Female Reproductive and Genital
Problems Lewis Question and Answers
/Already Graded A+
1. A 34-yr-old patient 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
accurate?
a. "If you do not become pregnant within the next few years, you never will."
b. "Women often have more difficulty becoming pregnant after about age 35."
c. "Stop taking oral contraceptives several years before you want to have a child."
d. "You have many more years of fertility left, so there is no rush to have children." -
ANSWERS ANS: B
The probability of successfully becoming pregnant decreases after age 35 years,
although some patients may have no difficulty in becoming pregnant. Oral
contraceptives do not need to be withdrawn for several years for a woman to become
pregnant. Although the patient may be fertile for many years, it would be inaccurate to
indicate that there is no concern about fertility as she becomes older. Although the risk
for infertility increases after age 35 years, not all patients have difficulty in conceiving.
DIF: Cognitive Level: Apply (application) REF: 1242 TOP: Nursing Process:
Implementation MSC: NCLEX: Health Promotion and Maintenance
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 husband's 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 - ANSWERS ANS: C
The statements made by the couple are consistent with the diagnosis of defensive
coping. No data indicate that ineffective sexuality and ineffective denial are problems.
Although the couple is quarreling about finances, the data do not provide information
indicating that the finances are inadequate.
DIF: Cognitive Level: Apply (application) REF: 1243 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Psychosocial Integrity
(Page 519).
3. A young 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 can 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. -
ANSWERS ANS: B
Ovulation prediction kits indicate when luteinizing hormone (LH) levels first rise.
Ovulation occurs about 28 to 36 hours after the first rise of LH. This information can be
used to determine the best time for intercourse. Body temperature rises at ovulation.
Postcoital cervical smears are used in infertility testing, but they do not predict the best
time for conceiving and are not obtained by the patient. Determination of the time of
ovulation can be predicted by basal body temperature charts or ovulation prediction kits
and is not dependent on regular menstrual periods.
DIF: Cognitive Level: Apply (application) REF: 1243 TOP: Nursing Process:
Implementation MSC: NCLEX: Health Promotion and Maintenance
.
4. A patient has an induced abortion with suction curettage at an ambulatory surgical
center. Which instructions will the nurse include when discharging the patient?
a. "Avoid contraceptives until your reexamination."
b. "Heavy vaginal bleeding is expected for 2 weeks."
c. "Abstain from sexual intercourse for the next 2 weeks."
d. "Irregular menstrual periods are expected for a few months." - ANSWERS ANS: C
Because infection is a possible complication of this procedure, the patient is advised to
avoid intercourse until the reexamination in 2 weeks. Patients may be started on
contraceptives on the day of the procedure. The patient should call the doctor if heavy
vaginal bleeding occurs. No change in the regularity of the menstrual periods is
expected.
DIF: Cognitive Level: Apply (application) REF: 1243 TOP: Nursing Process:
Implementation MSC: NCLEX: Health Promotion and Maintenance
5.A patient 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. - ANSWERS ANS:
B
Uterine contractions take 12 to 36 hours to begin after the hypertonic saline is instilled.
Because the saline is feticidal, the nurse does not need to discuss any possibility of a
live delivery or that the pregnancy termination will not be successful. General
anesthesia is not needed for this procedure.
, DIF: Cognitive Level: Apply (application) REF: 1244 TOP: Nursing Process:
Implementation MSC: NCLEX: Health Promotion and Maintenance
6. A 28-yr-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 to control symptoms. - ANSWERS ANS: A
The patient's symptoms indicate possible PMS, but they also may be associated with
other diagnoses. Having the patient keep a symptom diary for 2 or 3 months will help in
confirming a diagnosis of PMS. The nurse should not implement interventions for PMS
until a diagnosis is made. DIF: Cognitive Level: Apply (application) REF: 1244 TOP:
Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
7. A 19-yr-old patient has been diagnosed with primary dysmenorrhea. How will the
nurse suggest that the patient manage 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. -
ANSWERS ANS: D
NSAIDs should be started as soon as the menstrual period begins and taken at regular
intervals during the usual time frame when pain occurs. Aerobic exercise may help
reduce symptoms. Heat therapy, such as warm packs, is recommended for relief of
pain. Antidepressant therapy is not a typical treatment for dysmenorrhea.
8. A patient 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 patient's room and minimize disturbances.
d. Provide teaching about options for termination of the pregnancy. - ANSWERS ANS:
B
Because the patient is at risk for rupture of the fallopian tube and hemorrhage, frequent
monitoring of vital signs is needed. The patient has asked to be left alone, so staying
with her and encouraging her to discuss her feelings are inappropriate actions.
Minimizing contact with her and closing the door of the room is unsafe because of the
risk for hemorrhage. Because the patient has requested time to grieve, it would be
inappropriate to provide teaching about options for pregnancy termination.
Problems Lewis Question and Answers
/Already Graded A+
1. A 34-yr-old patient 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
accurate?
a. "If you do not become pregnant within the next few years, you never will."
b. "Women often have more difficulty becoming pregnant after about age 35."
c. "Stop taking oral contraceptives several years before you want to have a child."
d. "You have many more years of fertility left, so there is no rush to have children." -
ANSWERS ANS: B
The probability of successfully becoming pregnant decreases after age 35 years,
although some patients may have no difficulty in becoming pregnant. Oral
contraceptives do not need to be withdrawn for several years for a woman to become
pregnant. Although the patient may be fertile for many years, it would be inaccurate to
indicate that there is no concern about fertility as she becomes older. Although the risk
for infertility increases after age 35 years, not all patients have difficulty in conceiving.
DIF: Cognitive Level: Apply (application) REF: 1242 TOP: Nursing Process:
Implementation MSC: NCLEX: Health Promotion and Maintenance
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 husband's 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 - ANSWERS ANS: C
The statements made by the couple are consistent with the diagnosis of defensive
coping. No data indicate that ineffective sexuality and ineffective denial are problems.
Although the couple is quarreling about finances, the data do not provide information
indicating that the finances are inadequate.
DIF: Cognitive Level: Apply (application) REF: 1243 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Psychosocial Integrity
(Page 519).
3. A young 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 can 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. -
ANSWERS ANS: B
Ovulation prediction kits indicate when luteinizing hormone (LH) levels first rise.
Ovulation occurs about 28 to 36 hours after the first rise of LH. This information can be
used to determine the best time for intercourse. Body temperature rises at ovulation.
Postcoital cervical smears are used in infertility testing, but they do not predict the best
time for conceiving and are not obtained by the patient. Determination of the time of
ovulation can be predicted by basal body temperature charts or ovulation prediction kits
and is not dependent on regular menstrual periods.
DIF: Cognitive Level: Apply (application) REF: 1243 TOP: Nursing Process:
Implementation MSC: NCLEX: Health Promotion and Maintenance
.
4. A patient has an induced abortion with suction curettage at an ambulatory surgical
center. Which instructions will the nurse include when discharging the patient?
a. "Avoid contraceptives until your reexamination."
b. "Heavy vaginal bleeding is expected for 2 weeks."
c. "Abstain from sexual intercourse for the next 2 weeks."
d. "Irregular menstrual periods are expected for a few months." - ANSWERS ANS: C
Because infection is a possible complication of this procedure, the patient is advised to
avoid intercourse until the reexamination in 2 weeks. Patients may be started on
contraceptives on the day of the procedure. The patient should call the doctor if heavy
vaginal bleeding occurs. No change in the regularity of the menstrual periods is
expected.
DIF: Cognitive Level: Apply (application) REF: 1243 TOP: Nursing Process:
Implementation MSC: NCLEX: Health Promotion and Maintenance
5.A patient 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. - ANSWERS ANS:
B
Uterine contractions take 12 to 36 hours to begin after the hypertonic saline is instilled.
Because the saline is feticidal, the nurse does not need to discuss any possibility of a
live delivery or that the pregnancy termination will not be successful. General
anesthesia is not needed for this procedure.
, DIF: Cognitive Level: Apply (application) REF: 1244 TOP: Nursing Process:
Implementation MSC: NCLEX: Health Promotion and Maintenance
6. A 28-yr-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 to control symptoms. - ANSWERS ANS: A
The patient's symptoms indicate possible PMS, but they also may be associated with
other diagnoses. Having the patient keep a symptom diary for 2 or 3 months will help in
confirming a diagnosis of PMS. The nurse should not implement interventions for PMS
until a diagnosis is made. DIF: Cognitive Level: Apply (application) REF: 1244 TOP:
Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance
7. A 19-yr-old patient has been diagnosed with primary dysmenorrhea. How will the
nurse suggest that the patient manage 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. -
ANSWERS ANS: D
NSAIDs should be started as soon as the menstrual period begins and taken at regular
intervals during the usual time frame when pain occurs. Aerobic exercise may help
reduce symptoms. Heat therapy, such as warm packs, is recommended for relief of
pain. Antidepressant therapy is not a typical treatment for dysmenorrhea.
8. A patient 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 patient's room and minimize disturbances.
d. Provide teaching about options for termination of the pregnancy. - ANSWERS ANS:
B
Because the patient is at risk for rupture of the fallopian tube and hemorrhage, frequent
monitoring of vital signs is needed. The patient has asked to be left alone, so staying
with her and encouraging her to discuss her feelings are inappropriate actions.
Minimizing contact with her and closing the door of the room is unsafe because of the
risk for hemorrhage. Because the patient has requested time to grieve, it would be
inappropriate to provide teaching about options for pregnancy termination.
