MSN 377 Exam 2 Questions and Answers Latest Update 2025
11. A patient with abdominal pain and irregular vaginal bleeding is admitted to the hospital with
a suspected ectopic pregnancy. Before actual diagnosis, what is the most appropriate action by
the nurse?
A. Provide analgesics for pain relief.
b. Monitor vital signs, pain, and bleeding frequently.
c. Offer support for the patient's emotional response to the loss of the pregnancy.
d. Explain the need to obtain a blood sample for β-human chorionic gonadotropin monitoring. -
Answers 11. b.
Ectopic pregnancy is a life-threatening condition. If the fallopian tube ruptures, profuse bleeding
can lead to hypovolemic shock. While all the interventions are indicated, the priority is
monitoring the vital signs and pain for evidence of bleeding.
12. Which manifestations of menopause are related to estrogen deficiency (select all that apply)?
a. Cessation of menses
b. Breast engorgement
c. Vasomotor instability
d. Reduction of bone fractures
e. Decreased cardiovascular risk - Answers 12. a, c.
The lack of estrogen in menopause contributes to many of the signs of aging, including
cessation of menses, vasomotor instability (hot flashes), atrophic changes of vaginal and
external genitalia and breast tissue, increased risks for osteoporosis and coronary artery
disease, redistribution of fat, muscle and joint pain, loss of skin elasticity, and atrophic lower
urinary tract changes.
22. A patient with a stage 0 cervical cancer identified from a Papanicolaou (Pap) test asks the
nurse what this finding means. The nurse's response should include which information?
a. Atypical cells characteristic of inflammation are present.
b. Cancer cells have extended beyond the cervix to the upper vagina.
c. Cancer cells are present and are confined to the epithelial layer of the cervix.
,d. This is a common finding on Pap testing, and she will be examined often to see if the
abnormal cells spread beyond the cervix. - Answers 22. c.
A stage 0 cervical cancer indicates cancer in situ that is confined to the epithelial layer of the
cervix and requires treatment. Stage 0 is the least invasive.
Stage I is confined to the cervix.
Stage II has spread beyond the cervix to the upper two-thirds of the vagina but not the tissues
around the uterus.
Stage III involves the pelvic wall, lower third of the vagina, and/or kidney problems.
Stage IV indicates spread to distant organs.
23. Fertility and normal reproductive function can be maintained when a cancer of the cervix is
successfully treated with which therapy?
a. External radiation therapy
b. Internal radiation implants
c. Conization or laser surgery
d. Cryotherapy or subtotal hysterectomy - Answers 23. c.
Conization (an excision of a cone-shaped section of the cervix) and laser treatment both are
effective to locally remove or destroy malignant cells of the cervix and preserve fertility.
Radiation treatments often impair ovarian and uterine function and lead to sterility. A subtotal
hysterectomy would be contraindicated in the treatment of cervical cancer because the cervix
would be left intact in this procedure.
24. A woman who has been postmenopausal for 10 years calls the clinic because of vaginal
bleeding. The nurse schedules a visit for the patient and informs her to expect to have which
diagnostic procedure?
a. An endometrial biopsy
b. Abdominal radiography
c. A laser treatment to the cervix
d. Only a routine pelvic examination and Pap test - Answers 24. a.
Postmenopausal vaginal bleeding is an early sign of endometrial cancer. When it occurs, a
sample of endometrial tissue must be taken to exclude cancer. An endometrial biopsy can be
done as an office procedure and is indicated in this case.
, Abdominal x-rays and Pap tests are not reliable tests for endometrial cancer. Laser treatment of
the cervix is indicated only for cervical dysplasia.
25. A patient has been diagnosed with ovarian cancer. In planning care for the patient, the nurse
recognizes that treatment of the patient depends on what?
a. Results of a direct-needle biopsy of the ovary
b. Results of a laparotomy with multiple biopsies
c. Whether the patient desires to maintain fertility
d. The findings of metastasis by ultrasound or CT scan - Answers 25. b.
Treatment of ovarian cancer is determined by staging from the results of laparotomy with
multiple biopsies of the ovaries and other tissue throughout the pelvis and lower abdomen.
The patient's desire for fertility is not a consideration because of the high mortality rate
associated with ovarian cancer. Although diagnosis of ovarian tumors may be made by
transvaginal ultrasound or CT scan, the treatment of ovarian cancer depends on the staging of
the tumor.
27. Which factors are associated with endometrial cancer (select all that apply)?
a. Obesity
b. Smoking
c. Family history
d. Early sexual activity
e. Early menarche and late menopause
f. Unopposed estrogen-only replacement therapy - Answers 27. a, b, e, f.
Endometrial cancer is at higher risk in obese patients because adipose cells store estrogen,
which is the major risk factor, especially unopposed estrogen. Smoking is a risk factor for
endometrial and cervical cancers. Early menarche and late menopause are risk factors for
endometrial cancer.
Early sexual activity is a risk factor for cervical cancer. Family history is a risk factor for ovarian
cancer. (BRCA1 & BRCA2 genes)
29. A 44-year-old woman undergoing a total abdominal hysterectomy asks whether she will
need to take estrogen until she reaches the age of menopause. What is the best response by
the nurse?
11. A patient with abdominal pain and irregular vaginal bleeding is admitted to the hospital with
a suspected ectopic pregnancy. Before actual diagnosis, what is the most appropriate action by
the nurse?
A. Provide analgesics for pain relief.
b. Monitor vital signs, pain, and bleeding frequently.
c. Offer support for the patient's emotional response to the loss of the pregnancy.
d. Explain the need to obtain a blood sample for β-human chorionic gonadotropin monitoring. -
Answers 11. b.
Ectopic pregnancy is a life-threatening condition. If the fallopian tube ruptures, profuse bleeding
can lead to hypovolemic shock. While all the interventions are indicated, the priority is
monitoring the vital signs and pain for evidence of bleeding.
12. Which manifestations of menopause are related to estrogen deficiency (select all that apply)?
a. Cessation of menses
b. Breast engorgement
c. Vasomotor instability
d. Reduction of bone fractures
e. Decreased cardiovascular risk - Answers 12. a, c.
The lack of estrogen in menopause contributes to many of the signs of aging, including
cessation of menses, vasomotor instability (hot flashes), atrophic changes of vaginal and
external genitalia and breast tissue, increased risks for osteoporosis and coronary artery
disease, redistribution of fat, muscle and joint pain, loss of skin elasticity, and atrophic lower
urinary tract changes.
22. A patient with a stage 0 cervical cancer identified from a Papanicolaou (Pap) test asks the
nurse what this finding means. The nurse's response should include which information?
a. Atypical cells characteristic of inflammation are present.
b. Cancer cells have extended beyond the cervix to the upper vagina.
c. Cancer cells are present and are confined to the epithelial layer of the cervix.
,d. This is a common finding on Pap testing, and she will be examined often to see if the
abnormal cells spread beyond the cervix. - Answers 22. c.
A stage 0 cervical cancer indicates cancer in situ that is confined to the epithelial layer of the
cervix and requires treatment. Stage 0 is the least invasive.
Stage I is confined to the cervix.
Stage II has spread beyond the cervix to the upper two-thirds of the vagina but not the tissues
around the uterus.
Stage III involves the pelvic wall, lower third of the vagina, and/or kidney problems.
Stage IV indicates spread to distant organs.
23. Fertility and normal reproductive function can be maintained when a cancer of the cervix is
successfully treated with which therapy?
a. External radiation therapy
b. Internal radiation implants
c. Conization or laser surgery
d. Cryotherapy or subtotal hysterectomy - Answers 23. c.
Conization (an excision of a cone-shaped section of the cervix) and laser treatment both are
effective to locally remove or destroy malignant cells of the cervix and preserve fertility.
Radiation treatments often impair ovarian and uterine function and lead to sterility. A subtotal
hysterectomy would be contraindicated in the treatment of cervical cancer because the cervix
would be left intact in this procedure.
24. A woman who has been postmenopausal for 10 years calls the clinic because of vaginal
bleeding. The nurse schedules a visit for the patient and informs her to expect to have which
diagnostic procedure?
a. An endometrial biopsy
b. Abdominal radiography
c. A laser treatment to the cervix
d. Only a routine pelvic examination and Pap test - Answers 24. a.
Postmenopausal vaginal bleeding is an early sign of endometrial cancer. When it occurs, a
sample of endometrial tissue must be taken to exclude cancer. An endometrial biopsy can be
done as an office procedure and is indicated in this case.
, Abdominal x-rays and Pap tests are not reliable tests for endometrial cancer. Laser treatment of
the cervix is indicated only for cervical dysplasia.
25. A patient has been diagnosed with ovarian cancer. In planning care for the patient, the nurse
recognizes that treatment of the patient depends on what?
a. Results of a direct-needle biopsy of the ovary
b. Results of a laparotomy with multiple biopsies
c. Whether the patient desires to maintain fertility
d. The findings of metastasis by ultrasound or CT scan - Answers 25. b.
Treatment of ovarian cancer is determined by staging from the results of laparotomy with
multiple biopsies of the ovaries and other tissue throughout the pelvis and lower abdomen.
The patient's desire for fertility is not a consideration because of the high mortality rate
associated with ovarian cancer. Although diagnosis of ovarian tumors may be made by
transvaginal ultrasound or CT scan, the treatment of ovarian cancer depends on the staging of
the tumor.
27. Which factors are associated with endometrial cancer (select all that apply)?
a. Obesity
b. Smoking
c. Family history
d. Early sexual activity
e. Early menarche and late menopause
f. Unopposed estrogen-only replacement therapy - Answers 27. a, b, e, f.
Endometrial cancer is at higher risk in obese patients because adipose cells store estrogen,
which is the major risk factor, especially unopposed estrogen. Smoking is a risk factor for
endometrial and cervical cancers. Early menarche and late menopause are risk factors for
endometrial cancer.
Early sexual activity is a risk factor for cervical cancer. Family history is a risk factor for ovarian
cancer. (BRCA1 & BRCA2 genes)
29. A 44-year-old woman undergoing a total abdominal hysterectomy asks whether she will
need to take estrogen until she reaches the age of menopause. What is the best response by
the nurse?
