Womens health issues saunders

70. Women who are on hormone replacement therapy (HRT) for an extended period of time have been shown to be high risk for which of the following complications? 1. Endometrial cancer. 2. Gynecomastia. 3. Renal dysfunction. 4. Mammary hypertrophy.

1. Endometrial cancer. Women on HRT are high risk for gynecological cancers, especially endometrial and breast cancers.

58. The nurse has provided a single, perimenopausal woman, G3 P2012, with contracep- tive counseling. The woman has four sex partners and smokes 1 pack of cigarettes per day. Which of the following methods is best suited for this client? 1. Male condom. 2. Intrauterine device. 3. NuvaRing. 4. Oral contraceptives.

1. Male condom.

66. A woman is taking Fosamax (alendronate) for osteoporosis. The nurse should advise the woman about which of the following when taking the medication? 1. Remain upright for 30 minutes after taking the medication. 2. Take only after eating a full meal. 3. Take medication in divided doses 3 times each day. 4. Do not break or crush the tablet.

1. Remain upright for 30 minutes after taking the medication. This is a true statement. Clients are to take the medication on an empty stomach, immediately after awakening and remain upright for at least 30 minutes. Esophageal irritation, ulceration, and erosions can develop when the medication is taken improperly.

18. Which of the following sexually transmitted infections is characterized by a foul- smelling, yellow-green discharge that is often accompanied by vaginal pain and dyspareunia? 1. Syphilis. 2. Herpes simplex. 3. Trichomoniasis. 4. Condylomata acuminata.

3. Trichomoniasis. Trichomoniasis is characterized by a yellowish green, foul-smelling discharge. Trichomoniasis is a sexually transmitted infection caused by a protozoan. Women who develop the infection during pregnancy may develop preterm labor. Women who are infected with trichomoniasis have an increased risk of contracting HIV if exposed

16. A woman, seen in the emergency department, is diagnosed with pelvic inflammatory disease (PID). Before discharge, the nurse should provide the woman with health teaching regarding which of the following? 1. Endometriosis. 2. Menopause. 3. Ovarian hyperstimulation. 4. Sexually transmitted infections.

4. Sexually transmitted infections. PID usually occurs as a result of an as- cending sexually transmitted infection. The most common organisms to cause PID are the organisms that cause gonorrhea and chlamydia.

15. Four women who use superabsorbent tampons during their menses are being seen in the medical clinic. The woman with which of the following findings would lead the nurse to suspect that the woman's complaints are related to her use of tampons rather than to an unrelated medical problem? 1. Diffuse rash with fever. 2. Angina. 3. Hypertension. 4. Thrombocytopenia with pallor.

1. Diffuse rash with fever. A diffuse rash with fever should be taken very seriously. These are symptoms of toxic shock syndrome (TSS).

17. A woman has contracted herpes simplex 2 for the first time. Which of the following signs/symptoms is the client likely to complain of? 1. Flu-like symptoms. 2. Metrorrhagia. 3. Amenorrhea. 4. Abdominal cramping.

1. Flu-like symptoms. The initial infection of herpes simplex 2 is often symptom free but, if symp- toms do occur, the client may complain of flu-like symptoms as well as vesicles at the site of the viral invasion.

38. The nurse is working with a client who states that she has multiple sex partners. Which of the following contraceptive methods would be best for the nurse to recom- mend to this client? 1. Intrauterine device. 2. Female condom. 3. Bilateral tubal ligation. 4. Birth control pills.

2. Female condom. The key to answering this question is the fact that the client has multiple sex partners. The client is high risk for becoming pregnant, but as impor- tant is also high risk for acquiring a sexu- ally transmitted infection.

71. The nurse is counseling a woman who has been diagnosed with mild osteoporosis. Which of the following lifestyle changes should the nurse recommend? Select all that apply. 1. Eat yellow and orange vegetables. 2. Go on daily walks. 3. Stop smoking. 4. Consume dairy products. 5. Sleep at least eight hours a night.

2. Go on daily walks. 3. Stop smoking. 4. Consume dairy products.

25. An asymptomatic woman is being treated for HIV infection at the women's health clinic. Which of the following comments by the woman shows that she understands her care? 1. "If I get pregnant, my baby will be HIV positive." 2. "I should have my viral load and antibody levels checked every day." 3. "Since my partner and I are both HIV positive, we use a condom." 4. "To be safe, my partner and I engage only in oral sex."

3. "Since my partner and I are both HIV positive, we use a condom."

48. A breastfeeding woman is requesting that she be prescribed Seasonale (ethinyl estra- diol and levonorgestrel) as a birth control method. Which of the following informa- tion should be included in the patient teaching session? 1. The woman will menstruate every 8 to 9 weeks. 2. The pills are taken for 3 out of every 4 weeks. 3. Breakthrough bleeding is a common side effect. 4. Breastfeeding is compatible with the medication.

3. Breakthrough bleeding is a common side effect. Women who wish to breastfeed can take some types of birth control pills (BCPs), but not pills that contain an estrogen medication. Seasonale contains an estrogen. Estrogen inhibits milk production. If they wish to take BCPs, breastfeeding women should take progestin-only pills.

64. The nurse met four clients in the family planning clinic today. It would be most appropriate for the nurse to recommend the intrauterine device (IUD) to which of the clients? 1. Unmarried, 22-year-old, recent college graduate. 2. Married, 24-year-old, G0 P0000. 3. Unmarried, 25-year-old, history of chlamydia. 4. Married, 26-year-old, G3 P2102.

4. Married, 26-year-old, G3 P2102. This client is in a stable relationship and has had children. She is the best candidate for the IUD.

61. A nurse is providing contraceptive counseling to a perimenopausal client, G3 P2012, who is in a monogamous relationship. Which of the following comments by the woman indicates that further teaching is needed? 1. "The calendar method is the most reliable method for me to use." 2. "If I use the IUD, I am at minimal risk for pelvic inflammatory disease." 3. "I should still use birth control even though I had only 2 periods last year." 4. "The contraceptive patch contains both estrogen and progesterone."

1. "The calendar method is the most reliable method for me to use." This is not true. The menstrual cycle of perimenopausal women is very irregular. It is very difficult to identify safe and unsafe periods for these women.

33. A woman has a history of toxic shock syndrome. Which of the following forms of birth control should she be taught to avoid? Select all that apply. 1. Diaphragm. 2. Intrauterine device. 3. Birth control pills (estrogen-progestin combination). 4. Contraceptive sponge. 5. Depo-Provera (medroxyprogesterone acetate).

1. Diaphragm. 3. Birth control pills (estrogen-progestin combination). TSS is associated with women who use tampons, especially superabsorbent tampons, and those who use barrier types of contraceptives.

13. A woman is noted to have multiple soft warts on her perineum and rectal areas. The nurse suspects that this client is infected with which of the following sexually trans- mitted infections? 1. Human papillomavirus (HPV). 2. Human immunodeficiency virus (HIV). 3. Syphilis. 4. Trichomoniasis.

1. Human papillomavirus (HPV). Human papillomavirus (HPV) is char- acterized by flat warts on the vaginal and rectal surfaces. HIV/AIDS is characterized by nonspecific symptoms like weight loss, dry cough, and fatigue. Primary syphilis is characterized by a non- painful lesion, called a chancre. Trichomoniasis is characterized by a yel- lowish green vaginal discharge that usually has a very strong, offensive odor.

63. Which of the following clients, who are all seeking a family planning method, is the best candidate for birth control pills? 1. 19-year-old with multiple sex partners. 2. 27-year-old who bottle feeds her newborn. 3. 29-year-old with chronic hypertension. 4. 37-year-old who smokes one pack per day.

2. 27-year-old who bottle feeds her newborn. Birth control pills that contain both estrogen and progesterone are inappropriate for clients who breast- feed because the estrogen inhibits milk production. There is no such contraindi- cation for mothers who bottle feed. It is important to remember, however, that women who breastfeed can use progestin-only pills.

69. A woman states that she feels "dirty" during her menses so she often douches to "clean myself." The nurse advises the woman that it is especially important to refrain from douching while menstruating because douching will increase the likelihood of her developing which of the following gynecological complications? 1. Fibroids. 2. Endometritis. 3. Cervical cancer. 4. Polyps.

2. Endometritis. The act of douching can cause serious gynecological infections up to and including PID. When a woman douches she disrupts the normal flora in her vagina. Pathogens can then invade the area and be pushed upward into the upper gynecological system.

53. A woman is using the contraceptive sponge as a birth control method. Which of the following actions is it important for her to perform to maximize the sponge's effectiveness? 1. Insert the sponge at least one hour before intercourse. 2. Thoroughly moisten the sponge with water before inserting. 3. Spermicidal jelly must be inserted at the same time the sponge is inserted. 4. A new sponge must be inserted every time a couple has intercourse.

2. Thoroughly moisten the sponge with water before inserting.

37. The nurse teaches a couple that the diaphragm is an excellent method of contraception providing that the woman does which of the following? 1. Does not use any cream or jelly with it. 2. Douches promptly after its removal. 3. Leaves it in place for 6 hours following intercourse. 4. Inserts it at least 5 hours prior to having intercourse.

3. Leaves it in place for 6 hours following intercourse. The diaphragm should be left in place for at least 6 hours after intercourse has ended. It is recommended that women not douche unless medically advised to do so.

50. A postpartum woman is using the lactational amenorrhea method of birth control. The nurse should advise the client that the method is effective only if which of the following conditions is present? Select all that apply. 1. Being less than 6 months postpartum. 2. Being amenorrheic since delivery of the baby. 3. Supplementing with formula no more than once per day. 4. Losing less than 10% of weight since delivery. 5. Sleeping at least 8 hours every night.

1. Being less than 6 months postpartum. 2. Being amenorrheic since delivery of the baby.

43. A woman is being issued a new prescription for a low-dose combination birth control pill. What advice should the nurse give the woman if she ever forgets to take a pill? 1. Take it as soon as she remembers, even if that means taking two pills in one day. 2. Skip that pill and refrain from intercourse for the remainder of the month. 3. Wear a pad for the next week because she will experience vaginal bleeding. 4. Take an at-home pregnancy test at the end of the month to check for a pregnancy.

1. Take it as soon as she remembers, even if that means taking two pills in one day. This is correct. To maintain the hormonal levels in the bloodstream, the woman should take the pill as soon as she remembers.

39. A woman has gotten pregnant with a Copper T intrauterine device (IUD) in place. The physician has ordered an ultrasound to be done to evaluate the pregnancy. The client asks the nurse why this is so important. The nurse should tell the woman that the ultrasound is done primarily for which of the following reasons? 1. To assess for the presence of an ectopic pregnancy. 2. To check the baby for serious malformations. 3. To assess for pelvic inflammatory disease. 4. To check for the possibility of a twin pregnancy.

1. To assess for the presence of an ectopic pregnancy. When pregnancy occurs with an IUD in place, an ectopic pregnancy should be ruled out. Symptoms of PID are not similar to those of early pregnancy. The most common symptoms of PID are abdominal pain, dyspareunia, foul-smelling vaginal dis- charge or bleeding, and fever.

52. Four women with significant health histories wish to use the diaphragm as a contra- ceptive method. The nurse should counsel the woman with which of the following histories that the diaphragm may lead to a recurrence of her problem? 1. Urinary tract infections. 2. Herpes simplex infections. 3. Deep vein thromboses. 4. Human papilloma warts.

1. Urinary tract infections. Because the lip of the diaphragm must be inserted under the symphysis, the woman's urethra is some- times pinched. This makes it difficult to completely empty the bladder when uri- nating. As a result, the woman is high risk for developing urinary tract infections.

55. The nurse has given postvasectomy teaching to a client. Which of the following responses by the client indicates that the teaching was effective? 1. "I will measure my urinary output for two days." 2. "I will ejaculate the same amount of semen as I did before the surgery." 3. "I will refrain from having an erection until next week." 4. "I will irrigate the wound twice today and once more tomorrow."

2. "I will ejaculate the same amount of semen as I did before the surgery." The vas deferens is ligated during a vasectomy.

68. A client asks a nurse to express an opinion on the value of taking hormone replace- ment therapy (HRT). The nurse should be aware that it is recognized that HRT is effective in which of the following situations? 1. No woman should ever take hormone replacement therapy. 2. Women experiencing severe menopausal symptoms. 3. Women with severe coronary artery disease. 4. Women with a history of breast cancer.

2. Women experiencing severe menopausal symptoms. Women who are experiencing severe menopausal symptoms can benefit from HRT therapy. However, it is recommended that they not be on the medication for an extended period of time.

40. An adolescent woman confides to the school nurse that she is sexually active. The young woman asks the nurse to recommend a "very reliable" birth control method, but she refuses to be seen by a gynecologist. Which of the following methods would be best for the nurse to recommend? 1. Contraceptive patch. 2. Withdrawal method. 3. Female condom. 4. Contraceptive sponge.

3. Female condom. The female condom is about 95% effective as a contraceptive device and is also effective as an infection-control device.

45. What is essential for the nurse to teach a woman who has just had an intrauterine de- vice (IUD) inserted? 1. Palpate her lower abdomen each month to check the patency of the device. 2. Remain on bed rest for 24 hours after insertion of the device. 3. Report any complaints of painful intercourse to the physician. 4. Insert spermicidal jelly within 4 hours of every sexual encounter.

3. Report any complaints of painful intercourse to the physician. The sudden onset of dyspareunia can indicate the development of PID. The client should be examined to determine whether or not she has developed an infection.

90. A nurse is caring for a client who states that she is a lesbian. Which of the following should the nurse consider when caring for this client? 1. Lesbian women are usually less sexually active than straight women. 2. Lesbian women need not be asked about domestic violence issues. 3. Lesbian women should be tested for cervical cancer every three to seven years. 4. Lesbian women are at higher risk for bacterial vaginosis than are straight women.

4. Lesbian women are at higher risk for bacterial vaginosis than are straight women. This statement is true, although the precise reason for the high incidence of bacterial vaginosis in gay women is unknown.

29. A man has been diagnosed with a chlamydial infection. The nurse would expect the client to complain of pain at which of the following times? 1. When urinating. 2. When ejaculating. 3. When the penis becomes erect. 4. When the testicles are touched.

1. When urinating. Men infected with Chlamydia often complain of pain on urination. Because chlamydia is usually a silent infection in women, it is often their male partners who are first identified as being infected because they complain of painful urination.

24. After a sex education class, the school nurse overhears an adolescent woman discussing safe sex practices. Which of the following comments by the young woman indicates that teaching about infection control was effective? 1. "I don't have to worry about getting infected if I have oral sex." 2. "Teen women are most high risk for sexually transmitted infections (STI)." 3. "The best thing to do if I have sex a lot is to use spermicide each and every time." 4. "Boys get human immunodeficiency virus (HIV) easier than girls do."

2. "Teen women are most high risk for sexually transmitted infections (STI)."

6. A client has been diagnosed with pubic lice. Which of the following signs/symptoms would the nurse expect to see? 1. Macular rash on the labia. 2. Pruritus. 3. Hyperthermia. 4. Foul-smelling discharge.

2. Pruritus. Pruritus is, by far, the most common symptom of pubic lice. Pubic lice, not to be confused with head lice, are commonly called crabs. They are insects, usually sexually transmitted, that invade the pubic hair. Although they are not the same as head lice, the pubic infestation is treated with the same pediculicidal shampoos.

23. A woman has been diagnosed with syphilis. Which of the following nursing interven- tions is appropriate? 1. Council the woman about how to live with a chronic infection. 2. Question the woman regarding symptoms of other sexually transmitted infections. 3. Assist the primary health care practitioner with cryotherapy procedures. 4. Educate the woman regarding the safe disposal of menstrual pads.

2. Question the woman regarding symptoms of other sexually transmitted infections. Any time someone is infected with one sexually-transmitted infection (STI), it is recommended that he or she be assessed for other STIs.

19. The nurse is educating a group of adolescent women regarding sexually transmitted infections (STIs). The nurse knows that learning was achieved when a group member states that the most common sign/symptom of sexually transmitted infections is which of the following? 1. Menstrual cramping. 2. Heavy menstrual periods. 3. Flu-like symptoms. 4. Lack of signs or symptoms.

4. Lack of signs or symptoms. Most commonly, women experience no signs or symptoms when they have contracted a sexually transmitted infection.

49. Five women wish to use the Ortho Evra (patch) for family planning. Which of the women should be carefully counseled regarding the safety considerations of the method? Select all that apply. 1. The woman who smokes 1 pack of cigarettes each day. 2. The woman with a history of lung cancer. 3. The woman with a history of deep vein thrombosis. 4. The woman who runs at least 50 miles each week. 5. The woman with a history of cholecystitis.

1. The woman who smokes 1 pack of cigarettes each day. 3. The woman with a history of deep vein thrombosis. Women who use the patch are particularly high risk for the development of thrombi. Women with certain medical conditions, such as dia- betes or DVT, or with lifestyle issues, like smoking, that place them at high risk for thrombi

4. The nurse is administering Depo-Provera (medroxyprogesterone acetate) to a postpar- tum client. Which of the following data must the nurse consider before administering the medication? 1. The capsule must be taken at the same time each day. 2. The client must be taught to use sunscreen whenever in the sunlight. 3. The medicine is contraindicated if the woman has lung or esophageal cancer. 4. The client must use an alternate form of birth control for the first two months.

2. The client must be taught to use sunscreen whenever in the sunlight. The medication is contraindicated for use by women who have breast cancer or who are pregnant. It is not contraindicated for use by those suffering from lung or esophageal cancer.

60. The nurse has taught a couple about the temperature rhythm method of fertility con- trol. Which of the following behaviors would indicate that the teaching was effective? 1. The woman takes her basal body temperature before retiring each evening. 2. The couple charts information from at least six menstrual cycles before using the method. 3. The couple resumes having intercourse as soon as they see a rise in the basal body temperature. 4. The woman assesses her vaginal discharge daily for changes in color and odor.

2. The couple charts information from at least six menstrual cycles before using the method. It is essential that a full 6 months of information be obtained before using the rhythm method as a birth control device. All activities should be recorded on the BBT sheet. For example, the couple should document when the woman has a period, when they have intercourse, when they sleep late, and when the woman feels ill.

51. A woman is being taught how to use the diaphragm as a contraceptive device. Which of the following statements by the woman indicates that the teaching was effective? Select all that apply. 1. Petroleum-based lubricants may be used with the device. 2. The device must be refitted if the woman gains or loses 10 pounds or more. 3. The anterior lip must be pushed under the symphysis pubis. 4. Additional spermicide must be added if the device has been in place over 6 hours. 5. The diaphragm should be cleaned with a 10% bleach solution after every use.

2. The device must be refitted if the woman gains or loses 10 pounds or more. 3. The anterior lip must be pushed under the symphysis pubis. 4. Additional spermicide must be added if the device has been in place over 6 hours. This is true. If a woman's weight either increases or decreases by 10 lb or more, the device must be refitted. This is true. For the diaphragm to fit appropriately, the anterior lip must be pushed snugly under the symphysis. This is true. Although the device is a type of barrier, it is ineffective without spermicide and the action of spermi- cide is only effective for 6 hours.

12. A nonpregnant young woman has been diagnosed with bacterial vaginosis (BV). The nurse questions the woman regarding her sexual history, including her frequency of intercourse, how many sexual partners she has, and her use of contraceptives. What is the rationale for the nurse's questions? 1. Clients with BV can infect their sexual partners. 2. The nurse is required by law to ask the questions. 3. Clients with BV can become infected with HIV and other sexually transmitted infections more easily than uninfected women. 4. The laboratory needs a full client history to know for which organisms and antibi- otic sensitivities it should test.

3. Clients with BV can become infected with HIV and other sexually transmitted infections more easily than uninfected women. This statement is true. The change in normal flora increases the woman's susceptibility to other organisms.

3. A postpartum client has decided to use Depo-Provera (medroxyprogesterone acetate) as her contraceptive method. What should the nurse advise the client regarding this medication? 1. Take the pill at the same time each day. 2. Refrain from breastfeeding while using the method. 3. Expect to have no periods as long as she takes the medicine. 4. Consider switching to another birth control method in a year or so.

4. Consider switching to another birth control method in a year or so. Many women who use Depo-Provera for over 2 years have been found to suffer from loss of bone density. Some of the changes in bone density may be irreversible. Both amenorrhea and menorrhagia are side effects of the medication. The client should be advised to notify her health care practi- tioner regarding any significant menstrual pattern changes.

11. A gravid, married client, 24 weeks' gestation, is found to have bacterial vaginosis. Her health care practitioner has ordered metronidazole (Flagyl) to treat the problem. Which of the following educational information is important for the nurse to provide the woman at this time? 1. The woman must be careful to observe for signs of preterm labor. 2. The woman must advise her partner to seek therapy as soon as possible. 3. A common side effect of the medicine is a copious vaginal discharge. 4. A repeat culture should be taken two weeks after completing the therapy.

1. The woman must be careful to observe for signs of preterm labor. Clients with bacterial vaginosis are high risk for preterm labor. Male partners rarely need treatment. Female partners in lesbian relationships may, however, need to be treated. Bacterial vaginosis is characterized by a discharge that is often foul-smelling. The discharge is not related to the therapy.

34. What does cervical mucus look like at time of ovulation?

The cervical mucus does become thin and elastic at the time of ovulation.

5. Which statement by the client indicates that she understands the teaching provided about the intrauterine device (IUD)? 1. "The IUD can remain in place for a year or more." 2. "I will not menstruate while the IUD is in." 3. "Pain during intercourse is a common side effect." 4. "The device will reduce my chances of getting infected."

1. "The IUD can remain in place for a year or more." IUDs can remain in place for extended periods of time. The client should expect to menstruate regularly while the IUD is in place. Women who have IUDs in place are at risk of developing pelvic infections.

35. A client is being taught about the care and use of the diaphragm. Which of the following comments by the woman shows that she understands the teaching that was provided? 1. "I should regularly put the diaphragm up to the light and look at it carefully." 2. "This is one method that can be used during menstruation." 3. "I can leave the diaphragm in place for a day or two." 4. "The diaphragm should be well powdered before I put it back in the case."

1. "I should regularly put the diaphragm up to the light and look at it carefully." The diaphragm should not be used during menstruation. If the diaphragm is left in place for extended periods of time, then the woman is much higher risk for serious complica- tions, especially toxic shock syndrome.

27. A triage nurse answers a telephone call from the male partner of a woman who was recently diagnosed with cervical cancer. The man is requesting to be tested for human papillomavirus (HPV). The nurse's response should be based on which of the following? 1. There is currently no approved test to detect HPV in men. 2. A viral culture of the penis and rectum is used to detect HPV in men. 3. A Pap smear of the meatus of the penis is used to detect HPV in men. 4. There is no need for a test because men do not become infected with HPV.

1. There is currently no approved test to detect HPV in men.

22. A woman has been diagnosed with primary syphilis. Which of the following physical findings would the nurse expect to see? 1. Cluster of vesicles. 2. Pain-free lesion. 3. Macular rash. 4. Foul-smelling discharge.

2. Pain-free lesion. A pain-free lesion, called a chancre, is consistent with a diagnosis of primary syphilis. A reddish brown rash is seen with stage 2 syphilis. A macular rash is not seen with primary syphilis. A reddish brown rash is seen with stage 2 syphilis. A foul-smelling discharge is not seen with primary syphilis. It is seen with trichomoniasis. A cluster of vesicles is consistent with a diagnosis of herpes

59. A client who has been taking birth control pills for 2 months calls the clinic with the following complaint: "I have had a bad headache for the past couple of days and I now have pain in my right leg." Which of the following responses should the nurse make? 1. "Continue the pill, but take one aspirin tablet with it each day from now on." 2. "Stop taking the pill, and start using a condom for contraception." 3. "Come to the clinic this afternoon so that we can see what is going on." 4. "Those are common side effects that should disappear in a month or so."

3. "Come to the clinic this afternoon so that we can see what is going on."

20. A woman has been diagnosed with pelvic inflammatory disease (PID). Which of the following organisms are the most likely causative agents? Select all that apply. 1. Gardnerella vaginalis. 2. Candida albicans. 3. Chlamydia trachomatis. 4. Neisseria gonorrhoeae. 5. Treponema pallidum.

3. Chlamydia trachomatis. 4. Neisseria gonorrhoeae.

62. The nurse is interviewing a client regarding contraceptive choices. Which of the following client statements would most influence the nurse's teaching? 1. "I have 2 children." 2. "My partner and I have sex twice a week." 3. "I am 25 years old." 4. "I feel funny touching my private parts."

4. "I feel funny touching my private parts." This statement is very important. If the client refuses to touch her genital area, she is an unlikely candidate for a num- ber of contraceptive devices: female condom, diaphragm, sponge, cervical cap, and IUD.

44. A couple is seeking family planning advice. They are newly married and wish to delay childbearing for at least 3 years. The woman, age 26, G0 P0000, has no med- ical problems and does not smoke. She states, however, that she is very embarrassed when she touches her vagina. Which of the following methods would be most appropriate for the nurse to suggest to this couple? 1. Diaphragm. 2. Cervical cap. 3. Intrauterine device (IUD). 4. Birth control pills (BCP).

4. Birth control pills (BCP). The birth control pill would be the best choice for this client. She has no medical contraindications to the pill, she wishes to bear children in the future, and it requires no vaginal manipulation. Intrauterine device is effective and the client is in a monogamous relationship, but nulliparous women often complain of cramping and have a relatively high incidence of spontaneous rejection of the device. Plus, the client will need to palpate for the string after each menses. This requires vaginal manipulation.

65. A nurse is educating a group of women in her parish about osteoporosis. The nurse should include in her discussion that which of the following is a risk factor for the disease process? 1. Multiparity. 2. Increased body weight. 3. Late onset of menopause. 4. Heavy alcohol intake.

4. Heavy alcohol intake.

46. A 16-year-old woman who had unprotected intercourse 24 hours ago has entered the emergency department seeking assistance. Which of the following responses by the nurse is appropriate? 1. "You can walk into your local pharmacy and buy Plan B (levonorgestrel)." 2. "I am sorry but because of your age I am unable to assist you." 3. "The emergency room doctor can prescribe high-dose birth control pills (BCP) for you." 4. The nurse's response is dependent upon which state he or she is practicing in.

4. The nurse's response is dependent upon which state he or she is practicing in.