Practice Quiz Exam 1

The nurse is working in an OB/GYN office, where part of her duties include obtaining a patient's history and performing an initial assessment. Which woman is likely to be referred for genetic counseling after her first visit? a. A pregnant woman who will be 40 years or older when her infant is born. b. A woman whose partner is 38 years of age. c. A patient who carries a Y-linked disorder d. An anxious woman with a normal quadruple screening result.

A!! a. A pregnant woman who will be 40 years or older when her infant is born. [A. Pregnant women who will be 35 years of age or older when the infant is born should be referred to a genetic counselor. B. Men who father children after the age of 40 should also be sent for referral. Men who father children in their 5th decade or later are more likely to have offspring with a new autosomal dominant mutation. C. Women who are carriers of X-linked disorders should be referred for genetic counseling. Women do not carry a Y chromosome. D. Pregnant women with abnormal prenatal screening results, such as triple or quadruple screening, or suspicious ultrasound findings may require referral to other health care specialists. This patient simply requires further support and encouragement.]

Which man is most likely to have abnormal sperm formation resulting in infertility? A. A 20-year-old man with undescended testicles. B. An uncircumcised 40-year-old C. A 35-year-old man with previously treated sexually transmitted disease D. A 16-year-old adolescent who is experiencing nocturnal emissions.

A. A 20-year-old man with undescended testicles. [A. For normal sperm formation, a man's testes must be cooler than his core body temperature.B. Circumcision does not prevent fertility.C. Scar tissue in the fallopian tubes as a result of a sexually transmitted disease can be a cause of infertility in women.D. Nocturnal emissions of seminal fluid are normal and expected in teenagers.]

A couple is trying to cope with an infertility problem. They want to know what they can do to preserve their emotional equilibrium. The nurse's most appropriate response is: A. "Tell your friends and family so that they can help you." B. "Talk only to other friends who are infertile, because only they can help." C. "Get involved with a support group. I'll give you some names." D. "Start adoption proceedings immediately, because obtaining an infant is very difficult."

C. "Get involved with a support group. I'll give you some names." [A. Although talking about their feelings may unburden them of negative feelings, infertility can be a major stressor that affects the couple's relationships with family and friends. B. Limiting their interactions to other infertile couples may be a beginning point for addressing psychosocial needs, but depending on where the other couple is in their own recovery process, this may or may not be of assistance to them. C. Venting negative feelings may unburden the couple. A support group may provide a safe haven for the couple to share their experiences and gain insight from others' experiences. D. This statement is not supportive of the psychosocial needs of this couple and may be detrimental to their well-being.]

A couple has been counseled for genetic anomalies. They ask you, "What is karyotyping?" Your best response is: A. "Karyotyping will reveal if the baby's lungs are mature." B. "Karyotyping will reveal if your baby will develop normally." C. "Karyotyping will provide information about gender of the baby and the number and structure of chromosomes." D. "Karyotyping will detect any physical deformities the baby has."

C. "Karyotyping will provide information about gender of the baby and the number and structure of chromosomes." [A. The L/S ratio, not karyotyping, reveals lung maturity. B. Although karyotyping can detect genetic anomalies, the range of normal is nondescriptive. C. Karyotyping provides genetic information, such as gender and chromosomal structure. Karyotyping is completed by photographing or using computer imaging to arrange chromosomes in pairs from largest to smallest. The karyotype can then be analyzed. D. Although karyotyping can detect genetic anomalies, not all such anomalies display obvious physical deformities. The term deformities is a nondescriptive word. Furthermore, physical anomalies may be present that are not detected by genetic studies (e.g., cardiac malformations).]

Which combination of sex chromosomes is present in a female? a. XY B. XYY C. XXY D. XX

D. XX [A. An XY is the indication for a male. B. There are normally only two sex chromosomes. C. There are normally only two sex chromosomes. D. The combination of an X chromosome from each parent produces a female.]

The nurse is precepting a student who asks about fetal circulation. The nurse explains that the fetal circulatory shunts are still required after birth. Is this statement true or false? True or False

False [Fetal circulatory shunts are not needed after birth because the infant oxygenates blood in the lungs, metabolizes substances in the liver, and stops circulating blood to the placenta. As the infant breathes, blood flow to the lungs increases, pressure in the right-sided heart falls, and the foramen ovale closes.]

The nurse who has chosen to work in the field of genetics must have a clear understanding of genetic abnormalities when counseling parents. The nurse is explaining a single gene abnormality to new parents and states, "Although you are second cousins, you are at no greater risk for having a child with a genetic disorder." True or False

False [Parental consanguinity (blood relationships) increases the risk of having a child with an autosomal recessive disorder.]

A physician prescribes clomiphene citrate (Clomid, Serophene) for a woman experiencing infertility. She is very concerned about the risk of multiple births. The nurse's most appropriate response is: a. "This is a legitimate concern. Would you like to discuss this further before your treatment begins?" b. "No one has ever had more than triplets with Clomid." c. "Ovulation will be monitored with ultrasound so that this will not happen." d. "Ten percent is very low risk, so you don't need to worry too much."

a. "This is a legitimate concern. Would you like to discuss this further before your treatment begins?" [A. The incidence of multiple pregnancies with the use of these medications is increased. The patient's concern is legitimate and should be discussed so that she can make an informed decision. B. This statement is inaccurate and negates the patient's concerns. C. Ultrasound cannot ensure that a multiple pregnancy will not occur. D. The percentage quoted in this statement is inaccurate. Furthermore, the patient's concern is discredited with a statement such as "Don't worry."]

The average man is taller than the average woman at maturity because of: a. A longer period of skeletal growth. b. Earlier development of secondary sexual characteristics. c. Earlier onset of growth spurt. d. Starting puberty at an earlier age.

a. A longer period of skeletal growth. [A. The man's greater height at maturity is the combined result of beginning the growth spurt at a later age and continuing it for a longer period. B. Girls develop earlier than boys. C. Boys' growth spurts start at a later age. D. Girls start puberty approximately 6 months to 1 year earlier than boys.]

The conscious decision on when to conceive or avoid pregnancy throughout the reproductive years is called: a. Family planning b. Birth control c. Contraception d. Assisted reproductive therapy

a. Family planning [A. Family planning is the process of deciding when and if to have children. B. Birth control is the device and/or practice used to reduce the risk of conceiving or bearing children. C. Contraception is the intentional prevention of pregnancy during sexual intercourse. D. Assisted reproductive therapy is one of several possible treatments for infertility.]

Which of these is a secondary sexual characteristic? a. Female breast development b. Production of sperm c. Maturation of ova d. Secretion of gonadotropin-releasing hormone

a. Female breast development [A. A secondary sexual characteristic is one not directly related to reproduction, such as development of the characteristic female body form. B. Production of sperm is directly related to reproduction and is a primary sexual characteristic. C. Maturation of ova is directly related to reproduction and is a primary sexual characteristic. D. Secretion of hormones is directly related to reproduction and is a primary sexual characteristic.]

A number of major hormones are necessary for healthy reproduction to occur. These hormones are produced by a number of different organs. The anterior pituitary gland is responsible for producing (select all that apply): a. Follicle-stimulating hormone (FSH) b. Luteinizing hormone (LH) c. Gonadotropin-released hormone (GnRH) d. Oxytocin e. Prolactin

a. Follicle-stimulating hormone (FSH) b. Luteinizing hormone (LH) e. Prolactin [FSH and LH are both produced by the anterior pituitary gland. Both of these hormones assist in the stimulation and maturation of the ovarian follicle. Prolactin is also produced by the anterior pituitary and is required for milk production (lactogenesis) to occur. DIF: Cognitive Level: Comprehension REF: p. 202 | Table 11-1 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance Incorrect Feedback: GnRH is produced by the hypothalamus and stimulates the release of FSH and LH. Oxytocin is produced by the posterior pituitary gland and is responsible for stimulating uterine contractions during birth.]

A young female patient comes to the health unit at school to discuss her irregular periods. In providing education regarding the female reproductive cycle, the nurse describes the regular and recurrent changes related to the ovaries and the uterine endometrium. Although this is generally referred to as the menstrual cycle, the ovarian cycle includes which phases? SATA: a. Follicular b. Ovulatory c. Luteal d. Proliferative e. Secretory

a. Follicular b. Ovulatory c. Luteal [The follicular phase is the period during which the ovum matures. It begins on day 1 and ends around day 14. The ovulatory phase occurs near the middle of the cycle, approximately 2 days before ovulation. After ovulation and under the influence of the luteinizing hormone, the luteal phase corresponds with the last 12 days of the menstrual cycle. DIF: Cognitive Level: Comprehension REF: p. 208-209 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance Incorrect Feedback: The proliferative and secretory phases are part of the endometrial cycle. The proliferative phase takes place during the first half of the ovarian cycle when the ovum matures. The secretory phase occurs during the second half of the cycle when the uterus is prepared to accept the fertilized ovum. These are followed by the menstrual phase if fertilization does not occur.]

A gravida patient at 32 weeks of gestation reports that she has severe lower back pain. The nurse's assessment should include: a. Observation of posture and body mechanics. b. Palpation of the lumbar spine. c. Exercise pattern and duration. d. Ability to sleep for last least 6 hours uninterrupted.

a. Observation of posture and body mechanics. [A. Correct posture and body mechanics can reduce lower back pain caused by increasing lordosis. B. Pregnancy should not cause alterations in the spine. Any assessment for malformation should be done early in the pregnancy. C. Certain exercises can help relieve back pain. D. Rest is important for well-being, but the main concern with back pain is to assess posture and body mechanics.]

Chromosomes are composed of genes, which are composed of DNA. Abnormalities are either numerical or structural in nature. Which abnormalities are structural? SATA: a. Part of a chromosome is missing. b. The material within a chromosome is rearranged. c. One or more sets of chromosomes are added. d. Entire single chromosome is added. e. Two chromosomes adhere to each other.

a. Part of a chromosome is missing. b. The material within a chromosome is rearranged. e. Two chromosomes adhere to each other. [It is critical to remember that characteristics of structural abnormalities include part of a chromosome missing or added, rearrangement of material within chromosomes, two chromosomes that adhered to each other, and fragility of a specific site on the X chromosome.]

Both members of an expectant couple are carriers for phenylketonuria (PKU), an autosomal recessive disorder. In counseling them about the risk to their unborn child, the nurse should tell them that: a. The child has a 25% chance of being affected. b. The child will be a carrier, like the parents. c. The child has a 50% chance of being affected. d. One of four of their children will be affected.

a. The child has a 25% chance of being affected. [A. Each child born to a couple who carries an autosomal recessive trait has a 25% chance of having the disorder, because the child receives either a normal or an abnormal gene from each parent. B. If one member of the couple has the autosomal recessive disorder, all of their children will be carriers. If both parents are carriers, each child has a 50% chance of being a carrier. C. The child has a 25% chance of being affected and a 50% chance of being a carrier. D. Each child has the identical odds of being affected. Because both parents are carriers, each child has a 25% chance of being affected, a 50% change of being a carrier, and a 25% change of not having the gene transmitted.]

Which statement by the patient indicates that she understands breast self-examination? a. "I will examine both breasts in two different positions." b. "I will perform breast self-examination 1 week after my menstrual period starts." c. "I will examine the outer upper area of the breast only." d. "I will use the palm of the hand to perform the examination."

b. "I will perform breast self-examination 1 week after my menstrual period starts." [A. She should use four positions: standing with arms at her sides, standing with arms raised above her head, standing with hands pressed against hips, and lying down. B. The woman should examine her breasts when hormonal influences are at a low level. C. The entire breast needs to be examined, including the outer upper area. D. She should use the sensitive pads of the middle three fingers.]

A patient in her first trimester complains of nausea and vomiting. She asks, "Why does this happen?" The nurse's best response is: a. "It is due to an increase in gastric motility." b. "It may be due to changes in hormones." c. "It is related to an increase in glucose levels." d. "It is caused by a decrease in gastric secretions."

b. "It may be due to changes in hormones." [A. Gastric motility decreases during pregnancy. B. Nausea and vomiting are believed to be caused by increased levels of hormones, decreased gastric motility, and hypoglycemia. C. Glucose levels decrease in the first trimester. D. Gastric secretions do decrease, but this is not the main cause of nausea and vomiting.]

A woman who is 16 weeks pregnant asks the nurse, "Is it possible to tell by ultrasound if the baby is a boy or girl yet?" The best answer is: a. "A bay's sex is determined as soon as conception occurs." b. "The baby has developed enough that we can determine the sex by examining the genitals through ultrasound." c. "Boys and girls look alike until approximately 20 weeks after conception, and they they begin to look different." d. "It might be possible to determine your baby's sex, but the external organs look very similar right now."

b. "The baby has developed enough that we can determine the sex by examining the genitals through ultrasound." [A. This is a true statement, but the external genitalia are similar in appearance until approximately the 12th week. B. Although gender is determined at conception, the external genitalia of males and females look similar through the 9th week. By the 12th week, the external genitalia are distinguishable as male or female. C. The external genitalia are similar in appearance until approximately 12 weeks, not 20 weeks. D. The external genitalia are different at approximately week 12.]

A woman is 16 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is: a. "You should have felt the baby move by now." b. "Within the next month, you should start to feel fluttering sensations." c. "The baby is moving, but you can't feel it yet." d. "Some babies are quiet, and you don't feel them move."

b. "Within the next month, you should start to feel fluttering sensations." [A. Because this is her first pregnancy, movement is felt toward the later part of the 17 to 20 weeks. This statement may be alarming to the woman. B. Maternal perception of fetal movement usually begins 17 to 20 weeks after conception. C. This is a true statement. The fetus's movements are not strong enough to be felt until 17 to 20 weeks; however, this statement does not answer the concern of the woman. D. Fetal movement should be felt by 17 to 20 weeks. If movement is not felt by the end of that time, further assessment will be necessary.]

During her annual gynecologic checkup, a 17-year-old woman states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse should document this complaint as: a. Amenorrhea b. Dysmenorrhea c. Dyspareunia d. PMS

b. Dysmenorrhea [A. Amenorrhea is the absence of menstrual flow. B. Dysmenorrhea is pain during or shortly before menstruation. Pain is described as sharp and cramping or sometimes as a dull ache. It may radiate to the lower back or upper thighs. C. Dyspareunia is pain during intercourse. D. PMS is a cluster of physical, psychologic, and behavioral symptoms that begin in the luteal phase of the menstrual cycle and resolve within a couple of days of the onset of menses.]

The role of the nurse in family planning is to: a. Advise couples on which contraceptive to use. b. Educate couples on the various methods of contraception. c. Decide on the best method of contraception for the couple. d. Refer the couple to a reliable physician.

b. Educate couples on the various methods of contraception. [A. The nurse should not advise the couple, only educate them. B. The nurse's role is to provide information to the couple so that they can make an informed decision about family planning. C. The nurse cannot decide on the best method for the couple; only they can decide which method is best for them. D. The nurse can educate and if the couple decides on a method that requires a physician visit, the nurse can then assist the couple in selecting an appropriate physician or primary health care provider.]

With regard to the use of intrauterine devices (IUDs), nurses should be aware that: a. Return to fertility can take several weeks after the device is removed. b. IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse. c. IUDs offer the same protection agAINST SEXUALLY TRANSMITTED diseases as the diaphragm d. Consent forms are not needed for IUD insertion

b. IUDs containing copper can provide an emergency contraception option if inserted within a few days of unprotected intercourse. [A. Return to fertility is immediate after removal of the IUD. B. The woman has up to 5 days to insert the IUD after unprotected sex. C. IUDs offer no protection for sexually transmitted diseases. D. A consent form is required for insertion, as is a negative pregnancy test.]

A number of cardiovascular system changes occur during pregnancy. Which finding is considered normal for a woman during pregnancy? a. Cardiac output rises by 25% b. Increased pulse rate c. Increased blood pressure. d. Decreased RBC production

b. Increased pulse rate. [A. Cardiac output increases by 50% with half of this rise occurring in the first 8 weeks gestation. B. The pulse increases about 15 to 20 beats/min, which persists to term. C. In the first trimester, blood pressure usually remains the same as the prepregnancy level, but it gradually decreases up to about 20 weeks of gestation. During the second trimester, both the systolic and diastolic pressures decrease by about 5 to 10 mm Hg. D. Production of RBCs accelerates during pregnancy.]

The karyotype of a person is 47, XY, +21. This person is a: a. Normal male b. Male with Down syndrome c. Normal female d. Female with Turner syndrome

b. Male with Down syndrome [A. A normal male has 46 chromosomes. B. This person is male because his sex chromosomes are XY. He has one extra copy of chromosome 21 (for a total of 47 instead of 46), resulting in Down syndrome. C. A normal female has 46 chromosomes and XX for the sex chromosomes. D. A female with Turner syndrome has 45 chromosomes; the sex chromosomes have just one X.]

Which statement related to changes in the breasts during pregnancy is the most accurate? a. During the early weeks of pregnancy there is decreased sensitivity/ b. Nipples and areolae become more pigmented. c. Montgomery tubercles are no longer visible around the nipples d. Venous congestion of the breasts is more visible in the multiparous woman.

b. Nipples and areolae become more pigmented. [A. Fullness, heightened sensitivity, tingling and heaviness of the breasts occur in the early weeks of gestation in response to increased levels of estrogen and progesterone. B. Nipples and areolae become more pigmented, and the nipples become more erectile and may express colostrum. C. Montgomery tubercles may be seen around the nipples. These sebaceous glands may have a protective role in that they keep the nipples lubricated for breastfeeding. D. Venous congestion in the breasts is more obvious in primigravidas.]

The maternity nurse understands that vascular volume increases 40% to 60% during pregnancy to: a. Compensate for decreased renal plasma flow. b. Provide adequate perfusion of the placenta. c. Eliminate metabolic wastes of the mother. d. Prevent maternal and fetal dehydration.

b. Provide adequate perfusion of the placenta. [A. Renal plasma flow increases during pregnancy. B. The primary function of increased vascular volume is to transport oxygen and nutrients to the fetus via the placenta. C. Assisting with pulling metabolic wastes from the fetus for maternal excretion is one purpose of the increased vascular volume. D. This is not the primary reason for the increase in volume.]

With regard to the assessment of female, male, and couple infertility, nurses should be aware that: a. The couple's religious, cultural, and ethnic backgrounds provide emotional clutter that does not affect the clinical scientific diagnosis. b. The investigation is lengthy and can be very costly. c. The woman is assessed first; if she is not the problem, the male partner is analyzed. d. Semen analysis is for men; the postcoital test is for women.

b. The investigation is lengthy and can be very costly. [A. Religious, cultural, and ethnic-bred attitudes about fertility and related issues always have an impact on diagnosis and assessment. B. Fertility assessment and diagnosis take time, money, and commitment from the couple. C. Both partners are assessed systematically and simultaneously, as individuals and as a couple. D. Semen analysis is for men, but the postcoital test is for the couple.]

A patient states, "My breasts are so small, I don't think I will be able to breastfeed." The nurse's best response is: a. "It may be difficult, but you should try anyway." b. "You can always supplement with formula." c. "All women have approximately the same amount of glandular tissue to secrete milk." d. "The ability to produce breast milk depends on increased levels of estrogen and progesterone."

c. "All women have approximately the same amount of glandular tissue to secrete milk." [A. The size of the breasts does not ensure success or failure in breastfeeding. B. Supplementation decreases the production of breast milk by decreasing stimulation. Stimulation of the breast, not the size of the breast, brings about milk production. C. All women have 15 to 20 lobes arranged around and behind the nipple and areola. These lobes, not the size of the breast, are responsible for milk production. D. Increased levels of estrogen decrease the production of milk by affecting prolactin.]

A 35-year-old woman has an amniocentesis performed to find out whether her baby has a chromosome defect. Which statement by this patient indicates that she understands her situation? a. "The doctor will tell me if I should have an abortion when the test results come back." b. "I know support groups exist for parents who have a baby with birth defects, but we have plenty of insurance to cover what we need." c. "When all the lab results come back, my husband and I will make a decision about the pregnancy." d. "My mother must not find out about all this testing. If she does, she will think I'm having an abortion."

c. "When all the lab results come back, my husband and I will make a decision about the pregnancy." [A. The final decision about the future of the pregnancy lies with the patient only. B. Support groups are extremely important for parents of a baby with a defect. Insurance will help cover expenses, but the defect also takes a toll on the emotional, physical, and social aspects of the parents' lives. C. The final decision about genetic testing and the future of the pregnancy lies with the patient. She will involve only those people whom she chooses in her decisions. D. An amniocentesis is performed to detect chromosomal defects. Many women have this done to prepare and educate themselves for the baby's arrival. The woman should also be assured that her care is confidential.]

Which woman is most likely to have osteoporosis? a. A 50-year-old woman receiving estrogen therapy. b. A 60-year-old woman who takes supplemental calcium. c. A 55-year-old woman with a sedentary lifestyle. d. A 65-year-old woman who walks 2 miles each day.

c. A 55-year-old woman with a sedentary lifestyle. [A. Hormone therapy may prevent bone loss. B. Supplemental calcium will help prevent bone loss, especially when combined with vitamin D. C. Risk factors for the development of osteoporosis include smoking, alcohol consumption, sedentary lifestyle, family history of the disease, and a high-fat diet. D. Weight-bearing exercises have been shown to increase bone density.]

The microscopic examination of scrapings from the cervix, endocervix, or other mucous membranes to detect premalignant or malignant cells is called: a. Bimanual palpation b. Rectovaginal palpation c. A Papanicolaou test d. DNA testing

c. A Papanicolaou test [A. Bimanual palpation is a physical examination of the vagina; the Pap test is a microscopic examination for cancer. B. Rectovaginal palpation is a physical examination performed through the rectum; the Pap test is a microscopic examination for cancer. C. The Pap test is a microscopic examination for cancer that should be performed regularly, depending on the patient's age. D. DNA testing for the various types of HPV that cause cervical cancer is now available. Samples are collected in the same way as a Pap test.]

A 36-year-old woman has been diagnosed as having uterine fibroids. When planning care for this patient, the nurse should know that: a. Fibroids are malignant tumors of the uterus that require radiation or chemotherapy b. Fibroids will increase in size during the perimenopausal period c. Abnormal uterine bleeding is a common finding. d. Hysterectomy should be performed.

c. Abnormal uterine bleeding is a common finding. [A. Fibroids are benign tumors of the smooth muscle of the uterus, and their etiology is unknown. B. Fibroids are estrogen-sensitive and shrink as levels of estrogen decline. C. The major symptoms associated with fibroids are menorrhagia and the physical effects produced by large leimyomas. D. A hysterectomy may be performed if the woman does not want more children and other therapies are not successful.]

What is important in instructing a patient in the use of spermicidal foams or gels? a. Insert 1 to 2 hours before intercourse b. One application is effective for several hours. c. Avoid douching for at least 6 hours. d. Effectiveness is about 85%

c. Avoid douching for at least 6 hours [A. Foams or gels should be inserted just before intercourse and are effective for about 1 hour. B. Each application is effective for about 1 hour. C. Douching within 6 hours of intercourse removes the spermicide and increases the risk of pregnancy. D. Effectiveness is about 74% when used alone.]

The drug of choice to treat Gonorrhea is: a. Penicillin G b. Tetracycline c. Ceftriaxone d. Acyclovir

c. Ceftriaxone [A. Penicillin is used to treat syphilis. B. Tetracycline is used to treat chlamydial infections. C. Ceftriaxone is effective for treatment of all gonococcal infections. D. Acyclovir is used to treat herpes genitalis.]

It is important for the nurse to understand that the levator ani is a(n): a. Imaginary line that divides the true and false pelvis/ b. Basin-shaped structure at the lower end of the spine c. Collection of three pairs of muscles. d. Division of the Fallopian tube.

c. Collection of three pairs of muscles. [A. The linea terminalis is the imaginary line that divides the false pelvis from the true pelvis. B. The basin-shaped structure at the lower end of the spine is the bony pelvis. C. The levator ani is a collection of three pairs of muscles that support internal pelvic structures and resist increases in intraabdominal pressure. D. The fallopian tube divisions are the interstitial portion, isthmus, ampulla, and infundibulum.]

Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? a. Mammogram b. Ultrasound c. Core needle biopsy d. CA 15-3

c. Core needle biopsy [A. Mammography is a clinical screening tool that may aid early detection of breast cancers. B. Transillumination, thermography, and ultrasound breast imaging are being explored as methods of detecting early breast carcinoma. C. When a suspicious mammogram is noted or a lump is detected, diagnosis is confirmed by either a core needle biopsy or needle localization biopsy. D. CA-15 is a serum tumor marker that is used to test for the presence of breast cancer.]

To relieve a leg cramp, the patient should be instructed to: a. Massage the affected muscle. b. Stretch and point the toe. c. Dorsiflex the foot. d. Apply a warm pack.

c. Dorsiflex the foot. [A. Since she is prone to blood clots in the legs, massaging the affected leg muscle is contraindicated. B. Pointing the toes will contract the muscle and not relieve the pain. C. Dorsiflexion of the foot stretches the leg muscle and relieves the painful muscle contraction. D. Warm packs can be used to relax the muscle, but more immediate relief is necessary, such as dorsiflexion of the foot.]

A couple comes in for an infertility workup, having attempted to get pregnant for 2 years. The woman, 37, has always had irregular menstrual cycles but is otherwise healthy. The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional test is needed? a. Testicular biopsy b. Antisperm antibodies c. FSH level d. Examination for testicular infection

c. FSH level [A. A testicular biopsy would be indicated only in cases of azoospermia (no sperm cells) or severe oligospermia (low number of sperm cells). B. Antisperm antibodies are produced by a man against his own sperm. This is unlikely to be the case here, because the husband has already produced children. C. The woman has irregular menstrual cycles. The scenario does not indicate that she has had any testing related to this irregularity. Hormone analysis is performed to assess endocrine function of the hypothalamic-pituitary-ovarian axis when menstrual cycles are absent or irregular. Determination of blood levels of prolactin, FSH, luteinizing hormone (LH), estradiol, progesterone, and thyroid hormones may be necessary to diagnose the cause of irregular menstrual cycles. D. Examination for testicular infection should be done before semen analysis. Furthermore, infection affects spermatogenesis.]

Which 16-year-old female is most likely to experience secondary amenorrhea? a. Girl who is 5 ft 2in 130 lbs b. Girl who is 5ft 9 in, 150 lb c. Girl who is 5ft 7in, 96 lb d. Girl who is 5 ft 4 in, 120 lb

c. Girl who is 5ft 7in, 96 lb [A. This girl's (5 ft 2 in, 130 lb) body mass index (BMI) is sufficient to assist with sex hormone production. A low BMI (or body fat) is a risk factor for secondary amenorrhea. B. This girl's (5 ft 9 in, 150 lb) BMI is sufficient to assist with sex hormone production. Low body fat is a risk factor for secondary amenorrhea. C. Because of her height and low body weight, a female who is 5 ft 7 in and 96 lb is at risk of developing secondary amenorrhea, which occurs in women who are thin and have a low percentage of body fat. Fat is necessary to make sex hormones that stimulate ovulation and menstruation. D. This girl's (5 ft 4 in, 120 lb) body fat is sufficient to assist with sex hormone production. Low BMIs are a risk factor for secondary amenorrhea.]

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.

c. Have difficulty remembering to take oral contraceptives daily. [A. Disadvantages of injectable progestins are prolonged amenorrhea and uterine bleeding. B. Use of injectable progestin carries an increased risk of venous thrombosis and thromboembolism. C. Advantages of DMPA include a contraceptive effectiveness comparable to that of combined oral contraceptives with the requirement of only four injections a year. D. 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.]

While instructing a couple regarding birth control, the nurse should be aware that the method called natural family planning: a. Is the same as coitus interrupts, or "pulling out" b. Uses the calendar method to align the woman's cycle with the natural phases of the moon c. Is the only contraceptive practice acceptable to the Roman Catholic Church d. Relies on barrier methods during fertility phases

c. Is the only contraceptive practice acceptable to the Roman Catholic Church [A. "Pulling out" is not the same as periodic abstinence, another name for natural family planning. B. The phases of the moon are not part of the calendar method or any method. C. Natural family planning is the only contraceptive practice acceptable to the Roman Catholic Church. D. Natural family planning is another name for periodic abstinence, which is the accepted way to pass safely through the fertility phases without relying on chemical or physical barriers.]

Which contraceptive method provides protection against sexually transmitted diseases? a. Oral contraceptives b. Tubal ligation c. Male or female condoms d. IUD

c. Male or female condoms [A. Oral contraceptives do not provide any barrier protection against sexually transmitted diseases because they work systemically. B. A tubal ligation is considered a permanent contraceptive method but does not offer any protection against sexually transmitted diseases. The male condom is inexpensive and offers the best protection available. C. Only the barrier methods provide some protection from sexually transmitted diseases. Because latex condoms provide the best protection available, they should be used during any potential exposure to a sexually transmitted disease. D. IUDs are inserted in the uterus but do not block or inhibit sexually transmitted diseases.]

The purpose of the ovum's zona pellucida is to: a. Make a pathway for more than one sperm to reach the ovum. b. Allow the 46 chromosomes from each gamete to merge. c. Prevent multiple sperm from fertilizing the ovum. d. Stimulate the ovum to begin mitotic cell division.

c. Prevent multiple sperm from fertilizing the ovum. [A. Once one sperm has entered the ovum, the zona pellucida changes to prevent other sperm from entering. B. Each gamete (sperm and ovum) has only 23 chromosomes. There will be 46 chromosomes when they merge. C. Fertilization causes the zona pellucida to change its chemical composition so that multiple sperm cannot fertilize the ovum. D. Mitotic cell division begins when the nuclei of the sperm and ovum unite.]

One of the most effective methods for preventing venous stasis is to: a. Wear elastic stockings in the afternoons b. Sleep with the foot of the bed elevated. c. Rest often with the feet elevated. d. Sit with the legs crossed.

c. Rest often with the feet elevated. [A. Elastic stockings should be applied before lowering the legs in the morning. B. Elevating the legs at night may cause pressure on the diaphragm and increase breathing problems. C. Elevating the feet and legs improves venous return and prevents venous stasis. D. Sitting with the legs crossed will decrease circulation in the legs and increase venous stasis.]

Alterations in hormonal balance and mechanical stretching are responsible for several changes in the integumentary system during pregnancy. Stretch marks often occur on the abdomen and breasts. These are referred to as: a. Chloasma b. Linea nigra c. Striae gravidarum d. Angiomas

c. Striae gravidarum [A. Chloasma is a facial melasma also known as the "mask of pregnancy." This condition is manifested by a blotchy, hyperpigmentation of the skin over the cheeks, nose and forehead especially in dark complexioned women. B. Linea nigra is a pigmented line extending from the symphysis pubis to the top of the fundus in the midline. C. Striae gravidarum or stretch marks appear in 50% to 90% of pregnant women during the second half of pregnancy. They most often occur on the breasts and abdomen. This integumentary alteration is the result of separation within the underlying connective (collagen) tissue. D. Angiomas and other changes also may appear.]

In practical terms regarding genetic health care, nurses should be aware that: a. Genetic disorders equally affect people of all socioeconomic backgrounds, races, and ethnic groups b. Genetic health care is more concerned with populations than individuals. c. The most important of all nursing functions is providing emotional support to the family during counseling. d. Taking genetic histories is the province of large universities and medical centers.

c. The most important of all nursing functions is providing emotional support to the family during counseling. [A. Although anyone may have a genetic disorder, certain disorders appear more often in certain ethnic and racial groups. B. Genetic health care is highly individualized, because treatments are based on the phenotypic responses of the individual. C. Nurses should be prepared to help with a variety of stress reactions from a couple facing the possibility of a genetic disorder. D. Individual nurses at any facility can take a genetic history, although larger facilities may have better support services.]

Which question by the nurse will most likely promote sharing of sensitive information during a genetic counseling interview? a. "How many people in your family are mentally retarded or handicapped?" b. "What kinds of defects or diseases seem to run in the family?" c. "Did you know that you can always have an abortion id the fetus is abnormal?" d. "Are there any family members who have learning or developmental problems?"

d. "Are there any family members who have learning or developmental problems?" [A. This question assumes that there are genetic problems that result in intellectual disability in the family. Some individuals may find these terms offensive. B. Some individuals may not be aware of which diseases are genetically linked and may not answer the question accurately. C. This is taking the decision away from the parents. They are seeking counseling in order to prevent problems, not to find out what to do if there is a problem. D. The nurse should probe gently by using lay-oriented terminology rather than direct questions or statements.]

Informed consent concerning contraceptive use is important because some of the methods: a. Are invasive procedures that require hospitalization. b. Require a surgical procedure to insert. c. May not be reliable. d. Have potentially dangerous side effects.

d. Have potentially dangerous side effects. [A. The only contraceptive method that requires hospitalization is sterilization. B. The only surgical procedure used would be for permanent sterilization. C. Some have more effective rates, and this should be included in the teaching. D. It is important for couples to be aware of potential side effects so they can make an informed decision about the use of contraceptives.]

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."

d. "The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide later." [A. Spermicide should be used inside the cap as an additional chemical barrier. B. The cervical cap should remain in place for 6 hours after the last act of intercourse. C. Repeated intercourse with the cervical cap is more convenient, because no additional spermicide is needed. D. 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.]

Some of the embryo's intestines remain within the umbilical cord during the embryonic period because the: a. Umbilical cord is much larger at this time than it will be at the end of pregnancy. b. Intestines begin their development within the umbilical cord. c. Nutrient content of the blood is higher in this location. d. Abdomen is too small to contain all the organs while they are developing.

d. Abdomen is too small to contain all the organs while they are developing. [A. The intestines remain within the umbilical cord only until approximately week 10. B. Intestines begin their development within the umbilical cord, but only because the liver and kidneys occupy most of the abdominal cavity. All the intestines are within the abdominal cavity around week 10. C. Blood supply is adequate in all areas. Intestines stay in the umbilical cord for approximately 10 weeks because they are growing faster than the abdomen. D. The abdominal contents grow more rapidly than the abdominal cavity, so part of their development takes place in the umbilical cord. By 10 weeks, the abdomen is large enough to contain them.]

The function of the cremaster muscle in men is to: a. Aid in voluntary control of excretion of urine. b. Entrap blood in the penis to produce an erection. c. Assist with transporting sperm d. Aid in temperature control of the testicles

d. Aid in temperature control of the testicles [A. The urinary meatus aids in controlling the excretion of urine. B. Entrapment of the blood in the penis is a result of its spongy tissue. C. Seminal fluid assists with transporting sperm. D. A cremaster muscle is attached to each testicle. Its function is to bring the testicle closer to the body to warm it or allow it to fall away from the body to cool it, thus promoting normal sperm production.]

The nurse providing care in a women's health care setting must be aware that which sexually transmitted disease (STD) can be cured? a. Herpes b. AIDS c. Venereal Warts d. Chlamydia

d. Chlamydia [A. Because no cure is known for herpes, treatment focuses on pain relief and preventing secondary infections. B. Because no cure is known for AIDS, prevention and early detection are the main focus. C. Condylomata acuminata is caused by the human papillomavirus. No treatment eradicates the virus. D. The usual treatment for chlamydia bacterial infection is doxycycline or azithromycin. Concurrent treatment of all sexual partners is needed to prevent recurrence.]

Between 6 and 10 days after conception, the trophoblast secretes enzymes that enable it to burrow into the endometrium until the entire blastocyst is covered. This is termed implantation. Tiny projections then develop out of the trophoblast and extend into the endometrium. These projections are referred to as: a. Decidua basalis b. Decidua capsularis c. Decidua vera d. Chorionic villi

d. Chorionic villi [A. The deciduas basalis is the portion of the endometrium where the chorionic villi tap into the maternal blood vessels. B. The deciduas capsularis is the portion of the endometrium that covers the blastocyst. C. The portion of the endometrium that lines the rest of the uterus is called deciduas vera. D. These villi are vascular processes that obtain oxygen and nutrients from the maternal bloodstream and dispose of carbon dioxide and waste products into the maternal blood.]

While evaluating a patient for osteoporosis, the nurse should be aware of what risk factor? a. African-american race b. Low protein intake c. Obesity d. Cigarette smoking

d. Cigarette smoking [A. Women at risk for osteoporosis are likely to be Caucasian or Asian. B. Inadequate calcium intake is a risk factor for osteoporosis. C. Women at risk for osteoporosis are likely to be small boned and thin. Obese women have higher estrogen levels as a result of the conversion of androgens in the adipose tissue. Mechanical stress from extra weight also helps preserve bone mass. D. Smoking is associated with earlier and greater bone loss and decreased estrogen production.]

A pregnant woman has come to the emergency department with complaints of nasal congestion and epistaxis. What is the correct interpretation of these symptoms by the practitioner? a. These conditions are abnormal. Refer the patient to an ear, nose, and throat specialist. b. Nasal stuffiness and nosebleeds are caused by a decrease in progesterone. c. Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and epistaxis are within normal limits. d. Estrogen causes increased blood supply to the mucous membranes and can result in congestion and nosebleeds.

d. Estrogen causes increased blood supply to the mucous membranes and can result in congestion and nosebleeds. [A. The patient should be reassured that these symptoms are within normal limits. No referral is needed at this time. B. Progesterone is responsible for the heightened awareness of the need to breathe in pregnancy. Progesterone levels increase during pregnancy. C. Progesterone affects relaxation of the smooth muscles in the respiratory tract. D. As capillaries become engorged, the upper respiratory tract is affected by the subsequent edema and hyperemia, which causes these conditions, seen commonly during pregnancy.]

An appropriate nursing measure when a baby has an unexpected anomaly is to: a. Remove the baby from the delivery area immediately. b. Tell the parents that the baby has to go to the nursery immediately. c. Inform the parents immediately that something is wrong. d. Explain the defect and show the baby to the parents as soon as possible.

d. Explain the defect and show the baby to the parents as soon as possible. [A. The parents should be able to touch and hold the baby as soon as possible. B. This would raise anxiety levels of the parents; they should be told about the defect and allowed to see the baby. C. They should be told immediately, but they should be told about the defect and be allowed to see the infant. D. Parents experience less anxiety when they are told about the defect as early as possible and are allowed to touch and hold the baby.]

While you are assessing the vital signs of a pregnant woman in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate? a. Have the patient stand up and retake her blood pressure. b. Have the patient sit down and hold her arm in a dependent position. c. Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms. d. Have the patient turn to her left side and recheck her blood pressure in 5 minutes.

d. Have the patient turn to her left side and recheck her blood pressure in 5 minutes. [A. Pressures are significantly higher when the patient is standing. This option causes an increase in systolic and diastolic pressures. B. The arm should be supported at the same level of the heart. C. The supine position may cause occlusion of the vena cava and descending aorta, creating hypotension. D. Blood pressure is affected by positions during pregnancy. The supine position may cause occlusion of the vena cava and descending aorta. Turning the pregnant woman to a lateral recumbent position alleviates pressure on the blood vessels and quickly corrects supine hypotension.]

The most basic information a maternity nurse should have concerning conception is: a. Ova are considered fertile 48 to 72 hours after ovulation. b. Sperm remain viable in the woman's reproductive system for an average of 12 to 24 hours. c. Conception is achieved when a sperm successfully penetrated the membrane surrounding the ovum. d. Implantation in the endometrium occurs 6 to 10 days after conception.

d. Implantation in the endometrium occurs 6 to 10 days after conception. [A. Ova are considered fertile for approximately 24 hours after ovulation. B. Sperm remain viable in the woman's reproductive system for an average of 2 to 3 days. C. Penetration of the ovum by the sperm is called fertilization. Conception occurs when the zygote, the first cell of the new individual, is formed. D. After implantation, the endometrium is called the decidua.]

The nurse who is teaching a group of women about breast cancer should tell the women that: a. Risk factors identify almost all women who will develop breast cancer. b. African-American women have a higher rate of breast cancer. c. One in 10 women in the United States will develop breast cancer in her lifetime. d. The exact cause of breast cancer is unknown.

d. The exact cause of breast cancer is unknown. [A. Risk factors help identify a small percentage of women in whom breast cancer eventually will develop. B. Caucasian women have a higher incidence of breast cancer; however, African-American women have a higher rate of dying of breast cancer after they are diagnosed. C. One in eight women in the United States will develop breast cancer in her lifetime. D. The exact cause of breast cancer in unknown.]