Chapter 12 Care of the Patient with a Reproductive Disorder

Chapter 12  Care of the Patient with a Reproductive Disorder

MULTIPLE CHOICE

1. The nurse admits a patient, age 72, who is scheduled for a vaginal hysterectomy. In what position will this patient be placed in the operating room for her surgery?
a. Lateral
b. Lithotomy

c. Trendelenburg d. Supine

ANS: B
The patient is placed in a lithotomy position, and the uterus is removed through the vagina.

DIF: Cognitive Level: Application REF: Page 569 OBJ: 12 TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

2. On the second postoperative day, a 63-year-old patient who has had an abdominal hysterectomy complains of gas pains and abdominal distention. She has not had a bowel movement since surgery. Which nursing intervention will best stimulate peristalsis and relieve distention?

1. Offering carbonated beverages
2. Encouraging ambulation at least four times per day
3. Administering a 1,000-mL soapsuds enema
4. Applying an abdominal binder

ANS: B
Early ambulation is very helpful to return the bowel to normal function.

DIF: Cognitive Level: Analysis REF: Page 570 OBJ: 12 TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

3. A patient tells the nurse that his wife, who has been diagnosed with inoperable ovarian cancer, is talking about dying and fear of death. He asks the nurse for suggestions that will be of assistance to his wife. Which response by the nurse would be most helpful?

1. “Your wife will probably die of another disease before she dies of ovarian cancer.”
2. “Talk of death is normal at this time but will diminish in the future.”
3. “Your wife is expressing an acceptance of utilizing hospice care.”
4. “It is perfectly normal to want to talk about death. It is most helpful to support her

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 12-2

by listening.”

ANS: D
In patients with inoperable cancer, a nursing diagnosis of Fear related to diagnosis of cancer is appropriate. Assisting patients with recognizing and clarifying fears and with developing coping strategies for those fears by listening is helpful.

DIF: Cognitive Level: Application REF: Page 569-570, Nursing Diagnoses boxes
OBJ: 12 TOP: Ovarian cancer
KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

4. A patient, age 41, has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis. She asks the nurse if she will have “hot flashes.” The nurse’s response is based on the knowledge that

1. only the uterus was removed, and the ovaries are still producing estrogen.
2. the patient is too young to have hot flashes associated with menopause.
3. the uterus, ovaries, and fallopian tubes were removed, and she will have surgically

   induced menopause.

4. the uterus and fallopian tubes were removed, and she will not experience “hot

   flashes.”

ANS: C
A total abdominal hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, fallopian tubes, and ovaries. If the ovaries are removed in these surgeries, the surgery will induce menopause and hot flashes may occur.

DIF: Cognitive Level: Analysis REF: Page 569 OBJ: 12 TOP: Hysterectomy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

5. On the fourth postoperative day after a modified radical mastectomy, the nurse finds the patient with her back to the nurse. She is crying and tells the nurse she feels ugly and is worried that her husband will not be in love with her anymore. The nurse bases subsequent nursing interventions on diagnosis?

1. Disturbed body image related to removal of her breast
2. Deficient knowledge related to inadequate education
3. Impaired social interaction related to depression
4. Fear related to the cancer diagnosis and surgical intervention

ANS: A
After losing a breast, many patients experience grief over the loss of a body part. The process of grieving is essential for personal adaptation to the loss. The nurse can assist the patient to find helpful coping mechanisms.

DIF: Cognitive Level: Analysis REF: Page 580, NCP 12-1
OBJ: 19 TOP: Mastectomy KEY: Nursing Process Step: Planning

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 12-3

MSC: NCLEX: Psychosocial Integrity