Chapter 11: Structural Disorders and Neoplasms of the Reproductive System Lowdermilk: Maternity & Women’s Health Care, 11th Edition

TEST BANK FOR MATERNITY & WOMEN’S HEALTH CARE 11TH EDITION BY LOWDERMILK Chapter 11: Structural Disorders and Neoplasms of the Reproductive System Lowdermilk: Maternity & Women’s Health Care, 11th Edition MULTIPLE CHOICE 1. The nurse should be aware that a pessary is most effective in the treatment of which disorder? a. Cystocele b. Uterine prolapse c. Rectocele d. Stress urinary incontinence CORRECT ANSWER: B A fitted pessary may be inserted into the vagina to support the uterus and hold it in the correct position. Usually a pessary is used for only a short time and is not used for the client with a cystocele. A rectocele cannot be corrected by the use of a pessary. A pessary is not likely the most effective treatment for stress incontinence. DIF: Cognitive Level: Remember REF: p. 235 TOP: Nursing Process: Diagnosis MSC: Client Needs: Health Promotion and Maintenance 2. A postmenopausal woman has been diagnosed with two leiomyomas (fibroids). Which clinical finding is most commonly associated with the presence of leiomyomas? a. Abnormal uterine bleeding b. Diarrhea c. Weight loss d. Acute abdominal pain CORRECT ANSWER: A Most women are asymptomatic. Abnormal uterine bleeding is the most common symptom of leiomyomas. Diarrhea is not commonly associated with leiomyomas. Weight loss does not usually occur in the woman with leiomyomas, and the client with leiomyomas is unlikely to experience abdominal pain. DIF: Cognitive Level: Understand REF: p. 240 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity 3. Which woman is at the greatest risk for psychologic complications after hysterectomy? a. 55-year-old woman who has been having abnormal bleeding and pain for 3 years b. 46-year-old woman who has had three children and has just been promoted at work c. 62-year-old widow who has three friends who have had uncomplicated hysterectomies d. 19-year-old woman who had a ruptured uterus after giving birth to her first child CORRECT ANSWER: D The 19-year-old woman is still in her childbearing years. Often the uterus is related to self-concept in women in this age group, and they may feel that sexual functioning is related to having a uterus. The 55-year-old woman is past her childbearing years and has had bleeding and pain for 3 years. The hysterectomy may be well received as a method of pain relief. The 46-year-old woman has a family and positive events occurring in her life (job promotion). The 62-year-old woman is past her reproductive years and has relationships with others who have had positive outcomes. DIF: Cognitive Level: Understand REF: p. 243 TOP: Nursing Process: Diagnosis MSC: Client Needs: Psychosocial Integrity 4. A 48-year-old woman has just had a hysterectomy for endometrial cancer. Which statement alerts the nurse that further teaching is needed? a. ―I can‘t wait to go on the cruise that I have planned for this summer.‖ b. ―I know that the surgery saved my life, but I will miss having sexual intercourse with my husband.‖ c. ―I have asked my daughter to come and stay with me next week after I am discharged from the hospital.‖ d. ―Well, I don‘t have to worry about getting pregnant anymore.‖ CORRECT ANSWER: B Stating that she will miss having sexual intercourse with her husband indicates that further teaching is needed for this client regarding sexual activities after a hysterectomy. Although intercourse may be initially uncomfortable, the use of water-soluble lubricants, relaxation exercises, and changes in position may be helpful. Expressing plCORRECT ANSWER for a vacation is a positive psychologic state with plCORRECT ANSWER for the future. Stating that her daughter will stay with herindicates the client understands that she may need assistance during her acute recovery period.Stating that she no longer needs to worry about getting pregnant indicates knowledge related to the reproductive cycle and a positive outlook. DIF: Cognitive Level: Apply REF: p. 244 TOP: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 5. The nurse provides education to a client about to undergo external radiation therapy. Which statement by the client reassures the nurse that the teaching has been effective? a. ―I am using ointment to keep my skin from drying out.‖ b. ―I wash the irradiated area with deodorant soap.‖ c. ―My diet is high in protein, and I drink at least 2000 ml of fluid a day.‖ d. ―I wash off the markings for the radiation site after each treatment.‖ CORRECT ANSWER: C To maintain good nutrition, the woman should eat high-protein meals or use protein supplements and should have a high daily fluid intake of 2 to 3 L. The woman is counseled about good skin care and taught to avoid soaps, ointments, cosmetics, and deodorants because these may contain metals that would alter the radiation dose she receives. Markings may be made to indicate the exact location needed for irradiation and should remain until the treatment is complete. DIF: Cognitive Level: Understand REF: p. 253 TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity