Exam 1
A woman diagnosed with breast cancer is to undergo a lumpectomy followed by radiation therapy. When reviewing the treatment plan with the client, the nurse determines that the woman has understood the information based on which client statement? "The radiation will be targeted to the area near my underarm to get at the lymph nodes." "After they remove the tumor and some of the normal tissue, I'll start radiation in about 2 to 4 weeks." "I'll have a portion of my breast removed, and then they'll do high-dose radiation in the operating room." "After the lumpectomy, I'll have to wait about 6 months before I can begin to receive the radiation."
"After they remove the tumor and some of the normal tissue, I'll start radiation in about 2 to 4 weeks." Women undergoing breast-conserving therapy receive radiation after lumpectomy with the goal of eradicating residual microscopic cancer cells to limit locoregional recurrence. In women who do not require adjuvant chemotherapy, radiation therapy typically begins 2 to 4 weeks after surgery to allow healing of the lumpectomy incision site. Radiation is administered to the entire breast at daily doses over a period of several weeks. Breast-conserving surgery, the least invasive procedure, is the wide local excision (or lumpectomy) of the tumor along with a 1-cm margin of normal tissue.
The nurse is caring for a female client who is a victim of intimate partner violence (IPV). The client has experienced traumatic injury to the clitoris. Which statement will the nurse include when providing discharge education to this client? "There is a chance you will experience increased vaginal discharge due to the injury experienced." "The damage to your clitoris could cause you to experience incontinence in the future." "The clitoris functions to provide cushioning during intercourse. You might now have increased pain." "Damage to your clitoris may lead to decreased stimulation in future sexual experiences."
"Damage to your clitoris may lead to decreased stimulation in future sexual experiences." At the superior junction of the labia, there is a fleshy protrusion of tissue called the clitoris. The clitoris is an erectile tissue that enlarges and becomes sensitive when stimulated by the penis or touching that accompanies sexual foreplay. Depending on the severity of the damage, the clitoris may have decreased ability to function with future sexual experiences. The clitoris does not affect bladder function or provide cushioning during intercourse. The mons pubis is responsible for providing a cushion. Vaginal discharge should not increase. There may be a decrease in vaginal secretions related to sexual arousal if permanent damage to the clitoris occurs due to decreased sexual stimulation.
The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this client? Select all that apply. "Do you use drugs or use alcohol excessively? "Are you exposed to X-rays or other radioactive substances?" "When was the last time you had sex?" "Do you have a regular girlfriend?" "Have you ever had any type of trauma or surgery on or near your testicles?"
"Do you use drugs or use alcohol excessively? "Are you exposed to X-rays or other radioactive substances?" "Have you ever had any type of trauma or surgery on or near your testicles?" Conditions that may inhibit sperm production are trauma to the testes, surgery on or near the testicles that results in impaired testicular circulation, and endocrine imbalances, particular of the thyroid, pancreas, or pituitary glands. Drug use or excessive alcohol use and environmental factors such as exposure to X-rays or radioactive substances have also been found to negatively affect spermatogenesis. Men exposed to radioactive substances in their work environments should be provided adequate protection for the testes.
A client who came to the clinic after finding a mass in her breast is scheduled for a diagnostic breast biopsy. Which response is most appropriate by the nurse while preparing the client for the procedure? "If you do in fact have breast cancer, there are lots of treatment options." "Were your mother or grandmother ever diagnosed with breast cancer?" "Breast reconstruction is a way for you to maintain your feminine appearance." "During this procedure, a small sample of tissue will be removed for testing."
"During this procedure, a small sample of tissue will be removed for testing." At this time, the nurse will discuss the purpose of the procedure and not begin discussing breast cancer treatment or reconstruction. Determining if the client has a family history should have already been completed. If not, it is not appropriate at this time. It will only add to the client's stress and concern. It can be asked at a later time if needed. Discussing treatment and reconstruction can occur after the procedure, if indicated. At this time, the nurse should focus on helping the client stay calm, reducing stress, and making sure the procedure is being completed.
A woman opts to use a diaphragm for contraception. Which instruction would be most important for the nurse to provide? "Wet the diaphragm with water first before inserting it." "Replace the diaphragm every 6 months." "Keep the diaphragm in place for no more than 4 hours after intercourse." "Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more."
"Have your diaphragm refitted if you lose 10 pounds (4.5 kilograms) or more." Diaphragms should be refitted after pregnancy, abdominal or pelvic surgery, or weight loss or gain of 10 pounds (4.5 kilograms) or more. A diaphragm usually is replaced every 1 to 2 years. A diaphragm should remain in place for at least 6 hours after intercourse. A contraceptive sponge, not a diaphragm, should be wetted with water before insertion.
A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct? "Gonorrhea and syphilis are infections seen only in men." "Human papillomavirus is the cause of essentially all cases of cervical cancer." "STIs can't be transmitted through oral sexual intercourse." "At least antibiotics will cure a sexually transmitted infection."
"Human papillomavirus is the cause of essentially all cases of cervical cancer." Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer, which is the fourth most common cancer in women in the United States. Up to 95% of cervical squamous cell carcinomas and nearly all preinvasive cervical neoplasms are caused by the HPV. Antibiotics will only cure those STIs caused by bacterial infections. A viral STI infection is a lifetime infection. Gonorrhea and syphilis affect both men and women. Sexually transmitted infections are infections of the reproductive tract caused by microorganisms transmitted through oral sexual intercourse.
At a class for new mothers, the nurse notes that the participants need more teaching when one of the mothers makes which comment? "I can use warm compresses to ease the discomfort." "Breastfeeding every four hours appears to help." "I have been using a breast pump after feeding my baby." "I have to stop breastfeeding because of mastitis."
"I have to stop breastfeeding because of mastitis." The nurse should teach the women about the etiology of mastitis and encourage breastfeeding, emphasizing that it is safe for infants. Continued emptying of the breast or pumping improves the outcome, decreases the duration of symptoms, and decreases the incidence of breast abscess.
The nurse is teaching a group of middle school students about sexually transmitted infections (STIs). Which statement by the students indicates a need for additional teaching about condom use? "I will not store condoms in my wallet." "I will put the condom on just before insertion." "Latex condoms provide the best protection against STIs." "I will put the condom on just before orgasm."
"I will put the condom on just before orgasm." Condoms should be placed on the penis before any genital contact occurs. Applying them at a later time decreases their effectiveness. Latex condoms are best to protect against infection. Condoms should be stored in a cool, dry place that is away from direct sunlight. A wallet is subject to extreme changes in temperature and is an inappropriate place to store a condom.
A nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective? "I can pour hydrogen peroxide and water over my lesions." "I should rub rather than scratch in response to itching." "I will apply a water-based lubricant to my lesions." "I will wear loose cotton underwear."
"I will wear loose cotton underwear." Wearing loose cotton underwear promotes drying and helps avoid irritation of the lesions. The use of lubricants is contraindicated because they can prolong healing time and increase the risk of secondary infection. Lesions should not be rubbed or scratched because of the risk of tissue damage and additional infection. Cool, wet compresses can be used to soothe the itch. The use of hydrogen peroxide and water on lesions is not recommended.
A client who has had a mastectomy is to undergo breast reconstruction with augmentation. After teaching the client about the procedure, the nurse determines that the teaching was successful based on which client statement? "I'll use the same technique for breast self-exam as before." "The implants will be placed directly under my skin." "Once implanted, the implants are good for the rest of my life." "My implants will feel softer than normal breast tissue."
"I'll use the same technique for breast self-exam as before." Breast examination in women with reconstructive surgery is done exactly the same way as for natural breasts. Breasts with implants in place usually feel firmer than normal breast tissue on palpation due to the formation of a fibrotic band or capsule around the implant. The exact anatomical placement of breast implants can vary, but the location typically is subglandular (over the pectoral muscle) or subpectoral (under the muscle). Breast implants are not lifetime devices, but most are guaranteed for approximately ten years in case of rupture.
A 12-year-old girl expresses concern to the nurse because she has not begun her period yet. The nurse notes that the girl has grown 6 inches in the past year and a half and is beginning to develop breast buds. Which response by the nurse is appropriate? "It's difficult to say when you'll get your period but you should not be concerned at this time." "You sound concerned about not having your period. Is there a bigger issue bothering you?" "It is normal for females to begin menstruating between the ages of 12 and 15." "The average age to being you period is 12. I will notify the primary health care provider."
"It is normal for females to begin menstruating between the ages of 12 and 15." There is wide variation in the time required for adolescents to move through sexual developmental stages; however, the sequential order is fairly constant. In girls, pubertal changes typically occur in the following order: growth spurt, increase in transverse diameter of the pelvis, breast development, growth of pubic hair, onset of menstruation, growth of axillary hair, and vaginal secretions. Thelarche, which is the beginning of breast development, usually starts 1 to 2 years before menstruation. Given the signs of development that this patient has already exhibited, it seems likely that she will begin her period in the coming year. Her development is completely normal, so the nurse should not suggest something is wrong by stating she will notify the primary health care provider. The client doesn't indicate another issue is concerning her; therefore the nurse would address the client's current statement. The nurse would not tell the client to not be concerned as this is not theraputic as it does not address the client's concern.
A woman is diagnosed with primary dysmenorrhea and is prescribed ibuprofen as part of her treatment plan. When teaching the woman about using this medication, which instruction would be important for the nurse to emphasize? "It is normal for your bowel movements to be black." "Take the medication on an empty stomach." "Start taking the medication when you first get your period." "Add an aspirin to the regimen if you do not get relief right away."
"Start taking the medication when you first get your period." When taking a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, for dysmenorrhea, it is important for the woman to start therapy prophylactically and use sufficient doses to maximally suppress prostaglandin production. NSAIDs should be taken with food to prevent gastrointestinal upset. They should not be taken with aspirin because doing so can increase the risk of bleeding, which would be noted with black stools.
A female client comes to the clinic and asks the nurse what would be the most cost-effective method to determine ovulation patterns. What is the best response by the nurse? "The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months." "The least costly method would be to purchase a commercial kit from the store to assess the upsurge of LH that occurs just after ovulation." "The least costly method would be to purchase an at-home testing kit for sperm motility." "The least costly method would be a surgical procedure to determine if your fallopian tubes are blocked."
"The least costly method to determine ovulation patterns is to record the basal body temperature for at least 4 months." The least costly way to determine a woman's ovulation pattern is to ask her to record her basal body temperature (BBT) for at least 4 months.
The nurse educates a 15-year-old female client on ways to prevent pregnancy. Which statement will the nurse include in the teaching? "The use of a condom is a method often recommended to prevent pregnancy for people your age." "The withdrawal method is effective as long as you have a monogamous partner." "If you do not want to become pregnant within the next 10 years, an intrauterine device would be best." "Oral contraceptive pills are effective at preventing pregnancy as long as you take one each week."
"The use of a condom is a method often recommended to prevent pregnancy for people your age." The nurse would state condoms as the best option for preventing pregnancy for this age group. Oral contraceptives are also effective but must be taken daily at approximately the same time. The withdrawal method is not effective, regardless of the number of sexual partners because sperm can be released before ejaculation occurs. An intrauterine device could be removed if the client desired pregnancy in the upcoming years.
A female client with genital herpes is prescribed acyclovir as treatment. After teaching the client about this treatment, which statement by the client indicates effective teaching? "This drug will help to suppress any symptoms of the infection." "The severity of future attacks will be much less after using this drug." "This drug will help reduce my risk for a recurrence after discontinuing it." "If I use this drug, I will be cured of the infection."
"This drug will help to suppress any symptoms of the infection." No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. Advances in treatment with acyclovir 400 mg orally three times daily for 7 to 10 days, famciclovir 250 mg orally three times daily for 7 to 10 days, or valacyclovir 1 g orally twice daily for 7 to 10 days have resulted in an improved quality of life for those infected with herpes simplex virus (HSV). However, according to the CDC, these drugs neither eradicate latent virus nor affect the risk, frequency, or severity of recurrences after the drug is discontinued.
How should the nurse counsel a postpartum client on how to prevent mastitis? "Sterilize your bottles and pump equipment after each use." "If you notice that your breast is warm, hard, or red, stop feeding on that side and pump from that breast instead." "Be sure to keep your breasts covered when you are not feeding or pumping." "Wash your hands thoroughly, and let your breasts dry after each feeding."
"Wash your hands thoroughly, and let your breasts dry after each feeding." Handwashing is one of the best ways to prevent infection. If the woman feels that her breast is warm, hard, or red, she should increase the amount of breastfeeding from that side. It is not necessary to sterilize bottles and pumping equipment after each use; washing in the dishwasher is sufficient. Keeping the breasts exposed to the air to dry will aid in preventing infection.
The nurse is caring for a client requesting oral contraceptive pills (OCPs). She has multiple sexual partners. The nurse recommends condoms to the client, but the client states, "I cannot use condoms because I am allergic to latex." Which response by the nurse is appropriate? "We can have you allergy tested to see if certain condoms may work for you." "You can still use condoms because they make latex-free condoms." "Do you understand the potential ramifications of having multiple sexual partners?" "I will let the health care provider know you desire oral contraceptive pills."
"You can still use condoms because they make latex-free condoms." Because this client has multiple partners, there is concern over the risk for sexually transmitted infections (STIs) as well as pregnancy. Condoms are the only method of contraception that protects against STIs, which is an important concern if the client is not in a monogamous relationship. The nurse would inform the client of latex-free condoms and where to purchase them first. Regardless of whether the client chooses to use latex-free condoms, the client can discuss other options for contraception with the health care provider at that time. There is no need to have the client tested for latex sensitivity. The nurse should educate the client on risks associated with multiple sexual partners; however, using therapeutic language will be most effective.
The nurse is educating a female client diagnosed with human papillomavirus (HPV). Which information will the nurse include in the client's education plan? "You should be sure to receive consistent testing for cervical cancer." "Your best option is to surgically remove genital warts to prevent you from spreading the disease." "You will be prescribed an antiviral medication to take that will clear your infection." "During colder weather, you will note more outbreaks than during warmer weather."
"You should be sure to receive consistent testing for cervical cancer." An infection with HPV is a risk factor for developing cervical cancer. Women with a history of HPV should receive consistent testing/screening for cervical cancer. HPV is a virus; however, no antiviral to date resolves the virus in the body. Surgical removal is an option for genital warts; however, it is not the best option as the virus can still be spread without the presence of warts. Wart removal is done for comfort and appearance. Outbreaks are most noted during times of stress or illness and trauma; outbreaks are not temperature related.
A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which nursing intervention may help foster the client's self-esteem? Explain the cause of the sexually transmitted infection (STI). Provide the client with a telephone number for obtaining accurate information. Schedule an appointment for follow-up care. Affirm the client's good judgment in seeking treatment.
Affirm the client's good judgment in seeking treatment. The nurse should affirm the client's good judgment in seeking treatment. Acknowledging positive action helps increase the client's self-esteem. Explaining the cause of the STI and how to avoid potential consequences or complications dispels inaccurate beliefs and misconceptions and helps the client to acquire realistic information. It does not help the client's self-esteem to be positive. Providing the client with a telephone number for obtaining objective and authoritative information helps the client to ask more questions about an STI and its treatment. Medical follow-up promotes compliance with therapeutic regimen and does not help the client's self-esteem to be positive.
A client who delivered her baby 3 months ago is seen in the clinic and tells the nurse that she and her husband have yet to resume a sexual relationship. The nurse notes that no contraception is currently being used. What is the most appropriate nursing diagnosis for this client? Powerlessness related to failure of chosen contraceptive Decisional conflict related to unintended pregnancy Spiritual distress related to partner's preference for contraception Altered sexual pattern related to fear of pregnancy
Altered sexual pattern related to fear of pregnancy The nurse should recognize that this exceeds the recommended postpartum abstinence period and might contribute to a fear of a repeat pregnancy.
When preparing a teaching plan for a woman with mastitis, the nurse would include which instruction? Apply warm compresses to the affected breast. Limit fluid intake to minimize swelling. Avoid the use of a supportive bra to prevent pressure on the inflamed breast. Cease breastfeeding to prevent transmission to the infant.
Apply warm compresses to the affected breast. Warm compresses are soothing and help reduce inflammation. Breastfeeding is encouraged with mastitis to ensure continued emptying of the breast. Fluid intake is encouraged to promote milk production and resolution of infection. Wearing a supportive bra 24 hours a day is necessary to support the breasts.
The nurse is examining a pregnant female in her third trimester and measuring to determine if fetal growth has increased. Where would the nurse place the measuring tape? Just below the pubis symphysis At the top of the fundus At the uterine isthmus At the level of the corpus
At the top of the fundus The uterine fundus is located that the uppermost portion of the uterus; that is where the uterus is measured to determine fetal size and gestation. The isthmus is the uterine segment that connects the cervix to the uterus. The corpus, the main body of the uterus, is not the top of the uterus. One end of the measuring tape is placed at the top of the pubic symphysis and extended to the top of the fundus.
A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client? Report signs of an oral yeast infection. Take the drug on an empty stomach. Avoid alcohol consumption. Use a sunscreen when outside.
Avoid alcohol consumption. If alcohol is ingested when taking ceftriaxone, the client can experience a disulfiram-like reaction. Therefore the nurse would need to emphasize avoiding alcohol consumption. Taking the drug on an empty stomach may be appropriate but not the most important consideration. Using a sunscreen would be appropriate if the client was receiving doxycycline or tetracycline. Reporting the appearance of an oral yeast infection would be appropriate for a client receiving tetracycline
A young client desires to know her risk of developing breast carcinoma. She has a positive family history of breast carcinoma. The nurse would suggest that she should undergo which diagnostic test? DNA ploidy status fine-needle biopsy digital mammography BRCA-1 genetic marker
BRCA-1 genetic marker Individuals with BRCA1 and BRCA2 mutations have a 75% lifetime risk of breast cancer and a 30% lifetime risk of ovarian cancer. The genetic influences of BRCA1 and BRCA2 are recognized to be a risk factor for developing breast carcinoma among family members. DNA ploidy status is used to confirm a malignant breast mass. Digital mammography is used to screen for breast masses. A fine-needle biopsy is used to identify if a mass is benign or malignant.
When preparing for a class on breast cancer, the nurse should explain which nonmodifiable risk factors? Select all that apply. being a 52-year-old female failing to breastfeed infants high-fat dietary intake menarche at age 11 BRCA1 gene
BRCA1 gene menarche at age 11 being a 52-year-old female Risk factors can be divided into those that cannot be changed (nonmodifiable) and that that can (modifiable). Nonmodifiable risk factors include gender, age (>50 years old), genetic mutations, personal history of ovarian or colon cancer, early menarche (<12 years old) and race (higher in white women) just to name a few. Failing to breastfeed, high fat dietary intake, and lack of exercise are examples of modifiable risk factors.
Mammography is recommended for a client diagnosed with intraductal papilloma. Which factor should the nurse ensure when preparing the client for a mammography? Client has taken an aspirin before the testing. Client has not applied deodorant on the day of testing. Client has not consumed fluids 1 hour before testing. Client is just going to start her menses.
Client has not applied deodorant on the day of testing. When preparing a client for mammography, the nurse should ensure the client has not applied deodorant or powder on the day of testing because these products can appear on the X-ray film as calcium spots. It is not necessary for the client to avoid fluid intake 1 hour prior to testing. Mammography has to be scheduled just after the client's menses to reduce chances of breast tenderness, not when the client is going to start her menses. The client can take aspirin or acetaminophen after the completion of the procedure to ease any discomfort, but these medications are not taken before mammography.
A nurse is reviewing a labor plan with a client who has been admitted to the labor and birth unit. The client states that she has been drinking a significant amount of herbal teas lately to help with uterine contractions. Which is the priority action by the nurse?
Determine the type of herbal teas recently consumed. Certain herbal teas can be used during pregnancy, and most are made with flower or berries that are safe for both mother and fetus. To determine if the herbal tea is safe or has had any effect on the status of the birth, it is important for the nurse to find out what type of tea the client has been consuming and in what quantities.
A client presents at the clinic and is interested in obtaining emergency contraception (EC). The nurse explains that EC must be used within 72 hours of unprotected sex to be effective. This is because: ECs simply prevent embryo creation and uterine implantation from occurring in the first place. ECs are more effective than regular birth control. ECs can help prevent STIs. ECs can induce an abortion (elective termination of pregnancy) of a recently implanted embryo.
ECs simply prevent embryo creation and uterine implantation from occurring in the first place. ECs prevent the embryo creation and uterine implantation from occurring. There is no evidence that ECs have any effect on an already-implanted ovum or that they induce abortion (elective termination of pregnancy). They do not protect against STIs and are less effective than regular birth control.
A client has undergone a mastectomy for breast cancer. Which instruction should the nurse include in the postoperative client teaching plan? Restrict intake of medication. Avoid moving the affected arm in any way. Breathe rapidly for an hour. Elevate the affected arm on a pillow.
Elevate the affected arm on a pillow. When providing care to the client, the nurse should instruct the client to elevate the affected arm on a pillow. As part of the respiratory care, the nurse should instruct the client to turn, cough, and breathe deeply every 2 hours; rapid breathing is not encouraged. Active range-of-motion and arm exercises are necessary. To counter any pain experienced by the client, analgesics are administered as needed; intake of medication is not restricted.
In the resolution phase of sexual response, which response would be most commonly noted in the male? Erection is lost Scrotal sac thickens Testes are elevated against the perineum Rectal muscles contract
Erection is lost During the resolution phase, which is the final phase of the sexual response cycle, the male will lose his erection, his scrotal sac will thin back out and the testes will descend back down. Rectal contractions occur during the orgasm.
The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which information is important for the nurse to include? High-grade dysplasia progresses to invasive cervical cancer in about 2 years. High-grade dysplasia progresses to invasive cervical cancer in about 7 years. High-grade dysplasia progresses to invasive cervical cancer in about 9 years. High-grade dysplasia progresses to invasive cervical cancer in about 4 years.
High-grade dysplasia progresses to invasive cervical cancer in about 2 years. With cervical cancer, lesions start as dysplasia and progress over a period of time. Progression of a high-grade dysplasia takes about 2 years to develop into an invasive cancer.
A nurse is reviewing the history, physical exam, and diagnostic test findings for a woman diagnosed with endometrial cancer. The findings reveal that the cancer has spread to the cervix and other parts of the uterus and to nearby lymph nodes. The nurse interprets these findings as suggestive of which stage? I IV II III
III In stage I, the tumor is confined to the corpus uteri. In stage II, it has spread to the cervix, but not outside the uterus. In stage III, it has spread locally (to other parts of the uterus) and regionally (to nearby lymph nodes). In stage IV, it has invaded the bladder mucosa, bowel with distant metastases to the lungs, liver, and bone.
A client presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole. What is the paramount nursing intervention in discharge planning? Advise the client to take medication with a glass of milk. Counsel the client to refrain from sex for one week. Instruct the client not to drink alcohol with this treatment. Reassure the client further STI testing is not indicated.
Instruct the client not to drink alcohol with this treatment. While counseling to abstain from sex for one week is appropriate, the most important intervention is counseling to avoid alcohol during metronidazole treatment. Alcohol consumption while taking metronidazole creates a severe gastrointestinal reaction of nausea, vomiting, and flushing. Metronidazole does not have to be taken with milk. Further STI testing is indeed recommended with the diagnosis of an STI.
A young couple are disappointed that they are not yet pregnant and are seeking assistance at the health clinic. After assessing their medical history, the nurse discovers the female has a history of several episodes of PID. The nurse predicts this may be a source of the infertility related to which factor? It causes sperm-agglutinating antibodies to be produced in the vagina. It causes changes in cervical mucus that make it less receptive to penetration by sperm. It interferes with the transport of ova due to tubal scarring. It causes anovulation due to interference with secretion of pituitary hormones.
It interferes with the transport of ova due to tubal scarring. Pelvic inflammatory disease results in scarring and adhesions of the tubes, leading to poor transport of ova. PID does not affect hormone metabolism, nor does it affect the production of cervical mucus. Antibodies are present only in a few cases and are unrelated to PID.
A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response? "It is not transmitted to your newborn as it is protected in the uterus." "The risk of your newborn being infected with HIV infection is about 1%." "It is only transmitted through the birth canal so a cesarean birth will be scheduled." It is recommended to formula-feed your newborn as it is transmitted through your breast milk."
It is recommended to formula-feed your newborn as it is transmitted through your breast milk." An infected mother can transmit HIV infection to her newborn before or during birth and through breastfeeding. The risk of perinatal transmission of HIV from an infected mother to her newborn is about 25%. This risk falls to less than 1% if the mother receives antiretroviral therapy during pregnancy. HIV can be spread to the infant through breastfeeding. HIV-infected mothers should be counseled to avoid breastfeeding and use formula instead.
As part of caring for childbearing families, the nurse must be able to educate families regarding which topic? The best hospital for delivery of their babies Knowledge of reproductive anatomy and physiology The cost of obstetrical and neonatal care Proper selection of a physician
Knowledge of reproductive anatomy and physiology The obstetrical/gynecological nurse must be well versed in pregnancy and childbirth, as well as an understanding of clients of childbearing age. As a gynecological nurse, he or she must also have a good grasp of reproductive anatomy and physiology and the menstrual cycle. Helping select a physician, a hospital, or providing input on cost factors is not the nurse's job.
Which instruction should be given to a woman newly diagnosed with genital herpes? Limit stress and emotional upset as much as possible. Have your partner use a condom when lesions are present. Use a water-soluble lubricant for relief of pruritus. Obtain a Papanicolaou test every 3 years.
Limit stress and emotional upset as much as possible. Stress, anxiety, and emotional upset seem to predispose a client to recurrent outbreaks of genital herpes. Sexual intercourse should be avoided during outbreaks, and a condom should be used between outbreaks; it is not known whether the virus can be transmitted at this time. During an outbreak, creams and lubricants should be avoided because they may prolong healing. Because a relationship has been found between genital herpes and cervical cancer, a Papanicolaou test is recommended every year.
A woman is crying because she just recently received the results of her biopsies, and they confirm that she has invasive breast cancer. Which response by the nurse is the most appropriate? "You'll beat this thing, I know it. You are very strong." "I know a great support group you can join." "I'm sure you are going to be fine. You are in great hands." Listen to the woman talk, and remain silent for a while
Listen to the woman talk, and remain silent for a while When a woman first receives the devastating news of the diagnosis of cancer, most often the best response is to allow the woman to express her feelings and concerns before speaking. Giving her false reassurances is not therapeutic and can break reliability and trust in a provider-client relationship. Attempting to give her information about groups or next steps before she is in a state to take it in is also nontherapeutic.
A nurse is educating a 25-year-old client with a family history of cervical cancer. Which test should the nurse inform the client about to detect cervical cancer at an early stage? transvaginal ultrasound CA-125 blood test Papanicolaou test blood tests for mutations in the BRCA genes
Papanicolaou test The client should have Papanicolaou tests regularly to detect cervical cancer during the early stages. Blood tests for mutations in the BRCA genes indicate the lifetime risk of the client of developing breast or ovarian cancer. CA-125 is a biologic tumor marker associated with ovarian cancer, but it is not currently sensitive enough to serve as a screening tool. The transvaginal ultrasound can be used to detect endometrial abnormalities.
A 45-year-old female client tells the nurse she has a dimpling of the right breast that has occurred in the past 2 weeks. What action will the nurse take next? Determine if the client has a family history of breast cancer. Perform an examination of both of the client's breasts. Prepare the client for a right breast ultrasound. Notify the health care provider.
Perform an examination of both of the client's breasts. It would be most important for the nurse to palpate the breast to determine the presence of a mass and compare it to the left. Edema and pitting of the skin may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance (peau d'orange), a classic sign of advanced breast cancer. Determining if the client has a family history will not change the course of action and is not a priority. Before notifying the health care provider, the nurse will assess the client as the client is stable. The client will be assessed before additional procedures are completed to determine the best procedures, if any, for the client.
A 45-year-old female client tells the nurse she has a dimpling of the right breast that has occurred in the past 2 weeks. What action will the nurse take next? Determine if the client has a family history of breast cancer. Prepare the client for a right breast ultrasound. Perform an examination of both of the client's breasts. Notify the health care provider.
Perform an examination of both of the client's breasts. It would be most important for the nurse to palpate the breast to determine the presence of a mass and compare it to the left. Edema and pitting of the skin may result from a neoplasm blocking lymphatic drainage, giving the skin an orange-peel appearance (peau d'orange), a classic sign of advanced breast cancer. Determining if the client has a family history will not change the course of action and is not a priority. Before notifying the health care provider, the nurse will assess the client as the client is stable. The client will be assessed before additional procedures are completed to determine the best procedures, if any, for the client.
A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her? She has irregular menstrual cycles. She is 30 years old. She has a family history of thromboembolism. She has a history of allergy to foreign protein.
She has a family history of thromboembolism. The estrogen content of birth control pills may lead to increased blood clotting, leading to an increased incidence of thromboembolism. Women who already are prone to this should not increase their risk further.
The nurse is talking with the mother of a 2-year-old girl during a scheduled visit. Which teaching subject best supports the emphasis on preventive care?
Showing the mother how to teach handwashing to her child Teaching handwashing helps to prevent infection, emphasizes preventive care, and is basic to avoiding many common illnesses. Reminding the mother that the child will imitate her may promote safe parental role-modeling but does not reach the level of prevention that handwashing does. Knowing about developmental milestones and typical physical changes in toddlers does not directly promote preventive care.
A small amount of breast milk is obtained for culture and sensitivity testing from a client with mastitis. The nurse would expect the results to identify which organism as the most likely cause? group A streptococcus Escherichia coli Staphylococcus aureus Chlamydia trachomatis
Staphylococcus aureus The most common causative microorganism associated with mastitis is Staphylococcus aureus. Chlamydia is a sexually transmitted infection. Streptococcus is commonly associated with strep throat. E. coli is a common cause of urinary tract infections.
An older couple approaches the nurse's station seeking information about their hospitalized grandchild. What should be the nurse's response?
Tell the couple to seek information directly from the child's parents.
A nurse is assessing a 45-year-old client. The client asks for information regarding the changes that are most likely to occur with menopause. Which should the nurse tell the client? The uterus tilts backward. The uterus shrinks and gradually atrophies. Cervical muscle content increases. The outer layer of the cervix becomes rough.
The uterus shrinks and gradually atrophies. After menopause, the uterus shrinks and gradually atrophies. A full bladder, not menopause, causes the uterus to tilt backward. Cervical muscle content does not increase during menopause. Menopause has no significant effect on the outer layer of the cervix.
At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include? Antiviral drug regimens will cure this infection. The new recombinant human papillomavirus (HPV) vaccine will prevent the infection. This infection is lifelong as it cannot be treated with medication. This infection is the most common infectious cause of infertility.
This infection is the most common infectious cause of infertility. The young have the most to lose from acquiring STIs, since they may not reach their full reproductive potential. In women, chlamydia is linked with cervicitis, salpingitis, ectopic pregnancy, pelvic inflammatory disease, and infertility. It is likely the most common infectious cause of infertility in women. Recombinant human papillomavirus vaccine is for HPV infection. Antibiotics will cure this STI only.
In which client would the nurse suspect cancer? a 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge a 30-year-old with a mobile, rubbery, firm, well-circumscribed, nontender lump a 25-year-old with multiple small, round, and smooth lesions on both breasts that are painful during menstruation a 40-year-old with nipple retraction and a watery discharge
a 45-year-old with thickening in one breast with nipple irritation and retraction and a pink discharge The 25-year-old most likely has fibrocystic breast changes. The 30-year-old most likely has a fibroadenoma. The 40-year-old most likely has an intraductal papilloma. Further assessment is needed to confirm each of these, but this is what the nurse would first suspect.
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas one or more flat, wartlike papules in the genital area that are sensitive to touch copper-colored macules on the palms and soles that appeared after a brief fever a painless genital ulcer that appeared about 3 weeks after unprotected sex
a painless genital ulcer that appeared about 3 weeks after unprotected sex Explanation: A painless genital ulcer is a symptom of primary syphilis. Macules on the palms and soles after fever are indicative of secondary syphilis, as is patchy hair loss. Wartlike papules are indicative of genital warts.
A nurse is providing education to a woman about screening for breast cancer. The woman has no symptoms and no family history of breast cancer. Which recommendation would the nurse make based on the guidelines from the American Cancer Society? biennial mammography beginning at age 50 annual mammogram beginning at age 40 no breast self-exam clinical breast exam starting at age 30
annual mammogram beginning at age 40 The American Cancer Society guidelines recommend annual mammograms and clinical breast exams for women starting at age 40 and do not recommend stopping them at any age. The ACS also suggests that breast self-exams be optional for women from age 20 onward.
The nurse is teaching a young couple who desire to start their family the various methods for determining fertility. After discovering the woman regularly travels internationally for work, deals with a lot of job anxiety, and frequently uses an electric blanket at home, the nurse will discourage the use of which method? cervical mucus method symptothermal method basal body temperature method calendar method
basal body temperature method BBT is a method where the body temperature should be checked and recorded first thing in the morning, immediately after waking and before getting out of bed. It is important for the client to maintain a normal bedtime routine. Use of an electric blanket, stress, and anxiety can cause a false elevation in the BBT. The calendar method would depend upon her schedule. Cervical mucus and symptothermal methods would be viable options.
In the United States, what type of cancer accounts for one-third of cancer diagnoses and is the most common cancer in women? ovarian cancer uterine cancer breast cancer lung cancer
breast cancer According to the American Cancer Society (ACS), in the United States, breast cancer is the most common cancer in women and accounts for 1 in 3 cancer diagnoses.
A nurse is conducting a presentation for a group of pregnant clients about appropriate health promotion strategies to address issues related to infant mortality. Which strategy should the nurse encourage to reduce the infant's risk for infection after birth?
breastfeeding After birth, health promotion strategies can significantly improve an infant's health and chances of survival. Breastfeeding has been shown to reduce rates of infection in infants and to improve long-term health. Emphasizing the importance of placing an infant on their back to sleep will help reduce the incidence of sudden unexplained infant death (SUID). Newborn development support groups will help provide education about normal child development and child rearing. Folic acid supplementation is used during pregnancy to prevent neural tube defects.
Assessment of a client reveals evidence of a cystocele. The nurse interprets this as: downward displacement of the cervix. herniation of the rectum into the vagina. bulging of the bladder into the vagina. protrusion of intestinal wall into the vagina.
bulging of the bladder into the vagina. A cystocele is the bulging of the bladder into the vagina. A rectocele is a herniation of the rectum into the vagina. An enterocele is a protrusion of the intestinal wall into the vagina. A uterovaginal prolapse is the downward displacement of the cervix anywhere from low in the vagina to outside the vagina.
The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common bacterial STI in the United States would the nurse expect to include? syphilis genital herpes chlamydia gonorrhea
chlamydia Chlamydia is the most common and fastest-spreading bacterial STI in the United States, with 2.8 million new cases occurring each year. Gonorrhea is the second most frequently reported communicable disease in the U.S. The incidence of syphilis had been increasing for the past 6 years. Genital herpes is a viral STI. One in five people older than age 12, however, is infected with the virus that causes genital herpes.
The public health nurse is teaching a community class of couples on fertility awareness-based methods. The nurse determines that additional teaching is needed when one of the couples states that they will be using which method? basal body temperature method coitus interruptus method symptothermal method cervical mucus ovulation method
coitus interruptus method Fertility awareness refers to any natural contraceptive method that does not require hormones, pharmaceutical compounds, physical barriers, or surgery to prevent pregnancy. Techniques used to determine fertility include the cervical mucus ovulation method, the basal body temperature (BBT) method, the symptothermal method, standard days method, and 2-day method. Coitus interruptus or withdrawal is not considered a fertility awareness based method.
What is the most common early symptom of a sexually transmitted infection? menstrual cramping amenorrhea vaginal discharge dysuria
dysuria Sexually transmitted infections common in adolescents present with dysuria as the common denominator for early symptoms in the majority of STIs. The other symptoms may present but not as an early indicator of a sexually transmitted infection.
A nurse working in the OB clinic is talking to a client who asks the nurse why her primary care provider has not prescribed estrogen replacement therapy (ERT) to treat her pelvic organ prolapse (POP). The nurse informs the client that ERT is not for everyone and should not be given to clients who are at risk for developing which conditions? Select all that apply. breast cancer deep vein thrombosis (DVT) stroke pulmonary emboli (PE) myocardial infarction (MI) endometrial cancer
endometrial cancer myocardial infarction (MI) stroke breast cancer deep vein thrombosis (DVT) pulmonary emboli (PE) Before hormone therapy is considered, a thorough medical history must be taken to assess the risk for complications such as MI, endometrial cancer, stroke, breast cancer, PE, and DVT.
A woman at the infertility clinic for the first time asks, "What could have caused my infertility?" Learning has taken place when the woman can identify which common causes of infertility? Select all that apply. ovarian dysfunction endometriosis blocked fallopian tubes cervical factors absence of uterus
endometriosis blocked fallopian tubes ovarian dysfunction In women, ovarian dysfunction, tubal/pelvic pathology, and endometriosis are the primary contributing factors to infertility.
A client with breast cancer is receiving chemotherapy. On a follow-up visit, the nurse notes that the client's white blood cell count is decreased. The nurse notifies the primary care provider who prescribes a growth-stimulating factor to be administered. Which agent would the nurse expect to administer? tamoxifen letrozole filgrastim epoetin alfa
filgrastim Filgrastim is a growth-stimulating factor used to raise the white blood cell count. Epoetin alfa, also a growth-stimulating factor, is used to raise the red blood cell count. Tamoxifen is a selective estrogen receptor modulator used for women with hormone sensitive breast disease. Letrozole is an aromatase inhibitor used to treat advanced breast cancer.
After teaching a health education class on the female reproductive cycle, the nurse determines that the teaching was effective when the group identifies which phase as belonging to the ovarian cycle? proliferative phase follicular phase secretory phase ischemic phase
follicular phase The ovarian cycle consists of the follicular phase, ovulation, and the luteal phase. The proliferative, secretory, and ischemic phases occur in the endometrial cycle.
A mother brings her 10-year-old daughter to the clinic for a routine visit. The mother tells the nurse that she has noticed her daughter beginning to develop and asks the nurse about when her daughter may begin menstruating. The nurse understands that many factors are involved in determining the age at which menstruation begins. Which factor would the nurse include in the response as most important? weight genetics nutrition cultural practices
genetics Genetics is the most important factor in determining the age at which menarche starts, but geographic location, nutrition, weight, general health, nutrition, cultural and social practices, the girl's educational level, attitude, family environment, and beliefs are also important.
Which hormone stimulates the release of the follicle-stimulating hormone (FSH) from both male and female glands? prolactin-releasing hormone (PRH) gonadotropin-releasing hormone (GnRH) thyrotropin-releasing hormone (TRH) growth hormone-releasing hormone (GHRH)
gonadotropin-releasing hormone (GnRH) The male and female glands respond to LH and FSH, which are released from the anterior pituitary in response to stimulation from gonadotropin-releasing hormone that is released from the hypothalamus. GHRH stimulates the release of the growth hormone, which targets cell growth. THR stimulates the thyroid stimulating hormone, which targets the thyroid gland. PRH stimulates the release of prolactin, which is necessary for milk production.
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection? gonorrhea syphilis Candida albicans human immunodeficiency virus
gonorrhea Gonorrhea can be transmitted to the newborn in the form of ophthalmia neonatorum during birth by direct contact with gonococcal organisms in the cervix. The newborn would develop congenital syphilis if exposed in utero. Exposure to Candida would cause thrush in the newborn. Exposure to HIV during gestation could lead to the birth of an HIV-positive newborn.
The nurse is caring for a 14-year-old girl who fears she might have a sexually transmitted infection (STI). What would the nurse expect to assess if the adolescent has trichomoniasis? lesions on the vulva flu-like symptoms urinary incontinence green vaginal discharge
green vaginal discharge Symptoms of trichomoniasis include a yellow, green, or gray vaginal discharge with a foul odor. Urinary incontinence is not indicative of trichomoniasis, but dysuria is. Syphilis is associated with flu-like symptoms. Lesions on the vulva are a sign of venereal warts.
The nurse is reviewing the history and physical exam of a woman who has come to the clinic for a routine physical. Which factor would the nurse identify as increasing the client's risk for breast cancer? menarche at age 14 39 years of age history of ovarian cancer Asian race
history of ovarian cancer A personal history of ovarian cancer is considered a risk factor for breast cancer. Typically, breast cancer is associated with aging (women over 50 years of age). Breast cancer is more common in white women, but black women are more likely to die of it. Early menarche (before 12 years of age) or late onset of menopause (after age 55 years) is associated with an increased risk for breast cancer.
A clinic nurse explains to a client who is undergoing an infertility workup that the patency of her fallopian tubes will be checked. Which test is currently used to do this? hysterosalpingography uterine biopsy magnetic resonance imaging computed tomography scan
hysterosalpingography Hysterosalpingography is radiologic examination with radiopaque contrast of the fallopian tubes. It is widely used to assess the patency of the fallopian tubes in women who are subfertile.
A nurse is reviewing the statistical outcomes related to fetal deaths nationwide and notes that the numbers have changed over the last several decades. The best explanation would be:
improved prenatal care has reduced the numbers of fetal deaths. The number of fetal deaths in the United States has fallen. This has been attributed to the improvement in the delivery of prenatal care.
An anatomy professor is teaching a class of pre-nursing students about the female reproductive system. One student asks, "Where is the opening to the vagina?" The best answer the professor can give is: between the labia majora and by the paraurethral glands. between where you pee and where you poop. in what is called the vestibule, which is located between the labia minora. by the Bartholin glands.
in what is called the vestibule, which is located between the labia minora. The vestibule is the area between the labia minora. The urethral meatus (opening to the urethra), paraurethral (Skene) glands, vaginal opening or introitus, and Bartholin glands are located within the vestibule.
A 62-year-old female client arrives at a health care facility reporting skin redness in the breast area, along with skin edema. The primary care provider suspects inflammatory breast cancer. For which symptom of inflammatory breast cancer should the nurse assess? increased warmth of the breast palpable papilloma palpable mobile cysts induced nipple discharge
increased warmth of the breast Skin edema, redness, and warmth of the breast are symptoms of inflammatory breast cancer. Induced discharge is an indication of benign breast conditions, which are noncancerous. Cancer involves spontaneous nipple discharge. Papillomas and palpable mobile cysts are characteristics of fibroadenomas, intraductal papilloma, and mammary duct ectasia, which are benign breast conditions and are noncancerous.
Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because:
increasing numbers of children live with chronic disabilities due to advances in health care that allow children with formerly fatal diseases to survive. Advances in health care have led to more children living with chronic illness or disability. The statements about genetic disease and older women may contain some truth but have only added a few people to the chronic illness total. Acute care pediatric nursing positions are decreasing in community hospitals but are more available in medical centers. Uninsured families may or may not be able to access nonhospital care.
A program designed to decrease the infant mortality rate in the United States would probably make the greatest impact if it focused on which aspect of care?
increasing the number of women receiving prenatal care Receiving prenatal care has proven to be a major strategy for reducing infant mortality. The other interventions will not directly impact infant mortality rates to the degree that prenatal care will.
The nurse explains to a client diagnosed with trichomoniasis that the disease is caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse say is a factor that triggers growth of trichomoniasis? spontaneous abortion (miscarriage) being postmenopausal trauma to the bladder irritation of vaginal walls
irritation of vaginal walls Explanation: Factors that trigger growth of trichomoniasis include irritation of vaginal walls, pregnancy, sexual activity, trauma to the vaginal walls, systemic illness, menstruation, and emotional upsets.
The nurse is caring for a 2-year-old boy who needs a lumbar puncture. His mother is present. What would prevent informed consent from being obtained?
learning the mother is not the custodial parent
The nurse is providing care to a client who has had surgery as treatment for breast cancer. The nurse would be alert for the development of which complication? lymphedema fibrocystic breast disease breast abscess fibroadenoma
lymphedema Lymphedema occurs in some women after breast cancer surgery. It causes disfigurement and increases the lifetime potential for infection and poor healing. Fibrocystic breast disease and fibroadenoma are two benign breast conditions that occur usually in premenopausal woman. Breast abscess is the infectious and inflammatory breast condition that is common among breastfeeding mothers.
A client is considering breast augmentation. What would the nurse recommend to the client to ensure that there are no malignancies? mammogram ultrasound breast biopsy mastopexy
mammogram When caring for a client considering breast augmentation, the nurse should provide her with a general guideline to have a mammogram to verify that there are no malignancies. Mastopexy involves a breast lift for drooping breasts. Ultrasound or breast biopsy would not be necessary unless there was evidence of a problem.
A nurse is obtaining a health history from a female client who reports that she started menstruating at age 11 years. The nurse would document this as: adrenarche, age 11. mensis, age 11. menarche, age 11. thelarche, age 11.
menarche, age 11. Menarche refers to the start of menstruation, which in this case would be at age 11 years. Thelarche refers to the development of breast buds; adrenarche refers to the appearance of pubic and then axillary hair and subsequent growth spurt. Mensis is a general term referring to menstruation.
A client is diagnosed with trichomoniasis infection. The nurse prepares to teach the client about which medication? miconazole metronidazole penicillin G fluconazole
metronidazole Oral metronidazole or tinidazole are used to treat trichomoniasis. Penicillin G may be used to treat syphilis. Miconazole and fluconazole are used to treat candidiasis.
A client is diagnosed with trichomoniasis infection. The nurse prepares to teach the client about which medication? penicillin G miconazole fluconazole metronidazole
metronidazole Oral metronidazole or tinidazole are used to treat trichomoniasis. Penicillin G may be used to treat syphilis. Miconazole and fluconazole are used to treat candidiasis.
A male client appears in the walk-in clinic and requests treatment for trichomoniasis as his girlfriend was recently diagnosed with it. What medication would the health care provider most likely prescribe? metronidazole penicillin G acyclovir clotrimazole
metronidazole Trichomoniasis is a common vaginal infection with the therapeutic management of metronidazole or tinidazole for both partners. Trichomoniasis is a common, curable sexually transmitted infection (STI) caused by a parasitic protozoa called Trichomonas.
A healthy 28-year-old female client who has a sedentary lifestyle and is a chain smoker is seeking information about contraception. The nurse informs this client of the various options available and the benefits and the risks of each. Which should the nurse recognize as contraindicated in the case of this client? a copper intrauterine device the medroxyprogesterone injection oral contraceptive pills (OCPs) implantable contraceptives
oral contraceptive pills (OCPs) Considering the client's smoking habit, oral contraceptive pills may be contraindicated. Oral contraceptives are highly effective when taken properly, but can aggravate many medical conditions, especially in women who smoke. The medroxyprogesterone injection or copper intrauterine devices are not contraindicated in this client and can be used with certain precautions. Implantable contraceptives are subdermal time-release implants that deliver synthetic progestin; these are highly effective and are not contraindicated in this client.
The nurse is meeting with a 36-year-old client who wishes to begin using contraceptives. The client reports being in a long-term, monogamous relationship, runs 2 miles per day, and smokes a pack of cigarettes each day. Which method will the nurse be least likely to suggest to the client? spermicides oral contraceptive pills (OCPs) condoms coitus interruptus
oral contraceptive pills (OCPs) Oral contraceptive pills (OCPs) are contraindicated for women who smoke; these women would be at a higher risk for blood clots. Condoms, coitus interruptus, and spermicides can be used at no risk.
After teaching a group of women about reproduction and the structures involved, the nurse determines that the teaching was successful when the group identifies which female reproductive structure as comparable to the male testes? fallopian tubes clitoris ovaries fundus
ovaries The ovaries are a set of paired glands resembling unshelled almonds that are the organs of gamete production in the female. They are homologous to the male testes. The fallopian tubes are the site of fertilization. The clitoris is a small, cylindrical mass of erectile tissue and nerves that is analogous to the male penis. The fundus is the upper portion of the uterus.
What is the medication of choice for early syphilis? ceftriaxone doxycycline penicillin G benzathine tetracycline
penicillin G benzathine A single dose of penicillin G benzathine intramuscular injection is the medication of choice for early syphilis or early latent syphilis of less than 1 year's duration. Clients who are allergic to penicillin are usually treated with doxycycline or tetracycline. Ceftriaxone is not the medication of choice for syphilis.
A nurse is reviewing the medical record of a woman who has given birth vaginally. The record reveals that the client required a right mediolateral episiotomy during birth. When assessing the client, the nurse would inspect which area to evaluate the status of the episiotomy? clitoris perineum labia vestibule
perineum The perineum is the most posterior part of the external female reproductive organs. This external region is located between the vulva and the anus. It is made up of skin, muscle, and fascia. Incising the perineum area to provide more space for the presenting part is called an episiotomy. An episiotomy does not involve the clitoris, vestibule, or labia.
Which hormone is called the hormone of pregnancy because it reduces uterine contractions during pregnancy? luteinizing hormone (LH) progesterone follicle-stimulating hormone (FSH) estrogen
progesterone Progesterone is called the hormone of pregnancy because it reduces uterine contractions, thus producing a calming effect on the uterus, allowing pregnancy to be maintained. FSH is primarily responsible for the maturation of the ovarian follicle. LH is required for both the final maturation of preovulatory follicles and the luteinization of the ruptured follicle. Estrogen is crucial for the development and maturation of the follicle.
What nursing intervention by the maternity nurse is the most important in providing family-centered care?
promoting uninterrupted infant bonding Since World War II many changes and innovations have occurred in maternity care and how nurses provide this care. The evolution has gone from task-oriented nursing services, to providing education and promoting breastfeeding, to family-centered care. Promoting uninterrupted infant bonding has been identified as a priority in the development of the family unit. Allowing doulas in the delivery room, having siblings at the bedside and providing early discharge are all parts of family-centered care, but establishing bonding between the infant and the family unit is the priority.
A woman is scheduled to undergo a modified radical mastectomy. Which information would the nurse include when describing this surgery to the client? removal of breast tissue and axillary nodes wide excision of the tumor along with a 1-cm margin of normal tissue sparing of the pectoral muscles and axillary lymph nodes the resulting concave appearance of the anterior chest
removal of breast tissue and axillary nodes A modified radical mastectomy is a surgical option conducive to breast reconstruction and resulting in greater mobility and less lymphedema. This procedure involves removal of breast tissue, and a few positive axillary nodes. The surgery will not produce a concave anterior chest. With a simple mastectomy, all breast tissue, the nipple, and the areola are removed, but the axillary nodes and pectoral muscles are spared. A lumpectomy, or breast-conserving surgery, involves the wide local excision of the tumor along with a 1-cm margin of normal tissue.
A woman is scheduled to undergo a modified radical mastectomy. Which information would the nurse include when describing this surgery to the client? sparing of the pectoral muscles and axillary lymph nodes the resulting concave appearance of the anterior chest removal of breast tissue and axillary nodes wide excision of the tumor along with a 1-cm margin of normal tissue
removal of breast tissue and axillary nodes A modified radical mastectomy is a surgical option conducive to breast reconstruction and resulting in greater mobility and less lymphedema. This procedure involves removal of breast tissue, and a few positive axillary nodes. The surgery will not produce a concave anterior chest. With a simple mastectomy, all breast tissue, the nipple, and the areola are removed, but the axillary nodes and pectoral muscles are spared. A lumpectomy, or breast-conserving surgery, involves the wide local excision of the tumor along with a 1-cm margin of normal tissue.
The nurse is teaching a family planning class at a health fair. Which physiologic change during the plateau stage of sexual response will the nurse point out? scrotal elevation retraction of the clitoris labia minor lightens in color lengthening of the vagina
retraction of the clitoris Retraction of the clitoris occurs during the plateau stage prior to orgasm. Lengthening of the vagina and scrotal elevation occur during excitement. The labia minora deepens in color.
A couple who is in for fertility testing ask the nurse what tests are commonly performed to assess fertility. The nurse replies that there are only three primary tests that are used. What are these tests? semen analysis, urinalysis, and ovulation monitoring serologic test for syphilis, semen analysis, and tubal patency assessment semen analysis, ovulation monitoring, and tubal patency assessment pelvic sonogram, ovulation monitoring, and semen analysis
semen analysis, ovulation monitoring, and tubal patency assessment Only three tests are commonly used to test fertility: semen analysis in the male and ovulation monitoring and tubal patency assessment in the female. Additional testing may be performed both on the man and the woman, which may include urinalysis, serologic test for syphilis, and pelvic sonogram, but these are not the primary tests used.
A woman has been assessing her basal body temperature for 4 months. Upon reviewing her temperature history log, the nurse notes no change in her daily temperatures. Which should the nurse expect the health care provider to prescribe first? serum progesterone level endometrial biopsy clomiphene vaginal discharge culture
serum progesterone level There should be a significant increase in temperature, usually 0.5° to 1° F, within a day or two after ovulation has occurred. The temperature remains elevated for 12 to 16 days, until menstruation begins. The cause of this rise in temperature is the hormone progesterone. If there is no change in the woman's monthly temperature, the progesterone level should be assessed.
A male client asks the nurse to explain which structure is cut during a vasectomy. What response should the nurse give the client? the epididymis the scrotum the ejaculatory ducts the vas deferens
the vas deferens The two vas deferens or ductus deferentia are ligated and cut in the male sterilization procedure, called a vasectomy. The epididymis serves as a site for sperm to mature and be stored until ejaculation occurs. The ejaculatory ducts empty into the urethra and receive secretions from the prostate gland to make up semen. The scrotum is a sac-like structure that sits behind the penis and houses the testicles.
When teaching the client how to use a contraceptive sponge, the nurse must tell the client that leaving the sponge in place longer than 30 hours may lead to: sexually transmitted infections. pelvic inflammatory disorder. toxic shock syndrome. cervical inflammation.
toxic shock syndrome. The sponge provides protection for up to 12 hours but should not be left in place for more than 30 hours after insertion to avoid the risk of toxic shock syndrome.
The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms? trichomoniasis herpes simplex 2 syphilis human papillomavirus
trichomoniasis Trichomoniasis symptoms are vulvar itching and a malodorous foamy yellow vaginal discharge.
A nurse is speaking to a local women's group about the various types of cancer affecting the female reproductive tract. The nurse explains that ovarian cancer is the leading cause of death from gynecologic malignancies based on the understanding that this type of cancer: arises from extremely rare types of cells that are resistant to treatment. typically manifests with vague symptoms resulting in late diagnosis. spreads more easily than other female reproductive cancers. is closely associated with highly resistant sexually transmitted infections.
typically manifests with vague symptoms resulting in late diagnosis. Tumors of the ovary have been lethal largely because they present with nonspecific symptoms and therefore frequently are far advanced and inoperable by the time they are diagnosed. Ease of spread and types of cells involved are not reasons underlying the fatal nature of this type of cancer. Ovarian cancer is not associated with sexually transmitted infections. Cervical cancer is linked to human papillomavirus infection.
The nurse is preparing a woman who is suspected of having endometrial cancer for diagnostic testing. Which test would the nurse most likely prepare the client for first? endometrial biopsy ultrasound Papanicolaou test CA-125 test
ultrasound Typically the noninvasive ultrasound is done first before an invasive endometrial biopsy is attempted. A Papanicolaou test is helpful in identifying cervical cancer. CA-125 testing may be done to assist in the diagnosis of ovarian cancer, although it is not confirmatory. An endometrial biopsy is done after an ultrasound which detects diffuse endometrial thickening.
There are two major functions of the reproductive system, continuation of the species and sexual pleasure. In the male, the reproductive system has a third function. What is this third function? production of sex hormones stimulation of sexual maturation elimination of solid wastes urinary elimination
urinary elimination Some of the structures in the reproductive tract serve dual purposes. Most often these alternate functions have to do with urinary elimination because the urinary and reproductive systems are closely connected.
Which factor in a client's history indicates she is at risk for candidiasis? menopause nulliparity use of spermicidal jelly use of corticosteroids
use of corticosteroids Small numbers of the fungus Candida albicans are commonly in the vagina. Because corticosteroids decrease host defense, they increase the risk of candidiasis. Pregnancy, not nulliparity, increases the risk of candidiasis. Candidiasis is rare before menarche and after menopause. The use of hormonal contraceptives, not spermicidal jelly, increases the risk of candidiasis.
A nurse is caring for a client who has been prescribed gonadotropin-releasing hormone (GnRH) medication for uterine fibroids (uterine myomas). For which side effect of GnRH medications should the nurse monitor the client? vaginitis vaginal dryness urinary tract infections increased vaginal discharge
vaginal dryness Vaginal dryness is one of the side effects of GnRH medications. The other side effects of GnRH medications are hot flashes, headaches, mood changes, musculoskeletal malaise, bone loss, and depression. Increased vaginal discharge, urinary tract infections, and vaginitis are side effects of a pessary, not GnRH medications.
A woman with uterine prolapse is scheduled to undergo surgery. When providing preoperative teaching, the nurse reviews information about the type of surgery being planned. Based on the nurse's knowledge of the client's condition, the nurse would most likely include information about which surgery? bilateral salpingectomy anterior colporrhaphy posterior colporrhaphy vaginal hysterectomy
vaginal hysterectomy A vaginal hysterectomy is the treatment of choice for uterine prolapse because it removes the prolapsed organ that is bringing down the bladder and rectum with it. An anterior or posterior colporrhaphy is used to repair a cystocele or rectocele, respectively. Bilateral salpingectomy removes the fallopian tubes and would not be indicated in this situation.
A nurse is conducting a class and is describing the spermatic cord. Which structures would the nurse identify as being involved? Select all that apply. vas deferens blood vessels nerves seminal vesicles urethra
vas deferens blood vessels nerves The vas deferens is a cord-like duct that transports sperm from the epididymis. One such duct travels from each testis up to the back of the prostate and enters the urethra to form the ejaculatory ducts. Other structures, such as blood vessels and nerves, also travel along with each vas deferens and together form the spermatic cord. The urethra is the terminal duct of the reproductive and urinary systems. The seminal vesicles produce nutrient seminal fluid and with the prostate are connected to the ejaculatory duct leading into the urethra
A group of women are attending a community presentation regarding the leading health concerns of women. Which interventions should the nurse recommend to have the greatest impact on the leading cause of death?
weight control and being knowledgeable about family history of cardiovascular disease Cardiovascular disease is the leading cause of death of women in the United States. Interventions that address reduction of this risk would be a priority. Elevations in death rates are in part attributed to the difficulty recognizing cardiovascular concerns in women. The second leading cause of death in women is cancer, specifically lung and cervical. Lower respiratory tract infections have increased over recent years as a cause of death in women, but they are not the number one cause. Alzheimer disease, although impacting the mortality rates of women, is not the greatest cause of death.
