Test Bank For Maternity and Pediatric Nursing 4th Edition Ricci Kyle Carman

Maternity and Pediatric Nursing 4th Edition Ricci Kyle Carman Test Bank/ 20. After teaching a group of students about premenstrual syndrome, the instructor determines that additional teaching is needed when the students identify which of the following as a prominent assessment finding? A) Bloating B) Tension C) Dysphoria D) Weight loss 21. A nurse is describing the criteria needed for the diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following would the nurse include as a mandatory requirement for the diagnosis? A) Appetite changes B) Sleep difficulties C) Persistent anger D) Chronic fatigue 22. When reviewing the medical record of a client diagnosed with endometriosis, which of the following would the nurse identify as a risk factor for this woman? A) Low fat in the diet B) Age of 14 years for menarche C) Menstrual cycles of 24 days D) Short menstrual flow 23. A client who has come to the clinic is diagnosed with endometriosis. Which of the following would the nurse expect the physician to prescribe as a first-line treatment? A) Progestins B) Antiestrogens C) Gonadotropin-releasing hormone analogues D) NSAIDs 24. A woman comes to the clinic because she has been unable to conceive. When reviewing the woman’s history, which of the following would the nurse least likely identify as a possible risk factor? A) Age of 25 years B) History of smoking C) Diabetes since age 15 years D) Weight below standard for height and age 25. A couple comes to the clinic for a fertility evaluation. The male partner is to undergo a semen analysis. After teaching the partner about this test, which client statement indicates that the client has understood the instructions? A) “I need to bring the specimen to the lab the day after collecting it.” B) “I will place the specimen in a special plastic bag to transport it.” C) “I have to abstain from sexual activity for about 1–2 days before the sample.” D) “I will withdraw before I ejaculate during sex to collect the specimen.” 26. A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). Which of the following would the nurse need to stress to the group. Select all that apply. A) ECs induce an abortion like reaction. B) ECs provide some protection against STIs C) ECs are birth control pills in higher, more frequent doses D) ECs are not to be used in place of regular birth control E) ECs provide little protection for future pregnancies. Answer Key 1. C 2. D 3. C 4. A 5. C 6. D 7. D 8. B 9. A 10. C 11. D 12. B 13. A 14. B 15. A 16. B 17. A, B, E 18. A, B, C, D 19. A 20. D 21. C 22. C 23. D 24. A 25. C 26. C, D, E Chapter 5- Sexually Transmitted Infections 1. The nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. The goal of this therapy is to: A) Promote the progression of disease B) Intervene in late-stage AIDS C) Improve survival rates D) Conduct additional drug research 2. A woman who is HIV-positive is receiving HAART and is having difficulty with compliance. To promote adherence, which of the following areas would be most important to assess initially? A) The woman’s beliefs and education B) The woman’s financial situation and insurance C) The woman’s activity level and nutrition D) The woman’s family and living arrangements 3. When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection? A) Native Americans B) Heterosexual women C) New health care workers D) Asian immigrants 4. After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which of the following? A) Sexual intercourse B) Sharing needles for IV drug use C) Perinatal transmission D) Blood transfusion 5. The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which of the following would indicate to the nurse that the client has AIDS? A) 1,000 cells/mm3 B) 700 cells/mm3 C) 450 cells/mm3 D) 200 cells/mm3 6. When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? A) Hive-like rash for the past 2 days B) Five different sexual partners C) Weight gain of 5 lbs in 1 year D) Clear vaginal discharge 7. Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has: A) Trichomoniasis B) Bacterial vaginosis C) Candidiasis D) Genital herpes simplex 8. A client with trichomoniasis is to receive metronidazole (Flagyl). The nurse instructs the client to avoid which of the following while taking this drug? A) Alcohol B) Nicotine C) Chocolate D) Caffeine 9. A woman gives birth to a healthy newborn. As part of the newborn’s care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI? A) Genital herpes B) Hepatitis B C) Syphilis D) Gonorrhea 10. Which findings would the nurse expect to find in a client with bacterial vaginosis? A) Vaginal pH of 3 B) Fish-like odor of discharge C) Yellowish-green discharge D) Cervical bleeding on contact 11. A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: A) Amniotic fluid B) Placenta C) Birth canal D) Breast milk 12. The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for: A) Infertility B) Dyspareunia C) Cervical cancer D) Dysmenorrhea 13. A client is diagnosed with pelvic inflammatory disease (PID). When reviewing the client’s medical record, which of the following would the nurse expect to find? (Select all that apply.) A) Oral temperature of 100.4 degrees F B) Dysmenorrhea C) Dysuria D) Lower abdominal tenderness E) Discomfort with cervical motion F) Multiparity 14. Which instructions would the nurse include when teaching a woman with pediculosis pubis? A) “Take the antibiotic until you feel better.” B) “Wash your bed linens in bleach and cold water.” C) “Your partner doesn’t need treatment at this time.” D) “Remove the nits with a fine-toothed comb.” 15. A client with genital herpes simplex infection asks the nurse, “Will I ever be cured of this infection?” Which response by the nurse would be most appropriate? A) “There is a new vaccine available that prevents the infection from returning.” B) “All you need is a dose of penicillin and the infection will be gone.” C) “There is no cure, but drug therapy helps to reduce symptoms and recurrences.” D) “Once you have the infection, you develop an immunity to it.” 16. A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed with genital herpes. Which of the following would the nurse expect to include as a possible precipitating factor for a recurrent outbreak? (Select all that apply.) A) Exposure to ultraviolet light B) Exercise C) Use of corticosteroids D) Emotional stress E) Sexual intercourse. 17. After teaching a class on sexually transmitted infections, the instructor determines that the teaching was successful when the class identifies which statement as true? A) STIs can affect anyone if exposed to the infectious organism. B) STIs have been addressed more on a global scale. C) Clients readily view the diagnosis of STI openly. D) Most individuals with STIs are over the age of 30. 18. A group of students are reviewing information about STIs. The students demonstrate understanding of the information when they identify which of the following as the most common bacterial STI in the United States? A) Gonorrhea B) Chlamydia C) Syphilis D) Candidiasis 19. A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which of the following would the nurse identify? A) Asian American ethnicity B) Age under 25 years C) Married D) Consistent use of barrier contraception 20. A nurse at a local community clinic is developing a program to address STI prevention. Which of the following would the nurse least likely include in the program? A) Outlining safer sexual behavior B) Recommending screening for symptomatic individuals C) Promoting the use of barrier contraceptives D) Offering education about STI transmission 21. After teaching a class on preventing pelvic inflammatory disease, the instructor determines that the teaching was successful when the class identifies which of the following as an effective method? A) Advising sexually active females to use hormonal contraception B) Encouraging vaginal douching on a weekly basis. C) Emphasizing the need for infected sexual partners to receive treatment D) Promoting routine treatment for asymptomatic females as risk 22. A group of nursing students are reviewing information about vaccines used to prevent STIs. The students would expect to find information about which of the following? A) HIV B) HSV C) HPV D) HAV E) HBV 23. A mother brings her 12-year-old daughter in for well-visit checkup. During the visit, the nurse is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees and the daughter receives her first dose. The nurse schedules the daughter for the next dose, which would be given at which time? A) In 2 month B) In 2 months C) In 3 months D) In 4 months 24. A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects trichomoniasis based on which of the following? (Select all that apply.) A) Urinary frequency B) Yellow/green discharge C) Joint pain D) Blister-like lesions E) Muscle aches 25. A nurse is teaching a women with genital ulcers how to care for them. Which statement by the client indicates a need for additional teaching? A) “I need to wash my hands after touching any of the ulcers.” B) “I need to abstain from intercourse primarily when the lesions are present.” C) “I should avoid applying ice or heat to my genital area.” D) “I can try lukewarm sitz baths to help ease the discomfort.” Answer Key 1. C 2. A 3. B 4. A 5. D 6. B 7. C 8. A 9. D 10. B 11. B 12. C 13. B, C, D, E 14. D 15. C 16. A, C, D, E 17. A 18. B 19. B 20. B 21. C 22. C, D, E 23. B 24. A, B 25. B Chapter 6- Disorders of the Breasts 1. The nurse is developing the discharge plan for a woman who has had a left-sided modified radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which suggestion would most likely increase the woman’s symptoms? A) “Wear gloves when you are doing any gardening.” B) “Have your blood pressure taken in your right arm.” C) “Wear clothing with elasticized sleeves.” D) “Avoid driving to and from work every day.” 2. A laboratory technician arrives to draw blood for a complete blood count (CBC. for a client who had a right-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her left antecubital space. To obtain the blood specimen, the technician places a tourniquet on the client’s right arm. Which action by the nurse would be most appropriate? A) Assist in holding the client’s arm still. B) Suggest a finger stick be done on one of the client’s left fingers. C) Tell the technician to obtain the blood sample from the client’s left arm. D) Call the surgeon to perform a femoral puncture. 3. The nurse determines that a woman has implemented prescribed therapy for her fibrocystic breast disease when the client reports that she has eliminated what from her diet? A) Caffeine B) Cigarettes C) Dairy products D) Sweets 4. When assessing a client with suspected breast cancer, which of the following would the nurse expect to find? A) Painful lump B) Absence of dimpling C) Regularly shaped mass D) Nipple retraction 5. A woman who has undergone a right modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate at this time? A) Ask the client how she feels about having her breast removed. B) Attach a sign above her bed to have BP, IV lines, and lab work in her right arm. C) Encourage her to turn, cough, and deep breathe at frequent intervals. D) Position her right arm below heart level. 6. A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. Which nursing diagnosis would the nurse most likely include in the client’s preoperative plan of care as the priority? A) Risk for deficient fluid volume B) Activity intolerance C) Disturbed body image D) Impaired urinary elimination 7. A 42-year-old woman is scheduled for a mammogram. Which of the following would the nurse include when teaching the woman about the procedure? A) “The room will be darkened throughout the procedure.” B) “Each breast will be firmly compressed between two plates.” C) “Make sure to refrain from eating or drinking after midnight.” D) “A small needle will be inserted to get a sample for evaluation.” 8. During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman’s left breast. The nurse notifies the physician. Which of the following would the nurse anticipate the physician to order next? A) Mammogram B) Hormone receptor status C) Fine-needle aspiration D) Genetic testing for BRCA 9. A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start hormonal therapy. Which agent would the nurse expect the client to receive? A) Progestins B) Tamoxifen C) Cortisone D) Estrogen 10. As part of discharge planning, the nurse refers a woman to Reach to Recovery. This group’s primary purpose is to: A) Help support women who have undergone mastectomies B) Raise funds to support early breast cancer detection programs C) Provide all supplies needed after breast surgery for no cost D) Collect statistics for research for the American Cancer Society 11. A woman with breast cancer is undergoing chemotherapy. Which of the following side effects would the nurse interpret as being most serious? A) Vomiting B) Hair loss C) Fatigue D) Myelosuppression 12. A woman comes to the clinic reporting a nipple discharge. On examination, the area below the areola is red and slightly swollen, with tortuous tubular swelling. The nurse interprets these findings as suggestive of which of the following? A) Fibrocystic breast disorder B) Intraductal papilloma C) Duct ectasia D) Fibroadenoma 13. When performing a clinical breast examination, which would the nurse do first? A) Palpate the axillary area. B) Compress the nipple for a discharge. C) Palpate the breasts. D) Inspect the breasts. 14. Evaluation of a woman with breast cancer reveals that her mass is approximately 1.25 inches in diameter. Three adjacent lymph nodes are positive. The nurse interprets this as indicating that the woman has which stage of breast cancer? A) 0 B) I C) II D) III 15. After teaching a woman how to perform breast self-examination, which statement would indicate that the nurse’s instructions were successful? A) “I should lie down with my arms at my side when looking at my breasts.” B) “I should use the fingerpads of my three middle fingers to apply pressure to my breast.” C) “I don’t need to check under my arm on that side if my breast feels fine.” D) “I need to work from the center of my breast outward toward my shoulder.” 16. A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. When describing the medications that can be used as treatment, which of the following would the nurse be least likely to include? A) Tamoxifen B) Bromocriptine C) Danazol D) Penicillin 17. A group of students are reviewing information about benign and malignant breast masses. The students demonstrate understanding when they identify which of the following as indicating a benign breast mass. (Select all the apply.) A) Painless B) Unilateral location C) Firm consistency D) Absence of dimpling E) Fixed to chest wall 18. The nurse is developing a plan of care for a woman with breast cancer who is scheduled to undergo breast-conserving surgery. The nurse interprets this as which of the following? A) Removal of nipple and areolar area B) Lump removal followed by radiation C) Entire breast removal without lymph nodes D) Axillary lymph node removal 19. A woman comes to the clinic and asks the nurse about when she should have her first mammogram. Using the recommendations of the American Cancer Society, which would the nurse suggest? A) 30 years B) 35 years C) 40 years D) 45 years 20. After teaching a group of nursing students about the different types of chemotherapeutic agents used to treat breast cancer, the instructor determines that the teaching was successful when the students identify which of the following as an example of a selective estrogen receptor modulator (SERM)? (Select all that apply.) A) Tamoxifen B) Letozole C) Raloxifene D) Exemestane E) Anastrozole 21. A woman diagnosed with breast cancer is to receive trastuzumab. Which of the following would the nurse incorporate into the explanation about how this drug works? A) It blocks the effect of the HER-2/neu protein inhibiting the growth of cancer cells. B) The drug blocks the conversion of androgens to estrogens C) It interferes with hormone receptors that allow estrogen to enter a cell D) The drug ultimately attacks areas where micrometastasis has occurred. 22. A nurse is conducting a class on breast cancer prevention. Which statement would the nurse most likely include in the discussion? A) “Most often a lump is felt before it is seen.” B) “Early breast cancer usually has some symptoms.” C) “If the mass is not painful, it is usually benign.” D) “If lump is palpable, it has been there for some time.” 23. When describing programs for breast cancer screening, the nurse include breast self- examination (BSE). Which of the following most accurately reflects the current thinking about breast self-examination? A) BSE is essential for early breast cancer detection. B) A woman performing BSE has breast awareness. C) BSE plays a minimal role in detecting breast cancer D) A clinical breast exam has replaced BSE. 24. During a wellness visit to the clinic, a woman asks the nurse if there is anything she can do to reduce her risk for developing breast cancer. Which of the following would the nurse most likely include? (Select all that apply.) A) Eating three servings of fruit daily B) Keeping weight gain under 11 pounds after age 18 C) Eating at least seven portions of complex carbohydrates daily D) Limiting the intake of refined sugar products E) Using salt liberally when cooking 25. A woman comes to the clinic and tells the nurse that she has read an article about certain foods that have anticancer properties and help boost the immune system. The nurse identifies A) Garlic B) Soybeans C) Milk D) Leeks E) Flax seeds Answer Key 1. C 2. B 3. A 4. D 5. C 6. C 7. B 8. A 9. B 10. A 11. D 12. C 13. D 14. C 15. B 16. D 17. C, D 18. B 19. C 20. A, C 21. A 22. D 23. B 24. B, C, D 25. A, B, D, E Chapter 7- Benign Disorders of the Female Reproductive Tract 1. A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, which of the following would the nurse expect to find? A) Sporadic vaginal bleeding accompanied by chronic pelvic pain B) Heavy leukorrhea with vulvar pruritus C) Menstrual irregularities and hirsutism on the chin D) Stress incontinence with feeling of low abdominal pressure 2. To assist the woman in regaining control of the urinary sphincter for urinary incontinence, the nurse should teach the client to do which of the following? A) Perform Kegel exercises daily. B) Void every hour while awake. C) Limit her intake of fluid. D) Take a laxative every night. 3. When developing the plan of care for a woman who has had an abdominal hysterectomy, which of the following would be contraindicated? A) Ambulating the client B) Massaging the client’s legs C) Applying elasticized stockings D) Encouraging range-of-motion exercises 4. Which of the following would the nurse include when teaching women about preventing pelvic support disorders? A) Performing Kegel isometric exercises B) Consuming low-fiber diets C) Using hormone replacement D) Voiding every 2 hours 5. A client is diagnosed with an enterocele. The nurse interprets this condition as: A) Protrusion of the posterior bladder wall downward through the anterior vaginal wall B) Sagging of the rectum with pressure exerted against the posterior vaginal wall C) Bulging of the small intestine through the posterior vaginal wall D) Descent of the uterus through the pelvic floor into the vagina 6. A woman is scheduled for an anterior and posterior colporrhaphy as treatment for a cystocele. When the nurse is explaining this treatment to the client, which of the following descriptions would be most appropriate to include? A) “This procedure helps to tighten the vaginal wall in the front and back so that your bladder and urethra are in the proper position.” B) “Your uterus will be removed through your vagina, helping to relieve the organ that is putting the pressure on your bladder.” C) “This is a series of exercises that you will learn to do so that you can strengthen your bladder muscles.” D) “These are plastic devices that your physician will insert into your vagina to provide support to the uterus and keep it in the proper position.” 7. The nurse would be least likely to find which of the following in a client with uterine fibroids? A) Regularly shaped, shrunken uterus B) Acute pelvic pain C) Menorrhagia D) Complaints of bloating 8. A client with polycystic ovarian syndrome (PCOS. is receiving oral contraceptives as part of her treatment plan. The nurse understands that the rationale for this therapy is to: A) Restore menstrual regularity B) Induce ovulation C) Improve insulin uptake D) Alleviate hirsutism 9. When teaching a woman how to perform Kegel exercises, the nurse explains that these exercises are designed to strengthen which muscles? A) Gluteus B) Lower abdominal C) Pelvic floor D) Diaphragmatic 10. A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect? A) Increased vaginal discharge B) Urinary tract infection C) Vaginitis D) Vaginal ulceration 11. When preparing the discharge teaching plan for the woman who had surgery to correct pelvic organ prolapse, which of the following would the nurse include? A) Care of the indwelling catheter at home B) Emphasis on coughing to prevent complications C) Return to usual activity level in a few days D) Daily douching with dilute vinegar solution 12. A woman with polycystic ovary syndrome tells the nurse, “I hate this disease. Just look at me! I have no hair on the front of my head but I’ve got hair on my chin and upper lip. I don’t feel like a woman anymore.” Further assessment reveals breast atrophy and increased muscle mass. Which nursing diagnosis would most likely be a priority? A) Situational low self-esteem related to masculinization effects of the disease B) Social isolation related to feelings about appearance C) Risk for suicide related to effects of condition and fluctuating hormone levels D) Ineffective peripheral tissue perfusion related to effects of disease on vasculature 13. After teaching a local woman’s group about incontinence, the nurse determines that the teaching was successful when the group identifies which of the following as characteristic of stress incontinence? A) Feeling a strong need to void B) Passing a large amount of urine C) Most common in women after childbirth D) Sneezing may be an initiating stimulus 14. A woman is being evaluated for pelvic organ prolapse. A postvoid residual urine specimen is obtained via a catheter. Which residual volume finding would lead the nurse to suspect the need for further testing? A) 50 mL B) 75 mL C) 100 mL D) 120 mL 15. After teaching a woman with pelvic organ prolapse about dietary and lifestyle measures, which of the following statements would indicate the need for additional teaching? A) “If I wear a girdle, it will help support the muscles in the area.” B) “I should take up jogging to make sure I exercise enough.” C) “I will try to drink at least 64 oz of fluid each day.” D) “I need to increase the amount of fiber I eat every day.” 16. After teaching a group of students about genital fistulas, the instructor determines that the teaching was successful when the students identify which of the following as a major cause? A) Radiation therapy B) Congenital anomaly C) Female genital cutting D) Bartholin’s gland abscess 17. A nurse is providing care to a female client receiving treatment for a Bartholin’s cyst. The client has had a small loop of plastic tubing secured in place to allow for drainage. The nurse instructs the client that she will have a follow-up appointment for removal of the plastic tubing at which time? A) 1 week B) 2 weeks C) 3 weeks D) 4 weeks 18. After undergoing diagnostic testing, a woman is diagnosed with a corpus luteum cyst. The nurse anticipates that the woman will require: A) Biopsy B) No treatment C) Oral contraceptives D) Glucophage 19. A nurse is teaching a client how to perform Kegel exercises. Which of the following would the nurse include? (Select all that apply.) A) “Squeeze your rectal muscles as if you are trying to avoid passing flatus.” B) “Tighten your pubococcygeal muscles for a count of 10.” C) “Contract and relax your pubococcygeal muscles rapidly 10 times.” D) “Try bearing down for about 10 seconds for no more than 5 times.” E) “Do these exercises at least 5 times every hour.” 20. After teaching a group of students about pelvic organ prolapse, the instructor determines that the teaching was successful when the group identifies leiomyomas as which of the following? A) Cysts B) Pelvic organ prolapse C) Fistula D) Fibroid 21. A nurse is assessing a female client and suspects that the client may have endometrial polyps based on which of the following? A) Bleeding after intercourse B) Vaginal discharge C) Bleeding between menses D) Metrorrhagia 22. After teaching a group of students about ovarian cysts, the instructor determines that the teaching was successful when the students identify which type of cyst as being associated with hydatiform mole? A) Theca-lutein cyst B) Corpus luteum cyst C) Follicular cyst D) Polycystic ovarian syndrome 23. A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which of the following? (Select all that apply.) A) Rectocele B) Fecal incontinence C) Cystocele D) Urinary incontinence E) Enterocele 24. A nurse is reviewing the medical record of a client. Which of the following would lead the nurse to suspect that the client is experiencing polycystic ovarian syndrome? (Select all that apply) A) Decreased androgen levels B) Elevated blood insulin levels C) Anovulation D) Waist circumference of 32 inches E) Triglyceride level of 175 mg/dL F) High-density lipoprotein level of 40 mg/dL 25. A group of students are preparing a class presentation about polyps. Which of the following would the students most likely include in the presentation? A) Polyps are rarely the result of an infection. B) Endocervical polyps commonly appear after menarche. C) Cervical polyps are more common than endocervical polyps. D) Endocervical polyps are most common in women in their 50s. Answer Key 1. D 2. A 3. B 4. A 5. C 6. A 7. B 8. A 9. C 10. D 11. A 12. A 13. D 14. D 15. B 16. C 17. C 18. B 19. A, C 20. D 21. D 22. A 23. A, C, E 24. B, C, E 25. D Chapter 8- Cancers of the Female Reproductive Tract 1. The nurse would refer a client, age 54, for follow-up for suspected endometrial carcinoma if she reports which of the following? A) Use of oral contraceptives between ages 18 and 25 B) Onset of painless, red postmenopausal bleeding C) Menopause occurring at age 46 D) Use of intrauterine device for 3 years 2. Which of the following instructions would the nurse include when preparing a woman for a Pap smear? A) “Refrain from sexual intercourse for 1 week before the test.” B) “Wear cotton panties on the day of the test.” C) “Avoid taking any medications for 24 hours.” D) “Do not douche for 48 hours before the test.” 3. A woman comes to the clinic for a routine checkup. A history of exposure to which of the following would alert the nurse that she is at increased risk for cervical cancer? A) Hepatitis B) Human papillomavirus C) Cytomegalovirus D) Epstein-Barr virus 4. A client is scheduled to have a Pap smear. After the nurse teaches the client about the Pap smear, which of the following client statements indicates successful teaching? A) “I need to douche the night before with a mild vinegar solution.” B) “I will take a bath first thing that morning to make sure I’m clean.” C) “I will not engage in sexual intercourse for 48 hours before the test.” D) “I will get a clean urine specimen when I first wake up the morning of the test.” 5. Which finding obtained during a client history would the nurse identify as increasing a client’s risk for ovarian cancer? A) Multiple sexual partners B) Consumption of a high-fat diet C) Underweight D) Grand multiparity (more than five children) 6. A client is scheduled for cryosurgery to remove some abnormal tissue on the cervix. The nurse teaches the client about this treatment, explaining that the tissue will be removed by which method? A) Freezing B) Cutting C) Burning D) Irradiating 7. Which of the following statements best indicates that a client has taken self-care measures to reduce her risk for cervical cancer? A) “I’ve really cut down on the amount of caffeine I drink every day.” B) “I’ve thrown out all my bubble baths and just use soap and water now.” C) “Every time I have sexual intercourse, I douche.” D) “My partner always uses a condom when we have sexual intercourse.” 8. A client is suspected of having endometrial cancer. The nurse would most likely prepare the client for which procedure to confirm the diagnosis? A) Transvaginal ultrasound B) Colposcopy C) Pap smear D) Endometrial biopsy 9. Which of the following descriptions would the nurse include when teaching a client about her scheduled colposcopy? A) “A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas.” B) “A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument.” C) “Scrapings of tissue will be obtained and placed on slides to be examined under the microscope.” D) “After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples.” 10. The nurse is preparing a presentation for a local women’s group about ways to reduce the risk of reproductive tract cancers. Which of the following would the nurse include? A) Blood pressure evaluation every 6 months B) Yearly Pap smears starting at age 40 C) Yearly cholesterol screening starting at age 45 D) Consumption of two to three glasses of red wine per day 11. The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A) “Currently there is no reliable screening test for ovarian cancer.” B) “A Pap smear is almost always helpful in identifying this type of cancer.” C) “There’s a blood test for a marker, CA-125, that if elevated indicates cancer.” D) “A genetic test for two genes, if positive, will identify the ovarian cancer.” 12. Which of the following would the nurse be least likely to suggest when teaching a group of young women how to reduce their risk for ovarian cancer? A) Pregnancy B) Oral contraceptives C) Feminine hygiene sprays D) Breast-feeding 13. A woman is diagnosed with adenocarcinoma of the endometrium in situ. The nurse interprets this as indicating which of the following about the cancer? A) Spread to the uterine muscle wall B) Found on the endometrial surface C) Spread to the cervix D) Invaded the bladder 14. When preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects that the lesion would most likely be located at which area? A) Labia majora B) Labia minora C) Clitoris D) Prepuce 15. When describing the various types of reproductive tract cancers to a local women’s group, which of the following would the nurse identify as the least common type? A) Vulvar B) Vaginal C) Endometrial D) Ovarian 16. When assessing a female client for the possibility of vulvar cancer, which of the following would the nurse most likely expect the client to report? (Select all that apply.) A) Abnormal vaginal bleeding B) Persistent vulvar itching C) History of herpes simplex D) Lesion on the cervix E) Abnormal Pap smear 17. A nurse is reviewing the medical record of a woman diagnosed with vulvar cancer. Which of the following would the nurse identify as a risk factor for this cancer? (Select all that apply.) A) Age under 40 years B) HPV 16 exposure C) Monogamous sexual partner D) Hypertension E) Diabetes 18. A nurse is assisting with the collection of a Pap smear. When collecting the specimen, which of the following is done first? A) Insertion of the speculum B) Swabbing of the endocervix C) Spreading of the labia D) Insertion of the cytobrush 19. The plan of care for a woman diagnosed with a suspected reproductive cancer includes a nursing diagnosis of disturbed body image related to suspected reproductive tract cancer and impact on sexuality as evidenced by the client’s statement that she is worried that she won’t be the same. Which of the following would be an appropriate outcome for this client? A) Client will verbalize positive statements about self and sexuality. B) Client will demonstrate understanding of the condition and associated treatment. C) Client will exhibit positive coping strategies related to diagnosis. D) Client will identify misconceptions related to her diagnosis. 20. During a routine health check-up, a young adult woman asks the nurse about ways to prevent endometrial cancer. Which of the following would the nurse most likely include? (Select all that apply.) A) Eating a high-fat diet B) Having regular pelvic exams C) Engaging in daily exercise D) Becoming pregnant E) Using estrogen contraceptives 21. After teaching a group of students about cervical cancer, the instructor determines that the teaching was successful when the students identify which of the following as the area included with a cone biopsy? A) Clitoris B) Uterine fundus C) Ovarian follicle D) Transformation zone 22. A woman is scheduled for diagnostic testing to evaluate for endometrial cancer. The nurse would expect to prepare the woman for which of the following? A) CA-125 testing B) Transvaginal ultrasound C) Pap smear D) Mammography 23. A nurse is conducting a class for a local woman’s group about recommendations for a Pap smear. One of the participants asks, “At what age should a woman have her first Pap smear?” The nurse responds by stating that a woman should have her first Pap smear at which age? A) 18 B) 21 C) 25 D) 28 24. An instructor is describing the development of cervical cancer to a group of students. The instructor determines that the teaching was successful when the students identify which area as most commonly involved? A) Internal cervical os B) Junction of the cervix and fundus C) Squamous-columnar junction D) External cervical os