Chapter 55: Assessment: Reproductive System Harding: Lewis's Medical-Surgical Nursing

1. Which question would the nurse ask when assessing a 60-year-old patient who has a history of benign prostatic hyperplasia (BPH)?

a. "Have you noticed any unusual discharge from your penis?"

b. "Has there been any change in your sex life in the last year?"

c. "Has there been a decrease in the force of your urinary stream?"

d. "Have you been experiencing any difficulty in achieving an erection?"

ANS: C

Enlargement of the prostate blocks the urethra, leading to urinary changes such as a decrease in the force of the urinary stream. The other questions address possible problems with infection or sexual difficulties, but they would not be helpful in determining whether there were functional changes caused by BPH.

2. A 68-year-old male patient tells the nurse that he is worried because he does not respond to sexual stimulation the same way he did when he was younger. The nurse's best response to the patient's concern is which of the following?

a. "You may need additional stimulation with aging."

b. "Tell me more about how your reaction has changed."

c. "Interest in sex frequently decreases as men get older."

d. "Erectile dysfunction is common problem in older men."

b. "Tell me more about how your reaction has changed."

3. The nurse is assessing the sexual-reproductive functional health pattern of a 32-year-old woman. Which question is most useful in planning for appropriate health screening?

a "Do you have sex with men, women, or both?"

b. "Which gender do you prefer to have sex with?"

c. "Are you heterosexual, homosexual, or bisexual?"

d. "What types of sexual activities do you engage in?"

d. "What types of sexual activities do you engage in?"

4. Which explanation would the nurse provide to a patient being prepared for colposcopy with a cervical biopsy? Colposcopy involves visualization of the cervix with a binocular microscope and is similar to a speculum examination. A cervical biopsy may cause a minimal amount of pain (The cervix is not dilated, anesthesia is not required, and fasting is not necessary.)

a. It involves dilation of the cervix and biopsy of the tissue lining the uterus.

b. It will take place in a same-day surgery center so that local anesthesia can be used.

c. It is similar to a speculum examination and should cause little discomfort.

d. It requires that the patient have nothing to eat or drink for 6 hours before the

procedure.

c. It is similar to a speculum examination and should cause little discomfort.

5. A 49-year-old man who has type 2 diabetes, high blood pressure, hyperlipidemia, and gastroesophageal reflux tells the nurse that he has had recent difficulty in achieving an erection. Which of the following drugs from his current medications list may cause erectile dysfunction (ED)?

a. Ranitidine (Zantac)

b. Atorvastatin (Lipitor)

c. Propranolol (Inderal)

d. Metformin (Glucophage)

c. Propranolol (Inderal)

6. A 19-year-old patient calls the school clinic and tells the nurse, "My menstrual period is very heavy this time. I have to change my tampon every 4 hours." Which action would the nurse take next? Because a heavy menstrual flow is usually indicated by saturating a pad or tampon in 1 to 2 hours, the nurse should first assess how heavy the patient‘s usual flow is. (There is no need to schedule the patient for an appointment that day. The patient may need to call again, but this is not the first action that the nurse should take. Telling the patient that she does not have a heavy flow implies that the patient‘s concern is not important.)

a. Tell the patient that her flow is not unusually heavy.

b. Schedule the patient for an appointment later that day.

c. Ask the patient how heavy her usual menstrual flow is.

d. Have the patient call again if the heavy flow continues.

c. Ask the patient how heavy her usual menstrual flow is.

7. A woman calls the clinic because she is having an unusually heavy menstrual flow. She tells the nurse that she has saturated three tampons in the past 2 hours. The nurse estimates that the amount of blood loss over the past 2 hours is _____ mL. The average tampon absorbs 20 to 30 mL.

a. 20 to 30

b. 30 to 40

c. 40 to 60

d. 60 to 90

a. 20 to 30

8. Which finding from the assessment of a 42-year-old male patient would the nurse report to the health care provider? Clear penile discharge may be indicative of a sexually transmitted infection (STI)

a. One testis hangs lower than the other.

b. Genital hair distribution is diamond shaped.

c. Clear discharge is present at the penile meatus.

d. Inguinal lymph nodes are nonpalpable bilaterally.

c. Clear discharge is present at the penile meatus.

9. Which information obtained by the nurse and shown in the accompanying figure about a 72-year-old man who is complaining of erectile dysfunction is most important to communicate to the

health care provider?

a. Recent knee surgery

b. Use of antihypertensives

c. Low position of left testis

d. Pulse and blood pressure level

b. Use of antihypertensives

10. The following patients call the outpatient clinic. Which phone call should the nurse return first? The patient‘s dyspnea suggests a delayed reaction to the iodine dye used for the CT scan. (The other patient‘s symptoms are not unusual after the procedures they had done.)

a. A 44-year-old patient who has bloody discharge after a hysteroscopy earlier today

b. A 64-year-old patient who is experiencing shoulder pain after a laparoscopy

yesterday

c. A 34-year-old patient who is short of breath after having a pelvic CT with contrast

dye

d. A 54-year-old patient who has severe breast tenderness following a needle

aspiration breast biopsy

c. A 34-year-old patient who is short of breath after having a pelvic CT with contrast

dye

11. Which aspects of sexual response reported by a 70-year-old female would the nurse recognize as commonly experienced due to aging? (Select all that apply.) Changes associated with normal aging include decreased vaginal lubrication, difficulty maintaining arousal, difficulty achieving orgasm, and decreased libido and interest in sex. (Women do not have a refractory period after orgasm.)

a. Decreased refractory time

b. Decreased vaginal lubrication

c. Difficulty maintaining arousal

d. Increased libido and interest in sex

e. Increased ease of achieving orgasm

b. Decreased vaginal lubrication

c. Difficulty maintaining arousal

12. The nurse is explaining the phases of sexual arousal to a community group. Which changes would the nurse describe as normally occurring during the plateau phase of sexual arousal? (Select all that apply.) In the female plateau phase, the vagina expands, and the uterus is elevated. In the male plateau phase, the penis increases in diameter and the glans penis may become reddish purple. (Uterine contractions and male ejaculation occur during the orgasmic phase.)

a. Vagina expands.

b. Uterus contractions occur.

c. Penile diameter increases.

d. Ejaculation of semen occurs.

e. Glans penis becomes reddish purple.

a. Vagina expands.

c. Penile diameter increases.

e. Glans penis becomes reddish purple.