Unit 3 Module 2: Reproductive

Question 1

A woman needs to be tested for human papilloma virus. What test should be done?

Answer 1

A cell sample from the cervix and tested for HPV *. Remember HPV testing is not the same as a pap smear, but is an additional sample that is taken from the cervix.

Question 2

In which stage of syphilis is this symptom found?

Painless chancre is present at site of exposure

Answer 2

Primary

Question 3

What are the classic triad symptoms of endometriosis? (another damn select all that apply)?

• dysmenorrhea
• menorrhagia
• dyschezia
• infertility
• dyspareunia

Answer 3

• dysmenorrhea
• infertility
• dyspareunia

The others listed are symptoms of endometriosis, but not the classic triad.

Question 4

T/F: Women with triple negative breast cancer are lucky since there is receptor targeted therapy that is quite effective.

Answer 4

False. No one with cancer is “lucky.” AND Triple negative means Estrogen receptor, progesterone and HER2 receptor negative. This type of cancer is usually receptive to chemo, but not therapy targeted at receptors. It tends to be a more aggressive cancer with a high relapse rate.

Question 5

A patient comes into the clinic with suspected cold sores on his mouth. What action should the nurse take?

• Tell the patient he has herpes simplex virus infection.
• Put a surgical mask on the patient.
• Tell the patient that antibiotic therapy will cure his cold sores.
• Wear gloves when assessing the patient.

Answer 5

Wear gloves when assessing the patient.

Question 6

HPV has been associated with other cancers in addition to cervical cancer. SELECT ALL THAT APPLY to indicate what other types of cancers have been associated with HPV.

• rectal
• oral
• breast
• penile
• vaginal

Answer 6

• rectal
• oral
• penile
• vaginal

Question 7

Which two strains of HPV are associated with cervical cancer?

Answer 7

HPV type 16 & 18 cause 80% of all cervical cancer cases.

Question 8

Which of the following are caused by the HPV virus?

• psoriasis
• impetigo
• plantar warts
• cold sores
• some rectal cancers
• genital warts

Answer 8

• plantar warts
• some rectal cancers
• genital warts

Question 9

In which stage of syphilis is this symptom found?

Maculopapular rash on chest, palms of hands and feet present

Answer 9

Secondary

Question 10

How does the body normally respond to HPV? This helps explain the change in the guidelines for Pap smears.

Answer 10

The body normally eradicates the virus on its own.

The screening guidelines changed to first pap at the age of 21 or 3 years after first intercourse due to many positive responses. The body normally clears HPV on its own. Delaying screening gives the body the chance to do this.

Question 11

A woman is having a speculum exam with a specimen taken for a pap smear. The goal is to take a sample of which cervical cells for evaluation under a microscope to look for cervical cancer changes?

• outer ring of the cervix
• squamous epithelial cells
• columnar epithelium cells
• cells in the transformation zone

Answer 11

Cells in the transformation zone

Question 12

What are some risk factors for prostate cancer? SATA:

• African American background
• diet high in meat and fat
• multiparity (fathered many kids)
• increasing age (Ex. over the age of 65)
• family history

Answer 12

• African American background
  
  • diet high in meat and fat
  • increasing age (Ex. over the age of 65)
  • family history

Question 13

Which of the following has been identified as a dietary addition that is protective against prostate cancer?

• Red meat
• Eating foods higher in fat like avocados and nuts
• Drinking green tea
• Diet high in supplements

Answer 13

Drinking green tea

Question 14

What is the most typical scenario for a patient with Chlamydia?

• Patient comes to the clinic with complaints of profound vaginal itching.
• The infection was found incidentally during a vaginal swab exam.
• Patient comes to the clinic with complaints of profound vaginal itching.
• The patient reports having frequent outbreaks of this infection over the last 5 years.

Answer 14

The infection was found incidentally during a vaginal swab exam.

Question 15

The nurse understands endometriosis to be:

• A condition that is very painful and is worse with constipation.
• Tissue that should be in the uterus is found in other areas and goes through changes with the menstrual cycle.
• A benign growth of ovarian tissue that responds to hormone stimulation.
• An inflammatory condition that is aggravated by hormonal changes with menses.

Answer 15

Tissue that should be in the uterus is found in other areas and goes through changes with the menstrual cycle.

Question 16

A patient tells the nurse that she has adhesions from endometriosis. The nurse understands this to be:

Answer 16

Scar tissue

Question 17

T/F: The symptoms of prostate cancer can look like the symptoms of benign prostatic hyperplasia.

Answer 17

True

Prostate cancer is usually asymptomatic in the early stages and then as it advances the symptoms are similar to BPH. Advanced disease can have symptoms from the metastasis.

Question 18

Which STI am I?

Very painful or itching sensation occurs prior to the presence of lesions.

Answer 18

HSV

Question 19

Which statement is characteristic of testicular cancer?

• Men at highest risk for testicular cancer are men over 50 years of age.
  
  • Men are taught to do monthly testicular exams as a screening method.
  • Testicular cancer masses should transilluminate when examined.
  • Most patients seek treatment due to a painful mass in the testicle.

Answer 19

Men are taught to do monthly testicular exams as a screening method.

TSE is encouraged to young men (15-35), as they are most at risk. The mass is painless and does not trans-illuminate (like a fluid fill cyst would).

Question 20

A 16-year old female starts to become sexually active for the first time and contracts HPV infection. What does the nurse expect to happen?

Answer 20

The patient’s body will most likely eradicate the virus on its own.

Question 21

In which stage of syphilis is this symptom found?

Gummas are present in various parts of the body

Answer 21

Tertiary

Question 22

T/F One theory is that endometriosis is caused by dormant embryonic cellular components are evolving into endometrial tissue outside of the uterus.

Answer 22

True. This is one of many theories. Other theories include: retrograde menstruation, spread through lymph and vascular as well as genetics, immunity or environmental.

Question 23

A patient had a PSA done 1 year ago and it was 1.5 ng/mL. A repeat test this year resulted in 25 ng/mL. How would the nurse interpret this information?

• That is a normal change in results.
• Was a digital rectal exam done prior to drawing the blood?
• This is a sign of prostate cancer.
• The man most likely has prostatitis.

Answer 23

Was a digital rectal exam done prior to drawing the blood?

This result is concerning and is a significant increase in a 1-year time period. This could be related to doing a digital rectal exam right before drawing the blood. It could also be prostate cancer, prostatitis or BPH. The nurse should recognize that this is a significant increase and should be further investigated.

Question 24

What are the symptoms of breast cancer? Select all that apply

• breast pain before menstruation
• discharge from the nipple
• inversion of nipples
• change in size of one breast
• palpable mass that comes and goes

Answer 24

• discharge from the nipple
• inversion of nipples
• change in size of one breast

Symptoms include: hard, uneven, painless mass; change in shape, size or feel or breast or nipple, orange peel appearance, and nipple drainage.

Painful breasts before menstruation is associated with premenstrual syndrome. Breast cancer masses don’t “come and go”.

Question 25

The cervix is normally lined with __________ epithelium, whereas the vagina is lined with __________. The area where the two types of tissues come together is called the ___________ zone.

Answer 25

Simple columnar, stratified squamous, transformation

Question 26

Which STI am I? Painless chancre lesion

Answer 26

Syphilis

Question 27

In which stage of syphilis is this symptom found? CNS effects like dementia

Answer 27

Tertiary

Question 28

A hospitalized patient who has been treated for a major systemic infection (sepsis) with multiple antibiotic drugs is at risk of developing which infection?

Answer 28

Candidiasis

Question 29

The nurse recognizes that a patient with creamy yellowish-white discharge from his penis may have which STI?

Answer 29

Gonorrhea

Question 30

A patient is diagnosed with advanced prostate cancer that has metastasized. What is the most likely presentation for this type of patient? - asymptomatic - complaints of incontinence - complaints of BPH-like symptoms as well as pain in the lower back and pelvis - shortness of breath

Answer 30

Complaints of BPH-like symptoms as well as pain in the lower back and pelvis Once advanced, BPH symptoms are common as well as signs of mets. Mets to the bones is common and may present as lower back or pelvic pain.

Question 31

A nurse is teaching a woman to do monthly self-exams of the breast to look for signs of breast cancer. What should the nurse teach the woman to watch for? Select all that apply. - asymmetry in the breasts - breasts that are atrophied - discharge from the nipple - skin that has the appearance of an orange peel - painful lumps in the breast

Answer 31

- asymmetry in the breasts - painful lumps in the breast - discharge from the nipple - skin that has the appearance of an orange peel

Question 32

T/F: Herpes simplex virus infections can't be spread unless there are lesions present.

Answer 32

False. Asymptomatic shedding of the virus still occurs even when lesions are not present. Additionally, people are always contagious when lesions are present.

Question 33

Which of the following men are at greatest risk of prostate cancer? - 40-year-old African American male - 85-year-old male - 50-year-old male with cardiovascular and kidney disease - 60-year-old male with poor dietary habits

Answer 33

85-year-old male Age alone is one of the strongest risk factors for cancer. We know that 1 in 6 men have prostate cancer by the age of 85.

Question 34

The age group that is most commonly diagnosed with endometriosis is:

Answer 34

25-35 years old. Most women are diagnosed with endometriosis during the time that women are typically trying to become pregnant (25-35) and it can lead to infertility. Often interventions are aimed at helping women become pregnant during this time frame if they have endometriosis and what to have children in case they become infertile.

Question 35

A patient has genital herpes. What clinical presentation does the nurse expect when examining the patient?

Answer 35

There is itching and painful sensations that occurred prior to the outbreak of lesions.

Question 36

Women who have endometriosis complain of: - dsymenorrhea - amenorrhea - high risk of pregnancy - lower back pain

Answer 36

Dsymenorrhea

Question 37

Which of the following pathology descriptions is describing a case of cervical cancer? - ASC-US - LSIL - CIN3 - HSIL

Answer 37

CIN3 ASC-US: atypical squamous cell of undetermined significance. CIN 1= mild dysplasia (LSIL) low grade squamous intraepithelial lesion CIN2= moderate (HSIL) high grade squamous intraepithelial lesion CIN3=severe dysplasia and carcinoma in situ **This one is cancer that has been contained to the cervix only. It has not crossed the basement membrane.

Question 38

A woman has been diagnosed with ER positive breast cancer. What does this mean? - Only chemotherapy can work for this patient. - The cancer is very aggressive. - The cancer will respond to targeted hormone therapy that targets estrogen receptors.

Answer 38

The cancer will respond to targeted hormone therapy that targets estrogen receptors.

Question 39

Emily is 27 years old and has endometriosis. 'Select all that apply' that are correlated with the occurrence of endometriosis. - She complains of constant pelvic pain throughout the month without variation. - She started having menstrual periods at the age of 16. - Her mother and older sister both have endometriosis. - She has not been able to become pregnant after trying for 5 years to conceive - Her periods have been heavy with intense cramping.

Answer 39

- Her mother and older sister both have endometriosis. - She has not been able to become pregnant after trying for 5 years to conceive - Her periods have been heavy with intense cramping.

Question 40

Which of the following pathology reports is the most dysplastic changes? - ASC-US - LSIL or CIN1 - HSIL or CIN2 - CIN3

Answer 40

CIN3

Question 41

Candidiasis infections are caused by:

Answer 41

Imbalance in the normal vaginal flora Candidiasis infections occur when the normal balance is off: normal flora disturbed; pH changes, decreased immune response or increased glucose levels.

Question 42

Which of the following women would be most likely (highest risk) of having endometriosis? - Woman who started her menstrual cycle at age 8. - Woman who had her first child at the age of 14. - Woman who has had 5 pregnancies. - Woman who has had HPV infection.

Answer 42

Woman who started her menstrual cycle at age 8.

Question 43

A patient is asking the nurse about her symptoms of endometriosis. She asks for further clarification. What is the best response by the nurse? "There is uterus tissue that changes from squamous epithelium to columnar epithelium and that causes the pain." “The best way to diagnose endometriosis in patients it through a vaginal ultrasound guided biopsy.” “Endometriosis is a risk factor for cervical cancer and therefore yearly pap smear screenings are recommended.” "When the endometrial tissue bleeds outside of the uterus, it causes inflammation and scarring which leads to a lot of the pain and chronic complications."

Answer 43

"When the endometrial tissue bleeds outside of the uterus, it causes inflammation and scarring which leads to a lot of the pain and chronic complications." The scarring (also called adhesions) causes a lot of the chronic problems with pain and infertility.

Question 44

Which of the following men is most suspicious of testicular cancer? - An 88-year-old male with bilateral enlarged testicles. - An 18-year-old with one large, painful testicle after trauma. - A 22-year-old male with a painless mass found incidentally during self-exam. - A 50-year-old male with urinary symptoms and swelling in his testicles.

Answer 44

A 22-year-old male with a painless mass found incidentally during self-exam.

Question 45

T/F Cervical cancer is a sexually transmitted disease.

Answer 45

True This may be debated, but what I want you to walk away knowing is that 80% of all cervical cancer is caused by the human papilloma virus, which is transmitted sexually.

Question 46

A patient tells the nurse that he has noticed a lesion on his penis that is moist and does not hurt. The nurse is suspicious that this is might be which STI?

Answer 46

Syphilis

Question 47

Which woman would be at highest risk of breast cancer due to estrogen exposure risk? - A woman who was on birth control pills for 40 years from the age of 15 to 55. - A woman whose husband had a vasectomy. - A woman who had menarche at the age of 18 and menopause at the age of 40.

Answer 47

A woman who was on birth control pills for 40 years from the age of 15 to 55.

Question 48

A patient has a rash on the soles of his feet. The nurse recognizes this can occur with which stage of syphilis?

Answer 48

Secondary

Question 49

Which STI am I? The most common sexually transmitted infection.

Answer 49

Chlamydia

Question 50

Which of the following statements is characteristic of prostate cancer? - I was screened for prostate cancer by having a trans-rectal ultrasound completed. - Prostate cancer is a very fast growing cancer. - The most common type of prostate cancer is adenocarcinoma. - Prostate specific antigen levels are considered abnormal if it is elevated more than 2 ng/mL.

Answer 50

The most common type of prostate cancer is adenocarcinoma.

Question 51

Which STI am I? Most characteristic symptom is a thick creamy yellow discharge, most commonly occurring in men.

Answer 51

Gonorrhea