a large cystocele, the nurses
first action
should be to use an ultrasound bladder scanner to check for the presence of
urine in the
bladder. The other actions may be appropriate, depending on the
findings with the
bladder
scanner.
