OB Ch 4: Health Promotion

Which statement by the client indicates that she understands BSE? a. "I will examine both breasts in two different positions." b. "I will examine my breasts 1 week after my menstrual period starts." c. "I will examine only the outer upper area of the breast." d. "I will use the palm of the hand to perform the examination."

"I will examine my breasts 1 week after my menstrual period starts."

A blind woman has arrived for an examination. Her guide dog assists her to the examination room. She appears nervous and says, "I've never had a pelvic examination." What response from the nurse would be most appropriate? a. "Don't worry. It will be over before you know it." b. "Try to relax. I'll be very gentle, and I won't hurt you." c. "Your anxiety is common. I was anxious when I first had a pelvic examination." d. "I'll let you touch each instrument that I'll use during the examination as I tell you how it will be used."

"I'll let you touch each instrument that I'll use during the examination as I tell you how it will be used."

The nurse guides a woman to the examination room and asks her to remove her clothes and put on an examination gown with the front open. The woman replies, "I have special undergarments that I do not remove for religious reasons." Which is the most appropriate response from the nurse? a. "You can't have an examination without removing all your clothes." b. "I'll ask the physician to modify the examination." c. "Tell me about your undergarments. I'll explain the examination procedure, and then we can discuss how you can comfortably have your examination." d. "I have no idea how we can accommodate your beliefs."

"Tell me about your undergarments. I'll explain the examination procedure, and then we can discuss how you can comfortably have your examination."

Which statement indicates that a client requires additional instruction regarding BSE? a. "Yellow discharge from my nipple is normal if I'm having my period." b. "I should check my breasts at the same time each month, after my period." c. "I should also feel in my armpit area while performing my breast examination." d. "I should check each breast in a set way, such as in a circular motion."

"Yellow discharge from my nipple is normal if I'm having my period."

Due to the effects of cyclic ovarian changes in the breast, when is the best time for breast self-examination (BSE)? a. Between 5 and 7 days after menses ceases b. Day 1 of the endometrial cycle c. Midmenstrual cycle d. Any time during a shower or bath

Between 5 and 7 days after menses ceases

The unique muscle fibers that constitute the uterine myometrium make it ideally suited for what? a. Menstruation b. Birth process c. Ovulation d. Fertilization

Birth process

To promote wellness and prevent illness throughout the life span, it is important for the nurse to be cognizant of immunization recommendations for women older than 18 years. Match each immunization with the correct schedule. a. Tetanus-diphtheria-pertussis (Tdap) b. Measles, mumps, rubella c. Herpes zoster d. Hepatitis B e. Influenza f. Human papillomavirus (HPV) 1. Three injections for girls between the ages 9 to 26 years 2. Primary series of three injections 3. Annually 4. Once and then a booster every 10 years 5. One dose after age 65 years 6. Once if born after 1956

1. F 2. D 3. E 4. A 5. C 6. B

A client at 24 weeks of gestation says she has a glass of wine with dinner every evening. Why should the nurse counsel her to eliminate all alcohol intake? a. Daily consumption of alcohol indicates a risk for alcoholism. b. She is at risk for abusing other substances as well. c. Alcohol places the fetus at risk for altered brain growth. d. Alcohol places the fetus at risk for multiple organ anomalies.

Alcohol places the fetus at risk for altered brain growth

A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection, and she has been using an over-the-counter cream for the past 2 days to treat it. How should the nurse initially respond? a. Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test for which she is scheduled. b. Reassure the woman that using vaginal cream is not a problem for the examination. c. Ask the woman to describe the symptoms that indicate to her that she has a vaginal infection. d. Ask the woman to reschedule the appointment for the examination.

Ask the woman to describe the symptoms that indicate to her that she has a vaginal infection.

Which body part both protects the pelvic structures and accommodates the growing fetus during pregnancy? a. Perineum b. Bony pelvis c. Vaginal vestibule d. Fourchette

Bony pelvis

A 62-year-old woman has not been to the clinic for an annual examination for 5 years. The recent death of her husband reminded her that she should come for a visit. Her family physician has retired, and she is going to see the women's health nurse practitioner for her visit. What should the nurse do to facilitate a positive health care experience for this client? a. Remind the woman that she is long overdue for her examination and that she should come in annually. b. Carefully listen, and allow extra time for this woman's health history interview. c. Reassure the woman that a nurse practitioner is just as good as her old physician. d. Encourage the woman to talk about the death of her husband and her fears about her own death.

Carefully listen, and allow extra time for this woman's health history interview.

Ovarian function and hormone production decline during which transitional phase? a. Climacteric b. Menarche c. Menopause d. Puberty

Climacteric

Preconception and prenatal care have become important components of women's health. What is the guiding principal of preconception care? a. Ensure that pregnancy complications do not occur. b. Identify the woman who should not become pregnant. c. Encourage healthy lifestyles for families desiring pregnancy. d. Ensure that women know about prenatal care.

Encourage healthy lifestyles for families desiring pregnancy.

During a health history interview, a woman states that she thinks that she has "bumps" on her labia. She also states that she is not sure how to check herself. The correct response by the nurse would be what? a. Reassure the woman that the examination will reveal any problems. b. Explain the process of vulvar self-examination, and reassure the woman that she should become familiar with normal and abnormal findings during the examination. c. Reassure the woman that "bumps" can be treated. d. Reassure her that most women have "bumps" on their labia.

Explain the process of vulvar self-examination, and reassure the woman that she should become familiar with normal and abnormal findings during the examination.

As part of their participation in the gynecologic portion of the physical examination, which approach should the nurse take? a. Take a firm approach that encourages the client to facilitate the examination by following the physician's instructions exactly. b. Explain the procedure as it unfolds, and continue to question the client to get information in a timely manner. c. Take the opportunity to explain that the trendy vulvar self-examination is only for women at risk for developing cancer. d. Help the woman relax through the proper placement of her hands and proper breathing during the examination.

Help the woman relax through the proper placement of her hands and proper breathing during the examination.

What is the primary reason why a woman who is older than 35 years may have difficulty achieving pregnancy? a. Personal risk behaviors influence fertility. b. Mature women have often used contraceptives for an extended time. c. Her ovaries may be affected by the aging process. d. Prepregnancy medical attention is lacking.

Her ovaries may be affected by the aging process.

Which part of the menstrual cycle includes the stimulated release of gonadotropin-releasing hormone (GnRH) and follicle-stimulating hormone (FSH)? a. Menstrual phase b. Endometrial cycle c. Ovarian cycle d. Hypothalamic-pituitary cycle

Hypothalamic-pituitary cycle

What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? a. Genetic changes and anomalies b. Extensive central nervous system damage c. Fetal addiction to the substance inhaled d. Intrauterine growth restriction

Intrauterine growth restriction

Which statement best describes Kegel exercises? a. Kegel exercises were developed to control or reduce incontinent urine loss. b. Kegel exercises are the best exercises for a pregnant woman because they are so pleasurable. c. Kegel exercises help manage stress. d. Kegel exercises are ineffective without sufficient calcium in the diet.

Kegel exercises were developed to control or

Many pregnant teenagers wait until the second or third trimester to seek prenatal care. What should the nurse recognize as reasons for this delay? (Select all that apply.) a. Lack of realization that they are pregnant b. Uncertainty as to where to go for care c. Continuing to deny the pregnancy d. Desire to gain control over their situation e. Wanting to hide the pregnancy as long as possible

Lack of realization that they are pregnant Uncertainty as to where to go for care Continuing to deny the pregnancy Wanting to hide the pregnancy as long as possible

Women of all ages will receive substantial and immediate benefits from smoking cessation. The process is not easy, and most people have attempted to quit numerous times before achieving success. Which organizations provide self-help and smoking cessation materials? (Select all that apply.) a. Leukemia and Lymphoma Society b. March of Dimes c. American Cancer Society d. American Lung Association e. Easter Seals

March of Dimes American Cancer Society American Lung Association

Which statements regarding menstruation (periodic uterine bleeding) are accurate? (Select all that apply.) a. Menstruation occurs every 28 days. b. During menstruation, the entire uterine lining is shed. c. Menstruation begins 7 to 10 days after ovulation. d. Menstruation leads to fertilization. e. Average blood loss during menstruation is 50 ml.

Menstruation occurs every 28 days. During menstruation, the entire uterine lining is shed. Average blood loss during menstruation is 50 ml.

How would the physiologic process of the sexual response best be characterized? a. Coitus, masturbation, and fantasy b. Myotonia and vasocongestion c. Erection and orgasm d. Excitement, plateau, and orgasm

Myotonia and vasocongestion

Which statement regarding female sexual response is inaccurate? a. Women and men are more alike than different in their physiologic response to sexual arousal and orgasm. b. Vasocongestion is the congestion of blood vessels. c. Orgasmic phase is the final state of the sexual response cycle. d. Facial grimaces and spasms of the hands and feet are often part of arousal.

Orgasmic phase is the final state of the sexual response cycle.

What are the two primary functions of the ovary? (Select all that apply.) a. Normal female development b. Ovulation c. Sexual response d. Hormone production e. Sex hormone release

Ovulation Hormone production

The microscopic examination of scrapings from the cervix, endocervix, or other mucous membranes to detect premalignant or malignant cells is called what? a. Bimanual palpation b. Rectovaginal palpation c. Papanicolaou (Pap) test d. Four As procedure

Papanicolaou (Pap) test

Which hormone is responsible for the maturation of mammary gland tissue? a. Estrogen b. Testosterone c. Prolactin d. Progesterone

Progesterone

What fatty acids (classified as hormones) are found in many body tissues with complex roles in many reproductive functions? a. GnRH b. Prostaglandins (PGs) c. FSH d. Luteinizing hormone (LH)

Prostaglandins (PGs)

What is the goal of a long-term treatment plan for an adolescent with an eating disorder? a. Managing the effects of malnutrition b. Establishing sufficient caloric intake c. Improving family dynamics d. Restructuring client perception of body image

Restructuring client perception of body image

Which questionnaire would be best for the nurse to use when screening an adolescent client for an eating disorder? a. Four Cs b. Dietary Guidelines for Americans c. SCOFF screening tool d. Dual-energy x-ray absorptiometry (DEXA) scan

SCOFF screening tool

Which phase of the endometrial cycle best describes a heavy, velvety soft, fully matured endometrium? a. Menstrual b. Proliferative c. Secretory d. Ischemic

Secretory

Which action would be inappropriate for the nurse to perform before beginning the health history interview? a. Smile and ask the client whether she has any special concerns. b. Speak in a relaxed manner with an even, nonjudgmental tone. c. Make the client comfortable. d. Tell the client her questions are irrelevant.

Tell the client her questions are irrelevant.

Which female reproductive organ(s) is(are) responsible for cyclic menstruation? a. Uterus b. Ovaries c. Vaginal vestibule d. Urethra

Uterus

Individual irregularities in the ovarian (menstrual) cycle are most often caused by what? a. Variations in the follicular (preovulatory) phase b. Intact hypothalamic-pituitary feedback mechanism c. Functioning corpus luteum d. Prolonged ischemic phase

Variations in the follicular (preovulatory) phase

Which information regarding substance abuse is important for the nurse to understand? a. Although cigarette smoking causes a number of health problems, it has little direct effect on maternity-related health. b. Women, ages 21 to 34 years, have the highest rates of specific alcohol-related problems. c. Coffee is a stimulant that can interrupt body functions and has been related to birth defects. d. Prescription psychotherapeutic drugs taken by the mother do not affect the fetus; otherwise, they would not have been prescribed.

Women, ages 21 to 34 years, have the highest rates of specific alcohol-related problems.