Maternity and Pediatric Nursing 1st (first) Edition by Ricci, Susan Scott – Test Bank

Maternity and Pediatric Nursing 1st (first) Edition by Ricci, Susan Scott – Test Bank

Ch. 8: Cancers of the Female Reproductive Tract

Page: 228
1. The nurse would refer a client, age 54, for follow-up for suspected endometrial carcinoma if she reports which of the following?
A) Use of oral contraceptives between ages 18 and 25
B) Onset of painless, red postmenopausal bleeding
C) Menopause occurring at age 46
D) Use of intrauterine device for 3 years
Ans: B
Response:
Any episode of bright red painless bleeding occurring after menopause needs to be investigated. Abnormal uterine bleeding in postmenopausal women should be regarded with suspicion. Oral contraceptive use is associated with cervical cancer. Late menopause (after age 52) is associated with endometrial cancer. Use of an intrauterine device is not associated with endometrial cancer.

Page: 235
2. Which of the following instructions would the nurse include when preparing a woman for a Pap smear?
A) “Refrain from sexual intercourse for 1 week before the test.”
B) “Wear cotton panties on the day of the test.”
C) “Avoid taking any medications for 24 hours.”
D) “Do not douche for 48 hours before the test.”
Ans: D
Response:
The nurse should instruct the woman not to douche for 48 hours before the test to prevent washing away cervical cells, which might be abnormal. Sexual intercourse should be avoided for 48 hours before the test. Wearing cotton panties is unrelated to preparation for a Pap smear. Medications do not need to be withheld before the test.

Page: 230
3. A woman comes to the clinic for a routine check-up. A history of exposure to which of the following would alert the nurse that she is at increased risk for cervical cancer?
A) Hepatitis
B) Human papillomavirus
C) Cytomegalovirus
D) Epstein-Barr virus
Ans: B
Response:
Human papillomavirus is a major causative factor for cervical cancer. Hepatitis, cytomegalovirus, and Epstein-Barr virus are not associated with the development of cervical cancer.

Page: 235
4. A client is scheduled to have a Pap smear. After the nurse teaches the client about the Pap smear, which of the following client statements indicates successful teaching?
A) “I need to douche the night before with a mild vinegar solution.”
B) “I will take a bath first thing that morning to make sure I’m clean.”
C) “I will not engage in sexual intercourse for 48 hours before the test.”
D) “I will get a clean urine specimen when I first wake up the morning of the test.”
Ans: C
Response:
The woman should refrain from sexual intercourse for 48 hours before the test because sperm can obscure the specimen. Douching should be avoided for 48 hours before the test to prevent washing away cervical cells, which might be abnormal. Although a bath is an appropriate hygiene measure, it is not required before a Pap smear. Collecting a urine specimen also is not necessary.

Page: 224
5. Which finding obtained during a client history would the nurse identify as increasing a client’s risk for ovarian cancer?
A) Multiple sexual partners
B) Consumption of a high-fat diet
C) Underweight
D) Grand multiparity (more than five children)
Ans: B
Response:
Risk factors for ovarian cancer include a high-fat diet, obesity, nulliparity, early menarche, late menopause, and increasing age. Having multiple sexual partners is a risk factor for cervical cancer.

Page: 231
6. A client is scheduled for cryosurgery to remove some abnormal tissue on the cervix. The nurse teaches the client about this treatment, explaining that the tissue will be removed by which method?
A) Freezing
B) Cutting
C) Burning
D) Irradiating
Ans: A
Response:
Cryosurgery destroys abnormal cervical tissue by freezing. Conization involves cutting out a cone-shaped section of tissue. Laser therapy destroys cervical tissue by using high-energy light to burn it off. Radiation therapy involves irradiating the tissue for destruction.

Page: 231
7. Which of the following statements best indicates that a client has taken self-care measures to reduce her risk for cervical cancer?
A) “I’ve really cut down on the amount of caffeine I drink everyday.”
B) “I’ve thrown out all my bubble baths and just use soap and water now.”
C) “Every time I have sexual intercourse, I douche.”
D) “My partner always uses a condom when we have sexual intercourse.”
Ans: D
Response:
Unprotected sexual intercourse is a risk factor for cervical cancer. Use of barrier methods of contraception such as condoms is a key measure for reducing the risk for cervical cancer. Cessation of smoking and drinking alcohol, not caffeine, also are effective measures for risk reduction. Eliminating irritants such as bubble baths is a general measure to reduce perineal irritation and urinary tract infections. Douching has no effect on risk reduction for cervical cancer.

Page: 226
8. A client is suspected of having endometrial cancer. The nurse would most likely prepare the client for which procedure to confirm the diagnosis?
A) Transvaginal ultrasound
B) Colposcopy
C) Pap smear
D) Endometrial biopsy
Ans: D
Response:
An endometrial biopsy is the procedure of choice to make the diagnosis of endometrial cancer. A transvaginal ultrasound may be used to evaluate the endometrial cavity and measure the endometrial thickness to detect endometrial hyperplasia, but it does not confirm the diagnosis. Colposcopy is used to diagnose cervical cancer. A Pap smear screens for abnormal cervical cells.

Page: 234
9. Which of the following descriptions would the nurse include when teaching a client about her scheduled colposcopy?
A) “A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas.”
B) “A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument.”
C) “Scrapings of tissue will be obtained and placed on slides to be examined under the microscope.”
D) “After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples.”
Ans: B
Response:
A colposcopy is a microscopic examination of the lower genital tract using a magnifying instrument. Use of a microphone-like device over the abdomen describes an ultrasound. Obtaining tissue scrapings that are examined under a microscope describes a Pap smear. Insertion of a device under anesthesia near the umbilicus describes a biopsy obtained via laparoscopy.

Page: 221
10. The nurse is preparing a presentation for a local women’s group about way to reduce the risk of reproductive tract cancers. Which of the following would the nurse include?
A) Blood pressure evaluation every 6 months
B) Yearly Pap smears starting at age 40
C) Yearly cholesterol screening starting at age 45
D) Consumption of two to three glasses of red wine per day
Ans: C
Response:
Staying healthy is a major way to reduce one’s risk for cancer. Cholesterol should be checked annually starting at age 45. Blood pressure should be evaluated at least every 2 years. Pap smears are recommended every 1 to 3 years for sexually active women between the ages of 21 and 65. Alcohol should be consumed in moderation (not more than one drink per day), if at all.

Page: 223
11. The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate?
A) “Currently there is no reliable screening test for ovarian cancer.”
B) “A Pap smear is almost always helpful in identifying this type of cancer.”
C) “There’s a blood test for a marker, CA-125, that if elevated indicates cancer.”
D) “A genetic test for two genes, if positive, will identify the ovarian cancer.”
Ans: A
Response:
Currently there are no adequate screening tests for ovarian cancer. A Pap smear is used to screen for cervical cancer. The CA-125 marker may be elevated in women with ovarian cancer, but it is not specific for this cancer and may be elevated in other malignancies. Genetic testing via BRCA-1 and BRCA-2 provides information about a woman’s risk but does not predict if the woman will develop cancer.

Page: 225
12. Which of the following would the nurse be least likely to suggest when teaching a group of young women how to reduce their risk for ovarian cancer?
A) Pregnancy
B) Oral contraceptives
C) Feminine hygiene sprays
D) Breastfeeding
Ans: C
Response:
Risk reduction strategies include pregnancy, use of oral contraceptives, and breastfeeding. Women should avoid using talc and hygiene sprays on the genital area.

Page: 226
13. A woman is diagnosed with adenocarcinoma of the endometrium in situ. The nurse interprets this as indicating which of the following about the cancer?
A) Spread to the uterine muscle wall
B) Found on the endometrial surface
C) Spread to the cervix
D) Invaded the bladder
Ans: B
Response:
Carcinoma in situ is found only on the endometrial surface. In stage I, the cancer has spread to the uterine muscle wall. In stage II, it has spread to the cervix. In stage IV, it has invaded the bladder mucosa with distant metastases to the lungs, liver, and bone.

Page: 237
14. When preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects that the lesion would most likely be located at which area?
A) Labia majora
B) Labia minora
C) Clitoris
D) Prepuce
Ans: A
Response:
The diagnosis of vulvar cancer is made by biopsy of the suspicious lesion, which is most commonly found on the labia majora.

Page: 235
15. When describing the various types of reproductive tract cancers to a local women’s group, which of the following would the nurse identify as the least common type?
A) Vulvar
B) Vaginal
C) Endometrial
D) Ovarian
Ans: B
Response:
Of the cancers listed, vaginal cancer is the rarest, representing less than 3% of all genital cancers. Vulvar cancer represents approximately 4% of female genital cancers. Endometrial cancer is the most common type of gynecological cancer. Ovarian cancer is the eight most common cancer among women and the fifth most common cause of cancer deaths for women in the United States.