Question 1

Which action would the nurse teach to help the client prevent vulvovaginitis?

Accepted Answer

A)   Wipe back to front after urination.
B)   Cleanse the inner labial mucosa with soap and water.
C)   Use feminine hygiene sprays to avoid odor.
D)   Wear loose cotton underwear. D

Question 2

A nurse is caring for four postoperative clients who each had a total abdominal hysterectomy.Which client should the nurse assess first upon initial rounding?

Accepted Answer

A)   Client who has had two saturated perineal pads in the last 2 hours
B)   Client with a temperature of 99° F and blood pressure of 115/73 mm Hg
C)   Client who has pain of "4" on a scale of 0 to 10
D)   Client with a urinary catheter output of 150 mL in the last 3 hours A

Question 3

The nurse is educating a client on the prevention of toxic shock syndrome (TSS).Which statement by the client indicates a lack of understanding?

Accepted Answer

A)   "I need to change my tampon every 8 hours during the day."
B)   "At night, I should use a feminine pad rather than a tampon."
C)   "If I don't use tampons, I should not get TSS."
D)   "It is best if I wash my hands before inserting the tampon." A

Question 4

The nurse is doing preoperative teaching for a client who is scheduled for removal of cervical polyps in the office.Which statement by the client indicates a correct understanding of the procedure?

Accepted Answer

A)   "I hope that I do not have cancer of the cervix."
B)   "There should be little or no discomfort during the procedure."
C)   "There may be a lot of bleeding after the polyp is removed."
D)   "This may prevent me from having any more children."

Question 5

A 28-year-old client is diagnosed with endometriosis and is experiencing severe symptoms.Which actions by the nurse are the most appropriate at this time? (Select all that apply.)

Accepted Answer

A)   Reduce the pain by low-level heat.
B)   Discuss the high risk of infertility with this diagnosis.
C)   Relieve anxiety by relaxation techniques and education.
D)   Discuss in detail the side effects of laparoscopic surgery.
E)   Suggest resources such as the Endometriosis Association.

Question 6

A client has recently been diagnosed with stage III endometrial cancer and asks the nurse for an explanation.What response by the nurse is correct about the staging of the cancer?

Accepted Answer

A)   "The cancer has spread to the mucosa of the bowel and bladder."
B)   "It has reached the vagina or lymph nodes."
C)   "The cancer now involves the cervix."
D)   "It is contained in the endometrium of the cervix."

Question 7

A client is admitted to the emergency department with toxic shock syndrome.Which action by the nurse is the most important?

Accepted Answer

A)   Administer IV fluids to maintain fluid and electrolyte balance.
B)   Remove the tampon as the source of infection.
C)   Collect a blood specimen for culture and sensitivity.
D)   Transfuse the client to manage low blood count.

Question 8

A 55-year-old post-menopausal woman is assessed by the nurse with a history of dyspareunia,backache,pelvis pressure,urinary tract infections,and a frequent urinary urgency.Which condition does the nurse suspect?

Accepted Answer

A)   Ovarian cyst
B)   Rectocele
C)   Cystocele
D)   Fibroid

Question 9

The nurse is taking the history of a 24-year-old client diagnosed with cervical cancer.What possible risk factors would the nurse assess? (Select all that apply.)

Accepted Answer

A)   Smoking
B)   Multiple sexual partners
C)   Poor diet
D)   Nulliparity
E)   Younger than 18 at first intercourse

Question 10

The nurse is teaching a client who is undergoing brachytherapy about what to immediately report to her health care provider.Which signs and symptoms would be included in this teaching? (Select all that apply.)

Accepted Answer

A)   Constipation for 3 days
B)   Temperature of 99° F
C)   Abdominal pain
D)   Visible blood in the urine
E)   Heavy vaginal bleeding

Question 11

A client is scheduled to start external beam radiation therapy (EBRT)for her endometrial cancer.Which teaching by the nurse is accurate? (Select all that apply.)

Accepted Answer

A)   "You will need to be hospitalized during this therapy."
B)   "Your skin needs to be inspected daily for any breakdown."
C)   "It is not wise to stay out in the sun for long periods of time."
D)   "The perineal area may become damaged with the radiation."
E)   "The technician applies new site markings before each treatment."

Question 12

A postmenopausal client is experiencing low back and pelvic pain,fatigue,and bloody vaginal discharge.What laboratory tests would the nurse expect to see ordered for this client if endometrial cancer is suspected? (Select all that apply.)

Accepted Answer

A)   Cancer antigen-125 (CA-125) 
B)   White blood cell (WB
C)   count
C)   Hemoglobin and hematocrit (H&H) 
D)   International normalized ratio (INR) 
E)   Prothrombin time (PT)

Question 13

A client who had a hysterectomy has a 200-mg dose of ciprofloxacin (Cipro)ordered to infuse in 30 minutes.At what rate should the nurse infuse the medication if the pharmacy provides 200 mg in a 100-mL bag of normal saline? (Record your answer using a whole number.)___ mL/hr

Accepted Answer

The answer of A client who had a hysterectomy has...

Question 14

The nurse is caring for a postoperative client following an anterior colporrhaphy.What action can be delegated to the unlicensed assistive personnel (UAP)?

Accepted Answer

A)   Reviewing the hematocrit and hemoglobin results
B)   Teaching the client to avoid lifting her 4-year-old grandson
C)   Assessing the level of pain and any drainage
D)   Drawing a shallow hot bath for comfort measures

Question 15

A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy.She is concerned about a loss of libido.What intervention by the nurse would be best?

Accepted Answer

A)   Suggest increasing vitamins and supplements daily.
B)   Discuss the value of a balanced diet and exercise.
C)   Reinforce that weight gain may be inevitable.
D)   Teach that estrogen cream inserted vaginally may help.

Question 16

A client has a recurrent Bartholin cyst.What is the nurse's priority action?

Accepted Answer

A)   Apply an ice pack to the area.
B)   Administer a prophylactic antibiotic.
C)   Obtain a fluid sample for laboratory analysis.
D)   Suggest moist heat such as a sitz bath.

Question 17

A client has scheduled brachytherapy sessions and states that she feels as though she is not safe around her family.What is the best response by the nurse?

Accepted Answer

A)   "You are only reactive when the radioactive implant is in place."
B)   "To be totally safe, it is a good idea to sleep in a separate room."
C)   "It is best to stay a safe distance from friends or family between treatments."
D)   "You should use a separate bathroom from the rest of the family."

Question 18

The client is emotionally upset about the recent diagnosis of stage IV endometrial cancer.Which action by the nurse is best?

Accepted Answer

A)   Let the client alone for a long period of reflection time.
B)   Ask friends and relatives to limit their visits.
C)   Tell the client that an emotional response is unacceptable.
D)   Create an atmosphere of acceptance and discussion.

Question 19

The nurse is giving discharge instructions to a client who had a total abdominal hysterectomy.Which statements by the client indicate a need for further teaching? (Select all that apply.)

Accepted Answer

A)   "I should not have any problems driving to see my mother, who lives 3 hours away."
B)   "Now that I have time off from work, I can return to my exercise routine next week."
C)   "My granddaughter weighs 23 pounds, so I need to refrain from picking her up."
D)   "I will have to limit the times that I climb our stairs at home to morning and night."
E)   "For 1 month, I will need to refrain from sexual intercourse."

Question 20

A 20-year-old client is interested in protection from the human papilloma virus (HPV)since she may become sexually active.Which response from the nurse is the most accurate?

Accepted Answer

A)   "You are too old to receive an HPV vaccine."
B)   "Either Gardasil or Cervarix can provide protection."
C)   "You will need to have three injections over a span of 1 year."
D)   "The most common side effect of the vaccine is itching at the injection site."

Exam 71: Care of Patients with Gynecologic Problems