OB Test 1 NCLEX QUESTIONS

The nurse is caring for a client with advanced osteoporosis who implemented the use of a heating pad in the treatment of pain. Which action by the nurse demonstrates appropriate use of the heating​ pad? A. Alternating the heat with an ice pack every 30 minutes B. Utilizing the heat if the prescribed pain medication does not work C. Removing the heat every 20 to 30 minutes D. Encouraging the use of the heat before the client ambulates

Removing the heat every 20 to 30 minutes ​Rationale: The heat should be removed every 20 to 30 minutes to avoid a rebound effect from too much heat. Ice is not used in the treatment of pain for the client with osteoporosis. The heat should be utilized when the client experiences discomfort and can be used with or without the use of pain medication.

While conducting a physical​ assessment, the nurse notes a red rash in the axillary region of a young adult client. Which factor may be associated with the assessment​ finding? (Select all that​ apply.) A. Shaving B. Systemic disease C. Infection of the hair follicles D. Allergies E. Breast malignancy

Shaving Infection of the hair follicles Allergies ​Rationale: Redness,​ rash, irritation, or lesions of the axillary region may be due to​ allergies, shaving, or infection of the sweat glands or hair follicles. Systemic disease and breast malignancy do not manifest as an axillary rash.

The nurse is reviewing the chart of a client with osteoporosis. Which physical assessment finding should the nurse​ anticipate? A. Spinal curvature B. Poor posture C. Generalized pain D. Unsteady gait

Spinal curvature Rationale: The assessment findings associated with osteoporosis include spinal curvature. An unsteady​ gait, poor​ posture, and generalized pain are not findings associated with the physical assessment findings of osteoporosis.

The nurse is caring for a client from Southeast Asia who has HIV/AIDS. The client does not speak or comprehend English. What should the nurse do? A. Contact the hospital's chaplain B. Do an internet search for the Joint United Nations Programme on HIV/AIDS C. Utilize language-appropriate interpreters D. Ask a family member to obtain informed consent.

Utilize language-appropriate interpreters Interpreters are essential in enabling the nurses' communications to be understood accurately. It is not necessary for the family member to obtain informed consent.

A female client with gonorrhea informs the nurse that she ahd sexual intercourse with her boyfriend and asks the nurse, "Would he have any symptoms?" The nurse responds that in men, the symptoms of gonorrhea include: A. Impotence B. Scrotal swelling C. Urine retention D. Dysuria

Dysuria Rationale: Dysuria and mucopurulent urethral discharge characterize gonorrhea in men. These symptoms are usually so painful in men that they seek treatment right away.

The PRIMARY reason that a herpes simplex virus infection is a serious concern to a client with HIV is that it: A. Is an aquired immunodeficiency virus-defining illness B. Is curable only after 1 year of antiviral therapy C. Leads to cervical cancer D. Causes severe electrolyte imbalances

Is an AIDS-defining illness Rationale: HSV is one of a group of disorders that, when diagnosed in the presence of HIV, are considered to be diagnostic for AIDS. Other AIDS defining illnesses include Kaposi's sarcoma, CMV of the liver spleen or lymph, and Pneumocytis carinii pneumonia.

The nurse is caring for an adolescent client who has been diagnosed with a sexually transmitted infection​ (STI). Which problem should the nurse assess in this​ client? (Select all that​ apply.) A. Pain B. Impaired skin integrity C. Deficient knowledge D. Disturbed body image E. Risk of altered parenting

Pain Impaired skin integrity Deficient knowledge Disturbed body image ​Rationale: The nurse should assess the client for​ pain, deficient​ knowledge, disturbed body​ image, and impaired skin integrity. There is no need to assess the client for risk of altered parenting.

The nurse should understand that which physiological screening tests for sexual health are appropriate for both men and​ women? (Select all that​ apply.) A. Physical examination B. Lipid panel C. Mammography D. Blood pressure E. ​Prostate-specific antigen

Physical examination Lipid panel Blood pressure ​Rationale: The nurse understands that the physiological screening tests for the sexual health of men and women include a lipid​ panel, blood​ pressure, and a physical assessment. Mammography is a specific test for​ women, and​ prostate-specific antigen is a screening for men.

The nurse is caring for a client with osteoporosis. Which medication taken by the client may have contributed to this​ diagnosis? A. Acetaminophen B. Prednisone C. Calcium Supplements D. Vitamin D Supplements

Prednisone ​Rationale: Glucocorticoids such as prednisone may have contributed to the development of osteoporosis. Calcium supplements and vitamin D supplements are both used to treat osteoporosis. Acetaminophen is a pain​ reliever; it is not associated with the development of osteoporosis.

The nurse is assessing a client with syphilis. Which stage of syphilis is characterized by a​ chancre, painless ulcerations on the genital​ area? A. Secondary stage B. Tertiary stage C. Primary stage D. Latent stage

Primary stage ​Rationale: During the primary stage of​ syphilis, the client will experience​ chancre-like, painless ulcerations that last for up to 5 weeks. The second stage occurs up to 10 weeks after initial infection. The client will experience​ fever, malaise,​ lymphadenopathy, patchy​ alopecia, and a diffuse rash. During the latent​ stage, the client is asymptomatic for years to a lifetime. The tertiary stage can occur 2 years after the onset of symptoms and includes changes in the cardiovascular​ system, bone,​ skin, and viscera.

The nurse is caring for a client who is using complementary therapies to manage menopausal symptoms. Which client statement should indicate to the nurse the need for further​ discussion? (Select all that​ apply.) A. ​"Herbs have not been proven to be​ effective, but they​ can't hurt." B. ​"I understand that there is little​ high-level research on alternative treatments for menopausal​ symptoms." C. ​"A friend used black cohosh for relief of her hot​ flashes, so I think I will try​ it." D. ​"As long as I take soy​ supplements, I can go back to eating spicy​ foods." E. ​"Ginseng may not help with my hot​ flashes, but it may help me sleep​ better."

"Herbs have not been proven to be​ effective, but they​ can't hurt." ​"A friend used black cohosh for relief of her hot​ flashes, so I think I will try​ it." ​"As long as I take soy​ supplements, I can go back to eating spicy​ foods." ​"Ginseng may not help with my hot​ flashes, but it may help me sleep​ better." ​Rationale: Little​ high-level research has been done on alternative treatment options for menopause symptoms. While research has shown some herbs to be​ beneficial, they can interact with other medications and need to be discussed with the healthcare provider. Research suggests that soy is beneficial in reducing hot​ flashes, but diet adjustments should also be made to help reduce hot flashes. Although black cohosh has been a popular alternative to HRT for​ years, a Cochrane Database review​ (Leach &​ Moore, 2012) examined 16 studies and found​ that, compared to​ placebo, black cohosh did not decrease hot flashes and other symptoms. The authors concluded that evidence for use of black cohosh is lacking and further research is needed. Ginseng may not help with symptoms of hot​ flashes, but it can be used for some other symptoms of menopause.

The nurse is caring for a postmenopausal client prescribed estrogen therapy to reduce the risk of osteoporosis. Which client statement indicates the need for further​ teaching? A. "I have completed my smoking cessation​ program." B. "I understand that I may experience hot​ flashes." C. "I will be sure to maintain all​ follow-up appointments for​ evaluation." D. "I am glad I am not at risk for osteoporosis​ anymore."

"I am glad I am not at risk for osteoporosis​ anymore." Rationale: The client prescribed a selective estrogen receptor modulator to reduce the risk of osteoporosis should address other modifiable risk factors attributed to osteoporosis. Medication alone will not prevent osteoporosis. Hot flashes are a side effect of the medication. Smoking is a risk factor for osteoporosis. The client should maintain all​ follow-up appointments.

The nurse is caring for a​ middle-age female client who​ states, "Sexual intercourse has become​ painful." Which is the best response from the​ nurse? A. ​"Pain during sexual activity is normal with​ aging." B. ​"A sex therapist might be able to help you with your​ problem." C. ​"I would like to perform an exam and offer some​ suggestions." D. ​"Pain is a warning sign that something is​ wrong."

"I would like to perform an exam and offer some​ suggestions." ​Rationale: The most appropriate response by the nurse would be to suggest the client undergo an exam before being able to offer any suggestion about decreasing the discomfort during sexual intercourse. Pain with sexual activity is not associated with aging. It is inappropriate to refer to a sex therapist prior to assessing the client.

Which statement by the nurse indicates an understanding of the effects of vitamin D and calcium on​ osteoporosis? A. "Vitamin D is needed for renal absorption of phosphorus and​ calcium." B. "Impaired vitamin D activation reduces the serum calcium​ level." C. "A high intake of​ high-phosphate foods can help increase serum​ calcium." D. "Acidosis causes calcium to be deposited into​ bone."

"Impaired vitamin D activation reduces the serum calcium​ level." ​Rationale: The statement made by the​ nurse, "Impaired vitamin D activation reduces the serum calcium​ level," demonstrates an understanding of the effects of vitamin D and calcium and their association with osteoporosis. Vitamin D is essential because it facilitates calcium absorption from the intestines into the blood. Acidosis does not cause calcium to be deposited in the bone. Vitamin D increases renal absorption of calcium in the distal​ tubule, but the phosphate level is not affected by vitamin D. Foods high in phosphate decrease serum calcium.

The nurse is caring for a client newly diagnosed with osteoporosis who​ states, "I know I need the extra​ calcium, but I​ don't eat any dairy​ products." Which statement by the nurse provides the client with information for obtaining additional dietary​ calcium? A. "Seafood is an excellent source of​ calcium." B. "Many types of pasta are an excellent source of​ calcium." C. "Increase your consumption of​ vegetables." D. "You can increase your consumption of​ meat."

"Increase your consumption of​ vegetables." ​Rationale: The​ statement, "Increase your consumption of​ vegetables," provides information on an excellent source of calcium.​ Seafood, meat, and pasta are not excellent sources of calcium. Seafood should be consumed cautiously during​ pregnancy, as it contains high levels of mercury.

The nurse reviews with a client recovering from an oophorectomy the reason why symptoms of menopause are occurring. Which client statement should indicate to the nurse that teaching was​ effective? A. ​"Removal of my ovaries has caused an abrupt onset of​ menopause, and the symptoms can be​ severe." B. ​"Since my uterus has been​ removed, the symptoms of menopause have​ started." C. ​"Surgical menopause is usually less abrupt and should subside quickly once the body​ adjusts." D. ​"Removal of my fallopian tubes has started surgical​ menopause, and the symptoms start​ quickly."

"Removal of my ovaries has caused an abrupt onset of​ menopause, and the symptoms can be​ severe." ​Rationale: Surgical menopause is caused by removal of the​ ovaries, known as oophorectomy. Unlike medical​ menopause, onset of surgical menopause is abrupt and the symptoms may be severe. Removal of the uterus and fallopian tubes does not cause surgical menopause.

A male client with HIV becomes depressed and tells the nurse "I have nothing to live for now." Which statement would be the best response by the nurse? A. "You are a young person and have a great deal to live for" B. "You should not be too depressed; we are close to finding a cure for AIDS" C. "You are right; it is very depressing to have HIV" D. "Tell me more about how you are feeling about being HIV positive"

"Tell me more about how you are feeling about being HIV positive" Rationale: The nurse should respond with a statement that allows the client to express his thoughts and feelings. Statements of encouragement or agreement do not provide an opportunity for the client to express himself.

The nurse is providing teaching to an adolescent female. Which instruction by the nurse promotes safe sexual​ behavior? (Select all that​ apply.) A.​ "Latex condoms lubricated with petroleum jelly provide for comfort and additional barrier​ protection." B. ​"Insist that your sex partner use birth control to reduce the risk of​ HIV." C. ​"If your partner insists on having sex even though you​ don't want​ to, you should comply to show you really love​ him." D. ​"Women can carry and use female​ condoms." E. ​"You can choose to say​ 'No' to sex even if your​ long-term partner says that your relationship has matured beyond the mutual masturbation​ stage."

"Women can carry and use female​ condoms." "You can choose to say​ 'No' to sex even if your​ long-term partner says that your relationship has matured beyond the mutual masturbation​ stage." ​Rationale: The information provided to the adolescent female client that promotes safe sexual behavior includes carrying and using female condoms and encouraging the client in exercising independence in saying yes or no to sex if the​ long-term partner says that the relationship has matured beyond the mutual masturbation stage. Birth control does not reduce the risk of​ HIV, petroleum jelly does not provide additional barrier​ protection, and the client should never feel pressured to have sex to show love to the partner.

A male client is prescribed an androgen drug. The client​ asks, "What can I expect from​ this?" Which response by the nurse is​ accurate? (Select all that​ apply.) A. ​"You may notice a persistent and painful​ erection." B. ​"It will increase your sperm​ count." C. ​"You will probably notice that you will lose​ weight." D. ​"It will decrease your blood​ sugar." E. ​"It will boost your testosterone level to​ normal."

"You may notice a persistent and painful​ erection." "It will increase your sperm​ count." ​"It will boost your testosterone level to​ normal." ​Rationale: Androgen drugs are used to treat hypogonadism resulting in insufficient testosterone. They are also used to increase sperm count when low testosterone is the cause. Side effects include​ acne, weight​ gain, priapism​ (persistent and painful erection of the​ penis), and increased blood sugar.

The typical chancre of syphilis appears as: A. A grouping of small, tender pimples B. An elevated wart C. A painless, moist ulcer D. An itching, crusted area

A painless, moist ulcer Rationale: The chancre of syphilis is characteristically a painless, moist ulcer. The serous discharge is very infections. Because the chancre is usually painless and disappears, the client may not be aware of it or may not seek care.

A male client is dianosed with chlamydia. Azythromycin 1 g is prescribed. The supply of azithromycin is in 250-mg tablets. How many tablets should the nurse administer? A. 6 Tablets B. 2 Tablets C. 4 Tablets D. 1/2 Tablet

4 tablets Rationale: 250 x 4 = 1000mg = 1 g

What is the most important informartion for the nurse to teach a client newly diagnosed with genital herpes? A. Use condoms at all times during sexual intercourse B. A urologist should be seen only when lesions occur C. Oral sex is permissable without a barrier D. Determine if your partner has received a vaccination against herpes

A. Use condoms at all times during sexual intercourse Rationale: The client should be taught to abstain from sexual intercourse while lesions are present. Condoms should be used at all times as the virus can be shed without lesions present. Multiple partners would promote spread of genital herpes. There is no vaccine available to prevent genital herpes. Although periodic examination should be advised, a urologist does not necessarily need to be seen when lesions occur.

The nurse is caring for an older adult with a history of fractures as a result of osteoporosis. The client currently has a right radial fracture. Which is the priority nursing diagnosis for the​ client? A. ​Pain, Chronic B. ​Mobility: Physical, Impaired C. Activity Intolerance D. ​Nutrition, Imbalanced: Less than Body Requirements

Activity Intolerance ​Rationale: The priority nursing diagnosis for the client with right radial fracture is Activity Intolerance. The pain the client will experience with a new fracture is acute. The​ client's mobility should not be impaired with a right radial fracture. The nutritional status of the client can be assessed after the activity intolerance is addressed.​ (NANDA-I ©​ 2014)

A client is experiencing severe symptoms of menopause. About which treatment should the nurse prepare teaching for this​ client? (Select all that​ apply.) A. Acupuncture B. Hormone replacement therapy C. Soy and ginseng D. Bioidentical hormones E. Muscle relaxers

Acupuncture Hormone replacement therapy Soy and ginseng Bioidentical hormones ​Rationale: Menopausal symptoms can be treated with medications or the use of alternative and complementary therapies. Medications include hormone replacement therapy and selective serotonin reuptake inhibitors​ (SSRIs) and other​ antidepressants, and selective estrogen receptor modulators​ (SERMs). Alternative and complementary therapies include bioidentical​ hormones, acupuncture,​ biofeedback, massage,​ meditation, yoga,​ soy, and ginseng. Muscle relaxers are not used to treat manifestations of menopause.

A client reports burning on urination and a vaginal discharge. Which information should the nurse include in the​ client's documentation?​ (Select all that​ apply.) A. Allergies to any medications B. History of unprotected sex C. History of fever or chills D. Length of time since symptoms presented E. Names and phone numbers of all sexual contacts

Allergies to any medications History of unprotected sex History of fever or chills Length of time since symptoms presented ​Rationale: The​ client's sexual​ history, assessment, and examination must be​ documented, including symptoms like​ fever, chills, burning on​ urination, vaginal​ drainage, and their onset and duration. It is critical to document allergies for every​ client, especially because antibiotics may be ordered. An STI has not yet been​ confirmed, so a list of sexual contacts is not needed.

The nurse is preparing to administer an intramuscular injection of one antibiotic and an oral dose of another antibiotic for a client with gonorrhea. The client wants to know why both are needed. Which rationale for dual treatment should the nurse include in the​ explanation? A. Specific portal of entry B. Strength of the bacteria C. Antimicrobial resistance D. ​Client's immunity

Antimicrobial resistance ​Rationale: The goals of treatment for the client with gonorrhea include eradication of the organism and any coexisting​ disease, and prevention of reinfection or transmission. Due to concerns about antimicrobial resistance in N. gonorrhoeae​, the Centers for Disease Control and Prevention​ (CDC) recommends dual treatment that includes a single injection of an antibiotic and a single oral dose of another antibiotic. These medications should be administered at the same​ time, if possible.

An older adult client seeks medical attention for vaginal bacterial infections. Which change in the client should the nurse consider as an explanation for the​ infections? A. As vaginal pH​ rises, bacterial infections can become more common. B. Increased vaginal lubrication can result in more bacteria being harbored in the vagina. C. Night sweats can lead to more bacteria. D. Thickened vaginal tissues tear more easily.

As vaginal pH​ rises, bacterial infections can become more common. ​Rationale: Vaginal pH rises after​ menopause, predisposing women to bacterial infections. Night sweats do not increase vaginal infections. Vaginal tissue​ atrophies, not thickens. Vaginal lubrication decreases.

An​ 18-year-old man presents to the neighborhood clinic for an exam and requests a male nurse. Which aspect should the nurse keep in mind while taking the​ client's medical history and preparing to discuss contraceptive​ use? A. Remembering that teenagers will not be truthful about their sexual history B. Obtaining the​ client's height and weight when obtaining the health history C. Influencing the client so that he makes the choice recommended by the nurse D. Being aware of the​ client's cultural and religious beliefs

Being aware of the​ client's cultural and religious beliefs ​Rationale: The nurse needs to keep the​ client's cultural and religious beliefs in mind when discussing contraception. The nurse should provide useful information that allows the client to make an informed decision regarding contraception. Teenagers will be truthful about their sexual history when treated with respect. The​ client's height and weight are obtained during a physical examination.

A client diagnosed with osteoporosis indicates reluctance to taking medication on a daily basis. Which class of medication should the nurse anticipate will be​ prescribed? A. Tetracycline B. Bisphosphonate C. Oral calcium supplement D. Calcium channel blocker

Bisphosphonate ​Rationale: Recent studies suggest that​ once-weekly dosing with bisphosphonates may give the same bone density benefits as daily dosing because of the extended duration of drug action. Tetracyclines and calcium channel blockers are not used to treat osteoporosis. Oral calcium supplements are typically taken on a daily basis.

Which nursing diagnosis should the nurse consider when planning care for a client experiencing​ menopause? (Select all that​ apply.) A. Body​ Image, Disturbed B. Constipation C. ​Knowledge, Deficient D. ​Self-Esteem, Situational Low E. Sexuality​ Pattern, Ineffective

Body​ Image, Disturbed Knowledge, Deficient ​Self-Esteem, Situational Low Sexuality​ Pattern, Ineffective ​Rationale: A client with menopause may have diagnoses of ​Knowledge, Deficient about​ menopause; Body​ Image, Disturbed; ​Self-Esteem, Situational​ Low; and Sexuality​ Pattern, Ineffective. Constipation is not a diagnosis associated with menopause.​ (NANDA-I ©2014)

A client presents for evaluation of a possible sexually transmitted infection​ (STI). Which assessment finding should the nurse consider a potential indication of an​ STI? A. ​Thick, cottage​ cheese-like vaginal discharge B. Absence of expected menses C. Burning and frequency of urination D. Vaginal dryness

Burning and frequency of urination ​Rationale: Common symptoms of an STI include burning and increased frequency of urination. Vaginal dryness and absence of expected menses are not symptoms of STI.​ Thick, cottage​ cheese-like vaginal discharge is indicative of a yeast​ infection, not an STI.

The nurse is teaching a client who is trying to conceive about proper nutrition. Which essential nutrient should the client include in her daily​ diet? (Select all that​ apply.) A. Calcium B. Iron C. Vitamin E D. Protein E. Vitamin A

Calcium Iron Protein ​Rationale: A client who is trying to conceive should include ample quantities of essential​ nutrients, with particular emphasis on​ calcium, iron, and protein. Vitamins E and A are not essential for a client who is trying to conceive.

An 18 y.o. female is to have a pelvic exam. Which response by the nurse would be BEST when the client says that she is nervous about the upcoming pelvic exam? A. Can you tell me more about how you are feeling? B. You are not alone. Most women feel uncomfortable about this exam C. Do not worry about Dr. Smith. He is a specialist in female problems D. We will do everything we can to avoid embarrassing you

Can you tell me more about how you are feeling? Rationale: Asking the client to describe her nervousness gives her the opportunity to express her concerns. Responses that make assumptions about the source of the concern or offer reinforcement are not supportive and block successful communication.

Women who have HPV are at risk for development of: A. Sterility B. Cervical Cancer C. Uterine Fibroid tumors D. Irregular menses

Cervical Cancer Rationale: Women who have HPV are much more likely to contract cervical cancer than women who have never had the disease. Cervical cancer is now considered a sexually transmitted disease because of the high incidences in women with HPV.

The nurse is caring for a client who has been diagnosed with reactive arthritis. The nurse notes symptoms of a sexually transmitted infection​ (STI). Which STI should the nurse​ suspect? A. Chlamydia B. Herpes simplex virus C. Syphilis D. Gonorrhea

Chlamydia Rationale: Reactive arthritis​ (formally Reiter​ syndrome) is a complication of​ chlamydia, which is most likely to occur in men. It does not occur secondary to​ gonorrhea, herpes simplex​ virus, or syphilis.

The nurse is providing teaching to a community group. Which disorders should the nurse include that are considered multifactorial inheritance​ disorders? (Select all that​ apply.) A. Cleft lip B. Clubfoot C. Huntington disease D. Neural tube defect E. Cystic fibrosis

Cleft lip Clubfoot Neural tube defect ​Rationale: Multifactorial inheritance disorders are caused by a combination of environmental and genetic factors. Examples of multifactorial inheritance disorders include neural tube defects such as spina​ bifida, clubfoot, and cleft lip. Huntington disease is an autosomal dominant disorder. Cystic fibrosis is an autosomal recessive disorder.

The nurse is caring for a client who has been diagnosed with gonorrhea. Following the​ diagnosis, which intervention should the nurse perform​ next? A. Contact any potentially exposed sexual partners. B. Instruct the client to take antibiotics until symptoms resolve. C. Encourage the client to drink extra fluids to flush system. D. Perform a physical exam.

Contact any potentially exposed sexual partners. ​Rationale: Contacting sexual partners who may have been exposed to sexually transmitted infections​ (STIs) is a part of the care plan for a client who has been diagnosed with a sexually transmitted infection like gonorrhea. Drinking fluids is​ important, but would not be the next intervention. The antibiotics would need to be taken for the prescribed amount of​ time, not just until symptoms resolve. A physical examination is done initially as a part of diagnosis.

The nurse is obtaining a history on a​ middle-age female client. Which factor affecting sexual function should the nurse anticipate​ finding? (Select all that​ apply.) A. Decreased hormone production B. Climacteric C. Decreased sexual activity D. Sexual orientation experimentation E. Menopause

Decreased hormone production Climacteric Menopause ​Rationale: Based on the​ client's age, sexual functioning may be affected by the​ climacteric, menopause, and decreased hormone production. Decreased sexual activity may occur in the older​ adult, and experimentation with sexual orientation occurs more frequently during adolescence.

The nurse is addressing sexual functioning for a male client prescribed an​ anti-anxiety medication. Which information should the nurse include in the​ teaching? (Select all that​ apply.) A. Painful erection B. Decreased sexual desire C. Erectile dysfunction D. Delayed ejaculation E. Orgasmic dysfunction

Delayed ejaculation Decreased sexual desire ​Rationale: The effects of​ anti-anxiety medications on the sexual function of a male client include delayed ejaculation and decreased sexual desire. A painful erection and erectile dysfunction are adverse effects associated with antidepressants. Orgasmic dysfunction may occur in women.

The nurse is reviewing the chart of a pediatric client at risk for osteoporosis. Which factor in the​ client's history should the nurse identify as placing the client at risk for​ osteoporosis? A. Diabetes B. Cystic fibrosis C. Congenital cardiac disease D. Systemic lupus erythematosus

Diabetes ​Rationale: Diabetes is associated with a lower bone​ mass, placing the client at risk for osteoporosis. Cystic​ fibrosis, congenital cardiac​ disease, and systemic lupus erythematosus do not place the client at risk for osteoporosis. If the client has periods of​ immobility, the nurse can collaborate with physical therapy to provide the client with preventative exercises.

Which factor should the nurse identify as a health risk that may affect pregnancy​ outcomes? (Select all that​ apply.) A. Diabetes mellitus B. Alcohol use C. Migraines D. Caffeine intake E. Secondhand smoke

Diabetes mellitus Alcohol use Caffeine intake Secondhand smoke ​Rationale: Risk factors that may affect the​ client's pregnancy outcome include exposure to secondhand​ smoke, caffeine​ intake, alcohol​ use, and diabetes mellitus. Migraines are not commonly identified as a health risk that may adversely affect pregnancy outcomes.

The nurse suspects that a male client with a sexual disorder is experiencing a problem with elimination. Which assessment finding correlates with the​ nurse's concern? A. Difficulty voiding B. Inability to maintain an erection C. Clear discharge from the penis D. Arthritis in both hips and knees

Difficulty voiding Rationale: The proximity and interrelatedness of the sexual organs and organs of elimination may lead to difficulties such as urinary retention. The inability to maintain an erection is a problem related to perfusion. Clear discharge from the​ penis, arthritis in the hips and​ knees, and an inability to maintain an erection are not associated with difficulty voiding.

The nurse is caring for an older adult client experiencing discomfort during sexual activity as a result of osteoarthritis. Which nursing intervention is most appropriate for the​ client? A. Discussing the timing of sexual activity. B. Encouraging an increase in routine exercise. C. Incorporating the use of cold compresses on sore joints. D. Encouraging the client to have sex in a​ semi-reclined position.

Discussing the timing of sexual activity. ​Rationale: The nursing intervention that is most appropriate for the client is to discuss the timing of sexual activity. Sexual activity can take place at a time during the day in which the client is not experiencing much discomfort. An increase in routine exercise may exacerbate the joint pain. Warm compresses on painful joints can be utilized to provide comfort. A​ semi-reclined position is recommended for clients with heart failure that develop fatigue or shortness of breath.

A client asks about the symptoms of menopause during a wellness visit. Which vasomotor manifestation of menopause should the nurse​ describe? (Select all that​ apply.) A. Dizziness B. Palpitations C. Decreased body hair D. Night sweats E. Hot flashes

Dizziness Palpitations Night sweats Hot flashes ​Rationale: The manifestations of menopause affect many body​ systems, including the vasomotor system. Vasomotor manifestations include hot​ flashes, palpitations,​ dizziness, headaches,​ insomnia, and night sweats. Decreased body hair is an​ integumentary, not​ vasomotor, manifestation of menopause. Menopausal clients have integumentary manifestations that include decreased body​ hair, decreased skin​ elasticity, and decreased subcutaneous tissue.

A client experiencing perimenopausal symptoms asks what can be done to help control the symptoms. Which intervention should the nurse​ recommend? (Select all that​ apply.) A. Drinking cool liquids B. Increasing caffeine intake C. Engaging in regular exercise D. Dressing in layers E. Avoiding sexual intercourse

Drinking cool liquids Engaging in regular exercise Dressing in layers Rationale: Exercise can help manage the anxiety and mood swings associated with perimenopause. Dressing in loose layers of clothing that can be added or removed will increase comfort during hot flashes. Drinking cool liquids can help with hot flashes. Caffeine is not identified as having an impact on menopausal symptoms. Sexual intercourse does not have to be avoided during​ perimenopause, but lubricants may be used to decrease discomfort from vaginal dryness.

When planning care for a client with family planning​ needs, which intervention should the nurse​ include? (Select all that​ apply.) A. Encouraging the client to verbalize feelings about sexual health B. Teaching the client about fertility and contraception C. Consulting a social worker for genetic counseling D. Providing an environment that promotes discussion E. Emphasizing the importance of using condoms for disease prevention

Encouraging the client to verbalize feelings about sexual health Teaching the client about fertility and contraception Providing an environment that promotes discussion Emphasizing the importance of using condoms for disease prevention Rationale: When planning care for a client with family planning​ needs, the nurse needs to provide a​ nonjudgmental, accepting atmosphere to promote discussion. Other interventions should include encouraging the client to verbalize feelings of sexual​ health, teaching about fertility and​ contraception, and emphasizing the importance of condom use for disease prevention. The social worker is not the appropriate person to provide genetic counseling.

The nurse is obtaining a history on an adolescent client. Which reported behavior should be​ concerning? A. Verbalizing how to identify the warning signs of dating violence and date rape B. Engaging in sex with a diaphragm with a​ non-monogamous partner C. Asking a partner in a monogamous relationship to be tested for STDs D. Practicing abstinence for the first 6 months of a monogamous relationship

Engaging in sex with a diaphragm with a​ non-monogamous partner ​Rationale: While a diaphragm prevents​ pregnancy, it does not prevent transmission of infection. This method of birth control should not be used alone in​ non-monogamous relationships. This statement would be concerning. A person can be infected with HIV and able to infect others for 6 months before seroconversion. Practicing abstinence for the first 6 months of a monogamous​ relationship, then being retested would be ideal. Asking a partner in a monogamous relationship to be tested for STDs is not a concerning behavior. Verbalizing how to identify the warning signs of dating violence and date rape would demonstrate that the client is exhibiting responsible sexual behavior.

A client is experiencing the menopausal symptom of vaginal dryness. Which medication should the nurse anticipate being prescribed for this​ client? A. Vitamin D supplement B. Estrogen preparation C. Bisphosphonate D. Psychotropic

Estrogen preparation Rationale: Vaginal dryness can be treated with​ low-dose vaginal estrogen. Psychotropic medications are used to treat mental health disorders. Bisphosphonates are medications for osteoporosis. Vitamin D supplements are used to help increase calcium absorption.

When performing a preconception​ visit, which assessment finding by the nurse would necessitate a recommendation for genetic​ counseling? A. Exposure to secondhand smoke B. Client is 33 years old C. Family history of genetic disorders D. History of heavy alcohol use 2 years prior

Family history of genetic disorders ​Rationale: The nurse should recommend genetic counseling based on the​ couple's family history of genetic disorders. Genetic counseling should be suggested for a woman over 35 years. Genetic counseling is not recommended for a client exposed to secondhand smoke or with a history of alcohol use.

The nurse explains the importance of testing for sexually transmitted infections​ (STIs) to a newly pregnant client. During which time period should the nurse explain that this test will take​ place? A. Second prenatal visit B. First prenatal visit C. Only if the client has symptoms D. Immediately after finding out she is pregnant

First prenatal visit ​Rationale: Very few early manifestations of an infection are​ experienced, so clients may not know whether they are infected or not. All pregnant women should therefore be tested for​ STIs, including​ HIV, as part of routine medical care during their first prenatal visit.

A nurse is planning care for a 25 y.o. female client who has just been diagnosed with HIV. THe client asks the nurse, "How could this have happened?" The nurse responds to the question based on the most frequent mode of HIV transmission, which is: A. Hugging an HIV-positive sexual partner without using barrier protection B. Inhaling cocaine C. Sharing food utensils with an HIV-positive person without proper cleaning of the utensils D. Having sexual intercourse with an HIV-positive person without using a condom

Having sexual intercourse with an HIV-positive person without using a condom Rationale: HIV is transmitted through blood and body fluids, particularly vaginal and seminal fluids. A blood transfusion is one way the disease can be contracted. Other modes of transmission are sexual intercourse with an infected partner and sharing IV needles with an infected person. Women now have the highest rate of newly diagnosed HIV. Many of these women have contracted HIV from unprotected sex with male partners. HIV cannot be transmitted by hugging, inhaling cocaine, or sharing utensils.

A client has been prescribed an​ estrogen-progestin combination contraceptive. The nurse should monitor the client for which​ risk? (Select all that​ apply.) A. Acne B. Over age 35 C. Menstrual pain D. Smoking E. Increased menstrual bleeding

Over age 35 Smoking Rationale: A client who smokes or is over 35 years old is at an increased risk of thromboembolic disorders when using an​ estrogen-progestin combination contraceptive.​ Estrogen-progestin combination contraceptives often decrease​ acne, menstrual​ bleeding, and menstrual pain.

A sexually active male client has burning urination and milky discharge from the urethral meatus. What documentation should be included on the client's medical record? (Select all that apply) A. History of unprotected sex (sex without a condom) B. Length of time since symptoms presented C. History of fever or chills D. Presence of any enlarged lymph nodes upon examination E. Names and phone numbers of all sexual partners F. Allergies to any medications

History of unprotected sex (sex without a condom) Length of time since symptoms presented History of fever or chills Presence of any enlarged lymph nodes upon examination Allergies to any medications Rationale: The client is suspected of having an STI. Therefore, the client's sexual history, assessment, and examination must be documented including: symptoms (such as fever, chills, and enlarged glands) and their onset and duration. Allergies are critical to document for every client but are especially noteworthy in this case because antibiotics will be prescribed. To protect privacy, the names and phone numbers of partners should NEVER be placed in the medical record.

A client is experiencing signs of menopause. Which change in hormone level should the nurse use to confirm the​ client's health​ status? A. Increased androstenedione B. Increased estradiol ​(E2​) C. Increased luteinizing hormone​ (LH) D. Increased progesterone

Increased luteinizing hormone​ (LH) ​Rationale: During the menopausal​ period, ovarian production of estradiol ​(E2​) decreases. With decreased ovarian​ function, progesterone production is also markedly reduced. Levels of the hormone androstenedione also decrease during menopause. Luteinizing hormone and​ follicle-stimulating hormone​ (FSH) levels increase during menopause. Estradiol controls the amount of FSH and LH released by the pituitary gland via a negative feedback​ system; when estradiol production​ decreases, this feedback system ceases to function.

Which intervention by the nurse can help decrease the burning upon urination for a female client with​ gonorrhea? A. Running ice water over the perineal area B. Providing a Sitz bath C. Increasing fluids D. Taking diuretics

Increasing fluids ​Rationale: Drinking additional fluids helps dilute the urine and reduce the burning sensation. For dysuria and urinary​ retention, pouring water over the genitals to start urination and dilute the urine may be suggested. Sitz baths​ (with tepid​ water) for​ 15-30 minutes, several times a​ day, is soothing and decreases pain from ulcers and an irritated urethral meatus. Taking diuretics would not be an appropriate treatment for gonorrhea.

The nurse receives notification from the lab that a client tests positive for syphilis. Which nursing action should the nurse​ implement? (Select all that​ apply.) A. Initiate client teaching regarding sexually transmitted infections and their consequences. B. Inform the client that syphilis is not contagious if there are no symptoms of infection. C. Verify the​ client's drug allergies. D. Ensure that this case is reported to the public health system. E. Recommend that a pregnancy test be obtained.

Initiate client teaching regarding sexually transmitted infections and their consequences. Verify the​ client's drug allergies. Ensure that this case is reported to the public health system. Recommend that a pregnancy test be obtained. ​Rationale: In the event of a positive syphilis​ test, the nurse would report the case to the public health​ system, initiate client teaching regarding​ STIs, verify the​ client's drug allergies in preparation for the prescribed treatment​ regime, and, if the client is female, arrange for a pregnancy test. Syphilis is​ contagious, and it is critical to treat the infection to avoid​ complications, even when there are no symptoms present.

A client calls the nurse into the room and the nurse finds the client naked in bed. Based on the​ client's behavior, which nursing action is​ appropriate? (Select all that​ apply.) A. Ask if the client is ready for morning care. B. Instruct the client that you will come back when the client is dressed. C. Cover the client with a bed sheet. D. Remind the client that clothing is required to be worn during hospitalization. E. Inform the charge nurse of the​ client's behavior.

Instruct the client that you will come back when the client is dressed. Remind the client that clothing is required to be worn during hospitalization. Inform the charge nurse of the​ client's behavior. Rationale: The most appropriate actions would be informing the charge nurse of the​ client's behavior, instructing the client you will return when the client is​ dressed, and reminding the client that clothing is required to be worn during hospitalization. Covering the client with a bedsheet and asking if the client is ready for morning care are not appropriate nursing actions for a client exhibiting inappropriate sexual​ behavior, because they do not directly and assertively address the issue.

The nurse is teaching at a community health clinic about the risk factors for syphilis. Which statement should the nurse​ include? (Select all that​ apply.) A. It is contracted by unprotected sex. B. Only women are at risk for syphilis. C. It is only contracted through anal sex. D. It has an incubation period of 10 to 90 days. E. It spreads through the body by way of blood and lymph nodes.

It is contracted by unprotected sex. It has an incubation period of 10 to 90 days. It spreads through the body by way of blood and lymph nodes. Rationale: Syphilis is a sexually transmitted​ infection, wherein the microorganisms invade the body and spread through blood and lymph nodes. The incubation period is 10 to 90 days. Both men and women can be infected with​ syphilis; however, it is not only anal sex through which this infection can be contracted.

A client has just been fitted for a diaphragm. Which information about the diaphragm should the nurse include in the client​ teaching? A. It must be left in place for 12 hours after intercourse. B. It can be used during a menstrual period. C. It should be replaced every 3 years. D. It must be refitted after childbirth.

It must be refitted after childbirth. ​Rationale: The nurse needs to teach the client being fitted for a diaphragm that it must be refitted after childbirth. The diaphragm must be left in place for 6 hours after intercourse. Diaphragms should not be used during a menstrual period. The diaphragm should be replaced every 2 years.

The nurse interviews a​ middle-aged client experiencing menopause. Which option should the nurse discuss to help with the​ symptoms? (Select all that​ apply.) A. Lifestyle changes B. Hormone replacement therapy C. Nonpharmacologic methods of relief D. Calcium intake of 500 mg a day E. Sexual abstinence

Lifestyle changes Hormone replacement therapy Nonpharmacologic methods of relief ​Rationale: Many physiologic effects of menopause are amenable to either hormone replacement therapy​ (HRT) or nonpharmacologic methods of​ relief, such as lifestyle​ changes, so these options should be discussed. The recommended daily calcium intake for women over age 50 is 1200 mg to help prevent osteoporosis. Menopause does not require abstaining from sexual contact.

The nurse is teaching health promotion behaviors to a client diagnosed with osteoporosis. Which behavior should the nurse​ include? A. Decreasing smoking B. Exercising four times a week C. Limiting alcohol intake D. Avoiding foods high in purine

Limiting alcohol intake Rationale: The client should be instructed to limit alcohol intake. Alcohol has a direct toxic effect on osteoblast​ activity, suppressing bone formation during periods of alcohol intoxication. The client should be instructed to stop smoking​ altogether, not just decrease smoking. Smoking decreases the blood supply to​ bones, and nicotine slows the production of osteoblasts and impairs the absorption of​ calcium, contributing to decreased bone density. The instruction on exercising needs to be specified. Foods high in purine are associated with gout.​ Weight-bearing exercises are recommended for approximately 30 minutes four times a week.

A client presents with a sore tip of the penis. The client reveals having sex with two partners. Upon examination the nurse notices swelling in the​ client's groin, along with chancre. How should the nurse interpret this swelling in the​ groin? A. Allergic reaction B. Lymphadenopathy C. Necrosis D. Retention

Lymphadenopathy ​Rationale: Lymphadenopathy is a swelling or abnormal number of lymph nodes in a specific area of the body. Lymphadenopathy is inflammatory and usually caused by an infection. Necrosis is death of tissue. Retention is holding pockets of fluid. An allergic reaction produces​ hives, rash,​ fever, difficulty​ breathing, and itching.

The nurse is preparing teaching for home care to a client with family planning needs. Which topic should the nurse​ address? (Select all that​ apply.) A. Making a dental appointment B. Avoiding all vaccines C. Maintaining a​ balanced, nutritional diet D. Participating in a weekly exercise class E. Smoking cessation

Making a dental appointment Maintaining a​ balanced, nutritional diet Smoking cessation ​Rationale: When teaching on home care to a client with family planning​ needs, the nurse should include the importance of maintaining a​ balanced, nutritional diet and making a dental appointment. The nurse should also include smoking cessation or the importance of reducing the number of​ cigarettes, if possible. The client should maintain a regular exercise routine and not just participate in a weekly exercise class. The client should also receive the flu vaccine.

Which finding should the nurse identify as inappropriate sexual​ behavior? (Select all that​ apply.) A. Making sexual statements B. Whistling at the nurse C. Pulling at the condom catheter D. Touching the nurse improperly E. Exposing genitalia

Making sexual statements Whistling at the nurse Touching the nurse improperly Exposing genitalia Rationale: Clients who experience alterations in sexuality may act out and demonstrate inappropriate behavior. Findings the nurse can anticipate in a client exhibiting inappropriate sexual behavior include​ whistling, exposing​ genitalia, making sexual​ statements, and touching the nurse improperly. Pulling at a condom catheter may be a result of discomfort.

When educating a female client with gonorrhea, the nurse should emphasize that for women, gonorrhea: A. Is often marked by symptoms of dysuria or vaginal bleeding B. Does not lead to serious complications C. Can be treated, but not cured D. May not cause symptoms until serious complications occur

May not cause symptoms until serious complications occur Rationale: Many women do not seek treatment because they are unaware that they have gonorrhea. They may be symptom-free or have only mild symptoms until the disease progresses to PID.

Which procedure of clinical interruption of a pregnancy is most likely to be performed for a woman in the first 7 to 9 weeks of a​ pregnancy? A. Medical abortion by administration of mifepristone and misoprostol B. Medical abortion by dilation and curettage​ (D&C) and minisuction C. Surgical abortion by dilation and curettage​ (D&C) and minisuction D. Surgical abortion by dilation and extraction​ (D&E) and hypertonic saline

Medical abortion by administration of mifepristone and misoprostol ​Rationale: Clinical interruption of a pregnancy is performed in the early weeks by medical​ abortion, meaning that there is no surgical procedure involved. Medical abortion does not involve dilation and curettage. Mifepristone is administered to alter the uterine​ lining, followed 1 to 3 days later by administration of misoprostol to induce contractions to expel the embryo. Surgical abortions have higher risk than medical​ abortions, and are not as likely to be performed for an elective clinical interruption. The​ D&C can be performed during the first​ trimester, and a​ D&E can be done in the second trimester.

The nurse is performing a health history on a client with family planning needs. Which data should the nurse​ collect? (Select all that​ apply.) A. Vital signs B. Medication history C. Genital exam D. Number of sexual partners E. Family history of breast cancer

Medication history Number of sexual partners Family history of breast cancer ​Rationale: When performing a health history on a client with family planning​ needs, the nurse needs to obtain information on the​ client's medication​ history, family history of breast​ cancer, and number of sexual partners. Vital signs and genital exam are part of the physical examination of a client with family planning needs.

The nurse is planning a presentation on osteoporosis to clients in an​ assisted-living center. Which group would be appropriate for the nurse to exclude from the presentation as being at risk of developing this disease​ process? A. Asian American women B. Smokers C. Postmenopausal women D. Men with high testosterone levels

Men with high testosterone levels ​Rationale: Men with high testosterone levels are not at risk of developing​ osteoporosis; therefore, this SHOULD NOT be included in the presentation.​ Women, especially those who are postmenopausal and of Asian​ descent, are much more likely to develop osteoporosis. Smoking increases the​ client's risk of osteoporosis.

A client experiencing menopause is concerned about a loss in height. Which change should the nurse explain as being responsible for this​ finding? A. Menopause leads to hormone changes that affect muscle strength in the body. B. Menopause leads to bone changes that can cause scoliosis. C. Menopause can lead to​ osteoporosis, which in turn can lead to fractures and kyphosis. D. Menopause can lead to poor nutrition and decreased bone density.

Menopause can lead to​ osteoporosis, which in turn can lead to fractures and kyphosis. Rationale: Long-term estrogen deprivation results in an imbalance in bone remodeling and​ osteoporosis, leading to fractures and kyphosis. Scoliosis is curvature of the spine. Poor nutrition can affect how a woman responds to​ menopause, but menopause does not cause poor nutrition. Muscle weakness is not associated with menopause.

The nurse is preparing to examine a client who is experiencing menopause. Which information should the nurse obtain when performing a health​ history? (Select all that​ apply.) A. Menstrual history B. Sleep pattern C. Posture D. Vital signs E. Medications

Menstrual history Sleep pattern Medications ​Rationale: When performing a health history on a client experiencing​ menopause, the nurse should obtain information about the​ client's menstrual​ history, medications, and sleep pattern. Posture and vital signs are assessments that the nurse will include when completing the physical examination.

A couple who is going through fertility treatment is reviewing the process of in vitro fertilization​ (IVF) with the nurse. Which statement by the couple indicates that the teaching has been​ effective? (Select all that​ apply.) A. ​"The embryos will be placed in my uterus​ 7-10 days after​ retrieval." B. ​"The sperm will be deposited into my​ uterus." C. ​"My wife will have to have injections prior to the​ procedure." D. ​"An ultrasound will be used during the procedure to remove my​ eggs." E. ​"We can freeze embryos if we have​ extras."

My wife will have to have injections prior to the​ procedure." ​"An ultrasound will be used during the procedure to remove my​ eggs." "We can freeze embryos if we have​ extras." ​Rationale: For​ IVF, the woman will have to have injections to help the ova develop and to help prepare them for retrieval. Any extra embryos remaining after the IVF procedure can be frozen for use at a later date. With​ IVF, the ova and sperm will be manipulated in the lab for fertilization. The embryos will be placed in the uterus 2-3 days after retrieval. With​ IVF, ultrasound is used during the procedure to remove the​ woman's eggs.

Which intervention should the nurse discuss with a client newly diagnosed with herpes regarding viral​ shedding? A. Not sharing bath towels B. Abstaining from sex C. Following a​ low-protein diet D. Taking antivirals

Not sharing bath towels ​Rationale: Health teaching for clients with genital herpes involves helping them manage their condition with the least possible disruption in lifestyle and relationships. The use of hygiene​ practices, including not sharing towels or other personal​ items, and the use of latex​ condoms, will protect others from viral shedding. Abstaining from sex will help keep the virus from​ spreading, but there is still risk involved with viral shedding. A​ low-protein diet is not related to viral shedding. Taking antivirals helps decrease the length of the outbreak but is not related to viral shedding.

The nurse is interviewing a client with newly diagnosed syphilis. In order to prevent the spread of the disease, the nurse should focus the interview by: A. Motivating the client to undergo treatment B. Obtaining a list of the client's sexual contacts C. Increasing the client's knowledge of the disease D. Reassuring the client that medical records are confidential

Obtaining a list of the client's sexual contacts Rationale: An important aspect of controlling the spread of STDs is obtaining a list of sexual contacts who may have been exposed to the infected client. Many people with STDs are reluctant to reveal their sexual contacts which makes controlling STDs difficult.

When teaching a client about HIV, the nurse should take into account the fact that the MOST effective method know to control the spread of the infection is: A. Premarital serologic screening B. Prophylactic treatment of exposed people C. Lab screening of pregnant women D. Ongoing sex education about preventative behaviors

Ongoing sex education about preventative behaviors Rationale: Education to prevent behaviors that cause HIV transmission is the primary method for controlling the spread of HIV. Educating clients about using condoms during sex is a priority in controlling HIV transmission.

The nurse assesses the mouth and oral cavity of a client with HIV because the MOST common opportunistic infection initially presents as: A. Herpes simplex virus lesions on the lips B. Oral candidiasis C. Cytomegalovirus (CMV) infection D. Aphthae on the gingiva

Oral candidiasis Rationale: The most common opportunistic infection in HIV initially presents as oral candidiasis or THRUSH. Apthous stomatitis (recurrent canker sores) is not an opportunistic infection. HSV and CMV are opportunistic infections that present later in AIDS.

The nurse recognizes that family planning care involves more than preventing pregnancy. Which goal should the nurse consider to be a part of family planning​ care? (Select all that​ apply.) A. Encouraging acceptance of all available forms of contraception methods B. Promoting a healthy body image C. Providing knowledge about sexual and reproductive health D. Promoting healthy sexual function E. Encouraging the use of preferred contraceptive methods

Promoting a healthy body image Providing knowledge about sexual and reproductive health Promoting healthy sexual function ​Rationale: The role of the nurse is to help the client by promoting a healthy body​ image, promoting healthy sexual​ function, and providing knowledge of sexual and reproductive health. The nurse does not encourage one contraceptive practice over another or try to influence a client to accept all available forms of fertility treatment or contraception. Nurses should present all the options available to the client.

A​ middle-aged female client experiencing symptoms of menopause has increased​ follicle-stimulating hormone and luteinizing hormone levels. Which intervention should the nurse​ initiate? (Select all that​ apply.) A. Providing information about medications that might be prescribed to help with menopausal symptoms B. Asking​ open-ended questions about the​ client's body image C. Explaining physiologic manifestations of menopause D. Instructing the client to avoid​ over-the-counter vaginal lubricants E. Encouraging discussion of how menopausal symptoms are affecting sexual functioning

Providing information about medications that might be prescribed to help with menopausal symptoms Asking​ open-ended questions about the​ client's body image Explaining physiologic manifestations of menopause Encouraging discussion of how menopausal symptoms are affecting sexual functioning Rationale: The client is experiencing menopause and may have problems understanding the natural female aging​ process, sexual​ dysfunction, low​ self-esteem, or disturbed body image. Interventions to help the client with these problems include explaining the physiologic manifestations of​ menopause, providing information about medications that might be prescribed to help with menopausal​ symptoms, encouraging discussion of how menopausal symptoms are affecting sexual​ functioning, and instructing the client to use vaginal lubricants if experiencing decreased lubrication. Asking​ open-ended questions will further explore the​ client's thoughts and feelings about body image in a therapeutic manner.

The nurse is caring for a client with osteoporosis with a primary focus on preventing injury at night. Which is the best nursing intervention for the nurse to implement to maintain the safety of the​ client? A. Keeping the side rails up on the bed at all times B. Restricting fluids at night to decrease nocturia C. Increasing the​ client's use of assistive devices D. Providing lighting in toilet facilities

Providing lighting in toilet facilities ​Rationale: The nursing intervention that will maintain the safety of the client with osteoporosis is to provide lighting in the toilet facilities. Increasing the use of assistive devices would be dependent on the​ client's overall health. The client should only use the assistive devices that are necessary on which she has been properly fitted and trained. Restricting fluids to decrease nocturia is inappropriate and places the client at risk for dehydration and hypovolemia. It is not necessary to keep the side rails up on the bed at all times. The side rails should be kept up if indicated to prevent the client from getting out of bed alone.

The nurse is preparing to obtain a history on a new client. Which information should the nurse include that is specific to the sexual​ history? (Select all that​ apply.) A. Psychosocial history B. Activity level C. Relationship status D. Past medical history E. Nutritional status

Psychosocial history Relationship status Past medical history ​Rationale: Information collected during the sexual history includes the​ client's medical​ history, psychosocial​ history, and relationship status. The activity level and nutritional status are not specifically included in the sexual history.

The nurse is caring for a client who was diagnosed with chlamydia. Which action by the nurse is appropriate for this​ client? A. Visiting the home to follow up B. Reporting the sexually transmitted infection C. Tracking that the client filled a prescription D. Contacting sexual partners

Reporting the sexually transmitted infection Rationale: Sexually transmitted infections like​ chlamydia, gonorrhea, and syphilis are all reportable​ STIs, so the nurse may be involved with the reporting process. The nurse would not visit the​ client's home to follow up. Contacting sexual partners and filling prescriptions are the responsibility of the client.

The nurse is caring for a woman who is taking the infertility medication clomiphene. Which assessment finding would indicate to the nurse that the client is potentially experiencing adverse effects from the​ medication? (Select all that​ apply.) A. Reduction in urine output B. Reports of mood swings C. Weight gain of 10 pounds in 1 month D. Hot flashes E. Changes in the​ client's vision

Reports of mood swings Hot flashes Changes in the​ client's vision ​Rationale: For the female infertility medication​ clomiphene, visual​ changes, mood​ swings, and hot flashes are some of the adverse effects. Reduction in urine output and weight gain are not adverse effects of this medication.

The nurse is caring for a client experiencing sexual difficulty. The client was sexually assaulted in the past. Which intervention is most appropriate for this​ client? A. Recommending hormonal replacement therapy B. Requesting a referral for a therapist C. Encouraging the client to increase foreplay D. Obtaining a prescription for an LS and FSH level

Requesting a referral for a therapist Rationale: The intervention by the nurse that is most appropriate for the client who has a history of sexual assault and is experiencing sexual difficulty is referring the client to a therapist. Based on the​ client's concern and​ history, encouraging the client to increase​ foreplay, obtaining a prescription for LS and FSH​ levels, and hormonal replacement therapies are not appropriate.

The nurse is providing information to a client deciding on a form of contraception. Which aspect should be considered when determining the best contraceptive​ method? (Select all that​ apply.) A. Safety B. Affordability C. Ease of use D. Effectiveness E. Accountability

Safety Affordability Ease of use Effectiveness ​Rationale: Nurses should provide contraceptive information to the client to assist in making a decision. For determining the best​ method, the client will need to consider​ safety, effectiveness, ease of​ use, side​ effects, whether it is easily​ available, and whether it is affordable. The nurse will not make judgments about the​ client's accountability.

The nurse is caring for a client diagnosed with syphilis. The client has a rash covering both palms of the hands. The nurse explains that the client is in which stage of​ syphilis? A. Secondary stage B. Primary stage C. Tertiary stage D. Latent stage

Secondary stage ​Rationale: Manifestations of secondary syphilis after the initial chancre include a​ rash, especially on the palms of the hands or soles of the​ feet; mucous patches in the oral​ cavity; sore​ throat; generalized​ lymphadenopathy; condyloma lata​ (flat, broad-based​ papules) on the​ labia, anus, or corner of the​ mouth; flulike​ symptoms; and alopecia. The primary stage of syphilis is characterized by the appearance of a chancre and by regional enlargement of lymph​ nodes; little or no pain accompanies these warning signs. During the latent period a client has no​ symptoms, however, during the early part of this​ stage, sexual transmission is possible. Roughly​ 15% of untreated individuals progress to​ late-stage or tertiary syphilis.

The nurse is providing teaching on the prevention of osteoporosis. Which modifiable risk factor can increase a​ client's risk of developing​ osteoporosis? (Select all that​ apply.) A. Consumption of milk products B. Sedentary lifestyle C. Excessive alcohol consumption D. Moderate exercise E. Smoking

Sedentary Lifestyle Excessive alcohol consumption Smoking ​Rationale: Individuals who spend a lot of time sitting have a higher risk of osteoporosis than do their more active counterparts. Excessive alcohol consumption can interfere with the​ body's ability to absorb calcium. Tobacco use contributes to weak bones. The consumption of milk products and moderate exercise are both lifestyle choices that decrease the risk of​ osteoporosis, not contribute to the development of osteoporosis.

A client with a history of bone fractures is experiencing severe hot flashes from menopause. Which medication should the nurse anticipate being prescribed for this​ client? A. Selective serotonin reuptake inhibitor​ (SSRI) B. ​Serotonin-norepinephrine reuptake inhibitor​ (SNRI) C. Monoamine oxidase inhibitor​ (MAOI) D. Selective estrogen receptor modulator​ (SERM)

Selective estrogen receptor modulator​ (SERM) ​Rationale: A SERM combined with conjugated estrogen is used to treat hot flashes and reduce risk of bone fractures. Recent research also suggests that SSRIs and SNRIs are effective in relieving hot flashes and night​ sweats, but they do not reduce the risk of bone fracture. MAOIs are a class of antidepressants.

The nurse is reviewing the orders for a client with osteoporosis who has been prescribed a bisphosphonate. Which test should the nurse anticipate will be ordered while the client is on the​ medication? A. Alkaline phosphatase B. Ultrasound C. Serum bone Gla protein​ (osteocalcin) D. ​Dual-energy x-ray absorptiometry​ (DEXA)

Serum bone Gla protein​ (osteocalcin) Rationale: Serum bone Gla protein​ (osteocalcin) is most useful for evaluating the effects of treatment rather than to indicate the severity of the disease.​ Dual-energy x-ray absorptiometry​ (DEXA) and ultrasound both measure bone​ density, not efficacy of treatment. Alkaline phosphatase also does not indicate efficacy of treatment.

The nurse is discussing the need for therapeutic donor insemination​ (TDI) with a client. Which finding should the nurse identify as an indication for​ TDI? (Select all that​ apply.) A. Erectile dysfunction B. Epispadias C. Severe oligospermia D. Azoospermia E. Genetic male​ sex-linked disorder

Severe oligospermia Azoospermia Genetic male​ sex-linked disorder ​Rationale: TDI is used in cases of severe oligospermia​ (low sperm​ count), in cases of azoospermia​ (absence of​ sperm), or in those with a history of genetic male​ sex-linked disorders. Epispadias is a penile anatomic abnormality. The​ male's sperm can be used for​ insemination; donor sperm is not needed. Sperm from men with erectile dysfunction can still be used for​ insemination; donor sperm is not needed.

The nurse is caring for an older adult who is visually impaired and at risk for osteoporosis. Which activity is most appropriate to implement for the prevention of​ osteoporosis? A. Strength and balance training B. Aerobics C. Swimming D. Walking on a treadmill

Strength and balance training ​Rationale: Strength and balance training is the​ safest, most appropriate plan for exercise for the visually impaired client at risk for osteoporosis. Aerobics and walking on a treadmill are not the safest choices for a visually impaired client. The client may lose balance as well as not be able to adjust or stop a treadmill if needed. Swimming is not a​ weight-bearing exercise.​ Weight-bearing exercises influence the bone metabolism necessary to prevent osteoporosis.

The nurse is teaching a client with osteoporosis who has been prescribed calcium citrate supplements. Which information should the nurse include in the​ teaching? A. Take the calcium on an empty stomach. B. Take the calcium with meals. C. Take the calcium within 2 hours after meals. D. Take the calcium in the morning.

Take the calcium with meals. ​Rationale: The client prescribed calcium citrate supplementation should be instructed to take the calcium with meals. It does not matter what time of day the client takes the calcium.

Which group has experienced the GREATEST rise in the incidence of STDs over the past two decades? A. Teenagers B. Divorced people C. Young married couples D. Older adults

Teenagers Rationale: Statistics show that incidence of STDs are rising rapidly among teenagers, more-so than any other age group.

The nurse has completed the history of a client who reports erectile dysfunction. Which action should the nurse take next​? A. Teach the client about surgical procedures. B. Refer the client to a psychotherapist. C. Provide information on adaptions to the physical impairment. D. Tell the client that a physical assessment will be performed.

Tell the client that a physical assessment will be performed. Rationale: After obtaining the​ history, the nurse will tell the client that a physical assessment will be performed. An assessment and diagnosis should be formulated prior to referring the client to a psychotherapist or scheduling a surgery. There is no indication the client has any physical impairment.

The nurse is preparing information about sexual development for a group of parents with​ school-age children. Which factor does the nurse attribute to​ puberty? (Select all that​ apply.) A. The appearance of female breast buds B. The beginning of purposeful masturbation C. Growth of pubic hair D. Menstruation beginning about 2 years after breast buds develops in girls E. Nocturnal emissions signaling the beginning of puberty in boys

The appearance of female breast buds Growth of pubic hair Menstruation beginning about 2 years after breast buds develops in girls ​Rationale: Between the ages of 9 and​ 10, evidence of puberty begins. The production of​ testosterone, a hormone from the adrenal​ glands, contributes to the growth of pubic hair in both sexes. Girls develop breast​ buds, or​ thelarche, and menstruation begins about 2 years after the appearance of breast buds. Nocturnal emissions typically begin around age 13 to 15. Puberty typically begins with the development of pubic hair around age 10 in boys.

The nurse is reviewing the chart of an older adult client with a BMI of 19 ​kg/m2. Which implication does this clinical finding have on the risk for​ osteoporosis? A. The​ client's gender needs to be taken into consideration. B. The​ client's age in relation to the BMI should be factored in. C. The client is at risk for osteoporosis. D. The client is not at risk for osteoporosis.

The client is at risk for osteoporosis. ​Rationale: Any individual with a BMI less than 20 ​kg/m2​, regardless of​ age, sex, or weight​ loss, is at a greater risk for both bone loss and subsequent risk for fracture.

The nurse is screening clients in the clinic for osteoporosis. Which client has the greatest risk factor for​ osteoporosis? A. The client who walks at the park for 30 minutes each day B. The client who occasionally drinks a diet soda C. The client with a BMI greater than 25 ​kg/m2 D. The client taking selective serotonin reuptake inhibitors​ (SSRIs)

The client taking selective serotonin reuptake inhibitors​ (SSRIs) ​Rationale: Prolonged use of certain medications such as SSRIs increases the risk of developing osteoporosis. UNDERWEIGHT individuals have a​ two-fold increased risk for fracture when compared to people with a BMI greater than 25 ​kg/m2. A high intake of diet​ soda, not occasional​ consumption, can contribute to the development of osteoporosis. An individual who walks for 30 minutes in the park every day most likely gets sufficient vitamin​ D, which also helps prevent osteoporosis.

The nurse is caring for several clients on the unit. Which client is at the greatest risk for​ osteoporosis? A. The client treated for an eating disorder B. The client with early onset Alzheimer disease C. The client treated for withdrawal delirium tremens D. The client with impaired vision

The client treated for withdrawal delirium tremens ​Rationale: The client being treated for withdrawal delirium tremens is at the greatest risk for osteoporosis. Delirium tremens occurs as a result of alcohol withdrawal. The client who is an alcoholic is at risk for osteoporosis. Impaired vision does not place the client at risk for osteoporosis. The client with an eating disorder will require counseling and a nutritional consultation. The client with early onset Alzheimer disease is mobile and can walk.

The nurse is caring for a pregnant client who has syphilis. Which is a priority ​intervention? A. Treating the client with an antifungal B. Screening and treating the​ client's partner C. Treating the client with an antibiotic D. Scheduling treatment after birth of the baby

Treating the client with an antibiotic ​Rationale: Syphilis is a bacterial infection and can be safely treated and cured during pregnancy with an antibiotic. An antifungal does not treat bacterial infections. The​ client's partner should be screened and​ treated, but treating the client is a priority. There is no need to wait until the baby is born to treat the​ client; the client can safely take antibiotics during pregnancy.

The nurse is teaching a client diagnosed with genital herpes simplex virus​ (HSV). How should the nurse describe the signs of an​ outbreak? (Select all that​ apply.) A. Bleeding B. Ulcerations C. ​Small, flat,​ flesh-colored warts D. Burning E. Itching

Ulcerations Burning Itching ​Rationale: Itching and burning in the affected area are common manifestations of an HSV outbreak. The lesions are small ulcerations.​ Small, flat,​ flesh-colored warts are a symptom of HPV.

Benzathine penicillin G, 2.4 million units IM, is prescribed as treatment for an adult client with primary syphilis. The nurse should administer the injection in the: A. Deltoid B. Upper, outer quadrant of the buttock C. Quadriceps lateralis of the thigh D. Midlateral aspect of the thigh

Upper, outer quadrant of the buttock Rationale: Because of the large dose, the upper, outer quadrant of the buttock provides the best and largest area for this IM injection.

The nurse is reviewing the prescription for laboratory tests on a male client experiencing a sexual disorder. Which laboratory test is​ appropriate? (Select all that​ apply.) A. Urinalysis B. Serum hormone levels C. Papanicolaou test D. Hysteroscopic examination E. Complete blood count

Urinalysis Serum hormone levels Complete blood count ​Rationale: The prescribed laboratory tests that are most appropriate for the male client experiencing a sexual disorder include a​ urinalysis, complete blood​ count, and serum hormone levels. A Papanicolaou test and hysteroscopy examination are tests for a female client.

The nurse prepares teaching material for a client experiencing menopause. Which health promotion intervention should the nurse discuss with the​ client? (Select all that​ apply.) A. Wearing fitted clothing B. Using​ water-soluble gels to increase vaginal lubrication C. Undergoing hormone replacement therapy​ (HRT) as soon as possible D. Avoiding alcohol and cigarette use E. Eating more estrogenic​ food, such as brown​ rice, sweet​ potatoes, carrots,​ apples, corn, green​ beans, and tofu

Using​ water-soluble gels to increase vaginal lubrication Avoiding alcohol and cigarette use Eating more estrogenic​ food, such as brown​ rice, sweet​ potatoes, carrots,​ apples, corn, green​ beans, and tofu ​Rationale: Health promotion interventions for menopause include teaching the client about the use of​ water-soluble gels that increase vaginal lubrication and other ways to help her continue or resume a mutually satisfying sexual relationship with her partner. Eating foods that are mildly​ estrogenic, such as brown​ rice, sweet​ potatoes, carrots,​ apples, corn, green​ beans, and​ tofu, may also improve vaginal dryness. Avoiding alcohol and tobacco use is beneficial as well. The nurse should teach the client about dressing in loose​ layers, not in fitted clothing. The nurse should teach the client about the risks and the benefits of HRT but emphasize that not every woman needs or wants it.

The nurse is speaking to a group of young women about methods of contraception. The nurse asks the group to name a barrier method of contraception. Which response from a participant indicates the need for further​ teaching? A. Contraceptive sponge B. Vaginal contraceptive ring C. Spermicide D. Diaphragm

Vaginal contraceptive ring ​Rationale: The vaginal contraceptive ring is a​ sustained-release hormonal method and is not considered a barrier method of contraception.​ Spermicide, the​ diaphragm, and the contraceptive sponge are barrier methods. Either they prevent the transportation of sperm to the​ ovum, immobilize the​ sperm, or kill the sperm.

The nurse is assessing a client experiencing menopause. Which findings should the nurse expect in this​ client? (Select all that​ apply.) A. Vaginal dryness B. Cold intolerance C. Thinning hair D. Hot flashes E. Headaches

Vaginal dryness Thinning hair Hot flashes Headaches ​Rationale: The physical manifestations of menopause are thought to be related to diminishing estrogen. This accounts for the hot​ flashes, vaginal​ dryness, thinning​ hair, and headaches. Women experiencing menopause do not typically experience cold intolerance.

The nurse is caring for an older adult couple who express concern about the lack of intimacy in their relationship. Which initial strategy should the nurse use to address the​ couple's concern? A. Offer specific suggestions regarding sexual positioning. B. Refer the couple to the healthcare provider for further assessment. C. Validate desire for sexual activity in older adult couples. D. Determine the history of sexually transmitted diseases.

Validate desire for sexual activity in older adult couples. ​Rationale: The initial strategy that the nurse will use to address the​ couple's concern about the lack of intimacy in their relationship is to ask permission to validate their desire for sexual activity. Older adults often benefit from teaching related to​ sexuality; however, they may be hesitant to bring up sexual topics with the nurse. To help facilitate such​ discussion, the nurse can first validate the older​ adults' desire for sexual activity. Determining a history of sexually transmitted diseases does not address the concern. Offering specific suggestions regarding sexual positioning is an assumption that positioning is the problem. Referral of the couple to their healthcare provider may be appropriate after a thorough history has been obtained.

The nurse is preparing medication teaching on a bisphosphonate for a client newly diagnosed with osteoporosis. The nurse should teach the client to monitor for which adverse​ effect? A. Anorexia B. Tinnitus C. Vomiting D. Headaches

Vomiting ​Rationale: Adverse effects that may occur in a client taking a bisphosphonate include gastrointestinal problems such as​ nausea, vomiting, abdominal​ pain, and esophageal irritation.​ Tinnitus, anorexia, and headaches are not adverse effects of taking bisphosphonates.

A client experiencing menopause is being counseled about bone health and exercise. Which exercise should be recommended for bone​ health? A. Walking B. Swimming C. Cycling D. Stretching

Walking Rationale: Walking is the best method of maintaining bone health for a client in menopause.​ Weight-bearing exercise reduces the rate of bone​ loss, helps maintain optimum​ weight, and reduces cardiovascular risk.​ Swimming, cycling, and stretching are not​ weight-bearing exercises.

A client experiencing menopause does not want to take any prescribed medications for the symptoms. Which alternative or complementary therapy should the nurse review with the​ client? (Select all that​ apply.) A. Yoga B. Soy and ginseng C. Bioidentical hormones D. Massage E. Hormone replacement therapy

Yoga Soy and ginseng Bioidentical hormones Massage Rationale: Soy,​ ginseng, yoga, bioidentical​ hormones, and massage are all considered alternative or complementary therapies to manage menopausal symptoms. Hormone replacement therapy is not considered an alternative or complementary therapy.

The nurse is caring for a couple experiencing infertility who will have follicular stimulation and retrieval of​ ovum, followed by mixing with washed donor sperm. One day​ later, the fertilized ovum will be placed in the fallopian tube. Which procedure should the nurse identify the couple is scheduled to​ have? A. Tubal embryo transfer​ (TET) B. In vitro fertilization​ (IVF) C. Zygote intrafallopian transfer​ (ZIFT) D. Gamete intrafallopian transfer​ (GIFT)

Zygote intrafallopian transfer​ (ZIFT) ​Rationale: ZIFT is the return of fertilized​ ovum, at the zygote​ stage, into the fallopian tube 18-24 hours after retrieval. GIFT is placing retrieved ovum and washed sperm into the fimbriated end of the fallopian tube. TET is placing embryos into the fallopian tube 42-72 hours after retrieval. IVF is the placement of embryos into the uterus​ 2-3 days after the ova are retrieved.

A client with HIV is taking zidovudine (AZT). the expected outcome of AZT is to: A. destroy the virus B. enhance the body's antibody production C. slow replication of the virus D. Neutralize toxins produced by the virus

slow replication of the virus Rationale: AZT interferes with replication of HIV and thereby slows the progression of HIV to AIDS. There is no known cure to HIV. AZT does not destroy the virus, enhance the body's antibody production, or neutralize toxins produced by the virus.

Which statement should the nurse include in preconception counseling for the individual or couple of childbearing​ age? (Select all that​ apply.) A. ​"Preconception counseling must be started at least 6 months before attempting to​ conceive." B. ​"Once you become​ pregnant, it will be helpful to start working on good exercise​ habits." C. ​"Even if you do not want to have children​ now, it is helpful to discuss future goals with your​ partner." D. ​"There are many different methods of birth​ control; you can choose which fits your lifestyle and​ plan." E. ​"Maintaining a healthy weight for your height is important for both​ partners."

​"Even if you do not want to have children​ now, it is helpful to discuss future goals with your​ partner." ​"There are many different methods of birth​ control; you can choose which fits your lifestyle and​ plan." ​"Maintaining a healthy weight for your height is important for both​ partners." ​Rationale: Each partner benefits from understanding how each will be affected by a​ family-planning decision, whether it is to have a pregnancy or to prevent one. Future and present goals are both important to discuss. There are a variety of types of birth​ control, and one may be better suited for a client than the others. Healthy lifestyle choices are important for both partners. Preconception counseling​ doesn't have to start 6 months before conceiving. The mother does not need to wait until she is pregnant to start​ exercising; it is more beneficial to establish exercise routines before becoming pregnant.

The nurse is teaching a client about caring for herpes lesions. Which statement made by the client expresses​ understanding? A. ​"I should wash the lesions with antibacterial​ soap." B. ​"I should dry the lesions with a hair dryer on a cool​ setting." C. ​"I should wear​ jeans, not​ shorts, to keep the lesions​ covered." D. ​"I should wear nylon​ underwear."

​"I should dry the lesions with a hair dryer on a cool​ setting." ​Rationale: Teach the client how to keep herpes blisters clean and dry. The area should be washed daily with mild soap and water. Lesions should be dried using a hair dryer turned to a cool setting. The client should wear loose cotton clothing that will not trap moisture and avoid wearing panty hose and tight jeans. Keeping the lesions clean and dry reduces the possibility of secondary infection and speeds the healing process.

The nurse has completed discharge teaching for a client treated for genital herpes. Which statement by the client indicates teaching was effective​? ​(Select all that​ apply.) A. ​"I'm glad the medication prescribed will cure this​ infection." B. ​"I understand this antiviral medication will help shorten and prevent​ outbreaks." C. ​"I don't need to use a​ condom." D. ​"I'll try to keep my stress level​ down." E. ​"I will notify my sex partners so they can get​ treatment."

​"I understand this antiviral medication will help shorten and prevent​ outbreaks." "I'll try to keep my stress level​ down." "I will notify my sex partners so they can get​ treatment." ​Rationale: The client acknowledging the need to keep stress levels​ down, planning to notify sexual​ partners, and understanding about the antiviral​ medication, which will help shorten and prevent​ outbreaks, indicates correct understanding. The​ client's ability to describe preventive​ behaviors, health​ practices, and treatment modalities indicates goal achievement. The conceptions that unprotected sex is safe and that the medication will cure herpes are​ incorrect; herpes is a virus and cannot be cured.

The nurse is teaching the​ middle-age female client ways to promote healthy sexual functioning. Which client statement indicates an understanding of sexual health​ promotion? A. ​"I will cut back on smoking​ marijuana." B. ​"I will cut down on the amount of fat in my​ diet." C. ​"I will try and get some exercise twice a​ week." D. ​"I will drink only two alcoholic beverages in the​ evening."

​"I will cut down on the amount of fat in my​ diet." ​Rationale: Healthy sexuality depends upon the implementation of lifestyle choices that support heart​ health, including good nutrition. Lowering the amount of fat in the diet indicates the client understands sexual health promotion. Avoiding tobacco or​ marijuana, exercising​ daily, and avoiding alcohol promote healthy sexual functioning.

The nurse is teaching a client about oral contraceptives. Which client statement indicates a need for additional ​teaching? ​ (Select all that​ apply.) A. ​"Oral contraceptives are not very effective at preventing​ pregnancy." B. ​"Oral contraceptives require a medical​ prescription." C. ​"Oral contraceptives require daily use of​ medication." D. ​"Oral contraceptives often increase menstrual​ cramping." E. ​"Oral contraceptives carry an increased risk of blood​ clots."

​"Oral contraceptives are not very effective at preventing​ pregnancy." ​"Oral contraceptives often increase menstrual​ cramping." ​Rationale: Reduction of menstrual cramping and the effectiveness of oral contraceptives are advantages of oral contraceptives so further education would be needed if clients state otherwise. Disadvantages include the need for medical​ care, the need for a​ prescription, the use of a daily​ medication, and the potential risks and side​ effects, such as developing blood clots with use of oral contraception.

The nurse is discussing contraceptive options with a woman who is interested in information about intrauterine contraception​ (IUC). Which statement should the nurse include when discussing the disadvantages of these​ devices? A. ​"You will need to insert the device​ daily." B. ​"These require the use of daily​ medication." C. ​"The device may cause cramping and heavier​ bleeding." D. ​"This type of contraceptive causes loss of bone​ density."

​"The device may cause cramping and heavier​ bleeding." ​Rationale: An IUC requires the client to check the string after each menstrual cycle. Disadvantages of these devices include increased cramping and heavier bleeding. Oral contraception requires the use of daily medication. An IUC remains in place for years and is not inserted daily. An IUC does not lead to a reduction in bone density.

The nurse is caring for a client with erectile dysfunction​ (ED) resulting from vascular and nerve damage. The client relays concern of the inability to express sexual intimacy. Which statement by the nurse will provide support for the​ client? A. ​"I am going to obtain a prescription for an erectile dysfunction​ medication." B. ​"We can contact your healthcare provider to see what alternatives you​ have." C. ​"We can discuss other ways you can express your​ sexuality." D. ​"I encourage you to consider treatment with an​ androgen."

​"We can discuss other ways you can express your​ sexuality." ​Rationale: The statement that will provide the most support to the client that has experienced vascular and nerve damage​ is, "We can discuss other ways you can express your​ sexuality." Androgens are not used for the treatment of ED. A referral does not immediately address the​ client's concern about the inability to express sexual intimacy. An ED medication will not work after nerve damage has occurred.

A client in menopause is experiencing sexual issues. Which information should the nurse provide to the​ client? A. ​Water-based gels are helpful for vaginal lubrication. B. Dietary changes are not needed during menopause due to hormone changes. C. ​Oil-based lubricants can make sexual activity more enjoyable. D. Foreplay is not needed after menopause.

​Water-based gels are helpful for vaginal lubrication. ​Rationale: Water-soluble gels are helpful for vaginal lubrication in the client experiencing symptoms of menopause. Increased foreplay might be needed in menopause to allow more time for vaginal lubrication.​ Oil-based lubricants are not recommended. Dietary changes can be used to help with vaginal dryness and weight gain associated with menopause.

A client is trying to prevent complications of menopause such as osteoporosis and cardiovascular problems. Which intervention should the nurse suggest as most​ beneficial? A. Take 900 mg of calcium daily to prevent osteoporosis. B. ​Weight-bearing exercise reduces the rate of bone loss and reduces cardiovascular risk. C. Black cohosh can reduce cardiovascular risk during menopause. D. Hormone replacement therapy is essential for avoiding the complications of menopause.

​Weight-bearing exercise reduces the rate of bone loss and reduces cardiovascular risk. ​Rationale: The nurse should emphasize the importance of​ weight-bearing exercise, which reduces the rate of bone​ loss, helps maintain optimum​ weight, and reduces cardiovascular risk. The recommended daily calcium intake for women over age 50 is 1200 mg to help prevent osteoporosis. While there are benefits to undergoing​ HRT, osteoporosis and cardiovascular problems are still possible. Researchers studying black​ cohosh, which is often used to treat hot flashes and other symptoms​ (not cardiovascular​ problems), have concluded that evidence for its effectiveness is lacking and further research is needed.