Gynecologic Cancers: Cervical Cancer, Ovarian Cancer, Uterine Cancer

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Question 1: A nurse is educating a group of young women about cervical cancer.
Which statement by the nurse accurately describes a primary cause and a risk factor for cervical cancer?

Explanation

Choice A rationale:

Cervical cancer is not primarily caused by early sexual activity.

While certain sexual behaviors can increase the risk of cervical cancer, the primary cause is infection with high-risk strains of the human papillomavirus (HPV).

Early sexual activity can increase the risk of HPV exposure, but it is not the primary cause.

Choice B rationale:

Hormonal imbalances are not the primary cause of cervical cancer.

HPV infection is the primary cause, as it can lead to the development of cervical dysplasia and, if left untreated, cervical cancer.

Choice C rationale:

Smoking is indeed a risk factor for cervical cancer.

Smoking can weaken the immune system and make it more difficult for the body to fight off HPV infection.

Additionally, smoking may also contribute to the development of cervical dysplasia.

Choice D rationale:

Family history of ovarian cancer is not a risk factor for cervical cancer.

While family history may increase the risk of certain cancers, cervical cancer is primarily associated with HPV infection and other risk factors, such as smoking and a weakened immune system.


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Question 2: A client is concerned about her risk of ovarian cancer.
Which statement by the client indicates a correct understanding of the risk factors for ovarian cancer?

Explanation

Choice A rationale:

Age is indeed a significant risk factor for ovarian cancer.

Ovarian cancer risk increases with age, with the majority of cases occurring in women over the age of 50.

Younger women can still develop ovarian cancer, but age is a significant factor.

Choice B rationale:

Infertility is not a primary cause of ovarian cancer.

While there may be some associations between infertility treatments and ovarian cancer, it is not considered a primary cause.

The exact cause of ovarian cancer is not well understood but may involve genetic mutations, hormonal factors, and inflammation.

Choice C rationale:

BRCA gene mutations can increase the risk of ovarian cancer.

Women with BRCA1 or BRCA2 gene mutations have a significantly higher risk of developing ovarian cancer compared to those without these mutations.

This understanding indicates that the client has correctly grasped this risk factor.

Choice D rationale:

Ovarian cancer is not primarily caused by hormonal imbalances.

While hormones may play a role in the development of ovarian cancer, they are not considered the primary cause.

Genetic factors, such as BRCA mutations, are more significant contributors to ovarian cancer risk.


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Question 3: A nurse is assessing a patient with gynecologic cancers.
Select all the factors that are potential risk factors for uterine cancer.

Explanation

Choice A rationale:

Obesity is a potential risk factor for uterine cancer.

Excess body fat can lead to increased levels of estrogen, which can promote the growth of uterine cancer cells.

Maintaining a healthy weight is important in reducing the risk of uterine cancer.

Choice B rationale:

Diabetes is also a potential risk factor for uterine cancer.

High levels of insulin in people with diabetes may increase the risk of uterine cancer.

Proper management of diabetes is important in reducing this risk.

Choice C rationale:

Smoking is not a risk factor for uterine cancer.

Uterine cancer is primarily associated with hormonal imbalances and obesity, but smoking is not considered a significant risk factor for this type of cancer.

Choice D rationale:

Family history of ovarian cancer is not a risk factor for uterine cancer.

These two types of cancer have different risk factors and mechanisms.

Uterine cancer is more closely associated with hormonal factors and obesity.

Choice E rationale:

Hormone replacement therapy (HRT) is a potential risk factor for uterine cancer, specifically in women who have not had their uterus removed (i.e., those with an intact uterus).

HRT with estrogen alone can increase the risk of uterine cancer, but when combined with progesterone in women with an intact uterus, the risk is lower.

It's important for healthcare providers to discuss the risks and benefits of HRT with their patients, taking into account individual factors such as menopausal symptoms and medical history.


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Question 4: A client with cervical cancer asks the nurse about the pathophysiology of her condition.
How should the nurse explain the development of cervical cancer?

Explanation

Choice A rationale:

Cervical cancer does not begin with abnormal cell growth in the ovaries.

Cervical cancer has its origins in the cervix, not the ovaries.

The ovaries and cervix are distinct anatomical structures.

Choice B rationale:

Hormonal imbalances in the uterus do not directly cause cervical cancer.

Cervical cancer primarily arises due to persistent infection with high-risk strains of the human papillomavirus (HPV), along with other risk factors.

Choice D rationale:

Family history of uterine cancer may increase the risk of other gynecologic cancers but is not the primary cause of cervical cancer.

The primary cause is HPV infection.

Choice C rationale:

Cervical cancer starts with cellular changes in the cervix, leading to the development of precancerous lesions.

These precancerous lesions can progress to invasive cervical cancer over time.

The most common cause of cervical cancer is persistent infection with high-risk strains of HPV, which can lead to cellular changes in the cervix.


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Question 5: A nurse is providing care to a patient with ovarian cancer.
Which statement accurately describes ovarian cancer's origin and its different types?

Explanation

Choice A rationale:

Ovarian cancer does not originate from the cells of the cervix.

It arises from the cells of the ovaries.

The cervix and ovaries are distinct anatomical structures.

Choice B rationale:

All ovarian cancers do not have the same pathophysiology.

Ovarian cancer is a broad term that includes different histological types, including epithelial ovarian cancer, germ cell tumors, and stromal tumors.

Each of these types has its unique pathophysiology and characteristics.

Choice C rationale:

This statement is incorrect.

There are different types of ovarian cancer, as mentioned in choice D.

Choice D rationale:

Ovarian cancer originates from the cells of the ovaries and has different types, including epithelial ovarian cancer, germ cell tumors, and stromal tumors.

Each of these types has distinct pathophysiological features, prognosis, and treatment approaches.

Epithelial ovarian cancer is the most common type, accounting for the majority of cases.


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Question 6: A nurse is assessing a patient with suspected gynecologic cancer.
The patient complains of abnormal vaginal bleeding and pelvic pain.
Which of the following cancers is most likely indicated by these symptoms?

Explanation

Choice A rationale:

Abnormal vaginal bleeding and pelvic pain are more indicative of uterine or endometrial cancer than cervical cancer.

While cervical cancer can cause abnormal vaginal bleeding in later stages, uterine cancer is more commonly associated with these symptoms.

Choice B rationale:

Ovarian cancer may present with pelvic pain, but it is less likely to cause abnormal vaginal bleeding.

Uterine and endometrial cancer are more closely associated with abnormal vaginal bleeding.

Choice D rationale:

Endometrial cancer is a likely possibility, as it often presents with abnormal vaginal bleeding and pelvic pain.

However, uterine cancer is a more precise term for cancer originating in the uterus.

Choice C rationale:

This is the correct answer.

Uterine cancer is most likely indicated by the symptoms of abnormal vaginal bleeding and pelvic pain.

These are common presenting symptoms of uterine cancer, especially in the early stages.

It is essential to perform further diagnostic tests to confirm the diagnosis and determine the extent of the disease.


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Question 7: A client diagnosed with gynecologic cancer reports experiencing nonspecific symptoms such as bloating, abdominal discomfort, and urinary urgency.
Which cancer is commonly associated with these early-stage symptoms?

Explanation

Choice A rationale:

Cervical Cancer is not commonly associated with the early-stage symptoms mentioned in the question.

Cervical cancer typically presents with symptoms such as abnormal vaginal bleeding, pelvic pain, and pain during intercourse.

Choice C rationale:

Uterine cancer may cause symptoms like abnormal vaginal bleeding, pelvic pain, and pain during intercourse, but it is not commonly associated with bloating, abdominal discomfort, and urinary urgency, as mentioned in the question.

Choice D rationale:

Vaginal cancer is relatively rare and usually presents with symptoms like vaginal bleeding or discharge.

It is not commonly associated with bloating, abdominal discomfort, and urinary urgency.

Now, let's move on to , which is a "Select all that apply" question.


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Question 8:
A nurse is educating a group of patients about gynecologic cancers.
Which symptoms are commonly associated with advanced-stage ovarian cancer? Select all that apply.

Explanation

Choice A rationale:

Pelvic or abdominal pain is a common symptom of advanced-stage ovarian cancer.

Ovarian tumors can grow and put pressure on surrounding organs, causing pain.

Choice B rationale:

Ascites, the accumulation of fluid in the abdominal cavity, is a common sign of advanced ovarian cancer.

It results from the cancer's ability to block the flow of fluid and can lead to abdominal distension and discomfort.

Choice C rationale:

Dyspareunia, which is painful intercourse, is not a typical symptom of advanced-stage ovarian cancer.

It is more commonly associated with conditions such as vaginal infections or endometriosis.

Choice D rationale:

Constipation is not a common symptom of advanced ovarian cancer.

However, it can occur if the tumor presses on the colon or obstructs the bowel, but it's not as characteristic as the symptoms mentioned in choices A, B, and E.

Choice E rationale:

Abnormal vaginal bleeding can be a symptom of advanced-stage ovarian cancer.

However, it is important to note that this symptom is less specific to ovarian cancer and can be caused by various gynecological conditions.

Now, let's address .


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Question 9: A client presents with weight loss, fatigue, and postcoital bleeding.
Which gynecologic cancer is most likely causing these symptoms?

Explanation

Choice A rationale:

Cervical cancer typically presents with symptoms like abnormal vaginal bleeding, pelvic pain, and pain during intercourse.

Weight loss and fatigue are less commonly associated with cervical cancer.

Choice B rationale:

Ovarian cancer can cause vague abdominal symptoms, but it is not typically associated with postcoital bleeding.

Weight loss and fatigue may occur in advanced ovarian cancer, but the primary symptoms are different.

Choice D rationale:

Vulvar cancer can lead to symptoms like itching, pain, and skin changes in the vulvar area.

While postcoital bleeding is possible, it is not the most likely cause of weight loss and fatigue in this scenario.

Now, let's summarize the key points: Ovarian cancer is commonly associated with nonspecific symptoms such as bloating, abdominal discomfort, and urinary urgency.

Advanced-stage ovarian cancer can present with symptoms like pelvic or abdominal pain, ascites, and abnormal vaginal bleeding.

Uterine cancer can cause symptoms like weight loss, fatigue, and postcoital bleeding.

It's important to recognize the characteristic symptoms of different gynecologic cancers to facilitate early diagnosis and appropriate treatment.


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Question 10:

 

A nurse is reviewing treatment options for gynecologic cancers with a patient.
Which surgical procedure is commonly performed in the treatment of cervical cancer?

 

Explanation

Choice A rationale:

Cone biopsy is not a commonly performed surgical procedure in the primary treatment of cervical cancer.

It is typically used for diagnostic purposes or for treating precancerous lesions of the cervix.

In a cone biopsy, a cone-shaped piece of tissue is removed from the cervix for examination.

Choice C rationale:

Bilateral salpingo-oophorectomy involves the removal of both fallopian tubes and ovaries.

While this procedure may be performed in some cases of gynecologic cancer, it is not commonly the primary surgical treatment for cervical cancer.

Choice D rationale:

Debulking surgery is a procedure performed to remove as much of a tumor as possible in cases where the cancer has spread and cannot be completely removed.

It is more commonly associated with ovarian cancer or advanced stages of other gynecologic cancers, not cervical cancer.

Choice B rationale:

A total hysterectomy is a commonly performed surgical procedure in the treatment of cervical cancer.

In this procedure, the entire uterus, including the cervix, is removed.

Sometimes, nearby lymph nodes may also be removed during the surgery if there is evidence of lymph node involvement.

This surgery is done to remove the cancerous tissue and prevent the spread of the disease.


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Question 11:

 

A nurse is providing care to a patient with uterine cancer.
The patient is prescribed medications to manage their symptoms.
Which nursing intervention is appropriate for this patient?

 

Explanation

Choice A rationale:

Telling the patient that they don't need the prescribed medications and suggesting they manage their symptoms without them is not an appropriate nursing intervention.

The prescribed medications are likely necessary for symptom management, and it's important to discuss their benefits and risks with the patient.

Choice C rationale:

Advising the patient to take all the medications at once in the morning for convenience is not safe or appropriate.

The dosing schedule for medications should be determined by the healthcare provider based on the specific medications and the patient's needs.

It's important to follow the prescribed dosing instructions.

Choice D rationale:

Promising to administer the medications whenever the nurse remembers during their shift is not a responsible approach to medication administration.

Medications should be given on time and according to the prescribed schedule to ensure their effectiveness and safety.

Choice B rationale:

"Let's discuss the prescribed medications and their potential side effects" is the appropriate nursing intervention.

When a patient is prescribed medications, it is important to engage in a conversation with the patient about the purpose of the medications, how they should be taken, potential side effects, and any concerns the patient may have.

This allows the patient to make informed decisions about their treatment and ensures safe medication management.


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Question 12: A client is newly diagnosed with cervical cancer and is feeling overwhelmed.
What action should the nurse take to provide emotional support to the client?

Explanation

Choice A rationale:

Instructing the client to be strong and not show emotions is not an appropriate approach to providing emotional support.

Everyone copes with a cancer diagnosis differently, and it's essential to validate the client's feelings and emotions rather than telling them how to react.

Choice C rationale:

Telling the client that they need to handle their diagnosis on their own is not supportive or empathetic.

It's essential for the healthcare provider to offer assistance and emotional support to clients facing a cancer diagnosis.

Choice D rationale:

Delaying the visit until the client has calmed down is not an appropriate response to a newly diagnosed patient's emotional distress.

The nurse should be available to provide support and information when the client needs it.

Choice B rationale:

"I'm here to listen and support you during this difficult time" is the appropriate action to provide emotional support to the client.

It acknowledges the client's feelings, offers a listening ear, and conveys empathy and willingness to be there for the client during a challenging period.

This approach fosters trust and a therapeutic nurse-patient relationship.


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Question 13:
A nurse is educating a group of women about prevention strategies for gynecologic cancers.
Which strategies should the nurse include in the teaching? (Select three.).

Explanation

Choice A rationale:

Smoking cessation is an important preventive strategy for gynecologic cancers.

Smoking is a risk factor for cervical and ovarian cancers.

Cessation of smoking reduces the risk of developing these cancers.

Nicotine and other chemicals in tobacco can damage DNA and lead to the development of cancerous cells.

Choice D rationale:

Practicing safe sex is crucial in preventing certain gynecologic cancers, especially cervical cancer.

Human papillomavirus (HPV) is a sexually transmitted infection that can lead to cervical cancer.

Using condoms and practicing safe sex can reduce the risk of HPV infection, thus reducing the risk of cervical cancer.

Choice E rationale:

Maintaining a healthy weight is another important preventive strategy for gynecologic cancers, particularly endometrial cancer.

Obesity is a risk factor for endometrial cancer because excess body fat can increase estrogen levels, which can promote the development of cancerous cells in the endometrium.

Maintaining a healthy weight through diet and exercise can help reduce the risk of endometrial cancer.

Now, let's explain why Choices B and C are not correct:

Choice B rationale:

Eating a high-fat diet is not a recommended prevention strategy for gynecologic cancers.

In fact, a high-fat diet is associated with an increased risk of certain cancers, including breast and ovarian cancer.

Encouraging a high-fat diet would be counterproductive to cancer prevention efforts.

Choice C rationale:

Avoiding regular screenings is not a recommended strategy for preventing gynecologic cancers.

Regular screenings, such as Pap smears and mammograms, are essential for early detection and timely treatment of gynecologic cancers.

Avoiding these screenings can increase the risk of cancer going undetected until it reaches an advanced stage.


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Question 14: A client with ovarian cancer is scheduled for surgery.
What should the nurse prioritize in the preoperative care of this client?

Explanation

Choice C rationale:

Providing emotional support and information about the surgery should be the nurse's top priority in the preoperative care of a client with ovarian cancer.

A cancer diagnosis and impending surgery can be emotionally distressing for the patient.

The nurse should offer emotional support, answer questions, and provide information to alleviate anxiety and ensure the client feels informed and prepared for the surgery.

This approach helps in reducing the client's anxiety and contributes to their overall well-being.

Now, let's explain why the other choices are not correct:

Choice A rationale:

Administering chemotherapy before surgery is not a standard practice for ovarian cancer.

Ovarian cancer treatment typically involves surgery to remove the tumor (debulking surgery) followed by chemotherapy.

Administering chemotherapy before surgery is not the recommended sequence of treatment.

Choice B rationale:

Encouraging the client to eat a heavy meal the night before surgery is not advisable.

It's important for the patient to have an empty stomach before surgery to reduce the risk of aspiration during anesthesia induction.

The patient is usually instructed to fast for a specified period before surgery to ensure their safety during the procedure.

Choice D rationale:

Delaying surgery until the client's anxiety decreases is not a recommended approach.

Delaying surgery can have detrimental effects on the progression and management of ovarian cancer.

Addressing the client's anxiety through emotional support and information is a more appropriate way to prepare the client for surgery without unnecessary delays.


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Question 15: A nurse is caring for a patient with gynecologic cancer who is experiencing lymphedema as a complication.
What interventions should the nurse implement for this patient's care?

Explanation

Choice A rationale:

Elevating the affected limb and applying cold compresses is a standard nursing intervention for managing lymphedema.

Lymphedema is the accumulation of lymphatic fluid in tissues, leading to swelling.

Elevation and cold compresses can help reduce swelling by promoting lymphatic drainage and vasoconstriction.

This intervention can provide relief and improve the patient's comfort.

Now, let's explain why the other choices are not correct:

Choice B rationale:

Avoiding discussing lymphedema to prevent emotional distress is not an appropriate approach.

Open and honest communication with the patient about their condition is essential.

Providing information and addressing the patient's concerns can help them cope with lymphedema and adhere to treatment recommendations.

Avoiding the topic may lead to increased anxiety and uncertainty.

Choice C rationale:

Encouraging the patient to use the affected limb as much as possible is not recommended for managing lymphedema.

Overuse of the affected limb can worsen swelling and discomfort.

Patients with lymphedema are usually advised to avoid activities that may exacerbate the condition and to follow specific guidelines for limb care and exercise.

Choice D rationale:

Administering prophylactic antibiotics to prevent infection in the affected area is not a standard intervention for lymphedema management.

While it's important to prevent infections in patients with lymphedema, antibiotics are typically prescribed when an infection is present, not as a prophylactic measure.

Proper hygiene and skincare are essential for infection prevention in lymphedema patients.


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