NUR 335 OB EXAM 5 PRACTICE
QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS ALREADY
PASSED!!!
Question
A nurse in an outpatient women's health clinic is reviewing the medical record of a
25-year-old female client who presents with concerns about breast cancer. The
client notes that over the past year, while intensively training for a marathon and
wearing supportive athletic wear, she has lost more than 20 pounds. She reports
experiencing notable mood swings, a thin, milky discharge from both nipples, and
the presence of several tender breast masses that consistently change in size
depending on her menstrual cycle. Her recent mammogram was entirely negative
for malignancy.
Which of the client's current clinical manifestations directly correlate with a
diagnosis of fibrocystic breast changes? (Select all that apply.)
1. Milky discharge from both nipples
2. Extensive weight loss of over 20 pounds
3. Painful and tender breast lumps
4. Cyclic mood swings
5. Presence of multiple breast lumps
✔✔ 1, 3, 4, 5
Clinical Rationale
Fibrocystic breast changes are a common, non-cancerous (benign) condition
responsive to normal hormonal fluctuations during the menstrual cycle.
Painful, multiple lumps that fluctuate in size (Options 3 and 5): The
classic presentation of fibrocystic changes includes fluid-filled cysts and
fibrous tissue tissue. These lumps typically swell, become tender, and grow
larger right before a woman's menstrual period due to elevated estrogen and
progesterone levels, then shrink afterward.
, Milky discharge (Option 1): Bilateral, thin, milky or clear nipple discharge
(non-bloody galactorrhea) can be a benign finding commonly associated
with fibrocystic breasts.
Mood swings (Option 4): The same cyclic hormonal surges (luteal phase
transitions) that cause breast tissue to engorge and become painful are
heavily linked to emotional symptoms and mood changes, often mirroring
Premenstrual Syndrome (PMS).
Why Option 2 is incorrect: Extensive weight loss is not a characteristic
feature of fibrocystic breast condition. In this client's case, the weight loss is
easily explained by her intensive marathon training regimen.
Feedback
1 This is correct. Discharge from nipples that are milky may be due to the elicited
response from compression (resulting from the sports bra).
2 This is incorrect. The patient's weight loss is likely from intensive exercises.
3 This is correct. Fewer than 10% of women with breast cancer will present with
pain.
4 This is correct. The mood swing (tearfulness) may be due to the stress and fear of
a possible breast cancer diagnosis.
5 This is correct. Fibrocystic breasts have multiple tender-to-the-touch cysts that
fluctuate in size
The nurse is preparing to teach the community about risk factors for the second
most common cancer of the female reproductive system. Which of the following
groups of women are at higher risk for this cancer? Select all that apply.
,1. Menopausal women with an intact uterus who receive hormonal therapy
2. Women who have undergone treatment for breast cancer
3. Women who have many pregnancies and nursed their infants
4. Women who smoke and have many sexual partners
5. Women with a long-standing history of polycystic ovarian syndrome (PCOS) -
ANSWER.......125:
Feedback
1 This is correct. Unopposed estrogen therapy in women with a uterus can cause
endometrial hyperplasia in the lining of the uterus. The second most common
cancer of the female reproductive system is endometrial cancer.
2 This is correct. Tamoxifen is indicated for reducing risk for breast cancer in
women or as a treatment of breast cancer. The medication competes with estrogen
for binding sites in the breast but increases the risk for endometrial cancer.
3 This is incorrect. Women who have had no pregnancies are at higher risk for
endometrial cancer than those who have had several pregnancies and who have
nursed their infants.
4 This is incorrect. Smoking and having multiple sexual partners put the patient at
risk for other disease processes, not endometrial cancer.
, 5 This is correct. PCOS increases the risk for endometrial cancer
The nurse is assessing a 42-year-old patient who presents to the gynecology office
with complaints of pelvic pressure, backaches, menorrhagia, and urinary
frequency. The health-care provider (HCP) has diagnosed the patient with
leiomyoma of the uterus. What are the treatment options for this condition? Select
all that apply.
1. Routine pelvic examinations to assess rate of disease process
2. Oral contraceptives to control the bleeding and pain
3. Myomectomy for women who desire pregnancy
4. Hysterectomy for women who do not desire pregnancy
5. Antibiotic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) for
symptom management -ANSWER.......134:
Feedback
1 This is correct. Routine pelvic examinations may be performed to assess the rate
of growth of the leiomyomas (fibroids). A pelvic ultrasound to confirm the
diagnosis of tumors and rule out pregnancy is another option of diagnosis.
2 This is incorrect. This would be an option for another diagnosis such as
premenstrual syndrome (PMS), not fibroids, which could increase the growth due
to increased levels of estrogen and progesterone.
QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS ALREADY
PASSED!!!
Question
A nurse in an outpatient women's health clinic is reviewing the medical record of a
25-year-old female client who presents with concerns about breast cancer. The
client notes that over the past year, while intensively training for a marathon and
wearing supportive athletic wear, she has lost more than 20 pounds. She reports
experiencing notable mood swings, a thin, milky discharge from both nipples, and
the presence of several tender breast masses that consistently change in size
depending on her menstrual cycle. Her recent mammogram was entirely negative
for malignancy.
Which of the client's current clinical manifestations directly correlate with a
diagnosis of fibrocystic breast changes? (Select all that apply.)
1. Milky discharge from both nipples
2. Extensive weight loss of over 20 pounds
3. Painful and tender breast lumps
4. Cyclic mood swings
5. Presence of multiple breast lumps
✔✔ 1, 3, 4, 5
Clinical Rationale
Fibrocystic breast changes are a common, non-cancerous (benign) condition
responsive to normal hormonal fluctuations during the menstrual cycle.
Painful, multiple lumps that fluctuate in size (Options 3 and 5): The
classic presentation of fibrocystic changes includes fluid-filled cysts and
fibrous tissue tissue. These lumps typically swell, become tender, and grow
larger right before a woman's menstrual period due to elevated estrogen and
progesterone levels, then shrink afterward.
, Milky discharge (Option 1): Bilateral, thin, milky or clear nipple discharge
(non-bloody galactorrhea) can be a benign finding commonly associated
with fibrocystic breasts.
Mood swings (Option 4): The same cyclic hormonal surges (luteal phase
transitions) that cause breast tissue to engorge and become painful are
heavily linked to emotional symptoms and mood changes, often mirroring
Premenstrual Syndrome (PMS).
Why Option 2 is incorrect: Extensive weight loss is not a characteristic
feature of fibrocystic breast condition. In this client's case, the weight loss is
easily explained by her intensive marathon training regimen.
Feedback
1 This is correct. Discharge from nipples that are milky may be due to the elicited
response from compression (resulting from the sports bra).
2 This is incorrect. The patient's weight loss is likely from intensive exercises.
3 This is correct. Fewer than 10% of women with breast cancer will present with
pain.
4 This is correct. The mood swing (tearfulness) may be due to the stress and fear of
a possible breast cancer diagnosis.
5 This is correct. Fibrocystic breasts have multiple tender-to-the-touch cysts that
fluctuate in size
The nurse is preparing to teach the community about risk factors for the second
most common cancer of the female reproductive system. Which of the following
groups of women are at higher risk for this cancer? Select all that apply.
,1. Menopausal women with an intact uterus who receive hormonal therapy
2. Women who have undergone treatment for breast cancer
3. Women who have many pregnancies and nursed their infants
4. Women who smoke and have many sexual partners
5. Women with a long-standing history of polycystic ovarian syndrome (PCOS) -
ANSWER.......125:
Feedback
1 This is correct. Unopposed estrogen therapy in women with a uterus can cause
endometrial hyperplasia in the lining of the uterus. The second most common
cancer of the female reproductive system is endometrial cancer.
2 This is correct. Tamoxifen is indicated for reducing risk for breast cancer in
women or as a treatment of breast cancer. The medication competes with estrogen
for binding sites in the breast but increases the risk for endometrial cancer.
3 This is incorrect. Women who have had no pregnancies are at higher risk for
endometrial cancer than those who have had several pregnancies and who have
nursed their infants.
4 This is incorrect. Smoking and having multiple sexual partners put the patient at
risk for other disease processes, not endometrial cancer.
, 5 This is correct. PCOS increases the risk for endometrial cancer
The nurse is assessing a 42-year-old patient who presents to the gynecology office
with complaints of pelvic pressure, backaches, menorrhagia, and urinary
frequency. The health-care provider (HCP) has diagnosed the patient with
leiomyoma of the uterus. What are the treatment options for this condition? Select
all that apply.
1. Routine pelvic examinations to assess rate of disease process
2. Oral contraceptives to control the bleeding and pain
3. Myomectomy for women who desire pregnancy
4. Hysterectomy for women who do not desire pregnancy
5. Antibiotic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) for
symptom management -ANSWER.......134:
Feedback
1 This is correct. Routine pelvic examinations may be performed to assess the rate
of growth of the leiomyomas (fibroids). A pelvic ultrasound to confirm the
diagnosis of tumors and rule out pregnancy is another option of diagnosis.
2 This is incorrect. This would be an option for another diagnosis such as
premenstrual syndrome (PMS), not fibroids, which could increase the growth due
to increased levels of estrogen and progesterone.
