Lewis's Medical Surgical Nursing Test Bank 11th Edition [Harding]
Chapter 53 - Female Reproductive Problems
1. A 34-year-old woman who is discussing contraceptive options with the nurse says, I
want to have children, but not for a few years. Which response by the nurse is
appropriate?
A. If you do not become pregnant within the next few years, you never will.
B. You may have more difficulty becoming pregnant after about age 35.
C. You have many years of fertility left, so there is no rush to have children.
D. You should plan to stop taking oral contraceptives several years before you want to
become pregnant.
Answer: B
Explanation: Fertility begins to decline after age 35, making it potentially more difficult to
conceive. It is important to provide accurate information without causing unnecessary alarm.
The other options are misleading or incorrect.
2. The nurse in the infertility clinic is explaining in vitro fertilization (IVF) to a couple.
The woman tells the nurse that they cannot afford IVF on her husbands salary. The
man replies that if his wife worked outside the home, they would have enough money.
Which nursing diagnosis is appropriate?
A. Decisional conflict related to inadequate financial resources
B. Ineffective sexuality patterns related to psychological stress
C. Defensive coping related to anxiety about lack of conception
D. Ineffective denial related to frustration about continued infertility
Answer: C
Explanation: The couple's blaming and defensive remarks indicate defensive coping as a
response to the stress and anxiety of infertility. The other diagnoses are not supported by the
data provided.
3. A 29-year-old patient who is trying to become pregnant asks the nurse how to
determine when she is most likely to conceive. The nurse explains that
A. ovulation is unpredictable unless there are regular menstrual periods.
B. ovulation prediction kits provide accurate information about ovulation.
C. she will need to bring a specimen of cervical mucus to the clinic for testing.
D. she should take her body temperature daily and have intercourse when it drops.
Answer: B
,Explanation: Ovulation prediction kits detect the luteinizing hormone (LH) surge, which
occurs 28–36 hours before ovulation, providing a reliable method for timing intercourse.
Basal body temperature rises after ovulation, and cervical mucus testing is not typically done
by the patient at home.
4. A 25-year-old woman has an induced abortion with suction curettage at an
ambulatory surgical center. Which instructions will the nurse include when discharging
the patient?
A. Heavy vaginal bleeding is expected for about 2 weeks.
B. You should abstain from sexual intercourse for 2 weeks.
C. Contraceptives should be avoided until your reexamination.
D. Irregular menstrual periods are expected for the next few months.
Answer: B
Explanation: To prevent infection, patients are advised to avoid intercourse for about 2 weeks
post-procedure. Heavy bleeding is not expected, contraceptives can be started immediately,
and menstrual periods typically resume normally.
5. A 32-year-old woman is scheduled for an induced abortion using instillation of
hypertonic saline solution. Which information will the nurse plan to discuss with the
patient before the procedure?
A. The patient will require a general anesthetic.
B. The expulsion of the fetus may take 1 to 2 days.
C. There is a possibility that the patient may deliver a live fetus.
D. The procedure may be unsuccessful in terminating the pregnancy.
Answer: B
Explanation: After hypertonic saline instillation, uterine contractions and expulsion of the
fetus can take 12–36 hours. General anesthesia is not used, the saline is feticidal, and the
procedure is highly effective.
6. A 28-year-old patient reports anxiety, headaches with dizziness, and abdominal
bloating occurring before her menstrual periods. Which action is best for the nurse to
take at this time?
A. Ask the patient to keep track of her symptoms in a diary for 3 months.
B. Suggest that the patient try aerobic exercise to decrease her symptoms.
C. Teach the patient about appropriate lifestyle changes to reduce premenstrual syndrome
(PMS) symptoms.
D. Advise the patient to use nonsteroidal antiinflammatory drugs (NSAIDs) such as
ibuprofen (Advil) to control symptoms.
,Answer: A
Explanation: A symptom diary helps confirm a diagnosis of PMS by tracking the timing and
pattern of symptoms. Interventions should not be implemented until a diagnosis is confirmed.
7. A 19-year-old has been diagnosed with primary dysmenorrhea. How will the nurse
suggest that the patient prevent discomfort?
A. Avoid aerobic exercise during her menstrual period.
B. Use cold packs on the abdomen and back for pain relief.
C. Talk with her health care provider about beginning antidepressant therapy.
D. Take nonsteroidal antiinflammatory drugs (NSAIDs) when her period starts.
Answer: D
Explanation: NSAIDs are most effective when started at the onset of menses and taken
regularly. Aerobic exercise may help, heat is recommended for pain, and antidepressants are
not standard treatment for dysmenorrhea.
8. A 32-year-old who was admitted to the emergency department with severe abdominal
pain is diagnosed with an ectopic pregnancy. The patient begins to cry and asks the
nurse to leave her alone to grieve. Which action should the nurse take next?
A. Stay with the patient and encourage her to discuss her feelings.
B. Explain the reason for taking vital signs every 15 to 30 minutes.
C. Close the door to the patients room and minimize disturbances.
D. Provide teaching about options for termination of the pregnancy.
Answer: B
Explanation: The patient is at risk for rupture and hemorrhage, requiring frequent vital sign
monitoring. Respecting her need for space while ensuring safety is key. Teaching and
encouraging discussion are inappropriate at this time.
9. When caring for a 58-year-old patient with persistent menorrhagia, the nurse will
plan to monitor the
A. estrogen level.
B. complete blood count (CBC).
C. gonadotropin-releasing hormone (GNRH) level.
D. serial human chorionic gonadotropin (hCG) results.
Answer: B
Explanation: Menorrhagia can cause anemia, so monitoring the CBC is essential. Estrogen,
GNRH, and hCG levels are not typically relevant in this context.
, 10. A 47-year-old woman asks whether she is going into menopause if she has not had a
menstrual period for 3 months. The best response by the nurse is which of the
following?
A. Have you thought about using hormone replacement therapy?
B. Most women feel a little depressed about entering menopause.
C. What was your menstrual pattern before your periods stopped?
D. Since you are in your mid-40s, it is likely that you are menopausal.
Answer: C
Explanation: Assessing the patient's baseline menstrual pattern is the first step in evaluating
perimenopause. Assumptions about emotional response or menopausal status should not be
made without further assessment.
11. A 49-year-old woman is considering the use of combined estrogen-progesterone
hormone replacement therapy (HT) during menopause. Which information will the
nurse include during their discussion?
A. Use of estrogen-containing vaginal creams provides most of the same benefits as oral HT.
B. Increased incidence of colon cancer in women taking HT requires more frequent
colonoscopy.
C. HT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast
cancer.
D. Use of HT for up to 10 years to prevent symptoms such as hot flashes is generally
considered safe.
Answer: C
Explanation: Combined HT reduces fracture risk but increases cardiovascular disease and
breast cancer risk. Vaginal creams address local symptoms only, and HT is typically used
short-term.
12. A female patient tells the nurse that she has been having nightmares and acute
anxiety around men since being sexually assaulted 3 months ago. The most appropriate
nursing diagnosis for the patient is
A. anxiety related to effects of being raped.
B. sleep deprivation related to frightening dreams.
C. rape-trauma syndrome related to rape experience.
D. ineffective coping related to inability to resolve incident.
Answer: C
Chapter 53 - Female Reproductive Problems
1. A 34-year-old woman who is discussing contraceptive options with the nurse says, I
want to have children, but not for a few years. Which response by the nurse is
appropriate?
A. If you do not become pregnant within the next few years, you never will.
B. You may have more difficulty becoming pregnant after about age 35.
C. You have many years of fertility left, so there is no rush to have children.
D. You should plan to stop taking oral contraceptives several years before you want to
become pregnant.
Answer: B
Explanation: Fertility begins to decline after age 35, making it potentially more difficult to
conceive. It is important to provide accurate information without causing unnecessary alarm.
The other options are misleading or incorrect.
2. The nurse in the infertility clinic is explaining in vitro fertilization (IVF) to a couple.
The woman tells the nurse that they cannot afford IVF on her husbands salary. The
man replies that if his wife worked outside the home, they would have enough money.
Which nursing diagnosis is appropriate?
A. Decisional conflict related to inadequate financial resources
B. Ineffective sexuality patterns related to psychological stress
C. Defensive coping related to anxiety about lack of conception
D. Ineffective denial related to frustration about continued infertility
Answer: C
Explanation: The couple's blaming and defensive remarks indicate defensive coping as a
response to the stress and anxiety of infertility. The other diagnoses are not supported by the
data provided.
3. A 29-year-old patient who is trying to become pregnant asks the nurse how to
determine when she is most likely to conceive. The nurse explains that
A. ovulation is unpredictable unless there are regular menstrual periods.
B. ovulation prediction kits provide accurate information about ovulation.
C. she will need to bring a specimen of cervical mucus to the clinic for testing.
D. she should take her body temperature daily and have intercourse when it drops.
Answer: B
,Explanation: Ovulation prediction kits detect the luteinizing hormone (LH) surge, which
occurs 28–36 hours before ovulation, providing a reliable method for timing intercourse.
Basal body temperature rises after ovulation, and cervical mucus testing is not typically done
by the patient at home.
4. A 25-year-old woman has an induced abortion with suction curettage at an
ambulatory surgical center. Which instructions will the nurse include when discharging
the patient?
A. Heavy vaginal bleeding is expected for about 2 weeks.
B. You should abstain from sexual intercourse for 2 weeks.
C. Contraceptives should be avoided until your reexamination.
D. Irregular menstrual periods are expected for the next few months.
Answer: B
Explanation: To prevent infection, patients are advised to avoid intercourse for about 2 weeks
post-procedure. Heavy bleeding is not expected, contraceptives can be started immediately,
and menstrual periods typically resume normally.
5. A 32-year-old woman is scheduled for an induced abortion using instillation of
hypertonic saline solution. Which information will the nurse plan to discuss with the
patient before the procedure?
A. The patient will require a general anesthetic.
B. The expulsion of the fetus may take 1 to 2 days.
C. There is a possibility that the patient may deliver a live fetus.
D. The procedure may be unsuccessful in terminating the pregnancy.
Answer: B
Explanation: After hypertonic saline instillation, uterine contractions and expulsion of the
fetus can take 12–36 hours. General anesthesia is not used, the saline is feticidal, and the
procedure is highly effective.
6. A 28-year-old patient reports anxiety, headaches with dizziness, and abdominal
bloating occurring before her menstrual periods. Which action is best for the nurse to
take at this time?
A. Ask the patient to keep track of her symptoms in a diary for 3 months.
B. Suggest that the patient try aerobic exercise to decrease her symptoms.
C. Teach the patient about appropriate lifestyle changes to reduce premenstrual syndrome
(PMS) symptoms.
D. Advise the patient to use nonsteroidal antiinflammatory drugs (NSAIDs) such as
ibuprofen (Advil) to control symptoms.
,Answer: A
Explanation: A symptom diary helps confirm a diagnosis of PMS by tracking the timing and
pattern of symptoms. Interventions should not be implemented until a diagnosis is confirmed.
7. A 19-year-old has been diagnosed with primary dysmenorrhea. How will the nurse
suggest that the patient prevent discomfort?
A. Avoid aerobic exercise during her menstrual period.
B. Use cold packs on the abdomen and back for pain relief.
C. Talk with her health care provider about beginning antidepressant therapy.
D. Take nonsteroidal antiinflammatory drugs (NSAIDs) when her period starts.
Answer: D
Explanation: NSAIDs are most effective when started at the onset of menses and taken
regularly. Aerobic exercise may help, heat is recommended for pain, and antidepressants are
not standard treatment for dysmenorrhea.
8. A 32-year-old who was admitted to the emergency department with severe abdominal
pain is diagnosed with an ectopic pregnancy. The patient begins to cry and asks the
nurse to leave her alone to grieve. Which action should the nurse take next?
A. Stay with the patient and encourage her to discuss her feelings.
B. Explain the reason for taking vital signs every 15 to 30 minutes.
C. Close the door to the patients room and minimize disturbances.
D. Provide teaching about options for termination of the pregnancy.
Answer: B
Explanation: The patient is at risk for rupture and hemorrhage, requiring frequent vital sign
monitoring. Respecting her need for space while ensuring safety is key. Teaching and
encouraging discussion are inappropriate at this time.
9. When caring for a 58-year-old patient with persistent menorrhagia, the nurse will
plan to monitor the
A. estrogen level.
B. complete blood count (CBC).
C. gonadotropin-releasing hormone (GNRH) level.
D. serial human chorionic gonadotropin (hCG) results.
Answer: B
Explanation: Menorrhagia can cause anemia, so monitoring the CBC is essential. Estrogen,
GNRH, and hCG levels are not typically relevant in this context.
, 10. A 47-year-old woman asks whether she is going into menopause if she has not had a
menstrual period for 3 months. The best response by the nurse is which of the
following?
A. Have you thought about using hormone replacement therapy?
B. Most women feel a little depressed about entering menopause.
C. What was your menstrual pattern before your periods stopped?
D. Since you are in your mid-40s, it is likely that you are menopausal.
Answer: C
Explanation: Assessing the patient's baseline menstrual pattern is the first step in evaluating
perimenopause. Assumptions about emotional response or menopausal status should not be
made without further assessment.
11. A 49-year-old woman is considering the use of combined estrogen-progesterone
hormone replacement therapy (HT) during menopause. Which information will the
nurse include during their discussion?
A. Use of estrogen-containing vaginal creams provides most of the same benefits as oral HT.
B. Increased incidence of colon cancer in women taking HT requires more frequent
colonoscopy.
C. HT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast
cancer.
D. Use of HT for up to 10 years to prevent symptoms such as hot flashes is generally
considered safe.
Answer: C
Explanation: Combined HT reduces fracture risk but increases cardiovascular disease and
breast cancer risk. Vaginal creams address local symptoms only, and HT is typically used
short-term.
12. A female patient tells the nurse that she has been having nightmares and acute
anxiety around men since being sexually assaulted 3 months ago. The most appropriate
nursing diagnosis for the patient is
A. anxiety related to effects of being raped.
B. sleep deprivation related to frightening dreams.
C. rape-trauma syndrome related to rape experience.
D. ineffective coping related to inability to resolve incident.
Answer: C
