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MATERNAL CHILD NURSING CARE 6TH EDITION PERRY TEST BANK
Chapter 04: Reproductive System Concerns
Perry: Maternal Child Nursing Care, 6th Edition
MULTIPLE CHOICE
1. When assessing a patient for amenorrhea, the nurse should be aware that this is unlikely to be
caused by:
a.
anatomic abnormalities.
b.
type 1 diabetes mellitus.
c.
lack of exercise.
d.
hysterectomy.
ANS: C
Lack of exercise is not a cause of amenorrhea. Strenuous exercise may cause amenorrhea.
Anatomic abnormalities, type 1 diabetes mellitus, and hysterectomy all are possible causes of
amenorrhea.
PTS: 1 DIF: Cognitive Level: Comprehension
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
2. When a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic
intervention might be recommended?
a.
Increasing the intake of red meat and simple carbohydrates
b.
Reducing the intake of diuretic foods such as peaches and asparagus
c.
Temporarily substituting physical activity for a sedentary lifestyle
d.
Using a heating pad on the abdNoUmReSnINtGoTrBel.CieOvMe cramping
ANS: D
Heat minimizes cramping by increasing vasodilation and muscle relaxation and minimizing
uterine ischemia. Dietary changes such as eating less red meat may be recommended for
women experiencing dysmenorrhea. Increasing the intake of diuretics, including natural
diuretics such as asparagus, cranberry juice, peaches, parsley, and watermelon, may help ease
the symptoms associated with dysmenorrhea. Exercise has been found to help relieve
menstrual discomfort through increased vasodilation and subsequent decreased ischemia.
3. Which symptom described by a patient is characteristic of premenstrual syndrome (PMS)?
a.
“I feel irritable and moody a week before my period is supposed to start.”
b.
“I have lower abdominal pain beginning the third day of my menstrual period.”
c.
“I have nausea and headaches after my period starts, and they last 2 to 3 days.”
d.
“I have abdominal bloating and breast pain after a couple days of my period.”
ANS: A
PMS is a cluster of physical, psychologic, and behavioral symptoms that begin in the luteal
phase of the menstrual cycle and resolve within a couple of days of the onset of menses.
Complaints of lower abdominal pain, nausea and headaches, and abdominal bloating all are
associated with PMS. However, the timing reflected is inaccurate.
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4. A woman complains of severe abdominal and pelvic pain around the time of menstruation that
has gotten worse over the last 5 years. She also complains of pain during intercourse and has
tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely
related to:
a.
endometriosis.
b.
PMS.
c.
primary dysmenorrhea.
d.
secondary dysmenorrhea.
ANS: A
Symptoms of endometriosis can change over time and may not reflect the extent of the
disease. Major symptoms include dysmenorrhea and deep pelvic dyspareunia (painful
intercourse). Impaired fertility may result from adhesions caused by endometriosis. Although
endometriosis may be associated with secondary dysmenorrhea, it is not a cause of primary
dysmenorrhea or PMS. In addition, this woman is complaining of dyspareunia and infertility,
which are associated with endometriosis not with PMS or primary or secondary
dysmenorrhea.
PTS: 1 DIF: Cognitive Level: Comprehension
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. Nafarelin is currently used as a treatment for mild-to-severe endometriosis. The nurse should
tell a woman taking this medication that the drug:
a.
stimulates the secretion of gon a d ot r o p in - r e le a sing hormone
N U R activity.
(GnRH), thereby stimulating ovarian SI N G T B. C O M
b.
should be sprayed into one nostril every other day.
c.
should be injected into subcutaneous tissue bid.
d.
can cause her to experience some hot flashes and bone loss.
ANS: D
Nafarelin is a GnRH agonist, and its side effects are similar to effects of menopause. The
hypoestrogenism effect results in hot flashes and bone loss. Nafarelin is a GnRH agonist that
suppresses the secretion of GnRH and is administered twice daily by nasal spray.
PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
6. While interviewing a 31-year-old woman before her routine gynecologic examination, the
nurse collects data about the patient’s recent menstrual cycles. The nurse should collect
additional information associated with which patient statement?
a.
The woman says her menstrual flow lasts 5 to 6 days.
b.
She describes her flow as very heavy.
c.
She reports that she has had a small amount of spotting midway between her
periods for the past 2 months.
d.
She says the length of her menstrual cycle varies from 26 to 29 days.
ANS: B
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Menorrhagia is defined as excessive menstrual bleeding, in either duration or amount. Heavy
bleeding can have many causes. The amount of bleeding and its effect on daily activities
should be evaluated. A menstrual flow lasting 5 to 6 days is a normal finding. Mittlestaining, a
small amount of bleeding or spotting that occurs at the time of ovulation (14 days before onset
of the next menses), is considered normal. During her reproductive years, a woman may have
physiologic variations in her menstrual cycle. Variations in the length of a menstrual cycle are
considered normal.
PTS: 1 DIF: Cognitive Level: Comprehension
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
7. When evaluating a patient whose primary complaint is amenorrhea, the nurse must be aware
that lack of menstruation is most often the result of:
a.
stress.
b.
excessive exercise.
c.
pregnancy.
d.
eating disorders.
ANS: C
Amenorrhea, or the absence of menstrual flow, is most often a result of pregnancy. Although
stress, excessive exercise, and eating disorders all may be contributing factors, none is the
most common factor associated with amenorrhea.
PTS: 1 DIF: Cognitive Level: Knowledge
OBJ: Nursing Process: Assessment, Diagnosis
MSC: Client Needs: Health Promotion and Maintenance
8. A 36-year-old woman has been giNvUenRSaINdiGaTgBno.CsOisMof uterine fibroids. When
planning care for this patient, the nurse should know that:
a.
fibroids are malignant tumors of the uterus that require radiation or chemotherapy.
b.
fibroids increase in size during the perimenopausal period.
c.
menorrhagia is a common finding.
d.
the woman is unlikely to become pregnant as long as the fibroids are in her uterus.
ANS: C
The major symptoms associated with fibroids are menorrhagia and the physical effects
produced by large myomas. Fibroids are benign tumors of the smooth muscle of the uterus,
and their etiology is unknown. Fibroids are estrogen sensitive and shrink as levels of estrogen
decline. Fibroids occur in 25% of women of reproductive age and are seen in 2% of pregnant
women.
PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
9. During her gynecologic checkup, a 17-year-old girl states that recently she has been
experiencing cramping and pain during her menstrual periods. The nurse would document this
complaint as:
a.
amenorrhea.
b.
dysmenorrhea.
c.
dyspareunia.
d.
premenstrual syndrome (PMS).
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