Chapter 53: Nursing Assessment: Reproductive System:
Lewis’s Medical-Surgical Nursing, 5th Edition
1. The nurse is admitting a young adult female patient to the emergency department
after an automobile accident and is scheduled for abdominal x-rays. Which of the
following information is most important to report to the health care provider before the
x-rays are obtained?
A. Abdominal pain
B. Positive hCG testing
C. Temperature 38.9°C (102°F)
D. Blood pressure 172/88 mm Hg
Answer: B
Explanation: A positive hCG test indicates pregnancy. To protect the fetus from potential
radiation exposure, non-essential x-rays should be avoided, and alternative imaging
considered. The other findings are important but do not directly influence the decision to
proceed with x-rays in the same way.
2. The nurse is providing teaching a patient who has been treated for pelvic
inflammatory disease. Which of the following information should the nurse teach the
patient about?
A. Irregularities in the menstrual cycle
B. Changes in secondary sex characteristics
C. Possible difficulty with becoming pregnant
D. Use of hormone replacement therapy (HRT)
Answer: C
Explanation: Pelvic inflammatory disease may cause scarring of the fallopian tubes, leading
to difficulty with fertilization or implantation. Ovarian function is typically not affected, so
HRT, menstrual irregularities, and changes in secondary sex characteristics are not expected
outcomes.
3. The nurse is assessing a patient in the Sexual Health Clinic who has a positive
Venereal Disease Research Laboratory (VDRL) test, but no chancre is noted. The nurse
should plan to send the specimens for which of the following tests?
A. Gram stain
B. Cytological studies
C. Rapid plasma reagin (RPR) agglutination
D. Fluorescent treponemal antibody absorption (FTA-ABS)
Answer: D
Explanation: The FTA-ABS test is a treponemal-specific test used to confirm a syphilis
,diagnosis after a positive non-treponemal screening test like VDRL or RPR, especially when
false positives are suspected. Gram stain and cytology are for other STIs or cell
abnormalities.
4. Which of the following questions should the nurse ask when assessing a patient who
has a history of benign prostatic hyperplasia (BPH)?
A. "Have you noticed any unusual discharge from your penis?"
B. "Has there been any change in your sex life in the last year?"
C. "Do you find it hard to initiate your urinary stream?"
D. "Have you been experiencing any difficulty in achieving an erection?"
Answer: C
Explanation: Enlargement of the prostate blocks the urethra, leading to urinary changes such
as retention and difficulty initiating the urinary stream. The other questions address infection
or sexual difficulties, which are not the primary functional changes caused by BPH.
5. The nurse is performing a physical assessment on a male patient and obtains this
information. Which of the following findings is most important to report to the health
care provider?
A. One testis hangs lower than the other.
B. Inguinal lymph nodes are nonpalpable.
C. Genital hair distribution is diamond shaped.
D. Clear penile discharge is present at the meatus.
Answer: D
Explanation: Clear penile discharge is abnormal and can be a symptom of a sexually
transmitted infection (e.g., urethritis), requiring further investigation. The other findings are
normal male anatomical variations.
6. The nurse is assessing a male patient who is taking the following medications and tells
the nurse that he has had difficulty in achieving an erection. Which of the following
medications may cause erectile dysfunction (ED)?
A. Atorvastatin
B. Metformin
C. Propranolol
D. Ranitidine
Answer: C
Explanation: Propranolol, a beta-blocker used for hypertension, is known to cause erectile
dysfunction as a side effect. The other medications (a statin, metformin, and an H2 blocker)
are not typically associated with ED.
,7. A patient calls the clinic because of an unusually heavy menstrual flow. She tells the
nurse that she has saturated two tampons in the past 2 hours. Which of the following
amounts of blood loss should the nurse estimate from the patients information?
A. 10--20 mL
B. 20--30 mL
C. 30--40 mL
D. 40--60 mL
Answer: D
Explanation: A standard tampon can absorb approximately 20–30 mL of fluid. Saturation of
two tampons in two hours equates to an estimated blood loss of 40–60 mL, which is a
significant volume and indicates menorrhagia.
8. The nurse is preparing a patient for colposcopy with a cervical biopsy. Which of the
following information should the nurse explain to the patient about the procedure?
A. It involves dilation of the cervix and biopsy of the tissue lining the uterus.
B. It will take place in a same-day-surgery centre so that local anesthesia can be used.
C. It requires that the patient have nothing to eat or drink for 6 hours before the procedure.
D. It is similar to a speculum examination of the cervix and should result in little or no pain.
Answer: D
Explanation: Colposcopy is an outpatient procedure that visualizes the cervix with a
microscope, similar to a speculum exam. A cervical biopsy may cause minor discomfort but
is generally well-tolerated. The other options describe different procedures like dilation and
curettage (D&C).
9. The nurse is assessing an older-adult male patient and the patient says that he does
not respond to sexual stimulation the way he did when he was younger. Which of the
following responses to the patient's comment is best?
A. "Many men need more sexual stimulation with aging."
B. "Interest in sex frequently decreases as men get older."
C. "Erectile dysfunction is a common problem with older men."
D. "Tell me more about how your sexual response has changed."
Answer: D
Explanation: The nurse's initial response should be to further assess the patient's specific
concerns. The other statements may be accurate but do not address the patient's individual
experience or encourage open communication.
10. When scheduling a pelvic examination and Pap test for a patient, which of the
following instructions should the nurse include when preparing the patient?
A. Shower, but not a tub bath, before the examination.
B. Do not have sexual intercourse the day before the Pap test.
, C. Plan to have the Pap test just after her menstrual period.
D. Avoid douching for at least 24 hours before the examination.
Answer: D
Explanation: Douching can affect Pap test results by washing away cellular material or
masking abnormalities. The exam is not dependent on menstrual timing, and bathing or
sexual intercourse does not typically impact the results.
11. The following patients call the outpatient clinic. Which phone call should the nurse
return first?
A. A patient who has severe breast tenderness following a breast biopsy
B. A patient who has bloody discharge after a hysteroscopy earlier today
C. A patient who is complaining of dyspnea after a pelvic computed tomography (CT) with
contrast
D. A patient who is experiencing shoulder pain after a laparoscopy yesterday
Answer: C
Explanation: Dyspnea following a contrast CT scan is a potential sign of a serious allergic
reaction or contrast-induced pulmonary complication, which requires immediate assessment.
The other symptoms are common and expected after the respective procedures.
12. The nurse is assessing the sexual-reproductive functional health pattern for a
patient. Which of the following questions is most useful in determining the patient's
sexual orientation and risk factors?
A. "Do you have sex with men, women, or both?"
B. "Which gender do you prefer to have sex with?"
C. "What types of sexual activities do you prefer?"
D. "Are you heterosexual, homosexual, or bisexual?"
Answer: A
Explanation: This question is direct, non-judgmental, and effectively identifies the patient's
sexual partners, which is crucial for assessing specific health risks. It avoids assumptions
about identity or preference that might not reflect actual behavior.
13. A couple who has not been able to conceive is scheduled for a Postcoital test for
infertility. Which of the following information should the nurse provide to the couple in
preparation for the test?
A. Possible shoulder pain after the procedure
B. Sedative medications used during the procedure
C. Ways to determine the estimated time of ovulation
D. How long to refrain from intercourse before the test
Answer: C
Explanation: The Postcoital test requires intercourse to occur near the time of ovulation. The
Lewis’s Medical-Surgical Nursing, 5th Edition
1. The nurse is admitting a young adult female patient to the emergency department
after an automobile accident and is scheduled for abdominal x-rays. Which of the
following information is most important to report to the health care provider before the
x-rays are obtained?
A. Abdominal pain
B. Positive hCG testing
C. Temperature 38.9°C (102°F)
D. Blood pressure 172/88 mm Hg
Answer: B
Explanation: A positive hCG test indicates pregnancy. To protect the fetus from potential
radiation exposure, non-essential x-rays should be avoided, and alternative imaging
considered. The other findings are important but do not directly influence the decision to
proceed with x-rays in the same way.
2. The nurse is providing teaching a patient who has been treated for pelvic
inflammatory disease. Which of the following information should the nurse teach the
patient about?
A. Irregularities in the menstrual cycle
B. Changes in secondary sex characteristics
C. Possible difficulty with becoming pregnant
D. Use of hormone replacement therapy (HRT)
Answer: C
Explanation: Pelvic inflammatory disease may cause scarring of the fallopian tubes, leading
to difficulty with fertilization or implantation. Ovarian function is typically not affected, so
HRT, menstrual irregularities, and changes in secondary sex characteristics are not expected
outcomes.
3. The nurse is assessing a patient in the Sexual Health Clinic who has a positive
Venereal Disease Research Laboratory (VDRL) test, but no chancre is noted. The nurse
should plan to send the specimens for which of the following tests?
A. Gram stain
B. Cytological studies
C. Rapid plasma reagin (RPR) agglutination
D. Fluorescent treponemal antibody absorption (FTA-ABS)
Answer: D
Explanation: The FTA-ABS test is a treponemal-specific test used to confirm a syphilis
,diagnosis after a positive non-treponemal screening test like VDRL or RPR, especially when
false positives are suspected. Gram stain and cytology are for other STIs or cell
abnormalities.
4. Which of the following questions should the nurse ask when assessing a patient who
has a history of benign prostatic hyperplasia (BPH)?
A. "Have you noticed any unusual discharge from your penis?"
B. "Has there been any change in your sex life in the last year?"
C. "Do you find it hard to initiate your urinary stream?"
D. "Have you been experiencing any difficulty in achieving an erection?"
Answer: C
Explanation: Enlargement of the prostate blocks the urethra, leading to urinary changes such
as retention and difficulty initiating the urinary stream. The other questions address infection
or sexual difficulties, which are not the primary functional changes caused by BPH.
5. The nurse is performing a physical assessment on a male patient and obtains this
information. Which of the following findings is most important to report to the health
care provider?
A. One testis hangs lower than the other.
B. Inguinal lymph nodes are nonpalpable.
C. Genital hair distribution is diamond shaped.
D. Clear penile discharge is present at the meatus.
Answer: D
Explanation: Clear penile discharge is abnormal and can be a symptom of a sexually
transmitted infection (e.g., urethritis), requiring further investigation. The other findings are
normal male anatomical variations.
6. The nurse is assessing a male patient who is taking the following medications and tells
the nurse that he has had difficulty in achieving an erection. Which of the following
medications may cause erectile dysfunction (ED)?
A. Atorvastatin
B. Metformin
C. Propranolol
D. Ranitidine
Answer: C
Explanation: Propranolol, a beta-blocker used for hypertension, is known to cause erectile
dysfunction as a side effect. The other medications (a statin, metformin, and an H2 blocker)
are not typically associated with ED.
,7. A patient calls the clinic because of an unusually heavy menstrual flow. She tells the
nurse that she has saturated two tampons in the past 2 hours. Which of the following
amounts of blood loss should the nurse estimate from the patients information?
A. 10--20 mL
B. 20--30 mL
C. 30--40 mL
D. 40--60 mL
Answer: D
Explanation: A standard tampon can absorb approximately 20–30 mL of fluid. Saturation of
two tampons in two hours equates to an estimated blood loss of 40–60 mL, which is a
significant volume and indicates menorrhagia.
8. The nurse is preparing a patient for colposcopy with a cervical biopsy. Which of the
following information should the nurse explain to the patient about the procedure?
A. It involves dilation of the cervix and biopsy of the tissue lining the uterus.
B. It will take place in a same-day-surgery centre so that local anesthesia can be used.
C. It requires that the patient have nothing to eat or drink for 6 hours before the procedure.
D. It is similar to a speculum examination of the cervix and should result in little or no pain.
Answer: D
Explanation: Colposcopy is an outpatient procedure that visualizes the cervix with a
microscope, similar to a speculum exam. A cervical biopsy may cause minor discomfort but
is generally well-tolerated. The other options describe different procedures like dilation and
curettage (D&C).
9. The nurse is assessing an older-adult male patient and the patient says that he does
not respond to sexual stimulation the way he did when he was younger. Which of the
following responses to the patient's comment is best?
A. "Many men need more sexual stimulation with aging."
B. "Interest in sex frequently decreases as men get older."
C. "Erectile dysfunction is a common problem with older men."
D. "Tell me more about how your sexual response has changed."
Answer: D
Explanation: The nurse's initial response should be to further assess the patient's specific
concerns. The other statements may be accurate but do not address the patient's individual
experience or encourage open communication.
10. When scheduling a pelvic examination and Pap test for a patient, which of the
following instructions should the nurse include when preparing the patient?
A. Shower, but not a tub bath, before the examination.
B. Do not have sexual intercourse the day before the Pap test.
, C. Plan to have the Pap test just after her menstrual period.
D. Avoid douching for at least 24 hours before the examination.
Answer: D
Explanation: Douching can affect Pap test results by washing away cellular material or
masking abnormalities. The exam is not dependent on menstrual timing, and bathing or
sexual intercourse does not typically impact the results.
11. The following patients call the outpatient clinic. Which phone call should the nurse
return first?
A. A patient who has severe breast tenderness following a breast biopsy
B. A patient who has bloody discharge after a hysteroscopy earlier today
C. A patient who is complaining of dyspnea after a pelvic computed tomography (CT) with
contrast
D. A patient who is experiencing shoulder pain after a laparoscopy yesterday
Answer: C
Explanation: Dyspnea following a contrast CT scan is a potential sign of a serious allergic
reaction or contrast-induced pulmonary complication, which requires immediate assessment.
The other symptoms are common and expected after the respective procedures.
12. The nurse is assessing the sexual-reproductive functional health pattern for a
patient. Which of the following questions is most useful in determining the patient's
sexual orientation and risk factors?
A. "Do you have sex with men, women, or both?"
B. "Which gender do you prefer to have sex with?"
C. "What types of sexual activities do you prefer?"
D. "Are you heterosexual, homosexual, or bisexual?"
Answer: A
Explanation: This question is direct, non-judgmental, and effectively identifies the patient's
sexual partners, which is crucial for assessing specific health risks. It avoids assumptions
about identity or preference that might not reflect actual behavior.
13. A couple who has not been able to conceive is scheduled for a Postcoital test for
infertility. Which of the following information should the nurse provide to the couple in
preparation for the test?
A. Possible shoulder pain after the procedure
B. Sedative medications used during the procedure
C. Ways to determine the estimated time of ovulation
D. How long to refrain from intercourse before the test
Answer: C
Explanation: The Postcoital test requires intercourse to occur near the time of ovulation. The
