Lewis Test Bank
Study online at https://quizlet.com/_9xx1d1
1. The nurse in the women's health clinic has four patients who are waiting
to be seen. Which patient should the nurse see FIRST?: a. 22-year-old with
persistent red-brown vaginal drainage 3 days after having balloon thermotherapy
b. 42-year-old with secondary amenorrhea who says that her last menstrual cycle
was 3 months ago
c. 35-year-old with heavy spotting after having a progestin-containing IUD (Mirena)
inserted a month ago
D. 19-year-old with menorrhagia who has been using superabsorbent tampons and
has fever with weakness Rational:
The patients history and clinical manifestations suggest possible toxic shock syn-
drome, which will require rapid intervention. The symptoms for the other patients are
consistent with their diagnoses and do not indicate life-threatening complications.
2. A healthy 28-year-old who has been vaccinated against human papillo-
mavirus (HPV) has a normal Pap test. Which information will the nurse include
in patient teaching when calling the patient with the results of the Pap test?-
: Pap testing is recommended every 3 years for women your age.
3. To prevent pregnancy in a patient who has been sexually assaulted, the
nurse in the emergency department will plan to teach the patient about the
use of: levonorgestrel (Plan-B One-Step).
Rational:
Plan B One-Step reduces the risk of pregnancy when taken within 72 hours of inter-
course. The other methods are used for therapeutic abortion, but not for pregnancy
prevention after unprotected intercourse.
4. A 22-year-old tells the nurse that she has not had a menstrual period for
the last 2 months. Which action is MOST important for the nurse to take?: A.
Obtain a urine specimen for a pregnancy test.
b. Ask about any recent stressful lifestyle changes.
c. Measure the patients current height and weight.
d. Question the patient about prescribed medications. Rational:
Pregnancy should always be considered a possible cause of amenorrhea in women
of childbearing age. The other actions are also appropriate, but it is important to
check for pregnancy in this patient because pregnancy will require rapid implemen-
tation of actions to promote normal fetal development such as changes in lifestyle,
folic acid intake, etc.
5. Which information will the nurse include when teaching a patient who
has developed a small vesicovaginal fistula 2 weeks into the postpartum
period?: a. Take stool softeners to prevent fecal contamination of the vagina.
b. Limit oral fluid intake to minimize the quantity of urinary drainage.
C. Change the perineal pad frequently to prevent perineal skin breakdown.
, Lewis Test Bank
Study online at https://quizlet.com/_9xx1d1
d. Call the health care provider immediately if urine drains from the vagina.
Rational:
Because urine will leak from the bladder, the patient should plan to use perineal
pads and change them frequently. A high fluid intake is recommended to decrease
the risk for urinary tract infections. Drainage of urine from the vagina is expected
with vesicovaginal fistulas. Fecal contamination is not a concern with vesicovaginal
fistulas.
6. The nurse has just received change-of-shift report about the following four
patients. Which patient should be assessed FIRST?: a. A patient with a cervical
radium implant in place who is crying in her room
b. A patient who is complaining of 5/10 pain after an abdominal hysterectomy
C. A patient with a possible ectopic pregnancy who is complaining of shoulder pain
d. A patient in the fifteenth week of gestation who has uterine cramping and spotting
Rational:
The patient with the ectopic pregnancy has symptoms consistent with rupture and
needs immediate assessment for signs of hemorrhage and possible transfer to
surgery. The other patients should also be assessed as quickly as possible but do
not have symptoms of life-threatening complications
7. A 27-year-old patient tells the nurse that she would like a prescription for
oral contraceptives to control her premenstrual dysphoric disorder (PMD-D)
symptoms. Which patient information is MOST important to communicate to
the health care provider?: a. Bilateral breast tenderness
b. Frequent abdominal bloating
C. History of migraine headaches
d. Previous spontaneous abortion
Rational:
Oral contraceptives are contraindicated in patients with a history of migraine
headaches. The other patient information would not prevent the patient from receiv-
ing oral contraceptives.
8. The nurse notes that a patient who has a large cystocele, admitted 10 hours
ago, has not yet voided. Which action should the nurse take FIRST?: a. Insert
a straight catheter per the PRN order.
b. Encourage the patient to increase oral fluids.
c. Notify the health care provider of the inability to void. D. Use an ultrasound scanner
to check for urinary retention.
Rational:
Because urinary retention is common with a large cystocele, the nurses first action
should be to use an ultrasound bladder scanner to check for the presence of urine
Study online at https://quizlet.com/_9xx1d1
1. The nurse in the women's health clinic has four patients who are waiting
to be seen. Which patient should the nurse see FIRST?: a. 22-year-old with
persistent red-brown vaginal drainage 3 days after having balloon thermotherapy
b. 42-year-old with secondary amenorrhea who says that her last menstrual cycle
was 3 months ago
c. 35-year-old with heavy spotting after having a progestin-containing IUD (Mirena)
inserted a month ago
D. 19-year-old with menorrhagia who has been using superabsorbent tampons and
has fever with weakness Rational:
The patients history and clinical manifestations suggest possible toxic shock syn-
drome, which will require rapid intervention. The symptoms for the other patients are
consistent with their diagnoses and do not indicate life-threatening complications.
2. A healthy 28-year-old who has been vaccinated against human papillo-
mavirus (HPV) has a normal Pap test. Which information will the nurse include
in patient teaching when calling the patient with the results of the Pap test?-
: Pap testing is recommended every 3 years for women your age.
3. To prevent pregnancy in a patient who has been sexually assaulted, the
nurse in the emergency department will plan to teach the patient about the
use of: levonorgestrel (Plan-B One-Step).
Rational:
Plan B One-Step reduces the risk of pregnancy when taken within 72 hours of inter-
course. The other methods are used for therapeutic abortion, but not for pregnancy
prevention after unprotected intercourse.
4. A 22-year-old tells the nurse that she has not had a menstrual period for
the last 2 months. Which action is MOST important for the nurse to take?: A.
Obtain a urine specimen for a pregnancy test.
b. Ask about any recent stressful lifestyle changes.
c. Measure the patients current height and weight.
d. Question the patient about prescribed medications. Rational:
Pregnancy should always be considered a possible cause of amenorrhea in women
of childbearing age. The other actions are also appropriate, but it is important to
check for pregnancy in this patient because pregnancy will require rapid implemen-
tation of actions to promote normal fetal development such as changes in lifestyle,
folic acid intake, etc.
5. Which information will the nurse include when teaching a patient who
has developed a small vesicovaginal fistula 2 weeks into the postpartum
period?: a. Take stool softeners to prevent fecal contamination of the vagina.
b. Limit oral fluid intake to minimize the quantity of urinary drainage.
C. Change the perineal pad frequently to prevent perineal skin breakdown.
, Lewis Test Bank
Study online at https://quizlet.com/_9xx1d1
d. Call the health care provider immediately if urine drains from the vagina.
Rational:
Because urine will leak from the bladder, the patient should plan to use perineal
pads and change them frequently. A high fluid intake is recommended to decrease
the risk for urinary tract infections. Drainage of urine from the vagina is expected
with vesicovaginal fistulas. Fecal contamination is not a concern with vesicovaginal
fistulas.
6. The nurse has just received change-of-shift report about the following four
patients. Which patient should be assessed FIRST?: a. A patient with a cervical
radium implant in place who is crying in her room
b. A patient who is complaining of 5/10 pain after an abdominal hysterectomy
C. A patient with a possible ectopic pregnancy who is complaining of shoulder pain
d. A patient in the fifteenth week of gestation who has uterine cramping and spotting
Rational:
The patient with the ectopic pregnancy has symptoms consistent with rupture and
needs immediate assessment for signs of hemorrhage and possible transfer to
surgery. The other patients should also be assessed as quickly as possible but do
not have symptoms of life-threatening complications
7. A 27-year-old patient tells the nurse that she would like a prescription for
oral contraceptives to control her premenstrual dysphoric disorder (PMD-D)
symptoms. Which patient information is MOST important to communicate to
the health care provider?: a. Bilateral breast tenderness
b. Frequent abdominal bloating
C. History of migraine headaches
d. Previous spontaneous abortion
Rational:
Oral contraceptives are contraindicated in patients with a history of migraine
headaches. The other patient information would not prevent the patient from receiv-
ing oral contraceptives.
8. The nurse notes that a patient who has a large cystocele, admitted 10 hours
ago, has not yet voided. Which action should the nurse take FIRST?: a. Insert
a straight catheter per the PRN order.
b. Encourage the patient to increase oral fluids.
c. Notify the health care provider of the inability to void. D. Use an ultrasound scanner
to check for urinary retention.
Rational:
Because urinary retention is common with a large cystocele, the nurses first action
should be to use an ultrasound bladder scanner to check for the presence of urine
