UMB ABSN NU 335 Final Chapters
12) The pregnant client employed at a factory asks the nurse whether exposure to chemicals can cause harm to her fetus. The nurse should advise that exposure to which substance can lead to neurological damage? 1. Lead 2. Latex 3. Formaldehyde 4. Benzene
Answer: 1
18) Psychologic elder abuse includes, but is not limited to, which of the following? Select all that apply. 1. Verbal assaults 2. Humiliation 3. Desertion 4. Intimidation 5. Failure to provide reasonable care
Answer: 1, 2, 4
32) The client has been diagnosed with hepatitis B. Which statement indicates to the nurse that the client needs more education? Select all that apply. 1. "This infection could be sexually transmitted." 2. "I might get jaundiced from this illness." 3. "An immunization exists to prevent getting hepatitis B." 4. "I might have gotten this infection from food." 5. "The incubation period is 15-50 days."
Answer: 4, 5 Explanation: 4. Hepatitis B is found in blood and body fluids, and therefore can be sexually transmitted. Hepatitis A and E are foodborne, and transmitted by fecal-oral contamination. 5. The incubation period for hepatitis B is 45-160 days.
2) The nurse is teaching an in-service educational presentation about working with battered women. The nurse should explain that it is often frustrating for nurses to work with battered women for which reasons? Select all that apply. 1. There is little the nurse can really do to help. 2. Healthcare policies and practices are not supportive of abused women. 3. Both husband and wife must agree to therapy. 4. These women might return to the abusive situation. 5. Women often believe that they are the cause of the abuse.
Answer: 4, 5 Explanation: 4. Women often believe that escape is futile, or escape and then return when the crisis is over. 5. Women are often convinced by the abusers that it is their own behavior that causes the abuse.
21) The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? 1. Age 30, treated for PID 2. Age 25, monogamous 3. Age 20, pregnant 4. Age 27, uses a diaphragm
Answer: 1 Explanation: 1. Exposure to sexually transmitted infections increases the risk of abnormal cell changes and cervical cancer.
26) In teaching a group of adolescents, the nurse discusses which risk factors for cardiovascular disease (CVD) in women? Select all that apply. 1. Being over 55 and postmenopausal 2. Using cigarettes and tobacco 3. Being overweight 4. Having a low cholesterol level 5. Having an active lifestyle
Answer: 1, 2, 3
29) The nurse is teaching a group of young women how to prevent urinary tract infections. What will the nurse include in the teaching? Select all that apply. 1. The importance of good hygiene 2. How to recognize the signs and symptoms 3. How to take prescribed antibiotics 4. Fluids are restricted to 1000 ml 5. To urinate only when the urge is strong
Answer: 1, 2, 3
13) The 12-year-old client reports that menarche occurred 5 months ago. She has had bleeding every day this month, and is very worried. The nurse should explain that the most common cause of this bleeding is which of the following? 1. Dysfunctional uterine bleeding (DUB) 2. Diabetes mellitus (DM) 3. Pregnancy 4. Von Willebrand's disease
Answer: 1 Explanation: 1. Adolescents often experience DUB during the first 2 years following menarche due to hypothalamic immaturity after menarche.
14) The nurse is scheduling an ultrasound for a 51-year-old client with a suspected uterine tumor. The nurse includes in the client's teaching that the most common benign uterine tumor seen in women in their 50s is which of the following? 1. Fibroid tumor 2. Fibroadenoma 3. Fibrocystic tumor 4. Lymphoma
Answer: 1 Explanation: 1. By the age of 50, 70% of Caucasian women and 80% of African American women have fibroids.
31) The nurse is educating a client on intrauterine contraception (IUC). Which advantages of IUC will the nurse include? Select all that apply. 1. It is effective, continuous contraception. 2. It is relatively inexpensive over time. 3. It does not need to be inserted immediately prior to coitus. 4. Small amounts of estrogen are released daily. 5. It slightly increases the risk of ectopic pregnancy.
Answer: 1, 2, 3
32) Lesbian and bisexual women are greater risk for health and social disparities, including which of the following? Select all that apply. 1. Increased suicide risk 2. Increased risk of homelessness 3. Lack of screening for female-related cancers 4. Lack of screening for lung cancers 5. Increased divorce rates
Answer: 1, 2, 3
35) The culturally competent nurse recognizes that female genital mutilation (FMG) can include which health implications? Select all that apply. 1. Hemorrhage 2. Infertility 3. Urinary tract infections 4. Increased sexual pleasure 5. Easier childbirth
Answer: 1, 2, 3
5) The nurse is planning a community education presentation on battering. Which statement about battering should the nurse include? 1. Battering occurs in a small percentage of the population. 2. Battering is mainly a lower-class, blue collar problem. 3. Battered women are at greatest risk for severe violence when they leave the batterer. 4. If the batterer stops drinking, the violence usually stops.
Answer: 3
6) During a counseling session on natural family planning techniques, the nurse explains that cervical mucus at the time of ovulation should be of what consistency? 1. Egg white appearance and stretchable 2. Opaque and acidic 3. High in leukocytes 4. Lacking in quantity
Answer: 1 Explanation: 1. Cervical mucus at the time of ovulation has an "egg white" appearance and is known as fertile mucus; it is friendly to sperm because it assists passage through the cervix and uterus up into the fallopian tubes.
4) A pregnant client at 24 weeks' gestation is diagnosed with bacterial vaginosis. Her doctor orders Flagyl to treat the problem. What would be appropriate education for the nurse to provide? 1. The client must be careful to observe for signs of preterm labor. 2. The client should advise her partner to seek therapy as soon as possible. 3. The main side effect of the medication is a large amount of vaginal discharge. 4. A repeat culture should be taken 2 weeks after completing the therapy.
Answer: 1 Explanation: 1. Clients with bacterial vaginosis are at risk for preterm labor.
19) A public health nurse, along with a student, is visiting the home of an elderly woman who is widowed and lives alone. Her 40-year-old son is her caregiver, and the public health nurses visit about once a week to follow up on her high blood pressure, recent surgery for a hip fracture, and diabetes. The nurse and student find the home dirty, sink full of dirty dishes, and the client in clothes that are extremely soiled. She cannot reach her walker to get up, and she has been incontinent. The nurse recognizes this as which type of abuse? 1. Neglect 2. Abandonment 3. Physical abuse 4. Financial abuse
Answer: 1
24) The nurse is caring for a 20-year-old labor client who is autistic. This client will not talk with the nurse, she wants her mother right at her side, and she obviously does not understand what is happening. Which term best describes the disability of this client? 1. Developmental 2. Learning 3. Neurological 4. Sensory
Answer: 1
33) The nurse is teaching nursing students about the different kind of hepatitis. Which statement is the nurse likely to make? 1. Hepatitis A and B have vaccines to prevent them. 2. Hepatitis A, B, and C have vaccines to prevent them. 3. Hepatitis C, D, and E are all bloodborne. 4. Hepatitis A, C, and E are all fecal-oral contamination.
Answer: 1
7) A nurse is caring for a client admitted preoperatively for a bilateral mastectomy. Which statement indicates that this client is still in the shock phase of adjustment to her diagnosis? 1. "I can't understand why this is happening to me." 2. "I am so happy that my daughter graduates from high school this year." 3. "I know that breast cancer is now part of my life." 4. "I can't believe that I need to lose both of my breasts."
Answer: 1
22) Which client in the gynecology clinic should the nurse see first? 1. 22-year-old with fever, hypotensive, using tampons 2. 15-year-old, no menses for past 4 months 3. 18-year-old seeking information on contraception methods 4. 31-year-old, reports increasing dyspareunia
Answer: 1 Explanation: 1. A client using tampons who has a fever, is dizzy, and hypotensive might have toxic shock syndrome.
20) The client's Pap smear result is ASC-US. Which statement is the best way for the nurse to explain this ASC-US result? 1. "Abnormal squamous cells of undetermined significance." 2. "Cancer has invaded the upper cervix." 3. "High-grade squamous intraepithelial lesion (HSIL), which includes CIN." 4. "The focus of the Pap smear is the detection of high-risk pregnancy." 5. "The cervical cells are abnormal and the reason why is severe dysplasia and carcinoma in situ."
Answer: 1 Explanation: 1. ASC-US stands for abnormal squamous cells of undetermined significance. Preferred management is HPV testing; if positive, refer for colposcopy; if negative, repeat HPV co-testing in 3 years.
31) Abdominal hysterectomy is generally recommended for which condition? 1. Severe endometriosis 2. Removal of the ovaries 3. Suspected or confirmed cancer removal 4. Abnormal uterine bleeding
Answer: 1 Explanation: 1. Abdominal hysterectomy is recommended for severe endometriosis.
10) The nurse working in the emergency department knows that many batterers have feelings of ambivalence. In what way might this be evident? 1. The abuser alternates episodes of unmerciful beatings with periods of remorse and loving attention. 2. The abuser has alternating periods of sadness and happiness. 3. The abuser has alternating periods of maturity and immaturity. 4. The abuser alternates letting the person he abuses be independent and then dependent.
Answer: 1 Explanation: 1. Extremes in behavior and overreacting are typical patterns.
18) The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? 1. Age 37, multiple partners 2. Age 22, abstains from sexual intercourse 3. Age 32, pregnant with twins 4. Age 27, uses female condom
Answer: 1 Explanation: 1. Having multiple partners increases the client's risk of contracting sexually transmitted infections, including possible exposure to human papilloma virus (HPV). Contracting HPV increases risk of abnormal cervical cell changes and cervical cancer.
26) The nurse is teaching a group of parents of school-aged girls with intellectual disabilities. The nurse tells the parents which of the following? 1. The girls need education about STIs, contraception, and routine gynecological checkups. 2. The girls would be better off if they had permanent sterilization. 3. The girls will probably not be sexually active. 4. The girls are not able to understand about contraception and sex.
Answer: 1 Explanation: 1. In contemporary society, the need for sexual health education is imperative because some girls and women with intellectual disabilities may face unplanned pregnancies.
1) The client has been a victim of a violent, sadistic rape. She is crying, and asks the nurse "Why would someone do something like that?" The nurse should explain that which of the following is the primary purpose of sadistic rape? 1. Take pleasure from the victim's struggle and pain 2. Express feelings of rage 3. Feel a sense of power or mastery 4. Relieve intolerable anxiety
Answer: 1 Explanation: 1. In sadistic rape, the assailant has an antisocial personality and delights in torture and mutilation. In this type of rape, the victim and assailant are generally strangers, and the assault is planned. Sadistic rapes cause the most injuries, including homicide.
11) A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be: 1. Oral acyclovir 2. Ceftriaxone IM 3. Azithromycin p.o. 4. Penicillin G IM
Answer: 1 Explanation: 1. Malaise, dysuria, and tingling or painful vesicles are indicative of a primary herpes simplex outbreak. Acyclovir treats herpes.
34) The nurse working on a postoperative gynecology unit has to be knowledgeable of the psychological concerns of many of her clients. What will these concerns most often include? 1. Feelings of loss, grief, and anger 2. Feelings of euphoria and happiness 3. Feelings of control and calmness 4. Feelings of cheerfulness and satisfaction
Answer: 1 Explanation: 1. Many gynecological procedures have the potential to involve loss, so grieving, anger, sadness, and loss of control are just a few of the feelings the woman might experience.
22) The nurse is caring for an abused mother in the postpartum department. The client is afraid to go home, but has no money to do anything else. What can the nurse do to assist this individual and her baby? 1. Work with community services to have the client and her baby go to a safe place, complete paperwork to obtain financial assistance, and obtain some temporary assistance. 2. Explain that she will have to go home at this time, but provide her with paperwork to complete to obtain assistance. 3. Offer to have her partner come in and attend a counseling session with her. 4. Suggest that once she gets home, she should pursue getting a restraining order against her abuser.
Answer: 1 Explanation: 1. Nurses and medical personnel need to be alert to symptoms of battering, recognize these cues, and encourage women to seek assistance from community agencies. The most innovative and effective domestic violence programs in hospitals and urgent care facilities work collaboratively with domestic violence service agencies, develop a comprehensive community referral network, and work with multidisciplinary intervention teams.
6) The nurse at a shelter is counseling a group of battered women. What will the nurse will emphasize? 1. Battering will not stop or decrease if the woman becomes pregnant. 2. About 1 of every 5 women will experience abuse in her lifetime. 3. When these women go back to the situation after the abuser has cooled down, it will be better. 4. The battered woman can readily leave the situation.
Answer: 1 Explanation: 1. Pregnancy does not stop the abuser, and sometimes it increases the intensity of the abuse.
19) A home health nurse is making a home visit to a new mother who is diabetic and requires some follow-up to make sure her baby is doing well and that her diabetes is in control while she is breastfeeding. The client meets her at the door, crying, with bruises on her face and legs. The nurse knows the client has been in a questionable relationship. What is the first responsibility of the nurse for this client at this time? 1. Assist in getting the client and her baby to a safe situation. 2. Check her blood sugar and make sure it is within normal limits. 3. Ask her how she is doing with the breastfeeding. 4. Check the baby's heart rate and other vital signs.
Answer: 1 Explanation: 1. Providing the abused woman with information that empowers her in decision making and providing critical assistance in safety planning for her and her baby is the nurse's first responsibility.
15) When assessing a client asking about birth control, the nurse knows that the client would not be a good candidate for Depo-Provera (DMPA) if which of the following is true? 1. She wishes to get pregnant within 3 months. 2. She is a nursing mother. 3. She has a vaginal prolapse. 4. She weighs 200 pounds.
Answer: 1 Explanation: 1. Return of fertility after use may be delayed for an average of 10 months.
28) What is the most important aspect of care for the nurse to remember when screening a woman for partner abuse? 1. Ensuring privacy and confidentiality 2. Conveying warmth and empathy 3. Asking specific, direct questions about abuse 4. Clarifying her myths about battering
Answer: 1 Explanation: 1. Screening for women experiencing domestic violence must be done privately, with only the nurse and the client present, in a safe and quiet place.
13) The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The client asserts that her menarche was 5 years ago. Her menses are usually every 28 days, but her last menstrual period was 4 months ago. The client denies any sexual activity. Which is the best statement for the nurse to make? 1. "Your lack of menses might be related to your rapid weight loss." 2. "It is common and normal for runners to stop having any menses." 3. "Increase your intake of iron-rich foods to reestablish menses." 4. "Adolescents rarely have regular menses, even if they used to be regular."
Answer: 1 Explanation: 1. Secondary amenorrhea can be caused by rapid weight loss, including the development of the eating disorders anorexia and bulimia. Runners with low body fat might have irregular menses, but amenorrhea is not a normal condition.
10) The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client is at greatest risk for the infection? 1. 16-year-old sexually active girl, using no contraceptive 2. 22-year-old mother of two, developed dyspareunia 3. 35-year-old woman on oral contraceptives 4. 48-year-old woman with hot flashes and night sweats
Answer: 1 Explanation: 1. Teens have the highest incidence of sexually transmitted infections, especially chlamydia. A client not using contraceptives is not using condoms, which decrease the risk of contracting a STI.
2) A client describes breast swelling and tenderness. What piece of data would be most important for the nurse to gather initially? 1. Timing of the symptoms 2. Birth control method 3. Method of breast self-examination 4. Diet history
Answer: 1 Explanation: 1. The breast undergoes regular cyclical changes in response to hormonal stimulation. The nurse will want to determine when the swelling and tenderness occur within the menstrual cycle.
12) A client in the women's clinic asks the nurse, "How is the cervical mucus method of contraception different from the rhythm method?" The appropriate response by the nurse is that the cervical mucus method is which of the following? 1. More effective for women with irregular cycles 2. Not acceptable to women of many different religions 3. Harder to work with than is the rhythm method 4. Requires an artificial substance or device
Answer: 1 Explanation: 1. The cervical mucus method (Billings Ovulation Method) can be used by women with irregular cycles.
24) A nurse is providing contraceptive counseling to a perimenopausal client in a monogamous relationship. What comment by the client indicates that further teaching is necessary? 1. "The calendar method is the most reliable method for me to use." 2. "If I use the IUC, I will be at minimal risk for pelvic inflammatory disease." 3. "I should still use birth control, even though I had only three periods last year." 4. "The contraceptive skin patch contains both estrogen and progesterone."
Answer: 1 Explanation: 1. The client who believes the calendar method is the most reliable method requires more teaching. The menstrual cycle of perimenopausal women is irregular, and it is difficult to determine safe and unsafe times.
6) The nurse is working with a woman who is undergoing chemotherapy for breast cancer. The client states, "First, the cancer seemed unreal. Now I feel like I can cope." What is the nurse's best response? 1. "Women with breast cancer often go through several stages of adjustment." 2. "Women with breast cancer cope better than their partners cope." 3. "Women with breast cancer seek multiple opinions before starting treatment." 4. "Women with breast cancer become angry after treatment begins."
Answer: 1 Explanation: 1. The course of adjustment confronting the woman with cancer has been described in four phases: shock, reaction, recovery, and reorientation. The client's statement indicates shock followed by reaction.
33) A client using oral contraceptives tells the nurse that her family is complete, and she now desires permanent contraception. Which statement should the nurse include in teaching this client about sterilization options? 1. "Essure becomes effective 3 months after insertion." 2. "Vasectomy is effective immediately after the procedure." 3. "Tubal ligation cannot be performed until the client is age 35." 4. "Oral contraception should be taken until menopause."
Answer: 1 Explanation: 1. The insertion of Essure creates a tissue response that results in tubal occlusion in about 3 months.
21) The nurse is teaching a group of menopausal women about the signs and symptoms of menopause and how they can get relief. One of the main concerns of the group is vaginal dryness and difficult intercourse. What is the reason the nurse will give for this? 1. The loss of cervical gland function leads to dryness of the mucous membranes of the vagina. 2. The vaginal pH increases, and the number of Doderlein's bacilli decreases. 3. The uterine lining thins and the muscle layer atrophies. 4. The labia shrink and lose their pigmentation.
Answer: 1 Explanation: 1. The loss of cervical gland function leads to dryness of the mucous membranes of the vagina.
1) When discussing the feminization of poverty, the nurse educator will inform the students of what fact? 1. The out-of-wedlock birth rate is above 40%. 2. In 2012, 25% of the households headed by single mothers lived in poverty. 3. Poverty is not directly linked to level of education attained. 4. Women work fewer hours for more pay than men do.
Answer: 1 Explanation: 1. The reality is that many children will spend at least a portion of their lives in single-parent families.
32) The nurse in the OB-GYN office is explaining the benefits and risks associated with Essure to a client and her husband. What statement made by the client indicates that additional education is needed? 1. "A stainless steel microinsert is placed into the distal section of one fallopian tube." 2. "The Essure method of permanent sterilization requires no surgical incision." 3. "The steel microinserts create a benign tissue response that occludes the fallopian tubes." 4. "Women allergic to nickel should consult their physician before placement."
Answer: 1 Explanation: 1. The stainless steel microinsert is placed in the proximal section of both fallopian tubes.
30) The lesbian woman who is pregnant by in vitro fertilization from an unknown donor comes to the obstetric clinic in her seventh month with her partner. When asked by the nurse why she has waited so long to come in, the client remarks, "Oh, you know why." What does the nurse suspect? 1. The client is experiencing a fear of discrimination on the part of providers. 2. The client is without insurance, and is afraid she will be turned away. 3. The client is in good health, and did not need to come in any sooner. 4. The client is independent in her health care, and opted for self-care until now.
Answer: 1 Explanation: 1. The woman most likely has a fear of discrimination due to her sexual orientation. Women's health services in particular have not shown acceptance of lesbian, bisexual, or transgender status.
25) The nurse suspects that a client has been physically abused, but the woman refuses to report the abuse to the police. Which statement by the client suggests to the nurse that the relationship might be in the "honeymoon period" of the cycle of violence? 1. "My boyfriend says he will never hurt me again." 2. "My boyfriend only drinks alcohol on the weekends." 3. "My boyfriend yells less than he used to." 4. "My boyfriend has frequent bouts of insomnia."
Answer: 1 Explanation: 1. This is an example of a statement made during the honeymoon period of the cycle of violence.
7) A woman is asking the nurse about using the calendar method of contraception. She reports that her last six menstrual cycles were 28, 32, 29, 36, 30, and 27 days long, respectively. Based on this information, when should the nurse tell the client to abstain from intercourse? 1. Days 9-25 2. Days 9-15 3. Days 10-21 4. Days 10-16
Answer: 1 Explanation: 1. To calculate the period of abstinence, the nurse must subtract 18 from the shortest cycle length and 11 from the longest cycle length.
15) The clinic nurse teaches the pregnant client being treated for trichomoniasis about the risks to her pregnancy due to this infection. Which statement would indicate successful teaching? 1. "I am at risk of having a preterm birth because of this infection." 2. "I might need to have my membranes ruptured because of this infection." 3. "I am at risk of having a baby with a high birth weight." 4. "I may have intercourse with my husband while bring treated for this infection."
Answer: 1 Explanation: There is a risk of preterm birth and rupture of membranes.
30) The nurse is evaluating the outcomes of nursing care for a woman with a urinary tract infection. Which of the following does the nurse include in the evaluation? Select all that apply. 1. The client implements self-care measures for prevention. 2. The client completed the prescribed antibiotics. 3. The client knows self-care measures for worsening symptoms. 4. The client states that UTIs are controlled, not cured. 5. The client knows that cranberry juice can help prevent UTIs.
Answer: 1, 2 Explanation: 1. In the evaluation, the nurse should determine whether the client implements self-care measures to help prevent recurrent UTI as part of her personal routine. 2. Evaluation includes whether the client completed her prescribed course of antibiotic therapy.
27) The nurse is assessing a woman with a paralyzed arm who has lost her health insurance due to unemployment. The nurse recognizes that women with disabilities face which barriers to employment? Select all that apply. 1. No access to transportation 2. Lack of education and training 3. Lack of wheelchair access 4. Lack of wide door openings into buildings 5. Lack of readily available ramps
Answer: 1, 2 Explanation: 1. People with disabilities might not have access to transportation. 2. Lack of education and training is a common factor related to unemployment among women with disabilities.
17) The nurse teaches a group of young women that self-care measures for dysmenorrhea include which of the following actions? Select all that apply. 1. Taking vitamins B and E 2. Decreasing salt intake 3. Using cold packs as needed 4. Using intermittent exercise 5. Taking FSH replacement
Answer: 1, 2 Explanation: 1. Some nutritionists suggest that vitamins B and E help relieve the discomforts associated with menstruation. 2. Self-care measures such as regular exercise, rest, application of heat, and good nutrition—including reducing salt—will help dysmenorrhea symptoms.
34) The nurse is working with a group of recent immigrants from a country in which female genital mutilation (FGM) is practiced. In order to be effective in teaching about gynecologic care in the U.S., the nurse must keep which issues in mind? Select all that apply. 1. Women might undergo FGM willingly to support the status quo of society. 2. Women might undergo the procedure to be considered for marriage. 3. Women who immigrate to other countries feel a sense pride once the procedure has been performed. 4. Women might undergo the procedure to be gain greater sexual pleasure. 5. Women might undergo the procedure to lose their virginity.
Answer: 1, 2 Explanation: 1. The ritual is performed by various ethnic groups for a variety of reasons including perceived improved social acceptance. 2. The ritual is performed by various ethnic groups for a variety of reasons including marriageability.
11) A nurse in the emergency department recognizes in the husband of a client one of which of the following common characteristics of batterers? Select all that apply. 1. Emotionally immature 2. Tend to express their overwhelming feelings of inadequacy through violence 3. Feelings of insecurity and inferiority 4. A lack of respect in the community 5. Limited jealousy or possessiveness
Answer: 1, 2, 3
12) The nurse is instructing a young client on avoiding toxic shock syndrome. Education was successful when the client makes which statements? Select all that apply. 1. "I will wash my hands before inserting a tampon." 2. "I will change my tampon every 3-6 hours." 3. "I will not touch the part of the tampon I insert." 4. "I will just put the used tampon in the trash." 5. "I will take prophylactic antibiotics if needed."
Answer: 1, 2, 3
16) The nurse is writing a care plan for a client with abnormal uterine bleeding (AUB). Which goals does the nurse include? Select all that apply. 1. Preventing or treating anemia 2. Preventing endometrial hyperplasia 3. Restoring quality of life 4. Conducting pelvic exams monthly 5. Analyzing liver and kidney function
Answer: 1, 2, 3
18) What issues should the nurse consider when counseling a client on contraceptive methods? Select all that apply. 1. Cultural perspectives on menstruation and pregnancy 2. Effectiveness of the method 3. Future childbearing plans 4. Whether the client is a vegetarian 5. Age at menarche
Answer: 1, 2, 3
19) The nurse is providing health education to a group of young people. When teaching about the prevention of sexually transmitted infections (STIs), the nurse will teach which concepts? Select all that apply. 1. Decision-making skills in refusing intercourse 2. How to reduce high-risk behaviors 3. That Pap smears might be needed more often 4. The safety of oral sex 5. Use of petroleum-based lubricants with condoms
Answer: 1, 2, 3
23) The nurse in a community clinic recognizes that older women face various barriers to obtaining health care. Which of the following are barriers that must be overcome? Select all that apply. 1. Transportation difficulties 2. Lack of private health care coverage 3. Excessive medical costs not covered by Medicare 4. Adequate research on chronic conditions 5. The Family and Medical Leave Act
Answer: 1, 2, 3
9) The nurse working in the emergency department is admitting a woman who has been battered for a second time, and recognizes that the woman is again in the cycle of violence. The nurse knows that which of the following are characteristics of the phases of the cycle of violence? Select all that apply. 1. Batterer demonstrates power and control 2. Active battering from some event 3. A loving, contrite period 4. Defeat and admission of guilt by the victim 5. Blame and punishment for inferiority
Answer: 1, 2, 3
23) The nurse in the emergency department is admitting a 22-year-old woman who complains of watery diarrhea, dizziness, and vomiting. She is in the middle of her period, and has a tampon in place. The nurse suspects toxic shock syndrome, and assesses for the manifestations of which symptom? Select all that apply. 1. Fever 2. Rash 3. Desquamation of skin 4. Bloating 5. Urinary frequency and urgency
Answer: 1, 2, 3 Explanation: 1. A fever presents initially. 2. A rash on the trunk presents initially. 3. The fever and rash on the trunk present initially, followed by desquamation of the skin, especially the palms and soles, which usually occurs 1 to 2 weeks after the onset of symptoms.
4) The nurse working in the emergency department of a hospital is caring for a woman whom the nurse suspects is the victim of domestic violence. The nurse knows that which of the following are contributing factors to domestic violence? Select all that apply. 1. Experiencing or witnessing abuse as a child 2. Strong patriarchal family traditions 3. Linking masculinity to male honor 4. Low levels of marital conflict 5. Alcohol and drug abuse cause the violence
Answer: 1, 2, 3 Explanation: 1. Children who witness or experience abuse and battering are more likely to become batterers (men) or to be abused (women) in their own relationships. 2. Men raised in patriarchal families (those that encourage traditional gender roles) are more likely to engage in domestic violence. 3. Cultures that link definitions of manhood to dominance, toughness, or male honor are more likely to demonstrate violence against women.
4) The nurse is educating a group of women about the manifestations of benign breast conditions. What information topics will the nurse include? Select all that apply. 1. Masses rapid in appearance or disappearance 2. Galactorrhea is common 3. Galactorrhea is seen with some psychiatric medications 4. Ulcerations or skin erosions are possible 5. An increased breast size with dimpling
Answer: 1, 2, 3 Explanation: 1. Fluctuations in size and rapid appearance or disappearance of breast masses are common in fibrocystic breasts. 2. Galactorrhea is a benign change often associated with hormone therapy. 3. Galactorrhea is often seen in women who have nursed, who have fibrocystic changes in the breast, or are on some types of psychiatric medication.
2) The nurse is on a panel at a conference discussing poverty and health care for those living below the poverty level. Which statements should the nurse include? Select all that apply. 1. The poverty level is defined as a family of four living on less than $23,550 per year. 2. Two-thirds of Americans living in poverty are women and children. 3. The majority of single-parent families are headed by women. 4. The greatest number of people living under the poverty level are the elderly. 5. Parental race does not affect the level of poverty.
Answer: 1, 2, 3 Explanation: 1. Increasing numbers of U.S. women and their children are attempting to live on $23,550 or less, which is the current income that defines the poverty level for a family of four. 2. Currently, two-thirds of Americans living in poverty are women and children. 3. The majority of single parent-families are headed by women, and these families are four times more likely to live in poverty than families with two parents.
4) In a community clinic, a number of women working low-paying jobs come in for health care in the evening. The nurse knows that which of the following is true about the women's working situations? Select all that apply. 1. They have no health insurance. 2. They have "pink collar" jobs. 3. They earn less pay than do their male counterparts. 4. They will be receiving a pension upon retirement. 5. They have no problem securing child care.
Answer: 1, 2, 3 Explanation: 1. Lack of health insurance continues to be a major problem for the poor. 2. About one-third of women work in a cluster of "pink collar" occupations, which tend to be poorly paid when compared with male-dominated positions requiring comparable levels of responsibility, skill, and education. 3. Women are paid less than men for comparable work in virtually all occupations.
35) The nurse has assessed a client who is to undergo gynecological surgery. Upon what will the nurse base the nursing diagnosis? Select all that apply. 1. The client's attitudes toward motherhood 2. The client's body image 3. The client's attitudes about sexuality 4. The client's long-term risk reduction 5. The client's use of acupuncture
Answer: 1, 2, 3 Explanation: 1. Reproductive surgery may also be seen as a threat to femininity in any social or cultural group that emphasizes childbearing and motherhood. 2. Surgery to alter or remove reproductive organs may be perceived as a threat to self-concept. Body image is affected whenever a body part is lost. 3. Many women fear postoperative changes such as masculinization, weight gain, loss of sexuality, and permanent loss of the ability to have a child.
18) The nurse at a women's clinic is planning a class on premenstrual dysphoric disorder (PMDD). The nurse includes in the education information about what medications that are shown to be effective for PMDD? Select all that apply. 1. Fluoxetine hydrochloride (Prozac) 2. Sertraline hydrochloride (Zoloft) 3. Paroxeline CR (Paxil CR) 4. Hyoscyamine (Anaspaz) 5. Promethazine (Phenergan)
Answer: 1, 2, 3 Explanation: 1. Selective serotonin inhibitors such as fluoxetine hydrocholoride (Prozac) have been found to be effective in controlling PMDD. 2. Setraline hydrochloride (Zoloft) is a selective serotonin inhibitor and has been found to be effective in controlling PMDD. 3. Paroxeline CR (Paxil CR) is a selective serotonin inhibitor and has been found to be effective in controlling PMDD.
30) The nurse is caring for a battered woman in the emergency department. Which nursing guidelines are used in the care of this client? Select all that apply. 1. Letting the woman tell her story at her own pace 2. Anticipating ambivalence toward the batterer 3. Acknowledging the woman's feelings as reasonable 4. Letting the woman figure out how to identify specific problems on her own 5. Allowing her to believe in false beliefs if it makes her feel more secure
Answer: 1, 2, 3 Explanation: 1. The nurse should let the woman work through her story, problems, and situation at her own pace. 2. The nurse should anticipate ambivalence in the woman's love-hate relationship with the batterer. 3. The nurse should let the woman know that she is believed, and that her feelings are reasonable and normal.
22) The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statements indicate that teaching was effective? Select all that apply. 1. "I might have infertility because of this infection." 2. "It is important for me to finish my antibiotics." 3. "Tubal pregnancy could occur after PID." 4. "My PID was caused by a yeast infection." 5. "I am going to have an IUD placed for contraception."
Answer: 1, 2, 3 Explanation: 1. Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of PID. 2. Antibiotic therapy should always be completed when a client is diagnosed with any infection. 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.
14) Pesticide exposure can be linked to a variety of adverse health outcomes, including which of the following? Select all that apply. 1. Increased risk of cancer 2. Endocrine abnormalities 3. Liver damage 4. Birth defects 5. Cardiovascular diseases
Answer: 1, 2, 3, 4
30) A client is diagnosed with a cystocele. The nurse actively listens as the client talks about which treatment choice to make. The treatment options available to the client are which of the following? Select all that apply. 1. Kegel exercises 2. Vaginal pessaries 3. Surgical intervention 4. Estrogen 5. Fine-needle aspiration
Answer: 1, 2, 3, 4
8) The nurse is working in an obstetrical clinic in an urban setting. The nurse knows that which certain facts affect the health care of this group of women? Select all that apply. 1. Women who receive adequate prenatal care are less likely to develop preterm labor. 2. Women who do not receive prenatal care are more likely to have low-birth-weight babies. 3. A lack of prenatal care is a risk for infant morbidity and mortality. 4. Decreases in health insurance coverage have led to declines in preventive health care. 5. Women who do not receive prenatal care are more likely to have high-birth-weight babies.
Answer: 1, 2, 3, 4
1) A nurse is teaching contraception to a group of college students during a health class. What reason will the nurse include as to why couples might choose to use contraception? Select all that apply. 1. Couples use contraception to avoid pregnancy. 2. Couples use contraception to space future pregnancies. 3. Couples use contraception to gain control over the number of children conceived. 4. Couples use contraception to avoid decisions about the number of children to have. 5. Couples use contraception to avoid contracting sexually transmitted diseases.
Answer: 1, 2, 3, 5
19) The nurse teaching a group of new mothers and explains that barrier methods of contraception are appropriate if which of the following conditions exist? Select all that apply. 1. Just started an oral contraceptive 2. Is opposed to systemic medications 3. Is lactating 4. Is unconcerned about using contraception 5. Does not smoke and is perimenopausal
Answer: 1, 2, 3, 5
3) The culturally sensitive nurse will assess cultural attitudes and beliefs about contraception, which can include which of the following? Select all that apply. 1. Gender inequities 2. Religion 3. Deference to authority figures 4. Devaluation of large families 5. Attitudes about bleeding
Answer: 1, 2, 3, 5 Explanation: 1. Gender inequities may prohibit some Arab, Latina, and Eastern Indian women from seeking out or using a contraceptive method unless their husbands do not object. 2. The Roman Catholic Church considers all artificial methods of contraception unacceptable. 3. Deference to authority figures is not uncommon in traditional Chinese, Arab, Latina, and East Indian women, especially if the nurse is male. 5. Attitudes toward bleeding affect a woman's duties to her family and partner. Vaginal bleeding may be seen as "unclean" by Muslim and Orthodox Jewish women. Any contraceptive method that involves irregular bleeding might not be acceptable. Among women who feel a monthly period is necessary, any method that ultimately causes amenorrhea would not be acceptable.
12) The nurse is evaluating the outcomes of nursing care given a female client with a sexually transmitted infection (STI). Which of the following will the nurse verify about the client? Select all that apply. 1. Had an identified infection 2. Could identify the mode of transmission 3. Would never cope with the infection 4. Could recognize the symptoms of an STI 5. Would not disclose the STI to her partner
Answer: 1, 2, 4
27) The client with polycystic ovarian syndrome (PCOS) has been prescribed metformin (Glucophage). The nurse tells the client that the medication will do which of the following? Select all that apply. 1. "Decrease your excessive hair growth." 2. "Make it easier to lose weight." 3. "Increase your acne." 4. "Improve your chances of pregnancy." 5. "Make your menstrual periods irregular."
Answer: 1, 2, 4
34) The nurse is conducting a rape exam on a client in the emergency department after a sexual assault. What specimens will the nurse collect? Select all that apply. 1. Swabs of body stains and secretions 2. Samples of pubic hair 3. Toenail scrapings 4. Samples of head hair 5. Sputum, for disease analysis
Answer: 1, 2, 4
27) The nurse in the OB-GYN clinic has been seeing a client through her menopausal stage of life. The nurse assesses psychological concerns if the client makes which statement? Select all that apply. 1. "I feel so lost with all of the kids away from home." 2. "I wish I were younger, and could have a baby." 3. "Although my parents are aging, they travel a lot." 4. "I don't think I am a good wife anymore." 5. "I really enjoy being able to go out when I want."
Answer: 1, 2, 4 Explanation: 1. Adjustment to an "empty nest" is a psychological concern during menopause. 2. Some women express disappointment in approaching this time of their lives, whereas others might see it as a positive transition that offers freedom from menses or concern about contraception. 4. Numerous personal factors influence a woman's ability to transition and cope with these changes, such as self-concept.
35) The nurse is teaching a group of perimenopausal women about treatment choices for their symptoms. The nurse will include which information? Select all that apply. 1. Importance of continuing contraception 2. Benefits of menstrual regulation with hormones 3. Increase in vaginal dryness with hormones 4. Decrease in acne and hirsutism 5. Increase in endometrial cancer risk
Answer: 1, 2, 4 Explanation: 1. Thirty-eight percent of pregnancies for women ages 40 and older are unplanned; some form of contraception is needed. 2. Regulation of menses with effective contraception is a benefit to the perimenopausal woman. 4. Women on hormones might experience less acne and hirsutism.
25) The nurse assessing a 47-year-old client who is perimenopausal includes which important topics? Select all that apply. 1. Vasomotor symptoms 2. A decrease in vaginal lubrication 3. Pregnancy not being an option 4. Mood changes that occur 5. An increase in the libido
Answer: 1, 2, 4 Explanation: 1. Women need to know that vasomotor symptoms occur. It might be important to investigate other possible causes of the vasomotor symptoms. 2. Women need to know that a decrease in vaginal lubrication occurs, and that water-soluble lubricants should be used. 4. Mood changes and irritability occur, and the woman might experience more forgetfulness.
20) The nurse suspects that a pregnant client might be experiencing abuse when the client does which of the following? Select all that apply. 1. Gives an inappropriate explanation for the injuries 2. Hesitates in providing detailed information about the injury 3. Makes eye contact with the nurse while answering questions 4. Allows her partner to answer the nurse's questions 5. Frequently calls to change appointment times
Answer: 1, 2, 4, 5
23) The nurse is discussing the use of contraception with a client who has just become sexually active. What factors should the nurse include when educating the client on contraceptive methods? Select all that apply. 1. Contraindications in the client's health history 2. Religious or moral beliefs 3. Partner's belief in the effectiveness of the choice 4. Personal preferences to use method 5. Future childbearing plans
Answer: 1, 2, 4, 5
23) When evaluating the care given a battered woman, the nurse analyzes care plan components to determine which of the following? Select all that apply. 1. Compassionate, respectful care was delivered. 2. The woman has the necessary information to make decisions. 3. Medical records are deliberately vague. 4. Psychological care was given in the hospital. 5. The woman identifies culturally appropriate resources.
Answer: 1, 2, 5
31) The nurse is teaching a group of clients about risk factors for osteoporosis. The nurse will include which of the following risk factors in the teaching? Select all that apply. 1. Menopause at an early age increases bone loss 2. A family history of osteoporosis 3. A lifetime of high calcium intake 4. Having an active lifestyle 5. A vitamin D deficiency
Answer: 1, 2, 5 Explanation: 1. Abnormal absence of menses and early onset of menopause increase the risk of osteoporosis. 2. Family history of osteoporosis, especially a maternal hip fracture, increases the risk of osteoporosis. 5. Vitamin D deficiency increases the risk of osteoporosis.
12) The 22-year-old client is scheduled for her first gynecologic examination. What can the nurse do to make the client more comfortable during this exam? Select all that apply. 1. Create a trusting atmosphere. 2. Show the client what the speculum looks like. 3. Avoid telling the client what the exam involves. 4. Ask the client why she has delayed her first Pap test this long. 5. Provide a mirror for the client.
Answer: 1, 2, 5 Explanation: 1. It is important to create a trusting atmosphere and incorporate practices that help the client maintain a sense of control. 2. Show the client all of the equipment to be used. 5. Provide a mirror to increase learning about anatomy and to create a trusting atmosphere.
10) A woman who works full-time approaches her employer after suddenly discovering that she and her husband will be receiving a child for adoption. The woman knows that she is entitled to certain rights as a result of the Family and Medical Leave Act (FMLA) of 1993. The nurse knows that which criteria of the act apply to this client? Select all that apply. 1. An employee is entitled to return to the former position or one considered comparable. 2. The employee is covered because she works more than 25 hours per week. 3. The employee is covered by this act because 25 employees work at the company. 4. The act is part of a larger national paid maternity leave program. 5. The employee's medical coverage must continue during the leave.
Answer: 1, 2, 5 Explanation: 1. Job security to return to the employee's former position or one considered comparable is part of FLMA. 2. Employees must work at least 25 hours per week to be eligible. 5. Continued health insurance benefits are part of the protections and benefits to both men and women provided by FLMA.
5) The nurse working in a women's clinic is training a recent graduate of nursing school who has been hired. The experienced nurse explains that nurses caring for women of all ages must be which of the following? Select all that apply. 1. Aware of their own feelings 2. Judgmental when discussing sexuality 3. Aware of personal values and attitudes 4. Minimally knowledgeable about reproduction 5. Willing to discuss sexuality only one-on-one
Answer: 1, 3
31) Vicarious trauma is a phenomenon nurses might experience. What are the signs indicating this problem that the nurse should be aware of? Select all that apply. 1. Reduced sense of accomplishment 2. A positive effect on commitment to one's work 3. Questioning of personal belief systems 4. Balance of time for family, self, friends, and work 5. Frustration with the judicial system
Answer: 1, 3 Explanation: 1. Vicarious trauma refers to a gradual internal transformation that can negatively affect commitment to one's work, reduce any sense of accomplishment, and lead to a questioning of personal belief systems. 3. Vicarious trauma refers to a gradual internal transformation that can negatively affect commitment to one's work, reduce any sense of accomplishment, and lead to a questioning of personal belief systems.
34) The nurse assessing a 50-year-old female client at an orthopedic center asks about the use of complementary and alternative therapies. Which of the following are among those women often try during menopause? Select all that apply. 1. Vitamin and mineral supplements 2. Increasing caffeine intake 3. Soy and red clover 4. Selective estrogen receptor modulators 5. Salmon calcitonin
Answer: 1, 3 Explanation: 1. Vitamin and mineral supplements, especially calcium and vitamins D, E, and B complex, are used to control the symptoms of menopause.
36) The nurse is counseling a rape victim on her choices in pursuing legal action. The nurse will explain which of the following to the client? Select all that apply. 1. Prosecution procedures are described as a second rape. 2. The prosecution will victimize her in court during testimony. 3. Publicity can intensify her feelings of humiliation. 4. Prosecution of the assailant is a community responsibility. 5. The client's sexual history will be publicized.
Answer: 1, 3, 4 Explanation: 1. Many sexual assault survivors who have gone through the judicial process refer to it as a second rape—and sometimes a more damaging one. 3. Publicity can intensify her feelings of humiliation. 4. Prosecution of the assailant is a community responsibility in which the prosecuting attorney will act on the victim's behalf.
21) If a woman returns to an abusive situation, the nurse should encourage her to develop an exit, or safety, plan for herself and her children, if she has any. What should the plan include? Select all that apply. 1. Identify friends and family who know about the situation and will help her. 2. Call the police if violence begins. 3. Pack a change of clothes for herself and the children. 4. Have a plan for where she will go. 5. Have a planned escape route.
Answer: 1, 3, 4, 5 Explanation: 1. She should identify friends and family who know about the situation and will help her. Ask that she establish a code word for danger with those family and friends. 3. She should pack a change of clothes for herself and the children, including toilet articles and an extra set of car and house keys stored away from her house with a friend or neighbor. 4. She should have a plan for where she will go, regardless of the day or time. 5. She should have a planned escape route and emergency telephone numbers she can call.
13) When a woman seeks care for an injury, the nurse should be alert to which clues of abuse? Select all that apply. 1. Defensive injuries 2. Immediate reporting of symptoms or seeking care for injuries 3. Lack of eye contact 4. Providing too much detailed information about the injury 5. Vague complaints without accompanying pathology
Answer: 1, 3, 5
6) The nurse working in a women's clinic recognizes that which clients are most at risk for developing vulvovaginal candidiasis? Select all that apply. 1. Clients using antibiotics 2. Immunocompetent clients 3. Pregnant clients 4. Multiparous clients 5. Diabetic clients
Answer: 1, 3, 5
8) A nurse is teaching a group of college students at a Catholic university about natural family planning (NFP). Teaching was successful if the students say natural family planning is which of the following? Select all that apply. 1. "It is free, safe, and acceptable according to our religion." 2. "It includes breastfeeding for 1 year." 3. "It is useful in helping us plan pregnancies." 4. "It allows us to safely have intercourse during our fertile days." 5. "It does not involve the use of artificial substances or devices."
Answer: 1, 3, 5
26) Among women who have been sexually assaulted, which of the following are the most frequently diagnosed sexually transmitted infections (STIs)? Select all that apply. 1. Bacterial vaginosis 2. HIV 3. Chlamydia 4. Syphilis 5. Gonorrhea
Answer: 1, 3, 5 Explanation: 1. Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (STIs).
28) A client who was raped is in the emergency department. She asks the nurse what her alternatives are for emergency contraception. The nurse tells her she can receive which of the following treatments? Select all that apply. 1. Take levonorgestrel and ethinyl estradiol. 2. Have Essure implanted. 3. Have a laparoscopic tubal ligation. 4. Take levonorgestrel alone, but in a high dose. 5. Take high doses of male hormones.
Answer: 1, 4
16) The nurse is leading a discussion among nursing students about differences in living conditions between men and women. Which statement, if made by the nursing student, would correctly depict the susceptibility of older women? 1. "Older women tend to have more educational preparation than older men." 2. "Women typically earn less than men and often work in jobs without pension benefits or only limited benefits." 3. "Intermittent employment is less common in women, increasing their Social Security and retirement benefits." 4. "Women generally have fewer family caregiving responsibilities than men."
Answer: 2
17) After a sex education class at a high school, the nurse overhears a student discussing safe sex practices. Which statement indicates that teaching was successful? 1. "I don't have to worry about getting infected if I have oral sex." 2. "Teen women are the group at highest risk for sexually transmitted infections." 3. "The best thing to do if I have sex a lot is to use spermicide each and every time." 4. "Boys get the HIV virus more easily than girls do."
Answer: 2
2) The nurse who is taking a sexual history from a client should do which of the following? 1. Ask questions that the client can answer with "yes" or "no." 2. Ask mostly open-ended questions. 3. Have the client fill out a comprehensive questionnaire and review it after the client leaves. 4. Try not to make much direct eye contact.
Answer: 2
21) The nurse recognizes that what are the most common disabilities in women? 1. Asthma and headaches 2. Arthritis or rheumatism 3. Adverse kidney and nervous system functioning 4. Cardiovascular diseases
Answer: 2
32) A menopausal woman tells her nurse that she experiences discomfort from vaginal dryness during sexual intercourse, and asks, "What should I use as a lubricant?" The nurse should recommend which of the following? 1. Petroleum jelly 2. A water-soluble lubricant 3. Body cream or body lotion 4. Less-frequent intercourse
Answer: 2
36) A client who is currently 12 weeks pregnant is seeking information on pregnancy termination. The nurse is teaching the client about the risks involved if she were to take the medication mifepristone. Which adverse signs would the client need to know and report immediately to a physician? 1. Fatigue, lack of appetite, and inability to concentrate 2. Nausea, diarrhea, vomiting, and stomach pain 3. Increase in heart rate, inability to sit still, and lack of appetite 4. Headache, fatigue, and hunger
Answer: 2
9) The nurse is teaching a class on menstruation to young girls. What information would be important for 10-12-year-olds to know? 1. The age they will start having their periods 2. Variations in the age menstruation begins, length of the cycle, and duration of the menses 3. The number of days they will be ill when they have their menses 4. The number of days they will not be able to take part in physical education at school during their menses
Answer: 2
15) A nurse is teaching a class on the different types of uterine bleeding. The nurse explains that which of the following is one of the causes of abnormal uterine bleeding? 1. Iron-deficiency anemia 2. Polyps 3. Heavy periods every 2 months 4. Spotting between periods
Answer: 2 Explanation: 2. A classification system has been developed for the causes of AUB using the acronym PALM-COEIN. The P stands for Polyps.
5) The nurse is planning a community educational presentation for people living below the poverty level. The nurse knows that which of the following is the largest population in this socioeconomic category? 1. Adults in communal living situations 2. Young married couples under the age of 20 3. Single women with children 4. Single adults
Answer: 3
3) The nurse is caring for a client in the clinic whom she suspects has vaginosis. Which test best determines whether this sexually active woman has the disorder? 1. The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation 2. The addition of a 10% potassium hydroxide solution to the vaginal secretions 3. A vaginal pH of less than 4.5 4. A Gram stain positive for the fungus
Answer: 2 Explanation: 2. Adding a 10% potassium hydroxide solution to the vaginal secretion of a client with bacterial vaginosis, called a "whiff" test, produces a fishy smell.
20) The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority? 1. Encourage oral fluids 2. Administer cefotetan IV 3. Enforce bed rest 4. Remove IUC, if present
Answer: 2 Explanation: 2. Administration of medications to treat the disease is the first priority.
29) A client comes to the reproductive health clinic and reports that she woke up in a strange room this morning, her perineal area is sore, and she can't clearly remember what happened the previous evening. The client says that she is afraid that she was a victim of a drug-facilitated sexual assault. Which statement should the nurse include when discussing this possibility with the client? 1. "Drinking alcohol can lead to uninhibited sexual behavior, which is not the same as rape." 2. "Some men use drugs mixed into a drink to subdue a potential victim prior to a rape." 3. "It is rare that a woman doesn't remember what happened if she is actually raped." 4. "We need to check for forensic evidence of rape before we can be sure what happened."
Answer: 2 Explanation: 2. Drug-facilitated sexual assault occurs when a drug such as Rohypnol, which dissolves easily and is odorless, is slipped into the drink of an unsuspecting woman.
27) The nurse is preparing an education session for women on the prevention of urinary tract infections (UTIs). Which statement should be included? 1. Lower urinary tract infections rarely occur in women. 2. The most common causative organism of cystitis is E. coli. 3. Wiping from back to front after a BM will help prevent a UTI. 4. Back pain often develops with a lower urinary tract infection.
Answer: 2 Explanation: 2. E. coli is present in 75% to 90% of women with UTIs.
33) A lesbian woman tells her nurse that she has begun to work for a new company. The woman's biggest fear is that her new employer will find out about her sexual orientation. Why is this woman afraid of this discovery? 1. The Employment Non-Discrimination Act was passed into law. 2. It is still legal in many states to fire a lesbian on the basis of sexual orientation. 3. Fortune 500 companies have not enacted antidiscrimination workplace regulations for sexual orientation. 4. No state prohibits discrimination based on gender identity.
Answer: 2 Explanation: 2. Employment discrimination is the most frequent complaint the American Civil Liberties Union (ACLU) receives from gay and lesbian individuals.
3) A client is concerned about her risk for breast cancer. Following the initial history, the nurse identifies which of the following as a high risk factor for breast cancer? 1. History of late menarche and early menopause 2. Sister who has had breast cancer 3. Mother with fibrocystic breast disease 4. Multiparity
Answer: 2 Explanation: 2. Family history of first-degree relative (mother, sister, or daughter) with breast cancer increases the risk of breast cancer with the number of first-degree relatives with breast cancer.
34) The nurse is admitting a client who is 12 weeks pregnant and an IV drug user. She has had a number of sexual partners, complains of malaise, and has yellow in the eyes, nausea, and vomiting. Having obtained this history, the nurse suspects that the client has which condition? 1. Hepatitis E 2. Hepatitis C 3. Gonorrhea 4. Hepatitis A
Answer: 2 Explanation: 2. Hepatitis C is bloodborne, and found in drug users and those who have multiple sexual partners.
20) A client who is in perimenopause is having a number of severe symptoms. The nurse assesses this client and knows the doctor will likely prescribe what to assist in relieving the distress? 1. Calcium and vitamin D 2. A form of hormonal contraception 3. Prescriptive pain medication 4. Antibiotics
Answer: 2 Explanation: 2. Hormonal contraception is the correct answer, as pregnancy can still be a concern, plus the estrogen will relieve other symptoms, such as hot flashes and vaginal dryness.
7) The nurse working at a homeless shelter is studying case statistics. Of the total homeless population served at the shelter, which group would the nurse's statistics likely uncover as the fastest-growing group? 1. Unemployed women 2. Families with children 3. The mentally ill 4. The elderly
Answer: 2 Explanation: 2. In 2012, the number of homeless individuals fell slightly, by 0.4%, with the exception of homeless families.
9) The nurse is providing follow-up education to a client just diagnosed with vaginal herpes. What statement by the client verifies correct knowledge about vaginal herpes? 1. "I should douche daily to prevent infection." 2. "I could have another breakout during my period." 3. "I am more likely to develop cancer of the cervix." 4. "I should use sodium bicarbonate on the lesions to relieve discomfort."
Answer: 2 Explanation: 2. Menstruation seems to trigger recurrences of herpes.
23) The nurse's response to a client with a history of pelvic inflammatory disease who is trying to get pregnant is based on the knowledge that which condition can contribute to an infertility problem? 1. Hepatitis 2. Postinfection tubal damage 3. Pelvic abscess 4. Tubal infection
Answer: 2 Explanation: 2. Postinfection tubal damage is the most likely cause, as the infection causes tubal damage, which can lead to infertility.
28) The client demonstrates that the nurse's teaching regarding ways to prevent a recurrence of her urinary tract infection was effective when she makes which statement? 1. "I should wipe from back to front after urination." 2. "I should urinate when I feel the urge." 3. "I should try to restrict my intake of fruits." 4. "I should use a diaphragm."
Answer: 2 Explanation: 2. Retention overdistends the bladder, and can lead to infection.
16) A client comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (IUD) for 2 years. What is the most likely cause for the client's complaint? 1. Primary dysmenorrhea 2. Secondary dysmenorrhea 3. Menorrhagia 4. Hypermenorrhea
Answer: 2 Explanation: 2. Secondary dysmenorrhea is associated with pathology of the reproductive tract, and usually appears after menstruation has been established. Conditions that most frequently cause secondary dysmenorrhea include ovarian cysts and the presence of an intrauterine device.
9) The nurse educator is planning a class about contraception, and includes information about the effects of various contraceptive methods on sexually transmitted diseases. Which statement will the nurse include concerning spermicides? 1. "Spermicides are effective against gonorrhea and chlamydia, but not against HIV." 2. "Spermicides are not effective against sexually transmitted diseases, and can increase a woman's susceptibility to HIV." 3. "Spermicides are effective against HIV, but are not effective against the other sexually transmitted diseases." 4. "Whether or not spermicides are effective against sexually transmitted diseases depends on where the woman is in her cycle."
Answer: 2 Explanation: 2. Spermicides are not effective against any sexually transmitted disease. Spermicides have a negative effect on the integrity of vaginal cells, making them more susceptible.
31) The nurse at a women's clinic is reviewing a new client health information questionnaire. Which question does she find to be insulting and discriminatory toward lesbian client? 1. Who should be contacted in case of emergency? 2. What method of birth control do you use? 3. How often do you drink alcohol? 4. Do you feel safe in your relationship?
Answer: 2 Explanation: 2. The assumption that all women are in need of contraception for birth control is often cited as a reason that lesbian women may conceal their sexual orientation.
1) The nurse receives a phone call from a 25-year-old woman experiencing breast tenderness in the week prior to her menses, with palpable breast nodularity, without nipple discharge. What is the best response by the nurse? 1. "Please make an appointment at the breast cancer center as soon as possible." 2. "How much salty food do you regularly consume?" 3. "As long as you don't have nipple discharge, it isn't a serious condition." 4. "Eliminate caffeine and chocolate from your diet."
Answer: 2 Explanation: 2. The client is describing fibrocystic breast changes. A salt restriction with a mild diuretic taken the week before menstrual bleeding often improves the condition.
8) The nurse is seeing clients in the women's clinic. Which client should be treated with ceftriaxone IM and doxycycline orally? 1. A pregnant client with gonorrhea and a yeast infection 2. A nonpregnant client with gonorrhea and chlamydia 3. A pregnant client with syphilis 4. A nonpregnant client with chlamydia and trichomoniasis
Answer: 2 Explanation: 2. The combined treatment of ceftriaxone IM and doxycycline orally provides dual treatment for gonorrhea and chlamydia, which frequently occur together.
21) The nurse has presented a community education class on recommended health screenings for women. Which statement about the Pap smear by a class member indicates that additional teaching is necessary? 1. "It is recommended for women 21 years of age and older." 2. "It diagnoses cervical cancer." 3. "Intercourse at a young age is a risk factor for an abnormal Pap smear." 4. "Detects abnormal cells."
Answer: 2 Explanation: 2. The focus of the Pap smear is the detection of high-grade cervical disease. It does not diagnose cervical cancer.
25) A client is using the contraceptive sponge as a birth control method. What action is important in order to maintain the sponge's effectiveness? 1. Insert the sponge at least 1 hour before intercourse. 2. Thoroughly moisten the sponge with water before inserting. 3. Spermicidal jelly must be inserted at the same time the sponge is inserted. 4. A new sponge must be inserted every time a couple has intercourse.
Answer: 2 Explanation: 2. The sponge is moistened thoroughly with water before use to activate the spermicide.
29) The charge nurse is giving an in-service to the orthopedic and gynecology nurses concerning the relationship between estrogen and osteoporosis. Which is a statement the nurse would make concerning this relationship? 1. "Males have a higher incidence of osteoporosis than do females." 2. "Women who experience menopause at a younger age and have less bone mass could have more bone loss." 3. "Estrogen levels affect only bone mass, but they have nothing to with bone strength and bone density." 4. "Osteoporosis puts the client at a decreased risk for fractures of the forearm and vertebrae."
Answer: 2 Explanation: 2. This is a true statement, as women who experience menopause at a younger age and have less bone mass lose the benefit of estrogen for more years.
10) The nurse is interviewing a 16-year-old client who has been using deodorant tampons during her menses. She comes into the gynecology office complaining of a rash and open sores on her labia and tenderness in the vagina. After obtaining her history, what will the nurse determine is the most likely cause of this client's problem? 1. She had forceful intercourse, which caused the trauma. 2. She is reacting to the deodorant in the tampon. 3. She might be allergic to the underwear she is wearing. 4. She is having a normal reaction to her menses.
Answer: 2 Explanation: 2. This is the correct answer, as women often will react to the deodorant used on pads and tampons.
1) The clinic nurse is returning phone calls. Which call should the nurse return first? 1. The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month 2. The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day 3. The call from a 46-year-old mother of a teen wondering if her daughter should be on birth control 4. The call from a 34-year-old requesting information on douching after intercourse
Answer: 2 Explanation: 2. Using a single tampon for an entire day can lead to toxic shock syndrome, a potentially life-threatening condition. This client needs education on the danger of using one tampon longer than 3-6 hours.
12) The nurse is presenting a session on intimate partner violence. Which statement by a client indicates a need for further education? 1. "My daughter is not to blame for the violence in her marriage." 2. "Everyone experiences anger and hitting in a relationship." 3. "Abusers can be either husbands or boyfriends or girlfriends." 4. "The 'honeymoon period' follows an episode of violence."
Answer: 2 Explanation: 2. Violence is not a normal part of intimate relationships. Domestic violence, also called intimate partner violence (IPV), is defined as a pattern of coercive behaviors and methods used to gain and maintain power and control by one individual over another in an adult intimate relationship. This statement indicates that the client has likely been a victim of domestic violence.
35) The client who was raped is extremely upset when a pregnancy test confirms that she is pregnant, and requests information regarding pregnancy termination. Which statement is best for the nurse to include? 1. "Abortion is morally wrong, and should not be undertaken." 2. "Hypertension is a risk with any abortion." 3. "Surgical abortion in the first trimester is technically easier and safer than abortion in the second trimester." 4. "The most accurate method to determine gestational age are the results of a pregnancy test."
Answer: 3
28) The nurse is answering the perimenopausal client's questions about hormone replacement therapy. Which client statement indicates a need for further teaching? 1. "Estrogen therapy will decrease my chances of developing osteoporosis." 2. "If I am taking estrogen therapy, I will not have to worry about my cholesterol being checked." 3. "Osteoporosis is a decrease in bone strength due to bone density and quality." 4. "Bone mass tends to decrease after menopause."
Answer: 2 Explanation: 2. Cholesterol levels should be checked regularly even when normal, so this statement indicates the need for more
13) A client comes to the clinic complaining of a thick, white, tenacious discharge and vulvular soreness. Which medication treatment will the nurse teach the client about? Select all that apply. 1. Silver sulfadiazine 2. Metronidazole 3. Clindamycin cream 4. Ceftriaxone sodium 5. Doxycycline
Answer: 2, 3 Explanation: 2. Metronidazole is the preferred treatment for vulvovaginal candidiasis. 3. Although less effective than metronidazole, clindamycin cream can be used to treat vulvovaginal candidiasis.
24) When caring for the menopausal woman, nurses need to be empathetic in approaching which of the following areas? Select all that apply. 1. Administering medications 2. Health teaching 3. Providing physical care 4. Counseling 5. Encouraging hormone therapy
Answer: 2, 3, 4
35) In providing community education about hepatitis, the nurse includes information on the chronic forms of hepatitis. A form of hepatitis that becomes chronic is which of the following? Select all that apply. 1. Hepatitis A 2. Hepatitis B 3. Hepatitis C 4. Hepatitis D 5. Hepatitis E
Answer: 2, 3, 4
10) The OB-GYN nurse is teaching a client at the clinic that use of a spermicide has an increased effectiveness if used with which other items? Select all that apply. 1. A non-water-based lubricant 2. A diaphragm 3. A contraceptive sponge 4. Prophylactic antibiotics 5. A condom
Answer: 2, 3, 5
4) A client in the clinic asks the nurse about available contraceptives. Before responding, the nurse must assess which of the following factors? Select all that apply. 1. When menarche occurred 2. How frequently the client has intercourse 3. Whether the client has a history of thrombophlebitis 4. What the client's partner prefers 5. Whether the client is in a monogamous relationship
Answer: 2, 3, 5
9) The nurse interviews a 28-year-old client with a new medical diagnosis of endometriosis. Which question asked by the nurse is appropriate? Select all that apply. 1. "Are you having hot flashes?" 2. "Are you experiencing pain during intercourse?" 3. "Is a vaginal discharge present?" 4. "Are you having pain during your period?" 5. "Have you noticed any skin rashes?"
Answer: 2, 4 Explanation: 2. The primary symptoms of endometriosis include dyspareunia. 4. The primary symptoms of endometriosis include dysmenorrhea.
32) In educating a group of women at a community center, the nurse talks about the myths surrounding sexual assault. What topics would the nurse include? Select all that apply. 1. Older women are less likely to be sexually assaulted. 2. Rape is universal, and all societies have rape. 3. Women who party and do drugs set themselves up for sexual assault. 4. If the woman just relaxes, it will be over, and she might even like it. 5. Women lie about rape as an act of revenge.
Answer: 2, 4, 5 Explanation: 2. Rape is not universal to all societies, and not all men rape women. 4. Rape is an act of violence in which the perpetrator uses sex as a weapon to control, intimidate, and violate the victim. 5. While false allegations of rape do occur, they are the exception, not the rule.
22) The nurse in the community clinic instructs a client starting on a combined oral contraceptive that she must immediately report which of the following symptoms? Select all that apply. 1. Only four withdrawal bleeds per year 2. Speech problems 3. Unscheduled bleeding 4. Blood pressure of 126/84 5. New lumps in her breast
Answer: 2, 5 Explanation: 2. The woman using combined oral contraceptives should contact her healthcare provider if she develops speech problems. 5. The woman using combined oral contraceptives should contact her healthcare provider if she develops a breast lump.
11) The nurse in the clinic instructs a client using the natural method of contraception to begin counting the first day of her cycle as which day? 1. The day her menstrual period ceases 2. The first day after her menstrual period ceases 3. The first day of her menstrual period 4. The day of ovulation
Answer: 3
18) A woman is seen in the prenatal clinic. The nurse notices that the woman has a swollen eye and a bruise on her cheek. Which statement is most appropriate for the nurse to make? 1. "You must leave your partner before you are injured again." 2. "It is important that you refrain from doing things that anger your partner." 3. "Women who are abused often have injuries like yours." 4. "I am required by law to notify the police department of your injuries."
Answer: 3
20) The community health nurse manager is reviewing the charts of female elderly clients. Which issue are these clients most likely to experience? 1. Adequate financial resources to purchase medications 2. Senior services that provide transportation to healthcare appointments 3. Multiple medications prescribed by different physicians 4. Medicare that covers healthcare costs so no out-of-pocket expenses occur
Answer: 3
20) The nurse is instructing a client in the use of combined oral contraceptives. The nurse knows that additional teaching is required when the client makes which statement about the risks of taking combined oral contraceptives? 1. "They will lower my risk for breast cancer." 2. "They will increase my risk for cervical cancer." 3. "They will lower my risk for ovarian cancer." 4. "They will increase my risk for uterine cancer."
Answer: 3
27) A woman comes into the emergency department stating she was raped the day before, and requests emergency contraception. She states that she is in the middle of her cycle. The nurse knows which of the following about the client? 1. This client has waited too long before coming to the emergency department. 2. The client will have to wait 10 days before she can have emergency contraception. 3. The client can receive emergency contraception up to 72 hours to 5 days after the intercourse. 4. The client will have to wait and see whether she misses a period.
Answer: 3
6) A client asks her nurse, "Is it okay for me to take a tub bath during the heavy part of my menstruation?" What is the nurse's correct response? 1. "Tub baths are contraindicated during menstruation." 2. "You should shower and douche daily instead." 3. "Either a bath or a shower is fine at that time." 4. "You should bathe and use a feminine deodorant spray during menstruation."
Answer: 3
7) The nurse in the emergency department is caring for a pregnant woman who presents with bruised breasts and abdomen. When asked how this happened, she states she fell down the stairs. The husband stays very close to his wife and does most of the talking. Of what is the nurse aware? 1. The client likely did fall down the stairs. 2. The husband is being attentive and trying to help her feel better. 3. The husband could have battered her and possibly caused her to fall down the stairs. 4. This client is safe to return home after her wrist is fixed.
Answer: 3
34) The nurse is developing a teaching plan for a client undergoing a tubal ligation. What information should be included in the plan? 1. The surgical procedure is easily reversible. 2. Laparotomy is performed following a vaginal birth. 3. Minilaparotomy is performed in the postpartum period soon after a vaginal birth. 4. Tubal ligation can be done at any time the woman is either pregnant or not pregnant.
Answer: 3 Explanation: 3. A tubal ligation minilaparotomy is performed in the postpartum period soon after a vaginal birth.
25) The client diagnosed with endometriosis asks the nurse whether there are any long-term health risks associated with this condition. The nurse should include which statement in the client teaching about endometriosis? 1. "There are no other health risks associated with endometriosis." 2. "Pain with intercourse rarely occurs as a long-term problem." 3. "You are at increased risk for ovarian and breast cancer." 4. "Most women with this condition develop severe migraines."
Answer: 3 Explanation: 3. An increased risk for cancer of the ovary and breast is associated with endometriosis.
7) The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? 1. "She could become pregnant." 2. "She could have severe vaginal itching." 3. "He could get an infection in the tube that carries the urine out." 4. "It could cause us to develop a rash."
Answer: 3 Explanation: 3. Chlamydia is a major cause of nongonococcal urethritis (NGU) in men.
19) The nurse is about to tell a client that her Pap smear result was abnormal. Which statement should the nurse include? 1. "The Pap smear is used to diagnose cervical cancer." 2. "A loop electrosurgical excision procedure (LEEP) is needed." 3. "Colposcopy to further examine your cervix is the next step." 4. "Your cervix needs to be treated with cryotherapy."
Answer: 3 Explanation: 3. Colposcopy is an examination of the cervix through a magnifying device.
2) The nurse is planning an educational session about contraception. What will the nurse emphasize as being the most significant factor in determining the effectiveness of a specific method of contraception to avoid pregnancy? 1. Reliability 2. Ease of use 3. Consistency of use 4. Cost
Answer: 3 Explanation: 3. Consistency of use is the most important factor for determining the effectiveness of a specific type of contraception.
24) The nurse is caring for a client diagnosed with endometriosis. Which statement by the client would require a need for perhaps another treatment option? 1. "I am having many hot flashes since I had the Lupron injection." 2. "The pain I experience with intercourse is becoming more severe." 3. "I have vaginal dryness, reduced libido, and my clitoris has become larger since taking danazol. Is this normal?" 4. "I've noticed I have not had my period on a regular basis since being on the GnRH analogs."
Answer: 3 Explanation: 3. Danazol is a testosterone derivative that suppresses ovulation and causes amenorrhea. It is intended for short-term therapy. Because of adverse effects, many clinicians have moved away from danazol to other treatment options.
24) The nurse has been talking to a woman about the reorganization phase following a rape. Which response would indicate that the client understands this phase? 1. "By using denial and suppression in this phase, I will eventually be able to accept what has happened to me." 2. "During this time, I won't talk much about the rape, because I am examining my inward feelings regarding the rape." 3. "During this time, I will repeatedly replay the role of the victim until I come to terms with the experience." 4. "My perception of a normal sexual relationship will be similar to my perception prior to the rape."
Answer: 3 Explanation: 3. During reorganization, a victim adjusts her self-concept to include the rape.
3) The nurse is taking a history on a new client in the clinic. She determines from talking with the client that she is recently divorced, is dating, and has had sex with various men. The nurse would be concerned about and would provide some education on what issues? 1. The ethics of dating and having sex with more than one man 2. The client having some kind of permanent birth control done, so she does not become pregnant 3. Education about sexual activity and sexually transmitted infections 4. Referral to a psychologist or counselor for follow-up on the multiple dating
Answer: 3 Explanation: 3. Education about sexual activity and sexually transmitted infections is correct, since it has been determined that the client is having sex with multiple partners.
33) A 49-year-old client comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must take both hormones, what is the nurse's best reply? 1. "Hot flashes respond better when replacement includes both hormones." 2. "You are having very severe symptoms, so you need more hormones replaced." 3. "There is an increased risk of tissue abnormality inside the uterus if only one is given." 4. "Your blood pressure can become elevated if only one hormone is used."
Answer: 3 Explanation: 3. Estrogen alone, in a woman with a uterus (unopposed estrogen), increases the risk of endometrial (the lining of the uterus) cancer by eightfold and, therefore, is never given without progesterone in these women.
19) The nurse is teaching a group of women about menopause at a community clinic. The nurse tells them that the best indicator of menopause is which of the following symptoms? 1. No menses for 8 consecutive months 2. Hot flashes and night sweats 3. FSH levels rise and ovarian follicles cease to produce estrogen 4. Diagnosed with osteoporosis 4 months ago
Answer: 3 Explanation: 3. Examining FSH and estrogen levels is a very accurate indication of menopause.
17) When the nurse is teaching a woman about the use of a diaphragm, it is important to instruct her that the diaphragm should be rechecked for correct size how often? 1. Every five years routinely 2. When weight gain or loss beyond five pounds has occurred 3. After each birth 4. Only after significant weight loss
Answer: 3 Explanation: 3. The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more.
8) The nurse is conducting health screening at a community clinic. The client has asked whether there are any risks with body piercing and tattooing, or whether these activities would impact sexual activity. How should the nurse respond? 1. "You should avoid piercing your genitalia and your nipples." 2. "There are no problems that occur with either body piercing or tattooing." 3. "Both piercing and tattooing carry risks of infection, including hepatitis." 4. "The benefit of body art outweighs any risk of infection of a tattoo or piercing."
Answer: 3 Explanation: 3. For tattooing and body piercing, risks include infections such as HIV and hepatitis B and C because of the use of inadequately sterilized equipment, as well as allergic reactions, local swelling and burns, granulomas, and keloid formation.
28) A nurse is examining a client with a potential of polycystic ovarian syndrome. The nurse knows that which diagnostic is the most important indicator to support a diagnosis of polycystic ovarian syndrome? 1. Total estrogen level 2. Waist to chest ratio 3. Hyperandrogenism 4. Hypoinsulinemia
Answer: 3 Explanation: 3. Hyperandrogenism, as women with PCOS consistently have elevated serum androgen levels. These elevated androgen levels often lead to clinical manifestations such as hirsutism (excessive hair growth), acne, deepening voice, and increased muscle mass.
14) A 19-year-old woman comes to the gynecologist's office. When the nurse asks the reason for this visit, the client explains that she has never had a menstrual period, and that she is concerned there might be something wrong. What is the diagnosis that the physician is most likely to make based on this information? 1. Primary dysmenorrhea 2. Secondary infertility 3. Primary amenorrhea 4. Secondary amenorrhea
Answer: 3 Explanation: 3. Primary amenorrhea is the term for the condition when menses have never occurred.
13) A new nurse is teaching a class to expectant parents about environmental hazards at home. Which statement, if made by an expectant parent, would indicate the need for further teaching? 1. "Air pollution is an environmental hazard caused by the release of toxins into the air." 2. "Indoor air pollution poses the more serious threat to women's health." 3. "Radon, a naturally occurring radioactive gas, is the leading cause of lung cancer, which kills more women than any other type of cancer, including breast." 4. "Asthma is worsened by most forms of indoor air pollution."
Answer: 3 Explanation: 3. Radon is the second-leading cause of lung cancer. Smoking is the first.
26) The nurse is preparing educational materials at a family planning clinic. The client who is an appropriate candidate for using emergency contraception would be one who reports which of the following? 1. Forgetting to start her pill pack yesterday 2. Unprotected intercourse during her menses 3. That a condom broke yesterday in the middle of her cycle 4. Increased dysmenorrhea since IUC insertion
Answer: 3 Explanation: 3. Research indicates that oral hormonal EC taken as soon as possible within 72 hours, but up to 5 days, can reduce the risk of pregnancy after a single act of unprotected intercourse by at least 74%.
4) The nurse is taking a history of a new client in the clinic. Histories tend to be lengthy, and the sexual part can be difficult for the client. The nurse should use what technique to make it easier for the client? 1. Let the client fill out a paper copy, so she does not have to talk about intimate matters. 2. Skip the sexual part until the next time the client comes into the clinic. 3. Start with the easier medical and surgical questions, and develop a feeling of trust with the client. 4. Leave the sexual part of the history for the doctor to ask about.
Answer: 3 Explanation: 3. Starting with easy-to-answer questions and then going to the sexual ones helps, as client might be at ease by then.
24) Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (PID)? 1. CBC (complete blood count) with differential 2. Venereal Disease Research Laboratory (VDRL) 3. Throat culture for Streptococcus A 4. RPR (Rapid Plasma Reagin)
Answer: 3 Explanation: 3. Streptococcus of the throat is not associated with PID.
5) 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 response by the nurse is best? 1. "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." 2. "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation." 3. "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." 4. "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."
Answer: 3 Explanation: 3. 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.
5) A client has been diagnosed with bacterial vaginosis. The nurse obtains a sexual history from the client, including contraceptive measures, number of sexual partners, and frequency of intercourse. What is the rationale for the questions? 1. Clients can infect their sexual partners. 2. The nurse is required by law to ask the questions. 3. Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted diseases more easily. 4. The laboratory needs a full client history in order to know for which organisms and antibiotic sensitivities it should test.
Answer: 3 Explanation: 3. The change in normal flora increases the woman's susceptibility to other organisms, making the client more vulnerable to sexually transmitted diseases, including HIV.
30) The nurse is providing instructions for a woman who has just had intrauterine contraception inserted. What is essential for the nurse to teach the client? 1. To palpate her lower abdomen each month to check the patency of the device 2. To remain on bed rest for 24 hours after insertion of the device 3. To report any pain during intercourse to the physician 4. To insert spermicidal jelly within 4 hours of every sexual encounter
Answer: 3 Explanation: 3. The client should report any pain during intercourse to the physician. This can be due to an infection.
27) When a woman who has been raped is admitted to the emergency department, the nurse caring for the woman knows that which of the following is the priority nursing intervention? 1. Explaining exactly what will need to be done to preserve legal evidence 2. Assuring the woman that everything will be all right 3. Creating a safe, secure environment for her 4. Contacting family members
Answer: 3 Explanation: 3. The first priority in caring for a survivor of a sexual assault is to create a safe, secure environment.
17) The nurse walks in to find the client crying after the physician informed her of her diagnosis of human papilloma virus (HPV). Which statement by the nurse conveys an attitude of acceptance toward the client with a sexually transmitted infection? 1. "Don't worry about it. In a few weeks, with treatment, the lesions will disappear." 2. "You seem upset. I'll get the doctor." 3. "You seem upset. Can I help answer any questions?" 4. "I think you need to see a therapist."
Answer: 3 Explanation: 3. The nurse's attitude of acceptance and matter-of-factness conveys to the client that she is still an acceptable person who happens to have an infection.
8) A client is at a physician's office following the end of treatment for breast cancer. The client is not scheduled to receive any more radiation or chemotherapy at this time. With treatment behind her, the client can now look again to the future. Which phase of psychological adjustment is this client experiencing? 1. Shock 2. Reaction 3. Recovery 4. Reorientation
Answer: 3 Explanation: 3. The recovery phase begins during convalescence following the completion of medical treatment.
23) The nurse educator is talking with a group of students doing their gynecological rotation. The nurse describes a number of symptoms that include anovulation, reduced fertility, either decreased or increased menstrual flow, and menstrual cycle irregularities. The nurse is describing what condition? 1. Intermenstrual bleeding 2. Hypermenorrhea 3. Menopause 4. Primary amenorrhea
Answer: 3 Explanation: 3. This is the correct answer. Anovulation, reduced fertility, either decreased or increased menstrual flow, and menstrual cycle irregularities are some of the symptoms of menopause.
10) The client has been found to have vitiligo on her vulva. Which client statement indicates that the client requires additional teaching on this condition? 1. "This can occur in other places on my body." 2. "Vitiligo is only a decrease of pigmentation." 3. "Other serious health conditions are common with vitiligo." 4. "There usually are no other symptoms of this condition."
Answer: 3 Explanation: 3. Vitiligo is an absence of melanin, which results in white patches that are especially noticeable on dark-skinned individuals. It can occur in multiple areas on the body, and has no associated symptoms or health conditions.
11) The nurse is teaching a client who has been diagnosed with vulvitis. Which statement by the client indicates that the nurse's instruction has not been effective? 1. "I should stop having sexual intercourse." 2. "Non-deodorized tampons could make this condition recur." 3. "Wearing pantyhose daily will improve the problem." 4. "A different brand of soap might eliminate the irritation."
Answer: 3 Explanation: 3. Vulvitis is inflammation of the vulva. Tight clothing, especially if made of synthetic fibers, can predispose women to the condition. Pantyhose should not be worn.
26) Women with pyelonephritis during pregnancy are at significantly increased risk for which condition? 1. Foul-smelling discharge 2. Ectopic pregnancy 3. Preterm labor 4. A colicky large intestine
Answer: 3 Explanation: 3. Women with pyelonephritis during pregnancy are at significantly increased risk of preterm labor, preterm birth, development of adult respiratory distress syndrome, and septicemia.
2) The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (VVC), and knows the client understands when she makes which of the following statements? 1. "I need to apply the miconazole for 10 days." 2. "I need to douche daily." 3. "I need to add yogurt to my diet." 4. "I need to wear nylon panties."
Answer: 3 Explanation: 3. Yogurt helps reestablish normal vaginal flora.
5) A nurse is providing a client with instructions regarding breast self-examination (BSE). Which of the following statements by the client would indicate that the teaching has been successful? Select all that apply. 1. "I should perform BSE 1 week prior to the start of my period." 2. "When I reach menopause, I will perform BSE every 2 months." 3. "Knowing the density of my breast tissue is important." 4. "I should inspect my breasts while standing with my arms down at my sides." 5. "I should inspect my breasts while in a supine position with my arms at my sides."
Answer: 3, 4
11) The nurse educator is teaching a group of teens and 20-year-olds reproductive health care. When several of the women bring up douching, what is the best response the nurse could make? 1. "One should always douche after having intercourse." 2. "When douching, use force putting them in and get the solution up high." 3. "It is a good idea to douche before intercourse so the area is clean for the sperm." 4. "Douching is unnecessary because the lining of the vagina has numerous glands that provide natural cleansing."
Answer: 4
14) A 12-year-old girl and her mother are at the doctor's office for a routine check-up for the daughter. The mother tells the nurse that she would like the daughter to have the Gardasil vaccine that is effective against the human papilloma virus. The nurse does some teaching, and knows it has been successful when the mother makes which statement? 1. "The human papilloma virus is spread through casual contact in schools." 2. "Gardasil will protect against all types of the human papilloma virus." 3. "The human papilloma virus affects a million people in the United States." 4. "Gardasil will be given to my daughter in three doses."
Answer: 4
14) A woman who has been abused for a number of years asks the nurse for assistance in leaving the relationship. What response by the nurse is most appropriate? 1. Comment that she should have left long ago. 2. Remind the client that that fault was not likely all attributable to her abuser. 3. Encourage her to be sure with her decision, as her abuser will be difficult to deal with. 4. Assist the client to develop a safety plan.
Answer: 4
15) A woman with multiple bruises on her face and arms is seen in the emergency department. Her significant other is with her. When asked about her injuries, the woman states, "I ran into a door." Which action by the nurse is of highest priority? 1. Take the woman's vital signs. 2. Document the location of the bruises. 3. Assess for additional bruising. 4. Interview the woman in private.
Answer: 4
22) A client is asking the nurse what she can do about the "falling down of her reproductive organs and urinary tract wall." The nurse will tell the client to try what exercise? 1. Lifting weights to strengthen those muscles 2. Running two miles a day 3. Running up and down stairs a few times every day 4. Performing Kegel exercises and having regular sexual activity
Answer: 4
22) A home care nurse is looking over the charts of four elderly female clients. The nurse knows that which client has the highest risk for developing diabetes and heart disease? 1. A woman who is 55 and is white 2. A woman who is 60 and from a middle class background 3. All women over 55 4. A woman over 65 who is African American
Answer: 4
28) The nurse making home visits to a number of adult women with disabilities monitors the clients closely out of awareness of which of the following? 1. Healthcare services for women who are disabled are more than adequate. 2. They receive more preventive care than do women without disabilities. 3. These women seldom have sexual relations. 4. They receive less preventive care and have greater yearly health expenditures than do women without disabilities.
Answer: 4
18) A client asks the nurse about treatment for human papilloma viral warts. The nurse's response should be based on what knowledge? 1. An antiviral injection cures approximately 50% of all cases. 2. Aggressive treatment is required to cure warts. 3. Warts often spread when an attempt is made to remove them surgically. 4. No single treatment is best for all types of warts or for all clients.
Answer: 4 Explanation: 4. All atypical, pigmented, and persistent warts should be biopsied and treatment instituted promptly.
15) The nurse educator is talking with the students in the clinical area about amenorrhea. She has discussed both primary and secondary amenorrhea and their possible causes and knows that her teaching has been successful when, upon being questioned, a student explains that amenorrhea can be caused by which of the following? 1. Malfunctioning of the pancreas and insulin usage 2. Lack of testosterone after the time for menses to start 3. Lack of vitamin D and calcium in the system 4. Dysfunction of the hypothalamus
Answer: 4 Explanation: 4. Causes for amenorrhea include dysfunction of the hypothalamus, pituitary, and/or anovulation.
7) Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea? 1. 17-year-old, has never had a menstrual cycle 2. 16-year-old, had regular menses for 4 years, but has had no menses in 4 months 3. 19-year-old, regular menses for 5 years that have suddenly become painful 4. 14-year-old, irregular menses for 1 year, experiences cramping every cycle
Answer: 4 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.
31) A nurse is teaching a middle school health class on the different types of viral hepatitis. Which statement made by a student indicates the need for further teaching? 1. "Both hepatitis A and E are not chronic infections." 2. "Hepatitis A is characterized by symptoms of jaundice, anorexia, nausea, vomiting, malaise, and fever." 3. "Hepatitis B, C, and D have symptoms similar to those of hepatitis A, and can also include arthralgias, arthritis and skin eruptions or rash." 4. "Both hepatitis B and C have an incubation period of 45-160 days."
Answer: 4 Explanation: 4. Hepatitis B has an incubation period of 45-160 days, but hepatitis C has an incubation period of 14-180 days.
26) The client is undergoing lab work and ultrasound for a possible diagnosis of polycystic ovarian syndrome (PCOS). Which problem does the nurse expect to find in the client's history? 1. Multiple first-trimester fetal losses 2. Dyspareunia 3. Vulvitis 4. Oligomenorrhea
Answer: 4 Explanation: 4. Irregular menses, ranging from total absence of periods (amenorrhea) to intermittent or infrequent periods (oligomenorrhea) are the hallmarks of PCOS.
16) The nurse is educating a group of female adolescents regarding sexually transmitted infections. The nurse knows that learning was achieved when an individual states that the most common symptom is which of the following? 1. Menstrual cramps 2. Heavy menstrual periods 3. Flu-like symptoms 4. Usually there are no signs or symptoms
Answer: 4 Explanation: 4. It is common for women to experience no signs or symptoms when they have contracted a sexually transmitted disease.
17) The client with limited English language skills has a black eye, and bruises across her face and arms. The client's husband has been acting as an interpreter for her, and answers all of the questions the nurse asks, often without talking to his wife first. The nurse suspects the client has been a victim of domestic abuse. What should the nurse do next? 1. Ask the husband whether he has beaten his wife. 2. Ask the husband to have a female friend come in with his wife. 3. Provide written materials in English for the client to read at home. 4. Ask the husband to step out of the room, and obtain an interpreter.
Answer: 4 Explanation: 4. Screening for women experiencing domestic violence must be done privately. An interpreter should also be provided as necessary.
32) The nurse educator is discussing abdominal and vaginal hysterectomy with the students. The nurse explains that the one main disadvantage of a vaginal hysterectomy is which of the following? 1. More blood loss with the surgery 2. Increased pain postoperatively 3. A longer recuperation period 4. Trauma to the bladder
Answer: 4 Explanation: 4. The chance of doing some trauma to the bladder is greater with the vaginal hysterectomy.
1) A nonpregnant client is diagnosed with bacterial vaginosis (BV). What does the nurse expect to administer? 1. Penicillin G 2 million units IM one time 2. Zithromax 1 mg p.o. b.i.d. for 2 weeks 3. Doxycycline 100 mg p.o. b.i.d. for a week 4. Metronidazole 500 mg p.o. b.i.d. for a week
Answer: 4 Explanation: 4. The nonpregnant woman who is diagnosed with bacterial vaginosis (BV) is treated with metronidazole 500 mg orally twice a day for 7 days.
25) A client in the emergency department is diagnosed with pelvic inflammatory disease. Before discharge, the nurse will provide the client with some health teaching about which topic? 1. Endometriosis 2. Menopause 3. Ovarian hyperplasia 4. IUD for contraception
Answer: 4 Explanation: 4. The woman who uses an IUD for contraception and has multiple sexual partners needs to understand clearly the risk she faces.
29) The nurse in the clinic is seeing four clients. Which one is the best candidate for receiving an IUC? 1. An unmarried, 22-year-old college graduate 2. A married 24-year-old who has never been pregnant 3. An unmarried 25-year-old with a history of chlamydia 4. A married 26-year-old who has two children
Answer: 4 Explanation: 4. This client is the best candidate, as she is in a stable relationship, and has children.
30) The nurse is interviewing a new client in the clinic. The client is premenopausal, but is concerned about the bone changes and osteoporosis that can occur, since she is getting close to menopause. The nurse tells the client that prevention is the primary goal. Which of the following would be a primary goal for prevention? 1. Eliminating all alcohol intake 2. Taking 500 mg of calcium each day 3. Use of sunscreen to assist with absorption of vitamin D 4. Regular weight-bearing and muscle-strengthening exercises
Answer: 4 Explanation: 4. This is correct. Regular weight bearing of the long bones is a primary goal for the prevention of osteoporosis.
29) A 56-year-old client comes into the gynecology clinic with the complaints of constipation and a protrusion from her vagina. What does this client most likely have? 1. A cystocele 2. A prolapsed uterus 3. Polycystic ovarian syndrome 4. A rectocele
Answer: 4 Explanation: 4. This is the correct answer. The client often complains of constipation, and the anterior wall of the rectum protrudes through the vagina.
35) A client arrives at the emergency department stating that she was raped, but she felt so "dirty" that she went home and showered. She states that she has on clean clothes but has her other clothes in a bag. What will the nurse tell the client? 1. "I understand why you felt dirty, but you know you should not have taken a shower." 2. "We will probably never find out who raped you because you destroyed evidence." 3. "Do you want an emergency contraceptive pill?" 4. "I understand that was important to you. We will see what we can get from your clothes, and give them to the authorities."
Answer: 4 Explanation: 4. This is the correct statement. This is not the time to tell her what she did wrong, as she is psychologically upset. The ability to collect evidence that is comprehensive, appropriate, and reliable contributes to successful prosecution of perpetrators of sexual assault.
14) A female client who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires birth control. The nurse understands that which contraceptive method is inappropriate for this client? 1. Intrauterine device 2. Vaginal sponge 3. Combined oral contraceptives 4. Transdermal hormonal contraception
Answer: 4 Explanation: 4. Transdermal hormonal contraception is contraindicated because of the client's obesity.
8) The nurse is interviewing a client who has admitted to being a victim of domestic violence. What is the most typical description of how the domestic violence developed in a relationship? 1. "He changed overnight. Everything was fine, and all of a sudden he flipped out and beat me up; he nearly killed me." 2. "It was severe from the beginning. As soon as we got married, he began hitting me and threatening to kill me." 3. "We've both always dated other people. I thought that was understood. He was as emotionally abusive in the beginning as he is now." 4. "I don't know when it started, really. It was gradual. First, just yelling, blaming, and shoving. Then the beatings started; and now they're more frequent."
Answer: 4 Explanation: 4. Typically, these forms of abuse begin slowly and subtly after some form of commitment, such as engagement, onset of a sexual relationship, marriage, pregnancy, or first childbirth.
16) A couple asks the nurse what is the safest method of sterilization. What should the nurse reply? 1. "Laparotomy tubal ligation." 2. "Laparoscopy tubal ligation." 3. "Minilaparotomy." 4. "Vasectomy."
Answer: 4 Explanation: 4. Vasectomy (male sterilization) is a relatively minor procedure.
25) The nurse is caring for a new mother who is intellectually disabled. She has chosen to keep her baby, and will live with her parents, who both work full-time. Public health nurses are going to be following this client and her baby closely. What is the main thing the nurse will have to remember when caring for this client? 1. This client will need to have a babysitter at all times. 2. This client is not going to be able to keep this baby, due to her disability. 3. The father of the baby needs to move in with the family to assist with care. 4. The nurse and the client's family will have to give clear, concise, easy-to-understand directions multiple times.
Answer: 4 Explanation: 4. When working with clients with intellectual disabilities, it is important for the nurse to provide modified teaching materials and delivery to meet varying learning needs.