maternity newborn ch.26
A parent at an educational session on sexually transmitted infections (STIs) asks the nurse if there are vaccines available to prevent STIs. What is the nurse's best response?
"A vaccine has been approved vaccines to prevent the human papillomavirus." Explanation: Vaccine-preventable STIs can be effectively prevented through preexposure vaccination. Vaccines are under development or are undergoing clinical trials for certain STIs, including HIV and HSV. The only vaccines currently available are for prevention of HAV, HBV, and HPV infection. Vaccination efforts focus largely on integrating the use of these available vaccines into STI prevention and treatment activities. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, Low-Risk Human Papillomavirus, p. 605.
The pregnant client is discussing her dietary needs during pregnancy. Which statements indicate a correct understanding of the intake needed? Select all that apply.
"At least 8 glasses of water daily is needed to maintain hydration." "Taking in at least 1000 mg of calcium daily is important during pregnancy." "Taking my daily iron supplement is key to my pregnancy's health." Explanation: Dietary intake in pregnancy is important to the health and wellness of the mother and fetus. At least 8 glasses of water daily is needed to maintain hydration. Calcium needs are 1000 mg daily. The daily prenatal vitamin is needed to ensure adequate iron intake. A balanced diet in pregnancy is needed. Protein needs in pregnancy do increase, but they do not double. Limitations to sodium intake are not indicated in the absence of other problems. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 610.
A client diagnosed with human papillomavirus (HPV) asks the nurse if she will be at risk for developing cervical cancer. The nurse best responds by making which statement?
"Certain strains of the human papillomavirus (HPV) have been associated with causing cervical cancer." Explanation: The human papillomavirus (HPV) is associated with causing both genital warts and cervical cancer. There is not enough information to definitively indicate that this client will or will not contract cancer. The herpes simplex virus is associated with shingles and genital herpes, not cervical cancer. The HPV vaccine prevents certain strains of HPV, but does not decrease the risk for cervical cancer if the person has already been exposed to the virus. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 605.
The nurse instructs a pregnant patient on the need to increase foods containing folic acid. Which patient statement indicates that teaching has been effective?
"I will add spinach to my salad every evening." Explanation: The patient should be instructed to eat foods that are high in folic acid such as spinach, asparagus, and legumes. Adding spinach every day to the evening salad indicates that teaching about folic acid nutrition has been effective. Oranges, milk, cabbage, and cauliflower are not food items that will specifically influence the folic acid level. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 614.
A 22-year-old female is 25 weeks pregnant. She explains that she is having difficulty getting an adequate amount of protein into her diet because she is a vegetarian. How can the nurse best counsel this patient?
"In addition to getting protein from eating dairy, eat complementary proteins such as beans and rice together, or beans and wheat together." Explanation: Women who are vegetarian usually do not eat fish and sometimes do not eat eggs either. Most proteins from non-animal sources are incomplete proteins that need to be combined with other non-animal proteins to become complete proteins. Patient education on how to eat complementary proteins such as beans and rice, legumes and rice, or beans and wheat can help vegetarians increase protein in their diet. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 612.
After a discussion on the HPV vaccine with a mother and her 10-year-old daughter at a well-child visit, the nurse recognizes the discussion was successful when the mother makes which statement?
"My daughter will need three injections over a 6-month period." Explanation: The vaccine is administered intramuscularly in three separate 0.5 mL doses over a 6-month period. The first dose is given prior to infection with HPV. The second dose is administered 2 months later, and the third dose is given 4 months later. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 605.
A nurse is conducting a teaching session with a group of adolescent females at a local women's health clinic. When describing appropriate screening guidelines for cervical cancer, at which age would the nurse would instruct the group to have their first Papanicolau test?
21 Explanation: Although professional medical organizations disagree as to the recommended frequency of screening for cervical cancer, ACOG (2015) recommends that cervical cancer screening should begin at age 21 years (regardless of sexual history) since women younger than age 21 are at very low risk of cancer. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 603.
A young woman has been referred for a colposcopy by the health care provider. The nurse is educating the woman on the procedure. Which information about the colposcopy should the nurse provide?
A young woman has been referred for a colposcopy by the health care provider. The nurse is educating the woman on the procedure. Which information about the colposcopy should the nurse provide? You Selected: The results of the Papanicolau test were abnormal; therefore, this procedure must be done. Correct response: The results of the Papanicolau test were abnormal; therefore, this procedure must be done. Explanation: A colposcopy is performed when results of a Papanicolau test are abnormal. This is a painless procedure with no aftereffects, so urinating afterwards is not a problem, and sexual intercourse need not be avoided. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 605.
An older woman comes to the clinic looking pale and malnourished. She states she has lost "a lot" of weight. What is most important for the nurse to assess in this client?
Ability to chew and swallow Explanation: When the nurse obtains a health history and completes an assessment, it would be most important to know if the client has the ability to chew and swallow. By assessing the mouth, the nurse can observe if there are dental caries or misalignment of the teeth. The nurse can ascertain if the client wears dentures, if they fit, or if they are not in use. The nurse can also ascertain if the client may have had a previous stroke and if there is dysphagia. Following the assessment, the health history would include the client's bowel habits, and the ability to obtain and prepare the food. All of this information will be used by the health care provider to prescribe any further testing that may be needed. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 614.
A female client is found to carry the breast cancer susceptibility genes 1 and 2 (BRCA 1 and 2). The nurse would teach this client that routine screenings would include which tests? Select all that apply.
Annual breast MRI starting at age 25 Clinical breast exam every year Explanation: Women who carry the BRCA gene are at an increased risk of developing breast cancer. Their screenings are different from those of the general population. These women are encouraged to perform breast self-exams from the age of 18 and to have clinical breast exams every 6 to 12 months beginning at age 25. They are also advised to have annual breast MRIs from 25 to 29 years of age and both annual MRI and mammograms starting at the age of 30. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 606-607.
A nurse is teaching a group of pregnant women about the importance of good nutrition during pregnancy. After describing the B vitamins, the nurse determines that the teaching was effective when the group states which food as the best source of vitamin B12?
Beef Explanation: B12 is found almost exclusively in animal sources; therefore beef would be the best choice. . Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 613.
A young adult woman is admitted to the hospital with symptoms of anorexia nervosa. What information should the nurse obtain in determining the client's psychological status?
Body perception Explanation: Anorexia nervosa is defined as an intense fear of weight gain, abnormally low weight, calorie restriction, and a distorted perception of one's body. The acute problems of low weight and calorie restriction are physiologic problems that need to be addressed first because they are a threat to the life of the client. The distorted perception of the body is a psychological problem that will need to be identified. In planning care this need will be identified as a long term goal. The goal is to have the client understand positive body image. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 617.
A 17-year-old G2 P0010 patient develops hypertension at 32 weeks and is required to limit her intake of sodium and increase her protein intake. The patient is out of work and does not attend school. Her time is spent primarily at the local shopping mall with friends. The best dietary suggestion that the home visiting nurse can make to this patient is:
Bring water and a lunch from home rather than eating at the food court Explanation: A teenager has a developmental need for socialization. It is an appropriate statement that most foods purchased outside the home have more sodium than foods made in the home. Salads with dressing are high in sodium, and ice cream is not an appropriate source of protein. Dietary intake is the issue of concern. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 617.
A pregnant patient tells the nurse that saturated fats are avoided by using vegetable oil. What additional information about vegetable oil can the nurse use to reinforce this patient's decision?
Contains linoleic acid Explanation: Linoleic acid is a fat that is essential for new cell growth but cannot be manufactured by the body. Vegetable oils such as safflower, corn, olive, peanut, and cottonseed; fatty fish; omega-3-infused eggs; and omega-3-infused spreads are all good sources of linoleic acid. Vegetable oil does not aid in fluid balance, stimulate kidney function, or have high potassium content. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 612.
The nurse is planning a diet for a client who is at risk for cardiovascular disease. Which type of complete protein would the nurse teach the client to eat on a regular basis to reduce this risk?
Fish Explanation: Protein sources may be plant or animal sources. Lean proteins, such as poultry, fish, beans, and soy products are preferred to red meat. Consumption of red meat is associated with increased mortality from all causes. Consumption of an oily fish such as salmon four or more times per week is associated with a reduced risk of an acute coronary event. Beans, pork and nuts are all protein sources but they do not provide the most protective protein for the heart. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 612.
The sexual health nurse is presenting to a group of adolescents the government initiative that proposes to reduce the numbers of adolescents with sexually transmitted infections. What is the name of this initiative?
Healthy People 2020 Explanation: Healthy People 2020 proposes to reduce the proportion of adolescents and young adults with STIs. It also proposes to increase the proportion of sexually active persons aged 15 to 19 years who use condoms. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 619-620.
Why is a Papanicolau test done at the first prenatal visit?
It identifies abnormal cervical cells. Explanation: A Papanicolau test is a test for cervical cancer. Should abnormal cells be present, the woman may need to make a decision about her priorities of therapy for cervical disease or continuing the pregnancy. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 602-603.
A nurse is educating a 25-year-old client with a family history of cervical cancer. Which test should the nurse inform the client about to detect cervical cancer at an early stage?
Papanicolaou test Explanation: The client should have Papanicolaou tests regularly to detect cervical cancer during the early stages. Blood tests for mutations in the BRCA genes indicate the lifetime risk of the client of developing breast or ovarian cancer. CA-125 is a biologic tumor marker associated with ovarian cancer, but it is not currently sensitive enough to serve as a screening tool. The transvaginal ultrasound can be used to detect endometrial abnormalities. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 602.
The nurse tells the client that cervical cancer's incidence and mortality rates have greatly decreased in the past several decades. This can be attributed to which factor?
Papanicolau tests Explanation: The incidence and mortality rates of cervical cancer have decreased noticeably in the past several decades, with most of the reduction attributed to the Papanicolau test. The other tests are not used to screen for cervical cancer. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 602.
A nurse is preparing a woman for a Papanicolau test. The nurse has already washed her hands and gathered all necessary equipment (maintaining sterility). What is the next step in the procedure?
Position the client in stirrups or foot pedals so that her knees fall outward. Explanation: During a Papanicolau test, the next step would be to position the client in stirrups or foot pedals so that her knees fall outward. This would be followed by draping a sheet over the client and leaving the perineal area exposed. Next would be to support the client while the sample is obtained. Lastly, transfer the specimen to a container or slide. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 602 - 603.
A client comes to the clinic anxious and with self-described "sexual problems." Which reponse should the nurse make first to the client?
Provide assurance of confidentiality Explanation: It is essential that a client feel safe, particularly when communicating about sex and sexuality. Confidentiality is critical, and the nurse will need to remind the client of the nurse's discretion from the very beginning of the interaction. The nurse should communicate respect to the client, avoid making assumptions and using medical jargon, and listen carefully to the client's responses. This can only be done after the client feels secure in the situation. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 619.
A woman is being seen in the gynecologist's office for her annual well-woman exam. As the nurse is preparing the woman for the exam, the woman suddenly becomes anxious and tearful. The nurse suspects this behavior could be attributed to sexual assault. What should the nurse do first?
Provide reassurance Explanation: Pelvic examinations may trigger anxiety and posttraumatic stress disorder in women who have been victims of sexual assault. These women are also at an increased risk for pelvic pain, dyspareunia, urinary tract infections, and cervical cancer. Screenings and pelvic exams can be very difficult. It is most important for the nurse to provide reassurance for the woman during a very emotional and difficult time. The gynecologist should be notified of the situation and the woman may need to be referred to a counselor. These actions, however, should be performed after reassuring the woman. Having the woman confirm the sexual abuse will not alleviate the distress. Doing so may actually increase the woman's distress. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 623.
A 30-year-old woman had a Papanicolau test 4 weeks ago. The results of the test are classified as ASC-H, as per the Bethesda System. Which therapeutic management intervention should the nurse expect the health care provider to prescribe?
Refer for a colposcopy with human papillomavirus (HPV) testing. Explanation: A result of ASC-H for Papanicolau testing is classified by the Bethesda System. This system gives a uniform diagnostic term to Papanicolau test results. This classification means that the health care provider should refer the client for a colposcopy with HPV testing. A result of ASC-US means that the health care provider should refer to repeat the test in 4 to 6 months, or should refer to colposcopy. Results of AGC or AIS indicate the need for an immediate colposcopy with follow up based on results. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 604.
A nurse working in the Family Birthing Center is answering the nurse hot line phone. A client calls in to schedule her annual Papanicolau test. How could the nurse best educate the client before her procedure to make sure results are not affected?
Refrain from sexual intercourse 48 hours before testing to ensure clear results. Explanation: Nurses should use teaching guidelines with clients to optimize the Papanicolau test results. Strategies to educate would include: no douche, no tampons, no jellies, no spermicides, no intercourse. The optimal time for testing is 2 weeks after the first day of your last menses. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 602 - 603.
As part of a cancer-screening program, a nurse is teaching women how to conduct monthly breast self-exams. Which area does the nurse advise them is most often missed in this exam?
The armpit Explanation: Women often do not realize the tissue under the armpit is breast tissue and do not complete an examination of this tissue. Breast cancer would not affect the nipple tissue as it is mainly on the surface. The collarbone is much too high to be included as breast tissue. There is no breast tissue between the breasts. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 609.
A woman who professes to be a strict vegetarian voices concerns about her ability to meet the nutritional needs of her fetus. Which concerns should be addressed in this session?
The supplementation of Vitamin B12 should be addressed. Explanation: Vitamin B12 is almost exclusively met via animal sources. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 613.
A client has been referred for a colposcopy by the primary care provider. The client wants to know more about the examination. Which information regarding a colposcopy should the nurse give to the client?
The test is conducted because of abnormal results in a Papanicolau test. Explanation: The nurse should explain to the client that the colposcopy is done because the care provider has observed abnormalities in the Papanicolau test results. The nurse should also explain to the client that the procedure is painless and there are no adverse effects, such as pain during urination. There is no need to avoid intercourse for a week after the colposcopy. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 605.
How often should women diagnosed with human papillomavirus (HPV) have Papanicolau testing?
Yearly Explanation: Women with HPV should have annual Papanicolau testing because of the potential of HPV to cause dysplasia. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 602-605.
A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity?
administering HPV vaccine Explanation: Primary prevention is aimed at preventing the disease or condition before it occurs, so giving the HPV vaccine would be a primary prevention activity. If the woman does not receive primary prevention with the vaccine, then secondary prevention would focus on education about the importance of receiving regular Papanicolau tests and, for women over age 30, including an HPV test to determine whether the woman has a latent high-risk virus that could lead to precancerous cervical changes. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 605-606.
A nurse will be speaking at a local high school about women's health. The nurse is planning to talk about sexually transmitted infections (STIs) as well as routine checks, along with guidelines for Papanicolau testing. What should the nurse include in the Papanicolau test guidelines about when to have a first test?
at the age of 21 or within 3 years of first sexual intercourse Explanation: Amercian Cancer Society guidelines for Papanicolau testing recommend that the first Papanicolau test is done at age 21 or within 3 years of first sexual intercourse. Other guidelines state that the tests should be done yearly until age 30 using the glass slide method and every 2 years using liquid-based method. At age 30 to 70, the tests should be done every 2 to 3 years if the previous three Papanicolau tests were normal. They may be discontinued after age 70 if the previous three Papanicolau tests were normal and no Papanicolau tests in the previous 10 years were abnormal. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 603.
The nurse is teaching about an iron supplement that client is going to take every day. The nurse teaches the client to take the iron supplement with which type of fluid?
citrus juice Explanation: The citric acid in juice enhances absorption of iron in the GI tract. Ice water and tea do not enhance iron absorption, and milk can inhibit iron absorption. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 614.
In which clients is it most important to understand the importance of an annual Papanicolaou test?
clients infected with the human papillomavirus (HPV) Explanation: HPV causes genital warts, which are associated with an increased incidence of cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of hormonal contraceptives do not increase the risk of cervical cancer. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 602-604.
A client with a family history of cervical cancer is to undergo a Papanicolau test. During the client education, what group should the nurse include as at risk for cervical cancer?
clients who have genital warts Explanation: The presence of genital warts (condyloma) increases the risk of developing cervical cancer. Women with metrorrhagia or irregular menstrual cycles are at an increased risk of developing breast cancer, not cervical cancer. Clients who have never had a baby or those with a history of fibrocystic breast disease have an increased risk of developing breast cancer, but not cervical cancer. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 602.
A nurse is providing education to a client who is 8 weeks' pregnant. The client stated she does not like milk. What is a source of calcium that the nurse can recommend to the client?
dark, leafy green vegetables Explanation: Dark leafy green vegetables are a source of calcium. Red and orange vegetables contain a variety of vitamins, bread and rice contain carbohydrates, and meat and fish contain protein, but none of these foods are a good source of calcium. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 613-615.
A client presents for her annual Papanicolau test. She wants to know about the risk factors that are associated with cervical cancer. Which risk factor for cervical cancer should the nurse inform the client about?
early age at first intercourse Explanation: Early onset of sexual activity, within the first year of menarche, increases the risk of acquiring cervical cancer later on. Obesity, infertility, and hypertension are risk factors that are associated with endometrial cancer. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 603.
The nurse is planning to speak at a local community center to a group of middle-aged women about osteoporosis. Which measure would the nurse be sure to include as effective in reducing the risk for osteoporosis?
engaging in daily weight-bearing exercise Explanation: Engaging in daily weight-bearing exercise such as walking helps to reduce a woman's risk for osteoporosis. To prevent osteoporosis, women should increase their calcium and vitamin D intake. Avoiding excessive alcohol ingestion helps prevent osteoporosis. Limiting intake of cholesterol and saturated fats helps reduce the risk for cardiovascular disease, not osteoporosis. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 618-619.
A 30-year-old female is attending a health fair for women. The nurse at the fair is reviewing risk factors for cervical cancer. Which important risk factor should the nurse include at the fair?
exposure to diethylstilbestrol (DES) in utero Explanation: Cervical cancer has several risk factors: early age of first intercourse (in first year of menarche), lower socioeconomic status, unprotected sex, family history of cervical cancer, exposure to DES in utero, HIV, use of oral contraceptives, HPV, and multiple male partners. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 604.
What is the most common viral infection?
human papillomavirus (HPV) Explanation: HPV infection is the most common viral infection. Millions of Americans are infected with HPV, many unaware that they carry the virus. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 602.
The nurse is teaching a client ways to improve the diet. The nurse teaches the client that it us important to limit simple carbohydrates in the diet because these types of foods produce:
increased blood glucose. Explanation: The ingestion of simple carbohydrates such as sugar and white flour can lead to short-term spikes in the blood glucose level. Simple carbohydrates also produce a higher glycemic index. The hemoglobin A1C is a laboratory test that measures the levels of glucose over a 3-month time frame. Simple carbohydrates will not affect insulin resistance, which is caused by the pancreas. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 611.
A client who is in her sixth week of gestation is being seen for a routine prenatal care visit. The client asks the nurse about changes in her eating habits that she should make during her pregnancy. The client informs the nurse that she is a vegetarian. The nurse knows that she has to monitor the client for which risks arising from her vegetarian diet? Select all that apply.
iron-deficiency anemia decreased mineral absorption low gestational weight gain Explanation: When caring for a pregnant client who follows a vegetarian diet, the nurse should monitor her for iron-deficiency anemia, decreased mineral absorption, and low gestational weight gain. Risk of epistaxis and increased risk of constipation are not reported to be associated with a vegetarian diet. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 612-614.
A nurse is conducting a health promotion program, encouraging lifestyle changes to help clients prevent various benign and treatable conditions. Which suggestions would the nurse most likely include? Select all that apply.
low-fat diet regular exercise high vegetable-fruit diet adequate fluid intake Explanation: Many of the conditions can be improved and/or prevented by following a low-fat, high vegetable-fruit diet, and getting regular exercise. High-impact aerobics should be avoided because of the excessive downward pressure placed on organs. Educating your clients will help improve their lives and possibly prevent many disorders. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 610-614.
The nurse is teaching a premenopausal client about dietary and lifestyle modifications that can reduce the risk factors for developing pelvic organ prolapse (POP). The nurse is describing which type of prevention?
primary Explanation: Informing the client about factors in her lifestyle that might be modified to reduce her risk of developing POP would be an exmaple of primary prevention. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 602.
A nurse is assisting with the collection of a Papanicolau test. When collecting the specimen, which action is done first?
spreading of the labia Explanation: For a Papanicolau test, the practitioner obtains a sample by spreading the labia; inserting the speculum; inserting the cytobrush and swabbing the endocervix; and inserting the plastic spatula and swabbing the cervix. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 602 - 603.
A nurse is conducting an in-service program for a group of nurses about cervical cancer. The nurse determines that the teaching was successful when the group identifies which area as most commonly involved?
squamous-columnar junction Explanation: Cervical cancer starts with abnormal changes in the cellular lining or surface of the cervix. Typically these changes occur in the squamous-columnar junction of the cervix. Here, cylindrical secretory epithelial cells (columnar) meet the protective flat epithelial cells (squamous) from the outer cervix and vagina in what is termed the transformation zone. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 603.
A nurse is conducting an in-service program for a group of nurses about cervical cancer. The nurse determines that the teaching was successful when the group identifies which area as most commonly involved?
squamous-columnar junction Explanation: Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 603.
The nurse educates the vegetarian client about which nutritional need during pregnancy?
taking a B12 supplement Explanation: B12 is found almost exclusively in animal proteins and therefore is absent in the vegetarian diet. Fiber and dark green vegetables are needed. Vitamins A and C are not protein based and are found in a vegetarian diet. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, p. 612.
A client has been diagnosed with cervical cancer during her second trimester of pregnancy. She decides to delay treatment until after the baby is born. The nurse prepare her for birth by explaining the birth will most likely be:
via cesarean section. Explanation: In women with early-stage disease and absence of nodal involvement, there is an increasing tendency to preserve the pregnancy. The birth (when the fetal maturity is attained) should be performed using a cesarean section. Discussion with the client and her family is essential, and treatment must be individualized. Reference: O'Meara, A., Maternity, Newborn, and Women's Health, 1st ed., Philadelphia, Wolters Kluwer, 2019, Chapter 26: Wellness and Health Promotion, pp. 602 - 605.
