NSG 211 exam 5
A postpartum client plans to use the lactational amenorrhea method of birth control. The nurse should advise the client that the method is effective only if which of the following conditions are present? Select all that apply. 1. Being less than 6 months postpartum. 2. Being amenorrheic since delivery of the baby. 3. Supplementing with formula no more than once per day. 4. Losing less than 10% of weight since delivery. 5. Sleeping at least 8 hours every night.
Answers 1 and 2 are correct. 1. The lactational amenorrhea method (LAM) can be effective until 6 months postpartum. 2. As long as the client has had no period since delivery, the LAM can be effective. 3. If the mother gives any supplementation, the LAM is not reliable. 4. There are no weight loss restrictions when using the LAM. 5. There are no sleep requirements when using the LAM.
Four women who use superabsorbent tampons during their menses are being seen in the medical clinic. The client with which of the following findings would lead the nurse to suspect that the client'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.
answer: 1 1. A diffuse rash with fever should be taken very seriously. These are symptoms of toxic shock syndrome (TSS). 2. Angina is not related to tampon use. 3. Hypertension is not related to tampon use. Hypotension, however, may be related. 4. Thrombocytopenia is not related to tampon use.
A client 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.
answer: 1 1. Human papillomavirus (HPV) is characterized by flat warts on the vaginal and rectal surfaces. 2. HIV/AIDS is characterized by nonspecific symptoms like weight loss, dry cough, and fatigue. 3. Primary syphilis is characterized by a nonpainful lesion, called a chancre. 4. Trichomoniasis is characterized by a yellowish green vaginal discharge. Like bacterial vaginosis, it usually has a very strong, fishy smell.
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."
answer: 1 1. IUDs can remain in place for extended periods of time. 2. The client should expect to menstruate regularly while the IUD is in place. 3. If dyspareunia occurs, the client should contact her healthcare practitioner. 4. Women who have IUDs in place are at slightly higher risk of developing pelvic infections.
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.
answer: 1 1. The cervical mucus becomes thin and elastic at the time of ovulation in order for sperm to enter the uterus. 2. The cervical mucus becomes almost transparent and alkaline at the time of ovulation. 3. The mucus is leukocyte poor. 4. The quantity of cervical mucus increases at the time of ovulation.
An infertility specialist is evaluating whether a woman's cervical mucus contains enough estrogen to support sperm motility. Which of the following tests is the physician conducting? 1. Ferning capacity. 2. Basal body temperature. 3. Colposcopy. 4. Hysterotomy.
answer: 1 1. When a woman's cervical mucus is estrogen rich, it is slippery and elastic (thread-like), and when assessed under a microscope, the practitioner will observe "ferning"—that is, an image that looks like a fern. The woman is then in her fertile period. When she is not in her fertile period, the mucus is thick and gluey. 2. Basal body temperature assessments are performed to determine if and when ovulation occurs. 3. Colposcopy is a procedure performed to examine the cervix closely. It is not performed to evaluate the receptivity of a woman's cervical mucus to sperm. 4. A hysterotomy is a procedure in which an incision is made into the uterus.
The nurse is teaching an uncircumcised male to use a condom. Which of the following information should be included in the teaching plan? 1. Apply mineral oil to the tip and shaft of the condom-covered penis. 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.
answer: 2 1. Oil- and petroleum-based products can destroy the latex in condoms. 2. The foreskin should be pulled back before applying the condom. 3. Before beginning to put the condom on, a reservoir should be created by pinching the end of the condom. 4. The condom should be removed immediately after ejaculation.
A client who is sexually active is asking the nurse about vaccines administered to prevent human papillomavirus (HPV). Which of the following should be included in the counseling session? 1. The vaccines are not recommended for women who are already sexually active. 2. The vaccines protect recipients from all strains of the virus. 3. The most common side effect from the vaccines is pain at the injection site. 4. Anyone who is allergic to eggs is advised against receiving the vaccines.
answer: 3 1. This statement is not true. The vaccine can be administered to women as young as 9 and up to age 26, whether sexually active or not. 2. This statement is not true. The vaccine does not protect against many strains of HPV. 3. This statement is true. There are very few side effects experienced by those who receive the vaccine. 4. This statement is not true.
What is essential for the nurse to teach a woman who has just had an intrauterine device (IUD) inserted? 1. "Palpate your lower abdomen each month to check the patency of the device." 2. "Remain on bedrest 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."
answer:3 1. The client should palpate for the presence of the string at the external cervical os after each menses. 2. It is not necessary to go on bedrest after an IUD insertion. 3. Reports of dyspareunia (painful intercourse) should be communicated to the physician. 4. There is no need to insert spermicidal jelly when an IUD is in place. The IUD is effective immediately.
A client has just had an amniocentesis to determine whether her baby has an inheritable genetic disease. Which of the following interventions is highest priority at this time? 1. Assess the fetal heart rate. 2. Check the client's temperature. 3. Acknowledge the client's anxiety about the possible findings. 4. Answer questions regarding the genetic abnormality.
answer: 1 1. Assessing the fetal heart rate is the highest priority since, although rare, the fetus may have been injured during the procedure. 2. Taking the client's temperature is not the most important action to take at this time. 3. Psychosocial issues are always significant, but they must take a backseat to physiological assessments. 4. It is important to answer all questions posed by clients but, again, these should be answered only after physiological interventions are completed.
When a nurse is teaching a woman about her menstrual cycle, which of the following information should be included as the most important change that happens during the follicular phase of the menstrual cycle? 1. Maturation of the graafian follicle. 2. Multiplication of the fimbriae. 3. Secretion of human chorionic gonadotropin. 4. Proliferation of the endometrium.
answer: 1 1. FSH is elevated during the follicular phase and the graafian follicle (the site in the ovary where an ovum develops before ovulation) matures. 2. The fimbriae (finger-like tissues) are located at the ends of the fallopian tubes. They do not multiply in number. 3. The hormone hCG is not produced during the menstrual cycle. It is produced by the fertilized egg in early pregnancy. 4. Endometrial proliferation occurs during the secretory phase of the menstrual cycle.
A client 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.
answer: 1 1. The initial infection of herpes simplex 2 is often symptom-free but, if symptoms do occur, the client may complain of flu-like symptoms as well as vesicles at the site of the viral invasion. 2. Metrorrhagia is not associated with herpes simplex 2. 3. Amenorrhea is not associated with herpes simplex 2. 4. Abdominal cramping is not associated with herpes simplex 2.
The nurse teaches a couple that the diaphragm is an excellent method of contraception 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.
answer: 3 1. The diaphragm provides insufficient protection when used without spermicide. 2. It is recommended that women not douche unless medically advised to do so. 3. The diaphragm should be left in place for at least 6 hours after intercourse has ended. 4. The diaphragm should be inserted no earlier than 4 hours before intercourse. If put in place before that time, additional spermicide must be inserted before intercourse begins.
A couple is seeking infertility counseling. During the history, it is noted that the man is a cancer survivor, drinks one beer every night with dinner, and takes a sauna every day after work. The response provided by the nurse should be based on which of the following? 1. It is unlikely that any of these factors is affecting his fertility. 2. Daily alcohol consumption could be altering his sperm count. 3. Sperm may be malformed when exposed to the heat of the sauna. 4. Cancer survivors have the same fertility rates as healthy males.
answer: 3 1. This response is incorrect because exposing the testes to the heat of the sauna can alter the normal morphology of the sperm. 2. Alcohol consumed in excessive amounts can alter spermatogenesis, but one beer per day has not been shown to be a problem. 3. The high temperature of the sauna could alter the number and morphology of the sperm. 4. Chemotherapy has been shown to affect the ability of males to create sperm.
A male client has green color blindness, an X-linked recessive genetic disorder. His wife has no affected genes. Which of the following statements by the nurse is true regarding the couple's potential for having a child who is color blind? 1. All male children will be color blind. 2. All female children will be color blind. 3. All male children will be carriers for color blindness. 4. All female children will be carriers for color blindness.
answer: 4 1. This response is incorrect. None of their male children will be green color blind. 2. This response is incorrect. None of their female children will be green color blind. 3. This response is incorrect. Males do not carry X-linked recessive traits. 4. This response is correct. All of the females will be carriers.
A client has a history of toxic shock syndrome. Which of the following forms of birth control should she be taught to avoid? 1. Diaphragm. 2. Intrauterine device. 3. Birth control pills (estrogen-progestin combination). 4. Medroxyprogesterone acetate.
answer: 1 1. Toxic shock syndrome (TSS) is associated with diaphragm use. 2. TSS is not associated with IUD use. 3. TSS is not associated with the use of birth control pills. 4. TSS is not associated with the use of medroxyprogesterone acetate.
A client is 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 client 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.
answer: 1 1. When pregnancy occurs with an IUD in place, an ectopic pregnancy should be ruled out. 2. Malformations of the fetus are uncommon. 3. Symptoms of PID are not similar to those of early pregnancy. The most common symptoms of PID are abdominal pain, dyspareunia, foul-smelling vaginal discharge or bleeding, and fever. 4. Twin pregnancies are no more common with a failed IUD than in general.
A client has been diagnosed with primary syphilis. Which of the following physical findings would the nurse expect to see? 1. Cluster of vesicles. 2. Pain-free lesion. 3. Macular rash. 4. Foul-smelling discharge.
answer: 2 1. A cluster of vesicles is consistent with a diagnosis of herpes, not primary syphilis. 2. A pain-free lesion, called a chancre, is consistent with a diagnosis of primary syphilis. 3. A macular rash is not seen with primary syphilis. A reddish brown rash is seen with stage 2 syphilis. 4. A foul-smelling discharge is not seen with primary syphilis.
A client states that she feels "dirty" during her menses so she often douches to "clean myself." The nurse advises the client that it is especially important to refrain from douching while menstruating because douching will increase the likelihood of her developing which of the following gynecological complications? 1. Fibroids. 2. Endometritis. 3. Cervical cancer. 4. Polyps.
answer: 2 1. Fibroids are benign tumors of the myometrium. Douching does not increase the incidence of fibroids. 2. Douching can increase a client's potential for endometritis (pelvic inflammatory disease). 3. Cervical cancer is almost exclusively caused by the human papillomavirus that is contracted through sexual contact. 4. Polyps are abnormal tissue growths. They do not develop as a result of douching.
Most children born into families look similar but are not exactly the same. The children appear different because homologous chromosomes exchange genetic material at which of the following? 1. Centromere. 2. Chiasma. 3. Chromatid. 4. Codon.
answer: 2 1. The centromere is the site where sister chromatids attach during cell division. 2. A chiasma is the site where crossing over between non-sister chromatids takes place. At this site, genetic material is swapped between the chromatids. 3. A chromatid is one strand of a duplicated chromosome. Sister chromatids are attached at the chromosome's centromere. 4. A codon is a triad of messenger RNA that encodes for a specific amino acid in a protein.
A client asks a nurse to express an opinion on the value of taking hormone replacement therapy (HRT). The nurse should be aware that it is recognized that HRT is effective in which of the following situations? 1. No client 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.
answer: 2 1. This is not true. There are situations when hormone replacement therapy (HRT) is recommended. 2. Women who are experiencing severe menopausal symptoms can benefit from HRT. However, it is recommended that they not be on the medication for an extended period of time. 3. HRT should not be given to women to prevent or treat coronary artery disease. 4. Women with a history of breast cancer should not take HRT.
A woman asks the obstetrician's nurse about cord blood banking. Which of the following responses by the nurse would be best? 1. "I think it would be best to ask the doctor to tell you about that." 2. "The cord blood is frozen in case your baby develops a serious illness in the future." 3. "The doctors could transfuse anyone who gets into a bad accident with the blood." 4. "Cord blood banking is very expensive and the blood is rarely ever used."
answer: 2 1. This response is inappropriate. The client has asked the nurse for information regarding cord blood banking. 2. This statement is correct. The baby's umbilical cord blood is kept by a cord blood bank to be used if and when the baby should develop a serious illness such as leukemia. 3. The blood is not used in the same way that general blood donations are used. It is used to treat catastrophic illnesses. 4. This response is true, but it does not provide the client with the information she needs to make an informed decision.
A woman has been advised that the reason she has had a number of spontaneous abortions is because she has an inheritable mutation. Which of the following situations is consistent with this statement? 1. A client developed skin cancer after being exposed to the sun. 2. A client developed colon cancer from an inherited dominant gene. 3. A client's genetic analysis report revealed a reciprocal translocation. 4. A client's left arm failed to develop when she was a fetus.
answer: 3 1. The DNA in the client's skin cells did mutate, but the mutation will not affect the client's fertility because the woman's ovaries were not affected. 2. The inherited gene affects a client's risk of contracting colon cancer. It will not affect fertility. 3. A reciprocal translocation can result in infertility. 4. Failure of one arm to develop in utero is related to an environmental insult rather than a genetic insult.
A 19-year-old client with multiple sex partners is being counseled about the hepatitis B vaccination. During the counseling sessions, which of the following should the nurse advise the client to receive? 1. Hepatitis B immune globulin before receiving the vaccine. 2. Vaccine booster every 10 years. 3. Complete series of three intramuscular injections. 4. Vaccine as soon as she becomes 21.
answer: 3 1. The immune globulin is not administered before giving the vaccine. 2. The vaccine is administered in a series of three injections. Booster shots are not recommended for otherwise healthy people with noncompromised immune systems. 3. To be immunized against hepatitis B, a three-injection vaccine series is administered. 4. The vaccine can be administered at any age.
Infertility increases a client's risk of which of the following diseases? 1. Diabetes mellitus. 2. Nystagmus. 3. Cholecystitis. 4. Ovarian cancer.
answer: 4 1. Diabetes has been shown to affect a woman's fertility, but infertility has not been shown to increase a woman's risk of developing diabetes. 2. Infertility has not been shown to increase a woman's risk of developing nystagmus, involuntary eye movements. 3. Infertility has not been shown to increase a woman's risk of developing cholecystitis. 4. Infertility has been shown to increase a woman's risk of developing ovarian cancer.
A client seen in the emergency department is diagnosed with pelvic inflammatory disease (PID). Before discharge, the nurse should provide the client with health teaching regarding which of the following? 1. Endometriosis. 2. Menopause. 3. Ovarian hyperstimulation. 4. Sexually transmitted infections.
answer: 4 1. PID is not related to endometriosis. 2. PID is not related to menopause. 3. PID is not related to ovarian hyperstimulation. 4. PID usually occurs as a result of an ascending sexually transmitted infection.
Once oogenesis is complete, the resultant gamete cell contains how many chromosomes? 1. 23. 2. 46. 3. 47. 4. 92.
answer: 1 1. The haploid number of chromosomes—a complete string of unpaired chromosomes—is 23, the normal number of chromosomes in the gamete—in this case, in the ovum. 2. The diploid number of chromosomes is 46, the normal number of chromosomes in the somatic cells of human beings. The ovum and sperm each contribute 23 chromosomes that pair up. 3. Aneuploidy is characterized by a chromosomal number that is not equal to a multiple of the haploid number—that is, the number of chromosomes in the cell is NOT equal to 23, 46, 69, 92, and so on. Trisomy 21 (47 chromosomes) is an example of an aneuploid number, as is a chromosome number of 48 or 49. 4. Polyploidy is characterized by a chromosomal number that is equal to twice, three times, four times, and so on, of the diploid number—that is, the number of chromosomes in the cell is equal to 92 (2 × 46), 138 (3 × 46), and so on.
A client is to receive injections of menotropins for infertility prior to in-vitro fertilization. Which of the following is the expected action of this medication? 1. Prolongation of the luteal phase. 2. Stimulation of ovulation. 3. Suppression of menstruation. 4. Promotion of cervical mucus production.
answer: 2 1. The luteal phase occurs after ovulation. Menotropin injections are given to induce ovulation. 2. Menotropin is administered to infertile women to increase follicular growth and maturation of the follicles and to stimulate ovulation. 3. Menotropin does not suppress menstruation or promote cervical mucus production. 4. Menotropin does not suppress menstruation or promote cervical mucus production.
A woman is using the contraceptive sponge as a birth control method. Which of the following actions is it important for her to perform to maximize the sponge's effectiveness? 1. Insert the sponge at least 1 hour before intercourse. 2. Thoroughly moisten the sponge with water before inserting. 3. Insert spermicidal jelly at the same time the sponge is inserted. 4. Replace the sponge with a new one if intercourse is repeated.
answer: 2 1. The sponge may be inserted any time between 24 hours and a few minutes before intercourse. 2. The sponge must be moistened with water until it is foamy. 3. Additional spermicide need not be used. 4. This is not true. The sponge offers contraceptive protection for up to 24 hours no matter how many times a couple has intercourse.
A breastfeeding client is requesting that she be prescribed an ethinyl-estradiol-and-levonorgestrel-combined pill as a birth control method. Which of the following information should be included in the client teaching session? 1. The client 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.
answer: 3 1. Women who take the ethinyl-estradiol-and-levonorgestrel-combined pill menstruate every 3 months. 2. An ethinyl-estradiol-and-levonorgestrel-combined pill is a daily birth control pill. 3. Women who take an ethinyl-estradiol-and-levonorgestrel-combined pill do experience breakthrough bleeding fairly often. 4. Breastfeeding is not compatible with this pill.
A couple is seeking family planning advice. They are newly married and wish to delay childbearing for at least 3 years. The woman, age 26, has never been pregnant, 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 appropriate for the nurse to suggest to this couple? 1. Diaphragm. 2. Cervical cap. 3. Intrauterine device (IUD). 4. Birth control pills (BCPs).
answer:4 1. Diaphragm is not appropriate. The client must touch her vagina to insert the device. 2. Cervical cap is not appropriate. She must touch her vagina to insert the device. 3. Although the intrauterine device is effective and the client is in a monogamous relationship, it is recommended that the client palpate for the string after each menses. This requires vaginal manipulation. 4. The birth control pill would be the best choice for this client. She has no medical contraindications to the pill, she wishes to bear children in the future, and it requires no vaginal manipulation.
A client asks the nurse about the gamete intrafallopian transfer (GIFT) procedure. Which of the following responses would be appropriate for the nurse to make? 1. Fertilization takes place in the woman's body. 2. Zygotes are placed in the fallopian tubes. 3. Donor sperm are placed in a medium with donor eggs. 4. A surrogate carries the fetus.
answer: 1 1. This statement is true. Although the gametes are placed in the fallopian tubes artificially, fertilization does occur within the woman's body. 2. This statement is true of zygote intrafallopian transfer (ZIFT), not of gamete intrafallopian transfer (GIFT). 3. This statement is not true. Although donor eggs and sperm can be used, usually the couple's own gametes are used. When they are harvested, the gametes are placed directly into the fallopian tubes. 4. This statement describes surrogacy. A surrogate is usually impregnated via intrauterine insemination (IUI).
A client is receiving menotropins intramuscularly for ovarian stimulation. Which of the following is a common side effect of this therapy? 1. Piercing rectal pain. 2. Mood swings. 3. Visual disturbances. 4. Jerky tremors.
answer: 2 1. Piercing rectal pain has not been cited as a side effect of menotropins. 2. Mood swings and depression are common side effects of the hormonal therapy. 3. Visual disturbances have not been cited as a side effect of menotropins. 4. Jerky tremors have not been cited as a side effect of menotropins.
Which of the following client responses indicates that the nurse's teaching about care following chorionic villus sampling (CVS) has been successful? 1. If the baby stops moving, the woman should immediately go to the hospital. 2. The woman should take oral terbutaline every 2 hours for the next day. 3. If the woman starts to bleed or to contract, she should call her physician. 4. The woman should stay on complete bedrest for the next 48 hours.
answer: 3 1. CVS is performed well before mothers feel quickening. 2. Tocolytics, such as terbutaline, are not routinely administered following CVS. 3. The mother should notify the doctor if she begins to bleed or contract. 4. It is unnecessary for the mother to stay on complete bedrest following a CVS.
A woman who is a carrier for sickle cell anemia is advised that if her baby has two recessive genes, the penetrance of the disease is 100%, but the expressivity is variable. Which of the following explanations will clarify this communication for the mother? All babies with two recessive sickle cell genes will: 1. Develop painful vaso-occlusive crises during their first year of life. 2. Exhibit at least some signs of the disease while in the neonatal nursery. 3. Show some symptoms of the disease but the severity of the symptoms will be individual. 4. Be diagnosed with sickle cell trait but will be healthy and disease-free throughout their lives.
answer: 3 1. This response is incorrect. No one can make such a prediction. 2. Neonates virtually never exhibit signs of sickle cell because fetal hemoglobin does not sickle. 3. This response is correct. Babies with two recessive sickle cell genes will show some symptoms of the disease but the severity of the symptoms will be individual. 4. This response is incorrect. Virtually all children with sickle cell anemia will exhibit some symptoms during their lives.
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.
answer: 4 1. Lice are not treated with antibiotics. 2. After lice treatment, clothing should be washed thoroughly in hot water (at or hotter than 130° F (54.4° C)) and dried in a hot dryer for at least 20 minutes. 3. The over-the-counter shampoo should be applied for 10 minutes or as stated in the package insert, and then rinsed off. 4. To remove the nits, or eggs, the pubic hair may be combed with a fine-tooth nit comb after the shampoo is removed.
A triage nurse answers a telephone call from the male partner of a client who was recently diagnosed with cervical cancer. The man is requesting to be tested for human papillomavirus (HPV). The nurse's response should include 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.
answer: 1 1. This is true. The CDC has not approved any tests to detect HPV in men. 2. The CDC has not approved any tests to detect HPV in men. 3. The CDC has not approved any tests to detect HPV in men. 4. The CDC has not approved any tests to detect HPV in men.
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.
answer: 2 1. A macular rash is not indicative of pubic lice. 2. Pruritus is, by far, the most common symptom of pubic lice. 3. Hyperthermia is not commonly seen with an infestation of pubic lice. 4. Foul-smelling discharge is not commonly seen with an infestation of pubic lice.
Which of the following sexually transmitted infections is characterized by a foul-smelling, yellow-green discharge that is often accompanied by vaginal pain and dyspareunia? 1. Syphilis. 2. Herpes simplex. 3. Trichomoniasis. 4. Condylomata acuminata.
answer: 3 1. Syphilis is caused by the spirochete Treponema pallidum. If untreated, syphilis is a three-stage illness. The primary symptom is a pain-free lesion called a chancre. 2. The primary symptom of herpes simplex is the presence of a cluster of painful vesicles. 3. Trichomoniasis is characterized by a yellowish green, foul-smelling discharge. 4. Condylomata are vaginal warts.
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.
answer: 4 1. Female condoms, like male condoms, should be used only once. 2. Water-based lubricants can be used with female condoms. The same is true of male condoms. 3. Using both the male and female condom together is not recommended. 4. The female condom should be removed by twisting the outer ring and pulling gently.
A client is to have a hysterosalpingogram. In this procedure, the physician will be able to determine which of the following? 1. Whether or not the ovaries are maturing properly. 2. If the endometrium is fully vascularized. 3. If the cervix is incompetent. 4. Whether or not the fallopian tubes are obstructed.
answer: 4 1. Only the uterus and the fallopian tubes are evaluated during a hysterosalpingogram. 2. Tumors and other gross assessments of the uterus can be made out, but the vascularization of the endometrium is beyond the scope of the test. 3. The competency of the cervix cannot be evaluated during a hysterosalpingogram. 4. The primary goal of a hysterosalpingogram is to learn whether or not the fallopian tubes are patent.
A female client seeks care at an infertility clinic. Which of the following tests may the client undergo to determine what, if any, infertility problem she may have? Select all that apply. 1. Chorionic villus sampling. 2. Endometrial biopsy. 3. Hysterosalpingogram. 4. Serum progesterone assay. 5. Postcoital test.
Answers 2, 3, 4, and 5 are correct. 1. Chorionic villus sampling is done to assess for genetic disease in the fetus. 2. Endometrial biopsy is performed about 1 week following ovulation to detect the endometrium's response to progesterone. 3. Hysterosalpingogram is performed after menstruation to detect whether or not the fallopian tubes are patent. 4. Serum progesterone assay is performed about 1 week following ovulation to determine whether or not the woman's corpus luteum produces enough progesterone to sustain a pregnancy. 5. Postcoital tests are performed about 1 to 2 days before ovulation to determine whether healthy sperm are able to survive in the cervical mucus.
The genetic counselor informs a couple that they have a 25% probability of getting pregnant with a child with a severe genetic disease. The couple asks the nurse exactly what that means. Which of the following responses by the nurse is appropriate? 1. Their first child will have the genetic disease. 2. If they have four children, one of the children will have the disease. 3. Their fourth child will have the genetic disease. 4. Any baby they conceive may have the disease.
answer: 4 1. Each pregnancy has its own probability so it is impossible to predict which, if any, child will or will not have the disease. 2. Each pregnancy has its own probability so it is possible for all or none of the children to have the disease. 3. Each pregnancy has its own probability so it is impossible to predict which, if any, child will or will not have the disease. 4. This is true. Every time the woman gets pregnant, there is a possibility (25% chance) that she is carrying a child with the disease.
A female client asks the nurse about treatment for human papilloma viral warts. The nurse's response should include which of the following? 1. An antiviral injection cures approximately 50% 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.
answer: 4 1. There are no injections for treating warts. There are gels and creams that can be applied to the warts. 2. This statement is incorrect. Warts usually spontaneously disappear after a period of time. 3. This statement is incorrect. It is a common practice to remove warts surgically. 4. This statement is true. It is not uncommon for warts to return a few months after an initial treatment.
Four women with significant health histories wish to use the diaphragm as a contraceptive method. Which of the following clients should be counseled 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.
answer: 1 1. Women who use the diaphragm have increased incidence of urinary tract infections. 2. A diaphragm may be used by a woman with a history of herpes simplex infections, but the device will not protect the woman's partner from contracting the virus. 3. A woman with a history of DVT can safely use the diaphragm. 4. A diaphragm may be used by a woman with a history of HPV, but the device will not protect the woman's partner from contracting the virus.
A woman's temperature has just risen 0.4° F and will remain elevated during the remainder of her cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the change? 1. Estrogen. 2. Progesterone. 3. Luteinizing hormone (LH). 4. Follicle-stimulating hormone (FSH).
answer: 2 1. Estrogen begins to elevate before ovulation. It is not responsible for the temperature elevation. 2. Progesterone elevation occurs after ovulation and spikes at about 5 to 6 days after ovulation. Progesterone is thermogenic—that is, heat producing. Progesterone is the reason women's temperatures are elevated following ovulation. 3. LH spikes at the time of ovulation, but does not cause the spike in temperature. 4. FSH promotes the maturation of the ovum.
Five women, aged 35 to 39, wish to use a contraceptive skin patch containing a combination of female hormones (ethinyl estradiol and norelgestromin) for family planning. Which of the women should be carefully counseled regarding the safety considerations of the method? Select all that apply. 1. The client who smokes 1 pack of cigarettes each day. 2. The client with a history of lung cancer. 3. The client with a history of deep vein thrombosis. 4. The client who runs at least 50 miles each week. 5. The client with a history of cholecystitis.
Answers 1 and 3 are correct. 1. Women who smoke should be counseled against using the patch. 2. A history of lung cancer is not a contraindication to the patch. 3. Women who have a history of deep vein thrombosis (DVT) should be counseled against using the patch. 4. Being a runner is not a contraindication to the patch. 5. A history of cholecystitis is not a contraindication to the patch.
The nurse is providing counseling to a group of sexually active single women. Most of the women have expressed a desire to have children in the future but not within the next few years. Which of the following actions should the nurse suggest the women take to protect their fertility for the future? Select all that apply. 1. Use condoms during intercourse. 2. Refrain from smoking cigarettes. 3. Maintain an appropriate weight for height. 4. Exercise in moderation. 5. Refrain from drinking carbonated beverages.
Answers 1, 2, 3, and 4 are correct. 1. Condoms should be worn during sexual contact to prevent infection with a sexually transmitted disease, which can affect the long-term health of the woman's reproductive system. 2. Women who smoke have a higher incidence of infertility than those who do not smoke. 3. Women who are either overweight or underweight have increased incidence of infertility. 4. Body mass index (BMI) is related to the amount of exercise a woman engages in. Those who exercise excessively are more likely to have a very low BMI and those who rarely exercise, to be obese. Since fertility is related to body weight, it is recommended that women exercise in moderation. 5. There is some evidence that caffeine in large quantities may affect fertility, but decaffeinated carbonated beverages have never been cited as affecting one's fertility.
A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients' emotional responses to their infertility. Which of the following responses would the nurse expect to find? Select all that apply. 1. Anger at others who have babies. 2. Feelings of failure because they can't make a baby. 3. Sexual excitement because they want so desperately to conceive a baby. 4. Sadness because of the perceived loss of being a parent. 5. Guilt on the part of one partner because they are not able to give the other a baby.
Answers 1, 2, 4, and 5 are correct. 1. Infertility clients often express anger at others who are able to conceive. 2. Infertility clients often express a feeling of personal failure. 3. Infertility clients often express an aversion to sex because of the many restrictions/schedules/intrusions that are placed on their sexual relationship. 4. Sadness is another common feeling expressed by infertility clients. 5. Guilt is commonly expressed by infertility clients.
A client is being taught how to use the diaphragm as a contraceptive device. Which of the following statements by the client indicates that the teaching was effective? Select all that apply. 1. Petroleum-based lubricants may be used with the device. 2. The device must be refitted if the client 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 6 hours. 5. The diaphragm should be cleaned with a 10% bleach solution after every use.
Answers 2, 3, and 4 are correct. 1. This response indicates that further teaching is needed. Only water-based lubricants should be used with the diaphragm. 2. This is true. If a client's weight either increases or decreases by 10 lb or more, the device must be refitted. 3. This is true. For the diaphragm to fit appropriately, the upper part of the rim must be pushed snugly under the symphysis. 4. This is true. Although the device is a type of barrier, it is ineffective without spermicide and the action of spermicide is only effective for 6 hours. 5. This response indicates that further teaching is needed. The diaphragm should be cleaned with mild soap and water after each use.
A 54-year-old client calls her healthcare practitioner complaining of frequency and burning when she urinates. Which of the following factors that occurred within the preceding 3 days likely contributed to this client's problem? 1. She had intercourse with her partner. 2. She returned from a trip abroad. 3. She stopped taking hormone replacement therapy. 4. She started a weight-lifting exercise program.
answer 1 1. The fact that the client had intercourse in the last 3 days likely led to the symptoms she is reporting, which are symptoms of a urinary tract infection (UTI). 2. Returning from a recent trip abroad is not likely related to the symptoms the client is reporting, which are symptoms of a UTI. 3. Stopping hormone replacement therapy is unlikely related to the symptoms reported by the client. 4. It is unlikely that starting a weight-lifting program is related to the symptoms of a UTI that the client is reporting.
A client at 24 weeks' gestation is found to have bacterial vaginosis. Her primary healthcare provider has ordered metronidazole to treat the problem. Which of the following educational information is important for the nurse to provide to the client at this time? 1. The client must be careful to observe for signs of preterm labor. 2. The client must advise her partner to seek therapy as soon as possible. 3. A common side effect of the medicine is a copious vaginal discharge. 4. A repeat culture should be taken 2 weeks after completing the therapy.
answer: 1 1. Clients with bacterial vaginosis are at high risk for preterm labor. 2. Male partners rarely need treatment. Females may, however, need to be treated. 3. Bacterial vaginosis is characterized by a discharge that is often foul-smelling. The discharge is not related to the therapy. 4. An initial, diagnostic microscopic and culture assessment is done. It is not required that a repeat test be done 2 weeks later.
A woman who is infertile has been diagnosed with endometriosis. She asks the nurse why that diagnosis has made her infertile. Which of the following explanations is appropriate for the nurse to make? 1. "Scarring sometimes surrounds and blocks the ends of the fallopian tubes, preventing your eggs from being fertilized by your partner's sperm." 2. "You are producing insufficient quantities of follicle-stimulating hormone that is needed to mature an egg every month." 3. "Inside your uterus is a benign tumor that makes it impossible for the fertilized egg to implant." 4. "You have a chronic infection of the vaginal tract that makes the secretions hostile to your partner's sperm."
answer: 1 1. Endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity. The tissue may be on the tubes, ovaries, bladder, or colon. Adhesions develop from the monthly bleeding at the site of the misplaced endometrial tissue, causing pain and often resulting in infertility if scarring blocks the fallopian tube. 2. Endometriosis is not characterized by hormonal imbalances. Hormonal imbalances can, however, lead to infertility. 3. A benign tumor of the muscle of the uterus is called a fibroid. It can interfere with pregnancy, but it is not related to endometriosis. 4. Endometriosis is not caused by an infection.
A nurse working in an infertility clinic should include which of the following in her discussions with the couple? 1. Adoption as an alternative to infertility treatments. 2. The legal controversy surrounding intrauterine insemination. 3. The need to seek marriage counseling before undergoing infertility treatments. 4. Statistics regarding the number of couples who never learn why they are infertile.
answer: 1 1. It is important for the couple to be provided with all relevant information. Adoption is a viable alternative to infertility treatments. 2. Although there are moral/ethical issues surrounding intrauterine insemination (IUI), there are no legal controversies. Artificial insemination is a legal procedure. 3. Although it is not without merit, marriage counseling is not mandatory before seeking infertility treatments. 4. This response is not true. Although up to 10% of couples appear to have no physical cause of their infertility, in the majority of cases a cause is found: one-third of cases are related to female problems, one-third of cases are related to male problems, and one-third of cases are a combination of male and female problems.
A couple who has sought fertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occurs? 1. The testes are overheated. 2. The vas deferens is ligated. 3. The prostate gland is enlarged. 4. The flagella are segmented.
answer: 1 1. Spermatogenesis occurs in the testes. High temperatures reduce the development of the sperm. Some experts recommend that the man wear boxers, not briefs, to avoid body heat. 2. When the vas deferens is ligated, a man has had a vasectomy and is sterile. The sterility is not, however, due to impaired spermatogenesis, but rather to the inability of the sperm to migrate to the woman's reproductive tract. 3. The prostate does not affect spermatogenesis. An enlarged or hypertrophied prostate is usually a problem that affects older men. 4. The flagella are the "tails" of the sperm. They are normally divided into a middle and an end segment.
A couple is seeking infertility counseling. The practitioner has identified the factors listed below in the woman's health history. Which of these findings may be contributing to the couple's infertility? 1. The client is 36 years old. 2. The client was 13 years old when she started to menstruate. 3. The client works as a dental hygienist 3 days a week. 4. The client jogs 2 miles every day.
answer: 1 1. The client's age. For reproductive purposes, a woman aged 35+ years is considered to be "an older woman." Her fertility is reduced. If she does become pregnant, hers is considered to be a "geriatric pregnancy." 2. Age 13 at the time of menarche is not a significant factor. 3. Working as a dental hygienist has not been shown to affect fertility. 4. Excessive exercise can interrupt hormonal function, but jogging 2 miles a day is a moderate exercise pattern and is not considered excessive.
The nurse is providing an unmarried, perimenopausal woman with a pregnancy history of G3 P2012, with contraceptive counseling. The client has four sex partners and smokes 1 pack of cigarettes per day. Which of the following methods is best suited for this client? 1. Male condom. 2. Intrauterine device. 3. Etonogestrel/ethinyl estradiol vaginal ring. 4. Oral contraceptives.
answer: 1 1. The male condom is the best device for this client. 2. Because she has multiple sex partners, the IUD is not the best choice for this client. 3. The etonogestrel/ethinyl estradiol vaginal ring is a hormonal device. Because this client is over 35 years old and is a smoker, the etonogestrel/ethinyl estradiol vaginal ring is not the best choice for her. 4. Oral contraceptives are hormonally based. Because this client is over 35 years old and is a smoker, birth control pills are not the best choice for her.
A client is learning about the care and use of the diaphragm. Which of the following 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."
answer: 1 1. The woman should regularly check the diaphragm by looking at it with a good light source. 2. The diaphragm should not be used during menstruation. 3. If the diaphragm is left in place for extended periods of time, the woman is at much higher risk for serious complications, especially toxic shock syndrome. 4. The diaphragm should never be powdered because of the possibility of irritation, infection, or cancer.
The nurse is teaching a class on reproduction. When asked about the development of the ova, the nurse would include which of the following? 1. Meiotic divisions begin during puberty in girls. 2. At the end of meiosis, four ova are created. 3. Each ovum contains the diploid number of chromosomes. 4. Like sperm, ova have the ability to propel themselves.
answer: 1 1. This answer is correct. Meiosis I occurs during puberty. 2. This response is not true. At the completion of oogenesis only one ovum is created. At the completion of spermatogenesis, four sperm are created. 3. This response is not true. Each ovum contains the haploid number of chromosomes—a complete set of unpaired chromosomes, the mother's contribution to the baby's genetics. 4. This response is not true. Sperm have flagella that propel them through the woman's reproductive system. Ova, however, do not have the ability to propel themselves but rather are propelled externally by the cilia in the fallopian tubes.
A client is being issued a new prescription for a low-dose combination birth control pill. What advice should the nurse give the client about next steps if she ever forgets to take a 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.
answer: 1 1. This is correct. To maintain the hormonal levels in the bloodstream, the client should take the pill as soon as she remembers. 2. This is incorrect. If one pill is missed, it should be taken as soon as possible. If two or more pills are missed, an alternate form of contraception should be used for the remainder of the month. 3. Breakthrough bleeding can happen at any time, but it rarely happens when one pill is taken a little late. 4. A pregnancy test is not necessary unless the client is concerned that she may have become pregnant.
A nurse is providing contraceptive counseling to a perimenopausal client with an obstetrical history of G3 P2012, who is in a monogamous relationship. Which of the following comments by the client requires follow-up? 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."
answer: 1 1. This is not true. The menstrual cycle of perimenopausal women is very irregular. It is very difficult to identify safe and unsafe periods for these women. 2. This is true. This client is a multigravida in a monogamous relationship. She is low risk for infections as well as spontaneous expulsion of the device. 3. This is true. Even with very irregular menses the client may still be ovulating. 4. This is true. The patch contains both an estrogen and a progesterone medication.
A genetic counselor's report states, "The genetic nomenclature for this fetus is 46, XX." How should the nurse who reads this report interpret the cytogenetic results? 1. The baby is female with a normal number of chromosomes. 2. The baby is an intersex male with female chromosomes. 3. The baby is male with an undisclosed genetic anomaly. 4. There is insufficient information to answer this question.
answer: 1 1. This response is correct. The normal number of chromosomes is present—46—and the child is a female—XX. 2. This response is incorrect. Intersex individuals exhibit both male and female organs and characteristics. Intersexuality may be caused by a number of things, including an environmental insult or a genetic mutation. 3. This response is incorrect. An example of a male with a genetic defect is 46, XY, 16p13.3. The child is a male—XY—and the defect, as indicated in the nomenclature, is on the p arm of the 16th chromosome at location 13.3. 4. There is sufficient information to answer this question.
A client at 11 weeks' gestation, is being prepared for chorionic villus sampling (CVS). The woman is very anxious that the baby will be injured during the procedure. Which of the following statements would be appropriate for the nurse to make? 1. "It is unlikely that the baby will be injured because before inserting the needle, the doctor will locate the baby and placenta using ultrasound." 2. "I know how you feel. Every time I assist with the procedure I say a little prayer that the baby won't be hurt." 3. "Has your doctor told you about all of the possible complications that can happen during the procedure?" 4. "I understand how you feel, but you know how important it is to find out whether your baby has a genetic disease or not."
answer: 1 1. This statement is correct. It is unlikely that the baby will be injured because, before inserting the needle, the doctor will locate the products of conception using ultrasound. 2. Not only is it inappropriate for the nurse to acknowledge that he or she has fears regarding the procedure, it is inappropriate for the nurse to refer to a religious action as the client may have religious beliefs that differ from those of the nurse. 3. This statement does nothing to help to dispel the fears of the client. 4. This statement is not appropriate. The nurse's assumptions regarding the client's motivation for having a CVS may be completely incorrect.
A woman whose menstrual cycle is 35 days long states that she often has a slight pain on one side of her lower abdomen on day 21 of her cycle. She wonders whether she has ovarian cancer. Which of the following is the nurse's best response? 1. "Women often feel a slight twinge on one side or the other when ovulation occurs." 2. "You should seek medical attention as soon as possible since ovarian cancer is definitely a possibility." 3. "Ovarian cancer is unlikely because the pain is not a constant pain." 4. "It is more likely that such pain indicates an ovarian cyst because pain is more common with that problem."
answer: 1 1. This statement is true, and the discomfort at the location of the ovary where ovulation occurs is called by the German word of "mittelschmerz" which means "middle pain." It is a one-sided pain related to ovulation. Ovulation usually occurs 14 days before the first day of the menses. It generally alternates between the left and right ovaries every month. The location of the pain indicates which ovary has ovulated that month. 2. The history given by the woman is not indicative of ovarian cancer. 3. Ovarian cancer is not always painful, and symptoms would not occur on just one day of the month. 4. The timing of the pain is more significant than the type of pain, but it is not within the nurse's scope of practice to diagnose a condition.
It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long. Which of the following is an appropriate reply by the nurse? 1. "You are probably ovulating." 2. "Your hormone levels should be checked." 3. "You will probably menstruate early." 4. "Your breast changes are a worrisome sign."
answer: 1 1. This statement is true. Breast tenderness and left-or-right-sided pelvic pain, referred to as mittelschmerz, often occur at the time of ovulation. 2. Breast tenderness and mittelschmerz are symptoms of ovulation. They are not related to abnormal hormonal levels. 3. Menstruation occurs approximately 14 days after ovulation. 4. The breast changes are normal and often are felt by women at the time of ovulation.
The nurse is administering medroxyprogesterone acetate to a postpartum client. Which of the following data must the nurse consider before administering the medication? 1. The patch must be replaced at the same time each week. 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.
answer: 2 1. Medroxyprogesterone acetate is administered via intramuscular injection or subcutaneously every 3 months. 2. The client should use sunscreen while receiving medroxyprogesterone acetate for birth control. 3. The medication is contraindicated for use by women who have breast cancer or who are pregnant. It is not contraindicated for use by those suffering from lung or esophageal cancer. 4. After the first injection, it is often recommended that the client use an alternate form of birth control for at least a week, but not for 2 months. The client should know that medroxyprogesterone acetate will not protect her from sexually transmitted infections. TEST-TAKING HINT: Women can develop dark patches on their skin when using medroxyprogesterone acetate. The patches often become darker in women who are in the sun without protection.
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 recommend to this client? 1. Intrauterine device. 2. Female condom. 3. Bilateral tubal ligation. 4. Birth control pills.
answer: 2 1. The intrauterine device is an effective contraceptive device, but it will not protect against sexually transmitted infections. 2. The female condom is recommended both for contraception and for infection control. 3. Bilateral tubal ligation is an effective contraceptive method, but it will not protect against sexually transmitted infections. 4. Birth control pills are effective contraceptive methods, but they will not protect against sexually transmitted infections.
A woman who has had multiple miscarriages is advised to go through genetic testing. The client asks the nurse the rationale for this recommendation. The nurse should base their response on which of the following? 1. The woman's pedigree may exhibit a mitochondrial inheritance pattern. 2. The majority of miscarriages are caused by genetic defects. 3. A woman's chromosomal pattern determines her fertility. 4. There is a genetic marker that detects the presence of an incompetent cervix.
answer: 2 1. The pedigree should be analyzed for any and all abnormal inheritance patterns. 2. This is true. The incidence of miscarriage is very high—about one out of every five pregnancies—and the majority of miscarriages are related to a genetic defect. 3. A woman's fertility is determined by many factors. 4. This statement is not true. There is no genetic marker for incompetent cervix.
A client's amniocentesis results were reported as 46, XY. Her obstetrician informed her at the time that everything "looks good." Shortly after birth the baby is diagnosed with cerebral palsy. Which of the following responses will explain this result? 1. It is likely that the client received the wrong amniocentesis results. 2. Cerebral palsy is not a genetic disease. 3. The genes that cause cerebral palsy have not yet been discovered. 4. The genes were never tested for cerebral palsy.
answer: 2 1. This information is unsupported by the scenario. Cerebral palsy is not a genetic defect and is not detected through amniocentesis. 2. Cerebral palsy is not a genetic disease. It is caused by a hypoxic injury that can occur at any time during pregnancy, labor and delivery, or the postdelivery period. 3. Cerebral palsy is not a genetic disease. It is caused by a hypoxic injury that can occur at any time during pregnancy, labor and delivery, or the postdelivery period. 4. Cerebral palsy is not a genetic disease. It is caused by a hypoxic injury that can occur at any time during pregnancy, labor and delivery, or the postdelivery period.
After a sex education class, the school nurse overhears an adolescent discussing safe sex practices. Which of the following comments by the young person 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 at highest risk for sexually transmitted infections (STIs)." 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."
answer: 2 1. This is a fallacy. Both men and women can become infected from oral sex. 2. This is true. The mucous membranes of females and of the teenagers are more permeable to STIs than the mucous membranes of adults and males. 3. The best thing a sexually active man or woman can do is to use a condom—male or female—during intercourse. The only way to stay absolutely disease-free is to practice celibacy. 4. This is a fallacy. Females are more susceptible to disease than are males.
The nurse has taught a couple about the temperature rhythm method for birth control. Which of the following behaviors would indicate that the teaching was effective? 1. The client 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 client assesses her vaginal discharge daily for changes in color and odor.
answer: 2 1. This is not appropriate. The basal body temperature (BBT) should be taken upon awakening in the morning. 2. This is correct. The couple should chart temperatures for at least 6 months. 3. This is not appropriate. The couple should wait to engage in intercourse until the client's temperature has been elevated above preovulation baseline for at least 3 days. 4. An additional action that can be taken as a complement to the temperature rhythm method is cervical mucus assessment, but it is not required. The elasticity of the mucus should be assessed, not the color or odor of the mucus.
A nurse is educating a client who has been diagnosed with infertility on how to complete a basal body temperature chart to determine her ovulation pattern. The client states, "I really don't want to take my temperature every day. Is there any other way to find out if and when I ovulate?" 1. "There are a number of other ways to determine ovulation, but they all require you to be examined by an obstetrician every month." 2. "A test you can do at home requires you to spit on a microscopic slide and then look at the slide under a microscope." 3. "You can test your vaginal discharge each day to determine when you should have intercourse because the hormone progesterone is elevated." 4. "Although there are some tests that you can perform at home, they all cost well over a hundred dollars to purchase."
answer: 2 1. This response is incorrect. There are a number of ovulation predictor tests that women can use at home to determine when they are ovulating. 2. This statement is correct. One of the at-home ovulation predictor kits requires women to place saliva on a microscopic slide and, after allowing the saliva to dry, to look at the slide under a microscope. If ovulation is occurring, the saliva appears ferned, that is, the image on the slide looks like the leaflets of a fern, indicating the presence of high levels of estrogen in the woman's body. 3. Although the vaginal discharge does change during women's menstrual cycles, there are no ovulation detection tests that require women to test their vaginal discharge. 4. Some of the ovulation detection kits are very expensive, while others require a minimal expense. The women may have to test their saliva and urine repeatedly over the course of many days or months, however, requiring them to purchase multiple test kits.
Which instruction by the nurse should be included in the teaching plan for an infertile woman who has been shown to have a 28-day biphasic menstrual cycle? 1. Douche with a cider vinegar solution immediately before having intercourse. 2. Schedule intercourse every day from day 8 to day 14 of the menstrual cycle. 3. Be placed on follicle-stimulating hormone therapy by the fertility specialist. 4. Assess the basal body temperature pattern for at least 6 more months.
answer: 2 1. Unless medically indicated, douching should never be performed. A vinegar solution is especially inappropriate since sperm are unable to survive in an acidic environment. 2. This action is recommended. Pregnancy is most likely to occur with daily intercourse from 6 days before ovulation up to the day of ovulation. 3. If a client is experiencing a biphasic cycle, FSH therapy is probably not indicated. 4. The BBT chart does not need to be monitored for 6 more months, although it can be used to help time intercourse.
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 before the man's penis becomes flaccid 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.
answer: 3 1. Douching is not only ineffective as a contraceptive method, it can also adversely change the pH in the vagina, contributing to the risk of infection. 2. A post-coital contraceptive is not necessary if the man carefully removes the condom. 3. This is true. The man should carefully remove the condom while holding its edges. 4. Applying spermicide to the upper edges of the condom is not appropriate. While attempting to apply the spermicide, sperm could easily spill from the condom.
A client who is undergoing ovarian stimulation for infertility calls the infertility nurse and states, "My abdomen feels very bloated, my clothes are very tight, and my urine is very dark." Which of the following is the appropriate statement for the nurse to make at this time? 1. "Please take a urine sample to the lab so they can check it for an infection." 2. "Those changes indicate that you are likely already pregnant." 3. "It is important for you to come into the office to be examined today." 4. "Abdominal bloating is an expected response to the medications."
answer: 3 1. It is unlikely that this woman has a urinary tract infection. 2. It is unlikely that the client is already pregnant. 3. This client should be seen by her infertility doctor. 4. Abdominal bloating is a sign of ovarian hyperstimulation. TEST-TAKING HINT: This client is exhibiting signs of ovarian hyperstimulation. This is a serious complication. The client is likely third spacing her fluids (the fluids in her body are shifting into her interstitial spaces), resulting in abdominal distention, oliguria, and concentrated urine. The client should be evaluated by her physician.
A couple has been told that the male partner, who is healthy, is infertile "because he has cystic fibrosis." Which of the following explanations is accurate in relation to this statement? 1. Since the man is healthy, he could not possibly have cystic fibrosis. 2. Men with cystic fibrosis often have no epididymis. 3. Being infertile is not the same thing as being sterile. 4. Cystic fibrosis is a respiratory illness having nothing to do with reproduction.
answer: 3 1. The man may have both recessive genes for cystic fibrosis even though he is not ill. 2. This answer is incorrect. Some men with cystic fibrosis, however, have no vas deferens. 3. This statement is correct. Not all men with cystic fibrosis are sterile, meaning they produce no sperm. Cystic fibrosis experts report that 90% of men with cystic fibrosis produce normal amounts of sperm (Henderson, 2017). Although the sperm may be unable to mix with the semen because of the absence of the vas deferens, fertilization is possible with assistive reproduction technology (ART) such as IVF. 4. This statement is incorrect. Some men with cystic fibrosis have no vas deferens and, even if the vas is present, if the man is producing large amounts of thick mucus, the vas may become obstructed. Similarly, in women, the fallopian tubes may become obstructed with thick mucus
A woman asks a nurse about pre-symptomatic genetic testing for Huntington disease. The nurse should base her response on which of the following? 1. There is no genetic marker for Huntington disease. 2. Pre-symptomatic testing cannot predict whether or not the gene will be expressed. 3. If the woman is positive for the gene for Huntington, she will develop the disease later in life. 4. If the woman is negative for the gene, her children should be tested to see whether or not they are carriers.
answer: 3 1. There is a genetic marker for Huntington's disease. 2. In the case of Huntington's disease, if a person has the gene and lives long enough, there is virtually a 100% probability he or she will develop the disease. The gene has a high degree of expressivity or, in other words, people who carry the gene will develop the disease. 3. This answer is correct, if a person has the gene and lives long enough, virtually 100% of the time the disease will develop and progress. 4. There is no carrier state when a disease is transmitted via a dominant inheritance pattern as Huntington's disease is.
The public health nurse calls a client and states, "I am afraid that I have some disturbing 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 client 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. People 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."
answer: 3 1. This is not appropriate. The nurse should not assume knowledge of how the client feels. 2. This is not appropriate. The nurse must pursue the discussion since women often have no symptoms when infected with gonorrhea. 3. This is true. Women often have no symptoms when infected with gonorrhea. 4. This is not appropriate. The client has not been diagnosed with gonorrhea.
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 spermicide can increase the transmission of some viruses." 4. "That is not necessarily true. Spermicide has been shown to cause cancer in men and women who use it too frequently."
answer: 3 1. This statement is false. Spermicidal creams have been shown actually to increase the transmission of some sexually transmitted infections. 2. This statement is false. Spermicidal creams have been shown actually to increase the transmission of some sexually transmitted infections. 3. This statement is true. Spermicidal creams have been shown to actually increase the transmission of some sexually transmitted infections. 4. This statement is false. Spermicidal creams have not been shown to be cancer-causing agents.
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 liver infection that is contracted not only by sexual contact but also by contact with contaminated blood. An infected family member or caregiver can unknowingly pass the virus to your baby." 4. "Most parents want to protect their children from as many serious diseases as possible. Hepatitis B is one of those diseases."
answer: 3 1. This statement is inappropriate. The hepatitis B vaccine is not administered to prevent all babies from contracting hepatitis B vertically. The majority of babies receive the vaccine to prevent them from contracting the virus in the future. If a pregnant client is hepatitis B positive, her baby would also receive the hepatitis B immune globulin (HBIG), in addition to the vaccine, within 12 hours of delivery. This protocol minimizes the incidence of vertical transmission. 2. This statement is inappropriate. Vaccines are not administered simply because they are available. 3. This is the best answer. Hepatitis B is a very serious disease that can be transmitted sexually or via contact with blood and blood products. 4. This response implies that the mother in the scenario is not interested in protecting her child. That is very unlikely.
An adolescent client confides to the school nurse that she is sexually active. The client asks the nurse to recommend a "very reliable" birth control method, but she refuses to be seen by a physician or nurse practitioner. 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.
answer: 3 1. To obtain the contraceptive patch, the client must obtain a prescription for the device from a healthcare practitioner. 2. The withdrawal method (coitus interruptus) is an unreliable method, especially for teenage males. 3. The female condom is about 95% effective as a contraceptive device and is also effective as an infection-control device. 4. Although no prescription is needed to use the contraceptive sponge, it is only about 80% effective. In addition, since the contraceptive sponge uses a spermicide as its means of contraception and infection control, its use may actually be dangerous.
A nonpregnant young woman has been diagnosed with bacterial vaginosis (BV). The nurse questions the woman regarding her sexual history, including her frequency of intercourse, how many sexual partners she has, and her use of contraceptives. 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 to know for which organisms and antibiotic sensitivities it should test.
answer: 3 1. Unless the partner is female, the transmission to partners is low. 2. There is no law that requires the nurse to ask these questions. 3. This statement is true. The change in normal flora increases the client's susceptibility to other organisms. 4. There is no need to provide the laboratory with this information.
A couple inquire about the inheritance of Huntington disease (HD) because the prospective father's mother is dying of the illness. There is no history of the disease in his partner's family. The man has never been tested for HD. Which of the following responses by the nurse is appropriate? 1. "Because HD is an autosomal dominant disease, each and every one of your children will have a 1 in 4 chance of having the disease." 2. "Because only one of you has a family history of HD, the probability of any of your children having the disease is less than 10%." 3. "Because HD is such a devastating disease, if there is any chance of passing the gene along, it would be advisable for you to adopt." 4. "Because neither of you has been tested for HD, the most information I can give you is that each and every one of your children may have the disease."
answer: 4 1. If the prospective father possesses the gene, the probability of their children inheriting the gene is 1 in 2, or 50%. As the man has not been tested, it is impossible to determine the probabilities. 2. This statement is completely false. 3. It is improper for the nurse to recommend that the clients not have children. It is the couple's choice whether or not to get pregnant. It is the nurse's responsibility to give information that is as accurate as possible. 4. This statement is correct. No specific information can be given until or unless the potential father decides to be tested.
A postpartum client has decided to use 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.
answer: 4 1. Medroxyprogesterone acetate is either administered via intramuscular or subcutaneous injection every 3 months. 2. Medroxyprogesterone acetate is a progesterone-based contraceptive. It is safe for use and should not adversely affect the ability to breastfeed. 3. Both amenorrhea and menorrhagia are side effects of the medication. The client should be advised to notify her healthcare practitioner regarding any significant menstrual pattern changes. 4. Many women who use medroxyprogesterone acetate for over 2 years have been found to suffer from loss of bone density. Some of the changes in bone density may be irreversible.
A client is to have a hysterosalpingogram. Which of the following information should the nurse provide to the client prior to the procedure? 1. "The test will be performed through a small incision next to your belly button." 2. "You will be on bedrest for a full day following the procedure." 3. "An antibiotic fluid will be instilled through a tube in your cervix." 4. "You will be asked to move from side to side so that x-ray pictures can be taken."
answer: 4 1. No incision is created when clients have hysterosalpingograms. 2. The client will be able to ambulate normally after the procedure. 3. A dye is instilled into the uterine cavity. Some doctors do prescribe oral antibiotics following the procedure to prevent infection. 4. This statement is correct. A number of pictures will be taken throughout the procedure. The client, who will be awake, is asked to move into positions for the x-rays.
A 35-year-old client is being seen for her yearly gynecological examination. She states that she and her partner have been trying to become pregnant for a little over 6 months and that a friend had recently advised her partner to take ginseng to improve the potency of his sperm. The woman states that they have decided to take their friend's advice. On which of the following information should the nurse base their reply? 1. Based on their history, the client and her partner have made the appropriate decision regarding their fertility. 2. Ginseng can cause permanent chromosomal mutations and should be stopped immediately. 3. It is unnecessary to become concerned about this woman's fertility because she has tried to become pregnant for only a few months. 4. Although ginseng may be helpful, it would be prudent to encourage the woman to seek fertility counseling.
answer: 4 1. On the Web, there are sites that promote the intake of ginseng as a therapy for both male and female infertility, although there is no strong evidence to show that either is true. In addition, there is nothing in the question to suggest that the infertility problem is caused by the poor quality of the man's sperm. 2. There is no evidence that ginseng causes mutations; rather, there is some evidence to show that it is antimutagenic. 3. There is cause for concern for this woman because she is 35 years old and has been unable to get pregnant for more than 6 months. 4. Because fertility drops as a woman ages, it is advisable to encourage the couple to use conventional therapies in conjunction with the complementary therapy to maximize their potential of becoming pregnant.
A client is to undergo a postcoital test for infertility. The nurse should include which of the following statements in the client's pre-procedure counseling? 1. "You will have the test the day after your menstruation ends." 2. "You will have a dye put into your vein that will show up on x-ray." 3. "You should refrain from having intercourse for the four days immediately before the test." 4. "You should experience the same sensations you feel when your doctor does your Pap test."
answer: 4 1. The postcoital test is done 1 or 2 days prior to ovulation. 2. No dye is administered and there are no x-ray pictures taken during a postcoital test. 3. The test is performed a few hours after a couple has intercourse. 4. The client will undergo a speculum examination when cervical mucus will be harvested. TEST-TAKING HINT: The postcoital test is a simple assessment done to see whether the sperm are able to navigate the woman's cervical mucus to ascend into the uterus and fallopian tubes. A few hours postcoitus, in the days immediately prior to ovulation, the practitioner harvests cervical mucus to assess whether the sperm are still motile and to assess the ferning patterns of the mucus.
A nurse teaches a woman who wishes to become pregnant that if she assesses for spinnbarkeit she will be able to closely predict her time of ovulation. Which technique should the client be taught to assess for spinnbarkeit? 1. Take her temperature each morning before rising. 2. Carefully feel her breasts for glandular development. 3. Monitor her nipples for signs of tingling and sensitivity. 4. Assess her vaginal discharge for elasticity and slipperiness.
answer: 4 1. The temperature does elevate after ovulation, but the elevation is not defined as spinnbarkeit. 2. The breasts do become sensitive and some women do palpate tender nodules in the breasts at the time of ovulation, but those changes are not spinnbarkeit. 3. The nipples may tingle and become sensitive, but the sensations are not indicative of spinnbarkeit. 4. Spinnbarkeit is defined as the "thread" that is created when the vaginal discharge is slippery and elastic like raw egg white, at the time of ovulation. Sperm can penetrate it on their way to fertilize the egg. The changes are in response to high estrogen levels. The woman inserts her index and middle fingers into her vagina and touches her cervix. After removing her fingers, she separates her fingers and "spins a thread" between her fingers. When she is not in her fertile period, the mucus is thick and gluey.
A client is hospitalized in the acute phase of severe ovarian hyperstimulation syndrome. The nurse notes the client has fluid retention and 3 + pitting edema. Which of the following nursing goals is highest priority? 1. Client's weight will be within normal limits by date of discharge. 2. Client's skin will show no evidence of breakdown throughout hospitalization. 3. Client's electrolyte levels will be within normal limits within one day. 4. Client's lung fields will remain clear throughout hospitalization.
answer: 4 1. This is an important goal, but it is not the priority nursing goal. 2. This is an important goal, but it is not the priority nursing goal. 3. This is an important goal, but it is not the priority nursing goal. 4. This is the priority nursing goal related to ovarian hyperstimulation syndrome. TEST-TAKING HINT: A client who is suffering from ovarian hyperstimulation syndrome experiences intravascular hypovolemia and a related extravascular hypervolemia. Although the exact cause of the shift in fluids is unknown, the client may experience very serious complications, including pulmonary edema and ascites
A woman is pregnant. During amniocentesis it is discovered that her child has Down's syndrome with a mosaic chromosomal configuration. She asks the nurse what that means. What is the nurse's best response? 1. "Instead of two number 21 chromosomes, your child has three." 2. "Your baby's number 21 chromosomes have black and white bands on them." 3. "Some of your baby's number 21 chromosomes are longer than others." 4. "Some of your baby's cells have two number 21 chromosomes and some have three."
answer: 4 1. This is the definition of Down's syndrome but not of Down's syndrome with mosaic chromosomal configuration. 2. All chromosomes are banded. 3. The number 21 chromosomes are of normal length in Down's syndrome. 4. Mosaicism is characterized by the fact that some of the cells of the body have the abnormal number of chromosomes but some of the cells have the normal number. This may happen with rapid disjunction. In Down's syndrome, it means that some of the cells have three number 21 chromosomes and some have the normal number of two number 21 chromosomes. Mosaicism is not specific to Down's syndrome but can occur with other chromosomal abnormalities.
A woman asks the nurse, "My nuchal fold scan results were abnormal. What does that mean?" Which of the following comments is appropriate for the nurse to make at this time? 1. "I am sorry to tell you that your baby will be born with a serious deformity." 2. "The results show that your child will have cri du chat syndrome." 3. "The test is done to see if you are at high risk for preterm labor." 4. "An abnormal test indicates that your baby may have a chromosomal disorder."
answer: 4 1. This response is inappropriate. The nuchal fold scan is done either late in the first trimester or with the second trimester quad screen. A fetal genetic evaluation must be done before a definitive diagnosis can be made. A genetic analysis is the only absolute diagnostic tool. 2. Cri du chat syndrome is caused by a deletion on chromosome 5. Among other complications, children with cri du chat suffer from severe intellectual disability. 3. The first trimester assessment screens for Down's syndrome and other trisomy chromosomal syndromes. It does not screen for preterm labor risk. 4. This statement is true, but the definitive diagnosis can be made only via genetic testing.
A client has been notified that because of fallopian tube obstruction, her best option for becoming pregnant is through in-vitro fertilization. The client asks the nurse about the procedure. Which of the following responses is correct? 1. "During the stimulation phase of the procedure, the physician will make sure that only one egg reaches maturation." 2. "Preimplantation genetic diagnosis will be performed on your partner's sperm before they are mixed with your eggs." 3. "After ovarian stimulation, intrauterine insemination (IUI) will be performed with your partner's sperm." 4. "Any extra embryos will be preserved for you if you wish to conceive again in the future."
answer: 4 1. This response is not true. Physicians usually want a number of eggs to reach maturation. 2. Preimplantation genetic assessment, when done, is performed on the fertilized ova, not on the sperm or unfertilized ova. 3. Intrauterine insemination (IUI) will not be performed because the client's tubes are blocked. Although her ovaries will be stimulated, IUI will not be performed because the ova will be blocked from the uterus. Insemination will be performed in a petri dish. 4. This response is correct. Since multiple embryos are usually created during the in-vitro process, there are often more embryos created than are implanted. The couple may preserve the embryos.
In analyzing the need for teaching regarding sexual health in a client who is sexually active, which of the following questions is the most important for a nurse to ask? 1. "How old are your children?" 2. "Did you have intercourse last evening?" 3. "With whom do you have intercourse?" 4. "Do you use vaginal lubricant?"
answer:3 1. The ages of a client's children may be important, but it is not the most important information for the nurse to request. 2. Whether or not the client had intercourse the preceding night is important, but it is not the most important information for the nurse to solicit. 3. This question is the most important for the nurse to ask. The nurse is trying to learn whether or not the client is having intercourse with more than one partner and/or whether the client has intercourse with men or women or both. 4. Whether or not the client uses vaginal lubricant is important, but it is not the most important information for the nurse to ask about.
A couple is seeking advice regarding actions that they can take to increase their potential success in becoming pregnant. Which of the following recommendations should the nurse give to the couple? 1. The couple should use vaginal lubricants during intercourse. 2. The couple should delay having intercourse until the day of ovulation. 3. The woman should refrain from douching. 4. The man should be on top during intercourse.
answer:3 1. Use of vaginal lubricants is not recommended. Vaginal lubricants may alter the pH of the reproductive system, adversely affecting the couple's potential of becoming pregnant. 2. Delaying intercourse until the day of ovulation is a poor recommendation. The sperm live for about 3 days. If the couple has daily intercourse beginning 5 or 6 days before ovulation (the "fertile window") and continuing until the day of ovulation, they will maximize their potential of becoming pregnant. 3. The woman should refrain from douching. Douching can change the normal flora and the pH in the vagina, making the environment hostile to the sperm. 4. The position of the couple during intercourse will not affect the potential fertility of the woman.
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 now I 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 for the remainder of the month." 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."
answer: 3 1. This is inappropriate. This client should be seen by her healthcare practitioner. 2. This is inappropriate. This client should be seen by her healthcare practitioner. 3. This is an appropriate statement. This client should be seen by her healthcare practitioner. 4. This is inappropriate. This client should be seen by her healthcare practitioner.
An asymptomatic woman is being treated for HIV infection at the women's health clinic. Which of the following comments by the client 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 engage only in oral sex."
answer: 3 1. This is not true. When clients with HIV receive therapy during pregnancy and throughout labor and delivery and their babies receive oral therapy after delivery, the transmission rate of HIV is almost zero. 2. The viral load and CD4 counts should be monitored regularly, but they do not need to be assessed daily. 3. This is true. She and her partner should use condoms during sexual intercourse. 4. Even though the transmission of HIV via oral sex is likely much lower than it is from genital or rectal intercourse, it is still a dangerous practice.
Involves placement at the embryo stage. the patient must have at least one patent fallopian tube. Exogenous progesterone is used to enhance endometrial preparation.
FET: frozen embryo transfer
Involves retrieval of the oocytes from the ovaries usually via an intra-abdominal approach or a transvaginal approach under US guidance. The oocytes are then combined with partner/donor sperm in the lab. After fertilization, the normally developing embryos are placed in the uterus.
IVF
Involves the removal of a sample of the endometrium with a small pipette attached to suction. Provides information about the effects of progesterone (produced by the corpus luteum after ovulation) on the endometrium.
endometrial biopsy
A client has been notified that endometriosis is covering her fimbriae. She asks the nurse why that is such a problem. The nurse advises the woman that fertilization is often impossible when the fimbriated ends are blocked. Where does fertilization take place?
the outer third of the fallopian tube: ampulla
A nurse is explaining to a client about monthly hormonal changes. Starting with day 1 of the menstrual cycle, please place the following four hormones in the chronological order in which they rise during the menstrual cycle. 1. Follicle-stimulating hormone (FSH). 2. Gonadotropin-releasing hormone (GnRH). 3. Luteinizing hormone (LH). 4. Progesterone.
2, 1, 3, 4. Gonadotropin-releasing hormone stimulates the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH rises first and LH follows. After ovulation, progesterone rises.
A nurse is teaching an infertile couple about how the sperm travel through the man's body during ejaculation. Please put the following five major structures in order, beginning with the place where spermatogenesis occurs and continuing through the path that the sperm and semen travel until ejaculation. 1. Epididymis. 2. Prostate. 3. Testes. 4. Urethra. 5. Vas deferens.
3, 1, 5, 2, 4. The sperm are produced in the testes (3). They then proceed to the epididymis (1) where they mature. The vas deferens (5) is the conduit through which the sperm first travel during ejaculation. The prostate (2), encircling the neck of the urethra, produces a fluid that protects the sperm, and, finally, the sperm exit the male body via the urethra (4).
As a preceptor, you are observing a newly employed nurse answering questions from a pregnant client who is considering a bilateral tubal ligation in the hospital after the birth of her baby. Which of the following instructions by the nurse requires follow-up? Select all that apply. 1. The surgical procedure is easily reversible. 2. Menstruation usually ceases after the procedure. 3. Libido should remain the same after the procedure. 4. The incision will be made endocervically. 5. The procedure cannot be done at the time of a cesarean section.
Answers 1, 2, 4, and 5 require follow-up with both the client and the nurse. 1. This is not true. The surgical procedure is not easily reversible. It should be considered permanent sterilization. 2. This is not true. Menstruation will not cease. 3. The client's libido should remain unchanged. 4. This is not true. The procedure is performed at the umbilicus through an incision approximately 1 inch wide. It is not done through the cervix. 5. This is not true. The procedure can easily be done at the same time as a cesarean section after the baby's birth.
Chromosome syndrome: intellectual disabilities Head: microcephalic, small jaw and mouth, low set ears Cardiac anomalies Extremities: clenched fists with overlapping fingers; syndactyly (webbing of the fingers)
Trisomy 18: Edwards Syndrome
chromosome disorder: mild-moderate disability Head: sloping forehead, low set ears with small canals, protruding tongue Extremities: broad hands and short fingers with single palmar crease Cardiac: valve disease
Trisomy 21: Down Syndrome
chromosome syndrome: Webbed neck ovarian malfunction, underdeveloped reproductive organs, infertile Cortication of the aorta Short stature
Turner syndrome (Female: one normal X chromosome and the other X is altered or missing)
A client has been diagnosed with syphilis. Which of the following nursing interventions is appropriate? 1. Counsel the client about how to live with a chronic infection. 2. Inquire about symptoms of other sexually transmitted infections. 3. Assist the primary healthcare practitioner with cryotherapy procedures. 4. Educate the client regarding the safe disposal of menstrual pads.
answer: 2 1. Syphilis is treatable. The treatment of choice is penicillin. 2. Any time someone is infected with one sexually transmitted infection (STI), it is recommended that he or she be assessed for other STIs. 3. Cryotherapy is not performed on clients with syphilis. 4. This is unrelated.
A woman is menstruating. If hormonal studies were to be done at this time, which of the following hormonal levels would the nurse expect to see? 1. Both estrogen and progesterone are high. 2. Estrogen is high and progesterone is low. 3. Estrogen is low and progesterone is high. 4. Both estrogen and progesterone are low.
answer: 4 1. When the ovum is not fertilized, both estrogen and progesterone levels drop. The drop in hormones is followed by menstruation. 2. Estrogen rises before ovulation, not before menstruation. 3. Estrogen is low and progesterone is high after ovulation, when progesterone (being "pro gestation") prepares the uterine lining for possible implantation of a fertilized egg. Both progesterone and estrogen are low during menstruation. 4. When the ovum is not fertilized, both estrogen and progesterone levels drop. The hormonal drop is followed by menstruation.
Chromosome syndrome: Gynecomastia Underdeveloped reproductive organs, small firm testes, infertile Extremities: abnormally long legs Skin: minimal body and facial hair
Klinefelter syndrome (Males 47 XXY)
A client complaining of secondary amenorrhea is seeking care from her gynecologist. Which of the following may have contributed to her problem? 1. Athletic activities. 2. Vaccination history. 3. Pet ownership. 4. History of asthma.
answer:1 1. If the young woman exercises excessively—for example, as a competitive gymnast or runner—her body fat index could become so low that she becomes amenorrheic. 2. Vaccination history has not been shown to be related to secondary amenorrhea. 3. Pet ownership has not been shown to be related to secondary amenorrhea. 4. History of asthma has not been shown to be related to secondary amenorrhea.
The nurse is selecting educational materials for clients seeking contraception information. Which of the following issues about each client must the nurse consider before suggesting contraceptive choices? Select all that apply. 1. Age. 2. Ethical and moral beliefs. 3. Sexual patterns. 4. Socioeconomic status. 5. Childbearing plans.
All choices—1, 2, 3, 4, and 5—are correct. 1. The client's age should be considered. 2. The client's ethical and moral beliefs should be considered. 3. The client's sexual patterns should be considered. 4. The client's socioeconomic status should be considered. 5. The client's childbearing plans should be considered.
A client has been diagnosed with pelvic inflammatory disease (PID). Which of the following organisms are the most likely causative agents? Select all that apply. 1. Gardnerella vaginalis. 2. Candida albicans. 3. Chlamydia trachomatis. 4. Neisseria gonorrhoeae. 5. Treponema pallidum.
Answers 3 and 4 are correct. 1. Gardnerella vaginalis does not cause PID. 2. Candida albicans does not cause PID. 3. Chlamydia trachomatis is a common cause of PID. 4. Neisseria gonorrhoeae is a common cause of PID. 5. Treponema pallidum does not cause PID.
Chromosome syndrome: Severe intellectual disability, spinal cord abnormalities Head: very small or undeveloped eyes, cleft lip/palate Extremities: extra fingers or toes, weak muscle tone
Tirsomy 13: Patau Syndrome
The nurse is educating a group of adolescent clients regarding bacterial sexually transmitted infections (STIs). The nurse knows that learning was achieved when a group member states that they can expect the following, if they contract a sexually transmitted infection. 1. Menstrual cramping. 2. Heavy menstrual periods. 3. Flu-like symptoms. 4. Lack of signs or symptoms.
Answer: 4 1. Menstrual cramping is not usually related to sexually transmitted infections. 2. Heavy menstrual periods are not usually related to sexually transmitted infections. 3. Flu-like symptoms are not usually related to sexually transmitted infections. 4. Most commonly, women experience no signs or symptoms when they have contracted a sexually transmitted infection.
Nurses employed in a midwifery office are attending a conference to learn about factors that increase a woman's risk of becoming infertile. To evaluate the nurses' learning, the conference coordinator tests the nurses' knowledge at the conclusion of the seminar. The nurses should know that which of the following problems increase/s a client's risk of developing infertility problems? Select all that apply. 1. Women who have menstrual cycles that are up to 30 days long. 2. Women who experience pain during intercourse. 3. Women who have had pelvic inflammatory disease. 4. Women who have excess facial hair. 5. Women who have menstrual periods that are over 5 days long.
Answers 2, 3, and 4 are correct. 1. A 30-day menstrual cycle is well within normal limits. 2. Dyspareunia, or pain during intercourse, may be a symptom of a sexually transmitted infection (STI) or of endometriosis. Both STIs and endometriosis can adversely affect a woman's fertility. 3. A woman who has had pelvic inflammatory disease (PID) is much more likely to have blocked fallopian tubes than a woman who has never had PID. 4. Women who have facial hair (hirsutism) often have polycystic ovarian syndrome (PCOS). PCOS clients frequently have irregular menses, elevated serum cholesterol, and insulin resistance. Women with PCOS are often infertile. 5. A 5-day menstrual period is well within normal limits.
Involves laparoscopy and ovulation induction. The patient must have at least one patent fallopian tube. 3-5 oocytes are harvested from the ovary and immediately placed into a catheter along with washed, motile donor or partner sperm. The sperm and oocytes are injected into the fimbriated ends of the fallopian tube through a laparascope. Fertilization takes place in the fallopian tube.
GIFT: gamete intrafallopian transfer
procedure that evolved from the GIFT procedure. Following ovulation induction, retrieved oocytes are fertilized outside the body and the subsequent zygotes are placed in the distal fallopian tube
ZIFT: zygote intrafallopian transfer
