Sexuality and reproduction

When assessing the uterus of a 2-day postpartum client, which finding would the nurse evaluate as normal?

a moderate amount of lochia rubra

A couple has chosen fertility awareness as their method of contraception. The nurse explains that the unsafe period for them during the menstrual cycle would be at which time?

3 days before ovulation and 3 days after

uterine atony

serious condition that can occur after childbirth. It occurs when the uterus fails to contract after the delivery of the baby, and it can lead to a potentially life-threatening condition known as postpartum hemorrhage

While working with a client with a fairly recent spinal cord injury, the partner asks about the couple's ability to maintain a sexual relationship. Which response by the nurse is most accurate?

"If the parasympathetic impulses can pass from the sacral segments of spinal cord through pelvic nerves, an erection should be possible."

Parents of a 7-year-old girl are concerned about their daughter because she has begun to develop secondary sexual characteristics. What etiologic factor is most likely to underlie the child's condition?

Early activation of the hypothalamic-pituitary-gonadal axis

PID is a major risk factor for

Ectopic pregnancy

Patients who have had pelvic inflammatory disease (PID) are prone to which of the following complications?

Ectopic pregnancy

A couple who are pregnant with their first child have made an appointment with a clinical geneticist to discuss prenatal screening. The man states that they, "just want to make sure that there is nothing wrong with our baby." How could the clinician best respond to this statement?

"Testing the umbilical blood and performing amniocentesis can give us some information, but not a guarantee."

The nurse is caring for a client who has been in labor for the past 8 hours. The nurse determines that the client has transitioned into the second stage of labor based on which sign?

the urge to push occurs

After teaching a client with prostatitis about care measures, which statement indicates successful teaching?

"I might need to take the antibiotic for up to a month."

The nurse is admitting a primigravida client who has just presented to the unit in early labor. Which response should the nurse prioritize to assist the client in remaining calm and cooperative during birth?

"The baby is coming. I'll explain what's happening and guide you."

The nurse determines that a female client understands how to perform breast self-examination when the client states:

"The best time to perform the exam is 1 week after my period."

The nurse is caring for a client who is at her due date. The client asks. "How long is the health care provider going to let me go?" The nurse is correct to state that typical a mother should not pass how many weeks' gestation?

42 weeks The nurse is most correct to state that mothers do not progress longer than 42 weeks gestation. At that point, either a cesarean section or an induction would be completed. Actual dates do vary depending on the status of the fetus.

adolescence sexual development Characteristics common to the phase of pubescence include which of the following?

Increase in the amount, pigmentation, and curling of pubic hair, and growth spurt in height and weight

Fertility studies for men include a semen analysis to determine sperm count, sperm motility, and abnormal sperm. Which test can also be performed to determine infertility?

Blood test for luteinizing hormone (LH)

The nurse is documenting the length of time in the second stage of labor. Which data will the nurse use to complete the documentation?

Complete cervical dilation (dilatation) and time of fetal birth

The nurse is conducting a postpartum home visit. Which action would not necessarily be a responsibility of a visit?

Conducting a well-baby visit to start the child's immunizations

procedure in which cervical tissue is removed because abnormal cells are detected

Cone biopsy (conization)

When is syphilis highly contagious?

During its primary stage

How often do most women in the middle reproductive years menstruate?

Every 28 to 30 days

endometriosis

Growth of endometrial tissue outside of uterus

Which cells in the testes produce testosterone?

Leydig cells

The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client?

Monitor the client's vital signs and bleeding.

etonogestrel/ethinyl estradiol vaginal ring

Nuvaring Contraceptive Vaginal Ring

gestational diabetes onset occurs

Onset usually occurs in the second or third trimester

HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category?

Pregnancy Category X

A client has just given birth to a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent?

Third

alpha-fetoprotein analysis

This type of prenatal screening is a great predictor of neural tube defects

During an internal vaginal examination, the nurse practitioner notes a frothy and malodorous discharge. What bacteria does the practitioner suspect is causing this disorder?

Trichomonas

The nurse is examining a pregnant female in her third trimester and measuring to determine if fetal growth has increased. Where would the nurse place the measuring tape?

at the top of the fundus

fourth degree laceration

continues through anterior rectal wall

hydramnios

excessive amniotic fluid

The beginning of the third stage of labor

documented at time of birth

While in its dormant state, what structure provides residence for herpes simplex virus to allow for replication?

dorsal root ganglia

With increasing age comes a greater chance of a woman having been exposed to damaging environmental agents such as drugs, chemicals, and radiation. These factors may act on the aging oocyte to cause which abnormality in a fetus?

down syndrome

The nurse is reviewing findings from the maturation index with an understanding that the test indicates:

estrogen levels

dysmenorrhea

painful menstruation

dysmenorrhea

painful menustration

Following morning hygiene of an elderly client, the nurse is unable to replace the retracted foreskin of the penis. Which is the most likely outcome?

painful swelling

A 31-year-old pregnant woman has been prescribed administration of a tocolytic drug. During which period is a tocolytic drug usually administered?

pre-term labor

A patient comes to the clinic with complaints of a painless sore on her lip 2 weeks after she had oral sex with her boyfriend. The nurse observes a chancre on the lips and the physician orders testing for syphilis. If results are positive, what is the likely stage the patient is in?

primary

During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn?

respiratory function

prolactin

stimulates milk production

A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth?

the viral load

Cryotherapy

therapeutic use of cold

mucus in which form as indicating ovulation has occurred?

thin and copious

The cervix is 9 cm dilated. The nurse knows that the client is in which phase of labor?

transition phase

The nurse limits the amount of oral fluids given to a client receiving oxytocin for induction of labor. This is done to prevent what serious complication?

water intoxication

transvaginal ultrasound

would be used to identify endometrial thickness to determine the need for an endometrial biopsy for endometrial cancer

The client in active labor overhears the nurse state the fetus is ROA. The nurse should explain this refers to which component when the client becomes concerned?

Fetal position

A pregnant client is admitted to a maternity clinic for birth. Which assessment finding indicates that the client's fetus is in the transverse lie position?

Long axis of fetus is perpendicular to that of client.

Which nursing action prevents a complication associated with the lithotomy position for the birth of the fetus?

Placing a wedge under the hips

The nurse is leading a discussion with a group of pregnant women who have diabetes. The nurse should point out which situation can potentially occur during their pregnancy?

Polyhydramnios

A pregnant client reports an increase in a thick, whitish vaginal discharge. Which response by the nurse would be most appropriate?

This discharge is normal during pregnancy

During fetal development, the descent of the testes into what structure helps prevent injury to the sperm-producing cells?

Scrotum

A patient has had a pessary inserted for long-term treatment of a prolapsed uterus. As part of the teaching plan, what should the nurse advise the patient to do?

See her gynecologist to remove and clean the pessary at regular intervals.

eclampsia

Seizures that occur during a woman's pregnancy or shortly after giving birth.

A newly married female is talking to the nurse about her desire to get pregnant soon. Which suggestion would the nurse make to assist this client?

Sexual intercourse should occur between Day 13 and 15 of her menstrual cycle.

A client makes an appointment with an obstetrician and assessment reveals positive Hegar and Chadwick signs. What should the nurse teach the client about these results?

She is probably pregnant, but this must be confirmed by other means

A client is at the clinic for her yearly physical and is found to be anemic. What information from her history would most likely be a contributory factor to this finding?

She reports that her menstrual cycle is irregular and often lasts 7 to 10 days.

While providing care to a postpartum client on her first day at home, the nurse observes which behavior that would indicate the new mother is in the taking-hold phase?

Showing increased confidence when caring for the newborn

A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?

Significant genital enlargement

Which physical characteristic of the neonate is typically present in the neonate of a primigravid mother?

Significant head molding

Which diagnostic measure is most accurate in detecting neural tube defects?

Significant level of alpha-fetoprotein present in amniotic fluid

A female client who is a carrier of a genetic illness asks the nurse if she should have her partner tested for the condition prior to starting a family. What is the nurse's best response?

Since this is a condition that is linked to a recessive gene, testing may be advised.

jA female client who is a carrier of a genetic illness asks the nurse if she should have her partner tested for the condition prior to starting a family. What is the nurse's best response?

Since this is a condition that is linked to a recessive gene, testing may be advised.

A woman has heard that hypotension can be a problem during pregnancy, but she is not sure what it is or what causes it. The nurse explains that it is simply a temporary bout of low blood pressure due to impaired blood return to the heart. It is commonly caused by sleeping in a position that causes compression of the vena cava blood vessel. To avoid this condition, which suggestion should the nurse make?

Sleep on your side.

The nurse working at a family planning clinic evaluates a client's risk for complications from oral contraceptives. Which factor places the client at highest risk?

Smokes one pack of cigarettes per week

A woman is concerned that orgasm will be harmful during pregnancy. Which statement is factual?

Some women experience orgasm intensely during pregnancy.

The nurse conducting a health promotion class for teenage boys on human reproduction determines that the participants are understanding the information when they state:

Spermatogenesis continues throughout a man's reproductive years.

Which conditions are examples of neural tube defects? Select all that apply.

Spina bifida Anencephaly Encephalocele

When developing a teaching plan for a client who is 8 weeks pregnant, the nurse would suggest what foods to meet the client's need for increased folic acid? Select all that apply.

Spinach beans

To confirm a diagnosis of syphilis, the nurse would identify the gram-negative bacteria, Treponema palladium, on the laboratory report. The nurse knows that this bacteria is classified among:

Spirochetes

A female client with blocked fallopian tubes seeks assistance at a fertility clinic. Which assisted reproductive technology will bring the greatest chance for conception?

In vitro fertilization (IVF)

The nurse is caring for a 15-year-old adolescent mother after birth. The adolescent lives at home with her parents and has a boyfriend who is also 15 years old. Neither is currently working, and they both have plans for higher education. When addressing the psychosocial issues that may occur after the birth of the child, which of the following would be the most important for the nurse to include in client teaching?

Increased stress for new mothers Explanation: The increased psychological stress experienced by new mothers is the priority. A young adolescent mother is faced with the overwhelming situation of caring for a newborn.

taking-hold phase

Independence with self-care is an important aspect of the taking-hold phase. During the letting-go phase, the woman assumes responsibility and care for the newborn with increased confidence.

The nurse is assessing a 3-week-old infant who has not gained weight since birth. The infant's bowel sounds are present in all quadrants and breath sounds are clear to auscultation. The infant's mother reports that the child cries much of the night but sleeps better in the daytime. The mother reports that the child only breastfeeds about four times in a 24-hour period and that the mother doesn't seem to have much milk. Which nursing diagnosis would be of highest priority for this client?

Ineffective Breastfeeding The frequency of breastfeeding is the likely cause of the infant's inability to gain weight. Feeding should be priority for a newborn. Although the infant does demonstrate an impaired sleep pattern and impaired comfort, these are not as important as the infant's inability to gain weight. There is no evidence that the mother is at risk for impaired parenting.

A client tells a nurse that her menstrual cycle has become irregular. Which does the nurse consider as a cause of the irregularity? Select all that apply.

Infection of the reproductive organs Anorexia nervosa Primary ovarian insufficiency Oral contraception taken every day year round

A young client presenting at the health clinic with fever and mucopurulent vaginal drainage is diagnosed with acute pelvic inflammatory disease (PID). Which long-term affect is of greatest concern in the care of this client?

Infertility

The forensic nurse is caring for a client who was raped four days ago. Which of the following could the nurse teach the client is an effective contraceptive?

Insertion of a copper intrauterine device (IUD) Emergency contraception is provided in two ways: increased doses of oral contraceptive pills (usually within 72 hours) or insertion of a copper IUD within 5-7 days after unprotected intercourse. The other options are used for routine contraception.

A 28-year-old client who has just conceived arrives at a health care facility for her first prenatal visit to undergo a physical examination. Which intervention should the nurse perform to prepare the client for the physical examination?

Instruct the client to empty her bladder.

The nursing instructor is leading a discussion on the physical changes to a woman's body after the birth of the baby. The instructor determines the session is successful after the students correctly point out which process results in the return of nonpregnant size and function of the female organs

Involution

When the nurse is interviewing an adolescent, the patient states that she experienced her first menstrual cycle at age 11. The nurse documents this as:

menarche

A female client is preparing to begin treatment for infertility. What hormone would the nurse expect to be included in treatment?

menotropins

A nurse is caring for a 17-year-old female client with bulimia. Which complication of this disease may the nurse see in this child?

menstrual problems

Braxton Hicks contractions

sporadic contractions that occur in pregnancy before the onset of true labor

longitudinal fetal lie

straight up and down lie

The estrogen content in the contraceptive pill performs which action?

suppresses follicle-stimulating hormone (FSH)

cone biopsy

surgical removal of a cone-shaped section of the cervix

colporrhaphy

surgical suturing of a tear in the vagina

perineorrhaphy

suture of the perineum

a fundus of 12 weeks is palpated at

symphysis pubis

The nurse is educating the client at 12 weeks' gestation regarding the best types of exercise throughout pregnancy. Which activities should the nurse encourage?

Stretching and breathing exercises such as yoga

The nurse has just completed the admission assessment of a client diagnosed with invasive penile cancer. The most likely plan of treatment will be:

Surgical removal of the affected area

A 24-year-old female client is diagnosed with otosclerosis. Which teaching is most accurate?

Symptoms may be accelerated by pregnancy.

A urologist suspects that a client might have prostate cancer. Which test would be used to make a diagnosis of cancer?

tissue biopsy

A male athlete admitted to the emergency room is suspected of abusing androgens. Which physical characteristic would the nurse expect to see if the testosterone has been aromatized to estradiol?

enlarged breast

When fluoxymesterone is administered to a prepubescent adolescent for hypogonadism, what is the expected result?

enlarged sex organs

latent phase of labor

1st part of the 1st stage of labor, lasts 4-6h, cervix 0-3cm, contractions irregular, mild to mod frequency 5-30m and duration of 30-45s, some dilation and effacement, pt talkative and eager Use slow/ deep breathing

A nurse practitioner is teaching the student about sexual health and is evaluating the student's knowledge of sexual identity. The practitioner knows that the student understands when the student says which of the following?

"Gender role behavior is the behavior a person conveys about being male or female."

Which nursing action has a negative effect on fetal descent?

Administering narcotic pain medication

A 16-year-old girl tells the nurse that her friend has genital warts and asks the nurse how to make sure that she does not get them. Which of the following should the nurse recommend?

"Get the human papillomavirus vaccine."

The nurse is caring for a client who is considered low-risk and in active labor. During the second stage, the nurse would evaluate the client's FHR by Doppler at which frequency?

every 15 minutes

A postmenopausal female client diagnosed with osteoporosis asks the nurse how a decrease in estrogen can cause problems with bone density. Which statement is the best response from the nurse?

"A decrease in estrogen levels, which occurs at menopause, results in increased resorption of bone."

Which question would be most important for a nurse to ask when taking a history from a client who is suspected of having amenorrhea?

"Are you sexually active?" Explanation: Amenorrhea strongly suggests pregnancy in an adolescent and is the priority in a client with this diagnosis. Strenuous exercise can be a causative factor, but it is not the priority. Diet and medical visit history do not affect this current diagnosis.

The pregnant young adult asks the nurse when she will be able to hear the fetal heart beat. Which is the nurse's best response?

"At your 12-week appointment, you will be able to hear the heart beat by Doppler."

A nurse is educating a prenatal client at her second visit. The client is worried about "blotchy brown spots" on her forehead. The nurse reassures the client about this change by giving which appropriate response?

"Avoid sun because it will make the discoloring darker." Increased estrogen levels during pregnancy can cause pigmentation to increase. This discoloration is not harmful and will eventually fade; however, sunlight can make it darker

A 27-year-old client is in the first trimester of an unplanned pregnancy. She acknowledges that it would be best if she were to quit smoking now that she is pregnant, but states that it would be too difficult given her 13 pack-year history and circle of friends who also smoke. She asks the nurse, "Why exactly is it so important for me to quit? I know lots of smokers who have happy, healthy babies." What can the nurse tell the client about the potential effects of smoking in pregnancy?

"Babies of women who smoke tend to weigh significantly less than other infants

A client with premenstrual syndrome reports using ibuprofen to relieve pain. Which instruction by the nurse would be most appropriate?

"Be sure to take this drug with food or meals."

A pregnant client who is HIV positive asks the nurse if she will be able to breastfeed the newborn. Which response by the nurse is most appropriate?

"Breastfeeding will increase your newborn's risk of contracting HIV."

Two nursing students are debating the merits and demerits of infant circumcision. Which statement is most accurate?

"Circumcised men tend to have a lower incidence of penile cancer."

A woman of 16 weeks' gestation telephones the nurse because she has passed some "berry-like" blood clots and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to do?

"Come to the health facility with any vaginal material passed." This is a typical time in pregnancy for gestational trophoblastic disease to present. Asking the woman to bring any material passed vaginally would be important so the material can be assessed for this.

The nurse is obtaining a history from a client who states recurrent breast tenderness. The client inquires if there is something wrong with her breasts. Which question by the nurse is a priority?

"Does the tenderness occur around the same time each month?"

A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which statement by the client demonstrates the best understanding of his health problem?

"Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

A 3 1/2 year-old child is found masturbating in the family living room. Which response by the parent would best address this behavior?

"We do not touch ourselves in public. Please go to your room if you want to continue this behavior."

Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20 year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis?

"How many sexual partners have you had?" Explanation: Having multiple sex partners is a factor that has been identified in the development of PID.

A nurse is conducting a class on various issues that might develop after going home with a new infant. After discussing how to care for hemorrhoids, the nurse understands that which statement by the class would indicate the need for more information?

"I only eat a low-fiber diet." Eating a high-fiber diet helps to eliminate constipation and encourages good bowel function.

A nurse is teaching a client who is 30 weeks' pregnant about ways to deal with heartburn. The nurse determines a need for additional teaching based on which client statement?

"I should lie down for 1/2 hour after eating."

A 32-year-old woman with epilepsy mentions to the nurse during a routine well-visit that she would like to have children and asks the nurse for advice. Which response is most appropriate from the nurse?

"I'll let the doctor know so you can discuss your medications. In the meantime, I'll give you a list of folate-rich foods you can add to your diet."

After teaching the pregnant woman about ways to minimize flatulence and bloating during pregnancy, the nurse understands that which client statement indicates the need for additional teaching?

"I'll switch to chewing gum instead of using mints."

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions?

"I've been having bleeding off and on that's irregular and sometimes heavy."

A client that is 90 days postpartum states to the nurse, "I have not had a period since I had the baby. Do you think something may be wrong?" What is the best response by the nurse?

"If you are breastfeeding, it is common for there to be a delay before resuming menstruation."

A client with a history of HSV-2 infection asks the nurse about future sexual activity. Which of the following responses would be most appropriate?

"Inform all potential sexual partners about the infection, even if it is inactive."

A victim of rape is prescribed emergency contraception. After teaching the client about this therapy, the nurse determines that the teaching was effective based on which client statement?

"It contains high doses of a typical birth control pill"

A pregnant patient asks the nurse if it is all right for her take the varicella immunization for entrance into nursing school. What is the best response by the nurse?

"It is not recommended that pregnant women take the live virus. You should wait until after your child is born."

A new mother is concerned because it is 24 hours after birth and her breasts have still not become engorged with breast milk. How should the nurse respond to this concern?

"It takes about 3 days after birth for milk to begin forming." The formation of breast milk (lactation) begins in a postpartal woman regardless of her plans for feeding. For the first 2 days after birth, an average woman notices little change in her breasts from the way they were during pregnancy as, since midway through pregnancy, she has been secreting colostrum, a thin, watery, prelactation secretion. On the third day post birth, her breasts become full and feel tense or tender as milk forms within breast ducts and replaces colostrum. There is no need to recommend formula feeding to the mother. Mastitis is inflammation of the lactiferous (milk-producing) glands of the breast; there is no indication that the client has this condition. Lactational amenorrhea is the absence of menstrual flow that occurs in many women during the lactation period.

A nurse is teaching a client how to use a diaphragm. Which statement about using a diaphragm is appropriate?

"Leave the diaphragm in place for at least 6 hours after intercourse."

The nurse is providing client education to a 45-year-old female who asks how she can be certain that she has reached menopause. How should the nurse respond?

"Menopause is likely if you have not menstruated for 12 months."

A client who is planning a pregnancy asks the nurse about ways to promote a healthy pregnancy. What is the nurse's best response?

"Start taking folic acid, 400 mcg daily until you conceive." Explanation: When counseling a client who is planning to become pregnant, the nurse should discuss the role of folic acid in preventing neural tube defects.

A postpartum client decides to bottle-feed her neonate. Which client statement indicates the need for further teaching about preventing engorgement?

"Taking hot showers can help reduce engorgement."

During a group prenatal class, the nurse teaching the course is explaining the thinning of the cervix that accompanies the stages of labor leading up to delivery. A participant admits that she is not familiar with either the location or normal role of the cervix. Which response by the nurse would be most appropriate?

"The cervix is the opening between the uterus and the vagina and so it opens wide during the lead-up to birth."

The nurse is discharging a client at 35 weeks' gestation after a reactive nonstress test. The client asks the nurse how the fetus is doing. What is the nurse's best response?

"The fetal heart rate went up twice during the test, so your fetus is doing well."

A pregnant client and her partner come to preregister at the hospital and take a tour of the labor and delivery suite. The mother has a detailed birth plan she wants honored while in labor. How should the nurse best respond to this information?

"The nurses taking care of you will do their best to respect your wishes."

A pregnant client reports occasional headaches. She wants to know what she can take to alleviate the discomfort. What would be the best response by the nurse?

"The safest medication to take for your headaches during your pregnancy would be acetaminophen."

A client at 32 weeks' gestation has recently been diagnosed with acute herpes type 2. The client asks what can happen to the baby as a result of this infection. How should the nurse best respond?

"There is a chance your baby may have a form of intellectual disability." Explanation: Herpes type 2 (genital herpes) contamination can occur during birth. The infant is susceptible to intellectual disability, premature birth, low birth weight, blindness, death as a result of this infection. The infant is not protected from the infection as it is contaminated during vaginal birth. Premature birth is a risk, not postdate birth.

The mother of a child with Turner syndrome asks the nurse what the physician meant when the disease was explained as monosomy of the X chromosome. The nurse explains the syndrome as having which of the following characteristics?

"There is one X chromosome."

A client reports loss of interest in sexual relations and discomfort during intercourse. Which is the best response by the nurse?

"These are normal, manageable symptoms of menopause."

Parent's of a 5-year-old child inform the nurse that they are concerned about finding their child masturbating in the bathroom. What is the best response to the parents by the nurse?

"This is a normal behavior for this age group, because 5-year-olds are increasingly aware of self."

A 41-year-old male has presented to his family physician stating that for the last 2 years his erection "is as crooked as a dog's hind leg, and hurts too." He has subsequently been diagnosed with Peyronie disease. Which statement by his physician is most appropriate?

"This might need surgery but it could possibly disappear over time without needing treatment."

A client suffering a miscarriage at 12 weeks' gestations is very upset that the health care provider has ordered a D&C. How should the nurse respond after the client states she didn't have a D&C the time she lost a previous baby at 5 weeks' gestation?

"This procedure is needed to adequately remove all the fetal tissue." By this stage of pregnancy, the placenta has adhered to the uterine wall. This was not the case when the client was only 5 weeks pregnant. The total removal of the products of conception will be needed to ensure healing and prevent excessive bleeding and infection.

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education

"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)."

As part of an education program for pregnant women and their partners, the nurse illustrates the various settings available for birth. The nurse determines that the program was successful when the group correctly chooses which statement about home births?

"Women giving birth at home have control over every part of labor."

A male client is diagnosed with gonococcal urethritis. He tells the nurse he had recent sexual contact with a woman but states she did not appear to have any disease. What is the nurse's best response to the client?

"Women may not know they have gonorrhea because they may not have symptoms."

A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer?

"You will experience quickening, and you will actually feel the baby."

A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is

"You will need to practice birth control measures."

The nurse performs a routine prenatal assessment on a client at 35 weeks' gestation and finds vital signs: blood pressure 138/88 mm Hg, pulse 82/min, respirations 18/min, temperature 99.1° F (37.3° C). Which statement is most appropriate for the nurse to make at this time?

"Your blood pressure is slightly high. I will check it again before you leave."

When performing a vaginal examination on a pregnant client, the nurse determines the fetal head has reached the ischial spines. How would the nurse describe the station of the fetus at this time?

0 station

After attending a preconception workshop, a young woman asks the educator to explain neural tube defects (NTD). Which conditions are examples of neural tube defects? Select all that apply.

Encephalocele Spina bifida

The nurse is providing care to a client in labor. On examination, the nurse determines the fetus is at -1 station. The nurse interprets this as indicating that the fetus is:

1 cm above the ischial spines. Explanation: Station refers to the relationship of the presenting part to the level of the maternal pelvic ischial spines. Fetal station is measured in centimeters and referred to as a minus or plus, depending on its location above or below the ischial spines. When the presenting part is above the ischial spines, the distance is recorded as minus stations. When the presenting part is below the ischial spine, it is recorded as plus stations. Therefore this fetus is 1 cm above the ischial spines.

When caring for a client who is a primigravida, how long should the nurse expect the second stage of labor to last?

1 hour

A nurse in a prenatal clinic is assessing a client who is 28 weeks' pregnant. Which findings lead the nurse to suspect that the client has mild preeclampsia?

1+ protein, blood pressure 142/92 mmHg

A client comes to the office for a routine prenatal visit at 26 weeks gestation. The urine dipstick is negative for protein but 2+ for glucose. The nurse would teach the client about what testing that needs to be performed?

1-hour glucose tolerance testf

A nurse is assessing a postpartum client and notes an elevated temperature. Which temperature protocol should the nurse prioritize?

100.5ºF (38.1ºC) at 48 hours postbirth and remains the same the third day postpartum A temperature that is greater than 100.4ºF (38ºC) on two postpartum days after the first 24 hours puts the client at risk for a postpartum infection. A fever in the first 24 hours of birth is considered normal and could be caused by dehydration and analgesia.

In an ideal 28-day menstrual cycle, the secretory phase occurs during which days?

15-28

At what gestational age should a primigravida expect to start feeling quickening?

18-20 weeks

A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week?

1lb

Which consideration is a priority when caring for a mother with strong contractions 1 minute apart?

Fetal heart rate in relation to contractions

A woman comes to the clinic for her first prenatal checkup. The woman has a body mass index (BMI) of 22. The nurse would anticipate that this client should gain approximately how much weight during her pregnancy?

25-35lbs

average number of days in menstrual cycle

28 days

A client is using the rhythm (calendar-basal body temperature) method of family planning. In this method, the unsafe period for sexual intercourse is indicated by

3 full days of elevated basal body temperature and clear, thin cervical mucus

A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every:f24

4 weeks

Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation.

4, 1, 1, 1, 1 The GTPAL system is used to classifying pregnancy status. G = gravida, T= term, P = preterm, A = number of abortions, L= number of living children.

Active phase of labor:

4-7 cm moderate to strong contractions regular q 3-5 min lasts 40-70 sec

A woman is to undergo labor induction. The nurse determines that the woman requires cervical ripening if her Bishop score is:

5. Explanation: A Bishop score less than 6 usually indicates that a cervical ripening method should be used before labor induction.

Following ejaculation in a healthy adult, there are approximately 300 million sperm present. What percentage of these sperm would be considered normal [mobile and morphologically healthy] and able to fertilize an egg?

55%

After inoculation with HPV, genital warts may begin to grow. They usually manifest as soft, raised fleshy lesions on the external genitalia of either male or female. What is the incubation period for HPV-induced genital warts?

6 weeks to 8 months

The nurse tests the pH of fluid found on the vaginal exam and determines that the woman's membranes have ruptured based on which result

6.5 Explanation: Amniotic fluid is alkaline, so the membranes are probably ruptured if the pH ranges from 6.5 to 7.5.

During a health-teaching session, a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium. Which answer should the nurse supply?

7 days after fertilization

During routine preconception counseling, a client asks how early a pregnancy can be diagnosed. What is the nurse's best response?

8 days after conception

Transition phase of labor

8-10 cm strong to very strong contractions q 2-3 min lasts 45-90 sec

The fetal stage lasts

9 weeks to birth

Which patient in the ED should the advance nurse practitioner treat first?

A 21-year-old woman reporting sharp colicky abdominal pain, menstrual spotting, and dizziness

A nurse who works in a fertility clinic is conducting a program on options for various fertility issues. The nurse judges that the participants understand the education when they identify that donor eggs are the best option for which woman?

A 42-year-old Donor eggs provide a much higher likelihood of success for women older than 40 years of age, when both egg numbers and egg quality decline.

The nurse is counseling a group of perimenopausal and postmenopausal women about the pros and cons of hormone therapy (HT). Which member of the group should the nurse identify as likely to benefit most from HT while incurring the least risk?

A 49-year-old who is experiencing many menopausal symptoms

Alpha-fetoprotein (AFP)

A blood test that measures the level of alpha-fetoprotein in the mothers' blood during pregnancy as an indicator of possible birth defects in a fetus

Which statement is true regarding gestational diabetes?

A glucose challenge test should be performed between 24 and 28 weeks.

Which outpatient is at a greater risk for developing Treponema pallidum, the cause of syphilis? Select all that apply.

A homeless adolescent female performing oral sex for money A male who frequents clubs catering to exotic dancers and sexual favors An older adult female living in a condominium who regularly has sex with three to four different men per week

A client states that "she thinks" her water has broken. Which best provides confirmation of the rupture of membranes

A positive Nitrazine test

Which client is experiencing the effects of a positive feedback mechanism?

A pregnant client whose oxytocin levels are rising during the second stage of labor.

A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. Which phenomenon most likely contributed to her present condition?

A sharp reduction in the number of lactobacilli in the client's vaginal flora.

sperm count of infertility

A sperm count of fewer than 20 million spermatozoa per milliliter results in infertility. Normal sperm count ranges on average from 60 to 100 million /mL.

The client appears at the clinic stating that she is 8 months pregnant and has had no prenatal care due to a lack of health insurance. She states not feeling well with blurred vision and a terrible headache. The client's blood pressure is 190/100 and edema is present in her lower extremities. Which diagnostic test will provide additional pertinent data?

A urine dipstick test to check for protein

The nurse is analyzing the readout on the EFM and determines the FHR pattern is normal based on which recording?

Acceleration of at least 15 bpm for 15 seconds

A client in labor has received a spinal epidural block. Which nursing intervention should the nurse prioritize after assessing maternal hypotension and changes in the fetal heart rate (FHR)?

Administer supplemental oxygen.

When do most perinatal HIV infections occur?

After exposure during delivery

After the nurse instructs a client who is scheduled for in vitro fertilization (IVF) about the procedure, which statement by the client indicates to the nurse that the instructions have been successful?

After fertilization, three or four embryos will be transferred through the cervix."

The community health nurse is preparing for a family planning clinic. The nurse identifies which factors that influence contraceptive choices? Select All That Apply

Age Marital status Desire for future pregnancy Religious beliefs Level of education

Which nursing diagnosis will the nurse rank as the priority for premature newborn twins?

Altered Gas Exchange ABC's

The nurse is taking the history of a 30-year-old female client with amenorrhea. What factors does the nurse identify as contributing to the condition? Select all that apply.

Anorexia nervosa Long-distance running Pituitary tumor

The nurse is justified in assessing for sexual dysfunction among male clients who are receiving which of the following?

Antihypertensive medication

An older adult client has a history of ischemic heart disease, MI, unstable angina controlled by transdermal nitroglycerin patch, chronic smoking requiring use of nebulized bronchodilators, and hypertension treated with a potassium-sparing diuretic and a beta-adrenergic blocking medication. The man states that he has been unable to maintain his erection. Which aspects of the man's health problems/treatments would the nurse identify as contributing to his erectile difficulty (ED)? Select all that apply.

Antihypertensive medications Hypertension Smoking history Age

The nurse is assessing a client who is 4 hours postpartum. Uterus palpated at the level of the umbilical and to the left side of the abdomen, which action is most appropriate at this time?

Ask the client to empty her bladder. A full bladder may displace the uterine fundus to the left or right of the abdomen.

A 25-week gestation client is scheduled for amniocentesis. What should the nurse do to prepare the client for the procedure? Select all that apply.

Ask the client to void. Assess fetal heart rate. Monitor maternal vital signs.

During an admission assessment of a client in labor, the nurse observes that there is no vaginal bleeding yet. What nursing intervention is appropriate in the absence of vaginal bleeding when the client is in the early stage of labor?

Assess amount of cervical dilation. If vaginal bleeding is absent during admission assessment, the nurse should perform vaginal examination to assess the amount of cervical dilation. Vital signs are monitored frequently throughout the maternal assessment.

A client in labor for the past 10 hours shows no change in cervical dilation and has stayed at 5 to 6 cm for the past 2 hours. Her contractions remain regular at 2-minute intervals, lasting 40 to 45 seconds. Which action should the nurse perform first?

Assess for presence of a full bladder. Explanation: A full bladder will slow or stop cervical dilation and produce symptoms that could be misdiagnosed as arrest in labor. Other strategies, such as internal uterine monitoring, relaxation, and oxytocin augmentation, would be appropriate later, but assessing the bladder first is key.

The nurse has just applied a sterile pressure dressing to an epidural site after removing the epidural catheter in a client who is now recovering from a standard delivery. Which action should the nurse now prioritize?

Assess return of sensory and motor functions to the lower extremities.

A nurse in the maternity triage unit is caring for a client with a suspected ectopic pregnancy. Which nursing intervention should the nurse perform first

Assess the client's vital signs.

A nurse is providing information regarding ovulation to a couple who want to have a baby. Which fact should the nurse tell the clients?

At ovulation, a mature follicle ruptures, releasing an ovum.

The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation?

At the level of the umbillicus

During which time is the nurse correct to document the end of the third stage of labor?

At the time of placental delivery

The nurse planning a community education program on abuse of androgens to enhance athletic performance should include which adverse event as a potential harmful effect?

Azoospermia Potential harmful effects of androgen abuse to enhance sports performance includes azoospermia, gynecomastia, decreased testicular size, and acne.

A pregnant client's α-fetoprotein (AFP) returns elevated. The couple ask the health care worker to explain what this means. Which is the best response?

Elevated AFP means your baby is at risk of having a neural tube defect like spina bifida (an opening in the spine

When preparing for a class on breast cancer, the nurse should explain which nonmodifiable risk factors? Select all that apply.

BRCA1 gene menarche at age 11 being a 52-year-old female

A 38-year-old woman comes into the obstetrician's office for prenatal care, stating that she is about 12 weeks pregnant with her first child. What questions would the nurse ask this client, considering her age and potential sensitivity to being labeled an "older" primipara?

Be nonjudgmental in your history gathering and offer her pregnancy resources to read and explore.

A primigravida client admitted with signs of labor is evaluated with external electronic fetal monitoring that shows baseline FHR of 136 to 150 and two instances of FHR at 165 for 15 to 20 seconds. Which response should the nurse prioritize?

Before reporting to the RN, determine the uterine contraction pattern.

A client on the urology floor who has BPH asks the nurse how the pharmacologic agent finasteride will help decrease the size of his prostate. Which principle explains the mechanism of action?

Blocking effects of androgens on the prostate

During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings?

Both findings are normal at this point of the pregnancy.

A child with cystic fibrosis (CF) asks the nurse why he has this disease, but his parents are perfectly healthy. The nurse explains:

Both parents are carriers and have a recessive genotype with alleles for CF

Braxton Hicks contractions are termed "practice contractions" and occur throughout pregnancy. When the woman's body is getting ready to go into labor, it begins to show anticipatory signs of impending labor. Among these signs are Braxton Hicks contractions that are more frequent and stronger in intensity. What differentiates Braxton Hicks contractions from true labor?

Braxton Hicks contractions usually decrease in intensity with walking.

A client who has just given birth is concerned about the high rate of infant mortality in the United States. She is anxious about the health of her child and wants to know ways to keep her baby healthy. Which recommendation would best meet this goal?

Breast-feed the infant Explanation: Breast-feeding reduces the rates of infection in infants and helps to improve long-term maternal health. Placing the infant on his or her back to sleep prevents SIDS but does not prevent infections in the infant

What gland is responsible for urethral lubrication during male sexual stimulation

Bulbourethral glands

A 71-year-old man has visited his family physician for a checkup, during which the physician has initiated a discussion about the client's sexual function. Which phenomenon would the physician most likely consider pathological rather than an age-related change?

Cessation of androgen production.

In understanding the development of the musculoskeletal system, the nurse recognizes that what is implanted in a gel-like substance during fetal life?

Cartilage

A teenage client comes to the clinic and tells the nurse that she has not had a period for the last 2 months. After assessment and lab work, the client is told that she is 3 months' pregnant. She begins to sob and says she is too young to have a baby. When the nurse offers counseling for an abortion, the client gets even more upset and says that she cannot have an abortion as it is not permitted in her church. This client is most likely which of the following?

Catholic

There are four essential components of labor. The first is the passageway. It is composed of the bony pelvis and soft tissues. What is one component of the passageway?

Cervix

The nurse plays a major role in assessing the progress of labor. The nurse integrates understanding of the typical rule for monitoring labor progress. Which finding would the nurse correlate with this rule?

Cervix dilates 1 cm per hour.

While instructing the client about breast-feeding, which instructions should the nurse include to help the mother prevent mastitis? Select all that apply.

Change the breast pads frequently. Expose your nipples to air part of the day. Wash your hands before handling your breast and breast-feeding. Release the baby's grasp on the nipple before removing the baby from the breast

A 25-year-old client wants to know if her baby boy is at risk for Down syndrome because one of her distant relatives was born with it. Which information would the nurse share with the client while counseling her about Down syndrome?

Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg.

the most common cause of miscarriage in the first trimester is related to which factor?

Chromosomal defects in the fetus

A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for:

Circumcision Explanation: Phimosis refers to a tightening of the prepuce or penile foreskin that prevents its retraction over the glans.

The 29-year-old client presents at 5:30 a.m. with labor pains. Her history reveals G4, three previous vaginal births, and gynecoid pelvis. At 9 a.m. her assessment reveals 80% effaced and dilated at 3 cm. What nourishment can the nurse provide if the client mentions she hasn't eaten since 5 p.m. yesterday and is hungry?

Clear liquids but no solid food

A pregnant client wishes to know if sexual intercourse would be safe during her pregnancy. Which should the nurse confirm before educating the client regarding sexual behavior during pregnancy?

Client does not have an incompetent cervix.

For which client is preimplantation genetic diagnosis (PGD) a viable option?

Client whose partner has cystic fibrosis Explanation: Preimplantation genetic diagnosis (PGD) is a viable option when either parent has or is a carrier of a genetic disorder. It is also an option when the mother is of advanced maternal age or who has a history of multiple miscarriages. PGD is not a viable option for pregnant clients.

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last 6 months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?

Clotrimazole, an antifungal agent.

The nurse is providing prenatal education for a group of pregnant teenagers. The nurse talks about substance use during pregnancy and relates that use to which possible newborn consequences? Select all that apply

Congenital anomalies Low birth weight Premature birth

A nurse is reviewing the history of a pregnant woman and notes that the woman has a history of substance use. When teaching the woman about the possible effects of substance use on her baby, the nurse would identify that the fetus is at higher risk for which condition? Select all that apply.

Congenital anomalies Low birth weight Prematurity

A nurse is performing a genital examination on a 25-year-old male client. The nurse notes pigmented, wrinkled scrotal skin. Based on this information, what should the nurse do next?

Consider this a normal finding and proceed with the examination.

A 25-year-old woman with primary dysmenorrhea is seeking treatment options from the community health nurse. What should the nurse include in a treatment plan? Select all that apply.

Consulting a prescribing provider for oral contraceptives Administering ibuprofen as needed

contractions

Contractions that begin in the back and then radiate to the front are typical of true labor. Contractions that slow when a woman walks or changes position suggest false labor, as do irregular contractions. Contractions lasting 30 seconds or less commonly suggest Braxton Hicks contractions and are associated with false labor.

After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example?

Cryptorchidism

failure of one or both or both of the testes to descend into the scrotum?

Cryptorchidism

A couple in their 30's have presented to a fertility clinic due to their inability to conceive a child after trying for the last 18 months. Which conditions will the health care provider want to specifically rule out as potential contributing factors? Select all that apply.

Cryptorchidism in the husband Slow maturation of the endothelial lining after ovulation Low levels of LH and FSH in the wife Sexually transmitted infections like gonorrhea or chlamydia.

A client is admitted with primary hypogonadism. The nurse understands that the diagnosis of primary hypogonadism refers to which of the following? Select all that apply

Decrease in testicular function Originates in the testes Subfertility or infertility

The nurse is monitoring a primipara who has been receiving oxytocin and is now in hypertonic labor. If the nurse notes the fetal heart rate has suddenly dropped, which action should the nurse prioritize?

Decrease the oxytocin drip rate.

A female client severely reduced her body fat through extreme caloric restriction and exercise. Which reproductive abnormalities could she acquire as a result of the reduction in body fat?

Delay or cessation of menstruation

A couple is being assessed for infertility. The male partner is required to collect a semen sample for analysis. What instruction should the nurse give him?

Deliver sample for analysis within 1 to 2 hours after ejaculation.

A pregnant woman's ultrasound reveals intrauterine growth retardation (IUGR) and a TORCH agent is thought to be the cause. Which nursing action is appropriate?

Determine whether the client has been immunized against rubella. TORCH stands for toxoplasmosis, other, rubella (i.e., German measles), cytomegalovirus, and herpes. Hepatitis, tetanus, and cholera are not included among lists of TORCH agents.

An expectant mother is 23 weeks into her pregnancy when she goes into labor. Regarding fetal lung development, what is of greatest concern to the attending medical team?

Development of type II alveolar cells Type II alveolar cells begin to develop at approximately 24 weeks

A client is being discharged from the gynecological unit after treatment for an acute pelvic inflammatory disease (PID). What priority instruction regarding disease management should the nurse include?

Discuss the necessity of completing the antibiotic therapy.

A healthy, primiparous (first-time) mother delivered a healthy infant several hours ago, but the mother has experienced postpartum hemorrhage. Which disorder is most likely to underlie the client's excessive bleeding after delivery?

Disseminated intravascular coagulation

A client is scheduled to undergo a Papanicolaou test. The nurse should advise the client of which preparation

Do not douche before the procedure

A 22-year-old man has been accepted as a participant in a drug trial while his female friend of the same age was rejected. What is the most likely rationale for this decision?

Drugs pose a risk to the woman's ova.

In a busy sexually transmitted infection clinic on a university campus, a group of students have developed tetracycline- and penicillin-resistant strains of N. gonorrhoeae. Given these results, the nurse can expect that which treatment will be prescribed?

Dual therapy with ceftriaxone and azithromycin

A client is diagnosed with herpes simplex. Which statement about herpes simplex infection is true?

During early pregnancy, herpes simplex infection may cause spontaneous abortion or premature birth.

Letting go, taking in, taking hold phase

During the first 24 to 48 hours after giving birth, mothers often assume a very passive and dependent role in meeting their own basic needs, and allow others to take care of them. This is referred to as the taking-in phase. The taking-hold phase occurs when the client begins to assume control over her bodily functions. She is also showing strong interest in caring for the infant by herself. The letting-go phase occurs when the woman has assumed the responsibility for caring for herself and her infant.

A client has been diagnosed with an anterior pituitary tumor. Synthesis and release of follicle-stimulating hormone (FSH) has become deranged. What are the potential consequences of this alteration in endocrine function?

Dysfunction of spermatogenesis

Which statement best captures an aspect of normal spermatogenesis?

Each primary spermatocyte undergoes two nuclear divisions yielding four cells with 23 chromosomes each.

The nurse in the ER is caring for a client with lower abdominal pain that is greater on the right side and who has light vaginal spotting. When the client's human chorionic gonadotropin (hCG) level is lower than normal, the nurse plans care for a client with:

Ectopic pregnancy low hCG, would be most indicative of an ectopic pregnancy

secondary prevention

Efforts to limit the effects of an injury or illness that you cannot completely prevent.

In the male stages of the sexual act, emission precedes which stage, which is mediated through spinal cord reflexes?

Ejaculation

A client at 27 weeks' gestation still walks daily but reports "terrible" heartburn at night. Which action should the nurse point out will best address this situation?

Elevate the head of the bed

The nurse is monitoring a client who is in the second stage of labor, at +2 station, and anticipating birth within the hour. The client is now reporting the epidural has stopped working and is begging for something for pain. Which action should the nurse prioritize?

Encourage her through the contractions, explaining why she cannot receive any pain medication. At this point, any medication would be contraindicated as it would pass to the fetus and may cause respiratory depression. The nurse will have to work with the mother through the contractions and pushing. The client has progressed too far to retry the epidural medication. No meperidine should be given due to the risk to the fetus.

Which of the following diagnostic tests is used for severe bleeding that is unresponsive to other therapies

Endometrial ablation

The nurse working in a fertility clinic is assessing a client's risk for fallopian tube obstruction. Which disorder places the woman at greatest risk for fallopian tube obstruction?

Endometriosis

A nurse is applying ice packs to the perineal area of a client who has had a vaginal birth. Which intervention should the nurse perform to ensure that the client gets the optimum benefits of the procedure?

Ensure ice pack is changed frequently.

After teaching a group of students about erectile dysfunction, the instructor determines that the teaching was successful when the students identify which of the following as true?

Erectile dysfunction may be due to testosterone insufficiency.

A client who comes to the clinic complaining of perineal pain, dysuria, and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?

Escherichia coli

A client with genital herpes asks the nurse about what to expect with the infection. Which of the following responses would be most appropriate?

Even though you don't have symptoms, you could still spread the infection.

A gravida 4 para 4 mother calls the nurse's station reporting uterine pain following delivery. When the nurse responds to the call, the mother reports that she is having what feels like labor pains again off and on. What would be the nurse's response?

Explain to her that women who have had several babies prior to this delivery often experience afterpains, which is where the uterus is contracting and relaxing at intervals.

Which hormone increases during the premenstrual phase?

FSH

Letting go phase

Feelings of grief, guilt, and anxiety are part of the letting-go phase where the mother accepts the infant as it is and lets go of any fantasies.

A nurse is caring for a client who is at 28 weeks' gestation and is receiving terbutaline (Brethine) to control preterm labor. Which assessment parameters should the nurse prioritize?

Fetal heart rate (FHR) When a client is taking terbutaline, the nurse should closely monitor the maternal heart rate, the FHR, and the maternal blood pressure and fluid status.`

The fallopian tubes are narrow tubes that attach bilaterally to the uterus. Within the fallopian tube, fertilization of the ovum takes place. The end of the fallopian tube nearest the ovary is funnel-like. What are the fringed, finger-like projections around the funnel-shaped opening of the fallopian tube called?

Fimbriae

Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess?

Fishy smelling watery discharge

The nurse is assessing a 16-year-old female on a routine well-child visit. Which assessment finding will the nurse predict this healthy female will report concerning her menstrual cycles?

Flow usually lasts 4 to 6 days.

A client is seeking treatment for infertility. What decrease in hormone secretion from the anterior lobe of the pituitary gland that regulates fertility would the nurse recognize may cause this issue?

Follicle stimulating hormone (FSH)

The nurse is teaching a group of women about the hormone that makes the ovum within the ovaries mature each month. Which hormone is responsible for stimulating the ovum?

Follicle stimulating hormone (FSH)

Gonadotropin-releasing hormone (GnRH) stimulates the anterior pituitary to release which hormones?

Follicle-stimulating hormone (FSH) Luteinizing hormone (LH)

A client has just become pregnant and there is a consequent increase in secretions from the columnar epithelium of her endocervix. What effect will this have?

Formation of a mucoid plug to protect her uterus

A nursing instructor is explaining the stages of fetal development to a group of nursing students. The instructor determines the session is successful after the students correctly choose which time period as representing the pre-embryonic stage?

From fertilization to the end of the second week after fertilization

A nursing student studying obstetrics asks the faculty, "How does the sperm get so much energy to swim up the fallopian tubes?" The instructor responds based on which pathophysiologic principle?

Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm.

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely?

Fundal height has dropped since the last recording. Between 38 and 40 weeks of gestation, the fundal height drops as the fetus begins to descend and engage into the pelvis. Because it pushes against the diaphragm, many women experience shortness of breath. By 40 weeks, the fetal head begins to descend and engage into the pelvis. Although breathing becomes easier because of this descent, the pressure on the urinary bladder now increases, and women experience urinary frequency. The fundus reaches its highest level at the xiphoid process at approximately 36, not 39, weeks. By 20 weeks' gestation, the fundus is at the level of the umbilicus and measures 20 cm. At between 6 and 8 weeks of gestation, the cervix begins to soften (Goodell sign) and the lower uterine segment softens (Hegar's sign).

A 41-year-old pregnant woman and her husband are anxiously awaiting the results of various blood tests to evaluate the fetus for potential Down syndrome, neural tube defects, and spina bifida. Client education should include which information?

Further testing will be required to confirm any diagnosis

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of spontaneous abortion (miscarriage) within the first trimester. The nurse is correct to document the history as:

G = 3, T = 1, P = 0, A = 1, L = 1

how to classify pregnancy history

Gravida (G) is the total number of pregnancies she has had, including the present one. F = Full term: number of babies born at 37 or more weeks of gestation P = Preterm: number of babies born between 20 and 37 weeks of gestation A = Abortions: total number of spontaneous and elective abortions L = Living children, as of today.

The nurse is caring for a client with lichen simplex chronicus. What assessment finding does the nurse expect?

Gray-white plaques with an irregular surface

A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?

Gynecologic problems Explanation: In women with HIV, gynecologic problems, such as abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis may be the focus of a majority of complaints.

A group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condylomata?

HPV

Which factor in a client's history is most likely related to the diagnosis of cervical squamous dysplasia?

HPV

A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found?

Halfway between the symphysis pubis and the umbilicus

The nursing instructor is leading a discussion on the physical changes to a woman's body after the birth of the baby. The instructor determines the session is successful after the students correctly point out which process results in the return of nonpregnant size and function of the female organs?

Involution

The nurse has received the results of a client's postpartum hemoglobin and hematocrit. Review of the client's history reveals a prepartum hemoglobin of 14 g/dl (140 g/L) and hematocrit of 42% (0.42). Which result should the nurse prioritize?

Hemoglobin 9 g/dl (90 g/L) and hematocrit 32% (0.32) in a woman who has given birth by cesarean First, the nurse needs to determine the amount of blood loss during the delivery. For every 250 ml of blood lost during the delivery process, the hemoglobin should decrease by 1 g/dl (10 g/L) and the hematocrit by 2%. The acceptable amount of blood loss during a normal vaginal delivery is approximately 300 ml to 500 m and for a cesarean delivery approximately 500 mL to 1000 ml. The loss of hemoglobin from 14 gm/dl (140 g/L) to 9 gm/dl (90 g/L) is 5 and for the hematocrit from 42% to 32% is 10. This would indicate the client lost approximately 1250 ml of blood during the cesarean delivery (5 x 250 = 1250); this is too much and should be reported to the health care provider immediately. The other choices would be considered to be within normal range.

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem?

Hemorrhoids

An obese female informs the nurse that she is pregnant and is concerned about her baby's health because she realizes that she is obese. Which risk factor does the nurse understand may occur regarding the mother's obesity?

High birth weight leading to cesarean birth

A male newborn is born with hypospadias. The nurse doing the newborn physical assessment notes that the penis is also curved downward. What information would the nurse provide the parents for this infant?

His ability to void and have an erection in adulthood may be impaired and surgery is needed.

A pregnant client arrives in the emergency department and states, "My baby is coming." The nurse sees a portion of the umbilical cord protruding from the vagina. What should the nurse do first

Hold pressure on the fetal head.

Relaxin

Hormone produced during pregnancy that loosens and softens ligaments.

At 31 weeks' gestation, a 37-year-old woman with a history of preterm birth reports cramps, vaginal pain, and low, dull backache accompanied by vaginal discharge and bleeding. Assessment reveals cervix 2.1 cm long; fetal fibronectin in cervical secretions, and cervix dilated 3 to 4 cm. Which interactions should the nurse prepare to assist with?

Hospitalization, tocolytic, and corticosteroids

A 29-year-old woman has been trying for many months to become pregnant, and fertilization has just occurred following her most recent ovulation. What process will now occur that will differentiate this ovulatory cycle from those prior?

Human chorionic gonadotropin will be produced, preventing luteal regression.

Which chronic health issues increase a man's risk for developing erectile dysfunction? Select all that apply.

Hypertension Hyperlipidemia Diabetes mellitus

Which complication occurs as a result of ineffective breathing patterns?

Hyperventilation

An 18-year-old male is diagnosed with Klinefelter syndrome. What signs and symptoms are consistent with this diagnosis?

Hypogonadism and gynecomastia

A client has been in labor for 10 hours, with contractions occurring consistently about 5 minutes apart. The resting tone of the uterus remains at about 9 mm Hg, and the strength of the contractions averages 21 mm Hg. The nurse recognizes which condition in this client?

Hypotonic contractions

Which test is an x-ray study of the uterus and the fallopian tubes after injection of a contrast agent?

Hysterosalpingography

A female client who has chosen the cervical cap as her method of contraception states that she knows how to use it. Which statement by the client would indicate to the nurse that the client does understand this method of contraception?

I do not have any spermicidal allergies, so this method is OK for me. Spermicidal allergies are contraindications for the cervical cap

After teaching a client with prostatitis about care measures, which statement indicates successful teaching?

I might need to take the antibiotic for up to a month."

The nurse is teaching a male adolescent how to use a condom. Which teaching points would the nurse include? Select all that apply.

If the condom does not have a nipple receptacle, leave a small space at the end for semen to collect." "Use a condom with every act of intercourse." "Immediately after ejaculation remove the condom and discard it."

While in utero, a fetus swallows many substances that are deposited in the fetal intestinal system as meconium. What problem can arise from this occurrence?

If the fetus becomes stressed, the meconium is released into the amniotic fluid, placing the fetus at risk for pneumonia.

A 51-year-old man is receiving his annual physical exam and his care provider is explaining the rationale for performing a digital rectal exam (DRE). Which statement best captures the rationale for the procedure?

If the prostate is hardened on examination, a biopsy is indicated for further investigation.

A newly delivered mother asks the nurse "What can I do to help my womb to get back to a normal size more quickly?" The nurse's best response would be:

If you are breast-feeding, that will help make your uterus contract and get smaller."

The nursing instructor is teaching a session on the birth process. During which stage does the woman's cardiac output increase 80% above the pre-labor level?

Immediately after birth

A client reporting low abdominal pain, purulent cervical discharge, and painful intercourse is diagnosed with pelvic inflammatory disease (PID). The provider educates the client about this disease mentioning which statement?

Is a polymicrobial infection of the upper reproductive tract

oblique lie

Is one that is at some angle between the longitudinal and the transverse lie.

A patient is diagnosed with the most common type of uterine fibroid, an intramural fibroid. The nurse includes which information in teaching the patient about this type of fibroid?

It grows within the wall of the uterine muscle.

Which statement is true regarding hormonal contraception?

It increases risk for venous thromboembolism.

A nurse is educating adolescents on how to prevent infections. The nurse determines which statement(s) by participants indicates more education is needed?

It is okay to share glasses and eating utensils with my family and friends because they are all pretty healthy.

The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine. Which instructions are appropriate for the nurse to provide? Select all that apply.The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine. Which instructions are appropriate for the nurse to provide? Select all that apply.

It should be given before the child is sexually active. It prevents a common cause of cervical cancer. It can be given to boys and girls.

retinopathy of prematurity

It's an overgrowth of retinal blood vessels."

On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which response by the nurse is most appropriate?

It's important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke

A client who tells the nurse that she would like to use the basal body temperature method for family planning receives instructions about the method. Which client statement indicates to the nurse that the teaching has been successful?

It's important to take my temperature at about the same time every morning before arising." Doing so prevents other factors, such as eating or moving, from possibly influencing body temperature.

Which assessment finding is most clearly suggestive of initial genital herpes (herpes simplex virus, HSV) in a male client?

Itching, pain, and the emergence of pustules on the penis

A young client is admitted with torsion of the spermatic cord. Which is the most appropriate action to be taken by the nurse?

Keep the client NPO.

The nurse is preparing a talk on health issues in the LGBT population. Which statistics would the nurse include?

LGBT youth are 2 to 3 times more likely to attempt suicide.

A client with fibrocystic breast disease has been receiving treatment with danazol (Danocrine) therapy for the past 6 months. In anticipation of the drug being discontinued, the nurse instructs the client to inform the health care provider about which of the following?

Lack of return of regular menses within 90 days after discontinuing the drug.

Documentation of a newborn's weight identifies the newborn as extremely-low-birth-weight. The nurse correlates this information as placing the newborn's weight at which level?

Less than 1,000 g.

A woman in labor is having very intense contractions with a resting uterine tone >20 mm Hg. The woman is screaming out every time she has a contraction. What is the highest priority fetal assessment the health care provider should focus on at this time?

Look for late decelerations on monitor, which is associated with fetal anoxia.

A client receives an epidural block for pain relief during labor. Which interventions by the nurse are important when caring for a client with an epidural block? Select all that apply.

Make sure oxygen is available. Monitor vital signs frequently. Monitor fetal heart rate and contractions closely.

A gerontology nurse is discussing sexual dysfunction with an older adult male client. The nurse determines that the education has been effective when the client states:

Malnutrition may cause impotence."

A nurse is assessing a female client. When obtaining the client's history, the client tells the nurse that her menstrual cycle is usually 30 days and that she expects her next menstruation on March 20. Based on the client's information and the nurse's understanding of the female reproductive cycle, the nurse would identify ovulation as most likely occurring at which time?

March 6 Explanation: Ovulation usually occurs on day 14 in a 28-day cycle; however, whether a woman's cycle is 28 days or 120 days, ovulation takes place 14 days before menstruation.

The nurse is advising an adolescent male about sexual myths that have him concerned. Which statements describe accurate client education regarding these concerns? Select all that apply.

Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. No male or female should feel pressured into sexual activity at any age. Nocturnal emissions are normal in men of all ages.

Which statement should be incorporated into the education plan developed to present instruction about the female menstrual cycle to nursing students?

Menses ensues when the levels of estrogen and progesterone fall.

A nurse is giving a prenatal class on teratogens that have an affinity for specific body tissues. Which teratogen is accurately paired with the specific body tissue affected?

Mercury attacks the nervous tissue.

A patient asks the nurse if there are any available nonsurgical options to terminate a pregnancy if she is only 2 weeks pregnant. What information should the nurse provide to the patient about a medication that blocks progesterone?

Mifepristone (RU-486, Mifeprex) is used only in early pregnancy to terminate a pregnancy nonsurgically.

A patient asks the nurse if there are any available nonsurgical options to terminate a pregnancy if she is only 2 weeks pregnant. What information should the nurse provide to the patient about a medication that blocks progesterone?

Mifepristone (RU-486, Mifeprex) is used only in early pregnancy to terminate a pregnancy nonsurgically. Mifepristone (Mifeprex), formerly known as RU-486, is a medication used only in early pregnancy (up to 49 days from the last menstrual period) to induce abortion. It works by blocking progesterone.

A 22-year-old woman is in the clinic to end an early pregnancy. She takes three tablets of mifepristone (Mifeprex). Two days after she takes the medication, she returns to the clinic to see if she is still pregnant or if the medical abortion is complete. It is determined that she is still pregnant. The nurse will administer which drug?

Misoprostol

The nurse is assessing a pregnant client at 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are?

Montgomery glands (Montgomery tubercles); secrete lubricant for the nipples

A 13-year-old client undergoing puberty is alarmed to find small, white bumps surrounding her areolae. The nurse reassures her that these are a normal sign of her sexual maturation and tells her that they are:

Montgomery tubercles. Explanation: The small bumps or projections on the areolar surface known as Montgomery tubercles are sebaceous glands that keep the nipple area soft and elastic. At puberty and during pregnancy, increased levels of estrogen and progesterone cause the areola and nipple to become darker and more prominent and Montgomery glands to become more active.

The nurse is caring for a client who is in active labor. The client states, "I think my water just broke!" The fetal heart rate shows a prolonged variable deceleration to 80 beats per minute. The nurse performs a sterile vaginal exam and feels a pulsating cord in the vaginal canal. What are the nurse's priority interventions at this time? Select all that apply.

Move the client's bed into Trendelenburg position. Have the patient's family call for help. Keep fingers in the vagina to keep pressure off of the cord.

The nurse is caring for a client in the transition phase of the labor process. Which client statement requires nursing action?

My lips and fingers are tingling." Explanation: When the client reports that her lips and fingers are tinging, the nurse is correct to understand that she is hyperventilating

Naegale's Rule

Naegele rule is to subtract 3 months and add 7 days from the first day of the last menstrual period to determine an expected due date

The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which danger sign might occur at this point in her pregnancy?

excessive vomiting

A newly pregnant woman reports to the nurse that her breasts are excessively tender and that her areolae and nipples are becoming darker and more prominent. The nurse should describe which cause of these changes?

Normal changes of pregnancy due to increased levels of estrogen and progesterone

A client presents to the clinic seeking the safest contraceptive method to use. The nurse reviews the client's health history and notes that the client is 26 years old, married with no children, and a smoker. Based on the client's history the nurse identifies which methods are the most appropriate for this client? (Select All That Apply)

Norplant System Implanon Depo-Provera

A client at 25 weeks' gestation presents with a blood pressure of 152/99 mm Hg, pulse 78 beats/min, no edema, and urine negative for protein. What would the nurse do next?

Notify the health care provider Explanation: The client is exhibiting a sign of gestational hypertension, elevated blood pressure greater than or equal to 140/90 mm Hg that develops for the first time during pregnancy. The health care provider should be notified to assess the client. Without the presence of edema or protein in the urine, the client does not have preeclampsia.

The nurse is caring for a female client with dysmenorrhea that interferes with activities of daily living. The client is prescribed ibuprofen 400 mg three times daily. Which nursing action is completed with medication administration? Select all that apply.

Offer a light snack. Assess pain level. Offer an 8 ounce (240 mL) glass of water.

The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which schedule is recommended for prenatal care?

Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth.

Which of these complications does the nurse recognize may occur after illness with parotitis (mumps) in young men?

Orchitis with residual sterility

The nurse is instructing on maternal hormones which may impact the onset of labor. Which hormones are included in the discussion? Select all that apply.

Oxytocin Progesterone Prostaglandins

A client has been diagnosed with a Bartholin gland cyst. The nurse expects the client may experience which symptoms if this becomes infected?

Pain, tenderness, and dyspareunia

A client is complaining to the health care provider about several vague signs/symptoms. Which sign/symptom raises a "red flag" indicating the client may have developed endometrial cancer?

Painless abnormal bleeding

The nurse knows that which structures are a part of the male reproductive system? Select all that apply.

Pair of gonads Seminiferous tubules Prostate gland

With sexual stimulation the penis becomes erect. What is the physiologic cause of an erection?

Penile sinuses fill up with blood.

A nurse reads in a client's chart that he or she has gender dysphoria. The nurse determines that the client understands the diagnosis when making what statement?

People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria."

A neonate has been placed on cardiac and apnea monitoring in the neonatal nursery. The nurse notes that the apnea alarm repeatedly triggers. Place the following actions in the order they would be completed by the nurse. All options must be used.

Perform a focused assessment on the neonate. Count the respiratory rate for 60 seconds. Silence the alarm to decrease environmental stimuli. Check all connections on the apnea monitor. Document the assessment findings, interventions, and neonate's response.

A student nurse is enrolled in a growth and development class. Which of the following Freudian stages should the student nurse recognize in a child with an increase in gender difference awareness?

Phallic Stage Explanation: The Phallic Stage is the stage in which a child develops an increased awareness of gender differences. The Oral Stage is when the infant uses his or her mouth as a major source of satisfaction. The Anal Stage is when toilet training is taking place with the child. The Latency Stage involves identification with the same sex parent.

Which condition is a part of normal newborn screening?

Phenylketonuria

Which body structure controls reproductive hormone production and function for both males and females?

Pituitary gland

The nurse is documenting the results of a pelvic examination on a client's medical record. Which of the following would alert the nurse to the need for additional follow up?

Positive cervical motion tenderness Explanation: Positive cervical motion tenderness usually indicates a pelvic infection that necessitates additional follow up.

The nurse has received several laboratory studies back at the clinic. Which of these results should be reported to the local health department?

Positive gonorrhea Explanation: Gonorrhea and chlamydia are reportable communicable diseases

preeclampsia-eclampsia

Preeclampsia-eclampsia is defined as an elevation in blood pressure (systolic >140 mm Hg or diastolic >90 mm Hg) and proteinuria (300 or greater in 24 hours) developing after 20 weeks of gestation.

The partner of a pregnant client in her first trimester asks the nurse about the client's behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns?

Pregnant women often experience mood swings and self-centeredness but this is normal.

A mother 13 years of age delivers a low-birth-weight neonate, and the neonate is transferred to the neonatal intensive care unit. The mother reports receiving occasional prenatal care and has a history of excessive alcohol consumption. The growth and development of this neonate has been influenced by which of the following?

Prenatal factors

A client presents to the labor and deliver unit with symptoms of early labor. The nurse interviews the client and identifies that she is homeless, has had no prenatal care, and that she uses heroin and alcohol heavily. What factors are potential threats to the baby's current and future growth and development? Select all that apply.

Prenatal factors Environmental factors Caregiver factors Individual factors Not genetic, Genetic factors do not appear paramount in this case.

The nurse caring for the laboring client performs a sterile vaginal exam. Exam results are dilated 10 cm, effaced 100%, and +2 station. What is the priority nursing intervention?

Prepare for birth of the neonate.

The nurse is working in the labor and birth unit when a client with active herpes simplex virus-Type 2 (HSV-2) appears in active labor. Which adjustment in the plan of care is anticipated?

Prepare the client for a cesarean section.

A client comes to the emergency department complaining of sudden, sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?

Prepare the client for surgery

A nurse is teaching a client about a circumcision. Which external reproductive structure is removed by circumcision?

Prepuce

A client's menstrual period is two weeks late. She has been feeling tired and has had bouts of nausea in the morning. What classification of pregnancy symptoms is this client experiencing?

Presumptive

The nurse is providing a prenatal class for a group of women at the local women's center. The nurse informs the group about the importance of taking their folic acid supplements for the prevention of neural tube defects. What type of prevention is the nurse providing?

Primary prevention

primary prevention

Primary prevention is directed at keeping disease from occurring by removing all risk factors

In the menstrual cycle, every month the female reproductive system generates an ovum. When the ovum is not fertilized, production of which of the following leads to menstruation?

Progesterone by the corpus luteum beginning to decrease

Which situation would require the nurse to use critical thinking and decision-making skills in providing genetics-related nursing care?

Providing fertility counseling to a young family with a 2-year-old child with cystic fibrosis Cystic fibrosis is an autosomal recessive genetic disorder. Parents of a child diagnosed with cystic fibrosis have a 50% chance of having another child with cystic fibrosis

The nurse notes that the client has a moderate amount of bleeding after birth. Which instruction is anticipated to control bleeding?

Put the newborn to the breast to suck. Allowing the baby to suck on the breast stimulates oxytocin release which helps the uterus to contract and control bleeding

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

Syphilis

The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence?

Quickening The fluttering sensation that can be confused with gas is called "quickening." In the 2 weeks leading up to the 20-week mark, she may feel "flutters" that she may confuse with gas

During hospitalization for a suicide attempt, the client informs the nurse that she does not want to return to work because her boss expects sexual favors each week before he gives her a paycheck. The client informs the nurse that she needs the job but is embarrassed that she performs these favors. The nurse informs the client that this is illegal behavior and is called what?

Quid pro quo harassment. Explanation: Quid pro quo means that something is given or withheld in exchange for something else.

A 32-year-old woman presents to the labor and birth suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus?

ROA

A pregnant woman comes to the emergency department stating she thinks she is in labor. Which assessment finding concerning the pain will the nurse interpret as confirmation that this client is in true labor?

Radiates from the back to the front Contractions that begin in the back and then radiate to the front are typical of true labor. Contractions that slow when a woman walks or changes position suggest false labor, as do irregular contractions. Contractions lasting 30 seconds or less commonly suggest Braxton Hicks contractions and are associated with false labor.

A school nurse has been asked to conduct a sexuality education class for fourth grade children. What is the most effective method for the nurse to use to present the material to the children?

Read sexual education pamphlets with the children.

Ballotment

Rebounding of the fetus against the examiner's finger on palpation. When the examiner taps the cervix, the fetus floats upward in the amniotic fluid.

The nurse has been asked to present information to a group of civic leaders concerning women's health issues. In preparing the information, the nurse includes what goal from Healthy People 2030 related to women in labor?

Reduce the rate of cesarean births among low-risk women

A nurse who will be working at a health fair is preparing a presentation on reproductive health and contraception. Which of the following would the nurse expect to include as advantages of combined hormonal contraception? Select all that apply.

Reduced incidence of benign breast disease Improved acne control Reduced risk of ovarian cancer Decreased risk of anemia

After 2 years of infertility, a couple is interested in assisted reproduction. Which nursing interventions are appropriate when working with couples during infertility treatment? Select all that apply.

Refer them to a smoking cessation program. Recommend a folic acid supplement. Assess the couple's stress relief practices.

A nurse is caring for a 32-year-old client for whom pessary usage is recommended for uterine prolapse. Which instruction should the nurse include in the teaching plan for the client concerning the pessary?

Report any discomfort with urination and defecation.

The nurse is conducting a prenatal class for expectant parents on conception. The nurse provides additional teaching when a parent makes which statement?

Reproductive cells are formed through mitosis This answer indicates that additional teaching is needed because reproductive cells are formed through meiosis, not mitosis

A nurse is caring for a client who is 8 months pregnant. Which instruction is the nurse most likely to give her?

Rest on the left side for at least 1 hour in the morning and afternoon. his position relieves fetal pressure on the renal veins, helps the kidneys excrete fluid, and increases flow of oxygenated blood to the fetus

A pregnant client is admitted to a maternity clinic after experiencing contractions. The assigned nurse observes that the client experiences pauses between contractions. The nurse knows that which event marks the importance of the pauses between contractions during labor?

Restoration of blood flow to uterus and placenta

involution

Return of the uterus to a nonpregnant state after birth

A nurse is working as part of a community group focusing efforts on preventing isoimmunization during pregnancy at the local women's health clinic. Which measure would the group encourage?

Rho(D) immune globulin administration to Rh-negative women Rh incompatibility can be prevented with the use of Rho(D) immune globulin.

When performing health education regarding hygiene, the nurse should advise female clients to avoid the use of which products/activities? Select all that apply.

Routine douching Vaginal deodorants

A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection?

Safety of antiviral therapy during pregnancy has not been established.

Bishop score

Score for induction of labor Score cervix 0,1,2,3 Score of >8 = induction of labor

The nurse is explaining the discharge instructions to a client who has developed postpartum cystitis. The client indicates she is not drinking a glass of fluid every hour because it hurts too much when she urinates. What is the best response from the nurse?

Teach that adequate hydration helps clear the infection quicker.

A client with large uterine fibroids is scheduled to undergo a hysterectomy. Which intervention should the nurse perform as a part of the preoperative care for the client?

Teach turning, deep breathing, and coughing. Explanation: The nurse should teach the client turning, deep breathing, and coughing prior to the surgery to prevent atelectasis and respiratory complications such as pneumonia.

A client at 29 weeks' gestation tells the nurse she is experiencing aches in her hips and joints. What would the nurse do next?

Tell the client these are normal findings during pregnancy.

During a routine antepartal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse do next?

Tell the woman that this is entirely normal.

The nurse knows that there are three basic charting methods in predicting ovulation in order to prevent pregnancy.

Temperature method Cervical mucus method Calendar method

l

The average menstrual flow is 4 to 6 days in length. The cycle usually lasts 28 days. There should be no mucus during the menstrual cycle, with clear mucus being noted at the time of ovulation or approximately day 14. Menstruation usually begins at the age of 12 to 14 years.

components of the passageway

The cervix and vagina are soft tissues that form the part of the passageway known as the birth canal.

A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding?

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.

While triaging messages from the answering machine from clients with the following symptoms, which client would obtain the first visit of the day?

The client at 11 weeks' gestation experiencing abdominal cramping

The nurse is discussing the menstrual cycle with a female client. The client asks, "Why does my side hurt halfway through my monthly cycle almost every month? The nurse suspects the cause of the pain may be:

The client has a leakage of blood onto the peritoneal surface after ovulation has occurred.

A baby is born with what the primary care provider believes is a diagnosis of trisomy 21. This means that the infant has three number 21 chromosomes. What factor describes this genetic change?

The client has a nondisjunction occurring during meiosis. During meiosis, a pair of chromosomes may fail to separate completely, creating a sperm or oocyte that contains either two copies or no copy of a particular chromosome. This sporadic event, called nondisjunction, can lead to trisomy. Down syndrome is an example of trisomy

A client is attempting to become pregnant and is using varied methods to identify ovulation. What assessment finding would most clearly suggest that the client is ovulating?

The client has clear, thin cervical mucus

The nurse is studying the medical records of an Indian male client. The nurse finds that the client has dhat syndrome. What should the nurse infer from this?

The client may have concerns regarding loss of semen.

A client is in active labor at 39 weeks gestation. Which finding would cause the nurse to intervene?

The client previously had a stillbirth Previous stillbirth is one of several maternal factors that indicate the need for electronic fetal monitoring (EFM)

A nurse is caring for a female client in labor who has chosen hydrotherapy as her pain management for labor. As the nurse prepares the client for this treatment, which procedure is recommended as the most appropriate consideration?

The client should be in active labor.

A client's sex glands have responded to stimulation from follicle-stimulating hormone (FSH) and luteinizing hormone (LH). What endocrine activity has directly preceded the release of FSH and LH?

The client's anterior pituitary gland was stimulated by gonadotropin-releasing hormone (GnRH).

The nurse is assessing the genitalia of a 42-year-old female client diagnosed with a genitourinary disorder. The nurse recognizes that which finding does not describe the normal anatomy of the female genitalia.

The clitoris is located posterior to the urethra.

A woman asks "Why do I have to tell my sexual partner about chlamydia? I thought this was a "female" disease." What is the nurse's best response?

The condition is transmittable to men and may cause infertility."

The nurse in a primary care clinic and a client have come to see the primary care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the woman's plan to have a family. The woman responds, "Why do I have to plan for a family?" What would be the nurse's best response?

The couple can control the time between births when they plan their family.

When describing the role of a doula to a group of pregnant women, the nurse would include which information?

The doula primarily focuses on providing continuous labor support.

The nurse is assisting a pregnant client who has just underwent a nonstress test that was ruled reactive. Which factor will the nurse point out when questioned by the client about the results?

The fetal heart rate increases with activity and indicates fetal well-being A nonstress test is a noninvasive way to monitor fetal well-being. A reactive NST is a positive sign the fetus is tolerating pregnancy well by demonstrating heart rate increase with activity and indicates fetal well-being.

During a nonstress test (NST), a nurse notes three fetal heart rate (FHR) increases of 15 beats/minute, each lasting 15 seconds. These increases occur only with fetal movement. How should the nurse interpret this finding?

The fetus is not in distress at this time.

A nurse is teaching a group of clients about birth control methods. When providing instruction about subdermal contraceptive implants, the nurse should cite which feature as the main advantage of this method?

The implants provide effective, continuous contraception that isn't user dependent.

A 34-year-old client has been diagnosed with endometriosis. What topic should the nurse emphasize during health education?

The importance of reporting a possible pregnancy as soon as it occurs

The primary care provider has prescribed a karyotype for a newborn. The mother questions what the type of information that will be provided by the test. What information should be included in the nurse's response?

The karyotype will assess the baby's chromosomal makeup The pictorial analysis of the number, form, and size of an individual's chromosomes is referred to as a karyotype.

A pregnant client wants to know why the labor of a first-time-pregnant woman usually lasts longer than that of a woman who has already given birth once and is pregnant a second time. What explanation should the nurse offer the client?

The labor of a first-time-pregnant woman lasts longer because during the first pregnancy the cervix takes between 12 and 16 hours to dilate completely. The intensity of the Braxton Hicks contractions stays the same during the first and second pregnancies. Spontaneous rupture of membranes may occur before the onset of labor during each birth, not only during the first birth.

Which statement describes why hypertonic contractions tend to become very painful?

The myometrium becomes sensitive from the lack of relaxation and anoxia of uterine cells.

The nurse is most correct to assess for transient tachypnea of the newborn (TTN) in which neonate?

The neonate delivered by cesarean section

The nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks what the baby can do physically right after birth. Which is an accurate statement about neonatal ability following birth?

The newborn can suck, swallow, sneeze, and yawn

The nurse caring for clients in a physician's office takes into consideration developmental stage when assessing sexuality. Which is an example of a developmentally appropriate intervention?

The nurse teaches parents of a 4-year-old that they may cause anxiety in the child by intolerance of inconsistency of sex-role behavior.

A patient calls the clinic and tells the nurse they have a foamy, greenish, and itchy vaginal discharge. The patient asks the nurse what the significance of this discharge is. What is the best response by the nurse?

The patient may have trichomoniasis

respiratory developed by 23rd week

The respiratory musculature, alveoli, and bronchial tree are all developed by the 23rd week.

hypotonic contraction

The resting tone of the uterus remains less than 10 mm Hg, and the strength of contractions does not rise above 25 mm Hg

The pain of labor is influenced by many factors. What is one of these factors?

The woman is prepared for labor and birth.

what role do Braxton Hicks contractions play in aiding labor?

These contractions help in softening and ripening the cervix.

A primigravid client is 8 weeks' pregnant and has had her first examination. The healthcare provider stated the client has a positive Hegar's sign. The client is concerned that this sign means something is wrong. How should the nurse respond to this client's concerns?

This is a good sign. It means the uterus is softened.

A pregnant patient is experiencing changes in her breast and asks the nurse if this should be cause for concern. What is the nurse's best response about the cellular adaptation to stress in the pregnant woman?

This is hyperplasia, which refers to an increase in cells because of the hormones from pregnancy.

The laboring client who is at 3 cm dilation (dilatation) and 25% effaced is asking for analgesia. The nurse explains the analgesia usually is not administered prior to the establishment of the active phase. What is the appropriate rationale for this practice?

This may prolong labor and increase complications. Administration of pharmacologic agents too early in labor can stall the labor and lengthen the entire labor. The client should be offered nonpharmacologic options at this point until she is in active labor.

A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting?

Threatened abortion

thromboembolic disorder of the lower extremities

Thromboembolic disorders may present with subtle changes that must be evaluated with more than just physical examination. The woman may report lower extremity tightness or aching when ambulating that is relieved with rest and elevation. Edema in the affected leg, along with warmth and tenderness and a low grade fever

The nurse is explaining about the function of the mons pubis to a client. Which explanation describes the function of the mons pubis?

To protect the pelvic bones during sexual intercourse

A patient has been diagnosed with a vaginal infection and received a prescription for metronidazole (Flagyl). The nurse knows that this is the recommended treatment for a vaginal infection caused by what organism?

Trichomonas vaginalis

Which sexually transmitted infection has the following characteristics: thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina?

Trichomoniasis

If the monitor pattern of uteroplacental insufficiency were present, which action would the nurse do first?

Turn her or ask her to turn to her side.

Which instructions regarding future sexual activity should a nurse give a client with a vasectomy?

Use a reliable method of contraception until the physician ensures that sperm no longer are present.

A client is 9 days postpartum and breast-feeding her neonate. The client experiences pain, redness, and swelling of her left breast and is diagnosed with mastitis. The nurse teaching the client how to care for her infected breast should include which information?

Use a warm moist compress over the painful area.

An older adult female patient informs the nurse that she is sexually active but has a problem with vaginal dryness. What can the nurse tell the patient that may help relieve this problem?

Use a water-based lubricant with sexual intercourse.

A female client tells the nurse that vaginal intercourse with her partner is not as exciting as it used to be. Which of the following could the nurse teach her?

Use of Kegel exercises

The nurse is teaching a client with a latex allergy about birth control methods to protect against sexually transmitted diseases. What information should be included in the teaching? Select all that apply.

Use of latex condoms, cervical caps, and/or diaphragms are contraindicated for men and women with latex allergy. A natural condom can be placed over a latex condom for protection.

A female client is prescribed methotrexate for meningeal leukemia. What health education should the nurse prioritize?

Use reliable forms of barrier contraception.

A female client with chronic hepatitis B has been prescribed recombinant interferon alfa-2b in combination with ribavirin. Which of the following instructions should a nurse provide this client?

Use strict birth control methods. Explanation: A female client who has been prescribed recombinant interferon alpha-2b in combination with ribavirin should be instructed to use strict birth control methods. This is because ribavirin may cause birth defects.

Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy?

Using a reliable method of contraception for several weeks.

A laboring client is experiencing dysfunctional labor or dystocia due to the malfunction of one or more of the "four Ps" of labor. Which scenario best illustrates a power problem?

Uterine contractions are weak and ineffective.

Which condition is an example of physiologic hyperplasia?

Uterine enlargement in pregnancy

While examining the introitus, the nurse practitioner asks the client to "bear down." The nursing student observing the examination knows that the nurse practitioner is assessing the client for which condition?

Uterine prolapse

Which method does the nurse use to determine fetal presentation, position and attitude?

Utilize Leopold maneuvers Leopold maneuvers are a noninvasive method of assessing fetal presentation, position and attitude by placing hands on the maternal abdomen and locating fetal body parts. Ultrasounds are not done by nurses and not typically done at this stage of pregnancy. Assessing fetal kicks and a vaginal examination are not accurate.

A male client comes to the clinic because he thinks that he has syphilis. Which test would the nurse expect the client to have done?

VDRL

Which procedure is contraindicated in an antepartum client with bright red, painless bleeding?

Vaginal examination A vaginal examination is contraindicated in a client with bright red vaginal bleeding until placenta previa is ruled out.

Trichomonas

Vaginal irritation, copious malodorous and frothy/yellow-green discharge

An HIV-positive mother passes the virus to her infant during delivery. This type of transmission is known as:

Vertical transmission

The nurse limits the amount of oral fluids given to a client receiving oxytocin for induction of labor. This is done to prevent what serious complication?

Water intoxication Water intoxication is a serious complication that can occur with the continuous use of oxytocin, especially if the drug is administered by continuous infusion and the client is receiving fluids by mouth. Oxytocin may also cause fetal bradycardia, uterine rupture, and uterine hypertonicity. Having oral fluids would not increase the chance of infection occurring.

A woman you care for in a prenatal clinic tells you that her pregnancy was unplanned and unwanted. At what point in pregnancy does the average woman change her mind about an unwanted pregnancy?

When quickening occurs

Which question would be most important for a nurse to ask a female client who is starting on an angiotensin II receptor blocker for hypertension?

When was your last menstrual period It would be important to know when the patient's LMP occurred and that the client is not pregnant. These drugs are category C for the first trimester and category D for the second and third trimesters of pregnancy and should not be used in pregnancy unless the benefits outweigh the risks.

A 24-year-old male client with a complete transection of the spinal cord asks, "Will I be able to father children in the future?" The nurse responds:

With proper stimulation of your genitals, you may be able to produce an erection and ejaculation.

A male child asks the nurse what chromosomes he would receive from his father. The best response would be:

Y

The nurse is caring for a 48-year-old female client who asks, "How do you know when you have reached menopause?" Which statement is an appropriate response by the nurse?

You are considered to be menopausal when you have not menstruated for a full year and the hormone that fluctuates with menstruation no longer fluctuates

When a man cannot achieve an erection, the phase of the sexual response in which the man is experiencing difficulty is:

excitement phase

The nurse cares for a 56-year-old client who received an implantable cardioverter defibrillator (ICD) 2 days prior. The client tells the nurse "My wife and I can never have sex again now that I have this ICD." What is the nurse best response by the nurse?

You seem apprehensive about resuming sexual activity." Explanation: The client treated with an electronic device experiences not only lifestyle and physical changes but also emotional changes. At different times during the healing process, the client may feel angry, depressed, fearful, anxious, or a combination of these emotions. It is imperative for the nurse to observe the client's response to the device and provide the client and family members with emotional support and teaching as indicated. Identifying that the client appears apprehensive about resuming sexual activity acknowledges the client's concerns while allowing for further discussion. The remaining responses ignore the client's feelings and do not facilitate an ongoing conversation or explore the client's concern.

Early phase of labor

Your cervix will efface and dilate to 4 cm. Contractions will last about 30-45 seconds, giving you 5-30 minutes of rest between contractions

Menotropins

a combination of follicle-stimulating hormone and luteinizing hormone, may be used to stimulate the ovaries to produce eggs

Vernix

a greasy substance that protects the fetus in utero and can still be present at birth

A female client is having a procedure this morning that involves radiologic examination of the fallopian tubes using a radiopaque medium. What procedure should the nurse document as being performed?

a hysterosalpingography

The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that

a large percentage (70%) of those infected experience no symptoms of the disease.

cervical cap

a rubber cap that fits over the cervix, used with spermicide to prevent conception.

premenstrual syndrome

a syndrome that occurs in many women from 2 to 14 days before the onset of menstruation Bloating, headache, and depression are consistent with premenstrual syndrome (PMS)

Depo-Provera

a synthetic compound similar to progesterone injected into the woman's arm or buttock that protects her against pregnancy for 3 months by preventing ovulation

A postmenopausal woman presents to the clinic with painless vaginal bleeding. The health care provider wants to assess for endometrial cancer. The nurse would anticipate the health care provider prescribing which procedure first?

a transvaginal ultrasound

A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence?

a weight gain of 10 lb (4.5 kg)

A nurse is counseling women on birth control choices. Which woman is the best candidate for an IUD?

a woman who has one partner and three children Explanation: A women who is in a stable monogamous relationship and has already had one successful pregnancy is the best candidate for an IUD. An IUD is not without risk to a woman. IUDs do not protect against STIs. PID may be caused by IUDs. A woman in her twenties has several better, lower risk options.

mittelschmerz

abdominal pain caused by the release of accompanying prostaglandins. It is typically felt on one side of the abdomen and clearly marks ovulation

A woman in her third trimester has just learned that her fetus has been diagnosed with cri-du-chat syndrome. The nurse recognizes that this child will likely have which characteristic?

abnormal cat like cry

ectopic pregnancy

abrupt onset of sever, stabbing pain in lower quadrants abdominal distention, guarding, rigidity may or may not know she is pregnant signs/symptoms of shocks nausea/vomiting vaginal bleeding may occur

The pregnant client with hyperemesis is not obtaining relief from medications. Which alternative therapy can the nurse advocate for the client to use?

acupuncture

A 76-year-old man is recovering from a myocardial infarction. In regards to his recovery, it is important for the nurse to:

address any questions about sexuality

A client at 7 weeks' gestation is being treated for a ruptured ectopic pregnancy in the emergency department. The client's vital signs are blood pressure 84/45 mmHg, heart rate 122 beats/min, respiratory rate 26 breaths/min, temperature 98.6°F (36.8°C). What is the nurse's priority?

administering fluid resuscitation and preparing the client for surgery

The third stage of labor ends

after the birth of the placenta.

The vagina is a hostile environment for sperm. What characteristic of semen protects sperm from the vaginal environment?

alkaline fluid

The nurse is concerned that a client is not obtaining enough folic acid. Which test would the nurse anticipate being used to evaluate the fetus for potential neural tube defects?

alpha-fetoprotein analysis

The nurse is providing health screening for adolescent girls. Which of the following adolescent girls does the nurse identify as highest risk for an unplanned pregnancy? Select all that apply.

an adolescent girl living in poverty an adolescent girl with low self-esteem an adolescent girl with low educational achievement an adolescent girl dating an older boy

The nurse is assessing a client for amenorrhea. During the assessment, the nurse notes facial hair and acne. The nurse knows this could be related to:

an androgen excess secondary to a tumor.

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?

an azole antifungal agent

A client who had intracavity radiation treatment for cervical cancer 1 month earlier reports small amounts of vaginal bleeding. This finding most likely represents:

an expected effect of the radiation therapy. Explanation: After intracavity radiation, some vaginal bleeding occurs for 1 to 3 months. Intermittent, painless vaginal bleeding is a classic symptom of cervical cancer, but given the client's history, bleeding in more likely a result of the radiation.

Implanon

an implanted hormonal contraceptive

Damage to which lobe of the pituitary gland would result in problems related to the function of stimulating hormones?

anterior

A parent brings a 2-month-old infant to the clinic for a well-baby checkup. To best assess the interaction between the parent and infant, the nurse should observe them:

as the parent feeds the infant. Explanation: The nurse can best assess parent-infant interaction during feeding, such as by observing how closely the parent holds the infant and how the parent looks at the infant's face. These behaviors help reveal the parent's anxiety level and overall feelings for the infant.

The licensed practical nurse is evaluating the tracings on the fetal heart monitor. The nurse is concerned that there is a change in the tracings. What should the LPN do first?

assess and reposition the women

After an hour of oxytocin therapy, a woman in labor states she feels dizzy and nauseated. The nurse's best action would be to:

assess the rate of flow of the oxytocin infusion. A toxic effect of oxytocin therapy is water intoxication. Symptoms include dizziness and nausea. Assessing and slowing the infusion rate will relieve symptoms.

A woman is 20 weeks pregnant. The nurse would expect to palpate the fundus at which location?

at the umbilicus

The nurse planning care for a menopausal woman should include interventions to decrease risk for:

atherosclerosis

A nurse finds the uterus of a postpartum woman to be boggy and somewhat relaxed. This a sign of which condition?

atony The uterus in a postpartum client should be midline and firm. A boggy or relaxed uterus signifies uterine atony, which can predispose the woman to hemorrhage.

Cystic fibrosis is an example of which type of inheritance?

autosomal recessive

menstrual flow

average 5 days

The female external genitalia are made up of several components. What is in the vestibule of the female external genitalia?

bartholin glands

Which possible complication associated with back pain can lead to premature contractions?

bladder or kidney infections

The nurse is assessing a 39-year-old client during her 32-week prenatal checkup. The client has attended regular prenatal checkups throughout the pregnancy. Which assessment data is a priority for the nurse to complete?

blood pressure

A nurse is meeting with a group of pregnant clients who are in their last trimester to teach them the signs that may indicate they are going into labor. The nurse determines the session is successful after the clients correctly choose which signs as an indication of starting labor? Select all that apply.

bloody show lightening back ache

A pregnant woman carrying both a dominant (brown) and a recessive (blue) gene has a husband who has a recessive gene that pairs with her recessive gene. The woman asks what color eyes their baby will have. The best response would be:

blue

The nurse is assessing a woman at 37 weeks' gestation who has presented with possible signs of labor. The nurse determines the membranes have ruptured based on which color of the Nitrazine paper?

blue

chadwick sign

bluish discoloration of cervix that occurs normally in pregnancy at 6 to 8 weeks' gestation

A client is in the last trimester of pregnancy. The nurse should instruct the client to notify the primary health care provider immediately if she notices:

blurred vision.

The nurse at a health fair is teaching about the various changes of puberty. Which sequence of events will be best for the nurse to present when illustrating pubertal changes in females?

breast budding, appearance of pubic hair, menarche

During her first prenatal visit, a client asks a nurse what physiological changes she can expect during pregnancy. The nurse begins the discussion with the presumptive changes of pregnancy. Put the following presumptive changes in ascending chronological order according to when they occur. All options must be used.

breast changes frequent urination uterine enlargement in which the uterus can be palpated over the symphysis pubis quickening appearance of linea nigra, melasma, and striae gravidarum

The nurse is assessing a woman who had a forceps-assisted birth for complications. Which condition would the nurse assess in the fetus?

caput succedaneum

Which body system is most affected throughout the embryonic and fetal period by teratogens?

central nervous system

A woman has been in labor for the past 8 hours, and she has progressed to the second stage of labor. However, after 2 hours with no further descent, the provider diagnoses an "arrested descent." The woman asks, "Why is this happening?" Which response is the best answer to this question?

cephalopelvic disproportion (CPD) where baby's head cannot make it through the canal."

cancers of the female reproductive system. most readily detected and most easily cured cancer—if detected early—is:

cervical

There are many cancers of the female reproductive system. The nursing student knows that the most readily detected and most easily cured cancer—if detected early—is:

cervical cancer

While obtaining the history, a client reports that her mother was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which cancer?

cervical cancer

A 35-year-old African American woman who smokes regularly and had diabetes visits the health care unit with sustained elevated blood levels and is diagnosed with essential hypertension. Which contraceptive method is best for this client?

cervical cap Mechanical barriers like cervical caps do not use hormonal therapy and are appropriate in this case

When explaining to a class of pregnant women why labor begins, the nurse will include the fact that there are several theories that have been proposed to explain why labor begins, although none have been proven scientifically. Which idea is one of those theories?

change in estrogen-to-progesterone ratio

The nurse is assessing a 35-year-old woman at 22 weeks' gestation who has had recent laboratory work. The nurse notes fasting blood glucose 146 mg/dl (8.10 mmol/L), hemoglobin 13 g/dl (130 g/L), and hematocrit 37% (0.37). Based on these results, which instruction should the nurse prioritize?

check blood sugars daily

A nurse is caring for a postpartum client diagnosed with von Willebrand disease. What should be the nurse's priority for this client?

check the lochia The nurse should assess the client for prolonged bleeding time. von Willebrand disease is a congenital bleeding disorder

The nurse is caring for a group of clients at a public health clinic. Which sexually transmitted disease would the nurse focus the client education on curative goals?

chlamydia

When caring for a group of clients, the nurse recognizes which of these individuals has increased risk for balanitis?

client with STI

After 6 months of unsuccessfully trying to conceive, a 31-year-old woman and her husband have sought a referral to a fertility specialist in order to explore their options. A nurse at the clinic should recognize that the woman may benefit from:

clomiphene. Explanation: Clomiphene is used in treating ovulatory failure in patients who want to become pregnant and have a fertile partner.

While assessing a client's breast during the third trimester, which finding would the nurse expect?

colostrum from the nipples

nurse prepares a woman with an abnormal Papanicolaou test result for further diagnostic evaluation. Which procedure would the nurse expect to be done?

colposcopy

The nurse is caring for a client in the first stage of labor. While observing the fetal heart monitor, the nurse notes a decrease in the fetal heart rate baseline starting after the peak of the contraction and ending after the contraction has ended. What does the nurse anticipate is the cause of the deceleration?

compromised uteroplacental perfusion

The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is:

condoms

During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk of developing which diagnosis?

condylomata acuminata Explanation: HPV is an identified precursor to condylomata acuminata, or genital warts. Herpes, gonorrhea, and candidiasis are not likely to result directly from HPV.

Which term describes a procedure in which cervical tissue is removed because abnormal cells are detected?

cone biopsy

The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG?

continues progesterone production by corpus luteum

A mother in premature labor asks the nurse why her doctor has prescribed corticosteroids. The nurse's response is based on the fact that:

cortisol can accelerate maturation of type II cells and stimulate the formation of surfactant.

Which of the following terms is used to describe destruction of tissue by freezing?

cryotherapy

A nurse is reviewing the physical exam findings of a woman who has come to the clinic with reports of feeling a dragging sensation in her vagina. The exam reveals the posterior bladder wall protruding into the anterior vaginal wall. The nurse interprets this finding as indicative of which condition?

cystocele

A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition?

cytomegalovirus

If a woman is 3 months pregnant, which finding related to breast changes would the nurse expect to assess?

darkened breast areola

When preparing a class for a group of pregnant women about nicotine use during pregnancy, the nurse describes the major risks associated with nicotine use, including:

decreased birth weight in neonates. Spontaneous abortion (miscarriage) is associated with caffeine use. Increased risks of stillbirth and placental abruption (abruptio placentae) are associated with mothers addicted to cocaine.

A pregnant woman with premature ruptured membranes is trying to decide whether home care might be the best option for her. Which advantage should the nurse mention to the client that is most pertinent to her condition?

decreased exposure to infection

A client with gestational hypertension receives magnesium sulfate 50% 4 g in 250 mL D5W over 20 minutes. What priority assessment should the nurse perform when administering this drug?

deep tendon reflexes

The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication?

deep vein thrombosis

Many clients experience a slight fever after birth especially during the first 24 hours. To what should the nurse attribute this elevated temperature?

dehydration Many women experience a slight fever (100.4° F [38° C]) during the first 24 hours after birth. This results from dehydration because of fluid loss during labor. With the replacement of fluids the temperature should return to normal after 24 hours.

In the salt-losing form of congenital adrenal hyperplasia, the most important observation you would make in a newborn would be for:

dehydration With this form of the disorder, children are unable to produce aldosterone. This leads to the inability to retain sodium and fluid.

Erectile dysfunction is the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. The nurse knows that there may be many causes of erectile dysfunction, and a psychogenic cause would include which of the following?

depression

A nurse is teaching a group of young adults about the sexual cycle. The nurse determines that the teaching was successful when the group identifies the five phases as they occur. Place the phases below in the correct order from first to last. All options must be used.

desire excitement plateau orgasm resolution

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to:

detect fetal heart sounds with a Doppler.

The nurse explains Leopold's maneuvers to a pregnant client. For which purposes are these maneuvers performed? Select all that apply

determining the presentation of the fetus determining the position of the fetus determining the lie of the fetus

A nurse is teaching a health class for girls at the local high school. How should the nurse explain the primary goal of sex hormones?

development of the body's reproductive system

Which effect would the nurse identify as a normal physiologic change in the renal system due to pregnancy?

dilation of the renal pelvis

Sexually transmitted infections (STIs) are typically spread by which mechanisms?

direct contact

Placenta accreta

direct implantation into myometrium without intervening decidua -> severe bleeding at birth, need hysterectomy.

A 35-year-old female client controls the symptoms of her cardiovascular disease with ACE inhibitors. She discovers that she is pregnant and contacts her primary care provider regarding her medication regimen. What would the nurse expect the provider to do?

discontinue the drugs

prenatal screening

down syndrome

painful menstruation

dysmenorrhea

A nurse is conducting a presentation on breast cancer for a local women's group and explaining the possible risk factors associated with its development. The nurse determines that the group has understood the information when they identify which factor as increasing a woman's risk for breast cancer?

early menarche

A client in the first trimester reports having nausea and vomiting, especially in the morning. Which instruction would be most appropriate to help prevent or reduce the client's compliant

eat dry crackers or toast before rising

To promote health of the fetus, the nurse should instruct the woman in the first trimester of pregnancy to:

eat foods high in folic acid.

A 28-year-old client with a history of endometriosis presents to the emergency department with severe abdominal pain and nausea and vomiting. The client also reports her periods are irregular with the last one being 2 months ago. The nurse prepares to assess for which possible cause for this client's complaints

ectopic pregnancy

A woman is lightly stroking her abdomen in rhythm with her breathing during contractions. The nurse identifies this technique as:

effleurage.

During which stage of fetal development is exposure to teratogens most damaging?

embryonic stage

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common?

endometriosis

A G2P1 woman with type 1 diabetes is determined to be at 8 weeks' gestation by her health care provider. The nurse should point out which factor will help the client maintain glycemic control?

exercise The three main facets to glycemic control for the woman with pregestational diabetes are diet, exercise, and insulin. An individual with type 1 diabetes uses insulin and not oral hypoglycemic agents.

second-degree laceration

extends through perineal muscles

third degree laceration

extends through the anal sphincter muscle but not through the anterior rectal wall.

Which finding is most worrisome in a client in her 26th week of pregnancy?

facial edema Explanation: Generalized hair loss, hyperpigmented maxillary rash (chloasma), and nosebleeds are usually benign and common in pregnancy. Facial edema after the 24th week of gestation may indicate gestational hypertension

Which definition best explains the term "subfertility/infertility"?

failure to achieve pregnancy after 1 year of unprotected intercourse

Within the female internal reproductive structures, where is the egg most commonly fertilized?

fallopian tubes

The client is asking if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy?

family history of breast cancer Explanation: The risk of endometrial or breast cancer in women prescribed HRT may outweigh the benefits of relieving symptoms of menopause and preventing kyphosis or hip fractures associated with osteoporosis.

meconium aspiration

fetal aspiration of amniotic fluid containing meconium

The nurse is admitting a client who is in early labor. After determining that the birth is not imminent, which assessment should the nurse perform next?

fetal status

Lanugo

fine, soft hair, especially that which covers the body and limbs of a human fetus or newborn.

pre-embryonic stage

first 2 weeks

A nurse assesses and suspects vulvar cancer based on which assessment finding?

fleshy, ulcerated mass on the labia majora

A nurse is conducting an in-service education program about the female reproductive cycle for a group of nurses working at a women's health clinic. When describing the phases of the endometrial cycle, the nurse would explain that the proliferative phase of the endometrial cycle corresponds to which phase in the ovarian cycle?

follicular

When describing the phases of the endometrial cycle, the nurse would explain that the proliferative phase of the endometrial cycle corresponds to which phase in the ovarian cycle?

follicular

A nurse recognizes that labor is divided into how many stages?

four

A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. How does the nurse classify the laceration?

fourth degree

The most critical time for teratogenic influence in embryonic development is:

from day 15 to day 60 after conception. The embryo's development is most easily disturbed during the period when differentiation and development of the organs are taking place. This time interval, which is often referred to as the period of organogenesis, extends from day 15 to day 60 after conception.

A nurse conducting a community education class on genetics tells the class that meiosis occurs in which type of cell?

gamete producing

A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements?

gestational hypertension Hypertensive disorders represent the most common complication of pregnancy. Gestational hypertension is elevated blood pressure without proteinuria, other signs of preeclampsia, or preexisting hypertension. Abruptio placenta (separation of the placenta from the uterine wall), placenta previa (placenta covering the cervical os), and preeclampsia are high-risk, potentially life-threatening conditions for the fetus and mother during labor and birth.

A 55-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms he has experienced over the last several days. He reveals that he has had a number of new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last two days, the discharge has been occasionally blood-tinged. What differential diagnosis would be the care team's first priority?

gonorrhea

The nurse is performing an assessment of a woman who has come to a health care facility for a diagnosis of pregnancy. The women is positive for breast changes, nausea, and amenorrhea. On physical exam, it is noted that the client has softening of the cervix. How should the nurse document this in her notes?

goodell sign

Which type of pelvis has a roomy, round inlet and is most favorable for vaginal birth?

gynecoid

A client at 32 weeks of gestation has mild preeclampsia. She is discharged home with instructions to remain in bed rest. She is also instructed to call her healthcare provider if she experiences which of the following symptoms? Select all that apply.

headache blurred vision epigastric pain severe nausea and vomiting

A client in active labor is given spinal anesthesia. Which information would the nurse include when discussing with the client and family about the disadvantages of spinal anesthesia?

headache following anesthesia

The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which signs and symptoms would the nurse include? Select all that apply.

headache with visual changes in the third trimester sudden leakage of fluid during the second trimester lower abdominal pain with shoulder pain in the first trimester

A 30-week gestation mother is admitted to the labor and delivery unit with contractions every 10 minutes and intact membranes. The nurse is to administer terbutaline to help stop the contractions. What priority assessment of the client will the nurse perform when administering this drug?

heart rate

HELLP syndrome

hemolysis, elevated liver enzymes, low platelets

When an Rh-negative mother gives birth to an Rh-positive infant, the mother usually produces antibodies that will attack any subsequent pregnancies in which the fetus is Rh-positive. When subsequent babies are Rh-positive, erythroblastosis fetalis occurs. What is another name for erythroblastosis fetalis?

hemolytic disease of the newborn

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem?

hemorrhoids

An expectant mother is on heparin for previous blood clots and voicing concerns about how her medications will affect her baby. The nurse would inform the mother that:

heparin does not cross the placenta and is safe for her to take.

A client, age 42, visits the gynecologist. After examining the client, the healthcare provider suspects cervical cancer. What will be most important for the nurse to include in assessing the client's health history?

history of human papillomavirus infection

A nurse is counseling a client on how recessive disorders are transmitted from parent to child. The nurse knows that recessive disorders occur when which allele is present?

homozygous recessive

physiologic hyperplasia

hormonal and compensatory

A nurse is preparing a presentation for a local community women's group about menopause. When describing the body system changes that occur, the nurse would include which changes? Select all that apply.

hot flashes increased abdominal fat vaginal dryness decreased bone density

What hormone is the first to be produced when the ovum is fertilized and implanted in the uterine wall?

human chorionic gonadotropin

A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as:

hydatidiform mole.

A client asks why her breasts are enlarged during pregnancy. Which explanation is the best answer?

hyperplasia due to estrogen stimulation

A client is prescribed methylergonovine. The nurse reviews the client's medical record for possible contraindications to the use of this drug. Which, if found, would the nurse identify as being a contraindication to the prescribed drug?

hypertension

A client with a history of hypertension and heart disease is being seen by the urologist because of erectile dysfunction. What would be the most likely cause of the client's erectile dysfunction?

hypertension medication, atherosclerissi, depression

The nurse is providing care to a neonate. Review of the maternal history reveals that the mother is suspected of having a heroin use disorder. The nurse would be alert for which finding when assessing the neonate?

hypertonicity Newborns of mothers with heroin or other narcotic use disorder display irritability, hypertonicity, a high-pitched cry, vomiting, diarrhea, respiratory distress, disturbed sleeping, sneezing, diaphoresis, fever, poor sucking, tremors, and seizures

For what reason might a nurse administer androgen injections to a school-age boy?

hypogonadism

The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs:

in the middle to outer portion of the fallopian tube.

A woman who is breastfeeding her newborn reports that her breasts seem quite full. Assessment reveals that her breasts are engorged. Which factor would the nurse identify as the most likely cause for this development?

inability of infant to empty breasts

A woman who is 10 weeks pregnant arrives at the emergency department reporting vaginal bleeding and cramping. She states, "I've passed some small clots." Inspection of the perineal pad reveals moderate bleeding and some tissue. The client's cervix is dilated. The nurse interprets these findings as indicative of which of the following?

incomplete abortion

A nurse is caring for a pregnant client who is in labor. Which maternal physiologic responses should the nurse monitor for in the client as the client progresses through birth? Select all that apply.

increase in respiratory rate increase in heart rate increase in blood pressure

A nurse completes the initial assessment of a newborn. According to the due date on the antenatal record, the baby is 12 days postmature. Which of the following physical findings contradicts the estimated gestational age of the newborn?

increased amounts of vernix

A nurse completes the initial assessment of a newborn. According to the due date on the antenatal record, the baby is 12 days' postmature. Which physical finding does not confirm that this newborn is 12 days' postmature?

increased amounts of vernix Vernix caseosa is a whitish substance that serves as a protective covering over the fetal body throughout the pregnancy. Vernix usually disappears by term gestation. It is highly unusual for a 12-day postmature baby to have increased amounts of vernix

A nursing instructor is teaching students about fetal presentations during birth. The most common cause for increased incidence of shoulder dystocia is:

increasing birth weight

The increase in thickness of the endometrial layer during the first half of the menstrual cycle is controlled by the:

increasing level of estrogen

An expectant mother has arranged for her massage therapist to provide gentle hand, arm, and neck massage for the client while she is in labor in the hospital. Which trend in today's health care environment is most related to this arrangement?

increasing use of alternative treatment modalities

transverse fetal lie

indicates fetus is lying transversely in the uterus, horizontal, or perpendicular to the maternal sagittal axis

A client appears to be resting comfortably 12 hours after giving birth to her first child. In contrast, she labored for more than 24 hours, the primary care provider had to use forceps to deliver the baby, and she had multiple vaginal examinations during labor. Based on this information what postpartum complication is the client at risk for developing?

infection

The nurse is caring for a postpartum client with an episiotomy. The nurse assesses the client closely for what complication that the client is at greatest risk of developing?

infection An episiotomy involves cutting the perineum to accommodate the fetus, which can result in infection at the incision site.

A 30-year-old client asks the nurse about risk factors for ovarian cancer. Which risk factor should be included in client education?

infertility

A 15-year-old male client reports severe pain in the inguinal area and nausea. What action does the nurse take first?

inspect the client's genitalia

The nurse is caring for a client at 36 weeks' gestation with a temperature of 101.2°F (38.4°C). Examination indicates that the client is leaking amniotic fluid. What is the nurse's priority concern based on these findings?

intrauterine infection

The nurse is caring for a client at 36 weeks' gestation with a temperature of 101.2°F (38.4°C). Examination indicates that the client is leaking amniotic fluid. What is the nurse's priority concern based on these findings?

intrauterine infection Fever and premature rupture of membranes aren't normal findings in labor

First-degree laceration

involves only skin and superficial structures above muscle;

A nurse is planning care for an adolescent client who is 12 weeks' gestation. The nurse will monitor this client closely for the development of which complication during this stage of the pregnancy?

iron-deficiency anem

During the assessment of a woman in labor, the nurse explains that certain landmarks are used to determine the progress of the birth. The nurse identifies which area as one of these landmarks?

ischial spine

At 36 weeks' gestation, the fundus can be palpated

just below the ensiform cartilage.

The expert nurse is assisting a novice nurse insert a Foley catheter. The novice nurse has tried unsuccessfully to insert the catheter, and the expert nurse is providing verbal guidance while spreading which area to reveal the urethral opening?

labia majora and minora

An examination of the external genitalia of a female would concentrate on which structures? Select all that apply.

labia minora clitoris

The nurse is reviewing the role of the mammary glands in the reproductive process with a birth class. What should the nurse tell the class is the name of the ducts in the mammary glands that form a small reservoir for milk?

lactiferous

the name of the ducts in the mammary glands that form a small reservoir for milk?

lactiferous

A woman in labor who is receiving an opioid for pain relief is to receive promethazine. The nurse determines that this drug is effective when the woman demonstrates which finding?

less anxiety

A nursing student has learned that precipitous labor is when the uterus contracts so frequently and with such intensity that a very rapid birth will take place. This means the labor will be completed in which span of time?

less then 3 hours

Which statement best captures an aspect of the role of progesterone? Progesterone:

levels peak after ovulation and is present throughout the menstrual cycle.

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply

low platelet count hemolysis elevated liver enzymes

A primary care provider prescribes intravenous tocolytic therapy for a woman in preterm labor. Which agent would the nurse expect to administer?

magnesium sulfate

The cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to:

maintain testicular temperature

The nurse is caring for an older adult client following bilateral castration as part of testicular cancer treatment. The client asks the nurse what physical changes he can expect because of this surgery. The nurse explains the client can expect which effects?

maintenance of normal male characteristics

hypertonic contractions

marked by an increase in resting tone to more than 15 mm Hg. However, the intensity of the contraction may be no stronger than that associated with hypotonic contractions. In contrast to hypotonic contractions, these occur frequently and are most commonly seen in the latent phase of labor

The nurse going back to school for nurse midwifery can trace education for nurse midwifery to which nursing leader?

mary breckenridge

Between 18 and 32 weeks gestation, the fundal height in centimeters should

match the gestational age

An 18-year-old pregnant woman asks why she has to have a routine alpha-fetoprotein serum level drawn. You explain that this

may reveal chromosomal abnormalities.

The nurse is explaining the latest laboratory results to a pregnant client who is in her third trimester. After letting the client know she is anemic, which heme iron-rich foods should the nurse encourage her to add to her diet?

meats

Which symptom would most accurately indicate that a newborn has experienced meconium aspiration during the birth process?

meconium stained fluids followed by tachypnea

Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction?

medication use

Polycystic ovary syndrome is an endocrine disorder and a common cause of chronic anovulation. In addition to the clinical manifestations of PCOS, long-term health problems, including cardiovascular disease and diabetes, have been linked to PCOS. What drug has emerged as an important part of PCOS treatment?

metformin

A client at 6-weeks' gestation comes to the emergency department, and a transvaginal ultrasound confirms ectopic pregnancy with the tube intact. The client will be treated medically. What medication will the nurse prepare to administer to this client?

methotrexate

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

metronidazole

facial change characteristic in a neonate with fetal alcohol spectrum disorder?

microcephaly

At 16 weeks' gestation, the fundus can be palpated

midway between the symphysis pubis and umbilicus

A nurse is providing care to a client with uterine fibroids who is prescribed a progestin antagonist. Which medication would the nurse most likely expect the client to receive?

mifepristone

An adolescent girl comes to the clinic and reports occasional pain on one side of the abdomen which goes away with acetaminophen. What do these symptoms indicate?

mittelschmerz

A postpartum client visits her physician to discuss contraception. After a thorough discussion, the client decides to use hormonal contraceptives. The healthcare professional orders ethinyl estradiol-ethynodiol diacetate, one tablet by mouth daily, followed by 7 days without a dose before beginning the next cycle of tablets. Which type of combination hormonal contraceptive is ethinyl estradiol-ethynodiol diacetate?

monophasic

Ethinyl estradiol-ethynodiol diacetate is a

monophasic

menses

monthly period

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition?

mother age 42 with pregnancy Explanation: Advanced maternal age is a risk factor for cleft lip and palate

Which condition is a risk factor for the development of pelvic inflammatory disease (PID)?

multiple sexual partners

Which of the following nursing assessment findings would be most significant in determining sterility in a male client?

mumps at age 15 years

Which of the following nursing assessment findings would be most significant in determining sterility in a male client?

mumps at age 15 years Viral mumps infection that occurs after puberty can be the cause of orchitis, which may result in testicular atrophy and sterility

A full-term neonate delivered an hour after the mother received IV meperidine is showing signs of respiratory depression. The nurse should be prepared to administer which medication?

naloxone

A 21-year-old woman is prescribed an oral contraceptive pill to prevent pregnancy. The nurse should inform the client of which adverse effects of this medication?

nausea

An infant at 33 weeks' gestation dies after 1 week of life in the neonatal intensive care unit. This infant's death rate would be classified under which statistical category?

neonatal death The neonatal death rate is the number of deaths of an infant in the first 28 days of life. Gestational age is not a consideration when reporting deaths of infants. The other categories are not classifications for reporting infant deaths.

macrosomia

newborn weighs 4,000 to 4,500 g (8.13 to 9.15 lb) or more at birth

After receiving large doses of an ovulatory stimulant such as menotropins, a client comes in for her office visit. Assessment reveals the following: 6-lb (3-kg) weight gain, ascites, and pedal edema. Based on this assessment, what should the nurse do next?

notify the healthcare provider Ovarian hyperstimulation syndrome is caused by an excessive response to the medications used to produce eggs and make them grow.leading to fluid leaks in the abdomen.

A nurse caring for a pregnant client suspected substance use during pregnancy. What is the priority nursing intervention for this client?

obtain urine specimen for screening

Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting?

occiput

A pregnant woman at 37 weeks gestation calls the clinic to say she thinks that she is in labor. The nurse instructs the woman to go to the health care facility based on the client's report of contractions that are:

occurring about every 5 minutes.

Rectocele

occurs when the rectum sags and pushes against or into the posterior vaginal wall

Enterocele

occurs when the small intestine bulges through the posterior vaginal wall (especially common when straining)

uterine prolapse

occurs when the uterus descends through the pelvic floor and into the vaginal canal.

A client has expressed her desire to give birth with minimal intervention. She is now moving into the active phase of labor. What intervention by the nurse would be the priority of care?

offering support by reviewing the short-pant form of breathing

ovulation typically occurs

on day 14

A nurse is caring for a premenopausal client who had precancerous cells found during a routine Papanicolaou (Pap) test. At which time during the menstrual cycle would the nurse schedule a cervical biopsy?

one week after the end of the menstrual period

A postmenopausal woman is administered estradiol for the purpose of preventing which condition?

osteoporosis

Medroxyprogesterone is an effective form of birth control. Long-term use can cause what serious adverse effect?

osteoporosis

menopause screening

osteoporosis, cardiovascular disease, and cancer risk

A nursing student is studying gynecological cancers and is excited when she reads that birth control pills can have a positive effect on preventing which disease?

ovarian cancer Explanation: Risk-reduction strategies for preventing ovarian cancer include pregnancy, use of oral contraceptives, and breastfeeding. No research states that oral contraceptives help to prevent the other cancers.

The nurse is admitting a client with a suspected diagnosis of abruptio placentae. Which assessment data would require the nurse to notify the healthcare provider immediately? Select all that apply.

overt vaginal bleeding a rigid abdomen decreased blood pressure increased heart rate

The nurse teaches a pregnant woman about breast-feeding, stating that stimulation of the breast through sucking or touching stimulates the secretion of which hormone?

oxytocin

Four P's of labor

passage, passenger, power, psyche

A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have?

passive immunity

Which is the first step in establishing a pattern of inheritance?

pedigree

A positive chandelier sign is indicative of which of the following

pelvic infection

Which pelvic measurement is most important for the acceptance and passage of the fetal head during labor?

pelvic inlet

The nurse working in the genitourinary clinic understands that the most common cause for women suffering from urinary incontinence is:

pelvic organ prolapse (POP).

The nurse is admitting a client at 23 weeks' gestation in preparation for induction and delivery after it was determined the fetus had died secondary to trauma. When asked by the client to explain what went wrong, the nurse can point out which potential cause for this loss?

placental abruption The most common cause of fetal death after a trauma is placental abruption, where the placenta separates from the uterus, and the fetus is not able to survive

Norplant system

plan B

Phallic Stage (3-6 years)

pleasure zone is the genitals; coping with incestuous sexual feelings

Most human traits are determined by multiple pairs of genes, many with alternate codes, accounting for some dissimilar forms that occur with certain genetic disorders. What type of inheritance involves multiple genes at different loci, with each gene exerting a small additive effect in determining a trait?

polygenic inheritance

A nurse is educating a group of nursing students about the molding of the fetal skull during the birth process. What would the nurse include as the usual cause of molding?

poorly ossified bones of the cranial vault

The nurse is caring for a woman who gave birth vaginally to a healthy 6 pound (2.72 kg) newborn after a 2-hour labor at 37 weeks gestation. For which complication will the nurse assess as a priority due to the increased risk in this client?

postpartum hemorrage

When caring for a client requiring a forceps-assisted birth, the nurse would be alert for:

potential lacerations and bleeding

preclampsia

pregnancy induced hypertension

A client has been prescribed clomiphene. What outcome best indicates successful therapy?

pregnancy occurs

Early in pregnancy, frequent urination results mainly from which cause?

pressure on the bladder

Which hormone is called the hormone of pregnancy because it reduces uterine contractions during pregnancy?

progesterone

A patient reports menstrual cramps. The nurse understands that this is due to:

prostaglandins. Explanation: Prostaglandins in the uterus stimulate uterine contraction to clamp off vessels as the lining sheds away during menstruation. This causes menstrual cramps.

Screening for which disease process should be done prior to beginning testosterone replacement therapy?

prostate cancer

anal stage

psychosexual stage that focuses on toilet training

A client with advanced vaginal cancer asks the nurse, "What is the usual treatment for this type of cancer?" Which treatment should the nurse name?

radiation

The nurse is caring for a client on her second postpartum day. The nurse should expect the client's lochia to be

red and moderate

duration

refers to how long a contraction lasts and is measured from the beginning of one contraction to the end of that same contraction.

frequency

refers to how often the contractions occur and is measured from the beginning of one contraction to the beginning of the next contraction.

intensity

refers to the strength of the contraction determined by manual palpation or measured by an internal intrauterine pressure catheter

A nurse is explaining to a pregnant client about the changes occurring in the body in preparation for labor. Which hormone would the nurse include in the explanation as being responsible for causing the pelvic connective tissue to become more relaxed and elastic?

relaxin

The nurse is preparing to administer a prescribed medication to the pregnant client. Which order should the nurse question?

rubella

Which client immunization titer is most important to assess and document in the prenatal record of the pregnant woman?

rubella

Medications in pregnancy category A are considered

safe

After ovulation, the mucus will be

scant, thick and opaque in nature

HIV). What body fluids does the nurse inform them will transmit the virus

semen breast milk blood vaginal secretions

A couple comes to the clinic and states to the nurse, "I don't think we are ever going to be able to have children. We have been trying but have had no luck." What assessments does the nurse anticipate will be performed for this couple? Select all that apply.

semen analysis ovulation monitoring tubal patency

Select the structure responsible for secreting fructose that will provide energy for spermatic motility.

seminal vesicles

Preconception screening

sickle cell anema and cystic fibrosis

The nurse is preparing the client for the administration of an enema. The nurse will place the client into which position?

sims

Ultrasonography is most likely to detect which fetal abnormality?

skeletal abnormalities

A nurse is assisting with the pelvic examination of a female client. The client has given birth to two living children, ages 5 and 2 years. The nurse would expect the client's cervical os to appear as which shape on examination?

slit-like

While explaining the individual differences in physical traits in the family group, the health care provider states this is usually a result of:

small DNA sequence variation.

oral contraceptives

smoking increases the risks and transdermal contraceptive patch

Goodell sign

softening of the cervix

Hegar's sign

softening of the lower uterine segment

hegar sign

softening of the lower uterine segment

At the end of the first trimester (12 weeks' gestation)

some reflexes are present, kidney secretion begins, the heartbeat can be heard by Doppler, and the sex of the infant is distinguishable by outward appearance. The bones continue to ossify. The baby continues to be vulnerable to toxins during the entire pregnancy.

While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males this hormone is responsible for the:

sperm production

neural tube defects

spina bifida and anencephaly

A 44-year-old client has lost several pregnancies over the last 10 years. For the past 3 months, she has had fatigue, nausea, and vomiting. She visits the clinic and takes a pregnancy test; the results are positive. Physical examination confirms a uterus enlarged to 13 weeks' gestation; fetal heart tones are heard. Ultrasound reveals that the client is experiencing some bleeding. Considering the client's prenatal history and age, what does the nurse recognize as the greatest risk for the client at this time?

spontaneous abortion (miscarriage)

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

syphilis

Painless chancres or ulcerated lesions are associated with which systemic disease?

syphillis

During the proliferative phase before ovulation the mucus will be

tacky, crumbly, and yellow or white in color

Which should be included as part of the home care instructions for a client with epididymitis and orchitis?

take prescribed antibiotics

A nurse is providing care to a postpartum woman during the immediate postpartum period. The nurse recognizes that the mother will need assistance with meeting her basic needs based on the understanding that the mother is most likely in which phase?

taking-in phase During the first 24 to 48 hours after giving birth, mothers often assume a very passive and dependent role in meeting their own basic needs, and allow others to take care of them. This is referred to as the taking-in phase. The taking-hold phase occurs when the client begins to assume control over her bodily functions. She is also showing strong interest in caring for the infant by herself. The letting-go phase occurs when the woman has assumed the responsibility for caring for herself and her infant.

Five days postpartum following an uneventful vaginal delivery, a client phones the obstetrician's office stating various symptoms and requesting an appointment. As the nurse is documenting symptoms, which ones indicate a potential puerperal infection? Select all that apply.

temperature of 100.8° F (38.2° C) frequent abdominal pain requiring medication reddened area increasing around episiotomy The nurse must analyze normal symptoms following birth (5 days postpartum) and abnormal symptoms that may indicate a puerperal infection. Abnormal symptoms include a temperature over 100.8° F or 38.2° C, abdominal pain, and increasing reddened area around the episiotomy

Dinoprostone

terminates pregnancy's from 12-20 weeks

An older adult female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms?

tertiary syphillis

A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. His pulse rate is 120 beats/min. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects:

testicular torsion

A nurse is assessing the following antenatal clients. Which client is at highest risk for having a multiple gestation?

the 41-year-old client who conceived by in vitro fertilization The nurse should assess infertility treatment as a contributor to increased probability of multiple gestations. Multiple gestations do not occur with an adolescent birth; instead, chances of multiple gestations are known to increase due to the increasing number of women giving birth at older ages.

A 19-year-old female presents in advanced labor. Examination reveals the fetus is in frank breech position. The nurse interprets this finding as indicating:

the buttocks are presenting first with both legs extended up toward the face.

What client should the nurse assess most closely to determine whether sexual activity will be safe?

the client with a cardiovascular disease

The nurse is assisting a primigravid on calculating the due date of her baby using Naegele's rule. The most important information provided by the mother is:

the first day of the last menstrual period.

menarche

the first menstrual period

latency stage

the fourth psychosexual stage, in which the primary focus is on the further development of intellectual, creative, interpersonal, and athletic skills

A nurse is caring for a young female adult client diagnosed with atrial fibrillation who has just had a mitral valve replacement. The client is being discharged with prescribed warfarin. The client mentions to the nurse that she relies on the rhythm method for birth control. What education will be a priority for the nurse to provide to this client?

the high risk for complications if she becomes pregnant while taking warfarin

A client and her partner, both 25 years old, are having trouble conceiving. Infertility in this couple is defined as:

the inability to conceive after 1 year of unprotected attempts.

amniocentesis

the sampling of amniotic fluid using a hollow needle inserted into the uterus, to screen for developmental abnormalities in a fetus.

A client who is 6 weeks' pregnant comes to the clinic for her first prenatal visit. What is the most immediate need for the nurse to address for this client?

the schedule of prenatal visits

tertiary prevention

the stage in preventive stress management designed to heal individual or organizational symptoms of distress and strain

Identifying specific features of the newborn is typical of

the taking in phase

perimenopause

the term used to designate the transition phase between regular menstrual periods and no periods at all

In preparing for a preconception class, the nurse plans to include a discussion of potential risk factors. Which risk factor would be most important to include?

the use of OTC drugs with teratogens

The client, who has just been walking around her room, sits down and reports leg tightness and achiness. After resting, she states she is feeling much better. The nurse recognizes that this discomfort could be due to which cause?

thromboembolic disorder of the lower extremities

When teaching the client how to use a contraceptive sponge, the nurse must tell the client that leaving the sponge in place longer than 30 hours may lead to

toxic shock syndrome.

A client with a pendulous abdomen and uterine fibroid tumors has just begun labor and arrived at the hospital. After examining the client, the primary care provider informs the nurse that the fetus appears to be malpositioned in the uterus. Which fetal position or presentation should the nurse most expect in this woman?

transverse lie in which the fetus is more horizontal than vertical, occurs in the following instances: women with pendulous abdomens; uterine fibroid tumors that obstruct the lower uterine segment; contraction of the pelvic brim; congenital abnormalities of the uterus; or hydramnios. Anterior fetal position and cephalic presentation are normal conditions. Occipitoposterior position tends to occur in women with android, anthropoid, or contracted pelvis.

A client with a pendulous abdomen and uterine fibroid tumors has just begun labor and arrived at the hospital. After examining the client, the primary care provider informs the nurse that the fetus appears to be malpositioned in the uterus. Which fetal position or presentation should the nurse most expect in this woman?

transverse lie A transverse lie, in which the fetus is more horizontal than vertical, occurs in the following instances: women with pendulous abdomens

Select the condition that contributes to the risk of infertility in males

trichomoniasis

Mendelian, or single-gene, patterns of inheritance include autosomal dominant and recessive traits that are transmitted from parents to their offspring in a predictable manner. A recessive trait occurs when:

two copies (homozygous) of the recessive allele are present.

A client was in labor for more than 36 hours and now reports urine leaking from her vagina. On examination the nurse would be inspecting for:

urethrovaginal fistula.

A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy?

use of IUD for contraception

Clomiphene

used in infertility to induce ovulation

A nurse decides to perform fundal massage based on findings that support which condition?

uterine atony

Which factor puts a client on her first postpartum day at risk for hemorrhage?

uterine atony

A nurse decides to perform fundal massage based on findings that support which condition?

uterine atony Fundal massage is performed for uterine atony, which is failure of the uterus to contract and retract after birth.

The nurse is making a home visit to a woman who is 4 days postpartum. Which finding would indicate to the nurse that the woman is experiencing a problem?

uterus 1 cm below umbilicus

A group of students are reviewing the female reproductive system in preparation for a test. Which of the following if identified by the students as an internal structure indicates successful learning?

vagina

A nurse is teaching a group of women at the local health clinic about reproduction. After describing the various internal structures involved, the nurse determines that the teaching was successful when the group identifies which structure as connecting the external structures with the cervix?

vagina

The nurse is interviewing a postmenopausal client during an annual gynecologic exam. Which assessment finding presents the greatest concern in the care of this client?

vaginal bleeding Explanation: Vaginal bleeding in a client after menopause is abnormal and a predominant symptom for vaginal cancers.

A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply.

vaginal douching approximately once a week multiple sex partners intrauterine contraceptive device inserted 3 weeks ago

A nurse is caring for a client who has been prescribed gonadotropin-releasing hormone (GnRH) medication for uterine fibroids. For which side effect of GnRH medications should the nurse monitor the client?

vaginal dryness

A nurse is completing a continuing education program about the male and female reproductive organs. After reviewing the information, the nurse demonstrates understanding of the information by identifying which structures as male accessory organs? Select all that apply.

vas deferens bulbourethral glands prostate gland

Breast engorgement occurs on the second or third postpartum day in both breast-feeding and non-breast-feeding mothers. Which process causes engorgement?

vasodilation, which causes the breast to feel full

multigravida

woman who has been pregnant more than once

The nurse is caring for a group of hospitalized clients who require dietary prescriptions for their conditions. For which of these does the nurse encourage a diet with increased caloric intake? Select all that apply.

• Burn injury • Post-operative • Fever • Pregnant woman