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Hysterectomy (11 Questions)
1. Mrs. Gagnon, 54, had a vaginal hysterectomy earlier today. At 18:30, she appears pale and anxious, reports severe lower abdominal pain (8/10), dizziness, and weakness. Her lower abdomen is firm and distended. The surgical dressing shows minimal bleeding.
Vital signs:
BP: 88/54 mmHg
P: 124 bpm, weak
R: 24/min
SpO₂: 94% on room air
T: 37.2°C
Question:
What do you suspect is happening, and what is your immediate nursing intervention?
*
Reaction to anesthesia; administer naloxone
Urinary tract infection; encourage fluids
Internal hemorrhage; notify the physician immediately
Anxiety due to pain; offer lorazepam
2. Mme. Julie Martel, 48 years old, is postoperative day 1 following a vaginal hysterectomy performed for uterine prolapse. Her medical history includes multiparity and mild hypertension.
Current medical orders include:
*Acetaminophen 1,000 mg PO q6h scheduled
*Hydromorphone 1 mg PO q4h PRN pain ≥7/10
*Advance diet as tolerated
*Encourage ambulation
During morning assessment, she reports mild lower pelvic discomfort. The nurse observes small amounts of dark red bleeding in the patient's pad. Her vital signs are stable, and she is afebrile.
Question:
Which finding is expected at this time?
*
Heavy bright red vaginal bleeding
Mild vaginal spotting
Severe abdominal distension
Absence of bowel sounds
3. Mme. Nathalie Gervais, 52 years old, is postoperative day 1 following a total abdominal hysterectomy for large uterine fibroids. Surgery lasted over 3 hours.
Current orders include:
*NPO except ice chips
*IV D5½NS at 100 mL/hr
*Early ambulation as tolerated
She complains of abdominal bloating and discomfort. Bowel sounds are hypoactive, and she has not passed flatus since surgery.
Question:
Which nursing intervention best promotes the return of bowel function?
*
Maintain NPO status
Administer opioid analgesics
Apply an abdominal binder
Encourage chewing sugar-free gum
4. Mme. Caroline Beaulieu, 45 years old, underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) for severe endometriosis. During postoperative teaching, she asks whether she should expect her menstrual periods to return.
Question:
What is the most accurate response?
*
Menstruation will continue normally
Menstruation will return after healing
Menstruation will stop permanently
Menstruation will be irregular
5. Mme. Sophie Lavoie, 41 years old, is postoperative day 2 following a total abdominal hysterectomy with ovarian preservation for abnormal uterine bleeding. She asks whether she will experience monthly hormonal changes.
Question:
What explanation should the nurse provide?
*
She will continue menstruating monthly
She will not menstruate but ovaries will continue hormone production
She will enter immediate menopause
Hormone production will stop
6.1 Mme. Valérie Cormier, 49 years old, is postoperative day 2 following a TAH-BSO. She reports hot flashes, night sweats, irritability, and difficulty sleeping. Vital signs are stable, and the incision is healing well.
Question:
What is the most likely cause of her symptoms?
*
Postoperative infection
Acute blood loss anemia
Surgical menopause
Adverse reaction to opioids
6.2 Mme. Cormier reports persistent vasomotor symptoms affecting her quality of life. The physician discusses medical management options.
Question:
Which medication is commonly prescribed to manage these symptoms?
*
Growth hormone replacement therapy
Thyroid hormone replacement therapy
Testosterone replacement therapy
Estrogen replacement therapy
7. Mme. Chantal Perron, 56 years old, is postoperative day 1 following a total abdominal hysterectomy. Orders include: Semi-Fowler position and Incentive spirometry q2h
Question:
What is the primary benefit of semi-Fowler positioning?
*
Decreases pelvic bleeding
Prevents constipation
Reduces estrogen levels
Promotes lung expansion and comfort
8. Mme. Émilie Dufour, 47 years old, is preparing for discharge following a vaginal hysterectomy. She asks which activities she should avoid at home.
Question:
Which instruction is most important?
*
Resume sexual activity within one week
Avoid heavy lifting
Perform abdominal strengthening exercises
Take daily tub baths
9. Mme. Louise Morel, 60 years old, is postoperative day 1 following a total abdominal hysterectomy. A Foley catheter was removed 6 hours ago. She reports suprapubic pressure and has not voided.
Question:
What is the priority nursing action?
*
Encourage oral fluids
Reinsert the catheter immediately
Notify the physician
Perform a bladder scan
10. Mme. Marie-Andrée Bisson, 53 years old, is preparing for discharge after a total abdominal hysterectomy. She asks when she can safely resume sexual intercourse.
Question:
What is the most appropriate teaching?
*
Sexual activity is permanently contraindicated
Intercourse may resume after healing, usually 6–8 weeks
Pain during intercourse is unavoidable
Sexual desire will disappear