ch 4 adaptive quizzing womens health

The nurse is assessing a client who experienced menopause at 52 years of age. The nurse expects that the client began perimenopause at what approximate age? 48 49 50 51

48

The nurse is evaluating a client's understanding about the steps to be followed before undergoing a Papanicolaou test. Which statement by the client indicates the need for further teaching? "I should not have sexual intercourse 24 to 48 hours before the test." "I should clean my vagina by douching before the test." "I should track my menstruation cycle and schedule the test midcycle." "I should empty my bladder before undergoing the test."

"I should clean my vagina by douching before the test." A Papanicolaou test is done to detect carcinogenic conditions or infections, which can be determined by examining cells from the cervix collected during the pelvic examination. It is not recommended to use douches before a Pap test, because the contents of the douche may contaminate the samples. It is also not advised to have sexual intercourse before the test, becausethis may interfere with the results of the test. The midcycle period of menstruation is the best time for the test, because the cervical conditions are favorable for obtaining the specimen. The nurse should instruct the client to empty her bladder before the test to prevent discomfort during the procedure.

The nurse is caring for a client with a history of breast cancer. She had a lumpectomy 2 years ago and has asked the nurse about the best time to perform monthly breast self-examination (BSE). What is the nurse's best response? "The best time of the month to perform your breast self-examination is during your menstrual cycle." "The best time of the month to perform your breast self-examination is 2 weeks after your period." "The best time of the month to perform your breast self-examination is 5 to 7 days after menstruation stops." "The best time of the month to perform your breast self-examination is right before you start your period."

"The best time of the month to perform your breast self-examination is 5 to 7 days after menstruation stops."

A pathology report indicates that atypical endometrial cells were detected in a postmenopausal client's vaginal pool specimen. Which test does the nurse expect to be ordered for further evaluation of the client? Biopsy Chlamydia test Sexually transmitted infection test Human immunodeficiency virus (HIV) test

Biopsy Endometrial biopsy is suggested for postmenopausal client who are suspected to be at risk of adnexal tumors or cancers. A yearly chlamydia test is recommended for sexually active women under age 25; women aged 25 and older should be tested as needed when sexually active with new or multiple partners. An HIV test is conducted to determine the HIV status of the client. A sexually transmitted infection test doesn't give any information regarding endometrial tumors.

The nurse is caring for a pregnant client admitted with vaginal bleeding. When taking the client's history, the nurse is using open-ended questions. What are some additional ways to encourage this client to share her information? Facilitation Reflection Clarification Interruption Confrontation

Facilitation Reflection Clarification Confrontation

The nurse is teaching a client about contraceptive methods. The nurse suggests that the client use combined oral contraceptives. In which case would this method be the most appropriate? The client already has one child. The client is immunocompromised. The client has pelvic inflammatory disease. The client has a family history of ovarian cancer.

Combined hormonal oral contraceptives are known to reduce the development of ovarian and endometrial cancer in women. A woman with a family history of ovarian cancer is susceptible to developing ovarian cancer, and, therefore, the nurse should advise the client to use combined oral contraceptives. Immunocompromised clients are more susceptible to acquiring sexually transmitted infections. This client should use barrier methods of contraception. Already having a child is not a criterion for use of combined oral contraceptives; the contraceptive pill can be used by any woman, regardless of having a child or not. A client with pelvic inflammatory disease should use barrier methods of contraception.

What special instructions does the nurse include while teaching Kegel exercises? Contraction should be held for at least 10 seconds. Take a rest for up to 5 seconds between the contractions. Feel the pulling up over the three muscle layers during the exercises. Avoid straining or bearing-down motions while performing the exercises. Each contraction should be strong, and coordinated with the contraction of the abdomen.

Contraction should be held for at least 10 seconds. Feel the pulling up over the three muscle layers during the exercises. Avoid straining or bearing-down motions while performing the exercises.

The nurse who provides preconception care understands that it involves what? Is designed for women who have never been pregnant Includes risk factor assessments for potential medical and psychologic problems but by law cannot consider finances or workplace conditions Avoids teaching about safe sex to avoid political controversy Could include interventions to reduce substance use and abuse

Could include interventions to reduce substance use and abuse

A physically disabled client undergoing a pelvic examination is unable to lie comfortably in the lithotomy position. Which is the best nursing intervention to help the client undergo the pelvic examination comfortably? Encourage the client to lie in the V-shaped position. Encourage the client to lie in the M-shaped position. Encourage the client to lie in a comfortable alternative position. Encourage the client to lie in the side-lying position.

Encourage the client to lie in a comfortable alternative position.

What is the role of a registered nurse in women's health promotion and illness prevention? Integrating various modalities of care Providing comprehensive primary care Coordinating care in communities Working to influence health policy Collaborating with other health care practitioners

Integrating various modalities of care Working to influence health policy Collaborating with other health care practitioners

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

Listen carefully and allow extra time for this woman's health history interview.

The nurse is reviewing a female client's laboratory reports. In which phase of the ovarian cycle would the nurse consider the client to be if her progesterone levels are found to be high? Follicular phase Ovulatory phase Luteal phase Ischemic phase

Luteal phase The follicular, ovulatory, and luteal phases are the phases of the ovarian cycle. High progesterone levels are characteristic of the luteal phase, due to formation of the corpus luteum. Progesterone levels are low during the follicular phase, gradually increase in the ovulatory phase, and reach high levels in the luteal phase. The ischemic phase is not a part of the ovarian cycle, but it is a part of the endometrial cycle; progesterone levels decline in this phase.

During the assessment of a pregnant client the nurse finds symptoms that suggest the patient may have dysrhythmias, cardiomyopathy, and heart failure. To prevent these complications the nurse suggests that the patient maintain a healthy diet and stop rigorous exercise. What is the most likely reason for anticipating these complications in the patient? Maternal obesity. Maternal presentation of bulimia nervosa. Patient is a cigarette smoker. Maternal presentation of anorexia nervosa.

Maternal presentation of anorexia nervosa. Anorexia nervosa is a chronic eating disorder in which a client perceives himself or herself, in contrast to reality, to be too heavy. As such, clients with anorexia nervosa undertake severe diets and rigorous exercise. As a result, the client may have dysrhythmias and cardiomyopathy. To prevent these complications the nurse advises the client to maintain a healthy diet and stop rigorous exercise. Clients who are very obese are at increased risk for hypertension, diabetes, gallbladder disease, postterm pregnancy, and musculoskeletal problems. Bulimia nervosa is a chronic eating disorder in which the patient practices secret, uncontrolled binge eating episodes that alternate with methods to prevent weight gain. If the patient had bulimia, the nurse would anticipate that the patient may have dehydration and electrolyte imbalance, gastrointestinal abnormalities, and cardiac dysrhythmias. Cigarette smoking causes early menopause, osteoporosis, and chronic lung disorders.

What are the major goals of prenatal care? Monitor the development of the fetus. Provide family planning services to the parents. Improve the nutritional status of mother and fetus. Provide appropriate education and counseling to the parents. Minimize the risk of complications in both mother and fetus.

Monitor the development of the fetus. Improve the nutritional status of mother and fetus. Provide appropriate education and counseling to the parents. Minimize the risk of complications in both mother and fetus.

A client reports vaginal bleeding after menopause, along with hot flashes. Which intervention is the nurse's priority for client care? Notify the primary health care provider. Teach the client methods of hygiene and skin care. Evaluate the client's previous history. Explain to the client that both of these symptoms are normal and are due to low estrogen levels.

Notify the primary health care provider. Vaginal bleeding or palpable adnexal masses in postmenopausal women should be referred to the primary health care provider. Teaching methods of hygiene and skin care doesn't address the complication of vaginal bleeding. The client's previous history needs to be taken after notifying the primary health care provider. Hot flashes may be normal in women during menopause due to low estrogen levels, but vaginal bleeding after menopause needs medical attention.

A body mass index (BMI) of 32 is calculated for a woman. The nurse knows that this index puts the woman into which category of weight? Obesity Appropriate Underweight Overweight

Obesity Obesity is defined as a BMI of 30 or greater. A BMI of 32 puts the woman into the obese category. Overweight is defined as a BMI of 25 to 29.9.

What changes occur in the female reproductive system after menopause? Pinker areola Pendulous breasts Vaginal lengthening Shinier labia minora Constricted vaginal introitus

Pendulous breasts Shinier labia minora Constricted vaginal introitus

A client who is planning for a pregnancy and has type 1 diabetes mellitus is seeking preconception care. On which aspect does the nurse primarily focus while planning preconception care for the client? Prevention of miscarriage Prevention of maternal hypertension Prevention of fetal malformations Prevention of unintended pregnancy

Prevention of fetal malformations The offspring of women with type 1 diabetes mellitus have a higher chance of fetal malformations than the offspring of women who do not have diabetes mellitus. Therefore, preconception care should be mainly focused on the prevention of fetal malformations. The prevention of miscarriage should be a focus of preconception care for clients with histories of miscarriage or preterm labor. Maintenance of normal glucose levels is more relevant than maintenance of blood pressure for women with type 1 diabetes mellitus. Prevention of unintended pregnancy is not relevant for the client who is planning a pregnancy.

The nurse is assisting the primary health care provider during a pelvic examination. What finding would indicate a pelvic infection in the client? Palpable uterus Nonpalpable ovaries Palpable adnexal masses Prominent skene gland openings

Prominent skene gland openings Skene glands are located on each side of the urethra and produce mucus, which aids in the lubrication of the vagina. Generally, the openings to the skene glands are not visible, but prominent openings may be seen if the glands are infected. A palpable uterus is a normal finding of the pelvic examination. Palpable adnexal masses are abnormal findings that indicate unwanted growth or tumors. Nonpalpable ovaries are a result of menopause and are not indicative of infection.

Nurses can make a difference in stopping violence against women and preventing further injury. What nursing measures can be implemented for women to discourage their entry into abusive relationships? Promoting assertiveness Encouraging Pilates classes Encouraging positive self-regard Encouraging support and self-help groups Helping with confidence and empowerment Promoting aggressive behaviors and kickboxing classes

Promoting assertiveness Encouraging positive self-regard Encouraging support and self-help groups Helping with confidence and empowerment

A pregnant client is unable to curtail her alcohol abuse. Which nursing intervention could be performed to reduce complications in the fetus? Suggest that the client exercise. Suggest that the client terminate the high-risk pregnancy. Suggest that the client include folic acid in her diet. Suggest that the client take a multivitamin supplement.

Suggest that the client take a multivitamin supplement. Alcohol use during pregnancy can lead to fetal alcohol spectrum disorder (FASD), which includes fetal alcohol syndrome (FAS), fetal alcohol effects, and alcohol-related neurologic developmental disabilities. Pregnant women who are unable or unwilling to reduce their alcohol intake should take multivitamin supplements to help lessen the effects of prenatal alcohol exposure in the baby. Although this pregnancy is a high-risk one because of the exposure to alcohol, it is inappropriate for the nurse to suggest termination. Folic acid can help reduce the risk of neural tube defects in the fetus. It does not reduce alcohol-related complications. Exercise does not lessen the effects of prenatal alcohol exposure; however, low impact exercise is beneficial to maternal and fetal health.

The nurse-midwife is teaching a group of women who are pregnant about Kegel exercises. Which statement by a participant would indicate a correct understanding of the instruction? "I will only see results if I perform 100 Kegel exercises each day." "I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises." "I should only perform Kegel exercises in the sitting position." "I will perform daily Kegel exercises during the last trimester of my pregnancy to achieve the best results."

The correct technique for Kegel exercises is to hold the contraction for at least 10 seconds and rest for 10 seconds in between so the muscles can have time to recover; each contraction can be as strong as the woman can make it. Guidelines suggest that women perform between 30 and 80 Kegel exercises daily. Kegel exercises are best performed in a supine position with the knees bent. Kegel exercises should be performed throughout the pregnancy to achieve the best results.

The nurse is reviewing the laboratory results of a patient and notes that the patient has low levels of gonadotropin-releasing hormone (GnRH). Which physiologic process would be highly affected in the patient? Rate of respiration Development of ovum Gastric acid secretion Contraction of muscles

The hypothalamic-pituitary cycle plays an important role in the development and implantation of the ovum. The hypothalamus secretes gonadotropin, which triggers the secretion of follicle-stimulating hormone (FSH) from the anterior pituitary. FSH stimulates the development of ovarian graafian follicles, as well as the release of estrogen, which play an important role in fertilization and implantation of ova. Therefore, development of the ovum will be greatly affected in a patient with low levels of GnRH. The rate of respiration is controlled by the brain stem. Gastric acid secretion is controlled by the proton pump. Muscle contraction is controlled by acetylcholine (a neurotransmitter). Low levels of GnRH do not affect gastric acid secretion, rate of respiration, or the contraction of muscles.

What is the likely effect of low prostaglandin levels on the client's menstrual cycle? The endometrium in the uterus fails to form. Peak levels of progesterone are not attained in the luteal phase. The ovum remains entrapped in the graafian follicle. Ovum growth is inhibited in the proliferative phase.

The ovum remains entrapped in the graafian follicle.

The nurse is preparing to examine a client with cervical cancer. Which is the most suitable site of examination for the client? Clitoris Fallopian tube Bartholin glands Transformation zone

Transformation zone

What should the clinic nurse include in the instructions for a woman scheduling a pelvic examination? You can use a douche the day before the examination. You should avoid intercourse for 48 hours before the examination. Be sure to apply any vaginal medication you are taking before the examination. If you start your menstrual cycle on the day of the examination we will need to reschedule. Arrive at the clinic with a full bladder.

You should avoid intercourse for 48 hours before the examination. If you start your menstrual cycle on the day of the examination we will need to reschedule.