Menstrual Disorders
A 17-year-old reports severe cramping during the first two days of her period. The nurse should instruct the patient to:
A. Take NSAIDs at the onset of menses
B. Avoid exercise during her period
C. Apply an ice pack to the abdomen
D. Limit fluid intake
A – NSAIDs reduce prostaglandin production and relieve pain.
A couple has been unable to conceive after 1 year of unprotected intercourse. What should the nurse anticipate discussing first?
A. Female hormone levels
B. Male sperm analysis
C. Hysterosalpingogram
D. Genetic testing
B - It should always be done before more complex female evaluations.
A postmenopausal client reports painful intercourse and vaginal dryness. Which recommendation should the nurse make?
A. Apply water-based lubricant during intercourse
B. Take an oral antibiotic daily
C. Douche with warm water
D. Avoid all sexual activity
A - Vaginal dryness due to low estrogen can be relieved with lubricants; douching or antibiotics are not appropriate.
Which patient is at highest risk for developing cervical cancer?
A. 45-year-old with HPV infection
B. 35-year-old who uses oral contraceptives
C. 50-year-old with one lifetime partner
D. 25-year-old nulliparous woman
A - Persistent infection with high-risk HPV strains is the main cause of cervical cancer.
A patient with a cystocele reports urinary leakage when coughing. Which nursing action is most appropriate?
A. Teach Kegel exercises
B. Restrict fluid intake
C. Encourage bed rest
D. Apply cold compresses
A - Kegel exercises strengthen pelvic floor muscles and help reduce stress incontinence caused by bladder prolapse.
A nurse is assessing a 30-year-old with newly developed pelvic pain that begins before menstruation and lasts several days after. Which condition does the nurse suspect?
A. Primary dysmenorrhea
B. Endometriosis
C. PMS
D. Fibroids
B – Pain extending beyond menses suggests endometriosis.
A client with PCOS asks why she is taking metformin. The nurse’s best response is:
A. “It improves your body’s response to insulin.”
B. “It increases your estrogen levels.”
C. “It helps your ovaries release more eggs.”
D. “It replaces your missing hormones.”
A - Metformin decreases insulin resistance, lowering insulin levels and androgen production, which helps regulate menstrual cycles and improve fertility.
The nurse teaches a patient beginning estrogen therapy about potential complications. Which finding should be reported immediately?
A. Headache and blurred vision
B. Hot flashes
C. Nausea
D. Breast tenderness
A - Severe headache and visual changes suggest thromboembolic events or stroke, a major risk of estrogen therapy.
A patient with uterine (endometrial) cancer is scheduled for a hysterectomy. Which postoperative finding requires the nurse’s priority attention?
A. Scant vaginal drainage
B. Blood pressure 88/56 mmHg
C. Mild abdominal discomfort
D. Foley catheter draining clear urine
B - Hypotension may indicate internal bleeding or hemorrhage, which is life-threatening and requires immediate intervention.
A woman presents with sudden high fever, hypotension, and a rash resembling a sunburn after using tampons. What is the nurse’s priority?
A. Remove the tampon and obtain IV access
B. Administer oral fluids
C. Apply a cold compress
D. Instruct her to change brands
A - Toxic Shock Syndrome is a medical emergency.
Which statement by a patient with primary dysmenorrhea indicates effective teaching?
A. “Taking ibuprofen before my period starts may help.”
B. “This means I probably have an infection.”
C. “It usually begins in my late 20s.”
D. “I should avoid all physical activity.”
A - NSAIDs work best when started before prostaglandin levels rise at the onset of menstruation.
Which assessment finding is consistent with PCOS?
A. Decreased body hair and weight loss
B. Regular ovulation cycles
C. Acne and facial hair growth
D. Low insulin levels
C - Increased androgens cause hirsutism (excess hair) and acne in PCOS.
A nurse provides teaching on preventing osteoporosis. Which instruction is appropriate?
A. “Engage in weight-bearing exercises like walking.”
B. “Avoid dairy products to reduce fat.”
C. “Increase caffeine to improve calcium absorption.”
D. “You no longer need calcium after menopause.”
A - Weight-bearing exercise stimulates bone formation and reduces bone loss.
A nurse teaching a group about cervical cancer prevention should emphasize which strategy?
A. Annual Pap smears starting at age 18
B. HPV vaccination
C. Routine douching
D. Hormone therapy after menopause
B - The HPV vaccine prevents infection from high-risk HPV strains that cause most cervical cancers.
A nurse provides education about preventing TSS. Which statement indicates correct understanding?
A. “I’ll change tampons every 4–8 hours.”
B. “I’ll use high-absorbency tampons overnight.”
C. “I’ll avoid using pads on heavy days.”
D. “I’ll douche after every period.”
A - Changing tampons regularly reduces bacterial growth that can lead to TSS.
The nurse evaluates a patient using oral contraceptives for dysmenorrhea. Which finding indicates a need to contact the provider?
A. Mild nausea
B. Calf pain with swelling
C. Light spotting between periods
D. Breast tenderness
B - Calf pain and swelling may indicate deep vein thrombosis
The nurse is reinforcing education about lifestyle changes for a client with PCOS. Which statement shows understanding?
A. “Losing weight can help regulate my cycles.”
B. “I should avoid exercise to prevent fatigue.”
C. “Caffeine helps reduce insulin levels.”
D. “I don’t need to use birth control pills.”
A - Weight loss improves insulin sensitivity and helps restore ovulation and hormone balance.
A patient taking alendronate needs further teaching if she states:
A. “I’ll take it with a full glass of water.”
B. “I should lie down right after taking it.”
C. “I’ll sit upright for 30 minutes afterward.”
D. “I’ll take it on an empty stomach.”
B - Lying down can cause esophageal irritation or ulceration.
The nurse teaches a post-mastectomy client about lymphedema prevention. Which action should the patient take?
A. Avoid blood pressure measurements on the affected arm
B. Limit movement of the affected arm
C. Apply heating pad to the incision
D. Keep arm dependent at all times
A - Any trauma, including BP cuffs or IVs, increases lymph accumulation and swelling in the affected arm.
Which statement by a patient with fibroids indicates a need for further teaching?
A. “Fibroids are benign tumors.”
B. “They can cause heavy menstrual bleeding.”
C. “They are related to estrogen levels.”
D. “Fibroids always turn into cancer.”
D - Fibroids are benign and do not become malignant.
A nurse is caring for a client with secondary dysmenorrhea caused by fibroids. Which finding is most concerning?
A. Heavy bleeding with clots
B. Lower back discomfort
C. Dizziness and tachycardia
D. Constipation
C - Dizziness and tachycardia suggest significant blood loss and anemia, requiring immediate evaluation and possible fluid/blood replacement.
A woman diagnosed with infertility related to tubal blockage most likely has a history of:
A. Frequent UTIs
B. Pelvic inflammatory disease
C. Cervical dysplasia
D. Endometriosis
B - PID often leads to scarring and obstruction of the fallopian tubes, a common cause of infertility.
Following a bilateral oophorectomy, which symptom requires immediate attention?
A. Hot flashes
B. Night sweats
C. Chest pain and shortness of breath
D. Mood changes
C - Chest pain and dyspnea suggest a pulmonary embolism, a life-threatening postoperative complication.
A nurse reviews risk factors for ovarian cancer. Which client needs further teaching?
A. “I had my first full-term pregnancy at 22.”
B. “I smoke about a pack a day.”
C. “I have a BRCA1 gene mutation.”
D. “I have never been pregnant.”
A - Early full-term pregnancy is protective against ovarian cancer.
The nurse is providing discharge teaching after a total hysterectomy. Which statement by the patient indicates the need for further instruction?
A. “I can take short walks daily.”
B. “I’ll avoid lifting heavy objects for 6 weeks.”
C. “I’ll expect some light vaginal drainage.”
D. “I can resume sexual activity within a few days.”
D - Sexual intercourse should be avoided until cleared by the healthcare provider (usually 6 weeks) to prevent infection and promote healing.