Maternal Newborn Success Chapter 3

Which statement by the client indicates that she understands the teaching provided about the intrauterine device (IUD)? 1. "The IUD can remain in place for a year or more." 2. "I will not menstruate while the IUD is in." 3. "Pain during intercourse is a common side effect." 4. "The device will reduce my chances of getting infected."

1. "The IUD can remain in place for a year or more."

The nurse is developing a plan of care for clients seeking contraception informa- tion. Which of the following issues about the woman must the nurse consider be- fore suggesting contraceptive choices? Select all that apply. 1. Age. 2. Ethical and moral beliefs. 3. Sexual patterns. 4. Socioeconomic status. 5. Childbearing plans.

1. Age. 2. Ethical and moral beliefs. 3. Sexual patterns. 4. Socioeconomic status. 5. Childbearing plans.

An 18-year-old client is being evaluated for school soccer by the school nurse. The expected weight for the young woman's height is 120 lb. Her actual weight is 96 lb. The client states that she runs 6 miles every morning and swims 5 miles every af- ternoon. Which of the following actions should the nurse take at this time? 1. Ask the client the date of her last menstrual period. 2. Encourage the client to continue her excellent exercise schedule. 3. Congratulate the client on her ability to maintain such a good weight. 4. Advise the client that she will have to stop swimming once soccer starts.

1. Ask the client the date of her last menstrual period.

A woman has contracted herpes simplex 2 for the first time. Which of the following signs/symptoms is the client likely to complain of? 1. Flu-like symptoms. 2. Metrorrhagia. 3. Amenorrhea. 4. Abdominal cramping.

1. Flu-like symptoms.

A woman is being taught how to use the diaphragm as a contraceptive device. Which of the following statements by the woman indicates that further teaching is needed? 1. Petroleum-based lubricants may be used with the device. 2. The device must be refitted if the woman gains or loses 10 pounds or more. 3. The anterior lip must be pushed under the symphysis pubis. 4. Additional spermicide must be added if the device has been in place over 4 hours.

1. Petroleum-based lubricants may be used with the device.

A client has been admitted to the hospital with a diagnosis of bulimia from forced vomiting. Which of the following serum laboratory reports would the nurse expect to see? 1. Potassium 3.0 mEq/L. 2. Sodium 150 mEq/L. 3. pH 7.30. 4. pO

1. Potassium 3.0 mEq/L

A gravid, married client, 24 weeks' gestation, is found to have bacterial vaginosis. Her health care practitioner has ordered metronidazole (Flagyl) to treat the prob- lem. Which of the following educational information is important for the nurse to provide the woman at this time? 1. The woman must be careful to observe for signs of preterm labor. 2. The woman must advise her partner to seek therapy as soon as possible. 3. The main side effect of the medicine is a copious vaginal discharge. 4. A repeat culture should be taken two weeks after completing the therapy.

1. The woman must be careful to observe for signs of preterm labor.

A man has been diagnosed with a chlamydial infection. The nurse would expect the client to complain of pain at which of the following times? 1. When urinating. 2. When ejaculating. 3. When the penis becomes erect. 4. When the testicles are touched.

1. When urinating.

A woman is to receive 2.4 million units of penicillin G benzathine IM to treat syphilis. The medication is available as 1,200,000 units/mL. How many mL should the nurse administer? ______ mL

2

A woman states that she feels "dirty" during her menses so she often douches to "clean myself." The nurse advises the woman that it is especially important to re- frain from douching while menstruating because douching will increase the likeli- hood of her developing which of the following gynecological complications? 1. Fibroids. 2. Endometritis. 3. Cervical cancer. 4. Polyps.

2. Endometritis.

A client has been diagnosed with pubic lice. Which of the following signs/ symptoms would the nurse expect to see? 1. Macular rash on the labia. 2. Pruritus. 3. Hyperthermia. 4. Foul-smelling discharge.

2. Pruritus.

The nurse is teaching an uncircumcised male to use a condom. Which of the fol- lowing items should be included in the teaching plan? 1. Apply mineral oil to the shaft of the penis after applying the condom. 2. Pull back the foreskin before applying the condom. 3. Create a reservoir at the tip of the condom after putting it on. 4. Wait five minutes after ejaculating before removing the condom.

2. Pull back the foreskin before applying the condom.

The clinic nurse is interviewing a client preceding her annual check-up. Which of the following findings would make the nurse suspicious that the client is an anorexic? 1. Aversion to exercise and food allergies. 2. Significant weight loss and amenorrhea. 3. Respiratory distress and thick oral mucus. 4. Cardiac arrhythmias and anasarca.

2. Significant weight loss and amenorrhea.

A woman is using the contraceptive sponge as a birth control method. Which of the following actions is important in order to maximize the sponge's effectiveness? 1. Insert the sponge at least one hour before intercourse. 2. Thoroughly moisten the sponge with water before inserting. 3. Spermicidal jelly must be inserted at the same time the sponge is inserted. 4. A new sponge must be inserted every time a couple has intercourse. 54.

2. Thoroughly moisten the sponge with water before inserting.

An asymptomatic woman is being treated for HIV infection at the women's health clinic. Which of the following comments by the woman shows that she understands her care? 1. "If I get pregnant, my baby will be HIV positive." 2. "I should have my viral load and antibody levels checked every day." 3. "Since my partner and I are both HIV positive, we use a condom." 4. "To be safe, my partner and I only engage in oral sex."

3. "Since my partner and I are both HIV positive, we use a condom."

A couple seeking contraception and infection-prevention counseling state, "We know that the best way for us to prevent both pregnancy and infection is to use condoms plus spermicide every time we have sex." Which of the following is the best response by the nurse? 1. "That is correct. It is best to use a condom with spermicide during every sexual contact." 2. "That is true, except if you have intercourse twice in one evening. Then you do not have to apply more spermicide." 3. "That is not true. It has been shown that condoms alone are very effective and that the spermicide might increase the transmission of some viruses." 4. "That is not necessarily true. It has been shown that spermicide alone is just as effective as condoms with spermicide."

3. "That is not true. It has been shown that condoms alone are very effective and that the spermicide might increase the transmission of some viruses."

The nurse should suspect that a client is bulimic when the client exhibits which of the following signs/symptoms? 1. Significant weight loss and hyperkalemia. 2. Respiratory acidosis and hypoxemia. 3. Dental caries and scars on her knuckles. 4. Hyperglycemia and large urine output.

3. Dental caries and scars on her knuckles.

What is essential for the nurse to teach a woman who has just had an intrauterine device (IUD) inserted? 1. Palpate her lower abdomen each month to check the patency of the device. 2. Remain on bed rest for 24 hours after insertion of the device. 3. Report any complaints of painful intercourse to the physician. 4. Insert spermicidal jelly within 4 hours of every sexual encounter.

3. Report any complaints of painful intercourse to the physician.

The nurse is interviewing a client regarding contraceptive choices. Which of the following client statements would most influence the nurse's teaching? 1. "I have 2 children." 2. "My partner and I have sex twice a week." 3. "I am 25 years old." 4. "I feel funny touching my private parts."

4. "I feel funny touching my private parts."

A couple is seeking family planning advice. They are newly married and wish to de- lay childbearing for at least 3 years. The woman, age 26, G0 P0000, has no medical problems and does not smoke. She states, however, that she is very embarrassed when she touches her vagina. Which of the following methods would be most ap- propriate for the nurse to suggest to this couple? 1. Diaphragm. 2. Cervical cap. 3. Intrauterine device (IUD). 4. Birth control pills (BCP).

4. Birth control pills (BCP).

A school nurse notices that a young woman, with scars on the knuckles of her right hand, runs to the bathroom each day immediately after eating a high-calorie lunch. Which of the following actions by the nurse is appropriate at this time? 1. Nothing because her behavior is normal. 2. Question the young woman to see if she is being abused. 3. Recommend that the young woman be seen by her doctor. 4. Follow the young woman to the bathroom.

4. Follow the young woman to the bathroom.

A nurse is caring for a client who states that she is a lesbian. Which of the follow- ing should the nurse consider when caring for this client? 1. Lesbian women are usually less sexually active than straight women. 2. Lesbian women need not be asked about domestic violence issues. 3. Lesbian women should be tested for cervical cancer every three to seven years. 4. Lesbian women are at higher risk for bacterial vaginosis than are straight women.

4. Lesbian women are at higher risk for bacterial vaginosis than are straight women.

The nurse is teaching a young woman how to use the female condom. Which of the following should be included in the teaching plan? 1. Reuse female condoms no more than five times. 2. Refrain from using lubricant because the condom may slip out of the vagina. 3. Wear both female and male condoms together to maximize effectiveness. 4. Remove the condom by twisting the outer ring and pulling gently.

4. Remove the condom by twisting the outer ring and pulling gently.

A woman, seen in the emergency department, is diagnosed with pelvic inflamma- tory disease (PID). Before discharge, the nurse should provide the woman with health teaching regarding which of the following? 1. Endometriosis. 2. Menopause. 3. Ovarian hyperstimulation. 4. Sexually transmitted infections.

4. Sexually transmitted infections.

A female client asks the nurse about treatment for human papilloma viral warts. The nurse's response should be based on which of the following? 1. An antiviral injection cures approximately fifty percent of cases. 2. Aggressive treatment is required to cure warts. 3. Warts often spread when an attempt is made to remove them surgically. 4. Warts often recur a few months after a client is treated.

4. Warts often recur a few months after a client is treated.

A nurse is educating a group of women in her parish about osteoporosis. The nurse should include in her discussion that which of the following is a risk factor for the disease process? 1. Multiparity. 2. Increased body weight. 3. Late onset of menopause. 4.Heavy alcohol intake

4.Heavy alcohol intake

Women who are on hormone replacement therapy (HRT) for an extended period of time have been shown to be high risk for which of the following complications? 1. Endometrial cancer. 2. Gynecomastia. 3. Renal dysfunction. 4. Mammary hypertrophy.

1. Endometrial cancer.

A woman is noted to have multiple soft warts on her perineum and rectal areas. The nurse suspects that this client is infected with which of the following sexually transmitted infections? 1. Human papillomavirus (HPV). 2. Human immunodeficiency virus (HIV). 3. Syphilis. 4. Trichomoniasis.

1. Human papillomavirus (HPV).

During a counseling session on natural family planning techniques, how should the nurse explain the consistency of cervical mucus at the time of ovulation? 1. It becomes thin and elastic. 2. It becomes opaque and acidic. 3. It contains numerous leukocytes to prevent vaginal infections. 4. It decreases in quantity in response to body temperature changes.

1. It becomes thin and elastic.

The nurse has provided a single, perimenopausal woman, G3 P2012, with contra- ceptive counseling. The woman has four sex partners and smokes 1 pack of ciga- rettes per day. Which of the following methods is best suited for this client? 1. Male condom. 2. Intrauterine device. 3. NuvaRing. 4. Oral contraceptives.

1. Male condom.

A woman is being issued a new prescription for a low-dose combination birth con- trol pill. What advice should the nurse give the woman if she ever forgets to take her pill? 1. Take it as soon as she remembers, even if that means taking two pills in one day. 2. Skip that pill and refrain from intercourse for the remainder of the month. 3. Wear a pad for the next week because she will experience vaginal bleeding. 4. Take an at-home pregnancy test at the end of the month to check for a pregnancy

1. Take it as soon as she remembers, even if that means taking two pills in one day.

The nurse is conducting a seminar with young adolescent women regarding date rape. Which of the following guidelines is essential to include in the discussion? Select all that apply. 1. The girls should consume drinks from enclosed containers. 2. The girls should keep extra money in their shoes or bras. 3. The girls should keep condoms in their pocketbooks. 4. The girls should meet a new date in a public place. 5.The girls should go on group dates whenever possible

1. The girls should consume drinks from enclosed containers. 4. The girls should meet a new date in a public place. 5.The girls should go on group dates whenever possible

Five women wish to use the OrthoEvra (patch) for family planning. Which of the women should be carefully counseled regarding the safety considerations of the method? Select all that apply. 1. The woman who smokes 1 pack of cigarettes each day. 2. The woman with a history of lung cancer. 3. The woman with a history of deep vein thrombosis. 4. The woman who runs at least 50 miles each week. 5. The woman with a history of cholecystitis.

1. The woman who smokes 1 pack of cigarettes each day 3. The woman with a history of deep vein thrombosis.

A triage nurse answers a telephone call from the male partner of a woman who was recently diagnosed with cervical cancer. The man is requesting to be tested for hu- man papillomavirus (HPV). The nurse's response should be based on which of the following? 1. There is currently no approved test to detect HPV in men. 2. A viral culture of the penis and rectum is used to detect HPV in men. 3. A Pap smear of the meatus of the penis is used to detect HPV in men. 4. There is no need for a test because men do not become infected with HPV.

1. There is currently no approved test to detect HPV in men.

A woman has gotten pregnant with a Copper T intrauterine device (IUD) in place. The physician has ordered an ultrasound to be done to evaluate the pregnancy. The client asks the nurse why this is so important. The nurse should tell the woman that the ultrasound is done primarily for which of the following reasons? 1. To assess for the presence of an ectopic pregnancy. 2. To check the baby for serious malformations. 3. To assess for pelvic inflammatory disease. 4. To check for the possibility of a twin pregnancy.

1. To assess for the presence of an ectopic pregnancy.

Four women with significant health histories wish to use the diaphragm as a contra- ceptive method. The nurse should counsel the woman with which of the following histories that the diaphragm may lead to a recurrence of her problem? 1. Urinary tract infections. 2. Herpes simplex infections. 3. Deep vein thromboses. 4. Human papilloma warts.

1. Urinary tract infections.

A client is put on calcium supplements to maintain bone health. To maximize ab- sorption, the client is also advised to take which of the following supplements? 1. Vitamin D. 2. Vitamin E. 3. Folic acid. 4.Iron.

1. Vitamin D.

The nurse is developing a standard care plan for the administration of Mifeprex (misepristone/misoprostol; formerly known as RU-486). Which of the following educational information should the nurse include when counseling women? 1. Women should be evaluated by their health care practitioners 2 weeks after tak- ing the medicine. 2. This is the preferred method for terminating an ectopic pregnancy when an in- trauterine device is in place. 3. The only symptom clients should experience is bleeding 2 to 3 days after taking the medicine. 4. Women who experience no bleeding within 3 days should immediately take a home pregnancy test.

1. Women should be evaluated by their health care practitioners 2 weeks after tak- ing the medicine.

Which of the following clients, who are all seeking a family planning method, is the best candidate for birth control pills? 1. 19-year-old with multiple sex partners. 2. 27-year-old who bottle feeds her newborn. 3. 29-year-old with chronic hypertension. 4. 37-year-old who smokes one pack per day.

2. 27-year-old who bottle feeds her newborn.

A woman who has been abused for a number of years is finally seeking assistance in leaving her relationship. Identify the actions that the nurse should take at this time. Select all that apply. 1. Comment that the victim could have left long ago. 2. Assist the victim to develop a safety plan. 3. Remind the victim that the abuse was not her fault. 4. Assure the victim that she will receive support for her decision. 5. Help the victim to contact a domestic violence center.

2. Assist the victim to develop a safety plan. 3. Remind the victim that the abuse was not her fault. 4. Assure the victim that she will receive support for her decision. 5. Help the victim to contact a domestic violence center.

A woman has been diagnosed with primary syphilis. Which of the following physi- cal findings would the nurse expect to see? 1. Cluster of vesicles. 2. Pain-free lesion. 3. Macular rash. 4. Foul-smelling discharge.

2. Pain-free lesion.

A woman has been diagnosed with syphilis. Which of the following nursing inter- ventions is appropriate? 1. Council the woman about how to live with a chronic infection. 2. Question the woman regarding symptoms of other sexually transmitted infections. 3. Assist the primary health care practitioner with cryotherapy procedures. 4. Educate the woman regarding the safe disposal of menstrual pads.

2. Question the woman regarding symptoms of other sexually transmitted infections.

A man has just had a vasectomy. Which of the following postprocedure instructions should the nurse provide the client? 1. The man may have unprotected intercourse within 1 week after having the surgery. 2. The man should rest at home for at least 1 day following the surgery. 3. The man should be taught the signs and symptoms of prostatitis. 4. The man will be sedated from the anesthesia for a few hours after the surgery.

2. The man should rest at home for at least 1 day following the surgery.

A nonpregnant young woman has been diagnosed with bacterial vaginosis (BV). The nurse questions the woman regarding her sexual history, including her fre- quency of intercourse, how many sexual partners she has, and her use of contracep- tives. What is the rationale for the nurse's questions? 1. Clients with BV can infect their sexual partners. 2. The nurse is required by law to ask the questions. 3. Clients with BV can become infected with HIV and other sexually transmitted infections more easily than uninfected women. 4. The laboratory needs a full client history in order to know for which organisms and antibiotic sensitivities it should test.

3. Clients with BV can become infected with HIV and other sexually transmitted infections more easily than uninfected women.

The nurse teaches a couple that the diaphragm is an excellent method of contracep- tion providing that the woman does which of the following? 1. Does not use any cream or jelly with it. 2. Douches promptly after its removal. 3. Leaves it in place for 6 hours following intercourse. 4. Inserts it at least 5 hours prior to having intercourse.

3. Leaves it in place for 6 hours following intercourse.

A postpartum woman is using the lactational amenorrhea method of birth control. The nurse should advise the client that which of the following situations would be incompatible with the method? 1. Being three months postpartum. 2. Being amenorrheic since delivery of the baby. 3. Supplementing breastfeeding with formula. 4. Working full time outside of the home.

3. Supplementing breastfeeding with formula.

A 19-year-old client with multiple sex partners is being counseled about the hepati- tis B vaccination. During the counseling sessions, which of the following should the nurse advise the client to receive? 1. The hepatitis B immune globulin before receiving the vaccine. 2. A vaccine booster every 10 years. 3. The complete series of three intramuscular injections. 4. The vaccine as soon as she becomes 21.

3. The complete series of three intramuscular injections.

The nurse is providing education to a couple regarding the proper procedure for male condom use. The nurse knows that the teaching was effective when the couple states that which of the following procedures should be taken if the man's penis be- comes flaccid immediately after ejaculation? 1. The woman should douche with white vinegar and water. 2. The woman should consider taking a postcoital contraceptive. 3. The man should hold the edges of the condom during its removal. 4. The man should apply spermicide to the upper edges of the condom.

3. The man should hold the edges of the condom during its removal.

A client, who is sexually active, is asking the nurse about the vaccine that is given to prevent human papillomavirus (HPV). Which of the following should be included in the counseling session? 1. Gardasil® is not recommended for women who are already sexually active. 2. Gardasil® protects recipients from all strains of the virus. 3. The most common side effect from the vaccine is pain at the injection site. 4. Anyone who is allergic to eggs is advised against receiving the vaccine.

3. The most common side effect from the vaccine is pain at the injection site.

Which of the following sexually transmitted infections is characterized by a foul- smelling, yellow-green discharge that is often accompanied by vaginal pain and dys- pareunia? 1. Syphilis. 2. Gonorrhea. 3. Trichomoniasis. 4. Condylomata acuminata

3. Trichomoniasis.

A client states that she has been diagnosed with fibrocystic breast disease. She asks the nurse, "Does that mean that I have breast cancer?" Which of the following statements by the nurse is appropriate at this time? 1. "I am so sorry. I am sure that the doctor will do everything possible to cure you of the cancer." 2. "I am not the best person to ask about your diagnosis. I suggest that you ask the doctor." 3. "If your lumps are round and mobile they are not cancerous, but if they are hard to the touch you probably do have cancer." 4. "You do not have cancer, but it is especially important for you to have regular mammograms in order to monitor for any changes."

4. "You do not have cancer, but it is especially important for you to have regular mammograms in order to monitor for any changes."

The nurse met four clients in the family planning clinic today. It would be most ap- propriate for the nurse to recommend the intrauterine device (IUD) to which of the clients? 1. Unmarried, 22-year-old, recent college graduate. 2. Married, 24-year-old, G0 P0000. 3. Unmarried, 25-year-old, history of chlamydia. 4. Married, 26 year old, G3 P0121.

4. Married, 26 year old, G3 P0121.

The nurse in a pediatric clinic is caring for a 9-year-old girl who has been diag- nosed with gonorrhea. Which of the following actions is appropriate for the nurse to take? 1. Notify the physician so the child can be admitted to the hospital. 2. Discuss with the girl the need to stop future sexual encounters. 3. Question the mother about her daughter's menstrual history. 4. Report the girl's medical findings to child protective services.

4. Report the girl's medical findings to child protective services.

A 16-year-old woman, who had unprotected intercourse 24 hours ago, has entered the emergency department seeking assistance. Which of the following responses by the nurse is appropriate? 1. "You can walk into your local pharmacy and buy Plan B (levonorgestrel)." 2. "I am sorry but because of your age I am unable to assist you." 3. "The emergency room doctor can prescribe high-dose birth control pills (BCP) for you." 4. The nurse's response is dependent upon which state he or she is practicing in.

4. The nurse's response is dependent upon which state he or she is practicing in.

The nurse is teaching a client regarding the treatment for pubic lice. Which of the following should be included in the teaching session? 1. The antibiotics should be taken for a full 10 days. 2. All clothing should be pretreated with bleach before wearing. 3. Shampoo should be applied for at least 2 hours before rinsing. 4. The pubic hair should be combed after shampoo is removed.

4. The pubic hair should be combed after shampoo is removed.

A young woman is admitted to the emergency department in a disheveled state. She states that she awoke this morning without her underwear on but with no memory of what happened the evening before. She thinks she may have been raped. Which of the following assessments by the nurse is most likely accurate? 1. The woman is spoiled and is exhibiting attention-seeking behavior. 2. The woman is experiencing a psychotic break. 3. The woman regrets having had consensual sex. 4. The woman unknowingly ingested a date rape drug.

4. The woman unknowingly ingested a date rape drug.

A woman has been diagnosed with pelvic inflammatory disease. Which of the fol- lowing organisms is the most likely causative agent? 1. Herpesviridae. 2. Candida albicans. 3. Neisseria gonorrhoeae. 4. Treponema pallidum.

Neisseria gonorrhoeae.

The nurse advises the women to whom she is providing health care teaching at a local church that they should see their health care provider to be assessed for ovar- ian cancer if they experience which of the following signs/symptoms? 1. Vaginal bleeding and weight loss. 2. Frequent urination, breast tenderness, and extreme fatigue. 3. Abdominal pain, bloating, and a constant feeling of fullness. 4. Hardness on one side of the abdomen.

3. Abdominal pain, bloating, and a constant feeling of fullness.

A breastfeeding woman is requesting that she be prescribed Seasonale (ethinyl estradiol and levonorgestrel) as a birth control method. Which of the following in- formation should be included in the patient teaching session? 1. The woman will menstruate every 8 to 9 weeks. 2. The pills are taken for 3 out of every 4 weeks. 3. Breakthrough bleeding is a common side effect. 4. Breastfeeding is compatible with the medication.

3. Breakthrough bleeding is a common side effect.

A client has been admitted to the hospital with a diagnosis of bulimia. Which of the following physical findings would the nurse expect to see? 1. Mastoiditis. 2. Hirsutism. 3. Gynecomastia. 4. Esophagitis.

4. Esophagitis.

Which of the following questions should be asked of women during all routine medical examinations? Select all that apply. 1. "Has anyone ever forced you to have sex?" 2. "Are you sexually active?" 3. "Are you ever afraid to go home?" 4. "Does anyone you know ever hit you?" 5. "Have you ever breastfed a child?"

1. "Has anyone ever forced you to have sex?" 2. "Are you sexually active?" 3. "Are you ever afraid to go home?" 4. "Does anyone you know ever hit you?"

A nurse is providing contraceptive counseling to a perimenopausal client, G3 P2012, who is in a monogamous relationship. Which of the following comments by the woman indicates that further teaching is needed? 1. "The calendar method is the most reliable method for me to use." 2. "If I use the IUD, I am at minimal risk for pelvic inflammatory disease." 3. "I should still use birth control even though I had only 2 periods last year." 4. "The contraceptive patch contains both estrogen and progesterone."

1. "The calendar method is the most reliable method for me to use."

A woman has just entered an emergency department after a stranger rape. Which of the following interventions is highest priority at this time? 1. Create a safe environment. 2. Offer post-coital contraceptive therapy. 3. Provide sexually transmitted disease prophylaxis. 4. Take a thorough health history.

1. Create a safe environment.

A woman, who wishes to use the calendar method for contraception, reports that her last 6 menstrual cycles were 28, 32, 29, 36, 30, and 27 days long, respectively. In the future, if used correctly, she should abstain from intercourse on which of the following days of her cycle? 1. Days 9 to 25. 2. Days 10 to 15. 3. Days 11 to 20. 4.Days 12 to 17

1. Days 9 to 25.

Which of the following behaviors would indicate to a nurse that a gravid woman may be being abused? Select all that apply. 1. Denies that any injuries occurred even when bruising is visible. 2. Gives an implausible explanation for any injuries. 3. Gives the nurse eye contact while answering questions. 4. Allows her partner to answer the nurse's questions. 5. Frequently calls to change appointment times.

1. Denies that any injuries occurred even when bruising is visible. 2. Gives an implausible explanation for any injuries. 4. Allows her partner to answer the nurse's questions. 5. Frequently calls to change appointment times.

A woman has a history of toxic shock syndrome. She should be taught to avoid which of the following forms of birth control? 1. Diaphragm. 2. Intrauterine device. 3. Birth control pills (estrogen-progestin combination). 4. Depo-Provera (medroxyprogesterone acetate).

1. Diaphragm.

Four women who use superabsorbent tampons during their menses are being seen in the medical clinic. The woman with which of the following findings would lead the nurse to suspect that the woman's complaints are related to her use of tampons rather than to an unrelated medical problem? 1. Diffuse rash with fever. 2. Angina. 3. Hypertension. 4. Thrombocytopenia with pallor.

1. Diffuse rash with fever.

A woman is taking Fosamax (alendronate) for osteoporosis. The nurse should advise the woman about which of the following when taking the medication? 1. Remain upright for 30 minutes after taking the medication. 2. Take only after eating a full meal. 3. Take medication in divided doses 3 times each day. 4. Do not break or crush the tablet.

1. Remain upright for 30 minutes after taking the medication.

The nurse at Victims Assistance Services is speaking with a young woman who states that she was sexually assaulted at a party the evening before. The victim states, "I ran home and took a shower as soon as it happened. I felt so dirty." Which of the following responses should the nurse make first? 1. "That is too bad. The evidence kit will reveal less information." 2. "I understand. It was important for you to do that for yourself." 3. "Have you washed your clothes? If not, we might be able to obtain evidence from them." 4. "Do you remember what happened? If not, someone may have put a drug in your drink."

2. "I understand. It was important for you to do that for yourself."

The nurse has given postvasectomy teaching to a client. Which of the following re- sponses by the client indicates that the teaching was effective? 1. "I will measure my urinary output for two days." 2. "I will ejaculate the same amount of semen as I did before the surgery." 3. "I will refrain from having an erection until next week." 4. "I will irrigate the wound twice today and once more tomorrow."

2. "I will ejaculate the same amount of semen as I did before the surgery."

A young woman is seen in the emergency department. She states, "I took a preg- nancy test today. I'm pregnant. My parents will be furious with me!! I have to do something!" Which of the following responses by the nurse is most appropriate? 1. "You can take medicine to abort the pregnancy so your parents won't know." 2. "Let's talk about your options." 3. "The best thing for you to do is to have the baby and to give it up for adoption." 4. "I can help you tell your parents."

2. "Let's talk about your options."

After a sex education class, the school nurse overhears an adolescent woman dis- cussing safe sex practices. Which of the following comments by the young woman indicates that teaching about infection control was effective? 1. "I don't have to worry about getting infected if I have oral sex." 2. "Teen women are most high risk for sexually transmitted infections (STI)." 3. "The best thing to do if I have sex a lot is to use spermicide each and every time." 4. "Boys get human immunodeficiency virus (HIV) easier than girls do."

2. "Teen women are most high risk for sexually transmitted infections (STI)."

A woman is being seen in the gynecology clinic. The nurse notes that the woman has a swollen eye and a bruise on her cheek. Which of the following is an appropri- ate statement for the nurse to make? 1. "I am required by law to notify the police department of your injuries." 2. "Women who are abused often have injuries like yours." 3. "You must leave your partner before you are injured again." 4. "It is important that you refrain from doing things that anger your partner."

2. "Women who are abused often have injuries like yours."

The nurse is counseling a woman who has been diagnosed with mild osteoporosis. Which of the following lifestyle changes should the nurse recommend? Select all that apply. 1. Eat yellow and orange vegetables. 2. Go on daily walks. 3. Stop smoking. 4. Consume dairy products. 5. Sleep at least eight hours a night.

2. Go on daily walks. 3. Stop smoking. 4. Consume dairy products.

A woman with multiple bruises on her arms and face is seen in the emergency de- partment accompanied by her partner. When asked about the injuries, the woman states, "I ran into a door." Which of the following actions by the nurse is of highest priority? 1. Take the woman's vital signs. 2. Interview the woman in private. 3. Assess for additional bruising. 4. Document the location of the bruises.

2. Interview the woman in private.

The nurse is administering Depo-Provera (medroxyprogesterone acetate) to a post- partum client. Which of the following data must the nurse consider before administering the medication? 1. The medicine must be administered subcutaneously in the upper arm. 2. The client must be taught to use sunscreen whenever in the sunlight. 3. The medicine is contraindicated if the woman has lung or esophageal cancer. 4. The client must use an alternate form of birth control for the first two months.

2. The client must be taught to use sunscreen whenever in the sunlight.

The nurse has taught a couple about the temperature rhythm method of fertility control. Which of the following behaviors would indicate that the teaching was effective? 1. The woman takes her basal body temperature before retiring each evening. 2. The couple charts information from at least six menstrual cycles before using the method. 3. The couple resumes having intercourse as soon as they see a rise in the basal body temperature. 4. The woman assesses her vaginal discharge daily for changes in color and odor.

2. The couple charts information from at least six menstrual cycles before using the method.

A client, who has been taking birth control pills for 2 months, calls the clinic with the following complaint: "I have had a bad headache for the past couple of days and I now have pain in my right leg." Which of the following responses should the nurse make? 1. "Continue the pill, but take one aspirin tablet with it each day from now on." 2. "Stop taking the pill, and start using a condom for contraception." 3. "Come to the clinic this afternoon so that we can see what is going on." 4. "Those are common side effects that should disappear in a month or so."

3. "Come to the clinic this afternoon so that we can see what is going on."

An adolescent woman confides to the school nurse that she is sexually active. The young woman asks the nurse to recommend a "very reliable" birth control method, but she refuses to be seen by a gynecologist. Which of the following methods would be best for the nurse to recommend? 1. Contraceptive patch. 2. Withdrawal method. 3. Female condom. 4. Contraceptive sponge.

3. Female condom.

The nurse is developing a teaching plan for a client undergoing a bilateral tubal ligation. Which of the following should be included in the plan? 1. The surgical procedure is easily reversible. 2. Menstruation will cease after the procedure. 3. Libido should remain the same after the procedure. 4. The incision will be made endocervically.

3. Libido should remain the same after the procedure.

A postpartum client has decided to use Depo-Provera (medroxyprogesterone acetate) as her contraceptive method. What should the nurse advise the client regarding this medication? 1. Take the pill at the same time each day. 2. Refrain from breastfeeding while using the method. 3. Expect to have no periods as long as she takes the medicine. 4. Consider switching to another birth control method in a year or so.

4. Consider switching to another birth control method in a year or so.

The nurse is educating a group of adolescent women regarding sexually transmitted infections. The nurse knows that learning was achieved when a group member states that the most common sign/symptom of sexually transmitted infections is which of the following? 1. Menstrual cramping. 2. Heavy menstrual periods. 3. Flu-like symptoms. 4. Lack of signs or symptoms.

4. Lack of signs or symptoms.

A young woman was a victim of a sexual assault. After the rape examination was concluded, the client requests to be given emergency contraception (EC). Which of the following information should the nurse teach the client regarding the therapy? 1. EC is illegal in all 50 states. 2. The most common side effect of EC is excessive vaginal bleeding. 3. The same medicine that is used for EC is used to induce abortions. 4.EC is best when used within 72 hours of contact.

4.EC is best when used within 72 hours of contact.

A client is being taught about the care and use of the diaphragm. Which of the fol- lowing comments by the woman shows that she understands the teaching that was provided? 1. "I should regularly put the diaphragm up to the light and look at it carefully." 2. "This is one method that can be used during menstruation." 3. "I can leave the diaphragm in place for a day or two." 4. "The diaphragm should be well powdered before I put it back in the case."

1. "I should regularly put the diaphragm up to the light and look at it carefully."

The nurse suspects that a client has been physically abused. The woman refuses to report the abuse to the police. Which statement by the client suggests to the nurse that the relationship may be in the "honeymoon phase"? 1. "My partner said that he will never hurt me again." 2. "My partner only drinks alcohol on the weekends." 3. "My partner yells less than he used to." 4. "My partner has frequent bouts of insomnia."

1. "My partner said that he will never hurt me again."

The nurse is working with a client who states that she has multiple sex partners. Which of the following contraceptive methods would be best for the nurse to rec- ommend to this client? 1. Intrauterine device. 2. Female condom. 3. Bilateral tubal ligation. 4. Birth control pills.

2. Female condom.

The public health nurse calls a woman and states, "I am afraid that I have some dis- turbing news. A man who has been treated for gonorrhea by the health department has told them that he had intercourse with you. It is very important that you seek medical attention." The woman replies, "There is no reason for me to go to the doctor! I feel fine!" Which of the following replies by the nurse is appropriate at this time? 1. "I am sure that you are upset by the disturbing news, but there is no reason to be angry with me." 2. "I am sorry. We must have received the wrong information." 3. "That certainly could be the case. Women often report no symptoms." 4. "All right, but please tell me your contacts because it is possible for you to pass the disease on even if you have no symptoms."

3. "That certainly could be the case. Women often report no symptoms."

The nurse is educating a group of women on how to perform a breast self- examination (BSE). Which of the following actions should the nurse advise the women to take? 1. Use the fingertips of their index, middle, and ring fingers. 2. Use pressure in two intensities, light and deep. 3. Look for dimpling while bending forward from the waist. 4. Feel for lumps while encircling the breast from nipple outward.

3. Look for dimpling while bending forward from the waist.

A client is being seen following a sexual assault. A rape examination is being con- ducted. Which of the following specimens may be collected from the victim during the examination? Select all that apply. 1. Buccal swab for genetic analysis. 2. Samples of pubic hair. 3. Toenail scrapings. 4. Samples of head hair. 5. Sputum for microbiological analysis

1. Buccal swab for genetic analysis. 2. Samples of pubic hair. 4. Samples of head hair.

A client asks a nurse to express an opinion on the value of taking hormone replace- ment therapy (HRT). The nurse should be aware that it is recognized that HRT is effective in which of the following situations? 1. No woman should ever take hormone replacement therapy. 2. Women experiencing severe menopausal symptoms. 3. Women with severe coronary artery disease. 4. Women with a history of breast cancer.

2. Women experiencing severe menopausal symptoms.

The parent of a newborn angrily asks the nurse, "Why would the doctor want to give my baby the vaccination for hepatitis B. It's a sexually transmitted disease, you know!" Which of the following is the best response by the nurse? 1. "The hepatitis B vaccine is given to all babies. It is given because many babies get infected from their mothers during pregnancy." 2. "It is important for your baby to get the vaccine in the hospital because the shot may not be available when your child gets older." 3. "Hepatitis B can be a life-threatening infection that is contracted by contact with blood as well as sexually." 4. "Most parents want to protect their children from as many serious diseases as possible. Hepatitis B is one of those diseases."

3. "Hepatitis B can be a life-threatening infection that is contracted by contact with blood as well as sexually."