OB Test 3- Set 4
3) The nurse warns that the effectiveness of oral contraceptives is decreased in women who are taking: a. Antihistamines for seasonal allergies. b. Iron preparations for treatment of anemia. c. Appetite suppressants for weight reduction. d. Anticonvulsants for treatment of epilepsy.
ANS: D Anticonvulsants decrease the effectiveness of oral contraceptives.
39) A patient is using Depo-Provera as her method of birth control. Which clinical finding warrants immediate intervention by the nurse
a. Mid-cycle bleeding
17) What drug is recommended for congenital & late Syphilis
a. Penicillin- G
2) The nurse recognizes symptoms of cold stress in a preterm infant as: a) tremors and weak cry. b) plasma glucose level <40 mg/dL. c) warm skin with low core temperature. d) increased respiratory rate and periods of apnea.
ANS: D Signs of cold stress include increased respiratory rate with periods of apnea, decreased skin temperature, bradycardia, mottling of skin, and lethargy.
16) What is the drug of choice for Gonorrhea
a. Rocephin (ceftriaxone sodium)
1) The nurse instructs the woman taking oral contraceptives to report which possible side effect(s) Select all that apply. a. Abdominal pain b. Weight gain c. Headache d. Eye or visual problems e. Speech disturbances
ANS: A, C, D, E The memory aid ACHES is helpful: Abdominal pain, Chest pain, Headaches, Eye problems, Speech disturbances. Weight gain is an expected side effect of oral contraceptives.
13) During her gynecologic checkup, a 17-year-old girl states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse would document this complaint as: a. Amenorrhea. b. Dysmenorrhea. c. Dyspareunia. d. Premenstrual syndrome (PMS).
Anser B Dysmenorrhea
15) Which STD can be cured a. Chlamydia b. Gonorrhea
Anser bOTH
6) Which precaution should the nurse take while caring for a client who is undergoing internal radiation therapy for cervical cancer a. Wear gloves when assessing the cervical intracavity implant. b. Instruct the client to urinate in the lead-lined bedpan or "hat" every 2 hours. c. Prepare the client for an enema before inserting the implant. d. Limit staff or visitor exposure to 30 minutes or less in an 8-hour period.
Anser is D
63) While interviewing a 31-year-old woman before her routine gynecologic examination, the nurse collects data about the client's recent menstrual cycles. The nurse should collect additional information with which statement a. The woman says her menstrual flow lasts 5 to 6 days. b. She describes her flow as very heavy. c. She reports that she has had a small amount of spotting midway between her periods for the past 2 months. d. She says the length of her menstrual cycle varies from 26 to 29 days.
Answer B
13) During her gynecologic checkup, a 17-year-old girl states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse would document this complaint as: a. Amenorrhea. b. Dysmenorrhea. c. Dyspareunia. d. Premenstrual syndrome (PMS).
Answer B dysmenorrhea
59) What will the nurse advise when a woman asks what she can do to reduce the discomfort of hot flashes a. "Aerobic exercise helps control hot flashes." b. "Increase the amount of calcium and vitamin D in your diet." c. "Dress in layers of cotton clothing." d. "Drink plenty of fluids, particularly caffeinated beverages."
Answer C
6) Which precaution should the nurse take while caring for a client who is undergoing internal radiation therapy for cervical cancer a. Wear gloves when assessing the cervical intracavity implant. b. Instruct the client to urinate in the lead-lined bedpan or "hat" every 2 hours. c. Prepare the client for an enema before inserting the implant. d. Limit staff or visitor exposure to 30 minutes or less in an 8-hour period.
Answer D
complains of pruritus. Based on these findings, the nurse suspects that this woman has which of the following conditions a. Trichomoniasis b. Gonorrhea c. Candidiasis d. Bacterial vaginosis
Answer D Bacterial vaginosis
44) An essential component of counseling women regarding safe sex practices includes discussion regarding avoiding the exchange of body fluids. The physical barrier promoted for the prevention of sexually transmitted infections and human immunodeficiency virus is the condom. Nurses can help motivate patients to use condoms by initiating a discussion related to a number of aspects of condom use. The most important of these is: a. Strategies to enhance condom use. b. Choice of colors and special features. c. Leaving the decision up to the male partner. d. Places to carry condoms safely.
Answer: A
40) In reviewing genetic testing for a female client, you note the presence of BRCA1, BRCA2, and CHEK2. How should these findings be interpreted a. There is no increased likelihood that the client will develop breast or ovarian cancer. b. There is an increased likelihood only for the development of breast cancer in a woman. c. More information is needed to interpret these findings based on the clients family history and the clients current and past medical history. d. A radical bilateral mastectomy is required immediately because the cancer may have already undergone sub-metastasis.
Answer: C
50) The nurse is preparing a community education program on preventive health care for women. What common screening test will the nurse plan on explaining to the women attending the program a. Breast examination by a health professional b. Breast self-examination c. Breast biopsy d. Mammography
Answer: D
however, the pain has increased. Physical examination reveals lumpy areas bilaterally on the upper outer quadrants of each breast tissue. The areas of concern are approximately 2 cm in size. Based on this assessment, which diagnostic testing would be necessary (Select all that apply.) a. Ultrasound examination b. Fine-needle aspiration (FNA) biopsy c. Mammogram d. Open biopsy e. CBC with differential
Answer: a, b, c
22) A patient in her late 40s ask the nurse to ask what to expect in menopause 1) Change of Menstrual Flow 2) Amenorrhea 3) Reduced fertility 4) No ovulation
Answer: all of the above
34) During physical exam female patient ask the nurse what can be done to prevent breast cancer. What should the nurse tell the patient a. Exercise regularly b. Reduce intake of red meat c. Reduce intake of dietary fat d. Maintain normal body weight
Answer: all of the above
35) The nurse is reviewing spermicidal n-9 with the barrier method, what should the nurse emphasize and teach with their preparation a. Non systemic side effects b. It does not have toxicity c. It's over the counter
Answer: all of the above
complains of pruritus. Based on these findings, the nurse suspects that this woman has which of the following conditions a. Trichomoniasis b. Gonorrhea c. Candidiasis d. Bacterial vaginosis
Answer: d
15) Which STD can be cured a. Chlamydia b. Gonorrhea
Both A and B
24) A 30-year-old patient who experiences severe premenstrual syndrome every month asks for nonpharmacologic suggestions to treat this disorder. What should the nurse recommend
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. a. Eat more frequent meals b. Engage in aerobic activity c. Limit alcohol to two drinks per day d. Restrict the intake of chocolate and coffee e. Increase the intake of fruits and vegetables? i. Answer: A, B, D, E ii. Nonpharmacologic approaches for treating premenstrual syndrome include eating more frequent meals, engaging in aerobic activity, restricting the intake of chocolate and coffee, and increasing the intake of fruits and vegetables. Alcohol should be restricted and not limited to two drinks per day
1) The nurse instructs the woman taking oral contraceptives to report which possible side effect(s)
Select all that apply. a. Abdominal pain b. Weight gain c. Headache d. Eye or visual problems e. Speech disturbances? ANS: A, C, D, E The memory aid ACHES is helpful: Abdominal pain, Chest pain, Headaches, Eye problems, Speech disturbances. Weight gain is an expected side effect of oral contraceptives.
32) Which issues should the nurse consider when counseling a client on contraceptive methods
Select all that apply. a. Age at menarche b. Efficacy of the method c. Future childbearing plans d. 4. Whether the client is a vegetarian e. Cultural perspectives on menstruation and pregnancy? i. Answer: 2, 3, 5 ii. 2. Efficacy of contraceptive methods varies and must be considered when discussing contraception with clients. When pregnancy is medically contraindicated, high-efficacy methods (such as an IUD, hormonal methods, or sterilization) should be discussed with the client. When the client would like to avoid pregnancy at this time, but pregnancy is not medically contraindicated, lower-efficacy methods (such as diaphragm, cervical cap, or Today sponge) could be discussed. iii. 3. If a client desires children in the future, sterilization methods would be inappropriate to discuss. iv. 5. Cultural and religious beliefs, practices, and sanctions must be considered when discussing contraception with clients in order to avoid insulting a client for whom a particular type of contraceptive method is prohibited by her background.
54) A nurse is planning to teach couples about the physiology of the sex act. What correct information will the nurse provide
a. "An ovum must be fertilized within 24 hours of ovulation."
42) The nurse realizes that a man considering a vasectomy needs further information if he says:
a. "I'll need to remain in the hospital for a few days."
53) A woman has preinvasive cancer of the cervix. In discussing available treatments, the nurse includes:
a. Cryosurgery
26) What statement indicate the client understand teaching of vaginal infection
a. Discharge b. Fishy odor
9) Which sexually transmitted infection is not bacterial and thus not treatable with antibiotics
a. Herpes
4) A woman will be taking oral contraceptives using a 28-day pack. What advice should the nurse provide to protect this client from an unintended pregnancy
a. Take one pill at the same time every day. i. To maintain adequate hormone levels for contraception and to enhance compliance, clients should take oral contraceptives at the same time each day. If contraceptives are to be started at any time other than during normal menses or within 3 weeks after birth or an abortion, then another method of contraception should be used through the first week to prevent the risk of pregnancy. Taken exactly as directed, oral contraceptives prevent ovulation, and pregnancy cannot occur. No strong pharmacokinetic evidence indicates a link between the use of broad-spectrum antibiotics and altered hormonal levels in oral contraceptive users. If the client misses two pills during week 1, then she should take two pills a day for 2 days and finish the package and use a backup contraceptive method for the next 7 consecutive days.
20) A client has been using transdermal contraceptive comes in for an exam, which finding should cause the nurse to assess if this client should continue to use this type of birth control
a. Weight over 212 pounds
33) Patient has Trichomoniasis
a. You must treat both partners
46) A woman has a breast mass that is not well delineated and is nonpalpable, immobile, and nontender. Which condition is this client experiencing a. Fibroadenoma b. Lipoma c. Intraductal papilloma d. Mammary duct ectasia
answer C
27) The nurse is preparing teaching for breast self-examination. How does she explain to the patient a. Compare the breast b. Analyze symmetry c. Body shape and direction d. Look at color, thickening, edema, and venous patterns e. Study the skin surface
answer: all of the above
48) The nurse should be aware that a pessary is most effective in the treatment of which disorder a. Cystocele b. Uterine prolapse c. Rectocele d. Stress urinary incontinence
i. A fitted pessary may be inserted into the vagina to support the uterus and hold it in the correct position. Usually a pessary is used for only a short time and is not used for the client with a cystocele. A rectocele cannot be corrected by the use of a pessary. A pessary is not likely the most effective treatment for stress incontinence.
58) The nurse would tell the patient to expect what after she had an intrauterine device (IUD) inserted a. Menstrual flow will be lighter. b. Menstrual cramps will be eliminated. c. A string should be felt in the vagina. d. The device should be changed every 2 years
i. A woman should feel for the string periodically, especially after her period, to confirm the presence of the IUD.
52) When discussing estrogen replacement therapy (ERT) with a perimenopausal woman, the nurse should include the risks of a. Breast cancer b. Vaginal and urinary tract atrophy c. Osteoporosis d. Arteriosclerosis
i. ANS: A ii. Feedback iii. A Women with a high risk of breast cancer should be counseled against using ERT .
51) Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes a. Herpes simplex virus 2 (HSV-2) b. HPV c. HIV d. CMV
i. ANS: A (HSV 2) ii. The initial HSV genital infection is characterized by multiple painful lesions, fever, chills, malaise, and severe dysuria
7) The nurse explains that the fallopian tubes have which function(s) Select all that apply. a. Passage for sperm to meet ova b. Passage for ovum to uterus c. Safe environment for zygote d. Restriction for only one ovum to enter uterus e. Site for fertilization
i. ANS: A, B, C, E ii. The fallopian tube provides passage for both sperm and ova, offering an optimum place for fertilization and a safe environment for the zygote.
23) A client presents to the Women's Health Clinic for continuation of her contraceptive method. She has been using Depo-Provera (medroxyprogesterone acetate) for 24 months. In preparation for instituting a plan of care, the nurse would consider which option as a priority a. Schedule the client for follow-up baseline diagnostic testing to confirm that the client is not pregnant. b. Obtain information for an alternate contraception method. c. Ask the client for additional information related to her menstrual cycle. d. Inspect the skin for site selection of contraceptive method.
i. ANS: B ii. According to WHO (World Health Organization) guidelines, women should not be on Depo-Provera for more than 2 years because of bone density loss. Therefore, the nurse should include assessments for other types of contraception methods for the client. Although it may prove to be important to rule out possible pregnancy, based on the provided information, discontinuation of this method is the priority intervention. Depo-Provera can cause menstrual irregularities, but this is not the priority intervention. The nurse can follow up on this issue later. Because the current method of contraception should no longer be used, this option is not necessary.
11) When evaluating a patient whose primary complaint is amenorrhea, the nurse must be aware that lack of menstruation is most often the result of: a. Stress b. Pregnancy c. Excessive exercise d. Eating disorders
i. ANS: B ii. Amenorrhea, or the absence of menstrual flow, is most often a result of pregnancy. Although stress, excessive exercise, and eating disorders all may be contributing factors, none is the most common factor associated with amenorrhea.
12) An unmarried young woman describes her sex life as "active" and involving "many" partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). The nurse's most appropriate response is a. "The IUD does not interfere with sex." b. "The risk of pelvic inflammatory disease will be higher for you." c. "The IUD will protect you from sexually transmitted diseases." d. "Pregnancy rates are high with the IUDs."
i. ANS: B ii. Disadvantages of IUDs include an increased risk of pelvic inflammatory disease (PID) in the first 20 days after insertion, as well as the risks of bacterial vaginosis and uterine perforation. The IUD offers no protection against sexually transmitted diseases (STDs) or the human immunodeficiency virus (HIV). Because this woman has multiple sex partners, she is at higher risk of developing an STD. The IUD does not protect against infection, as does a barrier method.
29) When instructing a client in the use of spermicidal foam or gel, it is important to include the information that: a. Effectiveness is about 85%. b. Douching should be avoided for at least 6 hours. c. It should be inserted 1 to 2 hours before intercourse. d. One application is effective for several hours.
i. ANS: B ii. Douching within 6 hours of intercourse would remove the spermicide and increase the risk of pregnancy. Effectiveness is only 29% when used alone. The spermicidal foam or gel should be inserted 15 minutes before intercourse. One application is effective for about 1 hour.
5) The nurse learns that the most common cause of pathologic hyperbilirubinemia is which of the following a. Hepatic disease b. Hemolytic disorders in the newborn c. Postmaturity d. Congenital heart defect
i. ANS: B ii. Hemolytic disorders in the newborn are the most common cause of pathologic jaundice. Hepatic damage and prematurity may be causes of pathologic hyperbilirubinemia, but they are not the most common cause. Congenital heart defect is not a common cause of pathologic hyperbilirubinemia in neonates.
21) Decreased surfactant production in the preterm lung is a problem because surfactant: a. Causes increased permeability of the alveoli. b. Provides transportation for oxygen to enter the blood supply. c. Keeps the alveoli open during expiration. d. Dilates the bronchioles, decreasing airway resistance.
i. ANS: C ii. Surfactant prevents the alveoli from collapsing each time the infant exhales, thus reducing the work of breathing.
28) Which contraceptive method should be contraindicated in a client with a history of toxic shock syndrome a. Condom b. Spermicide c. Cervical cap d. Oral contraceptives
i. ANS: C ii. The cervical cap may increase the risk of toxic shock syndrome because it may be left in the vagina for a prolonged period. A condom is not contraindicated with a history of toxic shock syndrome. Spermicide is not contraindicated with a history of toxic shock syndrome. Oral contraceptives are not contraindicated with a history of toxic shock syndrome.
47) A 25-year-old woman has a family history of breast cancer. The nurse reviews the procedure for breast self-examination (BSE) and tells her that the best time for a woman to perform a breast self-examination is: a. A few days before her period. b. During her menstrual period. c. On the last day of menstrual flow. d. One week after the beginning of her period.
i. ANS: D ii. The best time for BSE is 1 week after the beginning of the menstrual period.
49) The nurse reminds a group of high school students that the most effective choice of birth control for preventing pregnancy and sexually transmitted diseases is to: a. Abstain from sex. b. Use the male condom. c. Use the female condom. d. Use the barrier method.
i. Abstinence is 100% effective in preventing pregnancy and sexually transmitted diseases.
55) Injectable progestins (DMPA, Depo-Provera) are a good contraceptive choice for women who a. Want menstrual regularity and predictability. b. Have a history of thrombotic problems or breast cancer. c. Have difficulty remembering to take oral contraceptives daily. d. Are homeless or mobile and rarely receive health care.
i. Advantages of DMPA include a contraceptive effectiveness comparable to that of combined oral contraceptives with the requirement of only four injections a year. Disadvantages of injectable progestins are menstrual irregularities. Use of injectable progestin carries an increased risk of venous thrombosis and thromboembolism. To be effective, DMPA injections must be administered every 11 to 13 weeks. Access to health care is necessary to prevent pregnancy or potential complications.
43) Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the woman's social, cultural, and interpersonal needs are met. Which action should the nurse take first when meeting with a new client to discuss contraception a. Obtain data about the frequency of coitus. b. Determine the woman's level of knowledge about contraception and commitment to any particular method. c. Assess the woman's willingness to touch her genitals and cervical mucus. d. Evaluate the woman's contraceptive life plan.
i. All of these actions are part of the assessment, but determination of the woman's level of knowledge regarding contraception and her commitment to a method is the primary step and is necessary before completing the process and moving on to a nursing diagnosis. Once the client's level of knowledge is determined, the nurse can interact with her to compare options, reliability, cost, comfort level, protection from sexually transmitted infections (STIs), and a partner's willingness to participate. Data about frequency of coitus should include the number of sexual partners, level of partner contraceptive involvement, and any partner objections. A woman's willingness to touch her genitals and cervical mucus is a key factor for the nurse to discuss only if the client expresses interest in using one of the fertility awareness methods of contraception.
38) Which client in the gynecology clinic should the nurse see first a. 22-year-old with fever, hypotensive, using tampons b. 15-year-old, no menses for past 4 months c. 18-year-old seeking information on contraception methods d. 31-year-old, reports increasing dyspareunia
i. Answer: 1 ii. Explanation: 1. A client using tampons who has a fever, is dizzy, and hypotensive might have toxic shock syndrome.
30) Abdominal hysterectomy is generally recommended for which condition a. Severe endometriosis b. Removal of the ovaries c. Suspected or confirmed cancer removal d. Abnormal uterine bleeding
i. Answer: 1 ii. Explanation: 1. Abdominal hysterectomy is recommended for severe endometriosis.
37) The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statements indicate that teaching was effective Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. a. "I might have infertility because of this infection. b. "It is important for me to finish my antibiotics. c. "Tubal pregnancy could occur after PID." (She didn't mention this as an answer) d. "My PID was caused by a yeast infection." e. "I am going to have an IUD placed for contraception.
i. Answer: 1, 2, 3 ii. Explanation: iii. 1. Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of PID. iv. 2. Antibiotic therapy should always be completed when a client is diagnosed with any infection. v. 3. The tubal scarring that occurs from tubal inflammation during PID can prevent a fertilized ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy.
31) A client has decided to use the NuvaRing vaginal contraceptive ring as her method of contraception. Which statement suggests the client needs further instruction a. "When I store my replacement rings, I should keep them in my refrigerator." b. "The contraceptive ring provides a sustained release of low-dose contraceptive." c. "Every 3 months, I will need to remove the contraceptive ring and replace it with a new one." d. "I do not need to be examined in order to determine the contraceptive ring size that is correct for me."
i. Answer: 3 ii. 3. The ring is left in place for 3 weeks and then removed for 1 week to allow for withdrawal bleeding.
14) The nurse is caring for a client diagnosed with endometriosis. Which statement by the client requires immediate follow-up a. "I've noticed my voice is lower since I started taking danazol." b. "I am having many hot flashes since I had the Lupron injection." c. "The pain I experience with intercourse is becoming more severe." d. "My leg has become painful and swollen since I started taking birth control pills."
i. Answer: 4 ii. Explanation: iii. 4. Combination oral contraceptive pills contain estrogen. A painful, swollen lower extremity can be a sign of deep vein thrombosis, which can cause thromboembolus, which is potentially life threatening. This is a complication and must be addressed immediately.
19) Which client is not a good candidate for Depo-Provera (DMPA) a. 1. One with a vaginal prolapse b. 2. One who weighs 200 pounds c. 3. One who wishes to breastfeed d. 4. One who wishes to get pregnant within 3 months
i. Answer: 4 ii. Explanation: iii. 4. Return of fertility after the use of Depo-Provera takes an average of 10 months.
36) A client asks the nurse, "Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy.What is the nurse's best response a. "Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred." b. "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation." c. "Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur." d. "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."
i. Answer: C ii. C) The basal body temperature method is used to detect ovulation by an increase in the basal temperature during the menstrual cycle. It requires that the woman take her temperature every morning upon awakening (before any activity) and record the findings on a temperature graph, and is based on the fact that the temperature almost always rises and remains elevated after ovulation because of the production of progesterone, a thermogenic (heat-producing) hormone.
62) The nurse instructing a man considering a vasectomy should state that after a vasectomy: a. Intercourse should be delayed for 6 weeks. b. Sperm will still be ejaculated for a month. c. Erections will be difficult to maintain. d. Monthly sperm counts for a year will be necessary.
i. Because sperm are distal to the severed vas deferens, sperm will be in the ejaculate for about a month. A sperm count after that period of time should be performed to confirm the absence of sperm. Intercourse does not have to be delayed, but an alternate method of contraception should be used. Erections and sexual pleasure are not affected by a vasectomy.
18) What should the nurse stress in teaching a woman to deal with the symptoms of premenstrual syndrome (PMS) a. Decrease her consumption of caffeine. b. Drink a small glass of wine with her evening meal. c. Decrease her fluid intake to prevent fluid retention. d. Eat three large meals a day to maintain glucose levels.
i. Caffeine increases irritability, insomnia, anxiety, and nervousness. Alcohol aggravates depression and should be avoided. Fluid intake should not be decreased. Three small to moderate meals and three snacks a day can help relieve symptoms. (A)
25) Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea a. 17-year-old, has never had a menstrual cycle b. 16-year-old, had regular menses for 4 years, but has had no menses in 4 months c. 19-year-old, regular menses for 5 years that have suddenly become painful d. 14-year-old, irregular menses for 1 year, experiences cramping every cycle
i. Explanation: 4. Dysmenorrhea, or painful menstruation, occurs at, or a day before, the onset of menstruation and disappears by the end of menses. Primary dysmenorrhea is defined as cramps without underlying disease.
61) Which statement about genital herpes is inaccurate a. Genital herpes is also known as genital warts. b. Stress, menstruation, trauma, and illnesses have been known to trigger recurrences. c. Genital herpes is chronic and recurring and has no known cure. d. Plain soap and water are all that is needed to clean hands that have come into contact with herpetic lesions.
i. Genital warts are one of the most common sexually transmitted infections (STIs)
57) With regard to endometriosis, nurses should be aware that: a. It is characterized by the presence and growth of endometrial tissue inside the uterus. b. It is found more often in African-American women than in white or Asian women. c. It may worsen with repeated cycles or remain asymptomatic and disappear after menopause. d. It is unlikely to affect sexual intercourse or fertility
i. Symptoms vary among women, ranging from nonexistent to incapacitating. With endometriosis, the endometrial tissue is outside the uterus. Symptoms vary among women, ranging from nonexistent to incapacitating. Endometriosis is found equally in white and African-American women and is slightly more prevalent in Asian women. Women can experience painful intercourse and impaired fertility
10) Which woman is at the greatest risk for psychological complications after hysterectomy a. 37-year-old who gave birth to her third child and required a third cesarean section with a hysterectomy due to an increta b. 46-year-old woman who has had three children and has just been promoted at work c. 25-year-old woman who had a ruptured uterus after giving birth to her first child d. 55-year-old woman who has been having abnormal bleeding and pain for 3 years
i. The 25-year-old woman is still in her childbearing years. Often the uterus is related to self-concept in women in this age group, and they may feel that sexual functioning is related to having a uterus. The 55-year-old woman is past her childbearing years and has had bleeding and pain for 3 years. The hysterectomy may be well received as a method of pain relief. The 46-year-old woman has a family and positive events occurring in her life (job promotion). The 37 year old woman has three children.
45) A woman currently uses a diaphragm and spermicide for contraception. She asks the nurse what the major differences are between the cervical cap and diaphragm. The nurse's most appropriate response is: a. "No spermicide is used with the cervical cap, so it's less messy." b. "The diaphragm can be left in place longer after intercourse." c. "Repeated intercourse with the diaphragm is more convenient." d. "The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide later."
i. The cervical cap can be inserted hours before sexual intercourse without the need for additional spermicide later. No additional spermicide is required for repeated acts of intercourse. Spermicide should be used inside the cap as an additional chemical barrier. The cervical cap should remain in place for 6 hours after the last act of intercourse. Repeated intercourse with the cervical cap is more convenient, because no additional spermicide is needed.
56) Early this morning, an infant boy was circumcised using the PlastiBell method. The nurse tells the mother that she and the infant can be discharged after: a. The bleeding stops completely. b. Yellow exudate forms over the glans. c. The PlastiBell rim falls off. d. The infant voids.
i. The infant should be observed for urination after the circumcision. Bleeding is a common complication after circumcision. The nurse will check the penis for 12 hours after a circumcision to assess and provide appropriate interventions for prevention and treatment of bleeding. Yellow exudates cover the glans penis in 24 hours after the circumcision. This is part of normal healing and not an infective process. The PlastiBell remains in place for about a week and falls off when healing has taken place.
60) The woman using a diaphragm correctly would tell the nurse that the diaphragm: a. Does not require the use of a spermicidal cream or jelly with it. b. Should be left in place for at least 6 hours after intercourse. c. Is removed immediately after intercourse for douching. d. Is effective for up to 48 hours if positioned properly.
i. To act as a barrier, the diaphragm must be left in place for at least 6 hours after intercourse and can be left in place up to 24 hours.
