Reproductive System Disorders NCLEX Practice Exam Quiz
Which of the following is a common symptom of prostate cancer?
A) Erectile dysfunction
B) Vaginal bleeding
C) Lower abdominal pain
D) Rapid weight loss
Which of the following conditions is most commonly associated with infertility in women?
A) Ovarian cysts
B) Polycystic ovary syndrome (PCOS)
C) Endometriosis
D) Pelvic inflammatory disease (PID)
A patient is diagnosed with endometriosis. What is a typical symptom of this condition?
A) Irregular periods
B) Painful intercourse
C) Unexplained weight loss
D) Increased appetite
A client with pelvic inflammatory disease (PID) should be educated to:
A) Avoid physical activity
B) Complete the entire course of prescribed antibiotics
C) Increase fluid intake to reduce symptoms
D) Avoid sexual activity until symptoms resolve
What is the first-line treatment for bacterial vaginosis (BV)?
A) Antifungal therapy
B) Oral antibiotics
C) Intravaginal estrogen therapy
D) Antiviral medications
A patient presents with painful urination, abnormal vaginal discharge, and lower abdominal pain. Which sexually transmitted infection (STI) is most likely?
A) Syphilis
B) Gonorrhea
C) Herpes simplex virus
D) Trichomoniasis
Which of the following is a risk factor for developing cervical cancer?
A) Multiple pregnancies
B) HPV infection
C) History of endometriosis
D) Use of hormonal contraceptives for less than one year
Which condition involves the growth of endometrial tissue outside the uterus?
A) Uterine fibroids
B) Polycystic ovary syndrome
C) Endometriosis
D) Ovarian cysts
A woman with polycystic ovary syndrome (PCOS) is at an increased risk for which of the following?
A) Diabetes
B) Hyperthyroidism
C) Ovarian cancer
D) Fibroids
A patient with a history of gestational diabetes is at increased risk of developing:
A) Type 1 diabetes
B) Type 2 diabetes
C) Hypoglycemia
D) Hypotension
What is a common side effect of oral contraceptives?
A) Weight loss
B) Nausea
C) Low blood pressure
D) Decreased risk of breast cancer
What is the primary goal of treatment for a patient diagnosed with fibroids?
A) Complete removal of the uterus
B) Hormonal therapy to shrink the fibroids
C) Radiation therapy
D) No treatment necessary unless symptomatic
Which of the following is a common complication of untreated chlamydia in women?
A) Ectopic pregnancy
B) Breast cancer
C) Ovarian cysts
D) Miscarriage
A patient with testicular cancer should be monitored for:
A) Increased appetite
B) Increased fatigue
C) Increased libido
D) Reduced sperm count
What is the treatment for a patient diagnosed with syphilis?
A) Oral antibiotics
B) Antiviral therapy
C) Topical steroids
D) Surgery
A pregnant woman experiencing sudden weight gain, headaches, and swelling may be at risk for:
A) Hyperemesis gravidarum
B) Preeclampsia
C) Gestational diabetes
D) Ectopic pregnancy
A patient diagnosed with HPV should be educated about the importance of:
A) Frequent Pap smears
B) Limiting physical activity
C) Avoiding sexual contact
D) Taking antibiotics
A client reports having painful menstrual periods with heavy bleeding. The nurse suspects:
A) Ovarian cysts
B) Uterine fibroids
C) Endometriosis
D) Pelvic inflammatory disease
Which of the following can increase the risk of breast cancer?
A) Family history of ovarian cancer
B) Prolonged use of hormonal contraception
C) Early menopause
D) Low-fat diet
A woman in the third trimester of pregnancy is complaining of burning with urination and pelvic discomfort. What should the nurse suspect?
A) Vaginal infection
B) Urinary tract infection (UTI)
C) Preterm labor
D) Gallbladder disease
Which of the following is a symptom of a urinary tract infection (UTI) in pregnancy?
A) Increased vaginal discharge
B) Painful urination
C) Elevated blood pressure
D) Abdominal cramping
Which is a common complication of untreated chlamydia in men?
A) Prostate cancer
B) Epididymitis
C) Penile discharge
D) Urinary retention
The most effective way to prevent the transmission of sexually transmitted infections is:
A) Using birth control pills
B) Abstaining from sexual activity
C) Using condoms
D) Taking antibiotics
A woman is diagnosed with oligomenorrhea. This condition is characterized by:
A) Absent menstrual periods
B) Heavy menstrual bleeding
C) Irregular menstrual cycles
D) Painful menstruation
A client with a history of spontaneous abortion should be monitored for:
A) High blood pressure
B) Future pregnancy complications
C) Chronic pelvic pain
D) Hyperthyroidism
Which of the following is a risk factor for cervical cancer?
A) High parity
B) HPV infection
C) Advanced age
D) Early menopause
What is a common symptom of endometrial cancer?
A) Increased vaginal discharge
B) Irregular bleeding between periods
C) Painful menstruation
D) Abdominal bloating
The recommended screening test for cervical cancer is:
A) Mammogram
B) Pap smear
C) Colonoscopy
D) MRI
A 35-year-old woman has a diagnosis of fibrocystic breast changes. She should be educated about:
A) Limiting alcohol consumption
B) The need for immediate breast biopsy
C) Regular breast self-examinations
D) Avoiding caffeine completely
Which of the following is a common treatment for menopause-related symptoms?
A) Antiviral medications
B) Hormone replacement therapy (HRT)
C) High-dose vitamin C
D) Antifungal therapy
31. A woman experiencing a missed period, nausea, and vomiting might be suspected of having:
A) Menstrual irregularities
B) Ectopic pregnancy
C) Ovarian cysts
D) Pelvic inflammatory disease
32. Which of the following conditions is most commonly associated with painful urination and pelvic pain in women?
A) Uterine fibroids
B) Pelvic inflammatory disease (PID)
C) Endometriosis
D) Polycystic ovary syndrome (PCOS)
33. Which of the following is a common symptom of menopause?
A) Irregular periods
B) Hot flashes
C) Increased appetite
D) Decreased urination
34. A 45-year-old woman with a history of heavy, prolonged menstrual bleeding is at risk for:
A) Uterine fibroids
B) Endometrial cancer
C) Polycystic ovary syndrome
D) Ovarian cysts
35. The nurse is providing teaching to a patient diagnosed with genital herpes. Which of the following is important for the nurse to include?
A) “You should avoid all physical activity while symptoms are present.”
B) “You can spread the infection even if you are not having an outbreak.”
C) “Once treated, genital herpes is completely curable.”
D) “You should only use antiviral medications during outbreaks.”
36. A woman with a history of breast cancer is prescribed tamoxifen. The nurse should monitor for which of the following side effects?
A) Weight loss
B) Hot flashes
C) Decreased bone density
D) Hair loss
37. A client with a history of recurrent miscarriage is being assessed for possible causes. Which of the following conditions could be a potential cause?
A) Polycystic ovary syndrome
B) Endometriosis
C) Hormonal imbalances
D) Uterine fibroids
38. The nurse is teaching a patient about the side effects of oral contraceptives. Which of the following should be included in the teaching?
A) “You may experience weight loss while taking the pill.”
B) “The pill may cause a decrease in libido.”
C) “You may experience mood changes or nausea.”
D) “There is no risk of blood clots with oral contraceptives.”
39. What is the most common cause of abnormal vaginal bleeding in postmenopausal women?
A) Cervical cancer
B) Uterine fibroids
C) Endometrial cancer
D) Polycystic ovary syndrome
40. Which of the following is a common symptom of a ruptured ovarian cyst?
A) Severe abdominal pain
B) Increased menstrual bleeding
C) Vaginal discharge
D) Difficulty swallowing
41. Which type of contraceptive is most appropriate for a woman with a history of blood clots?
A) Oral contraceptives
B) Copper intrauterine device (IUD)
C) Hormonal intrauterine device (IUD)
D) Depo-Provera injection
42. A patient diagnosed with testicular torsion presents with severe scrotal pain. What is the recommended intervention?
A) Bed rest and observation
B) Ice application to reduce swelling
C) Immediate surgical intervention to restore blood flow
D) Oral antibiotics to treat infection
43. Which of the following sexually transmitted infections is characterized by the presence of painless genital ulcers?
A) Gonorrhea
B) Syphilis
C) Trichomoniasis
D) Chlamydia
44. The nurse is caring for a patient with a diagnosis of ectopic pregnancy. The nurse should assess for:
A) Severe pelvic pain and vaginal bleeding
B) Lower back pain and mild cramping
C) Nausea and vomiting with weight gain
D) Abdominal bloating and constipation
45. What is the most appropriate nursing action for a patient diagnosed with fibroids who is experiencing heavy menstrual bleeding?
A) Administering antibiotics
B) Providing emotional support for anxiety
C) Educating the patient on possible surgical options
D) Encouraging iron supplements to prevent anemia
46. Which of the following is a common complication of untreated gonorrhea?
A) Pelvic inflammatory disease (PID)
B) Ovarian cysts
C) Endometriosis
D) Ovarian cancer
47. Which of the following is the primary purpose of hormone replacement therapy (HRT) during menopause?
A) To reduce the risk of heart disease
B) To regulate menstrual cycles
C) To reduce menopausal symptoms such as hot flashes and vaginal dryness
D) To prevent osteoporosis
48. Which of the following is an early sign of preeclampsia in pregnancy?
A) Severe abdominal pain
B) Persistent headache
C) Excessive weight loss
D) Sudden increase in fetal movement
49. A patient diagnosed with pelvic inflammatory disease (PID) is prescribed antibiotics. The nurse should include which of the following instructions in discharge teaching?
A) “You should avoid all sexual activity until treatment is completed.”
B) “You should take the antibiotics for at least one week after symptoms disappear.”
C) “The infection will go away on its own without treatment.”
D) “You should expect that the antibiotics will cause a decrease in menstrual flow.”
50. A patient with endometriosis is experiencing severe pelvic pain. Which of the following medications is most likely to be prescribed for pain management?
A) Nonsteroidal anti-inflammatory drugs (NSAIDs)
B) Antidepressants
C) Antiviral medications
D) Antifungal medications
51. Which of the following is a common risk factor for developing ovarian cancer?
A) Increased number of pregnancies
B) Early menopause
C) Family history of breast or ovarian cancer
D) Oral contraceptive use
52. What is the primary diagnostic test for detecting breast cancer?
A) MRI
B) Mammogram
C) Biopsy
D) Ultrasound
53. A patient presents with a clear, watery vaginal discharge and itching. Which condition should the nurse suspect?
A) Candidiasis
B) Bacterial vaginosis
C) Trichomoniasis
D) Chlamydia
54. A 35-year-old woman is diagnosed with infertility. Which of the following factors could contribute to her infertility?
A) Smoking
B) Regular exercise
C) Low caffeine intake
D) High-fat diet
55. Which of the following is an important consideration when caring for a patient receiving chemotherapy for ovarian cancer?
A) The patient should avoid all forms of physical activity.
B) The patient may experience hair loss and should be prepared for this.
C) The patient will be restricted from consuming any fluids during treatment.
D) The patient will need to be isolated from all visitors to avoid infection.
56. A patient undergoing a hysterectomy should be educated about:
A) The possibility of needing hormone therapy after surgery
B) The need for frequent Pap smears following surgery
C) The ability to become pregnant after surgery
D) The use of tampons to prevent infection
57. A 55-year-old woman is postmenopausal and reports vaginal dryness. Which of the following treatments should the nurse suggest?
A) Hormone replacement therapy (HRT)
B) Antibiotics
C) Oral contraceptives
D) Antiviral therapy
58. A client presents with a small, painless genital ulcer. Which STI should the nurse suspect?
A) Syphilis
B) Genital herpes
C) Chlamydia
D) Gonorrhea
59. A patient is prescribed the Depo-Provera injection for contraception. The nurse should educate the patient about the risk of:
A) Increased fertility after stopping the medication
B) Weight gain and potential bone density loss
C) Risk of ovarian cancer
D) Risk of cervical cancer
60. A patient diagnosed with a uterine fibroid is experiencing heavy menstrual bleeding. The nurse should anticipate that the patient will be treated with:
A) Hormonal therapy
B) Radiation therapy
C) Chemotherapy
D) Immunotherapy
61. Which of the following is a potential complication of untreated chlamydia infection in women?
A) Ovarian cysts
B) Pelvic inflammatory disease (PID)
C) Endometrial cancer
D) Ectopic pregnancy
62. A client presents with sudden, severe pelvic pain and vomiting. The nurse suspects ovarian torsion. What is the priority action?
A) Administer pain medication
B) Obtain a pelvic ultrasound
C) Perform a pelvic exam
D) Prepare the patient for surgery
63. Which of the following should be included in teaching for a patient undergoing a hysterectomy?
A) “You will be able to resume sexual activity within 2 weeks.”
B) “You will need to take hormone therapy for the rest of your life.”
C) “You will not be able to have children after this surgery.”
D) “You should expect normal menstrual cycles after recovery.”
64. A patient with polycystic ovary syndrome (PCOS) is at risk for which of the following long-term complications?
A) Infertility
B) Decreased testosterone levels
C) Increased risk of osteoporosis
D) Decreased risk of endometrial cancer
65. A patient is being treated for uterine fibroids. Which of the following treatments is most commonly used to manage this condition?
A) Radiation therapy
B) Hormonal therapy
C) Chemotherapy
D) Antiviral medications
66. A client diagnosed with vaginal cancer is experiencing pain during intercourse. Which of the following interventions should the nurse prioritize?
A) Administering pain medication before intercourse
B) Advising the client to avoid sexual activity completely
C) Suggesting the use of lubricants during intercourse
D) Recommending hormone replacement therapy
67. A 20-year-old woman presents with painful urination and a purulent discharge. The nurse suspects gonorrhea. What is the most appropriate initial diagnostic test?
A) Blood test
B) Urine culture
C) Pelvic ultrasound
D) Pap smear
68. Which of the following is a common symptom of a prolapsed uterus?
A) Severe abdominal pain
B) Painful urination
C) Pelvic pressure and urinary incontinence
D) Irregular vaginal bleeding
69. A client with a history of breast cancer is prescribed tamoxifen. Which of the following side effects should the nurse monitor for?
A) Hot flashes
B) Weight loss
C) Increased appetite
D) Hair growth
70. Which of the following statements about the human papillomavirus (HPV) vaccine is correct?
A) The vaccine is effective for both men and women.
B) The vaccine prevents all types of HPV.
C) The vaccine must be administered annually for full protection.
D) The vaccine is only recommended for those under 25.
71. A patient diagnosed with an ovarian cyst reports sudden, severe abdominal pain. The nurse suspects the cyst has ruptured. What is the priority nursing intervention?
A) Administering pain medication
B) Monitoring vital signs closely for signs of shock
C) Encouraging fluid intake
D) Preparing the patient for surgery
72. A 55-year-old woman is experiencing hot flashes and night sweats. Which treatment option should the nurse anticipate being recommended?
A) Antidepressants
B) Hormone replacement therapy (HRT)
C) Oral contraceptives
D) Antifungal medications
73. A client diagnosed with testicular cancer is scheduled for a radical orchiectomy. Which of the following is an important post-operative consideration?
A) Preventing respiratory complications
B) Ensuring that the client understands the possibility of infertility
C) Encouraging immediate return to physical activity
D) Restricting fluid intake to prevent edema
74. Which of the following is a common cause of secondary infertility in women?
A) Polycystic ovary syndrome (PCOS)
B) Endometrial cancer
C) Uterine fibroids
D) Pregnancy
75. A 30-year-old woman presents with sudden, sharp pelvic pain, and fainting. A ruptured ectopic pregnancy is suspected. Which is the priority intervention?
A) Administering pain medication
B) Preparing the patient for surgery
C) Encouraging fluid intake
D) Performing a pelvic ultrasound
76. A woman who has been diagnosed with cervical dysplasia is receiving cryotherapy. What should the nurse include in the teaching for this procedure?
A) “Expect bleeding for up to 2 weeks after the procedure.”
B) “There will be no pain associated with the procedure.”
C) “You can return to normal activity immediately.”
D) “You will need to take antibiotics after the procedure.”
77. The nurse is providing discharge instructions for a client following a mastectomy. Which of the following should be included?
A) “You will need to take antibiotics for the rest of your life.”
B) “You should avoid heavy lifting with your affected arm.”
C) “You can resume sexual activity immediately after surgery.”
D) “You should wear a bra with an underwire to support the breast.”
78. Which of the following is the most common cause of pelvic inflammatory disease (PID) in sexually active women?
A) Gonorrhea and chlamydia infections
B) Endometriosis
C) Uterine fibroids
D) Polycystic ovary syndrome (PCOS)
79. A patient is diagnosed with uterine fibroids. Which of the following symptoms is most commonly associated with this condition?
A) Painful intercourse
B) Severe menstrual bleeding
C) Vaginal dryness
D) Urinary retention
80. A woman with a history of hypertension and obesity is diagnosed with polycystic ovary syndrome (PCOS). What should be the nurse’s priority intervention?
A) Encouraging regular exercise
B) Educating the patient on dietary changes
C) Monitoring blood pressure regularly
D) Discussing fertility options
81. A woman undergoing chemotherapy for breast cancer reports vaginal dryness and discomfort. Which of the following interventions is appropriate?
A) Suggesting the use of vaginal lubricants
B) Recommending the use of tampons to prevent dryness
C) Advising the patient to avoid sexual activity
D) Recommending a hysterectomy
82. A woman with a history of recurrent yeast infections is prescribed fluconazole. What should the nurse include in the teaching?
A) “Complete the full course of medication even if symptoms improve.”
B) “Use tampons while taking the medication.”
C) “Discontinue all sexual activity while taking the medication.”
D) “The infection should resolve within 24 hours.”
83. Which of the following is the most common presenting symptom of endometrial cancer?
A) Irregular vaginal bleeding
B) Abdominal pain
C) Painful intercourse
D) Pelvic pressure
84. A woman undergoing radiation therapy for cervical cancer may experience which of the following side effects?
A) Weight loss and fatigue
B) Increased libido
C) Decreased menstrual bleeding
D) Reduced breast size
85. A patient with a history of endometriosis is considering pregnancy. The nurse should provide which of the following recommendations?
A) “You should consider in vitro fertilization.”
B) “It may take longer to conceive due to scar tissue formation.”
C) “Pregnancy will cure endometriosis.”
D) “You should avoid becoming pregnant for at least 2 years.”
86. A patient diagnosed with testicular cancer is about to undergo chemotherapy. Which of the following should be a priority nursing concern?
A) Loss of appetite
B) Risk of infertility
C) Increased risk of infection
D) Hair loss
87. A 45-year-old woman is experiencing difficulty with sexual arousal and vaginal dryness. Which of the following conditions should the nurse consider?
A) Menopause
B) Endometriosis
C) Polycystic ovary syndrome (PCOS)
D) Ovarian cancer
88. A patient is diagnosed with herpes simplex virus type 2 (HSV-2). Which of the following interventions should be included in the plan of care?
A) “You can transmit the virus even when no symptoms are present.”
B) “You should avoid any sexual activity for at least 6 months.”
C) “Once treated, you will never have another outbreak.”
D) “You should receive a vaccine to prevent outbreaks.”
89. The nurse is teaching a patient with a new diagnosis of HPV. Which of the following is important for the nurse to include in the teaching?
A) “The virus can be completely cured with medication.”
B) “You will need to be vaccinated against HPV to prevent future infections.”
C) “There is no cure for HPV, but the virus may go away on its own.”
D) “The infection always leads to cervical cancer.”
90. Which of the following is a typical finding in a patient with polycystic ovary syndrome (PCOS)?
A) Increased facial hair
B) Weight loss
C) Decreased insulin resistance
D) Increased estrogen levels
91. A patient with a history of uterine fibroids presents with heavy menstrual bleeding. What is the priority nursing action?
A) Administer pain medications
B) Monitor vital signs for signs of hypovolemic shock
C) Perform a pelvic examination
D) Schedule a hysterectomy
92. A 35-year-old woman is diagnosed with endometriosis. What is a common symptom associated with this condition?
A) Painful urination
B) Irregular vaginal bleeding
C) Chronic pelvic pain
D) Increased libido
93. A patient is being discharged after a hysterectomy. Which of the following should the nurse include in the discharge teaching?
A) “You may return to work in 2 weeks.”
B) “Expect a small amount of vaginal discharge for up to 6 weeks.”
C) “It is important to resume sexual activity within 2 weeks.”
D) “You should avoid all physical activity for 6 months.”
94. A patient is being treated for gonorrhea with antibiotics. Which of the following instructions should the nurse provide?
A) “You should inform your sexual partner and refrain from sexual activity until both partners have completed treatment.”
B) “You can continue with sexual activity as usual as long as you take your medication.”
C) “There is no need to notify your sexual partner, as gonorrhea is not contagious.”
D) “You will need to take the medication for 3 months to completely cure the infection.”
95. A patient is diagnosed with cervical dysplasia. Which of the following treatments is most commonly used for this condition?
A) Chemotherapy
B) Cryotherapy or laser therapy
C) Hysterectomy
D) Radiation therapy
96. A patient diagnosed with testicular cancer is scheduled for a radical orchiectomy. What should the nurse include in preoperative teaching?
A) “You will need to take testosterone supplements for life.”
B) “You may experience infertility after the procedure.”
C) “You will be able to father children immediately after surgery.”
D) “The procedure will result in a complete cure of cancer.”
97. A patient with polycystic ovary syndrome (PCOS) is being treated with oral contraceptives. Which of the following is the primary benefit of this treatment?
A) Increases fertility
B) Reduces androgenic symptoms such as acne and hirsutism
C) Prevents the development of ovarian cysts
D) Improves insulin sensitivity
98. A client diagnosed with a breast mass is scheduled for a mammogram. Which of the following is an important nursing consideration?
A) “You should avoid all physical activity for 24 hours before the test.”
B) “You should wear a loose-fitting bra for the test.”
C) “You should not wear deodorant or powder under your arms before the test.”
D) “The test is painful, but the discomfort is brief.”
99. A woman diagnosed with an ectopic pregnancy is being prepared for surgery. What is the priority nursing intervention?
A) Provide emotional support and answer questions
B) Monitor vital signs for signs of hypovolemic shock
C) Teach the patient about the surgical procedure
D) Encourage increased fluid intake
100. A patient is diagnosed with a Bartholin’s cyst. Which of the following is a common treatment for this condition?
A) Antifungal medication
B) Incision and drainage
C) Radiation therapy
D) Hormone therapy
101. A client is diagnosed with pelvic inflammatory disease (PID). Which of the following is a common symptom of PID?
A) Mild pelvic discomfort
B) Severe abdominal pain, fever, and vaginal discharge
C) Urinary retention
D) Increased appetite
102. A woman is receiving treatment for chlamydia. What is an important teaching point for the nurse to include?
A) “It is important to complete the full course of antibiotics even if symptoms disappear.”
B) “You should avoid all sexual activity for at least 2 months.”
C) “You will not be contagious after 1 week of treatment.”
D) “Chlamydia can be treated with over-the-counter medication.”
103. Which of the following is the most common cause of infertility in women?
A) Polycystic ovary syndrome (PCOS)
B) Endometriosis
C) Fibroids
D) Uterine cancer
104. A woman is experiencing hot flashes and vaginal dryness due to menopause. Which of the following treatment options should the nurse anticipate being recommended?
A) Estrogen therapy
B) Oral contraceptives
C) Antidepressants
D) Chemotherapy
105. A patient is diagnosed with uterine cancer. Which of the following is a common sign of uterine cancer?
A) Irregular vaginal bleeding
B) Severe abdominal pain
C) Loss of appetite
D) Weight gain
106. A patient with polycystic ovary syndrome (PCOS) has been prescribed metformin. What is the primary purpose of this medication for PCOS?
A) To increase fertility
B) To improve insulin sensitivity
C) To reduce testosterone levels
D) To shrink ovarian cysts
107. A woman with a history of multiple miscarriages is diagnosed with a luteal phase defect. What is the expected treatment for this condition?
A) Progesterone supplementation
B) Antibiotics
C) Oral contraceptives
D) Surgery to correct uterine abnormalities
108. A 60-year-old woman is undergoing a bone density scan due to a history of osteoporosis. Which of the following factors should the nurse consider when assessing risk for osteoporosis?
A) History of chronic corticosteroid use
B) Excessive exercise
C) High-fiber diet
D) Low cholesterol levels
109. A patient diagnosed with vaginal cancer is receiving radiation therapy. Which of the following side effects is most commonly associated with radiation therapy for vaginal cancer?
A) Increased libido
B) Vaginal dryness and irritation
C) Weight gain
D) Hair loss
110. A 35-year-old woman is considering becoming pregnant but is concerned about the potential risks of pregnancy due to her age. Which of the following should the nurse discuss with her?
A) “Women over 35 are at higher risk for pregnancy complications, but with proper care, many women have healthy pregnancies.”
B) “You should not attempt pregnancy until after the age of 40 to avoid complications.”
C) “Pregnancy is not recommended after the age of 35.”
D) “It is best to delay pregnancy until after menopause to reduce risks.”
111. A woman with a history of genital herpes is being treated with acyclovir. What should the nurse include in patient teaching regarding this medication?
A) “This medication will cure the infection permanently.”
B) “You will need to take this medication daily to prevent outbreaks.”
C) “You should take this medication only when you experience symptoms.”
D) “The medication may cause severe nausea, so you should take it with food.”
112. A client with a history of pelvic inflammatory disease (PID) asks the nurse about the long-term effects of this condition. Which of the following is a common long-term complication of PID?
A) Ovarian cysts
B) Chronic pelvic pain
C) Uterine cancer
D) Ectopic pregnancy
113. A woman with a family history of breast cancer is concerned about her risk. Which of the following is the most important factor in breast cancer prevention?
A) Routine mammograms after age 40
B) Annual breast self-examinations
C) Maintaining a healthy weight
D) Starting hormone replacement therapy at age 45
114. A 22-year-old woman presents with a vaginal discharge and painful urination. A urine culture confirms a diagnosis of gonorrhea. Which of the following is an appropriate intervention?
A) Prescribing antibiotics for the patient and all sexual partners
B) Prescribing antiviral medications
C) Instructing the patient to refrain from sexual activity for 1 month
D) Advising the patient to wait until symptoms resolve before starting treatment
115. A patient is diagnosed with a Bartholin’s cyst. What is the appropriate intervention?
A) Drainage and antibiotics
B) Chemotherapy
C) Hormonal therapy
D) Radiation therapy
116. A woman diagnosed with a yeast infection (candidiasis) is prescribed antifungal medication. What is the nurse’s most important teaching point for this patient?
A) “It is important to complete the full course of treatment even if symptoms disappear.”
B) “You should wait at least 2 weeks before resuming sexual activity.”
C) “The medication will cure the infection immediately.”
D) “Avoid using tampons during treatment.”
117. A client with polycystic ovary syndrome (PCOS) is struggling with infertility. Which treatment option is commonly used to induce ovulation in women with PCOS?
A) Oral contraceptives
B) Metformin
C) Clomiphene citrate
D) Intracytoplasmic sperm injection (ICSI)
118. A patient with a history of gestational diabetes is concerned about the possibility of developing type 2 diabetes later in life. What is the nurse’s best response?
A) “Gestational diabetes usually resolves after pregnancy, and your risk for type 2 diabetes is not increased.”
B) “You are at a higher risk for type 2 diabetes, so it’s important to maintain a healthy lifestyle and get regular screenings.”
C) “Gestational diabetes has no long-term impact on your health, so you need not worry about developing type 2 diabetes.”
D) “You will need to take insulin for the rest of your life.”
119. A woman presents with severe lower abdominal pain and a positive pregnancy test. An ultrasound reveals an ectopic pregnancy. What is the priority nursing intervention?
A) Prepare the patient for surgery
B) Administer pain medications
C) Administer methotrexate
D) Monitor for signs of hypovolemic shock
120. A patient diagnosed with a pelvic floor disorder is experiencing urinary incontinence. What is the most appropriate intervention?
A) Prescribe diuretics to reduce fluid retention
B) Encourage pelvic floor exercises (Kegel exercises)
C) Increase fluid intake to prevent dehydration
D) Instruct the patient to limit physical activity
121. A patient with breast cancer has undergone a mastectomy. What is an important post-operative consideration for the nurse?
A) “You should avoid all physical activity for 6 months.”
B) “Perform gentle arm exercises to prevent lymphedema.”
C) “Do not shower until the surgical incision has healed completely.”
D) “Wear tight clothing over the incision to prevent infection.”
122. A woman is undergoing a Pap smear. Which of the following instructions should the nurse give prior to the procedure?
A) “Avoid douching or using vaginal creams for 24 hours before the test.”
B) “Drink plenty of fluids to make the test more comfortable.”
C) “You should have a full bladder for this test.”
D) “Do not use a tampon for 1 week after the test.”
123. A patient with syphilis is being treated with penicillin. Which of the following statements indicates the need for further teaching?
A) “I should inform my partner to get tested and treated.”
B) “The medication should cure the infection completely.”
C) “I will stop the medication as soon as my symptoms go away.”
D) “I should avoid sexual activity until I complete the treatment.”
124. A patient with a history of recurrent urinary tract infections (UTIs) asks the nurse how to prevent them. Which response is most appropriate?
A) “Increase your fluid intake and wipe from back to front after using the toilet.”
B) “Wear cotton underwear and avoid tight-fitting clothing.”
C) “Drink cranberry juice daily and avoid using public restrooms.”
D) “Douche regularly to keep the vagina clean.”
125. A 50-year-old woman is experiencing menopausal symptoms, including hot flashes and night sweats. Which of the following is the most appropriate treatment?
A) Estrogen therapy
B) Increased caffeine intake
C) Antidepressants
D) Iron supplements
126. A patient diagnosed with an ovarian cyst is being monitored for complications. Which symptom would indicate the need for immediate medical attention?
A) Abdominal bloating
B) Painful urination
C) Severe, sharp pelvic pain
D) Mild fatigue
127. A woman is diagnosed with cervical cancer. Which of the following is the most common symptom of cervical cancer in its early stages?
A) Heavy menstrual bleeding
B) Pain during intercourse
C) Vaginal discharge with a foul odor
D) Abnormal vaginal bleeding or spotting
128. A client with endometrial cancer is undergoing radiation therapy. Which of the following side effects should the nurse monitor for during this treatment?
A) Nausea and vomiting
B) Vaginal dryness and irritation
C) Increased libido
D) Weight gain
129. A patient with fibroids is experiencing heavy menstrual bleeding. What is the most common surgical treatment for fibroids?
A) Hysterectomy
B) Myomectomy
C) Endometrial ablation
D) Oophorectomy
130. A patient is scheduled for a hysterectomy. What is the priority preoperative nursing intervention?
A) Administer preoperative antibiotics
B) Instruct the patient to avoid solid foods 24 hours before surgery
C) Perform a pelvic examination
D) Provide emotional support and address concerns about body image
131. A patient diagnosed with breast cancer is receiving chemotherapy. What is a common side effect of chemotherapy that the nurse should anticipate?
A) Increased libido
B) Hair loss
C) Weight gain
D) Abdominal cramps
132. A patient with a history of STIs is being screened for HIV. What is the nurse’s role in this process?
A) Ensure the patient understands the need for counseling and education about safe sexual practices
B) Provide immediate treatment after a positive result
C) Administer HIV medication to the patient
D) Educate the patient on the use of antiretroviral therapy
133. A woman diagnosed with polycystic ovary syndrome (PCOS) has elevated androgen levels. Which of the following symptoms is most likely associated with this condition?
A) Hair thinning
B) Hirsutism (excessive hair growth)
C) Weight loss
D) Increased breast tenderness
134. A woman who is 12 weeks pregnant reports sudden, severe abdominal pain and vaginal bleeding. What should the nurse suspect and prioritize?
A) Ectopic pregnancy
B) Placenta previa
C) Miscarriage
D) Round ligament pain
135. A 40-year-old woman is being treated for uterine fibroids. She asks the nurse about the impact of fibroids on fertility. What is the best response?
A) “Fibroids will have no impact on your ability to conceive.”
B) “Fibroids can cause infertility, but treatment can help improve fertility.”
C) “You will need to undergo a hysterectomy to have children.”
D) “Fibroids are always linked to miscarriage.”
136. A patient undergoing radiation therapy for cervical cancer reports vaginal dryness and irritation. What should the nurse recommend?
A) Use of vaginal lubricants
B) Decrease fluid intake
C) Avoid sexual activity for 6 months
D) Use of vaginal douches
137. A woman is concerned about breast cancer due to a family history. Which factor increases her risk for breast cancer?
A) Having children at a young age
B) History of breast cancer in a first-degree relative
C) Low-fat diet
D) Regular physical activity
138. A patient diagnosed with a hernia in the inguinal area is scheduled for surgery. What should the nurse educate the patient about post-operative care?
A) “You should avoid any physical activity for at least 6 months.”
B) “Wear a scrotal support for comfort and to reduce swelling.”
C) “You can return to work immediately after surgery.”
D) “There will be no restrictions on your activities once the surgery is complete.”
139. A woman is diagnosed with a uterine infection after childbirth. What is the priority treatment for this condition?
A) Pain management and rest
B) Oral antibiotics
C) Intravenous antibiotics and possible drainage
D) Surgical removal of the uterus
140. A woman with a family history of ovarian cancer asks about genetic testing. What is the nurse’s best response?
A) “Genetic testing is only for women with a confirmed diagnosis of ovarian cancer.”
B) “You can undergo genetic testing to determine if you have an increased risk of ovarian cancer.”
C) “Genetic testing is not helpful for ovarian cancer risk assessment.”
D) “You should wait until menopause to consider genetic testing.”
141. A patient diagnosed with uterine fibroids is experiencing heavy menstrual bleeding. What is the most likely treatment plan for this condition?
A) Chemotherapy
B) Hysterectomy
C) Hormonal therapy
D) Laparoscopic surgery
142. A woman diagnosed with pelvic inflammatory disease (PID) asks how she contracted the infection. The nurse explains that it is primarily caused by:
A) Stress
B) Sexual contact with an infected partner
C) Poor hygiene
D) Frequent douching
143. A woman is prescribed oral contraceptives for birth control. Which of the following side effects should be reported immediately?
A) Mild nausea
B) Sore breasts
C) Severe headache and visual disturbances
D) Irregular bleeding
144. A patient presents with painful intercourse, vaginal dryness, and decreased libido. The nurse suspects menopause. What is the first diagnostic test to confirm the diagnosis?
A) Mammogram
B) Pelvic ultrasound
C) Serum FSH (Follicle-Stimulating Hormone) levels
D) Pap smear
145. A woman with gestational diabetes asks if she is at risk for developing type 2 diabetes later in life. What is the nurse’s best response?
A) “You are at an increased risk for type 2 diabetes, and you should follow a healthy diet and exercise regularly.”
B) “Gestational diabetes has no long-term effects on your health, so you don’t need to worry about diabetes in the future.”
C) “Your blood sugar will return to normal after delivery, and you won’t be at risk for type 2 diabetes.”
D) “You will need to continue taking insulin after pregnancy to prevent type 2 diabetes.”
146. A woman who is 6 months pregnant has just been diagnosed with a urinary tract infection (UTI). What is the priority nursing intervention?
A) Administer IV fluids
B) Monitor fetal heart rate
C) Administer antibiotics as prescribed
D) Perform a pelvic exam
147. A woman is scheduled for a colposcopy after an abnormal Pap smear result. Which of the following is the primary purpose of the colposcopy?
A) To detect signs of endometrial cancer
B) To examine the cervix for abnormal cells
C) To remove abnormal tissue from the cervix
D) To assess for uterine fibroids
148. A patient with polycystic ovary syndrome (PCOS) is being treated with metformin. What is the most common reason for prescribing this medication in PCOS?
A) To regulate menstrual cycles
B) To reduce insulin resistance
C) To increase fertility
D) To promote weight loss
149. A patient is being treated for a urinary tract infection (UTI) during pregnancy. Which antibiotic is typically considered safe during pregnancy?
A) Ciprofloxacin
B) Penicillin
C) Tetracycline
D) Doxycycline
150. A woman who has recently had a miscarriage at 12 weeks gestation is experiencing heavy vaginal bleeding and dizziness. What is the nurse’s priority action?
A) Perform a pelvic examination
B) Encourage the patient to drink fluids
C) Monitor for signs of shock
D) Provide emotional support
151. A patient with an ectopic pregnancy is being treated with methotrexate. What should the nurse monitor for as a potential side effect of this medication?
A) Abdominal pain
B) Vomiting
C) Fatigue
D) Shortness of breath
152. A woman with a history of spontaneous abortions is concerned about her ability to carry a pregnancy to term. What is the most likely cause of recurrent miscarriages?
A) Stress
B) Hormonal imbalances
C) Genetic factors
D) Poor nutrition
153. A 32-year-old woman is diagnosed with a prolapsed uterus. Which of the following interventions is most commonly used to treat this condition?
A) Pelvic floor exercises
B) Hysterectomy
C) Vaginal pessary
D) Hormonal replacement therapy
154. A patient diagnosed with cervical cancer is scheduled for a radical hysterectomy. What is the most important post-operative nursing intervention?
A) Encourage early ambulation
B) Monitor for signs of hemorrhage
C) Teach the patient about hormone replacement therapy
D) Provide emotional support and address body image concerns
155. A woman with a family history of breast cancer asks about genetic testing. The nurse explains that genetic testing may identify an increased risk for cancer due to mutations in which genes?
A) BRCA1 and BRCA2
B) EGFR
C) MMR
D) P53
156. A woman undergoing menopause reports hot flashes and night sweats. What is the most appropriate intervention to alleviate these symptoms?
A) Estrogen therapy
B) Increased caffeine intake
C) Low-salt diet
D) Increased physical activity
157. A patient undergoing radiation therapy for pelvic cancer reports vaginal dryness and discomfort. What should the nurse recommend to alleviate these symptoms?
A) Use of vaginal lubricants
B) Increase fluid intake
C) Avoid sexual activity
D) Use of vaginal douches
158. A woman diagnosed with endometriosis is experiencing severe menstrual cramps and pain during intercourse. Which medication is most commonly prescribed for this condition?
A) Acetaminophen
B) Nonsteroidal anti-inflammatory drugs (NSAIDs)
C) Antidepressants
D) Antifungal agents
159. A pregnant woman at 32 weeks gestation presents with sudden onset of abdominal pain and vaginal bleeding. The nurse suspects placental abruption. What is the priority action?
A) Administer pain medication
B) Monitor fetal heart rate
C) Perform a pelvic exam
D) Administer corticosteroids
160. A woman with a family history of ovarian cancer is scheduled for a prophylactic oophorectomy. What should the nurse explain about the procedure?
A) “The procedure will increase your chances of developing breast cancer.”
B) “This procedure will reduce your risk of ovarian cancer but will require hormone replacement therapy.”
C) “The procedure will not affect your fertility, as it only removes the ovaries.”
D) “The procedure is not necessary unless you have symptoms of ovarian cancer.”
161. A patient diagnosed with fibrocystic breast changes asks how she can manage the condition. What is the nurse’s best response?
A) “You should avoid caffeine and salty foods.”
B) “Regular breast self-exams and mammograms are important for early detection of cancer.”
C) “You may need surgery to remove the cysts.”
D) “Fibrocystic changes will resolve on their own after menopause.”
162. A 25-year-old woman diagnosed with polycystic ovary syndrome (PCOS) asks about the possibility of becoming pregnant. What is the most appropriate response?
A) “PCOS always causes infertility, and you will need fertility treatment to conceive.”
B) “PCOS can affect fertility, but with appropriate treatment, pregnancy is possible.”
C) “Pregnancy is unlikely, and there are no treatments available for PCOS.”
D) “You will not have any fertility issues unless you are over 35.”
163. A patient undergoing a hysterectomy asks about the recovery process. What is the nurse’s best advice about post-operative care?
A) “You will be able to return to normal activities immediately after surgery.”
B) “Avoid lifting heavy objects for at least 6 weeks after surgery.”
C) “There will be no restrictions after the first week of recovery.”
D) “You will need to take pain medication for several months.”
164. A 30-year-old woman diagnosed with a Bartholin’s cyst is concerned about the treatment options. What is the most appropriate intervention for a Bartholin’s cyst that is causing pain?
A) Apply a topical antibiotic ointment
B) Drain the cyst using a needle
C) Perform a surgical excision of the gland
D) Recommend warm sitz baths and monitor for changes in size
165. A pregnant patient diagnosed with preeclampsia is being monitored for complications. What is the priority nursing intervention?
A) Encourage rest in a lateral position
B) Administer antihypertensive medications as prescribed
C) Monitor for signs of seizures
D) Monitor fetal heart rate
166. A patient who recently underwent a breast biopsy asks when they will receive the results. What is the nurse’s best response?
A) “You will receive the results in 1-2 weeks, and I will call you with the results.”
B) “The results will be available in 24 hours, and you will receive a call.”
C) “You will be scheduled for surgery in 2 weeks for further evaluation.”
D) “Results are typically available within 48 hours, but it may take longer.”
167. A woman with endometriosis is being treated with GnRH agonists. What side effect should the nurse monitor for?
A) Hot flashes
B) Nausea and vomiting
C) Weight loss
D) Abdominal cramps
168. A pregnant patient is diagnosed with gestational hypertension. What is the most appropriate intervention to manage this condition?
A) Bed rest and monitoring blood pressure
B) Administration of antihypertensive medication
C) Immediate delivery of the baby
D) Strict fluid restriction
Questions and Answers for study Guide
(1) Topic: Management of Pelvic Inflammatory Disease (PID) in Women
Question: A 26-year-old female presents with pelvic pain, fever, and abnormal vaginal discharge. She is diagnosed with pelvic inflammatory disease (PID). Describe the management strategies for PID, including nursing interventions, diagnostic tests, treatment options, and patient education.
Answer:
Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, usually caused by sexually transmitted infections (STIs) like chlamydia or gonorrhea. It can lead to serious complications such as infertility, chronic pelvic pain, and ectopic pregnancy if left untreated.
- Diagnostic Tests:
- Pelvic examination: The clinician will assess for tenderness or abnormal discharge.
- Blood tests: To check for elevated white blood cell count and signs of infection.
- Ultrasound: This may be performed to rule out abscesses or other abnormalities in the reproductive organs.
- Endometrial biopsy: In certain cases, to confirm the diagnosis and detect specific organisms.
- Treatment Options:
- Antibiotics: Broad-spectrum antibiotics are prescribed to target the causative organisms. Patients typically receive an IV antibiotic regimen, followed by oral antibiotics.
- Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be used to manage pain.
- Hospitalization: In severe cases, especially if the patient has a high fever or abscess, hospitalization and intravenous antibiotics are necessary.
- Nursing Interventions:
- Monitor for complications: Nurses should assess for signs of severe infection or shock, such as fever, chills, increased heart rate, and hypotension.
- Provide emotional support: Discuss the impact of PID on fertility and long-term health, as it may cause anxiety and concern for the patient.
- Encourage compliance with treatment: Ensure the patient understands the importance of completing the full course of antibiotics to prevent recurrence or resistance.
- Patient Education:
- Sexual activity: Educate the patient about avoiding sexual intercourse until treatment is completed to prevent further infections.
- Follow-up care: Reinforce the importance of returning for follow-up appointments to ensure the infection has been fully resolved.
- Prevention: Counsel the patient about the importance of safe sex practices, including using condoms, to prevent STIs and PID in the future.
(2) Topic: Endometriosis and its Impact on Women’s Health
Question: A 34-year-old woman is diagnosed with endometriosis after seeking medical attention for severe menstrual cramps, pelvic pain, and infertility. Explain the pathophysiology of endometriosis, the diagnostic methods used to confirm the diagnosis, and the treatment options available.
Answer:
Endometriosis is a chronic, often painful condition where tissue similar to the lining of the uterus grows outside of the uterus, commonly affecting the ovaries, fallopian tubes, and the peritoneum. It can cause significant pain, especially during menstruation, and may lead to infertility.
- Pathophysiology:
- In endometriosis, the tissue that normally lines the uterus (endometrium) grows outside the uterus, often in the pelvis. This tissue still responds to the menstrual cycle hormones, causing it to thicken, break down, and bleed. However, unlike the normal endometrial tissue, the blood has nowhere to exit the body, which leads to inflammation, scar tissue, and adhesions that can cause pain and organ dysfunction.
- Over time, endometrial tissue outside the uterus can form cysts, known as endometriomas, and may lead to the development of adhesions (scar tissue) that bind organs together.
- Diagnostic Methods:
- Pelvic ultrasound: This non-invasive imaging tool helps identify large endometriomas, though it cannot definitively diagnose endometriosis.
- Laparoscopy: The gold standard for diagnosing endometriosis. It allows direct visualization of the endometrial lesions and the removal of tissue samples for biopsy.
- Magnetic resonance imaging (MRI): Can be useful in visualizing deeper pelvic lesions and adhesions.
- Treatment Options:
- Medications:
- NSAIDs (e.g., ibuprofen) for pain relief.
- Hormonal therapy: Birth control pills, progestins, or GnRH agonists to suppress ovulation and reduce endometrial tissue growth.
- Danazol: A synthetic male hormone that reduces estrogen levels, often used for short-term treatment.
- Surgical interventions:
- Laparoscopic surgery: Can remove or destroy endometrial tissue, adhesions, and cysts.
- Hysterectomy: In severe cases, especially when fertility is no longer a concern, removing the uterus and ovaries may be considered.
- Medications:
- Nursing Interventions:
- Pain management: Help the patient manage chronic pain through pharmacological interventions and alternative therapies like heat pads or relaxation techniques.
- Emotional support: Endometriosis can lead to infertility, which may cause emotional distress. Offer psychological support or counseling.
- Education: Teach the patient about the importance of medication adherence and the potential for recurrence of symptoms.
- Patient Education:
- Lifestyle modifications: Encourage a healthy diet and regular exercise to manage symptoms and improve overall health.
- Fertility considerations: If the patient is experiencing infertility, refer to fertility counseling and discuss potential treatments such as in vitro fertilization (IVF).
- Pain management strategies: Discuss non-medication strategies, including stress management and alternative therapies.
(3) Topic: Polycystic Ovary Syndrome (PCOS) and Its Management
Question: A 25-year-old woman presents with irregular periods, excessive hair growth, and weight gain. She is diagnosed with polycystic ovary syndrome (PCOS). Describe the pathophysiology of PCOS, its diagnostic criteria, and the management strategies that should be employed.
Answer:
Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. It is characterized by an imbalance of reproductive hormones that can lead to various symptoms, including irregular menstruation, infertility, and metabolic complications.
- Pathophysiology:
- In PCOS, the ovaries produce an excess amount of androgens (male hormones), which disrupt the normal menstrual cycle and cause symptoms like hirsutism (excessive hair growth) and acne.
- The hormonal imbalance leads to the development of multiple cysts on the ovaries, hence the name “polycystic.” These cysts are immature follicles that have not been able to release eggs due to hormonal disruptions, leading to infertility.
- Women with PCOS are also at higher risk for metabolic disorders such as insulin resistance, which can lead to weight gain, diabetes, and cardiovascular diseases.
- Diagnostic Criteria:
- The Rotterdam criteria are used for diagnosing PCOS, which require the presence of at least two of the following:
- Irregular or absent ovulation (e.g., irregular menstrual cycles).
- Hyperandrogenism (e.g., excessive hair growth, acne).
- Polycystic ovaries, visible on ultrasound.
- Additional tests such as blood work may be used to check hormone levels (e.g., elevated testosterone) and to rule out other conditions.
- The Rotterdam criteria are used for diagnosing PCOS, which require the presence of at least two of the following:
- Management Strategies:
- Hormonal contraception: Birth control pills are commonly prescribed to regulate menstrual cycles, reduce androgens, and manage acne and hirsutism.
- Anti-androgen medications: Drugs such as spironolactone can be used to reduce excessive hair growth and acne.
- Metformin: This medication is used to manage insulin resistance, improve ovulation, and assist with weight management.
- Fertility treatment: If the woman desires pregnancy, medications like clomiphene citrate or gonadotropins may be prescribed to stimulate ovulation.
- Lifestyle modifications: Encouraging weight loss through diet and exercise can help manage insulin resistance and improve symptoms.
- Nursing Interventions:
- Monitor for complications: Regularly assess for signs of diabetes and hypertension, which are common in women with PCOS.
- Support with fertility concerns: Provide resources and counseling for women struggling with infertility due to PCOS.
- Promote adherence: Ensure the patient understands the importance of long-term management, including lifestyle changes and medication adherence.
- Patient Education:
- Diet and exercise: Advise on maintaining a healthy weight and regular exercise to improve insulin sensitivity and reduce the risk of cardiovascular disease.
- Hair removal options: Discuss methods for managing hirsutism, including topical treatments, waxing, or laser hair removal.
- Psychological support: Provide emotional support for women dealing with infertility and the cosmetic effects of PCOS.
(4) Topic: Management of Uterine Fibroids
Question: A 40-year-old woman presents with heavy menstrual bleeding, pelvic pressure, and abdominal bloating. She is diagnosed with uterine fibroids. Explain the pathophysiology of uterine fibroids, diagnostic methods, treatment options, and nursing interventions for this condition.
Answer:
Uterine fibroids (leiomyomas) are non-cancerous growths of the uterus that often appear during childbearing years. They can range in size from very small to large tumors, and the symptoms vary depending on their size, location, and number.
- Pathophysiology:
- Uterine fibroids are composed of smooth muscle cells and fibrous tissue. They develop in the walls of the uterus and may cause symptoms due to their size or location, such as pressure on surrounding organs.
- The exact cause of fibroid development is not fully understood but is thought to be related to estrogen and progesterone, as fibroids tend to shrink after menopause when hormone levels decrease.
- Diagnostic Methods:
- Pelvic examination: A physical exam may reveal an enlarged uterus or the presence of fibroids.
- Ultrasound: A transabdominal or transvaginal ultrasound is the primary method to visualize fibroids and assess their size and location.
- MRI: Magnetic resonance imaging can provide more detailed images, especially for larger fibroids or if there is a concern about malignancy.
- Hysteroscopy: This allows direct visualization of the uterine cavity and can help identify fibroids in the endometrial lining.
- Treatment Options:
- Medications:
- Gonadotropin-releasing hormone (GnRH) agonists: These drugs temporarily shrink fibroids by lowering estrogen levels.
- Progestins: Used to manage abnormal bleeding.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): To reduce pain and bleeding associated with fibroids.
- Surgical options:
- Myomectomy: Removal of fibroids while preserving the uterus, often done for women who want to maintain fertility.
- Hysterectomy: Removal of the uterus, considered when fibroids are causing significant symptoms and childbearing is no longer desired.
- Uterine artery embolization: A procedure that blocks the blood supply to the fibroids, causing them to shrink.
- Medications:
- Nursing Interventions:
- Pain management: Administer pain relief and anti-inflammatory medications as prescribed to help manage discomfort.
- Monitor for complications: Watch for signs of heavy bleeding, anemia, or urinary retention.
- Postoperative care: If surgery is performed, provide care for wound management and monitor for signs of infection or complications.
- Patient Education:
- Symptom management: Educate the patient on how to manage heavy menstrual bleeding, including the use of menstrual products.
- Follow-up care: Encourage regular follow-up visits to monitor the fibroids and symptoms.
- Fertility concerns: Discuss the impact of fibroids on fertility and the potential need for fertility treatments if the patient is trying to conceive.
(5) Topic: Ovarian Cancer: Risk Factors, Diagnosis, and Treatment
Question: A 52-year-old woman is diagnosed with ovarian cancer. Discuss the risk factors for ovarian cancer, diagnostic approaches, treatment options, and nursing interventions for the care of a woman with ovarian cancer.
Answer:
Ovarian cancer is one of the most common gynecological cancers, often diagnosed in advanced stages due to its subtle early symptoms. It typically originates in the ovaries, though it can spread to surrounding structures.
- Risk Factors:
- Age: Ovarian cancer is most common in women over 50, particularly postmenopausal women.
- Family history: A family history of ovarian or breast cancer increases the risk, especially if there is a hereditary mutation such as BRCA1 or BRCA2.
- Reproductive history: Women who have never been pregnant or who experienced early menstruation and late menopause are at higher risk.
- Hormonal factors: Use of estrogen-only hormone replacement therapy (HRT) and a history of infertility are linked to an increased risk of ovarian cancer.
- Genetics: Inherited gene mutations (e.g., BRCA1, BRCA2, and Lynch syndrome) contribute significantly to the risk of ovarian cancer.
- Diagnostic Approaches:
- Pelvic examination: During a physical exam, the clinician may feel an ovarian mass.
- Transvaginal ultrasound: Used to assess the ovaries and identify masses or abnormal growths.
- CA-125 blood test: A tumor marker often elevated in ovarian cancer, though it can also be elevated in non-cancerous conditions.
- CT or MRI scans: Used to determine the size, location, and spread of the tumor.
- Biopsy: In some cases, a biopsy is needed to confirm the diagnosis.
- Treatment Options:
- Surgery: Surgical removal of the ovaries (oophorectomy) and uterus (hysterectomy) is the most common treatment for ovarian cancer. Staging is done during surgery to assess the extent of the disease.
- Chemotherapy: Often used after surgery to eliminate any remaining cancer cells. Common chemotherapeutic agents include paclitaxel and carboplatin.
- Targeted therapy: Drugs that target specific cancer cells without affecting healthy cells. Bevacizumab and other targeted treatments may be used for advanced ovarian cancer.
- Radiation therapy: Less commonly used but may be an option in specific cases to shrink tumors or manage symptoms.
- Nursing Interventions:
- Monitor for side effects of chemotherapy: Chemotherapy can cause nausea, fatigue, neutropenia, and hair loss. Administer antiemetics and encourage rest.
- Pain management: Ovarian cancer often causes abdominal discomfort or pain, which requires careful pain management.
- Emotional support: Provide counseling and emotional support to help the patient cope with the diagnosis and treatment side effects.
- Assist with nutrition: Ovarian cancer and chemotherapy can lead to appetite loss and weight changes. Ensure proper nutrition and hydration.
- Patient Education:
- Post-surgical care: Educate the patient on proper wound care, the importance of early ambulation, and managing any postoperative complications.
- Chemotherapy side effects: Provide information on how to manage nausea, hair loss, and other side effects of chemotherapy.
- Lifestyle modifications: Encourage a healthy diet and exercise to improve overall well-being during treatment.
- Emotional and psychological support: Refer the patient to support groups or counseling to help them navigate the emotional challenges of living with cancer.
(6) Topic: Ectopic Pregnancy: Diagnosis and Management
Question: A 28-year-old woman presents with abdominal pain, vaginal bleeding, and dizziness. She is diagnosed with an ectopic pregnancy. Discuss the pathophysiology of ectopic pregnancy, diagnostic methods, treatment options, and nursing interventions.
Answer:
Ectopic pregnancy occurs when a fertilized egg implants outside the uterine cavity, most commonly in the fallopian tube. This is a life-threatening condition that requires prompt diagnosis and treatment.
- Pathophysiology:
- Ectopic pregnancies occur when the fertilized egg cannot travel to the uterus due to factors such as fallopian tube damage, abnormal tubal motility, or scarring. The growing embryo implants in the fallopian tube, cervix, ovaries, or abdominal cavity.
- As the pregnancy progresses, it can cause the tube to rupture, leading to internal bleeding, shock, and potentially life-threatening complications.
- Diagnostic Methods:
- Pelvic ultrasound: A transvaginal ultrasound is the most effective imaging tool for diagnosing ectopic pregnancy, allowing visualization of a gestational sac outside the uterus.
- Human chorionic gonadotropin (hCG) levels: A lower-than-expected rise in hCG levels can suggest an ectopic pregnancy.
- Laparoscopy: In some cases, a laparoscopy may be performed to confirm the diagnosis if the ultrasound results are inconclusive.
- Treatment Options:
- Methotrexate: This drug is used in early, non-ruptured ectopic pregnancies to stop the growth of the pregnancy tissue and allow it to be reabsorbed by the body.
- Surgical intervention: If the ectopic pregnancy is advanced or ruptured, surgery may be necessary to remove the pregnancy, and in some cases, the affected fallopian tube may need to be removed.
- Expectant management: In rare cases, if the pregnancy is not progressing and the patient is stable, expectant management may be considered, with careful monitoring.
- Nursing Interventions:
- Monitor vital signs: Regularly assess for signs of shock or hemorrhage (e.g., low blood pressure, rapid heart rate).
- Provide pain relief: Administer pain medications as prescribed and monitor for any changes in pain intensity.
- Emotional support: Offer psychological support, as an ectopic pregnancy can result in grief, loss, and anxiety.
- Patient Education:
- Post-treatment care: Explain the signs of complications, such as excessive bleeding or signs of infection, that require immediate medical attention.
- Contraception counseling: Discuss future contraception options and fertility considerations after an ectopic pregnancy.
- Follow-up care: Ensure the patient understands the importance of follow-up appointments to monitor recovery and ensure the pregnancy tissue has been fully absorbed.