Chapter 06: Reproductive System Concerns Lowdermilk: Maternity & Women’s Health Care, 11th Edition

TEST BANK FOR MATERNITY & WOMEN’S HEALTH CARE 11TH EDITION BY LOWDERMILK Chapter 06: Reproductive System Concerns Lowdermilk: Maternity & Women’s Health Care, 11th Edition MULTIPLE CHOICE 1. Which condition is the least likely cause of amenorrhea in a 17-year-old client? a. Anatomic abnormalities b. Type 1 diabetes mellitus c. Obesity d. Pregnancy CORRECT ANSWER: C A moderately obese adolescent (20% to 30% above ideal weight) may have early onset menstruation. Girls who regularly exercise before menarche can have delayed onset of menstruation to age 18 years. Anatomic abnormalities are a possible cause of amenorrhea. Type 1 diabetes mellitus is a possible cause of amenorrhea. Pregnancy is the most common cause of amenorrhea. DIF: Cognitive Level: Remember REF: p. 121 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 2. When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended? a. Increasing the intake of red meat to replace blood loss b. Reducing the intake of diuretic foods, such as peaches and asparagus c. Temporarily substituting physical activity for a sedentary lifestyle d. Using a heating pad on the abdomen to relieve cramping CORRECT ANSWER: D Heat minimizes cramping by increasing vasodilation and muscle relaxation and minimizing uterine ischemia. Dietary changes such as a low-fat vegetarian diet 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: Analyze REF: pp. 122-123 TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity 3. Nafarelin (Synarel) is used to treat mild-to-severe endometriosis. What instruction or information should the nurse provide to a client regarding nafarelin administration? a. Nafarelin stimulates the secretion of gonadotropin-releasing hormone (GnRH), thereby stimulating ovarian activity. b. It should be administered by intramuscular (IM) injection. c. Nafarelin should be administered by a subcutaneous implant. d. It can cause the client to experience some hot flashes and vaginal dryness. CORRECT ANSWER: D Nafarelin is a GnRH agonist, and its side 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. Nafarelin is administered twice daily by nasal spray and can be intranasally administered. Leuprolide is given once per month by IM injection. Goserelin is administered by subcutaneous implant. DIF: Cognitive Level: Apply REF: p. 127 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 4. While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the client‘s recent menstrual cycles. Which statement by the client should prompt the nurse to collect further information? a. ―My menstrual flow lasts 5 to 6 days.‖ b. ―My flow is very heavy.‖ c. ―I have had a small amount of spotting midway between my periods for the past 2 months.‖ d. ―The length of my menstrual cycles varies from 26 to 29 days.‖ CORRECT ANSWER: B Menorrhagia is defined as excessive menstrual bleeding, either in duration or in amount. Heavy bleeding can have many causes. The amount of bleeding and its effect on daily activities should be evaluated. A menstrual flow that lasts 5 to 6 days is a normal finding. Mittlestaining, a small amount of bleeding or spotting that occurs at the time of ovulation (14 days before the onset of the next menses), is considered normal. During her reproductive years, a woman may have physiologic variations in her menstrual cycle. Variations in the length of a menstrual cycle are considered normal. DIF: Cognitive Level: Understand REF: p. 131 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 5. A 21-year-old client complains of severe pain immediately after the commencement of her menses. Which gynecologic condition is the most likely cause of this client‘s presenting complaint? a. Primary dysmenorrhea b. Secondary dysmenorrhea c. Dyspareunia d. Endometriosis CORRECT ANSWER: A Primary dysmenorrhea, or pain during or shortly before menstruation, has a biochemical basis and arises from the release of prostaglandins with menses. Secondary dysmenorrhea develops after the age of 25 years and is usually associated with a pelvic pathologic condition. Dyspareunia, or painful intercourse, is commonly associated with endometriosis. Endometriosis is characterized by endometrial glands and stoma outside of the uterus. DIF: Cognitive Level: Remember REF: p. 122 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance