Maternity Ch. 2, Maternity Ch. 8 Violence against women, Maternity Ch. 6 Women's health problem, Maternity Ch. 1, Maternity Ch. 3, Maternity Ch. 5, Maternity ch. 4, Maternity Ch. 7 Social Issues, Old's Maternity Ch. 10, Maternity Ch. 9

1) A female is offered a position as a manager with a major city hotel that offers flexibility with childcare and family issues. What should this individual also investigate financially before accepting this position? A) Number of sick days B) Expectations to work holidays C) Number of overtime hours expected to work every month D) Wages that are commensurate with those of male employee managers

A) Answer: D Explanation: One reason for wage discrepancy is that women accept lower salaries in exchange for provisions such as flexibility for childcare responsibilities and family-related issues. This person needs to investigate the wages she will receive before accepting this position. The number of sick days, expectations to work holidays, and overtime hours would have a higher impact on work-life balance than on finances

1) A patient requiring back surgery wants to take family/medical leave to recover but is not sure if she is eligible. What should the nurse review as eligibility requirements for this coverage? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Work more than 25 hours per week 2. Have been in the job for at least 1 year 3. Be expected to return to work within 4 weeks 4. Be willing to accept a lower-paying position upon return 5. Have provisions to self-pay for health insurance while off from work

Answer: 1, 2 Explanation: Limitations to the Family Medical Leave Act (F M L A) include that employees must work at least 25 hours per week to be eligible and must have been in their position for at least 1 year. The maximum amount of leave allowed for F M L A is 12 weeks. The Act provides job security for the person to return to their former position, or one that is considered comparable. Health insurance benefits are covered while on leave.

A female patient with amenorrhea is suspected to have pituitary dysfunction. For which health problems should the nurse explain that the patient will most likely be evaluated? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Cancer 2. Adenoma 3. Head trauma 4. Turner syndrome 5. Polycystic ovarian syndrome

Answer: 1, 2, 3 Explanation: In pituitary dysfunction, cancer and head trauma can cause hypopituitarism. A pituitary adenoma can cause changes in the hormones that the pituitary gland manufactures. Turner syndrome is a genetic disorder that is linked to chronic anovulation or ovarian failure. Polycystic ovarian syndrome is a cause of chronic anovulation.

1) The nurse is working with a group of recent immigrants from a country in which female genital mutilation (F G M) is practiced. In order to be effective in teaching about gynecologic care in the U.S., the nurse must keep which issues in mind? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Women might undergo F G M willingly to support the status quo of society. B) Women might undergo the procedure to be considered for marriage. C) Women who immigrate to other countries feel a sense pride once the procedure has been performed. D) Women might undergo the procedure to gain greater sexual pleasure. Women might undergo the procedure to lose their virginity

Answer: A, B Explanation: 1. The procedure is performed by various ethnic groups for a variety of reasons, including perceived improved social acceptance. 2. The procedure is performed by various ethnic groups for a variety of reasons, including marriageability. 3. Women who immigrate to other countries may feel a sense of shame or embarrassment once the procedure has been performed. 4. The procedure is performed by various ethnic groups for a variety of reasons, including the reduction of female sexual desire. 5. Women might undergo the procedure to preserve their virginity.

1) Pesticide exposure can be linked to a variety of adverse health outcomes, including which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Increased risk of cancer B) Endocrine abnormalities C) Liver damage D) Birth defects E) Cardiovascular diseases

Answer: A, B, C, D Explanation: A) Pesticide exposure can be linked to a variety of adverse health outcomes, including an increased risk of cancer. B) Pesticide exposure can be linked to a variety of adverse health outcomes, including endocrine abnormalities. C) Pesticide exposure can be linked to a variety of adverse health outcomes, including liver damage. D) Pesticide exposure can be linked to a variety of adverse health outcomes, including birth defects. E) Cardiovascular diseases in not one of the adverse health outcomes linked to pesticide exposure.

1) The client with polycystic ovarian syndrome (P C O S) has been prescribed metformin (Glucophage). The nurse tells the client that the medication will do which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "Decrease your excessive hair growth." B) "Make it easier to lose weight." C) "Increase your acne." D) "Improve your chances of pregnancy." E) "Make your menstrual periods irregular."

Answer: A, B, D Explanation: A) Polycystic ovarian syndrome (P C O S) treatment with metformin decreases hirsutism. B) Polycystic ovarian syndrome (P C O S) treatment with metformin improves weight loss success. C) Polycystic ovarian syndrome (P C O S) treatment with metformin decreases acne. D) Polycystic ovarian syndrome (P C O S) treatment with metformin increases ovulation and therefore menstrual regularity and fertility. Polycystic ovarian syndrome (PCOS) treatment with metformin increases ovulation and therefore menstrual regularity and fertility

1) What are the three functions of the fallopian tubes? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Provide transport for the ovum from the ovary to the uterus B) Serve as a warm, moist, nourishing environment for the ovum or zygote C) Secrete large amounts of estrogens D) Provide a site for fertilization to occur E) Support and protect the pelvic contents

Answer: A, B, D Explanation: A) The fallopian tubes provide transport for the ovum from the ovary to the uterus. B) The fallopian tubes serve as a warm, moist, nourishing environment for the ovum or zygote. C) The ovaries, not the fallopian tubes, secrete large amounts of estrogens. D) The fallopian tubes provide a site for fertilization to occur. E) The female bony pelvis, not the fallopian tubes, supports and protects the pelvic contents.

A fetus has been diagnosed with myelomeningocele. Which of the following surgeries would be performed to correct this condition? A) Tubal ligation B) Intrauterine fetal surgery C) Cesarean section D) Sterilization

Answer: B Explanation: A) Tubal ligation is not an intrauterine fetal surgery. B) Intrauterine fetal surgery, which is generally considered experimental, is a therapy for anatomic lesions that can be corrected surgically and are incompatible with life if not treated. Examples include surgery for myelomeningocele and some congenital cardiac defects. C) A cesarean birth is not considered an intrauterine fetal surgery. D) Sterilization surgery does not involve the fetus.

1) A 38-year-old female is scheduled for a laparoscopic-assisted vaginal hysterectomy (L A V H) for severe endometriosis with the removal of both ovaries. What should the nurse expect to be prescribed for this patient postoperatively? A) Corticosteroid therapy B) Mineralocorticoid therapy C) Estrogen replacement therapy D) Progesterone replacement therapy

Answer: C Explanation: Supplemental estrogen replacement therapy is recommended in a premenopausal woman having both fallopian tubes and ovaries removed. Corticosteroid and mineralocorticoid therapies are indicated for adrenal gland dysfunction. Progesterone replacement therapy is not indicated for this patient's health problem

1) The nurse is planning a community education program on the role of complementary and alternative therapies during pregnancy. Which statement about alternative and complementary therapies should the nurse include? A) "They bring about cures for illnesses and diseases." B) "They are invasive but effective for achieving health." C) "They emphasize prevention and wellness." D) "They prevent pregnancy complications."

Answer: C Explanation: A) These therapies emphasize prevention and wellness, aiming for holistic health rather than cure or treatment. B) Most alternative and complimentary therapies are noninvasive. The only ones that are invasive are acupuncture, herbs, and foods. C) Complementary and alternative therapies have many benefits during pregnancy. They emphasize prevention and wellness, aiming for holistic health rather than cure or treatment. No method of treatment can prevent all pregnancy complications

1) The nurse is preparing an educational seminar about the frequency of intimate partner violence against females. Using the chart below, which age group should the nurse identify as experiencing the most intimate partner violence in 2010? A) 12-17 B) 18-24 C) 25-34 D) 35-49

Answer: C Explanation: The group experiencing the most intimate partner violence against women in 2010 is the solid green line which represents the 25-34 age group. The solid red line is the 12-17 age groups. The dotted red line is the 18-24 age group. The dotted blue line is the 35-49 age group. And the solid orange line is the 50 or older age group.

1) A nurse is providing a client with instructions regarding breast self-examination (B S E). Which of the following statements by the client would indicate that the teaching has been successful? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "I should perform B S E 1 week prior to the start of my period." B) "When I reach menopause, I will perform B S E every 2 months." C) "Knowing the density of my breast tissue is important." D) "I should inspect my breasts while standing with my arms down at my sides." E) "I should inspect my breasts while in a supine position with my arms at my sides."

Answer: C, D Explanation: A) B S E should be performed 1 week after the start of each menstrual period. B) B S E should be performed monthly, on the same day each month, during menopause. C) The effectiveness of B S E is determined by the woman's ability to perform the procedure correctly, by her knowledge of her own breast tissue, and by the density of her breast tissue. D) The breasts should be inspected while standing with arms at sides. E) Supine is not a correct position for B S E.

1) A newborn has been diagnosed with a disorder that occurs through an autosomal recessive inheritance pattern. The parents ask the nurse, "Which of us passed on the gene that caused the disorder?" What should the nurse tell them? A) The female B) The male C) Neither D) Both

Answer: D Explanation: A) It is not a sex-linked disorder or an abnormal chromosome disorder. B) It is not a sex-linked abnormality. C) In an autosomal recessive inherited disorder, both parents are carriers of the abnormal gene. D) An affected individual can have clinically normal parents, but both parents are generally carriers of the abnormal gene.

1) A couple asks the nurse what is the safest method of sterilization. What should the nurse reply? A) "Laparotomy tubal ligation." B) "Laparoscopy tubal ligation." C) "Minilaparotomy." D) "Vasectomy."

Answer: D Explanation: A) A laparotomy tubal ligation is a female sterilization procedure that involves more risks. B) A laparoscopy tubal ligation is a female sterilization procedure that involves more risks. C) Minilaparotomy is a female sterilization procedure that involves more risks. D) Vasectomy (male sterilization) is a relatively minor procedure.

The nurse suspects that a patient is experiencing bacterial vaginosis. What finding caused the nurse to make this clinical determination? A) Dysuria B) Vaginal itching C) Thick white vaginal discharge D) Fishy odor to vaginal discharge

Answer: D Explanation: D) The person with bacterial vaginosis may have a thin watery discharge with a fishy odor. Dysuria, vaginal itching, and thick white vaginal discharge are manifestations of vulvovaginal candidiasis.

1) The client diagnosed with endometriosis asks the nurse whether there are any long-term health risks associated with this condition. The nurse should include which statement in the client teaching about endometriosis? A) "There are no other health risks associated with endometriosis." B) "Pain with intercourse rarely occurs as a long-term problem." C) "You are at increased risk for ovarian and breast cancer." D) "Most women with this condition develop severe migraines."

wer: C Explanation: A) There are long-term health risks associated with endometriosis. B) Dyspareunia is a common symptom of endometriosis. C) An increased risk for cancer of the ovary and breast is associated with endometriosis. Endometriosis is not associated with increased migraines

1) While attending a community fair the nurse is surprised to learn the number of women who are homemakers, teachers, and nurses. What impact should the nurse recognize that this has on these individuals' income? A) Potential for longer lifespan B) Overall lower income than men C) Reduced risk for chronic illnesses D) Increased risk for health problems

A) Answer: B Explanation: Historical trends that have contributed to an existing wage gap include being limited to occupations such as child care, teaching, and nursing, which by virtue of being female-dominated professions pay lower salaries. The professions of homemakers, teachers, and nurses will not impact lifespan and chronic illness, or increase the risk for health problems

The nurse is concerned that a patient is at risk for developing vulvovaginal candidiasis (V V C). What assessment information caused the nurse to have this concern? Select all that apply. 1. 16 weeks pregnant 2. +3 glucose in the urine 3. Elevated blood pressure 4. Type 2 diabetes mellitus 5. Edematous lower extremities

Answer: 1, 2, 4 Explanation: Predisposing factors to vulvovaginal candidiasis (VVC) infections include pregnancy, glycosuria, and diabetes mellitus. Elevated blood pressure and edematous lower extremities is more likely to be associated with preeclampsia in the pregnant patient

1) An older patient is demonstrating a new onset of confusion and forgetfulness. While reviewing the patient's medical records, the nurse suspects these new manifestations are drug-induced. Which medications did the nurse identify as causing changes in cognitive functioning in this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Antihistamine for allergies 2. Antidepressant for nerve pain 3. Antibiotic for bronchial infection 4. Anticoagulant for atrial fibrillation 5. Antihypertensive for high blood pressure

Answer: 1, 2 Explanation: Certain drugs can cause cognitive impairment, especially when diminished kidney and liver function is present. Drugs that alter the central nervous system include antihistamines and antidepressants. These drugs may cause forgetfulness, confusion, disorientation, and inability to concentrate. Antibiotics, anticoagulants, and antihypertensives are not identified as causing cognitive impairment

1) The community nurse is conducting health assessments at the homeless shelter and notes that the majority of clients are female. What should the nurse identify as reasons for the percentage of women who are homeless? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Unemployment 2. Substance abuse 3. Recent prison release 4. Lack of family support 5. Inadequate child support

Answer: 1, 2, 3, 4 Explanation: Factors that increase the risk of female homelessness include unemployment, substance abuse, recent prison release and lack of family support. Inadequate child support is not identified as a factor that increases the risk of female homelessness.

1) During a routine prenatal visit the nurse suspects that a patient in the 14th week of gestation is affected by environmental pollution. What assessment findings caused the nurse to come to this conclusion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Headache 2. Scratchy throat 3. Chest wheezing 4. Abdominal pain 5. Itchy burning eyes

Answer: 1, 2, 3, 5 Explanation: Health conditions associated with air pollution include headache, throat irritation, asthma, and eye irritation. Abdominal pain is not a health condition associated with air pollution

1) The nurse is reviewing a list of families scheduled for community health visits. To visit these families according to the family life cycle each is in, in which order from first to last should the nurse visit these families? 1. Family with a 12-month-old child 2. Family whose oldest child is in the 5th grade 3. Family whose oldest child is attending college 4. Family whose youngest child just got a driver's license 5. Family whose youngest child got married last weekend 6. Family whose male partner retired from full-time employment

Answer: 1, 2, 4, 3, 5, 6 Explanation: According to the family life cycle stages, the family with a 12-month-old child would be seen first. The family with the oldest child in 5th grade would be seen second. Third, the family with the oldest child in college would be seen. The fourth family seen should be the one with the child who just received a driver's license. The fifth family would be the one whose youngest child was married the previous weekend. And the last family would be the one with a new retiree.

1) A pregnant patient is concerned about the development of several urinary tract infections (U T Is) over the last few months of her pregnancy. What should the nurse explain as reasons for the development of these infections in this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Decrease in bladder tone 2. Hyperemic bladder mucosa 3. Urethral stricture and loss of micturition reflex 4. Ureters elongate and are displaced by the uterus 5. Distal ureters hypertrophy leading to ureteral stenosis

Answer: 1, 2, 4, 5 Explanation: A number of structural and functional changes occur during pregnancy that predispose pregnant women to urinary tract infections. Ureters elongate and are laterally displaced by the gravid uterus. Progesterone, which relaxes smooth muscles, can facilitate hypertrophy of the distal ureters with resulting ureteral stenosis and dilation, especially in the second half of pregnancy. Though the bladder has an increased capacity in pregnancy, it also has a decreased tone because progesterone relaxes the smooth muscle. Estrogen causes the bladder mucosa to become hyperemic and more susceptible to trauma and infection. Pregnancy does not cause urethral strictures and loss of the micturition reflex.

1) The nurse is planning care for a client who is the victim of rape. Which psychosocial nursing diagnoses does the nurse include in the client's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Fear 2. Fatigue 3. Powerlessness 4. Risk for infection 5. Readiness for enhanced knowledge

Answer: 1, 3 Explanation: When planning the psychosocial care for a client who is the victim of rape, the nurse would include the nursing diagnoses of fear and powerlessness in the plan of care. Fatigue, risk for infection, and readiness for enhanced knowledge are not diagnoses that the nurse would include in the plan of care for a client who is the victim of rape.

1) The nurse is concerned that a clinic patient is at risk for experiencing poverty. Which information did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Of African-American descent 2. Attends church on Sunday mornings 3. Completed only up to 10th grade 4. Raising 2 children under the age of 10 alone 5. Works as a clothing assistant in a retail store

Answer: 1, 3, 4 Explanation: Factors that contribute to the feminization of poverty include being a member of an ethnic minority, not having sufficient education, and raising children as a single mother. Attending church and working in a retail store do not contribute to the feminization of poverty.

1) A female patient experiencing menopause is concerned that periodic lapses of memory are symptoms of Alzheimer disease. What should the nurse review with the patient to reduce the risk of developing Alzheimer disease (A D)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Increase rest 2. Stop smoking 3. Exercise regularly 4. Eat a healthy diet 5. Maintain mental activity

Answer: 2, 3, 4, 5 Explanation: Lifestyle practices may help prevent A D include smoking cessation, regular exercise of at least 30 minutes 5 days a week, eating a healthy diet, and remaining mentally active. Increased rest does not help prevent A D.

A female patient comes into the clinic because of concerns about a sore that was present on her labia but spontaneously healed. During the interview the patient asks what could occur if the infection is syphilis. In what order should the nurse explain the course of this sexually transmitted infection? 1. Latent period with no lesions 2. Development of a chancre sore 3. Skin eruptions and sore throat occur 4. Tertiary stage with various symptoms 5. Development of a fever, weight loss, and malaise

Answer: 2, 5, 3, 1, 4 Explanation: Syphilis is divided into early and late stages. During the early stage (primary), a chancre appears at the site where the T. pallidum organism entered the body. Symptoms include slight fever, loss of weight, and malaise. The chancre persists for about 4 weeks and then disappears. In 6 weeks to 6 months, secondary symptoms appear. Skin eruptions called condylomata lata, which resemble wart-like plaques and are highly infectious, may appear on the vulva. Other secondary symptoms are acute arthritis, enlargement of the liver and spleen, nontender enlarged lymph nodes, iritis, and a chronic sore throat with hoarseness. A latent phase with no lesions may be followed by a tertiary stage.

1) A female patient is anxious about having a pelvic examination. To help reduce the patient's fears in which order should the nurse explain that the examination will be performed? 1. The speculum is inserted 2. The speculum is removed 3. The perineum is inspected 4. The rectal examination is performed 5. The healthcare provider applies gloves 6. The bimanual examination is performed

Answer: 5, 3, 1, 2, 6, 4 Explanation: For a pelvic examination, the examiner dons gloves for the procedure. Let the woman know that the examiner begins with an inspection of the external genitalia. The speculum is then inserted to allow visualization of the cervix and vaginal walls and to obtain specimens for testing. After the speculum is withdrawn the examiner performs a bimanual examination of the internal organs using the fingers of one hand inserted in the woman's vagina while the other hand presses over the woman's uterus and ovaries. The final step of the procedure is generally a rectal examination.

1) The nurse is preparing an educational seminar for a group of middle-aged healthy women on health screening recommendations. What information should the nurse include during this educational session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Get a Pap test every 3 years 2. Schedule mammograms every 5 years 3. Get testing for H I V before the age of 60 4. Have a screening for colorectal cancer 5. Have blood pressure measured every year if 140/90

Answer: 3, 4 Explanation: A Pap test every 3 years is appropriate for women between the ages of 18 and 39. Mammograms should be obtained every 2 years through age 74. If the blood pressure measurement is 140/90 or higher, treatment should be discussed with the doctor or nurse. There is no age limit for H I V testing. Patient should be tested for H I V at least once if age 65 and have never been tested. Starting at age 50, patients should be screened for colorectal cancer.

1) The nurse is participating in the collection of evidence from a victim of rape. In which order should the evidence be collected from this victim? 1. Oral swabs are obtained 2. Blood samples are drawn for syphilis 3. Hair samples and fingernail scrapings taken 4. Clothing is removed and bagged for evidence 5. Swabs of body stains and secretions are taken

Answer: 4, 5, 1, 3, 2 Explanation: When collecting evidence from a rape victim, the victim's clothing is removed and placed in a paper bag. Swabs of body stains and secretions are taken. Then oral swabs are obtained. Hair samples and fingernail scrapings are taken. Blood samples are then drawn to evaluate for syphilis.

1) The 12-year-old client reports that menarche occurred 5 months ago. She has had bleeding every day this month, and is very worried. The nurse should explain that the most common cause of this bleeding is which of the following? A) Dysfunctional uterine bleeding (D U B) B) Diabetes mellitus (D M) C) Pregnancy D) Von Willebrand's disease

Answer: A Explanation: A) Adolescents often experience D U B during the first 2 years following menarche due to hypothalamic immaturity after menarche. B) Uterine bleeding is not a symptom of D M. C) Uterine bleeding is not a symptom of pregnancy. Although von Willebrand's disease can cause irregular uterine bleeding, it is quite rare

The nurse is providing follow-up education to a client just diagnosed with vaginal herpes. What statement by the client verifies correct knowledge about vaginal herpes? A) "I should douche daily to prevent infection." B) "I could have another breakout during my period." C) "I am more likely to develop cancer of the cervix." D) "I should use sodium bicarbonate on the lesions to relieve discomfort."

Answer: B Explanation: A) Douching does not prevent infection. B) Menstruation seems to trigger recurrences of herpes. C) There is no relation between herpes and cancer of the cervix. Burow's (aluminum acetate) solution, not sodium bicarbonate, relieves discomfort

1) The nurse is providing care to several pregnant clients at an O B-G Y N clinic. Which client might benefit from prenatal diagnostic testing? A) Paternal age of 35 years B) Maternal age of 30 years C) Family history of anxiety D) Family history of cystic fibrosis

Answer: D Explanation: A) Advanced paternal age is not a reason for prenatal diagnostic testing. B) Advanced maternal age is a reason for prenatal diagnostic testing; however, advanced maternal age is considered at the age of 35 years, not 30 years. C) A family history of anxiety is not a reason for prenatal diagnostic testing. D) Cystic fibrosis is an example of a single-gene disorder. This client would benefit from prenatal diagnostic testing.

A female client who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires birth control. The nurse understands that which contraceptive method is inappropriate for this client? A) Intrauterine device B) Vaginal sponge C) Combined oral contraceptives D) Transdermal hormonal contraception

Answer: D Explanation: A) This client may use an intrauterine device. B) This client may use the vaginal sponge. C) This client may use combined oral contraceptives. D) Transdermal hormonal contraception is contraindicated because of the client's weight.

1) patient seeks medical attention after being exposed to blood during a gang fight several weeks ago. For which types of hepatitis should the nurse anticipate that this patient will be tested? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. A 2. B 3. C 4. D 5. E

Answer: 2, 3, 4 Explanation: Hepatitis B, C, and D are transmitted through blood, body fluids, and blood products. Hepatitis A and E are transmitted through the oral-fecal route. Hepatitis A is also transmitted through contaminated food and water.

1) The nurse determines that a patient in the clinic has a learning disability. What did the nurse assess to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Dyslexia 2. Dysgraphia 3. Hearing loss 4. Osteoarthritis 5. Bilateral cataracts

Answer: 1, 2 Explanation: Learning disabilities can inhibit educational attainment and employment and include dyslexia and dysgraphia. Hearing loss and bilateral cataracts are sensory changes that would not necessarily impact learning. Osteoarthritis is not a learning disability.

While reviewing data, the nurse determines that a patient is at risk for pelvic inflammatory disease. Which information did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Age 23 2. Douches weekly 3. Smokes cigarettes 1 ppd 4. I U D inserted 2 months ago 5. Received H P V vaccination

Answer: 1, 2, 4 Explanation: Pelvic inflammatory disease (P I D) occurs most often in sexually active women under age 25. Other risk factors include regular douching and recent insertion of an intrauterine device. Smoking and receiving the H P V vaccination are not risk factors for the development of P I D.

1) While visiting the home of a single patient who is raising school-age children, the nurse becomes concerned that the quality of care for the children after school is less than adequate. What did the nurse observe that led to this conclusion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Children fighting in the front yard 2. Youngest child failing spelling and arithmetic 3. Middle child received an A on a writing assignment 4. Youngest child received a black eye from a child in school 5. Oldest child riding the bicycle in the street without a helmet

Answer: 1, 2, 4, 5 Explanation: Low-quality childcare is associated with increased peer arguments, lower cognitive and language scores, bullying, and risky or impulsive behavior. Higher academic scores are associated with mothers who have college educations.

1) While conducting a health interview, the nurse suspects that a middle-aged female client has undiagnosed learning disabilities. What did the nurse observe to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Difficulty reading instructions 2. Illegible signature on treatment forms 3. Difficulty tying shoes when eyeglasses are not being worn 4. Inability to hear normal conversation through the right ear 5. Inability to select correct paper money to pay the insurance co-pay

Answer: 1, 2, 5 Explanation: Learning disabilities can inhibit educational attainment and employment. Learning disabilities include dyslexia, which can hinder reading, writing, and spelling; dysgraphia, which manifests with poor handwriting; and dyscalculia, which includes difficulty with processing math. The inability to tie shoes without wearing eyeglasses and not hearing through the right ear are physical issues that do not necessarily impact learning.

1) At the end of a routine examination, a 68-year-old female asks the nurse what she should observe to determine if she should obtain custody of her two preschool-age grandchildren. What factors should the nurse tell this patient to look for? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Parental divorce 2. Long work hours 3. Drug or alcohol abuse 4. Intimate partner violence 5. Use of public transportation

Answer: 1, 3, 4 Explanation: The most common reasons why grandparents obtain guardianship of grandchildren include parental divorce, drug or alcohol abuse, and intimate partner violence. Long work hours and use of public transportation are not reasons for grandparents to obtain guardianship of grandchildren.

1) The nurse is caring for a client diagnosed with cystitis. When teaching the client about self-care techniques, which foods or beverages will the nurse advise the client to avoid? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Caffeine 2. Dairy products 3. Alcohol 4. Carbonated beverages 5. Acidic fruit juices

Answer: 1, 3, 4 Explanation: The nurse should advise the client to avoid foods or beverages that are bladder irritants, such as caffeine, alcohol, or carbonated beverages. Dairy products and acidic fruit juices are not considered bladder irritants and would not be included when advising the client to avoid bladder irritants.

A patient is being assessed for recurrent vulvovaginal candidiasis (V V C) infections. What should the nurse instruct this patient to do to help reduce the incidence of infection? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Avoid douching 2. Use vaginal sprays 3. Wear cotton underwear 4. Avoid tight-fitting clothing 5. Apply cornstarch to the vulva

Answer: 1, 3, 4 Explanation: Ways to prevent the recurrence of V V C include avoiding douching, wearing cotton underwear and avoiding tight-fitting clothing. Vaginal sprays should be avoided since they can irritate the vulva. Applying cornstarch to the vulva could encourage itching.

1) An older person contacts the emergency medical service at 11 P M to report that she has been left sitting in her wheelchair all day after her caregiver left in the morning to buy groceries. What type of elder abuse is this person experiencing? A) Abandonment B) Physical abuse C) Financial abuse D) Psychological abuse

Answer: A Explanation: A) Abandonment is the desertion of an elder by any person responsible for the care and custody of that elder, under circumstances in which a reasonable person would continue to provide care. There is no evidence that the older person is experiencing physical, financial, or psychological abuse.

1) During a routine physical examination a female patient asks the nurse what can be done to prevent the development of breast cancer. What should the nurse review with the patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Exercise regularly 2. Discuss starting tamoxifen 3. Reduce the intake of red meat 4. Maintain a normal body weight 5. Reduce the intake of dietary fat

Answer: 1, 3, 4, 5 Explanation: Actions to reduce modifiable risks for breast cancer include exercising regularly, reducing the intake of red meat, avoiding obesity, and reducing dietary fat. Women at high risk of breast cancer may choose to begin chemoprevention using tamoxifen

1) A college student is distraught after being diagnosed with pediculosis pubis. What should the nurse instruct this student to do to help prevent future infections? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Both partners need to be treated 2. Take the prescribed medication for 10 days 3. Avoid all sexual contact until treated and cured 4. Wash bed linens in hot water and dry in a dryer for 20 minutes 5. Testing for other sexually transmitted infections is recommended

Answer: 1, 3, 4, 5 Explanation: For pediculosis pubis, both partners need to be tested. All sexual contact should be avoided until treated and cured. Bed linens, towels, clothing, and other objects should be machine washed in hot water (at least 103°F) and dried in a hot dryer for 20 minutes. Both partners must be treated and tested for other S T Is. The medication for pediculosis pubis is topical, and repeated if nits are still present.

1) A married couple of Ashkenazi Jewish descent is pregnant with their first child. For which genetic health problems should the nurse provide teaching in anticipation of further testing? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Cystic fibrosis 2. Beta-thalassemia 3. Canavan disease 4. Tay-Sachs disease 5. Familial dysautonomia

Answer: 1, 3, 4, 5 Explanation: Genetic screening for individuals of Ashkenazi Jewish descent includes cystic fibrosis, Canavan disease, Tay-Sachs disease, and familial dysautonomia. Beta-thalassemia is a genetic disorder seen in individuals of Greek or Italian descent.

1) The nurse is reviewing data collected during a health history and physical assessment and suspects that the patient could be experiencing polycystic ovarian syndrome (P C O S). What information did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Body mass index 31 2. Hair loss and warm moist skin 3. Periods occur every 3 to 4 months 4. Fasting capillary blood glucose 123 m g/d L 5. Inability to become pregnant after 2 years of unprotected intercourse

Answer: 1, 3, 4, 5 Explanation: The most common clinical signs and symptoms of PCOS include obesity since half of women with PCOS are clinically obese. Irregular menses is the hallmark of PCOS. Hyperinsulinemia is associated with PCOS. The majority of women with PCOS struggle with some degree of infertility. Hair loss and warm moist skin are not manifestations of PCOS

1) The nurse is preparing teaching materials for female clients who wish to perform breast self-examination. In which order should the nurse ensure that the teaching materials present the process of inspection? 1. Compare the breasts 2. Study the skin surface 3. Analyze for symmetry 4. Study the shape and direction 5. Look at color, thickening, edema, and venous patterns

Answer: 1, 3, 4, 5, 2 Explanation: When inspecting the breasts, the breasts should be first compared, then analyzed for symmetry. Next the shape and direction should be studied, followed by looking at color, thickening, edema, and venous pattern. Lastly, the skin surface should be studied.

The nurse is preparing instructions for a patient newly diagnosed with genital herpes. What should the nurse encourage to promote healing of the lesions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Take sitz baths 2. Use vaginal sprays 3. Wear cotton underwear 4. Douche after intercourse 5. Wear loose fitting clothing

Answer: 1, 3, 5 Explanation: Actions to promote healing of genital herpes lesions include taking sitz baths, wearing cotton underwear, and wearing loose fitting clothing. Vaginal sprays and douching after intercourse will not help heal genital herpes lesions.

The nurse is ensuring that a patient has provided informed consent before agreeing to an amniocentesis. In which order should the nurse validate that informed consent was provided by the patient? 1. Information provides risk and benefits 2. Information provided clearly and concisely 3. Information included treatment alternatives 4. Information explaining the right to refuse treatment 5. Information reviews consequences if no treatment provided

Answer: 2, 1, 3, 5, 4 Explanation: Several elements must be addressed to ensure that the patient has given informed consent. The information must be clearly and concisely presented in a manner understandable to the patient and must include risks and benefits, the probability of success, and significant treatment alternatives. The patient also needs to be told the consequences of receiving no treatment or procedure. Finally, the patient must be told of the right to refuse a specific treatment or procedure. Each patient should be told that refusing the specified treatment or procedure does not result in the withdrawal of all support or care.

1) During an interview the nurse learns that a patient's sister was recently diagnosed with endometrial cancer. What should the nurse review to reduce the patient's risk for developing the same disease process? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Smoking cessation 2. Maintain a normal body mass index 3. Consider birth control without estrogen 4. Limit the intake of alcohol to one drink per day 5. Increase exercise to 30 minutes most days of the week

Answer: 2, 3 Explanation: Risk factors for endometrial cancer include obesity and long-term use of unopposed estrogen. Smoking, alcohol, and limited exercise are not risk factors for the development of endometrial cancer

1) The nurse is providing care for a female client who is the victim of sexual assault. Which sexually transmitted infections (S T Is) does the nurse anticipate medication prescriptions to prevent? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Syphilis 2. Gonorrhea 3. Chlamydia 4. Bacterial vaginosis 5. Herpes simplex virus

Answer: 2, 3, 4 Explanation: A client who is the victim of sexual assault is at the greatest risk for contracting gonorrhea, chlamydia, and bacterial vaginosis. The nurse would anticipate medication prescriptions for these S T Is. While the client is also at risk for syphilis and herpes simplex virus, these S T Is are not as common; therefore, the nurse would not anticipate medication prescriptions for these S T Is.

1) A patient experiencing menopause asks what complementary and alternative therapy can be taken to reduce the symptoms. After reviewing the patient's health history, for which problems should the nurse encourage the patient to avoid taking phytoestrogens? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Allergy to soy 2. Currently taking tamoxifen 3. Treated for breast cancer 5 years ago 4. Surgery for uterine fibroids in her 20s 5. Experiences insomnia several times a week

Answer: 2, 3, 4 Explanation: Women who have had or are at risk for diseases that are affected by hormones, such as breast cancer or uterine fibroids, and women who are taking medications that increase estrogen levels in the body such as tamoxifen need to be especially careful about using phytoestrogens. An allergy to soy and experiencing insomnia are not reasons for the patient to avoid taking phytoestrogens.

1) A female comes into the emergency department seeking treatment for possible rape. The patient recalls having a cocktail with friends at a local club but woke up in an alley three blocks away from the business. For which date rape drugs should the nurse prepare to have this patient tested? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Atropine 2. Ketamine 3. Scopolamine 4. Flunitrazepam 5. Gamma hydroxybutyrate

Answer: 2, 3, 4, 5 Explanation: Flunitrazepam (Rohypnol), a potent sedative-hypnotic has received considerable attention as the "date rape drug of choice" since the late 1990s. Typically, Rohypnol, which dissolves easily and is odorless, is slipped into the drink of an unsuspecting woman. Gamma hydroxybutyrate (G H B), ketamine, and scopolamine have also been identified as date rape drugs that are used to incapacitate a woman. Atropine is not identified as being a date rape drug.

A patient in her late 40s asks the nurse what she should expect when entering menopause. In which order should the nurse identify changes that the patient will experience during menopause? 1. Amenorrhea 2. Anovulation 3. Reduced fertility 4. Changes in menstrual flow 5. Menstrual cycle irregularities

Answer: 2, 3, 4, 5, 1 Explanation: Beginning 2 to 8 years before menopause, women experience episodes of anovulation, reduced fertility, decreased or increased menstrual flow, menstrual cycle irregularities, and then, ultimately, amenorrhea.

The nurse suspects that a newly admitted patient is experiencing manifestations of hepatitis A. What assessment findings did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Rash 2. Fever 3. Jaundice 4. Joint pain 5. Gray-colored stool

Answer: 2, 3, 5 Explanation: Hepatitis A is characterized by symptoms of fever, jaundice, and gray-colored bowel movements. A rash and arthritis are associated with hepatitis B, C, and D.

1) The nurse in the community clinic is preparing educational materials to be used for teaching patients with sexually transmitted infections. What information should the nurse include regarding the medications metronidazole or tinidazole? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Take this medication until symptoms disappear 2. Abstain from all alcohol while taking these medications 3. Stop taking oral contraceptives while taking these medications 4. Abstain from all alcohol for 72 hours after completing tinidazole 5. Abstain from all alcohol for 24 hours after completing metronidazole

Answer: 2, 4, 5 Explanation: Alcohol should be avoided when taking either metronidazole or tinidazole. When combined with alcohol, both metronidazole and tinidazole can produce effects similar to that of alcohol and Antabuse-abdominal pain, flushing, and tremors. The C D C (2010b) recommends abstaining from alcohol for 24 hours after completing metronidazole and 72 hours after completing tinidazole. If the woman is taking oral contraceptives, a backup nonhormonal contraceptive method is recommended during treatment with metronidazole. The patient should be encouraged to complete the full course of prescribed medications.

1) The nurse is providing care to a female client in the acute phase of recovery following a sexual assault. Which nursing actions are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Clarifying feelings 2. Creating a safe environment 3. Supporting advocacy efforts 4. Establishing a trusting relationship 5. Providing care for significant others

Answer: 2, 5 Explanation: During the acute phase of recovery following a sexual assault, the appropriate nursing actions include creating a safe environment and providing care for significant others. Clarifying feelings is an appropriate nursing action during the reorganizational phase of recovery following a sexual assault. Supporting advocacy efforts is an appropriate nursing action during the integration and recovery phases of recovery following a sexual assault. Establishing a trusting relationship is an appropriate nursing action during the outward adjustment phase following a sexual assault.

A patient using the calendar rhythm method of birth control asks for assistance to calculate her most fertile period. She states that her shortest cycle is 22 days and her longest cycle is 40 days. Using this information, which day should the nurse identify as being the end of the patient's fertile period?

Answer: 29 Explanation: The calendar rhythm method (C R M) is based on the assumption that ovulation tends to occur 14 days (plus or minus 2 days) before the start of the next menstrual period. The fertile phase is calculated from 18 days before the end of the shortest recorded cycle through 11 days from the end of the longest recorded cycle. For this situation the where the cycle lasts from 22 to 40 days, the fertile phase would be calculated as day 4 (22-18) to day 29 (40-11). The last day of the fertile phase would be day 29.

The nurse is assisting with the collection of evidence for a female client who is the victim of sexual assault. Which actions by the nurse are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Drawing blood to test for gonorrhea 2. Placing each piece of clothing in a plastic bag 3. Pulling hair from the head and pubic region as evidence 4. Collecting a urine sample if drug-facilitated rape is suspected 5. Obtaining informed consent prior to photographing the injured areas

Answer: 3, 4, 5 Explanation: When collecting evidence for a female client who is the victim of sexual assault, the nurse will assist in pulling hair from the head and pubic region as evidence, collect a urine sample if drug-facilitated rape is suspected, and obtain informed consent prior to photographing the areas of injury. The nurse would draw blood to test for syphilis, not gonorrhea. The nurse would place each piece of the client's clothing into a paper bag, which is sealed and labeled. A plastic bag is not appropriate.

The nurse is reviewing the Quality and Safety Education for Nurses (Q S E N) competencies while preparing an in-service program to address safety in the neonatal intensive care unit. In which order should the nurse present these competencies? 1. Safety 2. Informatics 3. Patient-centered care 4. Quality improvement 5. Evidence-based practice 6. Teamwork and collaboration

Answer: 3, 6, 5, 4, 1, 2 Explanation: The Quality and Safety Education for Nurses (Q S E N) project is designed "to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (K S A s) necessary to continuously improve the quality and safety of the healthcare systems within which they work. The project focuses on competencies in six areas: 1. Patient-centered care, 2. Teamwork and collaboration; 3. Evidence-based practice; 4. Quality improvement; 5. Safety; and 6. Informatics.

1) The nurse is preparing to meet with a female patient to review the most appropriate contraceptive method. In which order should the nurse complete the steps of this process? 1. Emphasize actions if pregnancy occurs 2. Instruct on the use of the selected method 3. Review side effects and warning symptoms 4. Assess for medical contraindications to specific methods 5. Learn about lifestyle, attitudes, religious beliefs and plans for children

Answer: 4, 5, 2, 3, 1 Explanation: In addition to completing a history and assessing for any medical contraindications to specific methods, spend time with a woman learning about her lifestyle, personal attitudes about particular contraceptive methods, religious and cultural beliefs, personal biases, and plans for future childbearing. Once the woman chooses a method, help her learn to use it effectively. Review any possible side effects and warning symptoms related to the method chosen and counsel the woman about what action to take if she suspects she is pregnant.

The manager of a maternal-child care area is preparing information to share with nursing staff regarding the leading causes of infant death in the United States. In which order, from most to least frequent, should the manager provide this information? 1. S I D S 2. Low birth weight 3. Unintentional injuries 4. Maternal complications 5. Congenital malformation

Answer: 5, 2, 1, 4, 3 Explanation: The five leading causes of deaths of infants in the United States, from highest to lowest in frequency, are congenital malformations, low birth weight, S I D S, maternal complications, and unintentional injuries.

1) The nurse is helping a victim of domestic violence create a safety plan. In which order should the nurse recommend that the steps of the plan be completed? 1. Decide where to go regardless of the day or time 2. Establish a code word that is shared with family and friends 3. Have money, identification, and bank account information prepared 4. Determine a planned escape route with emergency telephone numbers 5. Pack a change of clothes, toilet articles, and keys stored away from the home

Answer: 5, 3, 1, 2, 4 Explanation: The patient should pack a change of clothes including toilet articles and an extra set of car and house keys stored away from her house with a friend or neighbor; have money, identification papers, and bank account information prepared; have a plan for where she will go, regardless of the day or time; establish a code word for danger that is shared with family and friends; and have a planned escape route and emergency telephone numbers

A patient is concerned about contracting herpes genitalis from a sexual partner and asks the nurse what to expect if the infection is present. In which order should the nurse explain the infection to the patient? 1. Emotional trigger occurs 2. Lesions spontaneously appear 3. Take oral acyclovir as prescribed 4. Virus enters a dormant phase with no lesions 5. Development of single or multiple blister-like vesicles

Answer: 5, 3, 4, 1, 2 Explanation: The primary episode (first outbreak) of herpes genitalis is characterized by the development of single or multiple blister-like vesicles. Primary episodes usually last the longest and are the most severe. The recommended treatment of the first clinical episode of genital herpes is oral acyclovir, valacyclovir, or famciclovir. After the lesions heal, the virus enters a dormant phase, residing in the nerve ganglia of the affected area. Recurrences are usually less severe than the initial episode and seem to be triggered by emotional stress, menstruation, ovulation, pregnancy, and frequent or vigorous intercourse. Recurrence of the lesions is less severe.

1) The nurse is identifying a plan to help a rape victim work through the phases of recovery. In which order should the nurse perform the following actions to help this victim? 1. Clarify the victim's feelings 2. Establish a trusting relationship 3. Acknowledge the victim's success 4. Provide advocacy as requested by the victim 5. Allow the victim to grieve and express feelings

Answer: 5, 4, 2, 1, 3 Explanation: The order in which nursing actions should be provided to a victim during the phases of rape recovery include allowing the victim to grieve and express feelings during the acute phase; provide advocacy as identified by the victim during the outward adjustment phase; establish a trusting relationship and clarify the victim's feelings during the reorganizational phase; and acknowledge the victim's success during the integration and recovery phase

1) The client's Pap smear result is A S C-U S. Which statement is the best way for the nurse to explain this A S C-U S result? A) "Abnormal cells of an unknown cause." B) "Cancer has invaded the upper cervix." C) "High-grade squamous intraepithelial lesion (H S I L), which includes C I N." D) "The focus of the Pap smear is the detection of high-risk pregnancy." E) "The cervical cells are abnormal and the reason why is severe dysplasia and carcinoma in situ."

Answer: A Explanation: A) A S C-U S stands for abnormal squamous cells of undetermined significance. The nurse should tell the client that these are abnormal cells of an unknown cause. Preferred management is H P V testing; if positive, refer for colposcopy; if negative, repeat H P V co-testing in 3 years. B) A S C-U S does not indicate cancer. C) C I N refers to a lesion that may progress to invasive carcinoma (cancer). A S C-U S does not indicate cancer. D) The focus of the Pap smear is the detection of high-grade cervical disease, especially cervical intraepithelial neoplasia (C I N). ASC-US stands for abnormal squamous cells of undetermined significance. The cervical cells are abnormal, but the reason why is unknown

A nurse who tells family members the sex of a newborn baby without first consulting the parents would have committed which of the following? A) A breach of privacy B) Negligence C) Malpractice D) A breach of ethics

Answer: A Explanation: A) A breach of privacy would have been committed in this situation, because informing other family members of the child's sex without the parents' consent violates the parents' right to privacy. The right to privacy is the right of a person to keep his person and property free from public scrutiny (or even from other family members). B) Negligence is a punishable legal offense, and is more serious. C) Malpractice is a punishable legal offense, and is more serious. D) No breach of ethics has been committed in this situation.

1) Abdominal hysterectomy is generally recommended for which condition? A) Severe endometriosis B) Removal of the ovaries C) Suspected or confirmed cancer removal D) Abnormal uterine bleeding

Answer: A Explanation: A) Abdominal hysterectomy is recommended for severe endometriosis. B) Removal of the uterus through an abdominal incision is called a total abdominal hysterectomy (T A H), and removal of both fallopian tubes and ovaries is called a bilateral salpingo-oophorectomy (B S O); when both procedures are done at the same time it is termed a T A H-B S O. C) Total abdominal hysterectomy (T A H) is preferred when cancer is suspected or confirmed because it permits easier exploration of the abdomen and pelvis to determine the degree and extent of involvement. D) Vaginal hysterectomy is generally done for pelvic relaxation, abnormal uterine bleeding, or small fibroids.

1) The nurse is caring for a postpartal client of Hmong descent who immigrated to the United States 5 years ago. The client asks for the regular hospital menu because American food tastes best. The nurse assesses this response to be related to which of the following cultural concepts? A) Acculturation B) Ethnocentrism C) Enculturation D) Stereotyping

Answer: A Explanation: A) Acculturation (assimilation) is the correct assessment because the client adapted to a new cultural norm in terms of food choices. B) Ethnocentrism refers to a social identity that is associated with shared behaviors and patterns. C) Enculturation occurs when culture is learned and passed on from generation to generation, and often happens when a group is isolated. D) Stereotyping is the assumption that all members of a group have the same characteristics.

The client reports relief from headaches when she rubs the temples on each side of her head. The nurse understands that this is a form of which of the following? A) Acupressure B) Acupuncture C) Reflexology D) Hydrotherapy

Answer: A Explanation: A) Acupressure uses pressure from the fingers and thumbs to stimulate pressure points to relieve symptoms. B) Acupuncture uses 6-12 very fine stainless steel needles to stimulate specific points, depending on the client's medical assessment and condition. C) Reflexology is a form of massage that involves the application of pressure to designated points or reflexes on the client's feet, hands, or ears using the thumb and fingers. Hydrotherapy is therapy that makes use of hot or cold moisture in any form

A female patient schedules an appointment for a gynecologic examination. Which finding should indicate to the nurse that the patient is experiencing a vaginal infection? A) Foul odor from used tampons B) Scant menstrual flow at the end of the cycle C) Abdominal bloating a few days prior to menstruation D) Saturating a tampon every 2 hours during menstruation

Answer: A Explanation: A) An unusual odor when using tampons could indicate an infection. Scant menstrual flow at the end of the cycle is an expected finding. Abdominal bloating a few days prior to menstruation could be associated with premenstrual syndrome. Saturating a tampon every 2 hours during menstruation could indicate abnormal bleeding which should be evaluated. B) An unusual odor when using tampons could indicate an infection. Scant menstrual flow at the end of the cycle is an expected finding. Abdominal bloating a few days prior to menstruation could be associated with premenstrual syndrome. Saturating a tampon every 2 hours during menstruation could indicate abnormal bleeding which should be evaluated. C) An unusual odor when using tampons could indicate an infection. Scant menstrual flow at the end of the cycle is an expected finding. Abdominal bloating a few days prior to menstruation could be associated with premenstrual syndrome. Saturating a tampon every 2 hours during menstruation could indicate abnormal bleeding which should be evaluated. D) An unusual odor when using tampons could indicate an infection. Scant menstrual flow at the end of the cycle is an expected finding. Abdominal bloating a few days prior to menstruation could be associated with premenstrual syndrome. Saturating a tampon every 2 hours during menstruation could indicate abnormal bleeding which should be evaluated.

1) The nurse is providing care to a client who is the victim of sexual assault. Which assessment finding does the nurse anticipate during the disorganization phase of rape trauma syndrome? A) Anxiety B) Insomnia C) Dyspepsia D) Depression

Answer: A Explanation: A) Anxiety is an expected clinical manifestation that occurs during the disorganization phase of rape trauma syndrome. B) Insomnia is an expected clinical manifestation that often occurs during the reorganization phase of rape trauma syndrome. C) Dyspepsia is an expected clinical manifestation that often occurs during the reorganization phase of rape trauma syndrome. D) Depression is an expected clinical manifestation that often occurs during the reorganization phase of rape trauma syndrome.

1) A family has the following inherited disorder. What information should the nurse review with this family? A) There are various degrees of presentation B) The disorder will become milder in subsequent generations C) This is seen in consanguineous mating D) There is no male-to-male transmission

Answer: A Explanation: A) Autosomal dominant inherited disorders have varying degrees of presentation. This is an important factor when counseling families concerning autosomal dominant disorders. Although a parent may have a mild form of the disease, the child may have a more severe form. There is no evidence to support autosomal dominant inherited disorders will become milder in subsequent generations. Autosomal recessive inherited disorders are seen more when there is a history of consanguineous mating. No male-to-male transmission is associated with X-linked recessive inheritance disorders.

A premenopausal female received a recommendation by her healthcare provider to have a bone mineral density (B M D) test done. What should the nurse identify as being the reason for the test at this time in the patient's life? A) History of an eating disorder B) Takes N S A I Ds for osteoarthritis C) Lives with a spouse who smokes cigarettes D) Surgery for carpal tunnel syndrome last year

Answer: A Explanation: A) B M D testing may be indicated for premenopausal women with certain medical conditions such as eating disorders. B M D testing is not indicated when taking N S A I Ds for osteoarthritis, living with a spouse who smokes, or after having carpal tunnel surgery. B) B M D testing may be indicated for premenopausal women with certain medical conditions such as eating disorders. B M D testing is not indicated when taking N S A I Ds for osteoarthritis, living with a spouse who smokes, or after having carpal tunnel surgery. C) B M D testing may be indicated for premenopausal women with certain medical conditions such as eating disorders. B M D testing is not indicated when taking N S A I Ds for osteoarthritis, living with a spouse who smokes, or after having carpal tunnel surgery. D) B M D testing may be indicated for premenopausal women with certain medical conditions such as eating disorders. B M D testing is not indicated when taking N S A I Ds for osteoarthritis, living with a spouse who smokes, or after having carpal tunnel surgery.

1) Which is a known characteristic of domestic violence batterers? A) Feeling inferior to others B) Working in a low-paying job C) Having a low socioeconomic status D) Being diagnosed with posttraumatic stress disorder

Answer: A Explanation: A) Domestic violence batterers often have feelings of insecurity, inferiority, powerlessness, and helplessness that conflict with their assumptions of male supremacy. B) Batterers come from all occupations, not just from low-paying jobs. C) Batterers come from all socioeconomic strata. A diagnosis of posttraumatic stress disorder is not a known characteristic of domestic violence batterers

1) The nurse is working with a client who has experienced a fetal death in utero at 20 weeks. The client asks what her baby will look like when it is delivered. Which statement by the nurse is best? A) "Your baby will be covered in fine hair called lanugo." B) "Your child will have arm and leg buds, not fully formed limbs." C) "A white, cheesy substance called vernix caseosa will be on the skin." D) "The genitals of the baby will be ambiguous."

Answer: A Explanation: A) Downy fine hair called lanugo covers the body of a 20-week-old fetus. B) Limb buds have developed by 35 days post-fertilization. C) Vernix caseosa forms at about 24 weeks. D) Male and female external genitals appear similar until end of ninth week. At 16 weeks, sex determination is possible.

The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? A) Age 30, treated for P I D B) Age 25, monogamous C) Age 20, pregnant D) Age 27, uses a diaphragm

Answer: A Explanation: A) Exposure to sexually transmitted infections increases the risk of abnormal cell changes and cervical cancer. B) Practicing monogamy does not increase the risk of cervical cancer. C) Pregnancy does not increase the risk of cervical cancer. D) Use of a diaphragm does not increase the risk of cervical cancer.

1) The nurse is teaching a class to the community on mind-based therapies. A class participant gives an example of a friend with leukemia who was taught by her complementary therapist to concentrate on making antibodies that will fight and kill the cancer cells in the bloodstream. How would the nurse identify this technique? A) Guided imagery B) Qigong C) Biofeedback D) Homeopathy

Answer: A Explanation: A) Guided imagery is a state of intense, focused concentration used to create compelling mental images and is useful in imagining a desired effect. B) Qigong involves the use of breathing, meditation, self-massage, and movement. C) Biofeedback is learning to control physiologic responses to stimuli or thoughts. D) Homeopathy is not a mind-body therapy, but uses the concept of like curing like.

1) The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? A) Age 37, multiple partners B) Age 22, abstains from sexual intercourse C) Age 32, pregnant with twins D) Age 27, uses female condom

Answer: A Explanation: A) Having multiple partners increases the client's risk of contracting sexually transmitted infections, including possible exposure to human papilloma virus (H P V). Contracting H P V increases the risk of abnormal cervical cell changes and cervical cancer. B) Practicing abstinence does not increase risks of cervical cancer. C) Pregnancy of any type does not increase risks of cervical cancer. Use of a female condom does not increase risks of cervical cancer

1) A woman has come to the emergency department with multiple bruises on her body and a small laceration over her upper lip. She says she fell down the stairs while doing housework. Which observation would most cause the nurse to suspect that the client has been a victim of battering? A) The client is hesitant to provide details about how the injuries occurred. B) The client was accompanied to the emergency department by her mother instead of her partner. C) The client has sought care quickly after the incident. D) The client does not seem to be in pain.

Answer: A Explanation: A) Hesitation to provide detailed information about the injury and how it occurred is a common sign of abuse. B) Who accompanies the client to the emergency department is not a significant sign for abuse. C) Often a woman delays seeking care when there has been abuse. D) Pain level is not indicative of abuse. The experience of pain and how it is expressed is often a cultural issue.

There have been a number of historical trends that have contributed to the existing wage gap, including which of the following? A) There was a perception that men were the sole breadwinners. B) Women who were competitive in the work environment were viewed positively. C) Women in past generations generally were not limited to certain occupations. D) Increase in societal importance of women's intellectual traits.

Answer: A Explanation: A) Historically, there was a perception that men were the sole breadwinners, thus higher salaries for men were justified to support a family. B) Historically, women who were competitive in the work environment were viewed negatively. C) Women in past generations generally were limited to certain occupations. D) There was an increase in societal importance focusing on women's appearance, with intellectual traits being viewed less favorably.

When analyzing data collected during a sexual history, the nurse notes that a patient has limited information about contraception. What should the nurse do to address this patient's need? A) Provide the patient with the information B) Suggest that the patient talk with the nurse practitioner C) Schedule an appointment for the patient to see the midwife D) Discuss the implications if contraception is not used correctly

Answer: A Explanation: A) If a deficiency in knowledge is identified the nurse can identify a plan of care to address this deficiency and provide the teaching. The patient does not need to talk with a nurse practitioner or a midwife to discuss contraception. The implications of inappropriately used contraception can be included when discussing the individual types with the patient. B) If a deficiency in knowledge is identified the nurse can identify a plan of care to address this deficiency and provide the teaching. The patient does not need to talk with a nurse practitioner or a midwife to discuss contraception. The implications of inappropriately used contraception can be included when discussing the individual types with the patient. C) If a deficiency in knowledge is identified the nurse can identify a plan of care to address this deficiency and provide the teaching. The patient does not need to talk with a nurse practitioner or a midwife to discuss contraception. The implications of inappropriately used contraception can be included when discussing the individual types with the patient. If a deficiency in knowledge is identified the nurse can identify a plan of care to address this deficiency and provide the teaching. The patient does not need to talk with a nurse practitioner or a midwife to discuss contraception. The implications of inappropriately used contraception can be included when discussing the individual types with the patient

1) The client has been a victim of a violent, sadistic rape. She is crying and asks the nurse, "Why would someone do something like that?" The nurse should explain that which of the following is the primary purpose of sadistic rape? A) Take pleasure from the victim's struggle and pain B) Express feelings of rage C) Feel a sense of power or mastery D) Relieve intolerable anxiety

Answer: A Explanation: A) In sadistic rape, the assailant has an antisocial personality and delights in torture and mutilation. In this type of rape, the victim and assailant are generally strangers, and the assault is planned. Sadistic rapes cause the most injuries, including homicide. B) In anger rape, the sexual assault is used to express feelings of rage and to retaliate for what the attacker perceives as wrongs against him. These perceived wrongs most often have nothing to do with the rape victim. Considerable brutality and degradation can characterize this type of rape. Attacks on older women often are a form of anger rape. C) In power rape, the purpose of the assault is control or mastery. The assailant uses sexual intercourse to place a woman in a powerless position so that he can feel dominant, potent, and strong. He often believes that his victim enjoys the assault, and he exerts only the amount of force necessary to subdue his victim. Often power rape is a planned stranger attack, but most acquaintance rapes are also power rapes. The vast majority of all rapes are motivated by this need for power and control. D) Anxiety is not associated with a type of rape.

A patient and her partner are being treated for trichomoniasis. What should the nurse emphasize when teaching the couple about this infection? A) Avoid intercourse until symptom free B) Ensure a repeat test is completed in 3 months C) Limit alcohol intake while taking metronidazole D) Have annual screening for recurrence of the infection

Answer: A Explanation: A) In trichomoniasis, partners should avoid intercourse until both are cured. Retesting for gonorrhea is recommended 3 months following treatment secondary to increasing prevalence and the potential for P I D. Alcohol should be avoided, not limited, for 48 hours after taking metronidazole because of an effect similar to that of alcohol and disulfiram (Antabuse). Annual screening for sexually active individuals up to age 25 is recommended for chlamydia.

1) The nurse is admitting a Hispanic woman scheduled for a cholecystectomy. The nurse uses a cultural assessment tool during the admission. Which question would be most important for the nurse to ask? A) "What other treatments have you used for your abdominal pain?" B) "In what country were you were born?" C) "When you talk to family members, how close do you stand?" D) "How would you describe your role within your family?"

Answer: A Explanation: A) Knowing what other treatments the client has used for pain is most important because some traditional or folk remedies include the use of herbs, which can have medication interactions. B) Although information about the country of birth is helpful, it is not a physiological issue. Asking other questions is a higher priority. C) Although understanding the client's perception of appropriate personal space is helpful, it is not a physiological issue. Asking other questions is a higher priority. D) Although understanding the client's family roles is helpful, it is not a physiological issue. Asking other questions is a higher priority.

A premenopausal patient is experiencing vaginal dryness. What pharmacological intervention should the nurse suggest for this patient's symptom? A) Local low-dose vaginal estrogen B) Testosterone replacement therapy C) Menopausal hormone therapy with testosterone D) Menopausal hormone therapy with estrogen alone

Answer: A Explanation: A) Local low-dose vaginal estrogen is generally recommended to treat vaginal dryness or dyspareunia. Women are not provided with testosterone alone replacement therapy. Menopausal hormone therapy with testosterone helps to improve libido. Hormone therapy containing estrogen only is given to women who have undergone a hysterectomy. B) Local low-dose vaginal estrogen is generally recommended to treat vaginal dryness or dyspareunia. Women are not provided with testosterone alone replacement therapy. Menopausal hormone therapy with testosterone helps to improve libido. Hormone therapy containing estrogen only is given to women who have undergone a hysterectomy. C) Local low-dose vaginal estrogen is generally recommended to treat vaginal dryness or dyspareunia. Women are not provided with testosterone alone replacement therapy. Menopausal hormone therapy with testosterone helps to improve libido. Hormone therapy containing estrogen only is given to women who have undergone a hysterectomy. D) Local low-dose vaginal estrogen is generally recommended to treat vaginal dryness or dyspareunia. Women are not provided with testosterone alone replacement therapy. Menopausal hormone therapy with testosterone helps to improve libido. Hormone therapy containing estrogen only is given to women who have undergone a hysterectomy.

A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be: A) Oral acyclovir B) Ceftriaxone I M C) Azithromycin P O D) Penicillin G I M

Answer: A Explanation: A) Malaise, dysuria, and tingling or painful vesicles are indicative of a primary herpes simplex outbreak. Acyclovir treats herpes. B) Ceftriaxone I M does not treat herpes. C) Azithromycin does not treat herpes. D) Penicillin does not treat herpes.

After a pelvic examination, a patient is scheduled for tests to diagnose pelvic inflammatory disease. Which finding from the physical examination suggested to the nurse practitioner that further testing is required? A) Cervical tenderness B) Greenish vaginal discharge C) Open sores along the vagina D) Condylomata acuminata on the vulva

Answer: A Explanation: A) Manifestations of pelvic inflammatory disease include cervical tenderness or the chandelier sign. Greenish vaginal discharge is associated with gonorrhea. Open sores along the vagina might be associated with genital herpes. Condylomata acuminata on the vulva are genital warts.

1) The nurse is caring for a client pregnant with twins. Which statement indicates that the client needs additional information? A) "Because both of my twins are boys, I know that they are identical." B) "If my twins came from one fertilized egg that split, they are identical." C) "If I have one boy and one girl, I will know they came from two eggs." D) "It is rare for both twins to be within the same amniotic sac."

Answer: A Explanation: A) Not all same-sex twins are identical or monozygotic, because fraternal, or dizygotic, twins can be the same gender or different genders. B) Identical, or monozygotic, twins develop from a single fertilized ovum. They are of the same sex and have the same phenotype (appearance). C) The only way to have twins of different sexes is if they come from two separate fertilized ova. D) If the amnion has already developed approximately 8 to 12 days after fertilization, division results in two embryos with a common amniotic sac and a common chorion (monochorionic-monoamniotic placenta). This type occurs rarely.

Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which often results in which of the following? A) There is less trauma to the mother. B) More childbirth education classes are available. C) They are instrumental in providing change in the birth environment at work. D) They advocate for more home healthcare agencies.

Answer: A Explanation: A) Nurse-midwife models of care can be one way to ensure that mothers receive excellent prenatal and intrapartum care. B) It is appropriate for nurse-midwives, in conjunction with doctors and hospitals, to provide childbirth classes for expectant families. C) By working with other staff members and doctors, the nurse-midwife is able to implement changes as needed within the birthing unit. D) Clients are increasingly going home sooner, so there needs to be more follow-up in the home.

1) Which client in the gynecology clinic should the nurse see first? A) 32-year-old taking gonadotropins, reporting extremity edema B) 15-year-old, no menses for past 4 months C) 18-year-old seeking information on contraception methods D) 31-year-old, taking progestins, reports increasing dyspareunia

Answer: A Explanation: A) Ovarian hyperstimulation syndrome (O H S S) is a potentially life-threatening complication of ovulation induction by gonadotropin therapy, manifested by third-spacing. This client should be seen first. B) Secondary amenorrhea can be caused by pregnancy; teen pregnancy is a high risk. This client does not take priority of care. C) Unplanned pregnancy and sexually transmitted infections can be problematic in the future, but this client exhibits no signs or symptoms of a life-threatening condition at this time and does not need to be seen first. D) Although this client might have endometriosis, dyspareunia is not a life-threatening condition.

1) A female college student comes into the student health clinic, concerned about being pregnant from unprotected intercourse the evening before. What should the school nurse counsel this student? A) "Take Plan B One Step now." B) "Take 1 pill of Plan B now and the second pill in 5 days." C) "Take one half of Plan B One Step now and the second half in 3 days." D) "Wait 5 days and take 1 pill of Plan B followed by the second pill in 2 days."

Answer: A Explanation: A) Plan B One-Step is one pill containing 1.5 m g of levonorgestrel which should be taken as one dose within 72 hours of unprotected intercourse. Plan B comes as two tablets of 0.75 m g levonorgestrel to be taken at once and should be taken as soon after coitus as possible. The pill in Plan B One-Step does not need to be split or taken days apart. The Plan B pills should be taken immediately and not after waiting for 5 days. B) Plan B One-Step is one pill containing 1.5 m g of levonorgestrel which should be taken as one dose within 72 hours of unprotected intercourse. Plan B comes as two tablets of 0.75 m g levonorgestrel to be taken at once and should be taken as soon after coitus as possible. The pill in Plan B One-Step does not need to be split or taken days apart. The Plan B pills should be taken immediately and not after waiting for 5 days. C) Plan B One-Step is one pill containing 1.5 m g of levonorgestrel which should be taken as one dose within 72 hours of unprotected intercourse. Plan B comes as two tablets of 0.75 m g levonorgestrel to be taken at once and should be taken as soon after coitus as possible. The pill in Plan B One-Step does not need to be split or taken days apart. The Plan B pills should be taken immediately and not after waiting for 5 days. D) Plan B One-Step is one pill containing 1.5 m g of levonorgestrel which should be taken as one dose within 72 hours of unprotected intercourse. Plan B comes as two tablets of 0.75 m g levonorgestrel to be taken at once and should be taken as soon after coitus as possible. The pill in Plan B One-Step does not need to be split or taken days apart. The Plan B pills should be taken immediately and not after waiting for 5 days.

When assessing a client asking about birth control, the nurse knows that the client would not be a good candidate for Depo-Provera (D M P A) if which of the following is true? A) She wishes to get pregnant within 3 months. B) She is a nursing mother. C) She has a vaginal prolapse. D) She weighs 200 pounds.

Answer: A Explanation: A) Return of fertility after use may be delayed for an average of 10 months. B) A nursing mother can use Depo-Provera. C) Obesity and vaginal prolapse do not contraindicate the use of Depo-Provera. D) Obesity and vaginal prolapse do not contraindicate the use of Depo-Provera.

1) What is the most important aspect of care for the nurse to remember when screening a woman for partner abuse? A) Ensuring privacy and confidentiality B) Conveying warmth and empathy C) Asking specific, direct questions about abuse D) Clarifying her myths about battering

Answer: A Explanation: A) Screening for women experiencing domestic violence must be done privately, with only the nurse and the client present, in a safe and quiet place. B) Warmth and empathy are helpful, but confidentiality is more important. C) General questions about possible abuse both will facilitate trust building and are more likely to obtain accurate information, but privacy to obtain this information is the first priority. D) Clarifying myths is not essential during screening.

1) A pregnant client asks the nurse, "What is this "knuckle test" that is supposed to tell whether my baby has a genetic problem?" What does the nurse correctly explain? A) "In the first trimester, the nuchal translucency measurement is used to improve the detection rate for Down syndrome and trisomy 18." B) "You will need to ask the physician for an explanation." C) "It tests for hemophilia A or B." D) "It tests for Duchenne muscular dystrophy."

Answer: A Explanation: A) Screening tests, such as nuchal translucency ultrasound are designed to gather information about the risk that the pregnancy could have chromosome abnormalities or open spina bifida. B) This is not an appropriate response. The nurse must be aware of laboratory tests performed during pregnancy to intelligently answer clients' questions. C) D N A testing tests for hemophilia. DNA testing tests for Duchenne muscular dystrophy

1) The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The client asserts that her menarche was 5 years ago. Her menses are usually every 28 days, but her last menstrual period was 4 months ago. The client denies any sexual activity. Which is the best statement for the nurse to make? A) "Your lack of menses might be related to your rapid weight loss." B) "It is common and normal for runners to stop having any menses." C) "Increase your intake of iron-rich foods to reestablish menses." D) "Adolescents rarely have regular menses, even if they used to be regular."

Answer: A Explanation: A) Secondary amenorrhea can be caused by rapid weight loss, including the development of the eating disorders anorexia and bulimia. Runners with low body fat might have irregular menses, but amenorrhea is not a normal condition. B) It is common for runners to have amenorrhea, but it is not normal. C) Iron deficiency does not impact menstrual regularity. D) Although the first year or two after menarche might be characterized by irregular menses, once menses are established and regular, a lack of menses is secondary amenorrhea.

1) The nurse notes that a lesbian client who recently found a breast lump on self-examination has not had a mammogram for 10 years. When asked about this delay the client states that she was not made to feel comfortable during the last mammogram. What should the nurse recognize is the underlying problem that this client is describing? A) Social barrier B) Emotional barrier C) Fear of finding a health problem D) Discomfort with the examination

Answer: A Explanation: A) Since the patient is lesbian and did not feel comfortable during her last mammogram, the nurse suspects that the patient experienced discrimination and social barriers related to the client's sexual orientation. Lesbian women are at greater risk for health and social disparities such as lack of screening for female-related cancers (breast cancer and cervical cancer). There is no information to support fear of finding a health problem, or discomfort with the examination. Although the client is likely emotional over the experience, the underlying problem described is a social barrier or discrimination.

1) A client tells you that her mother was a twin, two of her sisters have twins, and several cousins either are twins or gave birth to twins. The client, too, is expecting twins. Because there is a genetic predisposition to twins in her family, there is a good chance that the client will have what type of twins? A) Dizygotic twins B) Monozygotic twins C) Identical twins D) Nonzygotic twins

Answer: A Explanation: A) Studies indicate that dizygotic twins tend to occur in certain families, perhaps because of genetic factors that result in elevated serum gonadotropin levels leading to double ovulation. B) Monozygotic twins, known also as identical twins, are not familial. C) Identical twins, known also as monozygotic twins, are not familial. D) Nonzygotic twins do not exist.

The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client is at greatest risk for the infection? A) 16-year-old sexually active girl, using no contraceptive B) 22-year-old mother of two, developed dyspareunia C) 35-year-old woman on oral contraceptives D) 48-year-old woman with hot flashes and night sweats

Answer: A Explanation: A) Teens have the highest incidence of sexually transmitted infections, especially chlamydia. A client not using contraceptives is not using condoms, which decrease the risk of contracting a S T I. B) Dyspareunia sometimes develops with chlamydia infection, but dyspareunia is not a symptom specific to chlamydia. C) There is no correlation between oral contraceptive use and an increased rate of chlamydia infection. Additionally, chlamydia is more commonly seen in young women. This client is experiencing signs of menopause, not of chlamydia infection

The nurse is completing the health history for a client desiring the Essure method of permanent sterilization. What should the nurse specifically ask when assessing this client? A) "Are you allergic to any metals?" B) "How many children do you have?" C) "When was your last menstrual period?" D) "Is your spouse aware of the procedure?"

Answer: A Explanation: A) The Essure® method of permanent sterilization uses a nickel-titanium alloy. The client should be asked about having an allergy to nickel. The number of children, last menstrual period, and spouse's knowledge about the procedure are not essential when completing the client's health history prior to this method of sterilization. B) The Essure® method of permanent sterilization uses a nickel-titanium alloy. The client should be asked about having an allergy to nickel. The number of children, last menstrual period, and spouse's knowledge about the procedure are not essential when completing the client's health history prior to this method of sterilization. C) The Essure® method of permanent sterilization uses a nickel-titanium alloy. The client should be asked about having an allergy to nickel. The number of children, last menstrual period, and spouse's knowledge about the procedure are not essential when completing the client's health history prior to this method of sterilization. D) The Essure® method of permanent sterilization uses a nickel-titanium alloy. The client should be asked about having an allergy to nickel. The number of children, last menstrual period, and spouse's knowledge about the procedure are not essential when completing the client's health history prior to this method of sterilization.

1) A client describes breast swelling and tenderness. What piece of data would be most important for the nurse to gather initially? A) Timing of the symptoms B) Birth control method C) Method of breast self-examination D) Diet history

Answer: A Explanation: A) The breast undergoes regular cyclical changes in response to hormonal stimulation. The nurse will want to determine when the swelling and tenderness occur within the menstrual cycle. B) The birth control method can contribute to the database, but does not have priority. C) The method of B S E can contribute to the database, but does not have priority. D) Diet history can contribute to the database, but does not have priority.

A client in the women's clinic asks the nurse, "How is the cervical mucus method of contraception different from the rhythm method?" The appropriate response by the nurse is that the cervical mucus method is which of the following? A) More effective for women with irregular cycles B) Not acceptable to women of many different religions C) Harder to work with than the rhythm method D) Requires an artificial substance or device

Answer: A Explanation: A) The cervical mucus method (Billings Ovulation Method) can be used by women with irregular cycles. B) The cervical mucus method (Billings Ovulation Method) can be used by women of many religions, and is safe and free. C) The cervical mucus method (Billings Ovulation Method) is easier to implement than is the rhythm method for most women. D) The cervical mucus method (Billings Ovulation Method) does not require any artificial device.

A patient schedules an appointment to be seen in the community clinic for dysuria, urgency, frequency, blood in the urine, and low back pain. For which health problem should the nurse provide care for this patient? A) Cystitis B) Pyelonephritis C) Glomerulonephritis D) Asymptomatic bacteriuria

Answer: A Explanation: A) The classic initial symptoms of cystitis include dysuria, urgency, frequency, low back pain and hematuria. Manifestations of acute pyelonephritis include a sudden onset with chills, high temperature, costovertebral angle tenderness or flank pain, nausea, vomiting, and general malaise. Manifestations of glomerulonephritis include periorbital edema, elevated blood pressure, and urinary changes. Asymptomatic bacteriuria has no characteristic manifestations.

1) The nurse is working with a woman who is undergoing chemotherapy for breast cancer. The client states, "First, the cancer seemed unreal. Now I feel like I can cope." What is the nurse's best response? A) "Women with breast cancer often go through several stages of adjustment." B) "Women with breast cancer cope better than their partners cope." C) "Women with breast cancer seek multiple opinions before starting treatment." D) "Women with breast cancer become angry after treatment begins."

Answer: A Explanation: A) The course of adjustment confronting the woman with cancer has been described in four phases: shock, reaction, recovery, and reorientation. The client's statement indicates shock followed by reaction. B) Partners are often the primary support person during treatment, but might also have difficulty adapting to the diagnosis. C) Some clients seek multiple opinions; some do not. D) Anger is not a stage of adjustment.

1) A pregnant client who is at 14 weeks' gestation asks the nurse why the doctor used to call her baby an embryo, and now calls it a fetus. What is the best answer to this question? A) "Fetus is the term used from the ninth week of gestation onward." B) "We call a baby a fetus when it is larger than an embryo." C) "An embryo is a baby from conception until the eighth week." D) "The official term for a baby in utero is really zygote."

Answer: A Explanation: A) The fetal stage begins in the ninth week. B) The embryonic stage ends with the eighth week, regardless of size. C) The preembryonic stage is from conception until day 15. A zygote is a fertilized ovum

The nurse is telling a new client how advanced technology has permitted the physician to do which of the following? A) Treat the fetus and monitor fetal development. B) Deliver at home with a nurse-midwife and doula. C) Have the father act as the coach and cut the umbilical cord. Breastfeed a new baby on the delivery table.

Answer: A Explanation: A) The fetus is increasingly viewed as a patient separate from the mother, although treatment of the fetus necessarily involves the mother. B) A nurse-midwife and a doula are not examples of technological care. C) Fathers being present during labor and coaching their partners represents nontechnological care during childbirth. D) Breastfeeding is not an example of technology impacting care.

1) The nurse is preparing a program about osteoporosis for a group of community members. What should the nurse emphasize as being the greatest risk factor for the development of this disorder? A) Family history B) Caucasian race C) Sedentary lifestyle D) Low lifetime intake of calcium

Answer: A Explanation: A) The greatest influencing factor for the development of osteoporosis is a family history of osteoporosis. Although Caucasian race, sedentary lifestyle, and low lifetime intake of calcium are risk factors, the greatest factor is family history. B) The greatest influencing factor for the development of osteoporosis is a family history of osteoporosis. Although Caucasian race, sedentary lifestyle, and low lifetime intake of calcium are risk factors, the greatest factor is family history. C) The greatest influencing factor for the development of osteoporosis is a family history of osteoporosis. Although Caucasian race, sedentary lifestyle, and low lifetime intake of calcium are risk factors, the greatest factor is family history. D) The greatest influencing factor for the development of osteoporosis is a family history of osteoporosis. Although Caucasian race, sedentary lifestyle, and low lifetime intake of calcium are risk factors, the greatest factor is family history.

1) Which action by the nurse is appropriate when providing care to a female client who is the victim of domestic violence? A) Providing adequate time for the client to tell her story B) Reporting the incident to the police to protect the client C) Telling the spouse about the client's accusations of abuse D) Stressing to the client that the abuse could have been avoided

Answer: A Explanation: A) The nurse should allow the client adequate time to work through her story, problems, and situation at her own pace. B) The nurse would not report the incident to the police to protect the client. Reporting the abuse is associated with the risk for further abuse towards the client. C) It is not appropriate for the nurse to tell the client's spouse about the accusations of abuse. This is a breach of confidentiality. D) It is not therapeutic for the nurse to stress to the client that the abuse could have been avoided.

1) Which term will the nurse use when teaching a client information regarding the entire female external genitalia? A) Vulva B) Clitoris C) Mons pubis D) Perineal body

Answer: A Explanation: A) The vulva is the term the nurse will use when documenting information about the entire female external genitalia. B) The clitoris is a structure included in the female external genitalia. This term is not used when referring to the entire female external genitalia. C) The mons pubis is a structure included in the female external genitalia. This term is not used when referring to the entire female external genitalia. The perineal body is a structure included in the female external genitalia. This term is not used when referring to the entire female external genitalia

The nurse manager is examining the descriptive statistics of increasing teen pregnancy rates in the community. Which inferential statistical research question would the nurse manager find most useful in investigating the reasons for increased frequency of teen pregnancy? A) What providers do pregnant teens see for prenatal care? B) What are the ages of the parents of pregnant teens in the community? C) Do pregnant teens drink caffeinated beverages? D) What do pregnant teens do for recreation?

Answer: A Explanation: A) Understanding which providers pregnant teens are most likely to seek out for prenatal care can lead to further investigation on why prenatal care with that provider is more acceptable to teens, which in turn can lead to greater understanding of the issue of teen pregnancy. B) A question about the age of parents of pregnant teens might prove useful in seeking causes of teen pregnancy, but it is not the most useful question in understanding the increased frequency of teen pregnancy. C) Whether pregnant teens drink caffeinated beverages gives no further insight into the issues of teen pregnancy. D) Understanding the recreational activities of pregnant teens would not lead to an understanding of the issues surrounding increasing teen pregnancy rates.

1) The nurse is providing care to a female client who is the victim of domestic violence. Which referral by the nurse is most appropriate? A) Group therapy B) Physical therapy C) Nutrition therapy D) Occupational therapy

Answer: A Explanation: A) Victims of domestic violence require counseling and advocacy from the nurse. The most appropriate referral for this client is group therapy. B) Physical therapy is not an appropriate referral for this client. C) Nutrition therapy is not an appropriate referral for this client. D) Occupational therapy is not an appropriate referral for this client.

1) The pregnant client employed at a factory asks the nurse whether exposure to chemicals can cause harm to her fetus. The nurse should advise the client that exposure to which substance can lead to neurological damage? A) Lead B) Latex C) Formaldehyde D) Benzene

Answer: A Explanation: A) Women exposed to lead during pregnancy are at risk for spontaneous abortion, prematurity, low birth weight, intrauterine growth restriction, and brain, kidney, and nervous system dysfunction. B) Exposure to latex is not known to cause neurological damage. C) Exposure to formaldehyde is not known to cause neurological damage. Exposure to benzene is not known to cause neurological damage

1) A patient with female genital mutilation is being prepared for a gynecologic examination. What cultural implications should the nurse keep in mind when assisting with this examination? A) Maintain a nonjudgmental attitude B) The procedure was performed by choice C) The patient is at increased risk for genital infection D) The procedure was performed to increase sexual satisfaction

Answer: A Explanation: A) Women who immigrate to other countries may feel a sense of shame or embarrassment once the procedure has been performed. The nurse needs to maintain a nonjudgmental attitude to support this patient's cultural needs. Most female genital mutilations are not performed by choice. They can increase the patient's risk for genital infection however this would not support the patient's cultural needs. Female genital mutilation is performed to reduce sexual satisfaction.

1) The nurse is caring for a female client with a history of pelvic inflammatory disease (P I D) who reports having difficulty conceiving after unprotected sex for over 2 years. Which deviation from the norm does the nurse recognize is most likely the cause of the client's infertility? A) Non-patent fallopian tube B) Unfavorable cervical mucus C) Absence of ovulation D) Abnormal endometrial preparation

Answer: A Explanation: A) Women with a history of pelvic inflammatory disease (P I D) have the risk of developing infertility. Specifically, obstruction and non-patent fallopian tubes often occur in P I D and are a common source of infertility among women with the disease. Unfavorable cervical mucus, absence of ovulation, and abnormal endometrial preparation may all lead to infertility; however, these are not most common among women diagnosed with P I D. B) Women with a history of pelvic inflammatory disease (P I D) have the risk of developing infertility. Specifically, obstruction and non-patent fallopian tubes often occur in P I D and are a common source of infertility among women with the disease. Unfavorable cervical mucus, absence of ovulation, and abnormal endometrial preparation may all lead to infertility; however, these are not most common among women diagnosed with P I D. C) Women with a history of pelvic inflammatory disease (P I D) have the risk of developing infertility. Specifically, obstruction and non-patent fallopian tubes often occur in P I D and are a common source of infertility among women with the disease. Unfavorable cervical mucus, absence of ovulation, and abnormal endometrial preparation may all lead to infertility; however, these are not most common among women diagnosed with P I D. D) Women with a history of pelvic inflammatory disease (P I D) have the risk of developing infertility. Specifically, obstruction and non-patent fallopian tubes often occur in P I D and are a common source of infertility among women with the disease. Unfavorable cervical mucus, absence of ovulation, and abnormal endometrial preparation may all lead to infertility; however, these are not most common among women diagnosed with P I D.

A female client with an intrauterine device calls the clinic because she is unable to locate the strings after her last menstrual period. What should the nurse counsel this client? A) Schedule an appointment immediately B) Wait a few days and recheck for the strings C) Take a tub bath and then recheck for the strings D) Perform a douche and then recheck for the strings

Answer: A Explanation: A) Women with intrauterine contraception should contact their healthcare providers if the strings are missing. The client should not wait a few days, take a tub bath, or douche before rechecking for the strings. B) Women with intrauterine contraception should contact their healthcare providers if the strings are missing. The client should not wait a few days, take a tub bath, or douche before rechecking for the strings. C) Women with intrauterine contraception should contact their healthcare providers if the strings are missing. The client should not wait a few days, take a tub bath, or douche before rechecking for the strings. D) Women with intrauterine contraception should contact their healthcare providers if the strings are missing. The client should not wait a few days, take a tub bath, or douche before rechecking for the strings.

1) Why is it important for the nurse to understand the type of family that a client comes from? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Family structure can influence finances. B) Some families choose to conceive or adopt without a life partner. C) The nurse can anticipate which problems a client will experience based on the type of family the client has. D) Understanding if the client's family is nuclear or blended will help the nurse teach the client the appropriate information. E) The values of the family will be predictable if the nurse knows what type of family the client is a part of.

Answer: A, B Explanation: A) Single-parent families often face difficulties because the sole parent may lack social and emotional support, need assistance with childrearing issues, and face financial strain. B) In the single mother by choice family, the mother is typically older, college-educated, and financially stable and has contemplated pregnancy significantly prior to conceiving. C) Each client and family must be assessed as individuals, without making assumptions. Although generalities can be drawn based on the type of family that a client comes from or currently is part of, stereotypes must be avoided. D) Each client and family must be assessed as individuals, without making assumptions. Although generalities can be drawn based on the type of family that a client comes from or currently is part of, stereotypes must be avoided. E) Each client and family must be assessed as individuals, without making assumptions. Although generalities can be drawn based on the type of family that a client comes from or currently is part of, stereotypes must be avoided.

During a wellness visit, a 50-year-old female experiencing menopause says that she jogs three times a week and feels like her symptoms are becoming worse. What should the nurse recommend to help with the discomfort of menopause? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Yoga B) Tai chi C) Meditation D) Weight lifting E) Kegel exercises

Answer: A, B, C Explanation: A) A variety of therapeutic modalities have been proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years, including mind-body practices such as yoga, tai chi, and meditation. Weight lifting helps maintain bone mass caused by the reduction in estrogen. Kegel exercises help maintain vaginal muscle tone and increase blood circulation to the perineal area. B) A variety of therapeutic modalities have been proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years, including mind-body practices such as yoga, tai chi, and meditation. Weight lifting helps maintain bone mass caused by the reduction in estrogen. Kegel exercises help maintain vaginal muscle tone and increase blood circulation to the perineal area. C) A variety of therapeutic modalities have been proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years, including mind-body practices such as yoga, tai chi, and meditation. Weight lifting helps maintain bone mass caused by the reduction in estrogen. Kegel exercises help maintain vaginal muscle tone and increase blood circulation to the perineal area. D) A variety of therapeutic modalities have been proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years, including mind-body practices such as yoga, tai chi, and meditation. Weight lifting helps maintain bone mass caused by the reduction in estrogen. Kegel exercises help maintain vaginal muscle tone and increase blood circulation to the perineal area. A variety of therapeutic modalities have been proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years, including mind-body practices such as yoga, tai chi, and meditation. Weight lifting helps maintain bone mass caused by the reduction in estrogen. Kegel exercises help maintain vaginal muscle tone and increase blood circulation to the perineal area

1) During the assessment phase of a family, the community nurse recognizes that culture influences childrearing and childbearing in which of the following ways? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Beliefs about the importance of children B) Beliefs and attitudes about pregnancy C) Norms regarding infant feeding D) Acculturation is important in rearing children E) Time orientation to the future is very important

Answer: A, B, C Explanation: A) Culture influences beliefs about the importance of children. B) Culture influences attitudes about pregnancy and the right vs. the obligation of women to bear children. C) Culture influences infant feeding norms and practices. D) Acculturation is not important in rearing children. E) Time orientation is a cultural difference and can emphasize the past, present, or future. It does not influence childbearing and childrearing.

What issues should the nurse consider when counseling a client on contraceptive methods? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Cultural perspectives on menstruation and pregnancy B) Effectiveness of the method C) Future childbearing plans D) Whether the client is a vegetarian E) Age at menarche

Answer: A, B, C Explanation: A) Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem. B) Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem. C) Decisions about contraception should be made voluntarily with full knowledge of advantages, disadvantages, effectiveness, side effects, contraindications, and long-term effects. Many outside factors influence this choice, including cultural practices, religious beliefs, personality, cost, effectiveness, availability, misinformation, practicality of method, and self-esteem. D) Vegetarianism has no impact on contraceptive method use. E) Age at menarche has no impact on contraceptive method use.

1) Lesbian, transgendered, and bisexual women are at greater risk for health and social disparities, including which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Increased suicide risk B) Increased risk of homelessness C) Lack of screening for female-related cancers D) Lack of screening for lung cancers E) Increased divorce rates

Answer: A, B, C Explanation: A) Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes increased suicide risk. B) Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes increased risk of homelessness. C) Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes lack of screening for female-related cancers. D) Lack of screening for lung cancer is not a specific risk factor for this demographic. E) Increased divorce rates is not a specific factor for this demographic.

1) In working with immigrants in an inner-city setting, the nurse recognizes that acculturation of immigrants often brings with it which of the following benefits? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Improved socioeconomic status B) Use of preventive care services C) Better nutrition D) Increase in substance abuse over time E) More physician visits due to language barriers

Answer: A, B, C Explanation: A) Improvement of socioeconomic status is a benefit of acculturation in the United States. B) Acculturation of immigrants increases the likelihood that the family members will use preventive health services. C) Improved socioeconomic status leads to better nutrition and access to health care. D) Substance abuse tends to increase over time as immigrants acculturate, especially among Hispanics. E) Language barriers with physicians tend to decrease the use of healthcare services.

1) In assessing a family, the community nurse uses a family assessment tool, which provides an organized framework to collect data concerning which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Access to laundry and grocery facilities B) Access to health care C) Sharing of religious beliefs and values D) Acculturation to traditional lifestyles E) Ability to include a new spouse into the family unit

Answer: A, B, C Explanation: A) Measuring access to laundry, grocery, and recreational facilities that meet the physical, emotional, and spiritual needs of members is part of the family assessment tool. B) Measuring access to healthcare that meets the physical, emotional, and spiritual needs of members is part of the family assessment tool. C) Learning about shared religious beliefs and values, which meet the physical, emotional, and spiritual needs of members, is part of the family assessment tool. D) Acculturation to traditional lifestyles is not measured with the family assessment tool. E) The ability to include a new spouse into the family unit is a developmental task/stage of those who are divorced, and is not a part of the family assessment tool.

Nursing research is vital to do which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Expand the science of nursing. B) Foster evidence-based practice. C) Improve client care. D) Visually depict nursing management. Plan and organize care

Answer: A, B, C Explanation: A) Research is vital to expanding the science of nursing. B) Research is vital to fostering evidence-based practice. C) Research is vital to improving client care. D) The nursing process is research-based, but is not a part of the clinical pathway. Visually depicting nursing management is part of concept mapping, not nursing research. E) Organizing patient care is an aspect of the nursing process. Planning and organizing care is part of nursing care plans, not nursing research.

The Quality and Safety Education for Nurses (Q S E N) project focused on competencies in which areas? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Client-centered care B) Teamwork and collaboration C) Evidence-based practice D) Family planning E) Injury and violence prevention

Answer: A, B, C Explanation: A) The Quality and Safety Education for Nurses (Q S E N ) project is designed "to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes (K S A s) necessary to continuously improve the quality and safety of the healthcare systems within which they work," which includes client-centered care. B) The Quality and Safety Education for Nurses (Q S E N ) project, is designed "to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work," which includes teamwork and collaboration. C) The Quality and Safety Education for Nurses (Q S E N ) project, is designed "to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes (K S A s) necessary to continuously improve the quality and safety of the healthcare systems within which they work," which includes evidence-based practice. D) Healthy People 2020 focuses on family planning. E) Healthy People 2020 focuses on injury and violence prevention.

The nurse is discharging a client after hospitalization for pelvic inflammatory disease (P I D). Which statements indicate that teaching was effective? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "I might have infertility because of this infection." B) "It is important for me to finish my antibiotics." C) "Tubal pregnancy could occur after P I D." D) "My P I D was caused by a yeast infection." E) "I am going to have an I U D placed for contraception."

Answer: A, B, C Explanation: A) Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of P I D. B) Antibiotic therapy should always be completed when a client is diagnosed with any infection. C) The tubal scarring that occurs from tubal inflammation during P I D can prevent a fertilized ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy. D) P I D is caused by bacteria, most commonly Chlamydia trachomatis or Neisseria gonorrhoeae. E) An intrauterine device (I U D) in place increases the risk of developing P I D; a client who has a history of P I D is not a good candidate for an I U D.

A client at 10 weeks' gestation is scheduled for a surgical abortion. Which approaches may be used to dilate the cervix for the procedure? Note: Credit will be given only if all correct choices and no incorrect choices are elected. Select all that apply. A) Misoprostol B) Mifepristone C) Metal dilators D) Sterile seaweed E) Paracervical block

Answer: A, B, C, D Explanation: A) After 8 weeks' gestation, the cervix is dilated with misoprostol or mifepristone, mechanically with metal dilators, or osmotically with sterile seaweed. A paracervical block is used to anesthetize the cervix. B) After 8 weeks' gestation, the cervix is dilated with misoprostol or mifepristone, mechanically with metal dilators, or osmotically with sterile seaweed. A paracervical block is used to anesthetize the cervix. C) After 8 weeks' gestation, the cervix is dilated with misoprostol or mifepristone, mechanically with metal dilators, or osmotically with sterile seaweed. A paracervical block is used to anesthetize the cervix. D) After 8 weeks' gestation, the cervix is dilated with misoprostol or mifepristone, mechanically with metal dilators, or osmotically with sterile seaweed. A paracervical block is used to anesthetize the cervix. E) After 8 weeks' gestation, the cervix is dilated with misoprostol or mifepristone, mechanically with metal dilators, or osmotically with sterile seaweed. A paracervical block is used to anesthetize the cervix.

1) A 17-year-old high school student comes into the nurse's office to find out what to do about severe menstrual cramps. What should the nurse recommend to this student? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Rest B) Good nutrition C) Regular exercise D) Application of heat E) D & C of the uterus

Answer: A, B, C, D Explanation: A) Treatment of primary dysmenorrhea includes rest, good nutrition, regular exercise, and application of heat. D & C of the uterus is a treatment for secondary dysmenorrhea. B) Treatment of primary dysmenorrhea includes rest, good nutrition, regular exercise, and application of heat. D & C of the uterus is a treatment for secondary dysmenorrhea. C) Treatment of primary dysmenorrhea includes rest, good nutrition, regular exercise, and application of heat. D & C of the uterus is a treatment for secondary dysmenorrhea. D) Treatment of primary dysmenorrhea includes rest, good nutrition, regular exercise, and application of heat. D & C of the uterus is a treatment for secondary dysmenorrhea. E) Treatment of primary dysmenorrhea includes rest, good nutrition, regular exercise, and application of heat. D & C of the uterus is a treatment for secondary dysmenorrhea.

A 40-year-old patient is being seen in the clinic for gynecological changes. Which approaches should the nurse use when completing this patient's health interview? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Avoid writing B) Clarify terms used C) Maintain eye contact D) Analyze body language E) Use simple yes-no questions

Answer: A, B, C, D Explanation: A) When conducting a sexual history the nurse should avoid writing, clarify terms being used, maintain eye contact unless it is culturally inappropriate, and analyze the patient's body language. Using closed questions will limit the amount of information collected and should be avoided. B) When conducting a sexual history the nurse should avoid writing, clarify terms being used, maintain eye contact unless it is culturally inappropriate, and analyze the patient's body language. Using closed questions will limit the amount of information collected and should be avoided. C) When conducting a sexual history the nurse should avoid writing, clarify terms being used, maintain eye contact unless it is culturally inappropriate, and analyze the patient's body language. Using closed questions will limit the amount of information collected and should be avoided. D) When conducting a sexual history the nurse should avoid writing, clarify terms being used, maintain eye contact unless it is culturally inappropriate, and analyze the patient's body language. Using closed questions will limit the amount of information collected and should be avoided. E) When conducting a sexual history the nurse should avoid writing, clarify terms being used, maintain eye contact unless it is culturally inappropriate, and analyze the patient's body language. Using closed questions will limit the amount of information collected and should be avoided.

1) The public health nurse is working with a student nurse. The student nurse asks which of the six groups of people they have seen today are considered to be families. How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "The married heterosexual couple without children" B) "The gay couple with two adopted children" C) "The unmarried heterosexual couple with two biological children" D) "The lesbian couple not living together that have no children" E) "The married heterosexual couple with three children, living with grandparents"

Answer: A, B, C, E Explanation: A) Families take many forms in today's society. The basis for people to be considered a family is a commitment to one another and the sharing of responsibilities, chores, and expenses. A couple without children is still a family. B) Families take many forms in today's society. The basis for people to be considered a family is a commitment to one another and the sharing of responsibilities, chores, and expenses. Gay and lesbian families are those in which two or more people who share a same-sex orientation live together, or in which a gay or lesbian single parent rears a child. C) Families take many forms in today's society. The basis for people to be considered a family is a commitment to one another and the sharing of responsibilities, chores, and expenses. A family may be formed without a legal marriage. D) A couple not living together and without children together are considered dating and not yet a family. E) Families take many forms in today's society. The basis for people to be considered a family is a commitment to one another and the sharing of responsibilities, chores, and expenses. Extended family members, including parents or grandparents, will often live with their adult children or grandchildren, creating intergenerational families.

1) Psychologic elder abuse includes, but is not limited to, which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Verbal assaults B) Humiliation C) Desertion D) Intimidation E) Failure to provide reasonable care

Answer: A, B, D Explanation: A) Psychologic abuse includes verbal assaults. B) Psychologic abuse includes humiliation. C) Abandonment is the desertion of an elder by any person responsible for the care and custody of that elder. D) Psychologic abuse includes intimidation. E) Failure on the part of a caregiver, or any person having custody of an elder, to provide reasonable care, is consider neglect.

1) The nurse educator is teaching student nurses what a fetus will look like at various weeks of development. Which descriptions would be typical of a fetus at 20 weeks' gestation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) The fetus has a body weight of 435-465 g. B) Nipples appear over the mammary glands. C) The kidneys begin to produce urine. D) Nails are present on fingers and toes. E) Lanugo covers the entire body.

Answer: A, B, D, E Explanation: A) A fetus at 20 weeks' gestation has a body weight of 435-465 g. B) A fetus at 20 weeks' gestation has nipples appear over the mammary glands. C) Kidneys of a fetus begin to produce urine at 12 weeks' gestation. D) A fetus at 20 weeks' gestation has nails present on fingers and toes. E) A fetus at 20 weeks' gestation has lanugo that covers the entire body.

1) The nurse is discussing the use of contraception with a client who has just become sexually active. What factors should the nurse include when educating the client on contraceptive methods? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Contraindications in the client's health history B) Religious or moral beliefs C) Partner's belief in the effectiveness of the choice D) Personal preferences to use method E) Future childbearing plans

Answer: A, B, D, E Explanation: A) Decisions about contraception should take into consideration any contraindications the client might have. B) Religious or moral beliefs often impact which choices are acceptable. C) The partner's belief in the effectiveness has no bearing on the actual effectiveness. D) Personal preferences need to be considered when deciding on a contraceptive method. E) Plans for future children should be considered before determining whether sterilization should be performed.

1) A 30-year-old patient who experiences severe premenstrual syndrome every month asks for nonpharmacologic suggestions to treat this disorder. What should the nurse recommend? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Eat more frequent meals B) Engage in aerobic activity C) Limit alcohol to two drinks per day D) Restrict the intake of chocolate and coffee E) Increase the intake of fruits and vegetables

Answer: A, B, D, E Explanation: A) Nonpharmacologic approaches for treating premenstrual syndrome include eating more frequent meals, engaging in aerobic activity, restricting the intake of chocolate and coffee, and increasing the intake of fruits and vegetables. Alcohol should be restricted and not limited to two drinks per day. B) Nonpharmacologic approaches for treating premenstrual syndrome include eating more frequent meals, engaging in aerobic activity, restricting the intake of chocolate and coffee, and increasing the intake of fruits and vegetables. Alcohol should be restricted and not limited to two drinks per day. C) Nonpharmacologic approaches for treating premenstrual syndrome include eating more frequent meals, engaging in aerobic activity, restricting the intake of chocolate and coffee, and increasing the intake of fruits and vegetables. Alcohol should be restricted and not limited to two drinks per day. D) Nonpharmacologic approaches for treating premenstrual syndrome include eating more frequent meals, engaging in aerobic activity, restricting the intake of chocolate and coffee, and increasing the intake of fruits and vegetables. Alcohol should be restricted and not limited to two drinks per day. Nonpharmacologic approaches for treating premenstrual syndrome include eating more frequent meals, engaging in aerobic activity, restricting the intake of chocolate and coffee, and increasing the intake of fruits and vegetables. Alcohol should be restricted and not limited to two drinks per day

1) The nurse is preparing an educational session for high school female students on self-care during menstruation. What should the nurse include regarding care when using a tampon? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Wash hands before inserting a tampon B) Wash hands after inserting the tampon C) Change the tampon every 8 to 12 hours D) Use tampons with the minimum amount of absorbency E) Avoid touching the part that will be inserted into the vagina

Answer: A, B, D, E Explanation: A) Teaching about the use of tampons should include washing the hands before and after inserting the tampon, using tampons with the least amount of absorbency, and to avoid touching the part of the tampon that will be inserted into the vagina. Tampons should be changed every 3 to 6 hours. B) Teaching about the use of tampons should include washing the hands before and after inserting the tampon, using tampons with the least amount of absorbency, and to avoid touching the part of the tampon that will be inserted into the vagina. Tampons should be changed every 3 to 6 hours. C) Teaching about the use of tampons should include washing the hands before and after inserting the tampon, using tampons with the least amount of absorbency, and to avoid touching the part of the tampon that will be inserted into the vagina. Tampons should be changed every 3 to 6 hours. D) Teaching about the use of tampons should include washing the hands before and after inserting the tampon, using tampons with the least amount of absorbency, and to avoid touching the part of the tampon that will be inserted into the vagina. Tampons should be changed every 3 to 6 hours. E) Teaching about the use of tampons should include washing the hands before and after inserting the tampon, using tampons with the least amount of absorbency, and to avoid touching the part of the tampon that will be inserted into the vagina. Tampons should be changed every 3 to 6 hours.

1) In learning about Duvall's life-cycle stages ascribed to traditional families, the nursing student recognizes that developmental tasks of each stage include which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Adjusting to new roles as mother and father B) Working out authority and socialization roles with the school C) Becoming a single parent with custodial responsibilities D) Becoming a couple and dating E) Adjusting to the loss of a spouse

Answer: A, B, E Explanation: A) Adjusting to new roles as mother and father occurs in Stage Ⅱ, which describes childbearing families with infants. B) Working out authority and socialization roles with schools occurs in Stage Ⅳ, which describes families with school-age children. C) Traditional family life-cycle stages do not include those in which divorce occurs. D) Becoming a couple and dating occurs before marriage, and is not a part of the traditional family life-cycle stages. E) Stage Ⅷ includes adjusting to the loss of a spouse.

1) The 22-year-old client is scheduled for her first gynecologic examination. What can the nurse do to make the client more comfortable during this exam? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Create a trusting atmosphere. B) Show the client what the speculum looks like. C) Avoid telling the client what the exam involves. D) Ask the client why she has delayed her first Pap test this long. E) Provide a mirror for the client.

Answer: A, B, E Explanation: A) It is important to create a trusting atmosphere and incorporate practices that help the client maintain a sense of control. B) Show the client all of the equipment to be used. C) To reduce fear and improve the client's sense of control, create a trusting atmosphere by explaining everything involved in the exam. D) Asking why the client has delayed her first Pap test is being judgmental, which does not foster a therapeutic relationship. Provide a mirror to increase learning about anatomy and to create a trusting atmosphere

1) Ovarian hormones include which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Estrogens B) Progesterone C) Parathyroid hormone D) Luteinizing hormone E) Testosterone

Answer: A, B, E Explanation: A) Ovarian hormones include the estrogens, progesterone, and testosterone. B) Ovarian hormones include the estrogens, progesterone, and testosterone. C) Ovarian hormones do not include the parathyroid hormone. D) Ovarian hormones do not include the luteinizing hormone, although the ovary is sensitive to it. E) Ovarian hormones include the estrogens, progesterone, and testosterone.

1) In assessing a new family coming to the clinic, the nurse determines they are an extended kin family because the family exhibits what as characteristics of an extended kin network family? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) A sharing of a social support network B) Each family establishes their own sources of goods and services C) Elderly parents share housing D) Children are members of two nuclear families E) A sharing of goods and services

Answer: A, E Explanation: A) Extended kin family networks share a social support network. B) Extended kin family networks share goods and services, rather than establishing their own sources of goods and services. C) Elderly parents sharing a household is a feature of the extended family system. D) Children being members of two nuclear families applies to the binuclear family. E) Extended kin family networks share goods and services.

A client is being prepared to take the oral mifepristone-vaginal misoprostol treatment for an abortion. For which reasons should the nurse instruct the client to contact the healthcare provider within 24 hours? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Nausea B) Itchy skin C) Weakness D) Stomach pain E) Bloody discharge

Answer: A, C, D Explanation: A) A woman who has taken the oral mifepristone-vaginal misoprostol regimen and within 24 hours develops nausea, weakness, or stomach pain should contact the healthcare provider immediately. Itchy skin and bloody discharge are not identified as needing to be reported to the healthcare provider. B) A woman who has taken the oral mifepristone-vaginal misoprostol regimen and within 24 hours develops nausea, weakness, or stomach pain should contact the healthcare provider immediately. Itchy skin and bloody discharge are not identified as needing to be reported to the healthcare provider. C) A woman who has taken the oral mifepristone-vaginal misoprostol regimen and within 24 hours develops nausea, weakness, or stomach pain should contact the healthcare provider immediately. Itchy skin and bloody discharge are not identified as needing to be reported to the healthcare provider. D) A woman who has taken the oral mifepristone-vaginal misoprostol regimen and within 24 hours develops nausea, weakness, or stomach pain should contact the healthcare provider immediately. Itchy skin and bloody discharge are not identified as needing to be reported to the healthcare provider. E) A woman who has taken the oral mifepristone-vaginal misoprostol regimen and within 24 hours develops nausea, weakness, or stomach pain should contact the healthcare provider immediately. Itchy skin and bloody discharge are not identified as needing to be reported to the healthcare provider.

The nurse suspects that a client is experiencing adverse effects from the progestin within a combined oral contraceptive. What did the nurse assess to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Pruritus B) Headache C) Hirsutism D) Weight gain E) Hypertension

Answer: A, C, D Explanation: A) Pruritus, hirsutism (facial hair), and weight gain are adverse effects of progestin within a combined oral contraceptive. Headache and hypertension are adverse effects of estrogen within a combined oral contraceptive. B) Pruritus, hirsutism (facial hair), and weight gain are adverse effects of progestin within a combined oral contraceptive. Headache and hypertension are adverse effects of estrogen within a combined oral contraceptive. C) Pruritus, hirsutism (facial hair), and weight gain are adverse effects of progestin within a combined oral contraceptive. Headache and hypertension are adverse effects of estrogen within a combined oral contraceptive. D) Pruritus, hirsutism (facial hair), and weight gain are adverse effects of progestin within a combined oral contraceptive. Headache and hypertension are adverse effects of estrogen within a combined oral contraceptive. E) Pruritus, hirsutism (facial hair), and weight gain are adverse effects of progestin within a combined oral contraceptive. Headache and hypertension are adverse effects of estrogen within a combined oral contraceptive.

1) The nurse is reviewing the spermicidal agent nonoxynol-9 (N-9) with a client planning to use the barrier method to prevent pregnancy. What should the nurse emphasize when teaching about this preparation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) It does not cause toxicity. B) It is inserted after intercourse. C) It has no systemic side effects. D) It can be purchased over-the-counter. E) It reduces the risk of sexually transmitted infections.

Answer: A, C, D Explanation: A) The major advantages of spermicidal preparations include low local toxicity, lack of systemic side effects, and ease of obtaining through an over-the-counter purchase. Spermicides are inserted before intercourse. Nonoxyol-9 does not offer protection against the organisms that cause gonorrhea, chlamydia, or H I V/A I D S and may actually increase a woman's risk of H I V infection. B) The major advantages of spermicidal preparations include low local toxicity, lack of systemic side effects, and ease of obtaining through an over-the-counter purchase. Spermicides are inserted before intercourse. Nonoxyol-9 does not offer protection against the organisms that cause gonorrhea, chlamydia, or H I V/A I D S and may actually increase a woman's risk of H I V infection. C) The major advantages of spermicidal preparations include low local toxicity, lack of systemic side effects, and ease of obtaining through an over-the-counter purchase. Spermicides are inserted before intercourse. Nonoxyol-9 does not offer protection against the organisms that cause gonorrhea, chlamydia, or H I V/A I D S and may actually increase a woman's risk of H I V infection. D) The major advantages of spermicidal preparations include low local toxicity, lack of systemic side effects, and ease of obtaining through an over-the-counter purchase. Spermicides are inserted before intercourse. Nonoxyol-9 does not offer protection against the organisms that cause gonorrhea, chlamydia, or H I V/A I D S and may actually increase a woman's risk of H I V infection. E) The major advantages of spermicidal preparations include low local toxicity, lack of systemic side effects, and ease of obtaining through an over-the-counter purchase. Spermicides are inserted before intercourse. Nonoxyol-9 does not offer protection against the organisms that cause gonorrhea, chlamydia, or H I V/A I D S and may actually increase a woman's risk of H I V infection.

1) During an assessment, the nurse determines that a female patient is at risk for developing osteoporosis. Which information did the nurse use to make this clinical determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Body weight of 120 lb B) Plays tennis twice a week C) Smokes 2 packs per day of cigarettes D) Ingests 2 to 3 cocktails every day E) Mother diagnosed with osteoporosis

Answer: A, C, D, E Explanation: A) Risk factors for the development of osteoporosis include body weight less than 127 lbs., smoking cigarettes, ingestion of alcohol, and having a family history of osteoporosis. An active lifestyle is an action to reduce the risk of developing osteoporosis. B) Risk factors for the development of osteoporosis include body weight less than 127 lbs., smoking cigarettes, ingestion of alcohol, and having a family history of osteoporosis. An active lifestyle is an action to reduce the risk of developing osteoporosis. C) Risk factors for the development of osteoporosis include body weight less than 127 lbs., smoking cigarettes, ingestion of alcohol, and having a family history of osteoporosis. An active lifestyle is an action to reduce the risk of developing osteoporosis. D) Risk factors for the development of osteoporosis include body weight less than 127 lbs., smoking cigarettes, ingestion of alcohol, and having a family history of osteoporosis. An active lifestyle is an action to reduce the risk of developing osteoporosis. Risk factors for the development of osteoporosis include body weight less than 127 lbs., smoking cigarettes, ingestion of alcohol, and having a family history of osteoporosis. An active lifestyle is an action to reduce the risk of developing osteoporosis

1) If a woman returns to an abusive situation, the nurse should encourage her to develop an exit, or safety, plan for herself and her children, if she has any. What should the plan include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Identify friends and family who know about the situation and will help her. B) Call the police if violence begins. C) Pack a change of clothes for herself and the children. D) Have a plan for where she will go. E) Have a planned escape route.

Answer: A, C, D, E Explanation: A) She should identify friends and family who know about the situation and will help her. Ask that she establish a code word for danger with those family and friends. B) She should ask a neighbor to call the police if violence begins. C) She should pack a change of clothes for herself and the children, including toilet articles and an extra set of car and house keys stored away from her house with a friend or neighbor. D) She should have a plan for where she will go, regardless of the day or time. E) She should have a planned escape route and emergency telephone numbers she can call.

The nurse manager is consulting with a certified nurse-midwife about a client. What is the role of the C N M? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth. B) Give primary care for high-risk clients who are in hospital settings. C) Give primary care for healthy newborns. D) Obtain a physician consultation for any technical procedures at delivery. E) Be educated in two disciplines of nursing.

Answer: A, C, E Explanation: A) A C N M is prepared to manage independently the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns. B) CNMs cannot give primary care for high-risk clients who are in hospital settings. The physician provides the primary care. C) A C N M is prepared to manage independently the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns. D) The C N M does not need to obtain a physician consultation for any technical procedures at delivery. E) The C N M is educated in the disciplines of nursing and midwifery.

1) Among women who have been sexually assaulted, which of the following are the most frequently diagnosed sexually transmitted infections (S T Is)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Bacterial vaginosis B) H I V C) Chlamydia D) Syphilis E) Gonorrhea

Answer: A, C, E Explanation: A) Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (S T Is). B) H I V is not one of the most frequently diagnosed S T Is following a sexual assault. C) Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (S T Is). D) Syphilis is not one of the most frequently diagnosed S T Is following a sexual assault. E) Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (S T Is).

1) When a woman seeks care for an injury, the nurse should be alert to which clues of abuse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Defensive injuries B) Immediate reporting of symptoms or seeking care for injuries C) Lack of eye contact D) Providing too much detailed information about the injury E) Vague complaints without accompanying pathology

Answer: A, C, E Explanation: A) Defensive injuries may be a sign of abuse. B) Delayed reporting of symptoms or seeking care for injuries may be a sign of abuse, not immediate reporting and seeking care. C) Lack of eye contact may be a sign of abuse. D) Hesitation in providing detailed information about the injury and how it occurred may be a sign of abuse. E) Vague complaints without accompanying pathology may be a sign of abuse.

1) Student nurses in their obstetrical rotation are learning about fertilization and implantation. The process of implantation is characterized by which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) The trophoblast attaches itself to the surface of the endometrium. B) The most frequent site of attachment is the lower part of the anterior uterine wall. C) Between days 7 and 10 after fertilization, the zona pellucida disappears, and the blastocyst implants itself by burrowing into the uterine lining. D) The lining of the uterus thins below the implanted blastocyst. E) The cells of the trophoblast grow down into the uterine lining, forming the chorionic villi.

Answer: A, C, E Explanation: A) During implantation, the trophoblast attaches itself to the surface of the endometrium for further nourishment. B) The most frequent site of attachment is the upper part of the posterior uterine wall. C) Between days 7 and 10 after fertilization, the zona pellucida disappears, and the blastocyst implants itself by burrowing into the uterine lining and penetrating down toward the maternal capillaries until it is completely covered. D) The lining of the uterus thickens, not thins. E) The cells of the trophoblast grow down into the thickened lining, forming the chorionic villi.

The nurse is serving on a panel to evaluate the hospital staff's reliance on evidence-based practice in their decision-making processes. Which practices characterize the basic competencies related to evidence-based practice? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Recognizing which clinical practices are supported by good evidence B) Recognizing and including clinical practice supported by intuitive evidence C) Using data in clinical work to evaluate outcomes of care D) Including quality-improvement measures in clinical practice E) Appraising and integrating scientific bases into practice

Answer: A, C, E Explanation: A) Recognizing which clinical practices are supported by sound evidence is a basic competency related to evidence-based practice. B) Including clinical practice supported by intuitive evidence is not a basic competency related to evidence-based practice. C) Using data in clinical work to evaluate outcomes of care is one of the basic competencies related to evidence-based practice. D) Including quality-improvement measures is a form of evidence that can be useful in making clinical practice decisions, but it is not a basic competency related to evidence-based practice. E) Appraising and integrating scientific bases into practice is one of the characteristics of the basic competencies related to evidence-based practice.

A female patient asks what can be done to control vaginal odor. How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Wear cotton underwear B) Use a mild vaginal deodorant C) Schedule douching to occur weekly D) Cleanse from front to back when toileting E) Use soap and water to cleanse the perineum

Answer: A, D, E Explanation: A) To control vaginal odor the patient should be instructed to wear cotton underwear, cleanse from front to back when toileting, and to use soap and water to cleanse the perineum. Vaginal deodorants and douching are not recommended. B) To control vaginal odor the patient should be instructed to wear cotton underwear, cleanse from front to back when toileting, and to use soap and water to cleanse the perineum. Vaginal deodorants and douching are not recommended. C) To control vaginal odor the patient should be instructed to wear cotton underwear, cleanse from front to back when toileting, and to use soap and water to cleanse the perineum. Vaginal deodorants and douching are not recommended. D) To control vaginal odor the patient should be instructed to wear cotton underwear, cleanse from front to back when toileting, and to use soap and water to cleanse the perineum. Vaginal deodorants and douching are not recommended. E) To control vaginal odor the patient should be instructed to wear cotton underwear, cleanse from front to back when toileting, and to use soap and water to cleanse the perineum. Vaginal deodorants and douching are not recommended.

1) A 7-year-old client tells the nurse that "Grandpa, Mommy, Daddy, and my brother live at my house." The nurse identifies this as what type of family? A) Binuclear B) Extended C) Gay or lesbian D) Traditional

Answer: B Explanation: A) A binuclear family includes divorced parents with joint custody of their biologic children, who alternate spending varying amounts of time in the home of each parent. B) An extended family consists of a couple who share the house with their parents, siblings, or other relatives. C) A gay or lesbian family is composed of two same-sex domestic partners; they might not have children. D) The traditional nuclear family consists of a husband provider, a wife who stays home, and the biologic children of this union.

The nurse is explaining the difference between descriptive statistics and inferential statistics to a group of student nurses. To illustrate descriptive statistics, what would the nurse use as an example? A) A positive correlation between breastfeeding and infant weight gain B) The infant mortality rate in the state of Oklahoma C) A causal relationship between the number of sexual partners and sexually transmitted infections D) The total number of spontaneous abortions in drug-abusing women as compared with non-drug-abusing women

Answer: B Explanation: A) A positive correlation between two or more variables is an inferential statistic. B) The infant mortality rate in the state of Oklahoma is a descriptive statistic, because it describes or summarizes a set of data. C) A causal relationship between the number of sexual partners and sexually transmitted infections is an inferential statistic. D) The total number of spontaneous abortions in drug-abusing women is an inferential statistic.

The nurse is seeing clients in the women's clinic. Which client should be treated with ceftriaxone I M and doxycycline orally? A) A pregnant client with gonorrhea and a yeast infection B) A nonpregnant client with gonorrhea and chlamydia C) A pregnant client with syphilis D) A nonpregnant client with chlamydia and trichomoniasis

Answer: B Explanation: A) A pregnant client would not be treated with doxycycline. B) The combined treatment of ceftriaxone I M and doxycycline orally provides dual treatment for gonorrhea and chlamydia, which frequently occur together. C) The combined treatment of ceftriaxone I M and doxycycline orally is not the correct treatment for syphilis, and a pregnant client would not be treated with doxycycline. D) The combined treatment of ceftriaxone I M and doxycycline orally is not the correct treatment for trichomoniasis.

The nurse is preparing an education session for women on the prevention of urinary tract infections (U T Is). Which statement should be included? A) Lower urinary tract infections rarely occur in women. B) The most common causative organism of cystitis is E. coli. C) Wiping from back to front after a B M will help prevent a U T I. D) Back pain often develops with a lower urinary tract infection.

Answer: B Explanation: A) About 60% of women will experience an episode of cystitis during their lifetime. B) E. coli is present in 75% to 90% of women with U T Is. C) Wiping from back to front increases the risk of U T Is because the E. coli of the bowel is being drawn toward the urethra. Women should be instructed always to wipe from front to back. D) Low back or flank pain is a sign of pyelonephritis, which is an upper urinary tract infection.

1) The nurse manager in a hospital with a large immigrant population is planning an in-service. Aware of how ethnocentrism affects nursing care, the nurse manager asks, "The belief that one's own values and beliefs are the only or the best values has which of the following results?" A) It implies newcomers to the United States should adopt the norms and values of the country. B) It can create barriers to communication through misunderstanding. C) It leads to an expectation that all clients will exhibit pain the same way. It improves the quality of care provided to culturally diverse client bases

Answer: B Explanation: A) Although acculturation involves adoption of some of the majority culture's practices and beliefs, each cultural group will continue to hold and express its own set of values and beliefs. B) When the nurse assumes that a client has the same values and beliefs as the nurse, misunderstanding will frequently occur, which in turn can negatively impact nurse-client communication. Ethnocentrism is the conviction that the values and beliefs of one's own cultural group are the best or only acceptable ones. C) Expression of pain is one area that varies greatly from one culture to another. D) The belief that one's own values and beliefs are the best will not improve the quality of care provided to culturally diverse client bases.

1) A client comes to the reproductive health clinic and reports that she woke up in a strange room this morning, her perineal area is sore, and she can't clearly remember what happened the previous evening. The client says she is afraid that she was a victim of a drug-facilitated sexual assault. Which statement should the nurse include when discussing this possibility with the client? A) "Drinking alcohol can lead to uninhibited sexual behavior, which is not the same as rape." B) "Some men use drugs mixed into a drink to subdue a potential victim prior to a rape." C) "It is rare that a woman doesn't remember what happened if she is actually raped." D) "We need to check for forensic evidence of rape before we can be sure what happened."

Answer: B Explanation: A) Although one effect of alcohol consumption is decreased inhibition, which can lead to less cautious sexual behavior, if a woman is drugged, the sexual act is nonconsensual and is therefore classified as rape. B) Drug-facilitated sexual assault occurs when a drug such as Rohypnol, which dissolves easily and is odorless, is slipped into the drink of an unsuspecting woman. C) Rohypnol, which dissolves easily and is odorless, can be slipped into the drink of an unsuspecting woman and causes amnesia of the attack. D) Forensic evidence is collected for possible legal prosecution of the attacker, but the absence of collectable evidence does not eliminate the possibility of rape.

1) The nurse at a women's clinic is reviewing a new client health information questionnaire. Which question does she find to be insulting and discriminatory toward lesbian clients? A) Who should be contacted in case of emergency? B) What method of birth control do you use? C) How often do you drink alcohol? D) Do you feel safe in your relationship?

Answer: B Explanation: A) Asking who should be contacted in an emergency is not an insulting or discriminatory question. Emergency contact is important for all clients. B) The assumption that all women are in need of contraception for birth control is often cited as a reason that lesbian women may conceal their sexual orientation. C) Lesbians should be assessed for chemical dependency like all clients. D) Asking whether the client feels safe in her relationship and assessing for domestic partner violence are common interventions for all clients who come into the clinic.

1) The nurse recognizes that what are the most common disabilities in women? A) Asthma and headaches B) Arthritis or rheumatism C) Adverse kidney and nervous system functioning D) Cardiovascular diseases

Answer: B Explanation: A) Asthma and headaches are health conditions associated with air pollution. B) The most common disabilities in women are arthritis or rheumatism and the incidence of disability increases with age. C) Adverse kidney and nervous system functioning are effects of lead exposure. Cardiovascular diseases are health conditions associated with air pollution

1) The true moment of fertilization occurs when what happens? A) Cortical reaction occurs B) Nuclei unite C) Spermatozoa propel themselves up the female tract D) Sperm surrounding the ovum release their enzymes

Answer: B Explanation: A) At the moment of penetration by a fertilizing sperm, the zona pellucida undergoes a reaction that prevents additional sperm from entering a single ovum, known as the block to polyspermy. This cellular change is mediated by release of materials from the cortical granules, organelles found just below the ovum's surface, and is called the cortical reaction. B) The true moment of fertilization occurs as the nuclei unite. Their individual nuclear membranes disappear, and their chromosomes pair up to produce the diploid zygote. C) Fertilization has not yet occurred when the spermatozoa are still in the female reproductive tract. This is part of the acrosomal reaction and occurs prior to fertilization

1) A female client presents in the emergency department (E D) after being sexually assaulted at a party. Which assessment finding indicates that the client may have been drugged? A) Attending the party with a large group of friends B) Accepting a beverage from a stranger at the party C) Dancing and kissing several men during the party D) Drinking large amounts of alcohol during the party

Answer: B Explanation: A) Attending a party with a large group of friends is not an assessment finding that would indicate the client may have been drugged. B) Accepting a drink from someone else or drinking a drink that was left unattended would indicate the client may have been drugged. C) Dancing and kissing several men during the party is not an assessment finding that would indicate the client may have been drugged. D) Drinking large amounts of alcohol at the party is not an assessment finding that would indicate the client may have been drugged. Having one or two drinks and then suddenly feeling very drunk would be an indicator that the client had been drugged.

1) The clinic nurse is returning phone calls. Which call should the nurse return first? A) The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month B) The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day C) The call from a 46-year-old mother of a teen wondering if her daughter should be on birth control D) The call from a 34-year-old requesting information on douching after intercourse

Answer: B Explanation: A) Because vomiting can lead to dehydration, this client is not completely normal or stable, but is not the top priority. B) Using a single tampon for an entire day can lead to toxic shock syndrome, a potentially life-threatening condition. This client needs education on the danger of using one tampon longer than 3-6 hours. C) A sexually active teen could be at risk for unintended pregnancy, as well as sexually transmitted infections. However, it is unclear whether the daughter is sexually active. This call is a low priority. D) This client requires education, but is not a top priority.

The nurse is reviewing care of clients on a mother-baby unit. Which situation should be reported to the supervisor? A) A 2-day-old infant has breastfed every 2-3 hours and voided four times. B) An infant was placed in the wrong crib after examination by the physician. C) The client who delivered by cesarean birth yesterday received oral narcotics. A primiparous client who delivered today is requesting discharge within 24 hours

Answer: B Explanation: A) Breastfeeding every 2 hours and voiding four times is within normal limits for a 2-day-old infant. There is no negligence in this situation. B) Placing an infant in the wrong crib is malpractice. Malpractice is negligent action by a professional person. C) Receiving oral narcotics at this point in the client's stay is within normal limits. There is no negligence in this situation. D) If the client is feeling well and able to care for her infant, it is normal to be discharged at this time. The mother and baby both must be within normal limits to be discharged.

A nurse is providing guidance to a group of parents of children in the infant-to-preschool age group. After reviewing statistics on the most common cause of death in this age group, the nurse includes information about prevention of which of the following? A) Cancer by reducing the use of pesticides in the home B) Accidental injury by reducing the risk of pool and traffic accidents C) Heart disease by incorporating heart-healthy foods into the child's diet D) Pneumonia by providing a diet high in vitamin C from fruits and vegetables

Answer: B Explanation: A) Cancer due to pesticide use is not a large cause of death in this age group. B) Unintentional injuries cause death in infants more often than cancer, heart disease, and pneumonia. C) Heart disease is not a large cause of death in this age group. Pneumonia does not cause a large number of deaths

1) A couple who came to the United States two years ago with their two children are seeing the nurse in the community clinic. The nurse knows their family is acculturating when the mother makes which statement? A) "The children are much less well-behaved than they used to be." B) "Our diet now includes hamburgers and French fries." C) "We celebrate the same holidays that we used to at home." D) "When the children leave the house, I worry about them."

Answer: B Explanation: A) Concern about behavior of the children is nearly universal, and is not an indicator of a family's acculturation. B) Inclusion of fast food in the diet is an indication of acculturation, because it shows a belief in the nutritional value of these foods and an acceptance of purchasing fast food as equivalent in value to home-cooked meals. C) The holidays that are celebrated might not change as a part of acculturation. Concern about the children leaving the home is universal, and is not an indicator of a family's acculturation

The nurse is preparing a report on the number of births by three service providers at the facility (certified nurse-midwives, family practitioners, and obstetricians). What is this an example of? A) Inferential statistics B) Descriptive statistics C) Evidence-based practice D) Secondary use of data

Answer: B Explanation: A) Inferential statistics allow the investigator to draw conclusions from data to either support or refute causation. B) Descriptive statistics concisely describe phenomena such as births by providers. C) Evidence-based practice is the use of research conclusions to improve nursing care. D) Secondary use of data is analyzing data in a different way than was originally undertaken, or looking at different variables from a data set.

1) The nurse is working with a client whose religious beliefs differ from those of the general population. What is the best nursing intervention to use to meet the specific spiritual needs of this family? A) Ask how important the client's religious and spiritual beliefs are when making decisions about health care. B) Show respect while allowing time and privacy for religious rituals. C) Ask for the client's opinion on what caused the illness. D) Identify healthcare practices forbidden by religious or spiritual beliefs.

Answer: B Explanation: A) Considering the impact of religious and spiritual beliefs might be part of the spiritual assessment process but is not an intervention. B) Providing spiritually sensitive care involves determining the current spiritual and religious beliefs and practices that will affect the mother and baby, accommodating these practices where possible, and examining one's own spiritual or religious beliefs to be more aware and able to provide nonjudgmental care. C) Asking what caused the client's illness is not an intervention, and does nothing to meet the spiritual needs specific to the family. D) Identifying what health practices might be forbidden by the family's beliefs might be part of the spiritual assessment process, but is not an intervention.

1) A client is concerned about her risk for breast cancer. Following the initial history, the nurse identifies which of the following as a high risk factor for breast cancer? A) History of late menarche and early menopause B) Sister who has had breast cancer C) Mother with fibrocystic breast disease D) Multiparity

Answer: B Explanation: A) Early menarche combined with late menopause is a breast cancer risk. B) Family history of first-degree relative (mother, sister, or daughter) with breast cancer increases the risk of breast cancer with the number of first-degree relatives with breast cancer. C) Fibrocystic breast disease is not a breast cancer risk factor. D) Multiparity is not a breast cancer risk factor.

1) The female and male reproductive organs are homologous, which means what? A) They are believed to cause vasoconstriction and muscular contraction B) They are fundamentally similar in function and structure C) They are rich in sebaceous glands D) They are target organs for estrogenic hormones

Answer: B Explanation: A) Efferent sympathetic motor nerves are believed to cause vasoconstriction and muscular contraction. B) The female and male reproductive organs are homologous; that is, they are fundamentally similar in function and structure. C) The labia minora are rich in sebaceous glands. D) The female internal reproductive organs are target organs for estrogenic hormones.

1) A pregnant woman tells the nurse-midwife, "I've heard that if I eat certain foods during my pregnancy, the baby will be a boy." The nurse-midwife should explain that this is a myth, and that the sex of the baby is determined at what time? A) At the time of ejaculation B) At the time of fertilization C) At the time of implantation D) At the time of differentiation

Answer: B Explanation: A) Ejaculation is the release of sperm from the male, and does not necessarily cause a pregnancy. B) Fertilization is the point at which the sex of the zygote is determined. C) Implantation is when the fertilized ovum is implanted in the uterine endometrium. The sex of the zygote has already been determined at this stage. D) Differentiation refers to a cell division process.

The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority? A) Encourage oral fluids B) Administer cefotetan Ⅳ C) Enforce bed rest D) Remove I U C, if present

Answer: B Explanation: A) Encouraging oral fluids is not a priority. B) Administration of medications to treat the disease is the first priority. C) Bed rest is not a priority. D) Removal of an I U C is not a nursing intervention.

1) A nurse teaches newly pregnant clients that if an ovum is fertilized and implants in the endometrium, the hormone the fertilized egg begins to secrete is which of the following? A) Estrogen B) Human chorionic gonadotropin (h C G) C) Progesterone D) Luteinizing hormone

Answer: B Explanation: A) Estrogen and progesterone are ovarian hormones. B) If the ovum is fertilized and implants in the endometrium, the fertilized egg begins to secrete human chorionic gonadotropin (h C G), which is needed to maintain the corpus luteum. C) Estrogen and progesterone are ovarian hormones. D) Luteinizing hormone is excreted by the anterior pituitary gland.

1) A woman has been unable to complete a full-term pregnancy because the fertilized ovum failed to implant in the uterus. This is most likely due to a lack of which hormone? A) Estrogen B) Progesterone C) F S H D) L H

Answer: B Explanation: A) Estrogens are associated with characteristics contributing to femaleness. B) Progesterone is often called the hormone of pregnancy because it inhibits uterine contractions and relaxes smooth muscle to cause vasodilation, allowing pregnancy to be maintained. C) F S H is a hormone secreted by the pituitary gland, and its lack would not affect the ability of the uterus to be prepared for implantation of the fertilized ovum. D) L H is a hormone secreted by the pituitary gland, and its lack would not affect the ability of the uterus to be prepared for implantation of the fertilized ovum.

1) Extended use of combined oral contraceptives (C O Cs) reduces the side effects of C O Cs such as which of the following? A) Cramping B) Hypertension C) Breast tenderness D) Bloating

Answer: B Explanation: A) Extended use of C O Cs reduces the side effects of C O Cs such as bloating, headache, breast tenderness, cramping, and swelling. B) Complications of C O Cs include: myocardial infarction, stroke, blood clots, and hypertension. C) Extended use of C O Cs reduces the side effects of C O Cs such as bloating, headache, breast tenderness, cramping, and swelling. D) Extended use of C O Cs reduces the side effects of C O Cs such as bloating, headache, breast tenderness, cramping, and swelling.

The nurse is planning teaching for a patient diagnosed with hepatitis A. What should the nurse emphasize when instructing the patient about this disease process? A) It is a chronic illness B) It is not a chronic illness C) A vaccination is not available D) It occurs in East and South Asia

Answer: B Explanation: A) Hepatitis A is self-limiting and is not a chronic condition. Hepatitis B, C, and D infections are chronic. There is a vaccination available for hepatitis A. Hepatitis E is common worldwide and occurs primarily in East and South Asia.

1) A nurse is teaching a class on the different types of uterine bleeding. The nurse explains that which of the following is one of the causes of abnormal uterine bleeding? A) Iron-deficiency anemia B) Polyps C) Heavy periods every 2 months D) Spotting between periods

Answer: B Explanation: A) Iron-deficiency anemia is a symptom of abnormal uterine bleeding, not a cause. B) A classification system has been developed for the causes of A U B using the acronym P A L M-C O E I N. The P stands for Polyps. C) Heavy periods every 2 months could be one of the symptoms of abnormal uterine bleeding, not a cause. D) Spotting between periods is a symptom of abnormal uterine bleeding, not a cause.

A maternity client is in need of surgery. Which healthcare member is legally responsible for obtaining informed consent for an invasive procedure? A) The nurse B) The physician C) The unit secretary D) The social worker

Answer: B Explanation: A) It is not the nurse's legal responsibility to obtain informed consent. B) Informed consent is a legal concept designed to allow clients to make intelligent decisions regarding their own health care. Informed consent means that a client, or a legally designated decision maker, has granted permission for a specific treatment or procedure based on full information about that specific treatment or procedure as it relates to that client under the specific circumstances of the permission. The individual who is ultimately responsible for the treatment or procedure should provide the information necessary to obtain informed consent. In most instances, this is a physician. C) Unit secretaries are not responsible for obtaining informed consent. D) It is not within a social worker's scope of practice to obtain informed consent.

A nursing student investigating potential career goals is strongly considering becoming a nurse practitioner (N P). The major focus of the N P is on which of the following? A) Leadership B) Physical and psychosocial clinical assessment C) Independent care of the high-risk pregnant client D) Tertiary prevention

Answer: B Explanation: A) Leadership might be a quality of the N P, but it is not the major focus. B) Physical and psychosocial clinical assessment is the major focus of the N P. C) N P s cannot provide independent care of the high-risk pregnant client, but must work under a physician's supervision. The NP cannot do tertiary prevention as a major focus

1) The nurse is preparing a class on reproduction. What is the cell division process called that results in two identical cells, each with the same number of chromosomes as the original cell? A) Meiosis B) Mitosis C) Oogenesis D) Gametogenesis

Answer: B Explanation: A) Meiosis is a process of cell division that leads to the development of ova and sperm. B) Mitosis results in the production of diploid body (somatic) cells, which are exact copies of the original cell. C) Oogenesis is the process that produces the female gamete, called an ovum (egg). D) Gametogenesis is the process by which germ cells, or gametes (ova and sperm), are produced.

1) The nurse teaching a high school class explains that during the menstrual cycle, the endometrial glands begin to enlarge under the influence of estrogen and cervical mucosal changes occur; the changes peak at ovulation. In which phase of the menstrual cycle does this occur? A) Menstrual B) Proliferative C) Secretory D) Ischemic

Answer: B Explanation: A) Menstruation occurs during the menstrual phase. B) The proliferative phase begins when the endometrial glands begin to enlarge under the influence of estrogen and cervical mucosal changes occur; the changes peak at ovulation. C) The secretory phase occurs after ovulation. The ischemic phase occurs if fertilization does not occur

1) The nurse is teaching a community education class on complementary and alternative therapies. To assess learning, the nurse asks, "In traditional Chinese medicine, what is the invisible flow of energy in the body that maintains health and ensures physiologic functioning?" Which answer indicates that teaching was successful? A) Meridians B) Chi C) Yin D) Yang

Answer: B Explanation: A) Meridians are the 14 pathways along which energy flows, connecting all parts of the body. B) Chi is the energy that flows through the body along meridians, or pathways, to maintain health. C) Yin and yang are opposites. Yin is the female force: passive, cool, wet, and close to the earth. D) Yin and yang are opposites. Yang is the masculine force: aggressive, hot, dry, and celestial.

The nurse who is taking a sexual history from a client should do which of the following? A) Ask questions that the client can answer with "yes" or "no." B) Ask mostly open-ended questions. C) Have the client fill out a comprehensive questionnaire and review it after the client leaves. D) Try not to make much direct eye contact.

Answer: B Explanation: A) Open-ended questions are often useful in eliciting information. Yes-or-no answers will not provide the necessary information. B) Open-ended questions are often useful in eliciting information. C) Asking a client to fill out a questionnaire about sexual history is not appropriate. D) It is helpful to use direct eye contact as much as possible, unless culturally unacceptable.

1) The nurse has presented a community education class on recommended health screenings for women. Which statement about the Pap smear by a class member indicates that additional teaching is necessary? A) "It is recommended for women 21 years of age and older." B) "It diagnoses cervical cancer." C) "Intercourse at a young age is a risk factor for an abnormal Pap smear." D) "Detects abnormal cells."

Answer: B Explanation: A) Pap smear screening is recommended for all women 21 years of age and older. B) The focus of the Pap smear is the detection of high-grade cervical disease. It does not diagnose cervical cancer. C) Several factors put a woman at high risk for an abnormal Pap: intercourse at a young age, multiple partners, history of immunotherapy, long-term combined oral contraceptive (C O C) use, smoking, and previous history of dysplasia. The purpose of the Papanicolaou smear (Pap smear) is to screen for the presence of cellular abnormalities by obtaining a sample containing cells from the cervix and the endocervical canal

A menopausal woman tells her nurse that she experiences discomfort from vaginal dryness during sexual intercourse, and asks, "What should I use as a lubricant?" The nurse should recommend which of the following? A) Petroleum jelly B) A water-soluble lubricant C) Body cream or body lotion D) Less-frequent intercourse

Answer: B Explanation: A) Petroleum jelly is not a healthy choice for vaginal lubrication. B) A water-soluble jelly should be used. C) Body creams and body lotions are not healthy choices for vaginal lubrication. D) "Less-frequent intercourse" is an inappropriate response.

1) Couples at risk for having a detectable single gene or chromosomal anomaly may wish to undergo which procedure? A) Preimplantation genetic screening (P G S) B) Preimplantation genetic diagnosis (P G D) C) Intracytoplasmic sperm injection (I C S I) D) Gamete intrafallopian transfer (G I F T)

Answer: B Explanation: A) Preimplantation genetic screening (P G S) is a term used when the embryos are screened for aneuploidy for the purpose of increasing the likelihood of a viable pregnancy with normal chromosomes. B) Preimplantation genetic diagnosis (P G D) is a term used when one or both genetic parents carry a gene mutation and testing is performed to determine whether that mutation or unbalanced chromosomal compliment has been passed to the oocyte or embryo. C) Intracytoplasmic sperm injection (I C S I) is a microscopic procedure to inject a single sperm into the outer layer of an ovum so that fertilization will occur. D) Gamete intrafallopian transfer (G I F T) involves the retrieval of oocytes by laparoscopy.

A client comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (I U D) for 2 years. What is the most likely cause for the client's complaint? A) Primary dysmenorrhea B) Secondary dysmenorrhea C) Menorrhagia D) Hypermenorrhea

Answer: B Explanation: A) Primary dysmenorrhea is defined as cramps without underlying disease. B) Secondary dysmenorrhea is associated with pathology of the reproductive tract, and usually appears after menstruation has been established. Conditions that most frequently cause secondary dysmenorrhea include ovarian cysts and the presence of an intrauterine device. C) Menorrhagia is excessive, profuse menstrual flow. D) Hypermenorrhea is an abnormally long menstrual flow.

1) Which myth regarding rape will the community health nurse include in a teaching session within the community? A) Rape is a type of sexual assault. B) Women lie about rape as an act of revenge. C) Both men and women can be victims of rape. Rape is one of the most underreported violent crimes

Answer: B Explanation: A) Rape is a type of sexual assault. This is not a myth regarding rape. B) One myth regarding rape is that women lie about rape as an act of revenge. This is appropriate for the nurse to include in the teaching session. C) Both men and women can be victims of rape. This is not a myth regarding rape. Rape is one of the most underreported violent crimes. This is not a myth regarding rape

1) The nurse receives a phone call from a 25-year-old woman experiencing breast tenderness in the week prior to her menses, with palpable breast nodularity, without nipple discharge. What is the best response by the nurse? A) "Please make an appointment at the breast cancer center as soon as possible." B) "How much salty food do you regularly consume?" C) "As long as you don't have nipple discharge, it isn't a serious condition." D) "Eliminate caffeine and chocolate from your diet."

Answer: B Explanation: A) Recommending that the client make an appointment at the breast cancer center is unnecessary and might frighten the client. B) The client is describing fibrocystic breast changes. A salt restriction with a mild diuretic taken the week before menstrual bleeding often improves the condition. C) Neither the absence nor presence of nipple discharge is an indicator of the seriousness of a breast condition. D) Research is inconclusive as to whether eliminating methylxanthines from the diet is effective at reducing the symptoms the client describes.

1) A patient with a rectocele is experiencing progressive pain and constipation. What should the nurse expect to be indicated for this patient? A) Enemas B) Surgery C) Laxatives D) Antibiotics

Answer: B Explanation: A) Surgery is often indicated for a rectocele. Enemas, laxatives, and antibiotics may help treat the symptoms but will not cure the problem.

1) After reviewing approaches for contraception with a female client, the nurse is concerned that barrier methods will not achieve the client's goal to prevent pregnancy. What did the client say to cause the nurse to draw this conclusion? A) "My partner doesn't mind wearing condoms." B) "I don't want to have to put anything in myself." C) "We should use a condom even with a diaphragm." D) "I know that spermicides are inserted before intercourse."

Answer: B Explanation: A) The client's request to not have to insert anything to prevent pregnancy indicates that the barrier method of a female diaphragm would not be an appropriate method of birth control because the client will not be motivated to use it. Wearing condoms and appropriately using spermicides indicates that the client would adhere to the use of a barrier method. B) The client's request to not have to insert anything to prevent pregnancy indicates that the barrier method of a female diaphragm would not be an appropriate method of birth control because the client will not be motivated to use it. Wearing condoms and appropriately using spermicides indicates that the client would adhere to the use of a barrier method. C) The client's request to not have to insert anything to prevent pregnancy indicates that the barrier method of a female diaphragm would not be an appropriate method of birth control because the client will not be motivated to use it. Wearing condoms and appropriately using spermicides indicates that the client would adhere to the use of a barrier method. D) The client's request to not have to insert anything to prevent pregnancy indicates that the barrier method of a female diaphragm would not be an appropriate method of birth control because the client will not be motivated to use it. Wearing condoms and appropriately using spermicides indicates that the client would adhere to the use of a barrier method.

1) The nurse is presenting a class to pregnant clients. The nurse asks, "The fetal brain is developing rapidly, and the nervous system is complete enough to provide some regulation of body function on its own, at which fetal development stage?" It is clear that education has been effective when a participant makes which response? A) "The 17th-20th week" B) "The 25th-28th week" C) "The 29th-32nd week" D) "The 33rd-36th week"

Answer: B Explanation: A) The nervous system function is not developed between the 17th and 20th weeks of gestation. B) Between the 25th and 28th week, the brain is developing rapidly, and the nervous system is complete enough to provide some degree of regulation of body functions. C) The complexity of the nervous system develops long before the 29th-32nd week. D) The complexity of the nervous system develops long before the 33rd-36th week.

1) The nurse is preparing a handout for female adolescents on the menstrual cycle. What phase of the cycle occurs if fertilization does not take place? A) Menstrual B) Proliferative C) Secretory D) Ischemic

Answer: D Explanation: A) Menstruation occurs during the menstrual phase. Some endometrial areas are shed, whereas others remain. B) The proliferative phase begins when the endometrial glands enlarge, the blood vessels become prominent and dilated, and the endometrium increases in thickness. C) The secretory phase follows ovulation. D) The ischemic phase occurs if fertilization does not occur.

1) Which of the following best describes a nuclear family? A) An unmarried woman who chooses to conceive or adopt without a life partner. B) Children live in a household with both biologic parents and no other relatives or persons. C) A couple shares household and childrearing responsibilities with parents, siblings, or other relatives. D) The head of the household is widowed, divorced, abandoned, separated, or most often, the mother remains unmarried.

Answer: B Explanation: A) The single mother by choice family represents a family composed of an unmarried woman who chooses to conceive or adopt without a life partner. B) In the nuclear family, children live in a household with both biologic parents and no other relatives or persons. C) In an extended family, a couple shares household and childrearing responsibilities with parents, siblings, or other relatives. D) In the single-parent family, the head of the household is widowed, divorced, abandoned, separated, or most often, the mother remains unmarried.

1) A nurse is performing an assessment on a family with a father and mother who both work. What type of family does she record this family as being? A) A traditional nuclear family B) A dual-career/dual-earner family C) An extended family D) An extended kin family

Answer: B Explanation: A) The traditional nuclear family is defined as a husband provider, a wife who stays home, and children. B) A dual-career/dual-earner family is characterized by both parents working, either by choice or necessity. C) An extended family is defined as a couple who share household and childrearing responsibilities with parents, siblings, or other relatives. D) An extended kin family is a specific form of an extended family in which two nuclear families of primary or unmarried kin live in close proximity to each other.

1) A female client comes into the clinic for a pregnancy test because she took the morning after pill immediately after having unprotected intercourse 3 days ago and has not had a menstrual period. What should the nurse respond to this client? A) "I'll make sure you have one during this visit." B) "You should wait for two weeks before having a pregnancy test." C) "It's unlikely that you are pregnant. Wait a few days and then take a pregnancy test." D) "How long did you wait to take the morning after pill after having unprotected intercourse?"

Answer: B Explanation: A) The woman should have her normal menses 2 weeks after taking emergency contraception. If she does not, she should follow up with a pregnancy test. A pregnancy test is not needed during this visit. The nurse has no way of knowing if the client is pregnant. The morning after pill should ideally be taken within 72 hours after having unprotected intercourse but can be taken up to 5 days after unprotected intercourse. B) The woman should have her normal menses 2 weeks after taking emergency contraception. If she does not, she should follow up with a pregnancy test. A pregnancy test is not needed during this visit. The nurse has no way of knowing if the client is pregnant. The morning after pill should ideally be taken within 72 hours after having unprotected intercourse but can be taken up to 5 days after unprotected intercourse. C) The woman should have her normal menses 2 weeks after taking emergency contraception. If she does not, she should follow up with a pregnancy test. A pregnancy test is not needed during this visit. The nurse has no way of knowing if the client is pregnant. The morning after pill should ideally be taken within 72 hours after having unprotected intercourse but can be taken up to 5 days after unprotected intercourse. The woman should have her normal menses 2 weeks after taking emergency contraception. If she does not, she should follow up with a pregnancy test. A pregnancy test is not needed during this visit. The nurse has no way of knowing if the client is pregnant. The morning after pill should ideally be taken within 72 hours after having unprotected intercourse but can be taken up to 5 days after unprotected intercourse.

The nursing instructor explains to the class that according to the 1973 Supreme Court decision in Roe v. Wade, abortion is legal if induced: A) Before the 30th week of pregnancy. B) Before the period of viability. C) To provide tissue for therapeutic research. Can be done any time if mother, doctor, and hospital all agree

Answer: B Explanation: A) This statement is not true, because the fetus is viable many weeks before the 30th week. B) Abortion can be performed legally until the period of viability. C) Abortion cannot be used for the sole purpose of providing tissue for therapeutic research. D) This is not true. Legal abortion can be done only up until the time of viability.

1) The nurse is presenting a session on intimate partner violence. Which statement by a client indicates a need for further education? A) "My daughter is not to blame for the violence in her marriage." B) "Everyone experiences anger and hitting in a relationship." C) "Abusers can be either husbands or boyfriends or girlfriends." D) "The 'honeymoon period' follows an episode of violence."

Answer: B Explanation: A) This statement recognizes that the blame for her assault lies with her assailant, not with the victim. B) Violence is not a normal part of intimate relationships. Domestic violence, also called intimate partner violence (I P V), is defined as a pattern of coercive behaviors and methods used to gain and maintain power and control by one individual over another in an adult intimate relationship. This statement indicates that the client has likely been a victim of domestic violence herself. C) Batterers come from all racial, ethnic, and religious groups and all professions, occupations, and socioeconomic strata. Batterers can also be either male or female. An acute episode of battering is followed by the tranquil phase, or honeymoon period, which is characterized by extremely loving, kind, and contrite behaviors by the batterer

1) The nurse working at a homeless shelter is studying case statistics. Of the total homeless population served at the shelter, which group would the nurse's statistics likely uncover as the fastest-growing group? A) Unemployed women B) Families with children C) The mentally ill D) The elderly

Answer: B Explanation: A) Unemployment is one aspect of this trend, but unemployed women are not the fastest-growing group. B) In 2012, the number of homeless individuals fell slightly, by 0.4%, with the exception of homeless families. C) The mentally ill are one part of this equation, but are not the fastest-growing group. D) The elderly are part of the group living in the shelters, but are not the fastest-growing group.

1) A nurse is working in a clinic where clients from several cultures are seen. As a first step toward the goal of personal cultural competence, the nurse will do which of the following? A) Enhance cultural skills. B) Gain cultural awareness. C) Seek cultural encounters. Acquire cultural knowledge

Answer: B Explanation: A) Ways to enhance cultural skill include learning a prevalent language and learning how to recognize health-manifesting skin color variations in different races. B) One begins to gain cultural competence by gaining cultural awareness or by gaining an effective and cognitive self-awareness of personal worldview biases, beliefs, etc. C) During daily interactions with clients from diverse backgrounds, these cultural encounters allow the nurse to appreciate the uniqueness of individuals from varying backgrounds. D) Another early step, although not the first step, is acquiring cultural knowledge, and includes studying information about the beliefs, biological variations, and favored treatments of specific cultural groups.

1) The nurse is reviewing preconception questionnaires in charts. Which couple are the most likely candidates for preconceptual genetic counseling? A) Wife is 30 years old, husband is 31 years old B) Wife and husband are both 29 years old, first baby for husband, wife has a normal 4-year-old C) Wife's family has a history of hemophilia D) Single 32-year-old woman is using donor sperm

Answer: C Explanation: A) An age under 35 is not a risk factor for genetic abnormalities. B) An age under 35 is not a risk factor for genetic abnormalities. C) For families in which the woman is a known or possible carrier of an X-linked disorder, such as hemophilia, the risk of having an affected male fetus is 25%. D) Sperm donors are screened for genetic disorders, and men with a possible genetic problem are not accepted for sperm donation.

A client who has been using transdermal hormonal contraception comes in for a routine wellness visit. Which finding should cause the nurse to question if the client should continue to use this form of contraception? A) Body weight of 179 lb B) Skin breakdown at the site of the patch C) Drinks 2 cups of caffeinated coffee a day D) Bicycles at the gym three evenings a week

Answer: B Explanation: A) Women who have a skin disorder that may result in a reaction at the site of application may not be candidates for the patch. Body weight needs to be below 198 l b s. for the patch. Caffeine and exercise are not contraindications for using the patch for contraception. B) Women who have a skin disorder that may result in a reaction at the site of application may not be candidates for the patch. Body weight needs to be below 198 l b s. for the patch. Caffeine and exercise are not contraindications for using the patch for contraception. C) Women who have a skin disorder that may result in a reaction at the site of application may not be candidates for the patch. Body weight needs to be below 198 l b s. for the patch. Caffeine and exercise are not contraindications for using the patch for contraception. D) Women who have a skin disorder that may result in a reaction at the site of application may not be candidates for the patch. Body weight needs to be below 198 l b s. for the patch. Caffeine and exercise are not contraindications for using the patch for contraception.

1) An older female patient is concerned about the finances needed to run her home. What event in this person's life should the nurse realize is causing her financial concern? A) Change in the number of prescribed medications B) Recent death of spouse after a long and costly illness C) Participation in activities at the community center D) Relocation of older children to another city

Answer: B Explanation: B) A husband's long, costly illness and the decrease or loss of his pension following his death can negatively impact a woman's financial resources. There is no information about how the patient's medications have changed. She could be prescribed less. Participating in activities and having adult children move away would not directly impact this older person's financial status.

1) The nurse is reviewing laboratory testing completed for a patient with suspected pelvic inflammatory disease. Which test result should the nurse identify as supporting this diagnosis? A) Decreased hematocrit level B) Elevated sedimentation rate C) Decreased hemoglobin level D) Elevated white blood cell count

Answer: B Explanation: B) In pelvic inflammatory disease the woman may have an elevated sedimentation rate. Decreased hematocrit and hemoglobin levels would indicate bleeding. An elevated white blood cell count indicates an infection, which may or may not occur with pelvic inflammatory disease.

1) Which questions are appropriate for the nurse to ask during a cultural assessment of a client who is new to the clinic? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) What genetic and other biological differences affect caregiving? B) Which family member must be consulted for decisions about care? C) What type of healthcare provider is the most appropriate? D) Does the client have beliefs or traditions that might impact the care plan? E) Are communications patterns established?

Answer: B, C, D Explanation: A) Genetic and biological differences are health concerns, such as hypertension that the nurse must keep in mind, but the nurse would not ask about genetic and biological differences during a cultural assessment. B) It is important that the nurse recognize cultural differences in regard to which family member must be consulted for decisions about care. C) Some cultures do not allow a person of the opposite sex to touch the client. Cultural sensitivity will recognize and allow for this. D) The nurse must be aware of traditions and beliefs that might impact the care plan. Communication patterns will have been established. The nurse must be able to communicate with the client, using the patterns of communication the client uses

1) During a follow-up wellness visit, the nurse determines that a female client is experiencing favorable outcomes after starting combined oral contraceptives. What data did the nurse use to determine this? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Reduced appetite B) Reduced menstrual flow C) Fewer menstrual cramps D) No pain with ovulation E) Cycle is regular at 28 days

Answer: B, C, D, E Explanation: A) Combined oral contraceptives have noncontraceptive benefits that include reduced menstrual flow, fewer menstrual cramps, mittelschmerz or pain with ovulation disappearing, and a more regular cycle. Combined oral contraceptives do not affect appetite. B) Combined oral contraceptives have noncontraceptive benefits that include reduced menstrual flow, fewer menstrual cramps, mittelschmerz or pain with ovulation disappearing, and a more regular cycle. Combined oral contraceptives do not affect appetite. C) Combined oral contraceptives have noncontraceptive benefits that include reduced menstrual flow, fewer menstrual cramps, mittelschmerz or pain with ovulation disappearing, and a more regular cycle. Combined oral contraceptives do not affect appetite. D) Combined oral contraceptives have noncontraceptive benefits that include reduced menstrual flow, fewer menstrual cramps, mittelschmerz or pain with ovulation disappearing, and a more regular cycle. Combined oral contraceptives do not affect appetite. E) Combined oral contraceptives have noncontraceptive benefits that include reduced menstrual flow, fewer menstrual cramps, mittelschmerz or pain with ovulation disappearing, and a more regular cycle. Combined oral contraceptives do not affect appetite.

1) The nurse interviews a 28-year-old client with a new medical diagnosis of endometriosis. Which question asked by the nurse is appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "Are you having hot flashes?" B) "Are you experiencing pain during intercourse?" C) "Is a vaginal discharge present?" D) "Are you having pain during your period?" E) "Have you noticed any skin rashes?"

Answer: B, D Explanation: A) Hot flashes are not a symptom of endometriosis. B) The primary symptoms of endometriosis include dyspareunia. C) Vaginal discharge is not a symptom of endometriosis. D) The primary symptoms of endometriosis include dysmenorrhea. Skin rashes are not a symptom of endometriosis

1) The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (V V C), and knows the client understands when she makes which of the following statements? A) "I need to apply the miconazole for 10 days." B) "I need to douche daily." C) "I need to add yogurt to my diet." D) "I need to wear nylon panties."

Answer: C Explanation: A) Applying miconazole for 10 days does not prevent or assist in treating vulvovaginal candidiasis. B) Douching daily does not prevent or assist in treating vulvovaginal candidiasis. C) Yogurt helps reestablish normal vaginal flora. D) Wearing nylon panties does not prevent or assist in treating vulvovaginal candidiasis.

A couple is at the clinic for preconceptual counseling. Both parents are 40 years old. The nurse knows that the education session has been successful when the wife makes which statement(s)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) "We are at low risk for having a baby with Down syndrome." B) "Our children are more likely to have genetic defects." C) "Children born to parents our age have sex-linked disorders." D) "The tests for genetic defects can be done early in pregnancy." E) "It will be almost impossible for us to conceive a child."

Answer: B, D Explanation: A) The risk for trisomy 21 (Down syndrome) is 1 in 385. B) Women 35 or older are at greater risk for having children with chromosome abnormalities. C) Sex-linked disorders are not related to the age of either parent. D) Genetic testing such as amniocentesis and chorionic villus sampling are done in the first trimester. E) Fertility decreases somewhat after age 35, but being over 35 does not mean that conception is impossible.

1) What are the three functions of cervical mucosa? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Form the relatively fixed axis of the birth passage B) Provide lubrication for the vaginal canal C) Provide nourishment and protective maternal antibodies to infants D) Provide an alkaline environment to shelter deposited sperm from the acidic vaginal secretions E) Act as a bacteriostatic agent

Answer: B, D, E Explanation: A) The female boney pelvis forms the relatively fixed axis of the birth passage. B) The cervical mucosa provides lubrication for the vaginal canal. C) The breasts provide nourishment and protective maternal antibodies to infants. D) The cervical mucosa provides an alkaline environment to shelter deposited sperm from the acidic vaginal secretions. E) The cervical mucosa acts as a bacteriostatic agent.

1) During a pelvic examination, a patient is diagnosed with a Bartholin gland cyst. For which treatment should the nurse prepare this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Pelvic ultrasound B) Antibiotic therapy C) Exploratory laparotomy D) Incision and drainage of the cyst E) Culture and sensitivity of the discharge

Answer: B, D, E Explanation: A) Treatment of a Bartholin gland cyst involves antibiotic therapy, incision and drainage of the abscess, and culture and sensitivity of the discharge. A pelvic ultrasound and exploratory laparotomy are not indicated for this health problem.

1) The nurse is conducting a health maintenance assessment for a new female client who recently moved to the city. Which finding would indicate the need for further assessment for intimate partner violence? A) A miscarriage two years ago noted during the reproductive history. B) A sprained ankle one year ago noted during the health history interview. C) A history of delaying treatment for a concussion and fractured extremity. A scar noted on the abdomen from a previous surgery during the physical examination

Answer: C Explanation: A) A miscarriage two years ago that is noted in the reproductive history would not cause the nurse to further assess the client for intimate partner abuse. B) Sprains and strains are not associated with intimate partner abuse. C) A client who delays treatment for a concussion or fractured extremity would indicate the need for further assessment for intimate partner violence. A scar from an old injury, not from a surgical procedure, would indicate the need for further assessment for intimate partner violence

1) A 58-year-old father and a 45-year-old mother gave birth to a baby boy 2 days ago. The nurse assesses a single palmar crease and low-set ears on the newborn. The nurse plans to counsel the couple about which chromosomal abnormality? A) Trisomy 13 B) Trisomy 18 C) Trisomy 21 D) Trisomy 26

Answer: C Explanation: A) A single palmar crease and low-set ears are not characteristics of trisomy 13. B) A single palmar crease and low-set ears are not characteristics of trisomy 18. C) A single palmar crease and low-set ears are characteristics of trisomy 21 (Down syndrome). D) Trisomy 26 is not a chromosomal abnormality.

1) A woman is experiencing mittelschmerz and increased vaginal discharge. Her temperature has increased by 0.6°C (1.0°F) over the past 36 hours. This most likely indicates what? A) Menstruation is about to begin. B) Ovulation will occur soon. C) Ovulation has occurred. D) She is pregnant, and will not menstruate.

Answer: C Explanation: A) A temperature increase does not occur when menstruation is about to begin. B) A temperature increase does not occur before ovulation has occurred. C) In some women, ovulation is accompanied by mid-cycle pain, known as mittelschmerz. This pain may be caused by a thick tunica albuginea or by a local peritoneal reaction to the expelling of the follicular contents. Body temperature increases about 0.3°C to 0.6°C (0.5°F to 1°F) 24 to 48 hours after the time of ovulation. D) Pregnancy can be detected through the presence of human chorionic gonadotropin hormone.

1) The nurse is assessing a client who reports seeing an acupuncturist on a weekly basis to treat back pain. The nurse understands that acupuncture is an example of what? A) A risky practice without evidence of efficacy B) A folk remedy C) A complementary therapy D) An alternative therapy

Answer: C Explanation: A) Acupuncture has been used in traditional Chinese medicine for over 3000 years. Good evidence is available on the efficacy of acupuncture for treatment of chronic pain. B) A folk remedy is a practice of a cultural group that either has no evidence to support efficacy or has been found not to have an effect. C) Acupuncture is a therapy that is used in conjunction with conventional medical treatment, and therefore is an example of a complementary therapy. D) Acupuncture is not categorized as an alternative therapy, because it is used in conjunction with conventional medical treatment.

1) The nurse is planning a community educational presentation for people living below the poverty level. The nurse knows that which of the following is the largest population in this socioeconomic category? A) Adults in communal living situations B) Young married couples under the age of 20 C) Single women with children D) Single adults

Answer: C Explanation: A) Adults living together are not usually below the poverty level. B) Young married couples are not the most likely to encounter poverty. C) Of households headed by single mothers, 40% live in poverty. D) Single adults are not the most likely to encounter poverty.

1) The nurse is helping a victim of domestic abuse to develop a safety plan. Which client action would require intervention by the nurse? A) Asking a neighbor to call police if violence begins B) Establishing a code word for danger with family and friends C) Keeping a bag packed in the home in case the need to leave arises D) Having a planned escape route and emergency phone numbers if violence occurs

Answer: C Explanation: A) Asking a neighbor to call the police if violence begins is an appropriate client action that would not require intervention from the nurse. B) Establishing a code word for danger with family and friends is an appropriate client action that would not require intervention from the nurse. C) Keeping a bag packed in the home if the need arises to leave would require intervention from the nurse. The bag should be kept at the home of a neighbor or family member. If the abuser finds the bag the client's risk for injury may increase. D) Having a planned escape route and emergency phone numbers if violence occurs is an appropriate client action that would not require intervention from the nurse.

A client asks her nurse, "Is it okay for me to take a tub bath during the heavy part of my menstruation?" What is the nurse's correct response? A) "Tub baths are contraindicated during menstruation." B) "You should shower and douche daily instead." C) "Either a bath or a shower is fine at that time." D) "You should bathe and use a feminine deodorant spray during menstruation."

Answer: C Explanation: A) Bathing in a tub is not contraindicated during menses. B) Douching should be avoided during menstruation. C) Bathing, whether it is a tub bath or a shower, is as important (if not more so) during menses as at any other time. D) Bathing is as important (if not more so) during menses as at any other time, but feminine deodorant sprays are unnecessary.

1) Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (P I D)? A) C B C (complete blood count) with differential B) Venereal Disease Research Laboratory (V D R L) C) Throat culture for Streptococcus A D) R P R (Rapid Plasma Reagin)

Answer: C Explanation: A) C B C with differential will be ordered to give an indication of the severity of the infection. B) The Venereal Disease Research Laboratory (V D R L) test checks for syphilis. C) Streptococcus of the throat is not associated with P I D. D) R P R is a test for syphilis, a cause of P I D.

1) Which statement regarding cervical mucus is accurate during ovulation and appropriate to include in an educational session with the client? A) Cervical mucus is thicker during ovulation. B) Cervical mucus is opaque during ovulation. C) Cervical mucus is clearer during ovulation. D) Cervical mucus is acidic during ovulation.

Answer: C Explanation: A) Cervical mucus is thinner, not thicker, during ovulation. B) Cervical mucus is clearer, not opaque, during ovulation. C) Cervical mucus is clearer during ovulation. D) Cervical mucus is alkaline, not acidic, during ovulation.

The nurse suspects that a female patient is experiencing amenorrhea because of ovarian failure. For which situation should the nurse assess this patient? A) Severe stress B) Recent head trauma C) Treatment for cancer D) Antianxiety medication

Answer: C Explanation: A) Chemotherapy and radiation are reasons for the development of ovarian failure. Severe stress, antianxiety medication, and head trauma can cause hypothalamic dysfunction as a reason for amenorrhea. B) Chemotherapy and radiation are reasons for the development of ovarian failure. Severe stress, antianxiety medication, and head trauma can cause hypothalamic dysfunction as a reason for amenorrhea. C) Chemotherapy and radiation are reasons for the development of ovarian failure. Severe stress, antianxiety medication, and head trauma can cause hypothalamic dysfunction as a reason for amenorrhea. D) Chemotherapy and radiation are reasons for the development of ovarian failure. Severe stress, antianxiety medication, and head trauma can cause hypothalamic dysfunction as a reason for amenorrhea.

The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? A) "She could become pregnant." B) "She could have severe vaginal itching." C) "He could get an infection in the tube that carries the urine out." D) "It could cause us to develop a rash."

Answer: C Explanation: A) Chlamydia does not cause a woman to become pregnant. B) Chlamydia does not cause vaginal itching. C) Chlamydia is a major cause of nongonococcal urethritis (N G U) in men. D) Chlamydia does not cause a rash.

Client safety goals, which are evaluated and updated regularly, are requirements for what? A) Clinical practice guidelines B) Scope of practice C) Accreditation D) Standards of care

Answer: C Explanation: A) Clinical practice guidelines are adopted within a healthcare setting to reduce variation in care management, to limit costs of care, and to evaluate the effectiveness of care. B) State nurse practice acts protect the public by broadly defining the legal scope of practice within which every nurse must function and by excluding untrained or unlicensed individuals from practicing nursing. C) The Joint Commission has identified client safety as an important responsibility of healthcare providers. D) Standards of care establish minimum criteria for competent, proficient delivery of nursing care.

While a child is being admitting to the hospital, the parent receives information about the pediatric unit's goals, including the statement that the unit practices family-centered care. The parent asks why that is important. The nurse responds that what communication dynamic is characteristic of the family-centered care paradigm? A) The mother is the principal caregiver in each family. B) The child's physician is the key person in ensuring that the health of a child is maintained. C) The family serves as the constant influence and continuing support in the child's life. D) The father is the leader in each home; thus, all communications should include him.

Answer: C Explanation: A) Culturally competent care recognizes that both matriarchal and patriarchal households exist. B) The physician is not present during the day-to-day routines in a child's life. C) Family-centered care is characterized by an emphasis on the family and family involvement throughout the pregnancy, birth, and postpartum period. D) Culturally competent care recognizes that both matriarchal and patriarchal households exist.

1) The nurse has been talking to a woman about the reorganization phase following a rape. Which response would indicate that the client understands this phase? A) "By using denial and suppression in this phase, I will eventually be able to accept what has happened to me." B) "During this time, I won't talk much about the rape, because I am examining my inward feelings regarding the rape." C) "During this time, I will repeatedly replay the role of the victim until I come to terms with the experience." D) "My perception of a normal sexual relationship will be similar to my perception prior to the rape."

Answer: C Explanation: A) Denial and suppression indicate the client is experiencing the outward adjustment phase of rape trauma syndrome. B) Denial and suppression indicate the client is experiencing the outward adjustment phase of rape trauma syndrome. C) During reorganization, a victim adjusts her self-concept to include the rape. D) Sexual relationships often develop dysfunction after rape.

1) The nurse is teaching a group of women about menopause at a community clinic. The nurse tells them that the best indicator of menopause is which of the following symptoms? A) No menses for 8 consecutive months B) Hot flashes and night sweats C) F S H levels rise and ovarian follicles cease to produce estrogen D) Diagnosed with osteoporosis 4 months ago

Answer: C Explanation: A) Eight consecutive months of amenorrhea are enough to qualify as menopause. B) Although hot flashes and night sweats are common in menopause, they are not the most reliable indicator of menopause. C) Examining F S H and estrogen levels is a very accurate indication of menopause. D) Menopause is not the only cause of osteoporosis; therefore, the diagnosis of osteoporosis 4 months ago is not an indicator of menopause.

1) A 49-year-old client comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must take both hormones, what is the nurse's best reply? A) "Hot flashes respond better when replacement includes both hormones." B) "You are having very severe symptoms, so you need more hormones replaced." C) "There is an increased risk of tissue abnormality inside the uterus if only one is given." D) "Your blood pressure can become elevated if only one hormone is used."

Answer: C Explanation: A) Estrogen, not progestin, improves hot flashes and most other perimenopausal symptoms. B) The severity of symptoms will be considered by the physician in determining the appropriate dose for the client. C) Estrogen alone, in a woman with a uterus (unopposed estrogen), increases the risk of endometrial (the lining of the uterus) cancer by eightfold and, therefore, is never given without progesterone in these women. D) Estrogen therapy does not cause hypertension.

1) The transcultural nursing theory was developed in 1961 by Dr. Madeleine Leininger. Its foundation is in which of the following? A) The framework categorizes a family's progression over time B) The family life cycle of a traditional nuclear family C) Anthropology and nursing D) Holistic health beliefs

Answer: C Explanation: A) Family development theories use a framework to categorize a family's progression over time according to specific, typical stages in family life. B) Duvall's eight stages is the foundation of the family life cycle of a traditional nuclear family. C) Transcultural nursing theory is rooted in caring that embraces the beliefs and practices of individuals or groups of similar or different cultures. An example of a holistic health belief is the hot and cold theory of disease

The current emphasis on federal healthcare reform has yielded what unexpected benefit? A) Assessment of the details of the family's income and expenditures B) Case management to limit costly, unnecessary duplication of services C) Many healthcare providers and consumers are becoming more aware of the vitally important role nurses play in providing excellent care to clients and families D) Education of the family about the need for keeping regular well-child visit appointments

Answer: C Explanation: A) Financial assessment is more commonly the function of a social worker. The social worker is part of the interdisciplinary team working with clients, and this professional's expertise is helping clients get into the appropriate programs. B) The case management activity mentioned will not provide a source of funding. C) Nurses must clearly articulate their role in the changing environment to define and differentiate practice roles and the educational preparation required for their new roles. D) The education of the family will not provide a source of funding.

1) Women with pyelonephritis during pregnancy are at significantly increased risk for which condition? A) Foul-smelling discharge B) Ectopic pregnancy C) Preterm labor D) A colicky large intestine

Answer: C Explanation: A) Foul-smelling discharge is not a symptom of pyelonephritis. B) Ectopic pregnancy is not a symptom of pyelonephritis. C) Women with pyelonephritis during pregnancy are at significantly increased risk of preterm labor, preterm birth, development of adult respiratory distress syndrome, and septicemia. A colicky large intestine is an incorrect response

1) Which statement by a pregnant client to the nurse would indicate that the client understood the nurse's teaching? A) "Because of their birth relationship, fraternal twins are more similar to each other than if they had been born singly." B) "Identical twins can be the same or different sex." C) "Congenital abnormalities are more prevalent in identical twins." D) "Identical twins occur more frequently than fraternal twins."

Answer: C Explanation: A) Fraternal twins are not more similar to each other than if they had been born singly. B) Identical, or monozygotic twins, have identical chromosomal structures, and, therefore, are always the same sex. C) Monozygotic twinning is considered a random event and occurs in approximately 3 to 4 per 1000 live births. Congenital anomalies are more prevalent and both twins may have the same malformation. D) Dizygotic, or fraternal, twins occur more frequently than do monozygotic twins.

The client reports using an alternative therapy that involves the manipulation of soft tissues. This therapy has reduced the client's stress, diminished pain, and increased circulation. Which therapy has this client most likely received? A) Guided imagery B) Homeopathy C) Massage therapy D) Reflexology

Answer: C Explanation: A) Guided imagery involves picturing a desired outcome. B) Homeopathy uses the concept of like curing like. C) Massage therapy involves the manipulation of soft tissues. D) Reflexology is the application of pressure to designated points or reflexes on the client's feet, hands, or ears using the thumb and fingers.

1) The nurse is caring for a client diagnosed with endometriosis. Which statement by the client would require a need for perhaps another treatment option? A) "I am having many hot flashes since I had the Lupron injection." B) "The pain I experience with intercourse is becoming more severe." C) "I have vaginal dryness, reduced libido, and my clitoris has become larger since taking danazol. Is this normal?" D) "I've noticed I have not had my period on a regular basis since being on the G n R H analogs."

Answer: C Explanation: A) Hot flashes are expected, and not a complication. B) Dyspareunia is a common symptom of endometriosis, and therefore is not a complication. C) Danazol is a testosterone derivative that suppresses ovulation and causes amenorrhea. It is intended for short-term therapy. Because of adverse effects, many clinicians have moved away from danazol to other treatment options. GnRH analogs suppress the menstrual cycle through estrogen antagonism

1) A woman with polycystic ovarian syndrome (P C O S) is prescribed clomiphene citrate for the treatment of infertility. Which statement does the nurse understand is true? A) The woman has abnormal ovaries B) The woman has low prolactin levels C) The woman's pituitary gland is intact D) The woman's thyroid gland is normal

Answer: C Explanation: A) In order to qualify for treatment with clomiphene citrate, the woman must have normal ovaries. B) In order to qualify for treatment with clomiphene citrate, the woman must have normal prolactin levels. C) In order to qualify for treatment with clomiphene citrate, the woman must have an intact pituitary gland. A normal-functioning thyroid gland is not essential for the client who takes clomiphene citrate; therefore, this statement may not be true

1) The nurse is teaching a client who has been diagnosed with vulvitis. Which statement by the client indicates that the nurse's instruction has not been effective? A) "I should stop having sexual intercourse." B) "Non-deodorized tampons could make this condition recur." C) "Wearing pantyhose daily will improve the problem." D) "A different brand of soap might eliminate the irritation."

Answer: C Explanation: A) Intercourse can occur, but with adequate lubrication. B) Use of deodorized and heavily scented products that come in contact with the vulva (toilet paper, soap, bubble bath, pads, tampons, etc.) can cause the inflammation. C) Vulvitis is inflammation of the vulva. Tight clothing, especially if made of synthetic fibers, can predispose women to the condition. Pantyhose should not be worn. D) Use of deodorized and heavily scented products that come in contact with the vulva (toilet paper, soap, bubble bath, pads, tampons, etc.) can cause the inflammation.

A female client is disappointed to learn that intrauterine contraception is not an option. For what reason is this form of contraception contraindicated for this client? A) Diabetes B) Breast cancer C) Endometriosis D) Uterine surgery

Answer: C Explanation: A) Intrauterine contraception is contraindicated in endometriosis. Intrauterine contraception is an excellent contraceptive option for women with diabetes; it may also be used in women with a history of breast cancer or uterine surgery. B) Intrauterine contraception is contraindicated in endometriosis. Intrauterine contraception is an excellent contraceptive option for women with diabetes; it may also be used in women with a history of breast cancer or uterine surgery. C) Intrauterine contraception is contraindicated in endometriosis. Intrauterine contraception is an excellent contraceptive option for women with diabetes; it may also be used in women with a history of breast cancer or uterine surgery. Intrauterine contraception is contraindicated in endometriosis. Intrauterine contraception is an excellent contraceptive option for women with diabetes; it may also be used in women with a history of breast cancer or uterine surgery

1) During a health interview focused on sexual history, a female patient makes a statement about douching and intercourse. What should the nurse do in response to this statement? A) Recommend the frequency of douching B) Explain the proper procedure to douche C) Take the time now to educate the patient about the practice D) Document that the patient has misunderstandings about the use of douches

Answer: C Explanation: A) It is essential that the nurse listen and use teachable moments to educate women about their bodies. Since the patient mentioned douching and intercourse, the time to review information about that practice with the patient is now. The nurse needs to do more than recommend the frequency of douching or explain the proper douching procedure. The nurse also needs to do more than document that the patient has misunderstandings about the use of douches. B) It is essential that the nurse listen and use teachable moments to educate women about their bodies. Since the patient mentioned douching and intercourse, the time to review information about that practice with the patient is now. The nurse needs to do more than recommend the frequency of douching or explain the proper douching procedure. The nurse also needs to do more than document that the patient has misunderstandings about the use of douches. C) It is essential that the nurse listen and use teachable moments to educate women about their bodies. Since the patient mentioned douching and intercourse, the time to review information about that practice with the patient is now. The nurse needs to do more than recommend the frequency of douching or explain the proper douching procedure. The nurse also needs to do more than document that the patient has misunderstandings about the use of douches. It is essential that the nurse listen and use teachable moments to educate women about their bodies. Since the patient mentioned douching and intercourse, the time to review information about that practice with the patient is now. The nurse needs to do more than recommend the frequency of douching or explain the proper douching procedure. The nurse also needs to do more than document that the patient has misunderstandings about the use of douches

The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect? A) Shortens newborn length of stay B) Decreases use of home health agencies C) Decreases healthcare costs D) Decreases the number of emergency department visits

Answer: C Explanation: A) Length of stay is often determined by third-party payer (insurance company) policies as well as the physiologic stability of the mother and newborn. Home healthcare agencies often are involved in client care to decrease hospital stay time. B) Home healthcare agencies often are involved in client care to decrease hospital stay time. C) Research indicates that self-care significantly decreases healthcare costs. D) Acute emergencies are addressed by emergency departments, and are not delayed by those practicing self-care.

1) Which of the following systems provides a uniform format and classification of terminology based on current understanding of cervical disease? A) Levonorgestrel intrauterine B) P A L M-C O E I N C) Bethesda D) B S E

Answer: C Explanation: A) Levonorgestrel intrauterine system is for contraception and control of excessive menstrual bleeding by suppression of endometrial growth. B) P A L M-C O E I N is a classification system developed for the causes of A U B. C) The Bethesda System for classifying Pap smears is a standardized method of reporting cytologic Pap smear findings and is the most widely used method in the United States. D) B S E is the acronym for breast self-examination and is not considered a system.

1) A client who wants to use the vaginal sponge method of contraception shows that she understands the appropriate usage when she makes which statement? A) "I need to use a lubricant prior to insertion." B) "I need to add spermicidal cream prior to intercourse." C) "I need to moisten it with water prior to use." D) "I need to leave it in no longer than 6 hours."

Answer: C Explanation: A) Lubricant and spermicidal cream are not needed with the vaginal sponge. B) Lubricant and spermicidal cream are not needed with the vaginal sponge. C) To activate the spermicide in the vaginal sponge, it must be moistened thoroughly with water. D) The sponge can remain in place for 24 hours.

A client who was raped is extremely upset when a pregnancy test confirms that she is pregnant, and requests information regarding pregnancy termination. Which statement is best for the nurse to make? A) "Abortion is morally wrong, and should not be undertaken." B) "Hypertension is a risk with any abortion." C) "Surgical abortion in the first trimester is technically easier and safer than abortion in the second trimester." D) "The most accurate method to determine gestational age are the results of a pregnancy test."

Answer: C Explanation: A) Many nurses are strongly opposed to abortion for religious, ethical, cultural, or personal reasons. In order to be effective in a therapeutic relationship, the nurse must avoid being judgmental. B) Endometritis is a risk with any abortion. C) Second-trimester abortion (greater than 13 weeks' gestation up to 24 weeks or per state law) may be done medically or surgically. D) The most accurate method to determine gestational age is by sonographic determination.

1) The community health nurse manager is reviewing the charts of female elderly clients. Which issue are these clients most likely to experience? A) Adequate financial resources to purchase medications B) Senior services that provide transportation to healthcare appointments C) Multiple medications prescribed by different physicians D) Medicare that covers healthcare costs so no out-of-pocket expenses occur

Answer: C Explanation: A) Older women, particularly those who are poor, face multiple barriers in obtaining adequate healthcare services, including excessive medical costs not covered by Medicare. B) Not all elderly have adequate access to transportation for healthcare. C) Polypharmacy, which means multiple medicines, is a common problem in the elderly population. Elderly women (as well as elderly men) often have multiple healthcare providers with different specialties who provide pharmacologic intervention. Lack of private health insurance coverage and excessive medical costs not covered by Medicare can be barrier in obtaining adequate healthcare services

1) The nurse is creating a handout on reproduction for teen clients. Which piece of information should the nurse include in this handout? A) The fertilized ovum is called a gamete. B) Prior to fertilization, the sperm are zygotes. C) Ova survive 12-24 hours in the fallopian tube if not fertilized. Sperm survive in the female reproductive tract up to a week

Answer: C Explanation: A) Ova and sperm are gametes; a fertilized ovum is a zygote. B) Sperm are gametes (as are ova); a zygote is a fertilized ovum. C) Ova are considered fertile for about 12 to 24 hours after ovulation. Sperm can survive in the female reproductive tract for 48 to 72 hours but are believed to be healthy and highly fertile for only about the first 24 hours

1) The nurse manager is preparing an educational in-service for staff nurses about elder abuse. The nurse manager develops a hypothetical situation: A wheelchair-bound client who lives with her daughter has experienced hunger because she cannot reach the cupboards to make lunch. Which category of elder abuse does this example describe? A) Psychologic abuse B) Physical abuse C) Neglect D) Financial abuse

Answer: C Explanation: A) Psychologic abuse is usually verbal. B) Physical abuse involves some degree of pain and injury. C) Neglect is a failure on the part of a caregiver, or any person having custody of an elder, to provide reasonable care, which is the degree of care that a reasonable person would provide. Financial abuse involves money

1) A patient receiving chemotherapy for breast cancer writes in a journal during the treatments and reads devotional material. Which phase of psychologic adjustment should the nurse identify that this patient is experiencing? A) Shock B) Denial C) Reaction D) Recovery

Answer: C Explanation: A) Reaction occurs in conjunction with the initiation of treatment. Coping mechanisms become evident during this phase, and may include things like journaling and reading devotional material. Shock generally extends from the discovery of the lump through the process of diagnosis. Denial of the reality of the illness is a common response by the woman during the periods of diagnosis and treatment. Recovery begins during convalescence following the completion of medical treatment. B) Reaction occurs in conjunction with the initiation of treatment. Coping mechanisms become evident during this phase, and may include things like journaling and reading devotional material. Shock generally extends from the discovery of the lump through the process of diagnosis. Denial of the reality of the illness is a common response by the woman during the periods of diagnosis and treatment. Recovery begins during convalescence following the completion of medical treatment. C) Reaction occurs in conjunction with the initiation of treatment. Coping mechanisms become evident during this phase, and may include things like journaling and reading devotional material. Shock generally extends from the discovery of the lump through the process of diagnosis. Denial of the reality of the illness is a common response by the woman during the periods of diagnosis and treatment. Recovery begins during convalescence following the completion of medical treatment. Reaction occurs in conjunction with the initiation of treatment. Coping mechanisms become evident during this phase, and may include things like journaling and reading devotional material. Shock generally extends from the discovery of the lump through the process of diagnosis. Denial of the reality of the illness is a common response by the woman during the periods of diagnosis and treatment. Recovery begins during convalescence following the completion of medical treatment

The nurse is developing a teaching plan for a client undergoing a tubal ligation. What information should be included in the plan? A) The surgical procedure is easily reversible. B) Laparotomy is performed following a vaginal birth. C) Minilaparotomy is performed in the postpartum period soon after a vaginal birth. D) Tubal ligation can be done at any time the woman is either pregnant or not pregnant.

Answer: C Explanation: A) Reversal of a tubal ligation depends on the type of procedure performed. Although theoretically reversible, clients are advised that the method should be considered irreversible. B) Laparotomy is performed following a cesarean birth or other abdominal surgery. C) A tubal ligation minilaparotomy is performed in the postpartum period soon after a vaginal birth. D) Tubal ligation can be done at any time the woman is not pregnant.

For prenatal care, the client is attending a clinic held in a church basement. The client's care is provided by registered nurses and a certified nurse-midwife. What is this type of prenatal care? A) Secondary care B) Tertiary care C) Community care D) Unnecessarily costly care

Answer: C Explanation: A) Secondary care is specialized care; an example is checking the hemoglobin A1C of a diabetic client at an endocrine clinic. B) Tertiary care is very specialized, and includes trauma units and neonatal intensive care units. C) Prenatal care is primary care. Community care is often provided at clinics in neighborhoods to facilitate clients' access to primary care, including prenatal care and prevention of illness. D) Community care decreases costs while improving client outcomes, and is not unnecessarily expensive.

When the nurse is teaching a woman about the use of a diaphragm, it is important to instruct her that the diaphragm should be rechecked for correct size how often? A) Every five years routinely B) When weight gain or loss beyond five pounds has occurred C) After each birth D) Only after significant weight loss

Answer: C Explanation: A) The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more. B) The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more. C) The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more. D) The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more.

A client asks the nurse, "Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy?" What is the nurse's best response? A) "Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred." B) "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation." C) "Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur." D) "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."

Answer: C Explanation: A) Taking the temperature every evening at the same time would not provide information about when ovulation occurs. B) Taking the temperature every day at the same time would not necessarily provide accurate information about when ovulation occurs. C) The basal body temperature method is used to detect ovulation by an increase in the basal temperature during the menstrual cycle. It requires that the woman take her temperature every morning upon awakening (before any activity) and record the findings on a temperature graph, and is based on the fact that the temperature almost always rises and remains elevated after ovulation because of the production of progesterone, a thermogenic (heat-producing) hormone. D) Using basal body temperature to determine the timing of ovulation is a proven scientific method, and is recognized as an effective means of birth control.

1) The student nurse encounters a 15-year-old girl who reports that she has no pubic or axillary hair and has not yet experienced growth of her breasts. The student asks the nurse about the physiology of this occurrence. The nurse explains that the client probably lacks which hormone? A) Testosterone B) Progesterone C) Estrogen D) Prolactin

Answer: C Explanation: A) Testosterone is responsible for the development of secondary sex characteristics in males. B) Progesterone and prolactin do not accomplish this change. C) Estrogens influence the development of secondary sex characteristics in females. Progesterone and prolactin do not accomplish this change

1) The nurse is about to tell a client that her Pap smear result was abnormal. Which statement should the nurse include? A) "The Pap smear is used to diagnose cervical cancer." B) "A loop electrosurgical excision procedure (L E E P) is needed." C) "Colposcopy to further examine your cervix is the next step." D) "Your cervix needs to be treated with cryotherapy."

Answer: C Explanation: A) The Pap smear is a screening tool for cervical abnormalities; it is not diagnostic. B) Although L E E P (the removal of the surface tissue of the cervix) might be performed to treat cervical dysplasia or carcinoma in situ, this client has not had a diagnostic examination yet. C) Colposcopy is an examination of the cervix through a magnifying device. D) Cryotherapy, or freezing of the cervix, is one treatment option for precancerous cervical lesions.

1) Which of the following federal departments actively investigates and prosecutes individuals who cross state lines to avoid paying child support, and now intercepts delinquent parents' income tax refunds? A) U.S. Department of Health and Human Services B) U.S. Department of Labor C) U.S. Department of Justice D) U.S. Equal Employment Opportunity Commission

Answer: C Explanation: A) The U.S. Department of Health and Human Services does not investigate and prosecute individuals who cross state lines to avoid paying child support. B) The U.S. Department of Labor keeps track of labor statistics. C) The U.S. Department of Justice actively investigates and prosecutes individuals who cross state lines to avoid paying child support, and now intercepts delinquent parents' income tax refunds. D) The U.S. Equal Employment Opportunity Commission receives complaints from pregnant women who were turned down for jobs, denied transfers to positions for which they were qualified, or fired unjustly.

1) What is the term for when children alternate between two homes, spending varying amounts of time with each parent in a situation called co-parenting and usually involving joint custody? A) Blended or reconstituted nuclear family B) Extended kin network family C) Binuclear family D) Extended family

Answer: C Explanation: A) The blended or reconstituted nuclear family includes two parents with biologic children from a previous marriage or relationship who marry or cohabitate. B) An extended kin network family is a specific form of an extended family in which two nuclear families of primary or unmarried kin live in proximity to each other. C) A binuclear family is a post-divorce family in which the biologic children are members of two nuclear households, with parenting by both the father and the mother. D) In an extended family, a couple shares household and childrearing responsibilities with parents, siblings, or other relatives.

The nurse is preparing educational materials at a family planning clinic. The client who is an appropriate candidate for using emergency contraception would be one who reports which of the following? A) Forgetting to start her pill pack yesterday B) Unprotected intercourse during her menses C) That a condom broke yesterday in the middle of her cycle D) Increased dysmenorrhea since I U C insertion

Answer: C Explanation: A) The client who forgot to start a new pill pack on time might not have had intercourse. B) Intercourse during menses does not lead to pregnancy. C) Research indicates that oral hormonal E C taken as soon as possible within 72 hours, but up to 5 days, can reduce the risk of pregnancy after a single act of unprotected intercourse by at least 74%. D) An I U C in place prevents conception, so emergency contraception is not indicated.

The nurse in the clinic instructs a client who is using the natural method of contraception to begin counting the first day of her cycle as which day? A) The day her menstrual period ceases B) The first day after her menstrual period ceases C) The first day of her menstrual period D) The day of ovulation

Answer: C Explanation: A) The day her menstrual period ceases is not an indicator of the first day of the cycle. B) The first day after her menstrual period ceases is not an indicator of the first day of the cycle. C) The first day of menstruation is the first day of the cycle. D) The day of ovulation is not an indicator of the first day of the cycle.

1) The nurse takes a telephone call from a women's health clinic patient. What information should cause the nurse to suspect that the patient is experiencing a cystocele? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Bloody urine B) Low back pain C) Onset of stress incontinence D) Feeling of fullness in the perineum E) Feels like something "fell out" of the vagina

Answer: C, D, E Explanation: Manifestations of a cystocele include symptoms of stress urinary incontinence (SUI), pelvic pressure and the perception of something "falling out" of the vagina. Hematuria and low back pain are not manifestations of a cystocele

1) The emergency department nurse is admitting a client who has been sexually assaulted. The nurse is explaining how the physical evidence will be collected. Which statement by the client indicates that teaching has been effective? A) "All the evidence will be kept in a locked cupboard until the police arrive." B) "You collect urine samples to make sure the rapist did not get me pregnant." C) "The evidence you collect might be able to identify the rapist." D) "Blood samples are taken to help identify whether the rapist had H I V."

Answer: C Explanation: A) The evidence must remain in the hands of the nurse until handed directly to the police. B) Urine should be collected in cases in which a drug-facilitated sexual assault is suspected. C) D N A can be obtained from collected evidence to identify the rapist. D) Blood is drawn to test for syphilis and to determine the woman's blood type, and additional blood may be drawn for a pregnancy test.

1) When a woman who has been raped is admitted to the emergency department, the nurse caring for the woman knows that which of the following is the priority nursing intervention? A) Explaining exactly what will need to be done to preserve legal evidence B) Assuring the woman that everything will be all right C) Creating a safe, secure environment for her D) Contacting family members

Answer: C Explanation: A) The legal interventions would not take priority over safety at this time. B) Assuring the woman that everything will be all right is not the first priority nursing intervention in caring for a survivor of a sexual assault. C) The first priority in caring for a survivor of a sexual assault is to create a safe, secure environment. Contacting family members is important, but is not the priority nursing intervention

1) The nurse is teaching a class about domestic violence to enhance education within the community. Which statement regarding the cycle of violence should the nurse include in the presentation? A) "The tension-building phase lasts a few hours." B) "The batterer often feels remorse during the tension-building phase." C) "The acute battery incident is often triggered by an external event, such as the loss of a job." D) "The acute battery incident often finds the victim hoping the relationship will change for the better."

Answer: C Explanation: A) The length of the tension-building phase of the cycle of violence varies considerably across individual cases and can range from weeks to years. It is often the acute battery incident that lasts a few hours. B) The batterer often feels remorse during the tranquil phase or honeymoon period, not the tension-building phase. C) An acute battery incident is often triggered by an external event for the abuser, such as the loss of a job. D) The victim of abuse often hopes the relationship will improve in the tension-building phase, not during the acute battery incident.

1) The nurse in the community should use a family assessment tool to obtain what type of information? A) How long the family has lived at its current address B) What other health insurance the family has had in the past C) How the family meets its nutritional needs and obtains food D) What eye color the family desires in its unborn child

Answer: C Explanation: A) The length of time at a residence is not included in the family assessment tool. B) Past health insurance coverage is not included in the family assessment tool. C) A family assessment is a collection of data about the family's type and structure, current level of functioning, support system, sociocultural background, environment, and needs. D) Desired eye color of a child is not included in the family assessment tool.

1) The nurse is planning a community education presentation on battering. Which statement about battering should the nurse include? A) Battering occurs in a small percentage of the population. B) Battering is mainly a lower-class, blue-collar problem. C) Battered women are at greatest risk for severe violence when they leave the batterer. D) If the batterer stops drinking, the violence usually stops.

Answer: C Explanation: A) The statistics on reported cases underrepresent the true incidence. As many as one in three women may be the victim of assault by her partner in her lifetime; however, it is a widely underreported crime. B) Domestic violence occurs among all sectors of society. It happens to women of all socioeconomic statuses, races, ethnicities, and religious faiths. C) Battered women are at greatest risk for injury or domestic homicide when they leave the abuser. D) Battered women sometimes think that the abuse will stop if their partners stop drinking or using drugs. Unfortunately, this usually does not happen.

1) The nurse is preparing a presentation on the menstrual cycle for a group of high school students. Which statement should the nurse include in this presentation? A) "The menstrual cycle has five distinct phases that occur during the month." B) "One hormone controls the phases of the menstrual cycle." C) "The secretory phase occurs when a woman is most fertile." D) "Menstrual cycle phases vary in order from one woman to another."

Answer: C Explanation: A) There are four phases of the menstrual cycle. B) Four hormones control ovulation and, therefore, the menstrual cycle. C) During the secretory phase, the vascularity of the entire uterus increases greatly, providing a nourishing bed for implantation. Although the length of the menstrual cycle might vary, the phases of the menstrual cycle always occur in the same order

1) The nurse walks in to find the client crying after the physician informed her of her diagnosis of human papilloma virus (H P V). Which statement by the nurse conveys an attitude of acceptance toward the client with a sexually transmitted infection? A) "Don't worry about it. In a few weeks, with treatment, the lesions will disappear." B) "You seem upset. I'll get the doctor." C) "You seem upset. Can I help answer any questions?" D) "I think you need to see a therapist."

Answer: C Explanation: A) This client needs a caring person to listen to her and convey acceptance of her. This statement does not convey this. B) The client does not need the doctor at this time. C) The nurse's attitude of acceptance and matter-of-factness conveys to the client that she is still an acceptable person who happens to have an infection. It is not up to the nurse to determine whether this client needs a therapist

1) The nurse is creating a poster for pregnant mothers. Which description of fetal development should the nurse include? A) Four primary germ layers form from the blastocyst. B) After fertilization, the cells only become larger for several weeks. C) Most organs are formed by 8 weeks after fertilization. The embryonic stage is from fertilization until 5 months

Answer: C Explanation: A) Three primary germ layers form from the blastocyst: ectoderm, mesoderm, and endoderm. B) After fertilization, the cells reproduce by mitosis, resulting in more cells, not larger cells. C) Most organs are formed during the embryonic stage, which lasts from the 15th day after fertilization until the end of the 8th week after conception. D) The embryonic stage ends before the fifth month.

A patient with osteoporosis wants a medication that does not need to be taken every day. What should the nurse expect to be prescribed for this patient? A) Teriparatide (Forteo) B) Alendronate (Fosamax) C) Zoledronic acid (Zometa®) D) Salmon calcitonin (Miacalcin®)

Answer: C Explanation: A) Zoledronic acid (Zometa®) is administered via Ⅳ once a year. Teriparatide (Forteo) necessitates a daily subcutaneous injection. Alendronate (Fosamax) is a daily oral medication. Salmon calcitonin (Miacalcin®) is to be taken daily as a nasal spray. B) Zoledronic acid (Zometa®) is administered via Ⅳ once a year. Teriparatide (Forteo) necessitates a daily subcutaneous injection. Alendronate (Fosamax) is a daily oral medication. Salmon calcitonin (Miacalcin®) is to be taken daily as a nasal spray. C) Zoledronic acid (Zometa®) is administered via Ⅳ once a year. Teriparatide (Forteo) necessitates a daily subcutaneous injection. Alendronate (Fosamax) is a daily oral medication. Salmon calcitonin (Miacalcin®) is to be taken daily as a nasal spray. D) Zoledronic acid (Zometa®) is administered via Ⅳ once a year. Teriparatide (Forteo) necessitates a daily subcutaneous injection. Alendronate (Fosamax) is a daily oral medication. Salmon calcitonin (Miacalcin®) is to be taken daily as a nasal spray.

1) A 24-year-old patient with an intellectual disability at 30 weeks' gestation asks when it is safe to have an abortion. How should the nurse respond to this patient? A) "Have you been hiding your pregnancy?" B) "The safe time to end a pregnancy has passed." C) "Is it safe for me to assume that you don't want to have this baby?" D) "I guess you didn't realize that an abortion should have occurred months ago."

Answer: C Explanation: C) The nurse should explain about the safe time to end a pregnancy in a more appropriate way. The patient has an intellectual disability and may not understand when an abortion can be performed. Asking if the patient is hiding the pregnancy is inappropriate. Asking if the patient does not want to have the baby is appropriate if the patient is asking for information about an abortion. Saying that the patient didn't realize that an abortion should have occurred months ago would be inappropriate because the patient has an intellectual disability.

A patient in the 2nd trimester of pregnancy is diagnosed with bacterial vaginosis. Which medication regimen should the nurse expect to be prescribed for this patient? A) Metronidazole 500 m g orally one dose B) Metronidazole 250 m g orally once a day for 7 days C) Metronidazole 500 m g orally twice a day for 7 days D) Metronidazole 250 m g orally twice a day for 14 days

Answer: C Explanation: C) The recommended treatment of bacterial vaginosis during pregnancy is Metronidazole 500 m g orally twice a day for 7 days. One dose of metronidazole is not sufficient. Metronidazole 250 m g should be taken 3 times for 7 days to be effective. Metronidazole 250 m g does not need to be taken for 14 days.

1) An older female patient with a known intellectual disability is newly diagnosed with osteoporosis and admitted with a fractured hip after falling in the home. What should the nurse realize could have contributed to this patient's health problem? A) Importance of resting during the day B) Need to reduce the amount of physical activity C) Understanding home environmental safety needs D) Reducing the oral intake of protein and carbohydrates

Answer: C Explanation: C) Understanding home environmental safety needs could have been an issue with the patient with an intellectual disability. Resting, reducing physical activity, and altering the intake of protein and carbohydrates would not be beneficial for the patient with osteoporosis.

A patient is being instructed on adverse effects of gonorrhea. For which reason should the nurse instruct the patient to contact the healthcare provider? A) Dysuria B) Urinary frequency C) Sharp abdominal pain D) Purulent, greenish-yellow vaginal discharge

Answer: C Explanation: C) Women should be informed of signs that the infection is worsening, such as sharp abdominal pain, and be encouraged to seek further care. Dysuria, urinary frequency, and purulent, greenish-yellow vaginal discharge are manifestations of gonorrhea and do not indicate that the infection is getting worse.

A patient experiencing symptoms of menopause asks if there are any vitamin supplements she should take at this time. Which vitamins should the nurse suggest to this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Vitamin A B) Vitamin C C) Vitamin D D) Vitamin E E) Vitamin B complex

Answer: C, D, E Explanation: A) Therapeutic modalities proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years include vitamins E, D, and B complex. Vitamins A and C have not been identified as being beneficial to reduce the symptoms associated with menopause. B) Therapeutic modalities proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years include vitamins E, D, and B complex. Vitamins A and C have not been identified as being beneficial to reduce the symptoms associated with menopause. C) Therapeutic modalities proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years include vitamins E, D, and B complex. Vitamins A and C have not been identified as being beneficial to reduce the symptoms associated with menopause. D) Therapeutic modalities proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years include vitamins E, D, and B complex. Vitamins A and C have not been identified as being beneficial to reduce the symptoms associated with menopause. E) Therapeutic modalities proposed as treatment or prevention measures for the discomforts and ailments of the perimenopausal and postmenopausal years include vitamins E, D, and B complex. Vitamins A and C have not been identified as being beneficial to reduce the symptoms associated with menopause.

1) Which couples may benefit from prenatal diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Couples including women under the age of 35 B) Couples with an unbalanced translocation C) Couples with a family history of a known or suspected single-gene disorder D) Couples including women with a teratogenic risk secondary to an exposure or maternal health condition E) Family history of birth defects and/or intellectual disability

Answer: C, D, E Explanation: A) Women age 35 or over at time of birth may benefit from prenatal diagnosis. B) Couples with a balanced translocation (chromosomal abnormality) may benefit from prenatal diagnosis. C) Couples with a family history of known or suspected single-gene disorder (e.g., cystic fibrosis, hemophilia A or B, Duchenne muscular dystrophy) may benefit from prenatal diagnosis. D) Women with a teratogenic risk secondary to an exposure or maternal health condition (e.g., diabetes, seizure disorder) may benefit from prenatal diagnosis. E) Family history of birth defects and/or intellectual disability (mental retardation) (e.g., neural tube defects, congenital heart disease, cleft lip and/or palate) may benefit from prenatal diagnosis.

1) The nurse is explaining the difference between meiosis and mitosis. Which statements would be best? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Meiosis is the division of a cell into two exact copies of the original cell. B) Mitosis is splitting one cell into two, each with half the chromosomes of the original cell. C) Meiosis is a type of cell division by which gametes, or the sperm and ova, reproduce. D) Mitosis occurs in only a few cells of the body. Meiotic division leads to cells that halve the original genetic material

Answer: C, E Explanation: A) Meiosis creates two cells that have half of the chromosomes of the original cell. B) Mitosis creates two cells that are exact copies of the original cell. C) Meiosis is a special type of cell division by which diploid cells give rise to gametes (sperm and ova). D) Mitosis makes growth and development possible. In mature individuals it is the process by which our body cells continue to divide and replace themselves. E) Meiosis creates two cells that contain half the genetic material of the parent cell.

The registered nurse who has completed a master's degree program and passed a national certification exam has clinic appointments with clients who are pregnant or seeking well-woman care. What is the role of this nurse considered to be? A) Professional nurse B) Certified registered nurse (R N C) C) Clinical nurse specialist D) Nurse practitioner

Answer: D Explanation: A) A professional nurse is one who has completed an accredited basic educational program and has passed the N C L E X-R N® exam. B) A certified registered nurse (R N C) has shown expertise in the field and has taken a national certification exam. C) A clinical nurse specialist has completed a master's degree program, has specialized knowledge and competence in a specific clinical area, and often is employed in hospitals on specialized units. D) A nurse practitioner has completed either a master's or doctoral degree in nursing and passed a certification exam, and functions as an advanced practice nurse. Ambulatory care settings and the community are common sites for nurse practitioners to provide client care.

A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role? A) A registered nurse who is the manager of a large obstetrical unit B) A registered nurse who is the circulating nurse during surgical deliveries (cesarean sections) C) A clinical nurse specialist working as a staff nurse on a mother-baby unit D) A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants

Answer: D Explanation: A) A registered nurse who is the manager of a large obstetrical unit is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination. B) A registered nurse who is a circulating nurse at surgical deliveries (cesarean sections) is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination. C) A clinical nurse specialist working as a staff nurse on a mother-baby unit might have the qualifications for an advanced practice nursing staff member but is not working in that capacity. A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk infants is working in an advanced practice nursing role. This nurse has specialized knowledge and competence in a specific clinical area, and is master's prepared

The nurse manager is planning a presentation on ethical issues in caring for childbearing families. Which example should the nurse manager include to illustrate maternal-fetal conflict? A) A client chooses an abortion after her fetus is diagnosed with a genetic anomaly. B) A 39-year-old nulliparous client undergoes therapeutic insemination. C) A family of a child with leukemia requests cord-blood banking at a sibling's birth. A cesarean delivery of a breech fetus is court ordered after the client refuses

Answer: D Explanation: A) Abortion is a different type of ethical situation. B) Achieving pregnancy through the use of therapeutic insemination is a form of reproductive assistance, and is not considered a maternal-fetal conflict. C) Cord-blood banking is a different type of ethical situation. D) Maternal-fetal conflict is a special ethical situation where the rights of the fetus and the rights of the mother are considered separately. Forced cesarean birth, coercion of mothers who practice high-risk behaviors, and, perhaps most controversial, mandating experimental in utero therapy or surgery in an attempt to correct a specific birth defect are interventions that infringe on the mother's autonomy.

1) A patient is demonstrating manifestations of acute cervicitis. Which laboratory test should the nurse expect to be completed for this patient? A) Sedimentation rate B) Blood test for V D R L C) White blood cell count D) Vaginal smear for S T Is

Answer: D Explanation: A) Acute inflammation of the cervix is usually the result of infection from Neisseria gonorrhoeae or Chlamydia trachomatis. A vaginal smear for S T Is will most likely be done. Sedimentation rate, blood test for V D R L, and white blood cell count are not indicated in the diagnosis of acute cervicitis. B) Acute inflammation of the cervix is usually the result of infection from Neisseria gonorrhoeae or Chlamydia trachomatis. A vaginal smear for S T Is will most likely be done. Sedimentation rate, blood test for V D R L, and white blood cell count are not indicated in the diagnosis of acute cervicitis. C) Acute inflammation of the cervix is usually the result of infection from Neisseria gonorrhoeae or Chlamydia trachomatis. A vaginal smear for S T Is will most likely be done. Sedimentation rate, blood test for V D R L, and white blood cell count are not indicated in the diagnosis of acute cervicitis. Acute inflammation of the cervix is usually the result of infection from Neisseria gonorrhoeae or Chlamydia trachomatis. A vaginal smear for STIs will most likely be done. Sedimentation rate, blood test for VDRL, and white blood cell count are not indicated in the diagnosis of acute cervicitis

1) The nurse is conducting a health maintenance assessment for a female client. Which neurologic data would cause the nurse to further assess for intimate partner abuse? A) Anxiety B) Depression C) Weight gain D) Tension headaches

Answer: D Explanation: A) Anxiety is a psychiatric, not neurologic, assessment finding that would cause the nurse to further assess for intimate partner abuse. B) Depression is a psychiatric, not neurologic, assessment finding that would cause the nurse to further assess for intimate partner abuse. C) Weight gain is a constitutional, not neurologic, assessment finding that would cause the nurse to further assess for intimate partner abuse. D) Tension headaches are a neurologic assessment finding that would cause the nurse to further assess for intimate partner abuse.

1) The nurse is preparing to assess the sexual history of a 35-year-old female patient. Which approach should the nurse first use to facilitate this data collection? A) Ask if the patient is sexually active B) Review the present method of birth control C) Determine the patient's number of children D) Talk about the patient's medical-surgical history

Answer: D Explanation: A) Asking if the patient is sexually active, reviewing the present method of birth control, and determining the patient's number of children are all intimate areas that should not be used to start a sexual history. B) Asking if the patient is sexually active, reviewing the present method of birth control, and determining the patient's number of children are all intimate areas that should not be used to start a sexual history. C) Asking if the patient is sexually active, reviewing the present method of birth control, and determining the patient's number of children are all intimate areas that should not be used to start a sexual history. D) When taking a history, the interview should start with less intimate areas, such as medical and surgical history, and then proceed to the sexual history toward the end of the history-taking session. This approach helps the woman develop a comfort level with the nurse before disclosing personal information.

1) The client with limited English language skills has a black eye and bruises across her face and arms. The client's husband has been acting as an interpreter for her, and answers all of the questions the nurse asks, often without talking to his wife first. The nurse suspects the client has been a victim of domestic abuse. What should the nurse do next? A) Ask the husband whether he has beaten his wife. B) Ask the husband to have a female friend come in with his wife. C) Provide written materials in English for the client to read at home. D) Ask the husband to step out of the room, and obtain an interpreter.

Answer: D Explanation: A) Asking the abuser whether he has abused his spouse is useless, as most abusers see their behavior as appropriate. B) Asking the husband to have a female friend come with his wife is not the best action for the nurse to take next. C) Written proficiency develops after verbal fluency; therefore, written materials in English are inappropriate for this client. D) Screening for women experiencing domestic violence must be done privately. An interpreter should also be provided as necessary.

When teaching a culturally diverse group of childbearing families about hospital birthing options, the culturally competent nurse does which of the following? A) Understands that the families have the same values as the nurse B) Teaches the families how childbearing takes place in the United States C) Insists that the clients answer questions instead of their husbands D) Incorporates the specific beliefs of the cultural groups that are attending the class

Answer: D Explanation: A) Assuming that the families have the same values as the nurse is ethnocentrism. B) Although it is important to explain health care during pregnancy and childbearing, this is not the top priority. C) The husband's answering questions might be a cultural norm, and insisting that the client answer could decrease the family's trust in the healthcare system. D) Providing culturally competent care involves recognizing the importance of the childbearing family's value system, acknowledging that differences occur among people, and respecting and responding to ethnic diversity in a way that leads to mutually desirable outcomes.

1) The labor and delivery nurse is caring for a laboring client who has asked for a priest to visit her during labor. The client's mother died during childbirth, and although there were no complications during her pregnancy, the client is fearful of her own death during labor. What would be the best way for the nurse to respond? A) "Nothing is going to happen to you. We'll take very good care of you during your birth." B) "Would you like to have an epidural so that you won't feel the pain of the contractions?" C) "The priest won't be able to prevent complications, and might get in the way of your providers." D) "Would you like me to contact someone from your parish or our hospital chaplain to come see you?"

Answer: D Explanation: A) Avoid statements of reassurance, as there are no guarantees of outcome during health care. Using such statements shuts down effective communication because the client's concern is downplayed. B) The client's expressed concern is not about pain; it is a fear of death and a desire to see a priest. The nurse should address the client's concern directly. C) Although this statement is true, it is not therapeutic. It downplays the client's concerns, and will shut down effective communication. The nurse should address the concerns the client expresses. Providing spiritually sensitive care involves determining the current spiritual and religious beliefs and practices that will affect the mother and baby and accommodating these practices where possible

The nurse is identifying complementary and alternative therapies for a patient with a history of liver disorders who is experiencing symptoms of menopause. Which herbal supplement should this patient be counseled to avoid? A) Ginger B) Ginseng C) Red clover D) Black cohosh

Answer: D Explanation: A) Black cohosh has been associated with liver inflammation and disease. Ginger is useful to control nausea and vomiting. Ginseng helps with mood symptoms and sleep disorders. Red clover helps with hot flashes. Ginger, ginseng, and red clover are not associated with liver disease. B) Black cohosh has been associated with liver inflammation and disease. Ginger is useful to control nausea and vomiting. Ginseng helps with mood symptoms and sleep disorders. Red clover helps with hot flashes. Ginger, ginseng, and red clover are not associated with liver disease. C) Black cohosh has been associated with liver inflammation and disease. Ginger is useful to control nausea and vomiting. Ginseng helps with mood symptoms and sleep disorders. Red clover helps with hot flashes. Ginger, ginseng, and red clover are not associated with liver disease. D) Black cohosh has been associated with liver inflammation and disease. Ginger is useful to control nausea and vomiting. Ginseng helps with mood symptoms and sleep disorders. Red clover helps with hot flashes. Ginger, ginseng, and red clover are not associated with liver disease.

1) The nurse teaching the phases of the menstrual cycle should include that the corpus luteum begins to degenerate, estrogen and progesterone levels fall, and extensive vascular changes occur in which phase? A) Menstrual phase B) Proliferative phase C) Secretory phase D) Ischemic phase

Answer: D Explanation: A) In the menstrual phase, estrogen levels are low, cervical mucus is scant, viscous, and opaque, and endometrium is shed. B) In the proliferative phase, endometrium and myometrium thickness increases and estrogen peaks just before ovulation. C) In the secretory phase, estrogen drops sharply, and progesterone dominates; vascularity of the entire uterus increases; and tissue glycogen increases, making the uterus ready for implantation. D) In the ischemic phase, the corpus luteum begins to degenerate, and as a result, both estrogen and progesterone levels fall. Small blood vessels rupture, and the spiral arteries constrict and retract, causing a deficiency of blood in the endometrium, which becomes pale.

A patient who is postmenopausal is encouraged to take calcium 1500 mg every day. How should the nurse instruct the patient to take this supplement? A) Take calcium 750 m g with breakfast and dinner B) Take the complete dose first thing in the morning C) Take the complete dose prior to bedtime every day D) Take calcium 500 m g three times a day with meals

Answer: D Explanation: A) Calcium supplementation is most effective when single doses do not exceed 500 m g and when taken with a meal. Taking calcium 750 m g twice a day is less effective. Taking calcium 1500 m g in the morning or at night is not recommended since the mineral will not have peak absorption. B) Calcium supplementation is most effective when single doses do not exceed 500 m g and when taken with a meal. Taking calcium 750 m g twice a day is less effective. Taking calcium 1500 m g in the morning or at night is not recommended since the mineral will not have peak absorption. C) Calcium supplementation is most effective when single doses do not exceed 500 m g and when taken with a meal. Taking calcium 750 m g twice a day is less effective. Taking calcium 1500 m g in the morning or at night is not recommended since the mineral will not have peak absorption. D) Calcium supplementation is most effective when single doses do not exceed 500 m g and when taken with a meal. Taking calcium 750 m g twice a day is less effective. Taking calcium 1500 m g in the morning or at night is not recommended since the mineral will not have peak absorption.

1) The nurse is interviewing a client who has admitted to being a victim of domestic violence. What is the most typical description of how the domestic violence developed in a relationship? A) "He changed overnight. Everything was fine, and all of a sudden he flipped out and beat me up; he nearly killed me." B) "It was severe from the beginning. As soon as we got married, he began hitting me and threatening to kill me." C) "We've both always dated other people. I thought that was understood. He was as emotionally abusive in the beginning as he is now." D) "I don't know when it started, really. It was gradual. First, just yelling, blaming, and shoving. Then the beatings started; and now they're more frequent."

Answer: D Explanation: A) Domestic violence does not begin suddenly, and will always escalate. B) Typically, these forms of abuse begin slowly and subtly after some form of commitment, such as engagement, onset of a sexual relationship, or marriage. C) Typically, these forms of abuse begin slowly and subtly after some form of commitment, such as engagement, onset of a sexual relationship, or marriage. D) Typically, these forms of abuse begin slowly and subtly after some form of commitment, such as engagement, onset of a sexual relationship, marriage, pregnancy, or first childbirth.

1) The nurse working with a client who is seeking a family and medical leave knows that the employee must meet which eligibility requirement of the Family and Medical Leave Act (F M L A) of 1993? A) Work at least 40 hours per week B) Have been employed for at least 1 month C) Work for a company with fewer than 50 employees D) Parental leave for childbirth or adoption by her employer

Answer: D Explanation: A) Employees must work at least 25 hours per week to be eligible. B) Employees must have been in their position for at least 1 year. C) F M L A applies only to companies with 50 or more employees. D) The Family and Medical Leave Act mandates parental leave for childbirth or adoption but applies only to companies with 50 or more employees.

1) The nurse is presenting a community education session on female hormones. Which statement from a participant indicates the need for further information? A) "Estrogen is what causes females to look female." B) "The presence of some hormones causes other to be secreted." C) "Progesterone is present at the end of the menstrual cycle." D) "Prostaglandin is responsible for achieving conception."

Answer: D Explanation: A) Estrogens are associated with characteristics contributing to femaleness, including breast alveolar lobule growth and duct development. B) It is true that the presence of some hormones causes other to be secreted. .X X C C) It is true that the proportions of progesterone and estrogen control the events of both ovarian and menstrual cycles. D) Prostaglandin is not related to conception. Prostaglandin production increases during follicular maturation and has basic regulatory functions in cells.

1) The client is undergoing lab work and ultrasound for a possible diagnosis of polycystic ovarian syndrome (P C O S). Which problem does the nurse expect to find in the client's history? A) Multiple first-trimester fetal losses B) Dyspareunia C) Vulvitis D) Oligomenorrhea

Answer: D Explanation: A) First-trimester fetal loss is not associated with polycystic ovarian syndrome (P C O S). B) Dyspareunia is not associated with polycystic ovarian syndrome (P C O S). C) Vulvitis is not associated with polycystic ovarian syndrome (P C O S). Irregular menses, ranging from total absence of periods (amenorrhea) to intermittent or infrequent periods (oligomenorrhea) are the hallmarks of PCOS

1) The nurse is preparing a handout on the ovarian cycle to a group of middle school girls. Which information should the nurse include? A) The hormone human chorionic gonadotropin stimulates ovulation. B) Irregular menstrual cycles have varying lengths of the luteal phase. C) The ovum leaves its follicle during the follicular phase. D) There are two phases of the ovarian cycle: luteal and follicular.

Answer: D Explanation: A) Human chorionic gonadotropin (h C G) is secreted by a fertilized ovum, and does not stimulate ovulation. B) In women whose menstrual cycles vary, usually it is only the length of the follicular phase that varies, while the luteal phase is of fixed length. C) The luteal phase begins when the ovum leaves its follicle. D) The ovarian cycle has two phases: the follicular phase (days 1 to 14) and the luteal phase (days 15 to 28 in a 28-day cycle).

1) A patient with amenorrhea has an elevated serum prolactin level. Which diagnostic test should the nurse expect will be prescribed for this patient? A) Laparoscopy B) Abdominal ultrasound C) C T scan of the abdomen D) Magnetic resonance imaging (M R I)

Answer: D Explanation: A) If serum prolactin levels are elevated, magnetic resonance imaging (M R I) will be ordered to rule out a pituitary tumor. A laparoscopy, abdominal ultrasound, or C T scan of the abdomen is not indicated for a patient with amenorrhea and an elevated serum prolactin level. B) If serum prolactin levels are elevated, magnetic resonance imaging (M R I) will be ordered to rule out a pituitary tumor. A laparoscopy, abdominal ultrasound, or C T scan of the abdomen is not indicated for a patient with amenorrhea and an elevated serum prolactin level. C) If serum prolactin levels are elevated, magnetic resonance imaging (M R I) will be ordered to rule out a pituitary tumor. A laparoscopy, abdominal ultrasound, or C T scan of the abdomen is not indicated for a patient with amenorrhea and an elevated serum prolactin level. D) If serum prolactin levels are elevated, magnetic resonance imaging (M R I) will be ordered to rule out a pituitary tumor. A laparoscopy, abdominal ultrasound, or C T scan of the abdomen is not indicated for a patient with amenorrhea and an elevated serum prolactin level.

1) A home care nurse is looking over the charts of four elderly female clients. The nurse knows that which client has the highest risk for developing diabetes and heart disease? A) A woman who is 55 and white B) A woman who is 60 and from a middle-class background C) All women over 55 D) A woman over 65 who is African American

Answer: D Explanation: A) Minority and low-income women 65 years old and older are more likely than white, higher income women to have serious health problems. B) Minority and low-income women 65 years old and older are more likely than white, higher income women to have serious health problems. C) By age 65, not age 55, half of all women have developed two or more chronic diseases. D) Minority and low-income women 65 years old and older are more likely than white, higher income women to have serious health problems.

A nonpregnant client is diagnosed with bacterial vaginosis (B V). What does the nurse expect to administer? A) Penicillin G 2 million units I M one time B) Zithromax 1 m g P O bid for 2 weeks C) Doxycycline 100 m g P O bid for a week D) Metronidazole 500 m g P O bid for a week

Answer: D Explanation: A) Penicillin is not used to treat bacterial vaginosis. B) Zithromax is not used to treat bacterial vaginosis. C) Doxycycline is not used to treat bacterial vaginosis. D) The nonpregnant woman who is diagnosed with bacterial vaginosis (B V) is treated with metronidazole 500 m g orally twice a day for 7 days.

1) The nurse explains to a preconception class that if only a small volume of sperm is discharged into the vagina, an insufficient quantity of enzymes might be released when they encounter the ovum. In that case, pregnancy would probably not result, because of which of the following? A) Peristalsis of the fallopian tube would decrease, making it difficult for the ovum to enter the uterus. B) The block to polyspermy (cortical reaction) would not occur. C) The fertilized ovum would be unable to implant in the uterus. Sperm would be unable to penetrate the zona pellucida of the ovum

Answer: D Explanation: A) Peristalsis of the fallopian tube is not a factor in this stage of fertilization. B) A block to polyspermy would indicate that the ovum had already been penetrated by a fertilizing sperm, which would occur later in the fertilization process. C) The ovum has not yet been fertilized in this example. D) About a thousand acrosomes must rupture to clear enough hyaluronic acid for even a single sperm to penetrate the ovum's zona pellucida successfully. If only a small amount of sperm were released, there most likely would be an insufficient quantity of acrosomes to penetrate the zona pellucida of the ovum and allow fertilization.

1) The nurse is providing care to a female client who presents in the emergency department (E D) with multiple bruises and lacerations. The nurse suspects the client is the victim of domestic violence. Which action by the nurse is appropriate? A) Reporting the incident to the police to enhance safety B) Documenting domestic violence in the medical record C) Avoiding photographs of the injuries to prevent embarrassment D) Communicating the level of confidentiality that can be expected

Answer: D Explanation: A) Reporting domestic violence may be mandatory in some states. However, it is important to note that reporting domestic violence may increase the client's risk for further abuse, not enhance the client's safety. B) The nurse would document the client's injuries in the medical record and use the term "probable battering." To protect the client's confidentiality and safety, it is critical that the nurse not refer to domestic violence or abuse on any discharge papers. C) Photographs of the client's injuries can be of great value along with documentation of the extent of the injuries and noting of the client's exact words in the medical record. D) It is important for the nurse to explain the assessment process to the client and communicate the level of confidentiality that can be expected.

1) A sexually active female asks why an H I V test is needed since she uses condoms with spermicidal agents when having intercourse. How should the nurse respond to this client? A) "Condoms do not protect against contracting H I V." B) "Spermicides only control bacteria and not viruses." C) "All sexually active people are at risk for contracting H I V." D) "The spermicide can make your vaginal cells more susceptible to H I V."

Answer: D Explanation: A) Research suggests that N-9 does not offer protection against the organisms that cause H I V/A I D S, and N-9 alone may actually increase a woman's risk of H I V infection because it has a negative effect on the integrity of vaginal cells, making them more susceptible to invasion by organisms such as H I V. Condoms do help reduce the risk of contracting H I V. Spermicides are prepared to render sperm inactive, not to kill bacteria or viruses. Although all sexually active individuals are at some risk for contracting H I V, this does not explain why the client should be tested for the virus. B) Research suggests that N-9 does not offer protection against the organisms that cause H I V/A I D S, and N-9 alone may actually increase a woman's risk of H I V infection because it has a negative effect on the integrity of vaginal cells, making them more susceptible to invasion by organisms such as H I V. Condoms do help reduce the risk of contracting H I V. Spermicides are prepared to render sperm inactive not to kill bacteria or viruses. Although all sexually active individuals are at some risk for contracting H I V, this does not explain why the client should be tested for the virus. C) Research suggests that N-9 does not offer protection against the organisms that cause H I V/A I D S, and N-9 alone may actually increase a woman's risk of H I V infection because it has a negative effect on the integrity of vaginal cells, making them more susceptible to invasion by organisms such as H I V. Condoms do help reduce the risk of contracting H I V. Spermicides are prepared to render sperm inactive not to kill bacteria or viruses. Although all sexually active individuals are at some risk for contracting H I V, this does not explain why the client should be tested for the virus. D) Research suggests that N-9 does not offer protection against the organisms that cause H I V/A I D S, and N-9 alone may actually increase a woman's risk of H I V infection because it has a negative effect on the integrity of vaginal cells, making them more susceptible to invasion by organisms such as H I V. Condoms do help reduce the risk of contracting H I V. Spermicides are prepared to render sperm inactive not to kill bacteria or viruses. Although all sexually active individuals are at some risk for contracting H I V, this does not explain why the client should be tested for the virus.

1) The couple at 12 weeks' gestation has been told that their fetus has sickle cell disease. Which statement by the couple indicates that they are adequately coping? A) "We knew we were both carriers of sickle cell disease. We shouldn't have tried to have a baby." B) "If we had been healthier when we conceived, our baby wouldn't have this disease now." C) "Taking vitamins before we got pregnant would have prevented this from happening." D) "The doctor told us there was a 25% chance that our baby would have sickle cell disease."

Answer: D Explanation: A) Self-blame and judgment do not indicate adequate coping. B) Preconception health and nutrition do not affect transmission of an autosomal recessive trait. Self-blame and judgment do not indicate adequate coping. C) Preconception health and nutrition do not affect transmission of an autosomal recessive trait. D) A true statement indicates adequate coping. When both parents are carriers of an autosomal recessive disease, there is a 25% risk for each pregnancy that the fetus will be affected.

1) A 38-year-old patient is concerned that a month after becoming a widow, her menstrual cycles stopped. What should the nurse suspect as being the cause for this patient's secondary amenorrhea? A) Ovarian failure B) Pituitary dysfunction C) Anatomical abnormality D) Hypothalamic dysfunction

Answer: D Explanation: A) Severe or prolonged stress such as that which occurs with an unexpected death can lead to hypothalamic dysfunction. Ovarian failure is related to exposure to radiation, chemotherapy, viral infection, and surgical removal of the ovary. Pituitary dysfunction is related to pituitary tumors or disease, use of antipsychotic medication, low prolactin levels, head trauma, and cancer. With an anatomic abnormality the patient would not have ever had a menstrual cycle. B) Severe or prolonged stress such as that which occurs with an unexpected death can lead to hypothalamic dysfunction. Ovarian failure is related to exposure to radiation, chemotherapy, viral infection, and surgical removal of the ovary. Pituitary dysfunction is related to pituitary tumors or disease, use of antipsychotic medication, low prolactin levels, head trauma, and cancer. With an anatomic abnormality the patient would not have had a menstrual cycle. C) Severe or prolonged stress such as that which occurs with an unexpected death can lead to hypothalamic dysfunction. Ovarian failure is related to exposure to radiation, chemotherapy, viral infection, and surgical removal of the ovary. Pituitary dysfunction is related to pituitary tumors or disease, use of antipsychotic medication, low prolactin levels, head trauma, and cancer. With an anatomic abnormality the patient would not have had a menstrual cycle. D) Severe or prolonged stress such as that which occurs with an unexpected death can lead to hypothalamic dysfunction. Ovarian failure is related to exposure to radiation, chemotherapy, viral infection, and surgical removal of the ovary. Pituitary dysfunction is related to pituitary tumors or disease, use of antipsychotic medication, low prolactin levels, head trauma, and cancer. With an anatomic abnormality the patient would not have had a menstrual cycle.

1) The nurse is preparing a female client for a scheduled pelvic examination. During the health history interview, the client states, "My husband constantly criticizes me and calls me stupid. I am afraid that he will begin to hit me one of these days." Which type of intimate partner violence is the client experiencing based on the assessment data? A) Sexual abuse B) Physical abuse C) Economic abuse D) Emotional abuse

Answer: D Explanation: A) Sexual abuse is forced sex, including vaginal, oral, or anal intercourse. This type of abuse also includes sexually demeaning treatment, forced use of objects, or forcing a woman to have sex with someone else against her will. B) Physical abuse may include acts such as pushing, shoving, slapping, hitting with a fist or object, kicking, choking, threatening with a gun or knife, or using a gun or knife against a woman. This type of abuse can also include forcing alcohol or drug use or denying a partner medical care. C) Economic abuse would include preventing a spouse or significant other from getting or keeping a job; making a spouse or significant other ask for money; controlling a spouse or significant other's money; destruction of property; or making all financial decisions for the spouse or significant other. D) Emotional abuse includes constant criticism, name calling, and unreasonable demands from a spouse or significant other. This type of abuse also includes damaging a spouse or significant other's relationship with a child and others who matter to him or her.

1) Duvall's eight stages in the family life cycle of a traditional nuclear family have been used as the foundation for contemporary models that describe the developmental processes and role expectations for different family types. Which of the following is an example of Stage Ⅳ of this family life cycle? A) Families launching young adults (all children leave home) B) Families with preschool-age children (oldest child is between 2.5 and 6 years of age) C) Middle-aged parents (empty nest through retirement) D) Families with schoolchildren (oldest child is between 6 and 13 years of age)

Answer: D Explanation: A) Stage Ⅵ is families launching young adults (all children leave home). B) Stage Ⅲ is families with preschool-age children (oldest child is between 2.5 and 6 years of age). C) Stage Ⅶ is middle-aged parents (empty nest through retirement). D) Stage Ⅳ is families with schoolchildren (oldest child is between 6 and 13 years of age).

A client scheduled to have a Mirena levonorgestrel intrauterine system (L N g-I U C) inserted asks how this device stops conception. What should the nurse say in response to this client? A) "It stops ovulation." B) "It slows sperm motility." C) "It shortens the menstrual cycle." D) "It causes the lining of the uterus to waste away."

Answer: D Explanation: A) The Mirena L N g-I U Cs causes the lining of the uterus (endometrium) to become waste away. This device does not stop ovulation, slow sperm motility, or shorten the menstrual cycle. B) The Mirena L N g-I U Cs causes the lining of the uterus (endometrium) to become waste away. This device does not stop ovulation, slow sperm motility, or shorten the menstrual cycle. C) The Mirena L N g-I U Cs causes the lining of the uterus (endometrium) to become waste away. This device does not stop ovulation, slow sperm motility, or shorten the menstrual cycle. D) The Mirena L N g-I U Cs causes the lining of the uterus (endometrium) to become waste away. This device does not stop ovulation, slow sperm motility, or shorten the menstrual cycle.

The nurse is teaching a client who is having the Skyla L N g-I U C device inserted for contraception. What should the nurse emphasize to the client about this device? A) This device will provide protection for 5 years B) This device will provide protection for 10 years C) This device should not be used with a copper allergy D) This device has a silver ring and could interfere with an M R I

Answer: D Explanation: A) The Skyla L N g-I U C device has a radiopaque silver ring at the top of the "T." The technician must be informed of this device if an M R I is required at any time. The Mirena levonorgestrel intrauterine system (L N g-I U C) provides protection for 5 years. The Copper I U C (ParaGard T 380A) provides protection for 10 years. The Skyla L N g-I U C device does not contain copper. B) The Skyla L N g-I U C device has a radiopaque silver ring at the top of the "T." The technician must be informed of this device if an M R I is required at any time. The Mirena levonorgestrel intrauterine system (L N g-I U C) provides protection for 5 years. The Copper I U C (ParaGard T 380A) provides protection for 10 years. The Skyla L N g-I U C device does not contain copper. C) The Skyla L N g-I U C device has a radiopaque silver ring at the top of the "T." The technician must be informed of this device if an M R I is required at any time. The Mirena levonorgestrel intrauterine system (L N g-I U C) provides protection for 5 years. The Copper I U C (ParaGard T 380A) provides protection for 10 years. The Skyla L N g-I U C device does not contain copper. D) The Skyla L N g-I U C device has a radiopaque silver ring at the top of the "T." The technician must be informed of this device if an M R I is required at any time. The Mirena levonorgestrel intrauterine system (L N g-I U C) provides protection for 5 years. The Copper I U C (ParaGard T 380A) provides protection for 10 years. The Skyla L N g-I U C device does not contain copper.

1) What is the function of the scrotum? A) Produce testosterone, the primary male sex hormone B) Deposit sperm in the female vagina during sexual intercourse so that fertilization of the ovum can occur C) Provide a reservoir where spermatozoa can survive for a long period D) Protect the testes and the sperm by maintaining a temperature lower than that of the body

Answer: D Explanation: A) The interstitial cells produce testosterone, the primary male sex hormone. B) The primary reproductive function of the penis is to deposit sperm in the female vagina during sexual intercourse so that fertilization of the ovum can occur. C) The epididymis provides a reservoir where spermatozoa can survive for a long period. D) The function of the scrotum is to protect the testes and the sperm by maintaining a temperature lower than that of the body.

1) The nurse is preparing to assess the development of a family new to the clinic. The nurse understands that which of the following is the primary use of a family assessment tool? A) Obtain a comprehensive medical history of family members. B) Determine to which clinic the client should be referred. C) Predict how a family will likely change with the addition of children. D) Understand the physical, emotional, and spiritual needs of members.

Answer: D Explanation: A) The medical history is one area that is explored using a family assessment tool, but it is not the primary use of the family assessment. B) Although referrals might take place as a result of the family assessment findings, this is not the primary purpose of the assessment. C) Family development models help predict how a family will likely change with the addition of children. Understanding the physical, emotional, and spiritual needs of members is the main reason for using a family assessment tool

1) A nurse counsels a couple on sex-linked disorders. Both the man and the woman are carriers of the disorder. They ask the nurse how this disorder will affect any children they might have. What is the nurse's best response? A) "If you have a daughter, she will not be affected." B) "Your son will be affected because the father has the disorder." C) "There is a 25% chance that your son will have the disorder because the mother has the disorder." D) "There is a 50% chance that your son will be a carrier only."

Answer: D Explanation: A) There is a 50% chance that a carrier mother will pass the abnormal gene to each of her daughters, who will become carriers. B) Fathers affected with a sex-linked disorder cannot pass the disorder to their sons, but all of their daughters become carriers of the disorder. C) Because it is sex-linked, there will be more than a 25% chance that a son would be a carrier only. D) There is a 50% chance that a carrier mother will pass the normal gene on to each of her sons, who will be unaffected.

The nurse reviewing charts for quality improvement notes that a client experienced a complication during labor. The nurse is uncertain whether the labor nurse took the appropriate action during the situation. What is the best way for the nurse to determine what the appropriate action should have been? A) Call the nurse manager of the labor and delivery unit and ask what the nurse should have done. B) Ask the departmental chair of the obstetrical physicians what the best nursing action would have been. C) Examine other charts to find cases of the same complication, and determine how it was handled in those situations. D) Look in the policy and procedure book, and examine the practice guidelines published by a professional nursing organization.

Answer: D Explanation: A) The nurse should find the standards, and not rely on another person to determine appropriateness of care. B) Physician care and nursing care are very different; physicians might not be up to date on nursing standards of care or nursing policies and procedures. C) What nursing action was undertaken in a different situation might not be based on the policies and procedures or other standards of care. The quality improvement nurse will obtain the most accurate information by examining the policies, procedures, and standards of care. Agency policies, procedures, and protocols contain guidelines for nursing action in specific situations. Professional organizations such as the Association of Women's Health, Obstetrical, and Neonatal Nurses (AWHONN) also publish standards of practice that should guide nursing care

1) The nurse works in a facility that cares for clients from a broad range of racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in a presentation to recently hired nurses on the client population of the facility? A) "Our clients come from a broad range of backgrounds, but we have a good interpreter service." B) "Many of our clients come from backgrounds different from your own, but it doesn't cause problems for the nurses." C) "Because most of the doctors are bilingual, we don't have to deal with the differences in cultural backgrounds of our clients." D) "Understanding the common values and health practices of our diverse clients will facilitate better care and health outcomes."

Answer: D Explanation: A) The role of a foreign language interpreter is to facilitate communication. The interpreter might not be able to interpret the cultural practices of clients. An example is a Spanish interpreter: The interpreter might be from Spain, but interprets language for clients from Guatemala and Nicaragua, countries about which the interpreter might know virtually nothing. B) Racial, ethnic, cultural, and religious backgrounds of clients have significant implications for how the clients perceive health, illness, and health care. It is important for nurses to understand the backgrounds of the client population that attends that facility. C) Bilingual physicians, like all physicians, have very busy schedules, and often do not understand nursing care. It is the responsibility of the nurse to become familiar with the backgrounds of the client population. Because of the implications for care based on cultural background, it is important for nurses to understand the backgrounds of the client population that accesses the facility. Without cultural awareness, caregivers tend to project their own cultural responses onto foreign-born clients; clients from different socioeconomic, religious, or educational groups; or clients from different regions of the country

The nurse at an elementary school is performing T B screenings on all of the students. Permission slips were returned for all but the children of one family. When the nurse phones to obtain permission, the parent states in clearly understandable English that permission cannot be given because the grandmother is out of town for 2 more weeks. Which cultural element is contributing to the dilemma that faces the nurse? A) Permissible physical contact with strangers B) Beliefs about the concepts of health and illness C) Religion and social beliefs D) Presence and influence of the extended family

Answer: D Explanation: A) The situation the nurse faces is not being caused by permissible contact with strangers. B) The situation the nurse faces is not caused by beliefs about the concepts of health and illness. C) The situation the nurse faces is not caused by religion and social beliefs. D) The presence and influence of the extended family is contributing to the situation the nurse faces. In many cultures, a family elder is the primary decision maker when it comes to health care. In this case, the parent cannot grant permission to the nurse until the parent consults the grandmother.

1) A client is planning to use condoms with a spermicidal cream as contraception. What should the nurse include when reviewing this method with the client? A) Coat the condom with spermicide before using B) Insert the spermicide 1 hour before having intercourse C) Insert the cream high into the vagina and remain supine D) Wait 15 minutes after inserting the spermicide into the vagina

Answer: D Explanation: A) The spermicidal preparation is inserted into the vagina before intercourse. The nurse needs to instruct the woman to insert any of these spermicidal preparations high in the vagina as close to the cervix as possible. Maintaining a supine position after application will help keep the preparation in the vagina after it dissolves. The spermicide is not applied to the condom. The spermicide does not need to be inserted 1 hour before intercourse. Waiting 15 minutes is appropriate if the spermicide is a suppository. B) The spermicidal preparation is inserted into the vagina before intercourse. The nurse needs to instruct the woman to insert any of these spermicidal preparations high in the vagina as close to the cervix as possible. Maintaining a supine position after application will help keep the preparation in the vagina after it dissolves. The spermicide is not applied to the condom. The spermicide does not need to be inserted 1 hour before intercourse. Waiting 15 minutes is appropriate if the spermicide is a suppository. C) The spermicidal preparation is inserted into the vagina before intercourse. The nurse needs to instruct the woman to insert any of these spermicidal preparations high in the vagina as close to the cervix as possible. Maintaining a supine position after application will help keep the preparation in the vagina after it dissolves. The spermicide is not applied to the condom. The spermicide does not need to be inserted 1 hour before intercourse. Waiting 15 minutes is appropriate if the spermicide is a suppository. D) The spermicidal preparation is inserted into the vagina before intercourse. The nurse needs to instruct the woman to insert any of these spermicidal preparations high in the vagina as close to the cervix as possible. Maintaining a supine position after application will help keep the preparation in the vagina after it dissolves. The spermicide is not applied to the condom. The spermicide does not need to be inserted 1 hour before intercourse. Waiting 15 minutes is appropriate if the spermicide is a suppository.

1) The community clinic nurse manager is working on a long-term budget. The manager understands that in the next few years, Medicaid is expected to pay for fewer births. This is, in part, because of which of the following? A) The U.S. economy is becoming stronger. B) More women are able to pay for private insurance. C) New public policies are providing other forms of payment. D) Rules for Medicaid have been changed.

Answer: D Explanation: A) The strength of the economy is not a factor in Medicaid regulations. B) Private insurance is expensive, and not affordable to poor women who would be eligible for Medicaid. C) Although some states are implementing affordable healthcare options, not all states have chosen to do so. D) Women receiving Temporary Assistance for Needy Families (T A N F) do not automatically receive Medicaid services when they become pregnant.

1) The nurse is preparing a community presentation on family development. Which statement should the nurse include? A) The youngest child determines the family's current stage. B) A family does not experience overlapping of stages. C) Family development ends when the youngest child leaves home. D) The stages describe the family's progression over time.

Answer: D Explanation: A) The youngest child is not a marker for which stage the family is in. B) Families with more than one child can experience multiple stages simultaneously. C) Families' development continues after the youngest child leaves home. D) Family development stages describe the changes and adaptations that a family goes through over time as children are added to the family.

1) Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea? A) 17-year-old, has never had a menstrual cycle B) 16-year-old, had regular menses for 4 years, but has had no menses in 4 months C) 19-year-old, regular menses for 5 years that have suddenly become painful D) 14-year-old, irregular menses for 1 year, experiences cramping every cycle

Answer: D Explanation: A) This is primary amenorrhea, or the lack of menses. B) Secondary amenorrhea is the term used when a client has had regular cycles that cease. C) Secondary dysmenorrhea is the sudden onset of pain and discomfort with menses. D) Dysmenorrhea, or painful menstruation, occurs at, or a day before, the onset of menstruation and disappears by the end of menses. Primary dysmenorrhea is defined as cramps without underlying disease.

1) The community nurse is planning to visit a family. The grandparents are helping the adult parents with child-rearing activities. For which type of family should the nurse plan care? A) Nuclear B) Blended C) Binuclear D) Extended

Answer: D Explanation: D) In an extended family, a couple shares household and childrearing responsibilities with parents, siblings, or other relatives. Families may reside together to share housing expenses and child care. In many cases, a child may be residing with a grandparent and one parent because of issues associated with unemployment, parental separation, parental death, or parental substance abuse. Grandparents may raise children due to the inability of parents to care for their own children. In the nuclear family, children live in a household with both biologic parents and no other relatives or persons. The blended family includes two parents with biologic children from a previous marriage or relationship who marry or cohabitate. A binuclear family is a post-divorce family in which the biologic children are members of two nuclear households, with parenting by both the father and the mother.

1) A lesbian female is surprised to learn of contracting the human papillomavirus. What should the nurse explain to this patient? A) "Are you telling me everything about your sexual orientation?" B) "It is rare for this infection to occur in women such as yourself." C) "Is it possible that your partner has been having intercourse with a man?" D) "Exposure to vaginal secretions can increase the risk of sexually transmitted infections."

Answer: D Explanation: D) Lesbian sexual contact can transmit a number of S T Is and the virus that causes cervical cancer, because it involves exposure to vaginal secretions. Women's health services in particular have not shown acceptance of lesbian status, as demonstrated by asking if the patient has been truthful about sexual orientation, stating that the infection is rare in people like the patient, and suggesting that the patient's partner is having intercourse with a man.

A patient treated for a urinary tract infection a month ago is experiencing symptoms of the same infection. What should the nurse suspect is the reason for the reoccurrence of the infection? A) Using oral contraceptives B) Wearing cotton underwear C) Cleansing from front to back D) Stopped antibiotics after 3 days

Answer: D Explanation: D) Not completing a full course of prescribed antibiotics could cause remaining bacteria to grow, leading to another infection. Use of oral contraceptives is not a risk factor for the development of a urinary tract infection. Wearing cotton underwear and cleansing from front to back are actions that reduce the risk of developing urinary tract infections.

1) The elderly parent of an employee at an insurance company sustains a myocardial infarction and needs assistance for several weeks after returning home from the hospital. What option should the employee consider to cover her absence while caring for her parent? A) Sick days B) Personal days C) Vacation days D) Family medical leave

Answer: D Explanation: The Family and Medical Leave Act (FMLA) offers twelve weeks of unpaid leave to care for a parent who is in recovery from an illness. The employee does not need to take sick days, personal days, or vacation days to care for her parent

1) The nurse is teaching an in-service educational presentation about working with battered women. The nurse should explain that it is often frustrating for nurses to work with battered women for which reasons? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) There is little the nurse can really do to help. B) Healthcare policies and practices are not supportive of abused women. C) Both husband and wife must agree to therapy. D) These women might return to the abusive situation. E) Women often believe that they are the cause of the abuse.

Answer: D, E Explanation: A) Healthcare providers can play a critical role in identifying and reducing violence, even in homicide prevention efforts. B) Since 1980, there have been a number of notable changes in healthcare policy and practices aimed at responding to violence against women. C) The abuser must seek behavior change therapy to accomplish permanent change. D) Women often believe that escape is futile, or escape and then return when the crisis is over. E) Women are often convinced by the abusers that it is their own behavior that causes the abuse.