Reproductive Health Alterations

A nurse is reinforcing teaching with a client about a semen analysis that will be done as part of an infertility evaluation. Which of the following client statements indicate an understanding of the teaching?

"I'm having this test done before my partner has any tests because it's simple and not invasive."

"I should avoid sperm ejaculation 2 to 7 days before my appointment."

"It's important that I don't use any lubricants during my sample collection."

A nurse is collecting data from a client who has abnormal uterine bleeding (AUB). Which of the following findings should the nurse identify as a risk factor for AUB?

Leiomyoma

-The nurse should identify that uterine abnormalities, such as uterine polyps, endometriosis, fibroids (leiomyomas), and cancer are risk factors for AUB.

A nurse who is rubella non-immune is caring for a client who is diagnosed with rubella. Which of the following should the nurse identify as a concern when caring for this client?

The nurse is at 17 weeks of gestation.

A nurse is reinforcing teaching about strategies to minimize the risk of mastitis for a client who is newly postpartum. Which of the following strategies should the nurse include?

Empty the breast, or breasts, used at each feeding.

Ensure the newborn has a proper latch every time.

Wash hands prior to touching breasts.

Treat nipples that become sore.

A nurse is collecting data from a client who has premenstrual dysphoric disorder (PMDD). Which of the following findings should the nurse identify as a risk factor for this condition?

Childhood sexual abuse

-The nurse should identify that childhood sexual abuse or trauma is a risk factor for premenstrual syndrome (PMS) and PMDD. Clients who have PMDD are also more likely to suffer from other comorbid psychological disorders, such as bipolar disorder, anxiety, major depression, ADHD, and schizophrenia.

A nurse is caring for a client who has tested positive for the BRCA1 gene mutation. The nurse should recognize that the client is at an increased risk for which of the following conditions?

Breast cancer

-BRCA1 and BRCA2 are tumor suppression genes. Gene mutation is associated with an increased risk for breast cancer.

A nurse is reinforcing teaching to a group of clients about modifiable risk factors for breast cancer. Which of the following factors should the nurse include?

Alcohol use

Obesity

Low fiber intake

A nurse is reinforcing teaching to a client who has a new diagnosis of chlamydia. Which of the following client statements demonstrate an understanding of the teaching?

"If a single-dose antibiotic is prescribed, I have to wait 7 days after the treatment to resume sexual activity."

"When doxycycline is prescribed, I should stay out of the sun if possible, or wear protective clothing and sunscreen."

A nurse is collecting data from a client who has infertility related to uterine factors. Which of the following conditions should the nurse identify as a uterine factor that increases the risk of infertility?

Adenomyosis

-The nurse should identify that adenomyosis is a condition in which the normal uterine lining (endometrial tissue) grows into the uterine wall muscle. This condition causes infertility due to uterine dysfunction.

A nurse is reviewing the medical record of a client who has a new diagnosis of abnormal uterine bleeding (AUB). Which of the following findings support this diagnosis?

Passing blood clots the size of a lemon

A decreased hemoglobin level

A decreased hematocrit level

A nurse is participating in the care of a client who requires a wet mount microscopy test to confirm their diagnosis. Which of the following results should the nurse suspect?

Trichomonas vaginalis

A nurse is reinforcing teaching with a client who has a new diagnosis of genital herpes. Which of the following client statements about their condition demonstrates an understanding of the teaching?

"If I become immunocompromised, I may experience severe genital herpes outbreaks."

"Genital herpes is caused by HSV-1 or HSV-2."

A nurse is reviewing the medical record of a client who has a rectovaginal fistula. Which of the following conditions should the nurse identify as risk factors for rectovaginal fistula?

Inflammatory bowel disease

Rectal trauma

Traumatic birth

A nurse is reviewing the medical record of a client who has a new diagnosis of endometriosis. Which of the following findings should the nurse identify as being associated with endometriosis?

Short menstrual cycles

Long periods

A nurse is collecting data from several clients who are seeking to add a child to their families. Which of the following scenarios should the nurse identify as most likely to require the use of a gestational carrier (GC)?

Male same-sex couple

A nurse is reviewing treatment options for clients who have follicular ovarian cysts. The nurse should identify that which of the following clients has a contraindication for receiving combined estrogen-progestin oral contraceptives (COCs)?

A client who has coronary artery disease

A nurse is reinforcing teaching with a client who is having an in vitro fertilization (IVF) procedure in 1 month. Identify the sequence of steps in the order the client will have them performed. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Gonadotropin therapy injections is the first step.

Egg retrieval from ovary is the second step.

Fertilization of the egg and sperm in the laboratory is the third step

Embryo transfer is the final step

A nurse is reinforcing client teaching about the use of metformin to treat polycystic ovarian syndrome (PCOS). Which of the following client statements indicates an understanding of the teaching?

"I should have my HbA1c levels checked twice a year."

A nurse is collecting data from a client who has a vaginal yeast infection. Which of the following microorganisms should the nurse identify as the likely cause of this condition?

Candida albicans

A nurse is reinforcing teaching about clomiphene citrate with a client who is undergoing fertility treatment. Which of the following client statements indicate an understanding of the teaching? (Select all that apply.)

"If I experience abdominal pain or swelling, I should call the provider right away."

"My chances of getting pregnant with twins increase with this medication."

"I can use an at-home ovulation kit to monitor my cycle."

A nurse is collecting data from a client who has a cystocele. Which of the following findings should the nurse expect?

Urinary incontinence

A nurse is reinforcing teaching for a client who has been diagnosed with a 1.5 cm (0.59 in) fibroadenoma in the left breast. Which of the following client statements indicate an understanding of the teaching? (Select all that apply.)

"Since I don't have any manifestations and it's small, I do not need to have surgery to remove the mass."

"I will contact my provider if I notice any changes in the size of the mass or start to have any manifestations."

"Once I go through menopause, the fibroadenoma may shrink in size."

A nurse is reinforcing teaching for a client who is experiencing perimenopausal manifestations. Which of the following client statements indicate an understanding of the teaching? (Select all that apply.)

"I can take estrogen replacement medications to help with my hot flashes and night sweats."

"I guess this weight gain is explained by perimenopause."

"Once I haven't had a period in 12 months, I'll officially be in menopause."

A nurse is collecting data from a group of clients who are being screened for breast cancer. Which of the following manifestations should the nurse identify as being associated with breast cancer?

Client reports an immovable breast mass

A nurse is reviewing the medical record of a client who has a new diagnosis of cervical cancer. Which of the following data should the nurse identify as risk factors associated with cervical cancer? (Select all that apply.)

HIV

Multiple sexual partners

Cigarette smoking

0500:Client presented to the ED with reports of lower abdominal pain, rated as 8 on a pain scale of 0 to 10, dysuria, increased VD , and flu-like symptoms. Client reports experiencing pain during vaginal intercourse. Abdomen is soft and nondistended. guarding on palpation.0530:Client reports worsening lower abdominal pain, radiating to pelvis. Rates pain as 10 on a pain scale of 0 to 10. Client also reports nausea and chills. Based on the assessment, which of the following findings should the nurse report to the provider?

0500:Temp 38˚ C (100.4˚ F)Heart rate 90/min RR 18/min BP 130/78 mm Hg0530:Temp 39.3˚ C (102.7˚ F)Heart rate 98/min RR 24/min BP 134/82 mm Hg

Generalized malaise; lower abdominal pain radiating to the back bilaterally. pain as 10. Burning and pain with urination x 1 day; yellow, purulent malodorous VD x 3 days; dark, cloudy urine. Bimanual exam: significant cervical motion tenderness experienced.

Vaginal discharge

Lower abdominal pain

Temperature

Respiratory rate

Pain with urination

Pain during intercourse

ay 1, 0700:Client called clinic with concerns of breast pain over the last 24 hr while breastfeeding infant and pumping at work. Client is concerned about a plugged duct. Client advised to continue breastfeeding and pumping as usual and make sure breasts are emptied fully with each feeding. May take acetaminophen, or ibuprofen, or use ice for pain.Day 2, 1500:Client presents to the clinic with reports of redness of right breast x 3 days, increasing pain, chills, and malaise for 24 hr. States pain is a 6 on a scale of 0 to 10 and increases when infant breastfeeds on the right side. Client states, "I feel like I have been hit by a bus."Day 5, 1200:Client presents to ED with report of mastitis that has not improved with dicloxacillin x 3 days. Client is lethargic and shivering violently. Accompanied by partner who expresses concern that the client had difficulty waking up this morning and was sometimes incoherent.

When prioritizing hypotheses, the nurse should identify that the client may have sepsis related to acute mastitis and intervene based on prioritized problems. Occasionally, mastitis can progress to systemic infection, sepsis, or development of an abscess if not treated in a timely manner or treated with ineffective antibiotics. Immediate action should be taken when a client has manifestations of sepsis, such as elevated WBC count, fever, hypotension, and tachycardia. The nurse should recognize that the provider should be alerted immediate, and timely care should be provided.

8 months ago:36-year-old client presents to clinic with concerns about fertility. Client and partner have been "trying everything" for 6 months to get pregnant. Client has been tracking menstrual cycles and reports a cycle every 20 to 48 days that lasts 2 to 5 days. Client and partner have regular intercourse 2 to 3 days per week.5 months ago:Client presents for follow-up regarding infertility. Pregnancy test today is negative. Semen analysis done 2 months ago, results of the analysis are within the expected reference ranges. Client reports ovulation x 1 in 3 months. The provider referred the client to infertility clinic.

8 months ago:Client advised to track ovulation with at-home ovulation kit for the next 2 months and have intercourse every 2 to 3 days while ovulating. Referral made to urology clinic for client's partner to have semen analysis.

When analyzing cues, the nurse should identify that abnormal period cycle length (20 to 48 days) and infrequent ovulation, along with the client's age are associated with infertility.