OB chapter 4,9,11,12,13

A young woman arrives at the emergency department and states that she thinks she has been raped. She is sobbing and expresses disbelief that this could happen because the perpetrator was a very close friend. Which statement is most appropriate at this time? a. "Rape is not limited to strangers and frequently occurs by someone who is known to the victim." b. "I would be very upset if my best friend did that to me; that is very unusual." c. "You must feel very betrayed. In what way do you think you might have led him on?" d. "This does not sound like rape. Didn't you just change your mind about having sex after the fact?"

A

Due to the effects of cyclic ovarian changes in the breast, when is the best time for breast self-examination (BSE)? a. Between 5 and 7 days after menses ceases b. Day 1 of the endometrial cycle c. Midmenstrual cycle d. Any time during a shower or bath

A

Historically, what was the justification for the victimization of women? a. Women were regarded as possessions. b. Women were the "weaker sex." c. Control of women was necessary to protect them. d. Women were created subordinate to men.

A

Ovarian function and hormone production decline during which transitional phase? a. Climacteric b. Menarche c. Menopause d. Puberty

A

The nurse who is evaluating the client for potential abuse should be aware that IPV includes a number of different forms of abuse, including which of the following? (Select all that apply.) a. Physical b. Sexual c. Emotional d. Psychologic e. Financial

A, B, D, E

Which nursing diagnoses would be most applicable for battered women? (Select all that apply.) a. Loss of trust b. Ineffective family coping c. Situational low self-esteem d. Risk for self-directed violence e. Enhanced communication

A,B,C,D

Many pregnant teenagers wait until the second or third trimester to seek prenatal care. What should the nurse recognize as reasons for this delay? (Select all that apply.) a. Lack of realization that they are pregnant b. Uncertainty as to where to go for care c. Continuing to deny the pregnancy d. Desire to gain control over their situation e. Wanting to hide the pregnancy as long as possible

A,B,C,E

Which statements regarding menstruation (periodic uterine bleeding) are accurate? (Select all that apply.) a. Menstruation occurs every 28 days. b. During menstruation, the entire uterine lining is shed. c. Menstruation begins 7 to 10 days after ovulation. d. Menstruation leads to fertilization. e. Average blood loss during menstruation is 50 ml.

A,B,E

How would the physiologic process of the sexual response best be characterized? a. Coitus, masturbation, and fantasy b. Myotonia and vasocongestion c. Erection and orgasm d. Excitement, plateau, and orgasm

B

Women of all ages will receive substantial and immediate benefits from smoking cessation. The process is not easy, and most people have attempted to quit numerous times before achieving success. Which organizations provide self-help and smoking cessation materials? (Select all that apply.) a. Leukemia and Lymphoma Society b. March of Dimes c. American Cancer Society d. American Lung Association e. Easter Seals

B,C,D

What are some common characteristics of a potential male batterer? (Select all that apply.) a. High level of self-esteem b. High frustration tolerance c. Substance abuse problems d. Excellent verbal skills e. Personality disorders

C,E

A blind woman has arrived for an examination. Her guide dog assists her to the examination room. She appears nervous and says, "I've never had a pelvic examination." What response from the nurse would be most appropriate? a. "Don't worry. It will be over before you know it." b. "Try to relax. I'll be very gentle, and I won't hurt you." c. "Your anxiety is common. I was anxious when I first had a pelvic examination." d. "I'll let you touch each instrument that I'll use during the examination as I tell you how it will be used."

D

What fatty acids (classified as hormones) are found in many body tissues with complex roles in many reproductive functions? a. GnRH b. Prostaglandins (PGs) c. FSH d. Luteinizing hormone (LH)

B

Which body part both protects the pelvic structures and accommodates the growing fetus during pregnancy? a. Perineum b. Bony pelvis c. Vaginal vestibule d. Fourchette

B

Which statement is most accurate regarding the reporting of IPV in the United States? a. Asian women report more IPV than do other minority groups. b. Caucasian women report less IPV than do non-Caucasians. c. Native-American women report IPV at a rate similar to other groups. d. African-American women are less likely to report IPV than Caucasian women.

B

Which information regarding substance abuse is important for the nurse to understand? a. Although cigarette smoking causes a number of health problems, it has little direct effect on maternity-related health. b. Women, ages 21 to 34 years, have the highest rates of specific alcohol-related problems. c. Coffee is a stimulant that can interrupt body functions and has been related to birth defects. d. Prescription psychotherapeutic drugs taken by the mother do not affect the fetus; otherwise, they would not have been prescribed.

B

Which questionnaire would be best for the nurse to use when screening an adolescent client for an eating disorder? a. Four Cs b. Dietary Guidelines for Americans c. SCOFF screening tool d. Dual-energy x-ray absorptiometry (DEXA) scan

C

Which statement by the client indicates that she understands BSE? a. "I will examine both breasts in two different positions." b. "I will examine my breasts 1 week after my menstrual period starts." c. "I will examine only the outer upper area of the breast." d. "I will use the palm of the hand to perform the examination."

B

In 1979, Lenore Walker pioneered the cause of women as victims of violence when she published her book The Battered Woman. While Walker conducted her research, she found a similar pattern of abuse among many of the women. This concept is now referred to as the "cycle of violence." Which phase does not belong in this three-cycle pattern of violence? a. Tension-building state b. Frustration, followed by violence c. Acute battering incident d. Kindness and contrite, loving behavior

B

Nurses must remember that pregnancy is a time of risk for all women. Which condition is likely the biggest risk for the pregnant client? a. Preeclampsia b. IPV c. Diabetes d. Abnormal Pap test

B

Individual irregularities in the ovarian (menstrual) cycle are most often caused by what? a. Variations in the follicular (preovulatory) phase b. Intact hypothalamic-pituitary feedback mechanism c. Functioning corpus luteum d. Prolonged ischemic phase

A

When the nurse is alone with a battered client, the client seems extremely anxious and says, "It was all my fault. The house was so messy when he got home, and I know he hates that." What is the most suitable response by the nurse? a. "No one deserves to be hurt. It's not your fault. How can I help you?" b. "What else do you do that makes him angry enough to hurt you?" c. "He will never find out what we talk about. Don't worry. We're here to help you." d. "You have to remember that he is frustrated and angry so he takes it out on you."

A

Which female reproductive organ(s) is(are) responsible for cyclic menstruation? a. Uterus b. Ovaries c. Vaginal vestibule d. Urethra

A

Which statement best describes Kegel exercises? a. Kegel exercises were developed to control or reduce incontinent urine loss. b. Kegel exercises are the best exercises for a pregnant woman because they are so pleasurable. c. Kegel exercises help manage stress. d. Kegel exercises are ineffective without sufficient calcium in the diet.

A

Which statement indicates that a client requires additional instruction regarding BSE? a. "Yellow discharge from my nipple is normal if I'm having my period." b. "I should check my breasts at the same time each month, after my period." c. "I should also feel in my armpit area while performing my breast examination." d. "I should check each breast in a set way, such as in a circular motion."

A

The unique muscle fibers that constitute the uterine myometrium make it ideally suited for what? a. Menstruation b. Birth process c. Ovulation d. Fertilization

B

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

B

A woman who is 6 months pregnant has sought medical attention, saying she fell down the stairs. What scenario would cause an emergency department nurse to suspect that the woman has been a victim of IPV? a. The woman and her partner are having an argument that is loud and hostile. b. The woman has injuries on various parts of her body that are in different stages of healing. c. Examination reveals a fractured arm and fresh bruises. d. She avoids making eye contact and is hesitant to answer questions.

B

During a health history interview, a woman states that she thinks that she has "bumps" on her labia. She also states that she is not sure how to check herself. The correct response by the nurse would be what? a. Reassure the woman that the examination will reveal any problems. b. Explain the process of vulvar self-examination, and reassure the woman that she should become familiar with normal and abnormal findings during the examination. c. Reassure the woman that "bumps" can be treated. d. Reassure her that most women have "bumps" on their labia.

B

Which statement regarding human trafficking is correct? a. Human trafficking is a multibillion-dollar business that primarily exists in the United States. b. Victims often experience the Stockholm syndrome. c. Vast majority of the victims are young boys and girls. d. Human trafficking primarily refers to commercial sex work.

B

Which trait is least likely to be displayed by a woman experiencing intimate partner violence (IPV)? a. Socially isolated b. Assertive personality c. Struggling with depression d. Dependent partner in a relationship

B

What are the two primary functions of the ovary? (Select all that apply.) a. Normal female development b. Ovulation c. Sexual response d. Hormone production e. Sex hormone release

B,D

A client at 24 weeks of gestation says she has a glass of wine with dinner every evening. Why should the nurse counsel her to eliminate all alcohol intake? a. Daily consumption of alcohol indicates a risk for alcoholism. b. She is at risk for abusing other substances as well. c. Alcohol places the fetus at risk for altered brain growth. d. Alcohol places the fetus at risk for multiple organ anomalies.

C

A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection, and she has been using an over-the-counter cream for the past 2 days to treat it. How should the nurse initially respond? a. Inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test for which she is scheduled. b. Reassure the woman that using vaginal cream is not a problem for the examination. c. Ask the woman to describe the symptoms that indicate to her that she has a vaginal infection. d. Ask the woman to reschedule the appointment for the examination.

C

Documentation of abuse can be useful to women later in court, should they elect to press charges. It is of key importance for the nurse to document accurately at the time that the client is seen. Which entry into the medical record would be the least helpful to the court? a. Photographs of injuries b. Clear and legible written documentation c. Summary of information (e.g., "The client is a battered woman.") d. Accurate description of the client's demeanor

C

In the 1970s, the rape-trauma syndrome (RTS) was identified as a cluster of symptoms and related behaviors observed in the weeks and months after an episode of rape. Researchers identified three phases related to this condition. Which phase is not displayed in a client with RTS? a. Acute Phase: Disorganization b. Outward Adjustment Phase c. Shock/Disbelief: Disorientation Phase d. Long-Term Process: Reorganization Phase

C

Intervention for the sexual abuse survivor is often not attempted by maternity and women's health nurses because of the concern about increasing the distress of the woman and the lack of expertise in counseling. What initial intervention is appropriate and most important in facilitating the woman's care? a. Initiating a referral to an expert counselor b. Setting limits on what the client discloses c. Listening and encouraging therapeutic communication skills d. Acknowledging the nurse's discomfort to the client as an expression of empathy

C

Nurses who provide care to victims of IPV should be keenly aware of what? a. Relationship violence usually consists of a single episode that the couple can put behind them. b. Violence often declines or ends with pregnancy. c. Financial coercion is considered part of IPV. d. Battered women are generally poorly educated and come from a deprived social background.

C

The microscopic examination of scrapings from the cervix, endocervix, or other mucous membranes to detect premalignant or malignant cells is called what? a. Bimanual palpation b. Rectovaginal palpation c. Papanicolaou (Pap) test d. Four As procedure

C

The nurse guides a woman to the examination room and asks her to remove her clothes and put on an examination gown with the front open. The woman replies, "I have special undergarments that I do not remove for religious reasons." Which is the most appropriate response from the nurse? a. "You can't have an examination without removing all your clothes." b. "I'll ask the physician to modify the examination." c. "Tell me about your undergarments. I'll explain the examination procedure, and then we can discuss how you can comfortably have your examination." d. "I have no idea how we can accommodate your beliefs."

C

What is the primary reason why a woman who is older than 35 years may have difficulty achieving pregnancy? a. Personal risk behaviors influence fertility. b. Mature women have often used contraceptives for an extended time. c. Her ovaries may be affected by the aging process. d. Prepregnancy medical attention is lacking.

C

What is the primary theme of the feminist perspective regarding violence against women? a. Role of testosterone as the underlying cause of men's violent behavior b. Basic human instinctual drive toward aggression c. Male dominance and coercive control over women d. Cultural norm of violence in Western society

C

Which phase of the endometrial cycle best describes a heavy, velvety soft, fully matured endometrium? a. Menstrual b. Proliferative c. Secretory d. Ischemic

C

Which statement is the most comprehensive description of sexual violence? a. Sexual violence is limited to rape. b. Sexual violence is an act of force during which an unwanted and uncomfortable sexual act occurs. c. Sexual violence encompasses a number of sexual acts. d. Sexual violence includes degrading sexual comments and behaviors.

C

Which statement regarding female sexual response is inaccurate? a. Women and men are more alike than different in their physiologic response to sexual arousal and orgasm. b. Vasocongestion is the congestion of blood vessels. c. Orgasmic phase is the final state of the sexual response cycle. d. Facial grimaces and spasms of the hands and feet are often part of arousal.

C

As part of their participation in the gynecologic portion of the physical examination, which approach should the nurse take? a. Take a firm approach that encourages the client to facilitate the examination by following the physician's instructions exactly. b. Explain the procedure as it unfolds, and continue to question the client to get information in a timely manner. c. Take the opportunity to explain that the trendy vulvar self-examination is only for women at risk for developing cancer. d. Help the woman relax through the proper placement of her hands and proper breathing during the examination.

D

Nurses are often the first health care professional with whom a woman comes into contact after being sexually assaulted. Which statement best describes the initial care of a rape victim? a. All legal evidence is preserved during the physical examination. b. The victim appreciates the legal information; however, decides not to pursue legal proceedings. c. The victim states that she is going to advocate against sexual violence. d. The victim leaves the health care facility without feeling re-victimized.

D

What is the goal of a long-term treatment plan for an adolescent with an eating disorder? a. Managing the effects of malnutrition b. Establishing sufficient caloric intake c. Improving family dynamics d. Restructuring client perception of body image

D

What is the most dangerous effect on the fetus of a mother who smokes cigarettes while pregnant? a. Genetic changes and anomalies b. Extensive central nervous system damage c. Fetal addiction to the substance inhaled d. Intrauterine growth restriction

D

Which action would be inappropriate for the nurse to perform before beginning the health history interview? a. Smile and ask the client whether she has any special concerns. b. Speak in a relaxed manner with an even, nonjudgmental tone. c. Make the client comfortable. d. Tell the client her questions are irrelevant.

D

Which hormone is responsible for the maturation of mammary gland tissue? a. Estrogen b. Testosterone c. Prolactin d. Progesterone

D

Which part of the menstrual cycle includes the stimulated release of gonadotropin-releasing hormone (GnRH) and follicle-stimulating hormone (FSH)? a. Menstrual phase b. Endometrial cycle c. Ovarian cycle d. Hypothalamic-pituitary cycle

D

Women with severe and persistent mental illness are likely to be more vulnerable to being involved in controlling and/or violent relationships; however, many women develop mental health problems as a result of long-term abuse. Which condition is unlikely to be a psychologic consequence of continued abuse? a. Substance abuse b. Posttraumatic stress disorder (PTSD) c. Eating disorders d. Bipolar disorder

D

To promote wellness and prevent illness throughout the life span, it is important for the nurse to be cognizant of immunization recommendations for women older than 18 years. Match each immunization with the correct schedule. a. Tetanus-diphtheria-pertussis (Tdap) b. Measles, mumps, rubella c. Herpes zoster d. Hepatitis B e. Influenza f. Human papillomavirus (HPV)

F,D,E,A,C,B