TOP 50 NCLEX GOLDEN POINT OF REPRODUCTIVE SYSTEM

Have a look on it, to review the GOLDEN points of reproductive system for NCLEX-RN

1. Perimenopause is the transitional phase preceding menopause when ovarian function declines and estrogen levels decrease. Symptoms include amenorrhea, emotional lability, vasomotor symptoms (e.g., hot flashes, sweating), urogenital changes, and decreased bone density.
2. Management of perimenopause includes
   • hormone therapy
   • promoting bone health such as vitamin D and Calcium supplement
   • performing weight bearing exercise
3. Contraindications of hormone therapy include history of thromboembolic events e.g., deep vein thrombosis, ischemic stroke,
4. Estrogen therapy increases the risk for blood clot formation.
5. Polycystic ovary syndrome PCOS results from an endocrine imbalance and can cause ovarian cysts and anovulatory cycles. Diagnosis is confirmed with transvaginal ultrasound. Manifestations of PCOS: increased hair growth (hirsutism), and acne.
6. To prevent an unwanted pregnancy following a vasectomy, alternative methods of birth control should be used until the semen samples are found to be free of sperm.
7. Following the vasectomy procedure, it can take several months for the remaining sperm to be ejaculated or absorbed. Alternative birth control should be used until the health care provider confirms that semen samples taken at a follow-up appointment are free of sperm; otherwise pregnancy occur.
8. Vasectomy is a surgical procedure performed for permanent male sterilization. During the procedure, the vasa deferentia (that is ducts that carry sperm from the testicles to the urethra) are cut and sealed, preventing sperm from entering the ejaculate. The vasa deferentia are served in the scrotum at the site before the seminal vesicles and prostate. As a result, the procedure should not affect the ability to ejaculate, amount and consistency of ejaculatory fluid, or other physiological mechanisms e.g. hormone production, erection, orgasm. Following a vasectomy, sperm continue to be produced but are absorbed by the body
9. Infertility is the inability to conceive after unprotected intercourse for >12 months. Factors contributing to female infertility include hormonal dysfunction (example, PCOS) with anovulation, high or low BMI, and conditions that can lead to reproductive tract scarring and damage (examples infection, endometriosis).
10. Chlamydial infection is the most common sexually transmitted infection and is diagnosed frequently among women, adolescents, and those with multiple sexual partners. Many clients are asymptomatic or have minor symptoms (e.g., spotting after sex, dysuria, abnormal vaginal discharge) but can still transmit the infection. Therefore, all sexually active women age <25 and any client age >25 at high risk (e.g., new and several sexual partners) should also receive treatment to prevent transmission and reinfection. A long-term consequence of an untreated chlamydial infection is infertility, pelvic inflammatory disease. Clients should be instructed in general safe practices such as using condoms, avoiding multiple sex partners to prevent transmission of sexually transmitted infections. Client should be taught to abstain from sexual intercourse for 7 days after initiation of the drug therapy e.g., single dose of the azithromycin, 7 days of doxycycline. This client received treatment today and therefore must wait 7 days before resuming intercourse.
11. A postmenopausal woman usually after age 51 is at risk for osteoporosis and heart disease. Client should remain upright after taking a bisphosphonate and consume calcium and vitamin D for bone health. Clotting disorder is a risk with Hormone Replacement Therapy. Intermittent vaginal spotting after menopause can be a sign of endometrial cancer.
12. Bisphosphonates such as alendronate, risedronate or ibandronate, decrease the bone resorption so that loss of bone density is minimized. They must be consumed in the morning, or an empty stomach, with at least 30 minutes before other drugs. The medication is taken with a full glass of water and the client remain upright for at least 30 minutes to aid absorption and prevent espohageal irritaion.
13. Unilateral leg swelling is a classic symptom of the venous thromboembolism.
14. Anemia in older adults is usually not related to lack of iron intake, especially once menstruation has stopped. Excessive iron intake can lead to iron overload, and risk of excess iron tends to be higher with aging.
15. Prostatitis is inflammation of the prostate gland that is usually caused by a bacterial infection. Symptoms include fever, rectogenital pain, burning, urinary hesitancy, and urinary urgency. Management includes antimicrobial such as ciprofloxacin, and anti-inflammatory such as ibuprofen medications. Alpha-adrenergic blockers such as tamsulosin, alfuzosin help relax the bladder and prostate. Suprapubic catheterization may be necessary for urinary retention in severe cases of acute prostatitis. Urethral catheterization is contraindicated due to the risk for additional pain and urethral inflammation.
16. Clients with acute prostatitis should be instructed to take stool softeners e.g., docusate as prescribed to reduce straining during defecation., tension causes the pubic muscles to press against the prostate, causing pain and take sitz baths in which the hips and buttocks are immersed in warm water to help relieve symptoms, and to decrease retained prostatic fluid via ejaculation. Hydration and avoidance of caffeine should also be promoted.
17. Client experiencing an outbreak of genital herpes should abstain from sexual activity when lesions are present and use condoms in future sexual encounters as transmission is possible even in the absence of active lesions. Keep the area with lesions clean and dry, avoid using bubble bath and perfumes soap, proper hand hygiene, and avoid touching the lesions, use sitz baths and oatmeal baths to provide comfort and relief of itching and burning.
18. Herpes simplex virus type 2 (HSV-2) is usually associated with genital herpes. Lesions are painful and appear as multiple small, vesicular lesions.
19. Gonorrhea and chlamydia are two infections leading causes of pelvic inflammatory disease and infertility. They referred to as silent infection because many affected women show no infection.
20. Herpes can lead to multiple, very painful genital vesicles/ulcers.
21. Human papillomavirus causes genital and anal warts.
22. Syphilis usually causes a painless genital ulcer.
23. The uterus and fallopian tubes are the organs affected by Pelvic inflammatory disease.
24. Trichomoniasis and candidiasis are the yeast infections can lead to vaginitis (vaginal inflammation and discharge). They do not usually involve the uterus or fallopian tubes to cause infertility.
25. Teaching about menstrual cycle physiology increases fertility awareness and helps couples optimize fertility awareness and helps couples optimize their chances of becoming pregnant sooner. Timing of sexual intercourse near ovulation i.e., FERTILE WINDOW is essential to conception because the ovum and sperm have limited viability in the reproductive tract.
26. Teaching the client about how to track menstrual cycles (length and regularity of menses) and recognize signs of ovulation (e.g., cyclic changes in cervical mucus) may improve the fertility awareness.
27. Urine ovulation predictor kits may also be used to detect the surge of LH that preceded ovulation by 12-24 hours.
28. Infertility is the inability to conceive after 12 months of frequent, unprotected intercourse for clients without medical complications (e.g., advanced medical age).
29. Priapism is a sustained, painful erection often associated with sickle cell anemia, as the sickling (crescent shaping) of red blood cells can lead to penile vascular occlusion, erectile tissue hypoxia, and tissue necrosis. Bluish discoloration is of most concern as it can be a sign of ischemia to the penis.
30. Priapism is a sustained, painful erection that lasts for more than 2 hours.
31. Although it depends on the type of surgical procedure performed, about 80-120 mL of serosanguineous or sanguineous drainage per hour for the first 24 hours following surgery can be expected. The nurse should notify the HCP if the drainage in the Jackson- Pratt closed wound drainage device changes from serosanguineous to sanguineous and if the amount increases significantly after the first 24 hours following surgery.
32. Beta-blockers are generally safe during pregnancy.
33. Marfan syndrome affects the connective tissues and is associated with dilation of the aortic root. Clients with Marfan syndrome are at high risk of mortality during pregnancy due to the potential for aortic dissection. Consistent use of reliable birth control is essential for preventing pregnacy.
34. Marfan syndrome is an autosomal dominant condition with a 50% chance of inheritance in offspring.
35. Following open radical prostatectomy, any rectal interventions such as suppositories or enemas must be avoided to prevent stress on the suture lines and problems with healing in the surgical area. The client should not strain when having a bowel movement for these reasons. Therefore, interventions to prevent constipation are an important part of postoperative care and discharge teaching.
36. Prevention of constipation is particularly important when client remains on opioids analgesics, which can cause constipation.
37. Straining, suppositories, and enemas are contraindicated in the clients who is being discharge from hospital after an open radical prostectomy.
38. Testicular cancer is the most common form of cancer in men aged 15-35. It is highly curable when diagnosed early.
39. Clients are at high risk for developing a tumor example: history of undescended testes are encouraged to perform a monthly TSE.
40. Client education for TSE testicular self-examination are:
    • Perform TSE monthly on the same day (easy to remember)
    • Perform while taking a warm shower or bath as warm temperatures will relax the scrotal tissue and make the testis hang lower in the scrotum
    • Use both hands to feel each testis separately
    • Palpate each testicle gently, using the thumb and first 2 fingers
    • Check that the testicles is normally egg-shaped and movable with a smooth surface.
41. The clinical finding that should be reported to the health care provider after TSE are:
    • Painless. hardened lupm or testes
    • Scrotal swelling or heaviness
    • Dull ache in pelvis or scrotum
42. It is normal for one testicle to be slightly larger or hang lower than the other. Some people confuse epididymis (small, coiled tube) as a small lump at the beginning. These donot need to be reported.
43. Inflammatory breast disease is an aggressive breast cancer with symptoms of red, warm, breast tissue. A breast mass may or may not be present.
44. Heavy uterine bleeding is a common disadvantage of having an intrauterine device.
45. Symptoms of ovarian cancer are bloating, urinary symptoms, pressure on bladder, pelvic pressure or pain, abdominal girth increase, GI disturbances,
46. Postmenopausal clients are at increased risk for osteoporosis, and coronary artery disease because of loss of ovarian function during the menopause causes a decreased in estrogen production, leading to reduced osteoblast activity and cardioprotective effect. Other changes may include weight gain, sleep disturbances, fat redistribution and vaginal atrophy.
47. Client education to reduce the effects of decreased estrogen level are
    • Consume dietary calcium and engaging in weight bearing exercise to promote bone health
    • Closely monitor cholesterol levels as increased LDL cholesterol increases risk for CAD
    • Seeking the assistance of a dietician
    • Maintain low-calorie diet rich in fruits and vegetables
    • Seeking support to cope with any emotional symptoms like depression, mood swings, sadness, difficulty concentrating caused by changingnhormone levels.
48. Cervical cap is barrier method of contraception used with the spermicide. The reusable, cup shaped cap is placed over the cervix before intercourse to block sperm from the uterus. To allow time for sperm to die, the cap should remain in place for >6 hours after intercourse but should not remain for more than 48 hours.
49. Use of cervical caps during the menses or during the postpartum period in clients with lochia discharge increases the risk of toxic shock syndrome; alternative contraceptive method should be used during this time.
50. PKU Phenylketonuria is characterized by deficiency or absence of an enzyme required to metabolize phenylalanine, an amino acid found in protein foods.
51. Clients with PKU should follow a low-phenylalanine diet before and during pregnancy to prevent potential teratogenic effects e.g., microcephaly, mental disability, heart defects.
52. Avoiding high protein foods e.g., meat, dairy, dry beans, nuts, eggs help to maintain phenylalanine levels in safe range.
53. If the newborn is also diagnosed with PKU, special formulas with low phenylalanine will likely be required. Excessive breastfeeding may pose harm to the newborn with PKU because phenylalanine is transferred via breast milk.
54. High levels of phenylalanine can cause intellectual disability by interfering with brain growth and development, which is particularly concerning for the developing fetus and infant.
55. The nurse should take immediate action when a client recovering from a vaginal hysterectomy saturates more than one perineal pad in an hour. The nurse should further assess the client and report these findings and excessive vaginal bleeding to the HCP.
56. Clomiphene is an infertility treatment for women that works by stimulating ovulation. It is necessary to engage in frequent sexual intercourse 5 days after completing the medicine regimen. Clomiphene may cause mood swings, nausea, hot flashes, and headache and increases the risk of multiple gestation.