Evolve Maternity and Women's Health Nursing - Women's Health

A client with endometriosis asks the nurse what side effects to expect from leuprolide (Lupron). What should the nurse include in the response?

Weight gain

Which risk factors are associated with the future development of osteoporosis in women? (Select all that apply.)

Cigarette smoking Familial predisposition Inadequate intake of dietary calcium

A client at 16 weeks' gestation arrives at the prenatal clinic for a routine visit. During the examination the nurse notes bruises on the client's face and abdomen. There are no bruises on her legs and arms. Further assessment is required to confirm:

Domestic abuse

A client with a history of endometriosis has abdominal surgery to remove adhesions. What should this client's postoperative plan of care include?

Encouraging the client to ambulate in the hallway

A client is taking a progesterone oral contraceptive (minipill). The nurse instructs the client to take one pill daily during the:

Entire menstrual cycle

A client making her first visit to the prenatal clinic asks which immunization can be administered safely to a pregnant woman. What should the nurse tell her?

Inactive influenza

A thin older adult client is found to have osteoporosis. What should the nurse include in the discharge plan for this client?

Instructions relative to diet and exercise

A nurse is writing a teaching plan about osteoporosis. How should the nurse explain what osteoporosis is?

It involves a decrease in bone substance.

A fetal monitor is applied to a client in labor. The nurse should take action in response to a fetal heart rate that:

Repeatedly drops abruptly to 90 beats/min unrelated to contractions

A pregnant client has a positive group B Streptoccus (GBS) test at 36 weeks' gestation. What is the priority instruction that the nurse will include in the client's teaching plan?

"This information will be in your prenatal record, but please remind your labor and delivery nurse of this finding."

An older female client tells the nurse in the clinic that she has a cystocele that was diagnosed a year ago. She has urinary frequency and burning on urination. The client asks, "The doctor wanted me to have surgery for the cystocele last year, but I can manage with peripads. It won't hurt not to have surgery, will it?" How should the nurse respond?

"Yes, you're risking kidney damage."

A new mother wishes to breastfeed her infant and asks the nurse whether she needs to alter her diet. How should the nurse respond?

"You'll need greater amounts of the same foods you've been eating and more fluids."

A 63-year-old woman with the diagnosis of estrogen-receptor positive cancer of the breast undergoes lumpectomy and radiation therapy, and tamoxifen (Nolvadex) is prescribed. The client asks the nurse how long she will have to take the medication. The nurse responds:

"You'll need to take it for 5 years, after which it will be discontinued."

A client who has just begun breastfeeding complains that her nipples feel very sore. What should the nurse encourage the mother to do? (Select all that apply.)

Apply cool packs to her breasts to reduce the discomfort Take the analgesic medication prescribed to limit the discomfort Assume a different position when breastfeeding to adjust the infant's sucking

A couple interested in family planning ask the nurse about the cervical mucus method of family planning. The nurse explains that with this method the couple must avoid intercourse when and a few days after the cervical mucus is:

Clear and stretchable

A nurse in the postpartum unit must complete several interventions before a client's discharge from the hospital. The nurse plans to delegate some of the tasks to the nursing assistant. Which activity must be performed by the nurse?

Comparing the identification bands of mother and infant

A 24-year-old client complains to the nurse in the women's health clinic that her breasts become tender before her menstrual period. What should the nurse recommend that the client do 1 week before an expected menses?

Decrease caffeine intake

A breastfeeding mother asks the nurse how human milk compares with cow's milk. How should the nurse respond

Fat in human milk is easier to digest and absorb than the fat in cow's milk

A nurse is obtaining a health history from a primigravida on her first visit to the prenatal clinic. Before discussing the client's health habits with her, what does the nurse consider the most important factor in the survival of the client's newborn?

Gestational age and birthweight

A primipara delivered 12 hours ago. Although an ice bag has been applied to her perineal area, the client continues to complain of rectal pressure resulting in excruciating pain in the area of the episiotomy that is not relieved with analgesics. What does the nurse conclude is the cause of the client's pain?

Hematoma in the perineal area

A woman in the family planning clinic has decided to use the diaphragm for contraception. What should the nurse teach her about using a diaphragm?

Insert the diaphragm before intercourse and leave it in at least 6 hours after intercourse to kill all the sperm.

One hour postpartum a nurse evaluates the amount of vaginal bleeding and determines that a client's uterus has become relaxed and boggy. What should the nurse do next?

Massage the uterus until firm

A 28-year-old woman seeks advice about oral contraceptives from the nurse in her company health office. What should the nurse tell her if she is a smoker

Oral contraceptives can cause thrombophlebitis.

A left modified radical mastectomy is performed on a client with breast cancer. What is the most important measure to be included in the care plan for the first postoperative day?

Placing the client in the semi-Fowler position with the left arm and hand elevated

What antidote to the side effects of terbutaline (Brethine) should a nurse have available?

Propranolol (Inderal)

A woman visits the prenatal clinic because an over-the-counter pregnancy test has rendered a positive result. After the initial examination verifies the pregnancy, the nurse explains some of the metabolic changes that occur during the first trimester of pregnancy. (Select all that apply.)

Sleep needs increase. Fluid retention increases. Calcium requirements increase

A nurse is teaching a childbirth preparation class about the discomfort of labor. What is the greatest influence on the perception of pain for a woman in labor?

Tension of the client

A thin 24-year-old woman who runs 10 miles each week asks the nurse for advice about preventing osteoporosis. Which vitamin and other dietary supplement should the nurse recommend?

Vitamin D and calcium citrate

What is most important information to teach to a client who has had a mastectomy before she leaves the hospital?

Why self-examination of the remaining breast is important

When seeing her preterm infant son in the neonatal intensive care unit for the first time, a mother exclaims, "He's so little! How will I ever be able to take care of him?" The nurse explains to the mother that she:

Will be encouraged to participate in his care as much as possible

The partner of a woman experiencing back pain in labor asks what he can do to help. The nurse demonstrates how to apply counterpressure to his partner's back. Where on the image should counterpressure be applied?

d

During a childbirth class, several participants have questions about the elective induction of labor. One participant states that it is more convenient for a woman with a busy schedule. What evidenced-based information should the nurse provide to the participant?

"The widespread use of elective induction increases the risk of unfavorable outcomes."

A client is scheduled for a vacuum aspiration abortion to terminate an unwanted pregnancy. What information should the nurse's teaching plan include?

A temperature of 100.4° F (38° C) or higher should be reported immediately.

When a client who had a mastectomy sees her incision for the first time, she exclaims, "I look horrible! Will it ever look better?" What is the nurse's best response?

"You seem shocked by the way you look now."

A new mother who wishes to breastfeed her infant asks a nurse whether she needs to alter her diet. How should the nurse respond?

"You'll need extra amounts of the same foods you've been eating, plus more fluids."

A 30-year-old client with a 35-day menstrual cycle is trying to become pregnant. The nurse counsels the client and her partner about the optimal timing of intercourse during the cycle. The nurse determines that the counseling has been effective when the couple state that they should have intercourse on the:

21st day of the cycle