23. To increase comfort, the nurse advises women to perform breast self-examination (BSE)

a. one week after their menstrual cycle.
b. one week before their menstrual cycle.
c. without regard to their menstrual cycle.
d. whenever it is most comfortable for them.


   24. The nurse knows the best position for the patient to assume when performing self breast palpation is:

a. sitting upright with one arm above the head.
b. lying flat on the back on a supportive mattress.
c. standing in front of a mirror in order to see well.
d. reclining in bed with a pillow under the shoulder.


   25. The nurse working with a patient in her 40s would advise her to have a clinical breast examination every:

a. one year.
b. two years.
c. three years.
d. five years.


   26. A patient is complaining of tender masses in her breasts that tend to change in size related to her menstrual cycle. The nurse can counsel this patient to try:

a. drinking several cups of green tea each day.
b. reducing her intake of caffeine and other stimulants.
c. sleeping on her side with pillows supporting the breasts.
d. using ice packs on the tender areas for 20 minutes at a time.


   27. A patient is complaining of tender, warm lumps in her breast and tender, swollen ipsilateral lymph nodes. Which question by the nurse would elicit the most useful information? The nurse asks:

a. “Are you currently breastfeeding?”
b. “Where in your menstrual cycle are you?”
c. “Have you had any recent breast trauma?”
d. “Do you have a family history of breast cancer?”


   28. A patient has a breast lump discovered during a clinical breast examination. The provider directs the patient to return after her next menstrual period for another examination. The nurse can most likely conclude that the patient:

a. has had a screening mammogram within the last year.
b. does not have significant risk factors for breast cancer.
c. frequently has lumps detected on her clinical breast exam.
d. has fibrocystic breast disease, making clinical judgment difficult.


   29. A woman has been diagnosed with breast cancer in situ and questions the nurse as to what that means. The best explanation by the nurse is that this type of cancer:

a. is only found in one area of the breast that was biopsied.
b. is confined to its original location and has not spread.
c. can be treated with locally administered chemotherapy.
d. only occurs in one breast or the other; it is not bilateral.


   30. A woman has unilateral breast swelling and complains that the affected breast is itching and has peeling skin. The nurse anticipates the physician will order:

a. a mammogram.
b. a dermatology consultation.
c. magnetic resonance imaging (MRI).
d. a positron emission tomography (PET scan).


   31. The nurse reviewing a patient’s chart sees the term “metrorrhagia” and knows that this woman is experiencing:

a. excess bleeding in either the amount or in the length of time.
b. bleeding that occurs at abnormal times during an ovulatory cycle; more often than every 21 days.
c. variable bleeding that occurs between the regular menses.
d. bleeding at abnormal times during an anovulatory cycle.


   32. A patient with painful menstrual periods (dysmenorrhea) is advised to take a nonsteroidal anti-inflammatory drug such as ibuprofen (Motrin) for her discomfort. When she asks why ibuprofen is better than acetaminophen (Tylenol), the nurse explains that ibuprofen works better because:

a. acetaminophen tends to cause more side effects when taken for cramps.
b. ibuprofen tends to work more quickly than either acetaminophen or aspirin.
c. menstrual cramps are related to an inflammation of the cervical tissue and ibuprofen decreases the inflammation.
d. the pain is related to an excessive production of prostaglandins, and ibuprofen inhibits the synthesis of prostaglandins.


   33. A physician tells the nurse that a patient has a positive “whiff test.” The nurse anticipates that the physician will write the patient a prescription for:

a. metronidazole (Flagyl).
b. miconazole (Monistat).
c. boric acid gelatin capsules.
d. clotrimazole (Gyne-Lotrimin).


   34. A patient has come to the clinic for a physical exam and complains of having her fourth vaginal yeast infection in 6 months. The diagnostic test results that the nurse would be most interested in is the:

a. Pap test.
b. blood glucose.
c. complete blood count.
d. absolute neutrophil count.


   35. The nurse evaluates that teaching related to toxic shock syndrome (TSS) has been effective when the patient states:

a. “I should change my tampons frequently.”
b. “I can use super absorbent tampons any time.”
c. “I should not use tampons at all during my period.”
d. “I can take ibuprofen for fever if I think I have TSS.”


   36. A woman is being prescribed leuprolide (Lupron) for endometriosis. The nurse determines that patient teaching has been effective when the patient states:

a. “Side effects will be similar to menopause.”
b. “A serious side effect is permanent bone loss.”
c. “I can take this medication for years if needed.”
d. “If I get ankle swelling, I should call my doctor.”


   37. The nurse understands that “dysfunctional uterine bleeding” is diagnosed:

a. most often in women who experience normal monthly menstrual periods.
b. more often than any other cause of abnormal vaginal bleeding.
c. after all pathologic causes of bleeding have been excluded.
d. when menstrual bleeding is either abnormally heavy or lengthy.


   38. A woman with heavy vaginal bleeding who does not wish to have more children is discussing endometrial ablation with the nurse. Which statement by the nurse is inconsistent with knowledge about this procedure? The nurse tells the patient:

a. “Since the endometrium scars after this procedure, the bleeding is halted.”
b. “Following this procedure, you will not need to use any contraception when you resume sexual activity.”
c. “There are several methods that have been approved for endometrial ablation.”
d. “Endometrial ablation is usually reserved for patients who have not responded to other treatments.”


   39. A patient undergoing a workup for infertility also complains of hirsutism and acne. The nurse anticipates diagnostic testing for:

a. uterine fibroids.
b. benign leiomyomata.
c. follicular ovarian cysts.
d. polycystic ovary syndrome.


   40. A nurse counseling a patient about infection with the Human Immunodeficiency Virus (HIV) explains that the virus is detectable in plasma within:

a. 3 days.
b. 5 days.
c. 1 week.
d. 1 month.


   41. A nurse in a women’s health clinic explains to a new graduate nurse that they follow current recommendations for opt-out Human Immunodeficiency Virus (HIV) testing. The nurse explains this means that patients:

a. are told about the testing but need to give specific consent for it.
b. are informed about testing but consent is assumed unless they decline.
c. can choose not to be informed of the test results when they are available.
d. can specify that they want results sent directly to them, not to the provider.


   42. A woman just diagnosed with chlamydia tells the nurse she is relieved that it’s “just chlamydia” and not something “serious.” The best response by the nurse is to say:

a. “You’re right; chlamydia is easily cured with common antibiotics.”
b. “Yes, chlamydia is not as serious as other STDs since it isn’t associated with any long-term effects.”
c. “Chlamydia can increase the risk of contracting ‘serious’ infections like HIV.”
d. “All STDs are equally serious because they show that you engage in unsafe behavior.”


   43. The nurse caring for a woman with a chlamydial infection anticipates an order for which medication?

a. metronidazole (Flagyl) 2 grams orally administered one time
b. ceftriaxone (Rocephin) 250 mg IM administered once
c. doxycycline (Vibramycin) 100 mg orally bid for 7 days
d. acyclovir (Zovirax) 800 mg every 4 hours orally for 7 days


   44. A patient diagnosed with gonorrhea was treated in the clinic with a single dose of cefixime (Suprax), 400 mg orally. Two weeks later she returns stating her symptoms are back. The nurse would most likely conclude that:

a. the woman’s sex partner(s) had not been treated.
b. cefixime is not the best drug to use in this patient.
c. the patient’s particular strain of gonorrhea is resistant to this medication.
d. the prescribed dose was too low to be effective against N. gonorrhoeae.


   45. A patient is being treated for trichomoniasis with metronidazole (Flagyl). Which instruction specific to this medication should the nurse give the patient?

a. “Don’t drink alcohol until 24 hours after you have finished this medication.”
b. “Avoid getting any direct sunlight for 1 week after you finish the Flagyl.”
c. “Make sure you take all the medication that has been prescribed for you.”
d. “Since only one dose is needed, we will watch you take it before you leave.”


   46. A nurse is assisting with a pelvic examination and the provider comments that the patient has “cervical motion tenderness.” With which condition does the nurse associate this finding?

a. gonorrhea
b. chlamydia
c. trichomoniasis
d. pelvic inflammatory disease


   47. A patient in the clinic has what appears to be a chancre. The nurse anticipates ordering tests to confirm which disease?

a. syphilis
b. chlamydia
c. gonorrhea
d. trichomoniasis


   48. A nurse is counseling a patient who engages in risky sexual behavior about getting tested for sexually transmitted diseases (STDs). The patient is hesitant to get tested, stating she is too embarrassed to do so. Which action by the nurse would most likely result in the patient’s agreeing to undergo STD screening? The nurse should advise the patient that:

a. records are kept confidential and not shared with outsiders.
b. home screening for some common diseases is now available.
c. there are serious consequences of having undiagnosed STDs.
d. health-care providers have seen many patients with STDs before.


   49. The nurse knows that the transformation zone is the area where the:

a. darker pink columnar cells line the vagina.
b. cervix communicates with the uterine body.
c. process of squamous metaplasia does not occur.
d. squamous cells constantly replace columnar cells.


   50. A nurse is assisting with a pelvic examination and traditional Pap testing. Which action by the nurse is most important for the accuracy of the test results? The nurse should:

a. suspend the sample in a special liquid preservative.
b. preserve the specimen on a special agar-coated slide.
c. preserve the specimen within 5 seconds of collection.
d. allow the sample to air dry on the slide before analysis.


   51. A nurse is explaining recommended guidelines for cervical cancer screening to a community group. Which statement by the nurse is most accurate? The nurse explains that women:

a. aged 21 to 29 should be screened every 2 years.
b. over age 60 do not need regular cervical screening.
c. 30 years of age and older need to continue annual screening.
d. need their first screen when they become sexually active.


   52. A nurse explains to a patient that a colposcopy is:

a. vaporization of abnormal cells using a laser beam.
b. a treatment that involves freezing of precancerous cells.
c. a specialized examination for the early detection and treatment of cancer.
d. a sampling method that uses a curette to obtain specimens.


   53. A patient had an endocervical sampling procedure 2 days ago and calls the clinic complaining of a thin vaginal discharge that looks like it contains “coffee grounds.” The best response by the nurse is to say:

a. “This may indicate an infection; call us if you develop a fever over 101.5°F.”
b. “This is an abnormal reaction to the drugs used during the procedure.”
c. “This is a normal result of the material used to stop cervical bleeding.”
d. “This might indicate an allergy to the solution used in the procedure.”


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