Chapter 07: Reproductive Health
MULTIPLE CHOICE
1. When assessing the patient for amenorrhea, the nurse should be aware that which may cause
amenorrhea?
a. Alcohol use
b. Type 1 diabetes mellitus
c. Lack of exercise
d. Cessation of oral contraception use
ANS: B
Type 1 diabetes may cause amenorrhea. Lack of exercise does not cause amenorrhea.
It is the use of oral contraception that may cause amenorrhea. Alcohol use does not
cause amenorrhea.
DIF: Cognitive Level: Knowledge REF: p. 107
OBJ: Nursing Process: Assessment
2. When a nurse is counselling a woman for primary dysmenorrhea, which nonpharmacological
intervention might be recommended?
a. Increase the intake of red meat and simple
carbohydrates.
b. Reduce the intake of diuretic foods, such
as peaches and asparagus.
c. Temporarily substitute physical activity for
a sedentary lifestyle.
d. Use a heating pad on the abdomen to
relieve cramping.
ANS: D
Heat minimizes cramping by increasing vasodilation and muscle relaxation and
minimizing uterine ischemia. Dietary changes such as eating less red meat may be
recommended for women experiencing dysmenorrhea. Increasing the intake of diuretics,
including natural diuretics such as asparagus, cranberry juice, peaches, parsley, and
watermelon, may help ease the symptoms associated with dysmenorrhea. Exercise has
been found to help relieve menstrual discomfort through increased vasodilation and
subsequent decreased ischemia.
DIF: Cognitive Level: Analysis REF: p. 110 OBJ: Nursing Process: Planning
,3. What symptom described by a woman is characteristic of premenstrual syndrome (PMS)?
a. Irritable and moody prior to menses.
b. Lower abdominal pain that begins halfway
through menstruation.
c. Nausea and headache after menses begins
lasting 2 to 3 days.
d. Abdominal bloating and breast pain
halfway through menstruation.
ANS: A
PMS is a cluster of physical, psychological, and behavioural symptoms that begin in the
luteal phase of the menstrual cycle and coincide with menses. Complaints of lower
abdominal pain, nausea and headaches, and abdominal bloating are all associated with
PMS; however, the timing reflected is inaccurate.
DIF: Cognitive Level: Application REF: p. 111
OBJ: Nursing Process: Assessment
4. A woman complains of severe abdominal and pelvic pain around the time of menstruation that
has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried
unsuccessfully to get pregnant for the past 18 months. What are these symptoms most likely
related to?
a. Endometriosis
b. PMS
c. Primary dysmenorrhea
d. Secondary dysmenorrhea
ANS: A
Symptoms of endometriosis can change over time and may not reflect the extent of the
disease. Major symptoms include dysmenorrhea and deep pelvic dyspareunia (painful
intercourse). Impaired fertility may result from adhesions caused by endometriosis.
Although endometriosis may be associated with secondary dysmenorrhea, it is not a
cause of primary dysmenorrhea or PMS. In addition, this woman is complaining of
dyspareunia and infertility, which are associated with endometriosis, not with PMS or
primary or secondary dysmenorrhea.
DIF: Cognitive Level: Comprehension REF: p. 113
OBJ: Nursing Process: Assessment
5. Nafarelin (Synarel) 200 mg BID per nasal spray currently is used as a treatment for mild-to-
severe endometriosis. What patient teaching should the nurse tell the woman who is taking this
medication?
, a. It stimulates the secretion of
gonadotropin-releasing hormone (GnRH),
thereby stimulating ovarian activity.
b. It should be sprayed into one nostril every
other day.
c. It should be injected into subcutaneous
tissue BID.
d. It can cause her to experience some
hot flashes and vaginal dryness.
ANS: D
Nafarelin is a GnRH agonist, and its adverse effects are similar to those of menopause.
The hypoestrogenism effect results in hot flashes and vaginal dryness. Nafarelin is a
GnRH agonist that suppresses the secretion of GnRH and is administered twice daily by
nasal spray.
DIF: Cognitive Level: Application REF: p. 113
OBJ: Nursing Process: Implementation
6. While interviewing a 31-year-old woman before her routine gynecological examination, the nurse
collects data about the patient’s recent menstrual cycles. The nurse should collect additional
information when the woman makes which statement?
a. The woman says her menstrual flow lasts 5
to 6 days.
b. She describes her flow as very heavy.
c. She reports that she has had a small
amount of spotting midway between her
periods for the past 2 months.
d. She says the length of her menstrual
cycle varies from 26 to 29 days.
ANS: B
Menorrhagia is defined as excessive menstrual bleeding, in either duration or amount.
Heavy bleeding can have many causes. The amount of bleeding and its effect on daily
activities should be evaluated. A menstrual flow lasting 5 to 6 days is a normal finding.
Mittelschmerz, a small amount of bleeding or spotting that occurs at the time of
ovulation (14 days before onset of the next menses), is considered normal. During her
reproductive years, a woman may have physiological variations in her menstrual cycle.
Variations in the length of a menstrual cycle are considered normal.
DIF: Cognitive Level: Comprehension REF: p. 107 | p. 114
OBJ: Nursing Process: Assessment
MULTIPLE CHOICE
1. When assessing the patient for amenorrhea, the nurse should be aware that which may cause
amenorrhea?
a. Alcohol use
b. Type 1 diabetes mellitus
c. Lack of exercise
d. Cessation of oral contraception use
ANS: B
Type 1 diabetes may cause amenorrhea. Lack of exercise does not cause amenorrhea.
It is the use of oral contraception that may cause amenorrhea. Alcohol use does not
cause amenorrhea.
DIF: Cognitive Level: Knowledge REF: p. 107
OBJ: Nursing Process: Assessment
2. When a nurse is counselling a woman for primary dysmenorrhea, which nonpharmacological
intervention might be recommended?
a. Increase the intake of red meat and simple
carbohydrates.
b. Reduce the intake of diuretic foods, such
as peaches and asparagus.
c. Temporarily substitute physical activity for
a sedentary lifestyle.
d. Use a heating pad on the abdomen to
relieve cramping.
ANS: D
Heat minimizes cramping by increasing vasodilation and muscle relaxation and
minimizing uterine ischemia. Dietary changes such as eating less red meat may be
recommended for women experiencing dysmenorrhea. Increasing the intake of diuretics,
including natural diuretics such as asparagus, cranberry juice, peaches, parsley, and
watermelon, may help ease the symptoms associated with dysmenorrhea. Exercise has
been found to help relieve menstrual discomfort through increased vasodilation and
subsequent decreased ischemia.
DIF: Cognitive Level: Analysis REF: p. 110 OBJ: Nursing Process: Planning
,3. What symptom described by a woman is characteristic of premenstrual syndrome (PMS)?
a. Irritable and moody prior to menses.
b. Lower abdominal pain that begins halfway
through menstruation.
c. Nausea and headache after menses begins
lasting 2 to 3 days.
d. Abdominal bloating and breast pain
halfway through menstruation.
ANS: A
PMS is a cluster of physical, psychological, and behavioural symptoms that begin in the
luteal phase of the menstrual cycle and coincide with menses. Complaints of lower
abdominal pain, nausea and headaches, and abdominal bloating are all associated with
PMS; however, the timing reflected is inaccurate.
DIF: Cognitive Level: Application REF: p. 111
OBJ: Nursing Process: Assessment
4. A woman complains of severe abdominal and pelvic pain around the time of menstruation that
has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried
unsuccessfully to get pregnant for the past 18 months. What are these symptoms most likely
related to?
a. Endometriosis
b. PMS
c. Primary dysmenorrhea
d. Secondary dysmenorrhea
ANS: A
Symptoms of endometriosis can change over time and may not reflect the extent of the
disease. Major symptoms include dysmenorrhea and deep pelvic dyspareunia (painful
intercourse). Impaired fertility may result from adhesions caused by endometriosis.
Although endometriosis may be associated with secondary dysmenorrhea, it is not a
cause of primary dysmenorrhea or PMS. In addition, this woman is complaining of
dyspareunia and infertility, which are associated with endometriosis, not with PMS or
primary or secondary dysmenorrhea.
DIF: Cognitive Level: Comprehension REF: p. 113
OBJ: Nursing Process: Assessment
5. Nafarelin (Synarel) 200 mg BID per nasal spray currently is used as a treatment for mild-to-
severe endometriosis. What patient teaching should the nurse tell the woman who is taking this
medication?
, a. It stimulates the secretion of
gonadotropin-releasing hormone (GnRH),
thereby stimulating ovarian activity.
b. It should be sprayed into one nostril every
other day.
c. It should be injected into subcutaneous
tissue BID.
d. It can cause her to experience some
hot flashes and vaginal dryness.
ANS: D
Nafarelin is a GnRH agonist, and its adverse effects are similar to those of menopause.
The hypoestrogenism effect results in hot flashes and vaginal dryness. Nafarelin is a
GnRH agonist that suppresses the secretion of GnRH and is administered twice daily by
nasal spray.
DIF: Cognitive Level: Application REF: p. 113
OBJ: Nursing Process: Implementation
6. While interviewing a 31-year-old woman before her routine gynecological examination, the nurse
collects data about the patient’s recent menstrual cycles. The nurse should collect additional
information when the woman makes which statement?
a. The woman says her menstrual flow lasts 5
to 6 days.
b. She describes her flow as very heavy.
c. She reports that she has had a small
amount of spotting midway between her
periods for the past 2 months.
d. She says the length of her menstrual
cycle varies from 26 to 29 days.
ANS: B
Menorrhagia is defined as excessive menstrual bleeding, in either duration or amount.
Heavy bleeding can have many causes. The amount of bleeding and its effect on daily
activities should be evaluated. A menstrual flow lasting 5 to 6 days is a normal finding.
Mittelschmerz, a small amount of bleeding or spotting that occurs at the time of
ovulation (14 days before onset of the next menses), is considered normal. During her
reproductive years, a woman may have physiological variations in her menstrual cycle.
Variations in the length of a menstrual cycle are considered normal.
DIF: Cognitive Level: Comprehension REF: p. 107 | p. 114
OBJ: Nursing Process: Assessment
