Women's Health, Dunham Ch 18

A 55-year-old female client is concerned because her twin sister has osteoporosis. She asks the nurse what she can do to prevent osteoporosis. Which methods of risk reduction should the nurse advise? Select all that apply.

"Avoid smoking." Rationale: Smoking increases the risk of osteoporosis. "Ensure adequate intake of vitamin D from diet, sunlight, and/or supplements." Rationale: Vitamin D helps with absorption of calcium which helps prevent osteoporosis. "Try to walk or jog three to four times per week." Rationale: Walking and jogging are weight-bearing exercises which will reduce the risk of osteoporosis.

The nurse is teaching a 16-year-old girl about the human papillomavirus (HPV) vaccine. Which statement by the teen indicates more teaching is needed?

"I don't need to have a Pap test if I am fully vaccinated." Rationale: Routine screening with pap tests are still recommended.

A female client with osteoporosis is being prescribed alendronate (Fosamax). What should the nurse include when teaching the client about bisphosphonates? Select all that apply.

"Take the medication in a sitting or standing position." Rationale: This reduces the risk of the pill becoming lodged in the esophagus where it can cause ulcerations and scarring. "Remain upright for at least 30 minutes after taking the pill." Rationale: This will decrease the risk of reflux of the pill into the esophagus. "Side effects include musculoskeletal aches and pains, gastrointestinal irritation, and esophageal ulcerations." Rationale: Most common side effects of alendronate are gastrointestinal irritation, and less common in esophageal ulcerations.

The clinic nurse is teaching a client about a screening colonoscopy procedure. Which statement should be included in the teaching?

"This is recommended every 10 years starting at age 50." Rationale: This is the recommended frequency for colon cancer screening.

The nurse is teaching a postmenopausal woman about osteoporosis prevention and calcium intake. The client states she is lactose intolerant. Which calcium-rich food should the nurse recommend for this client?

Green leafy vegetables Rationale: vegetable such as kale, collard greens, and spinach a good source of calcium which do not contain lactose.

The nurse is teaching health promotion to a class of high-school students. Which should be included regarding human papillomavirus (HPV)? Select all that apply.

HPV is the most common sexually transmitted virus in the United States. Rationale: HPV is the most common viral STI in the U.S. HPV can cause cancer of the penis. Rationale: HPV can cause cancer of the penis, anus, cervix, vulva, and vagina. Most cases of cervical cancer are caused from HPV. Rationale: HPV types 16 and 18 cause 70% of all cervical cancers.

The mother of a 10-year old girl asks the nurse when she should expect her daughter to have her first period. Which response by the nurse is correct?

2 to 2.5 years after the beginning of puberty. Rationale: Menarche occurs 2 to 2.5 years after the onset of puberty.

The nurse in an outpatient clinic is reviewing charts for clients coming in today. Which client should the nurse anticipate needing a Pap test today?

21-year-old woman with no prior Pap tests and a history of HPV vaccines completed Rationale: History of HPV vaccine does not change the recommendation for regular pap tests beginning at age 21.

The nurse in the primary care clinic is evaluating the immunization schedule of a 62-year-old female client. Which immunization is recommended for this client?

Herpes zoster vaccine (HZV) Rationale: This is the shingles vaccine; one dose recommended for adults over 60.

The nurse is teaching an adolescent female about cervical cancer screening (Pap test). Which statement indicates that teaching was effective?

I should get my first Pap test when I turn 21. Rationale: pap tests should begin at age 21.

The primary care nurse is reviewing records for female clients coming in today. Which clients are at higher risk of developing osteoporosis? Select all that apply.

Caucasian woman who smokes Rationale: Caucasian background and smoking are both risk factors for osteoporosis. 60-year-old woman with auto-immune disease who frequently takes corticosteroids Rationale: Corticosteroids increase risk of osteoporosis. Asian small-boned woman who drinks 3 alcoholic beverages a day Rationale: Asian background and alcohol consumption both increase the risk of osteoporosis.

The nurse is preparing a presentation to adolescent girls about health promotion. Which aspect of adolescent development should the nurse consider?

Adolescents often compare their beliefs with those of their peers. Rationale: adolescents are strongly influenced by their peers.

A postmenopausal client was prescribed vaginal estrogen cream. Which statement should be included in the nurse's teaching regarding this medication?

Apply the cream inside the vagina Rationale: The correct route of administration is vaginally, inserted with an applicator tube.

A female client in primary care is asking about hormone therapy for menopause symptoms. Which finding in the client's medical record should alert the nurse to a contraindication for estrogen?

Deep vein thrombosis Rationale: This is a contraindication to estrogen. Estrogen increases the risk of blood clots.

An elderly female client asks the nurse about testing for osteoporosis. Which is the appropriate test to determine osteoporosis?

Dual-energy x-ray absorptiometry scan (DXA) Rationale: This is the test to measure bone density, and to diagnose osteoporosis or osteopenia.

A 17-year-old female client received her first dose of the human papillomavirus (HPV) vaccine. When should the nurse advise the client to return for her next dose?

In 1 to 2 months Rationale: This is the correct dosing interval for HPV vaccine.

The nurse is reviewing the results of a dual-energy x-ray absorptiometry (DXA) with a client. The client had a T-score of -1. Which is the best interpretation of this DXA result?

Indicates osteopenia Rationale: This score indicates osteopenia, which puts a person at risk for osteoporosis.

A woman in her late 40s is reporting irregular menstrual cycles and asks the nurse if she still needs to use birth control. What is the best response by the nurse?

It is possible for a woman to become pregnant during perimenopause. Rationale: pregnancy as possible during perimenopause.

The nurse is caring for a client who identifies herself as lesbian. Which factors should the nurse consider when planning the client's care? Select all that apply.

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health disparities. Rationale: LBGT individuals experience health disparities related to societal stigma, discrimination, and denial of civil rights. Lesbians seek health care less often than do heterosexual women. Rationale: LGBT individuals face barriers to quality health care and see their healthcare provider less often than heterosexual women.

The community health nurse is talking to a group of adolescents about human papillomavirus (HPV) prevention. Which strategies should the nurse include to reduce the risk of HPV? Select all that apply.

Limit the number of sexual partners Rationale: Limiting number of lifetime partners minimizes the chance of exposure and transmission of HPV. Get vaccinated for HPV Rationale: Vaccines are available, which can prevent several types of HPV. Use condoms with sexual activity Rationale: Condoms reduce the chance of all sexually transmitted infections.

A female client with a history of breast cancer reports hot flashes and night sweats. Which treatment option would the nurse question if included in her plan of care?

Oral estrogen Rationale: Estrogen is contraindicated with a history of breast cancer

A female client was prescribed an estrogen-receptor modulator for the treatment of osteoporosis. Which sign or symptom of an adverse effect should the nurse teach the client to watch for?

Pain and swelling in calf Rationale: This may indicate venous thromboembolism, which is an adverse effect of estrogen-receptor modulator medications.

The nurse is talking to a 15-year-old female athlete about her cigarette smoking. Considering cognitive development of adolescents, which statement is the client most likely to be concerned about?

Smoking decrease his lung capacity, fitness, and endurance. Rationale: This statement addresses risks which the team can relate to now.

A 50-year-old female client is prescribed menopausal hormone therapy (MHT) for severe hot flashes. The client asks why she needs to take progesterone if her symptoms are due to low estrogen. Which is the best explanation by the nurse?

The use of progesterone with estrogen therapy reduces the risk of endometrial cancer. Rationale: Unopposed estrogen can cause endometrial hyperplasia, which increases the risk of uterine cancer.

A 49-year-old female client asks the nurse how she will know when she has reached menopause. Which answer by the nurse is best?

When you have not had a menstrual period in 12 months. Rationale: Menopause occurs 12 months after the last menstrual period.