1. A patient presents to the emergency department with heavy vaginal bleeding. The nurse
obtains information from the patient that this is not menstruating. How should the nurse
document this finding in the patient’s chart?
a. Polymenorrhea
b. Intermenstrual bleeding
c. Menometrorrhagia
d. Menorrhagia
ANS: C
Chapter: Chapter 31 Promoting Reproductive Health: Various Gynecological
Disorders
Objective: #1. Describe various gynecological disorders and discuss implications for
patient counseling and teaching.
Page: 979
Heading: What to Say> Correct Terminology for Abnormal Genital Bleeding
Integrated Processes: Communication and Documentation
Client Need: Physiological
Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Female Reproduction; Critical Thinking
Difficulty: Difficult
Feedback
A. Polymenorrhea is bleeding that occurs at short intervals. There is no provided
information as to the time frame of the patient’s cycle, however based on the
amount of blood flow, this is not correct.
B. Intermenstrual bleeding refers to bleeding of various amounts between regular
menses. There is no provided history related to history of the menstrual cycle,
however, based on the amount of blood this is not correct.
C. Menometrorrhagia refers to heavy blood flow that occurs at abnormal times
during the cycle.
D. Menorrhagia refers to excessive bleeding during menses.
2. The nurse is assessing a 17-year-old female patient who has been brought into the office
complaining of nausea, abdominal pain, and lightheadedness. Upon questioning from the
nurse, the timing of these symptoms occurs prior to menses. What clinical condition
should the nurse anticipate a work-up for?
, a. Pregnancy
b. Primary dysmenorrhea
c. Secondary dysmenorrhea
d. Gastroenteritis
ANS: B
Chapter: Chapter 31 Promoting Reproductive Health: Various Gynecological
Disorders
Objective: #1. Describe various gynecological disorders and discuss implications for
patient counseling and teaching.
Page: 980
Heading: Dysmenorrhea
Integrated Processes: Nursing Process: Assessment
Client Need: Physiological
Integrity: Physiological Adaptation
Cognitive Level: Analysis [Analyzing]
Concept: Female Reproduction; Critical Thinking
Difficulty: Difficult
Feedback
A. Although every female is considered pregnant until proven otherwise, based on
the presented facts, this is not correct.
B. As the patient relates the timing of these symptoms occur prior to menses, the
nurse should suspect that a work-up would be done for primary dysmenorrhea.
Primary dysmenorrhea begins 1 to 3 years following menarche due to multiple
hormonal/physiological factors.
C. Secondary dysmenorrhea typically begins later in life, so this would be unlikely
to apply to this patient.
D. Presenting symptoms could be seen in gastroenteritis, but again since the
timing of the events is linked to the menstrual flow cycle, this is not correct.
3. A patient diagnosed with stage 1 endometriosis asks the nurse what treatment option
would work best to resolve her symptoms. What is the best nursing response?
a. Danazol (Cyclomen)
b. Combination oral contraceptives
c. Anastrozole (Arimidex)
d. Laparoscopy
ANS: B
Chapter: Chapter 31 Promoting Reproductive Health: Various Gynecological
Disorders
Objective: #2. Develop a nursing plan of care for a patient with a diagnosis of
endometriosis.
Page: 987
Feedback
A. Danazol (Cyclomen) could be used if the patient was experiencing a more
severe form of the condition.
B. Oral contraceptive combination therapy is a common treatment approach.
C. Anastrozole (Arimidex) could be used if the patient was experiencing a more
severe form of the condition.
D. As the patient has already been diagnosed with stage 1 endometriosis, there is
no need to perform a surgical intervention (laparoscopy).
4. A patient diagnosed with endometriosis is very upset at how this condition has impacted
her life and ability to work and interact with her friends. How should the nurse respond to
the patient’s stated concerns?
a. Refer the patient to a psychologist for a more in-depth treatment option
b. Provide evidence-based resources of current therapies
c. Tell the patient that this is an acute exacerbation of a chronic disease, and it will
get better
d. Suggest that there are alternatives strategies that may alleviate some of her
concerns
ANS: D
Chapter: Chapter 31 Promoting Reproductive Health: Various Gynecological
Disorders
Objective: #2. Develop a nursing plan of care for a patient with a diagnosis of
endometriosis.
Page: 988
Heading: Implications for Nurses
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Female Reproduction
Difficulty: Moderate
Feedback
A. A referral to a psychologist would not be appropriate at this time and/or may
not be warranted as this is a medical condition, not a psychological diagnosis.
B. Providing evidence-based resources of current therapy may be considered, but
, it doesn’t address the patient’s primary stated concerns and doesn’t offer
support.
C. Simply stating that it will get better does not address the patient's concerns.
D. Endometriosis is a chronic condition and, even though the patient may
experience exacerbations, the nurse should provide some alternative therapy
strategies that may address her present concerns.
5. A patient diagnosed with polycystic ovary syndrome (PCOS) is being evaluated at the
clinic for response to therapy. What finding would best serve to indicate that therapy has
been effective?
a. Hemoglobin A1c 7%
b. BMI 32
c. FBS 180 mg/dL
d. No edema noted of lower extremities
ANS: A
Chapter: Chapter 31 Promoting Reproductive Health: Various Gynecological
Disorders
Objective: #3. Develop a nursing plan of care for a patient with polycystic ovary
syndrome.
Page: 993
Heading: Medications>Enhancing Ovulatory Function with Insulin Resistance
Integrated Processes: Nursing Process: Assessment
Client Need: Physiological
Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Female Reproduction; Critical Thinking
Difficulty: Difficult
Feedback
A. Management of a patient with PCOS is aimed at reducing glycemic load,
decreasing insulin resistance, and weight loss. A hemoglobin A1c of 7%
indicates that the patient has been compliant with therapy and has adequate
glycemic control.
B. A BMI of 32 is categorized as clinically obese.
C. A FBS of 180mg/dL is elevated.
D. No edema noted of lower extremities is a normal finding but is not directly
correlated with medical therapies used in the treatment of PCOS.
6. A patient diagnosed with polycystic ovary syndrome (PCOS) asks the nurse what she can
do to lose weight. How should the nurse respond to the patient’s concern?
a. "There are many treatment options, but it may take a while to find the right one
for you to lose that much weight."
b. "Combining calorie reduction with exercise is a combination approach that can
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