Chapter 46

Which information should the nurse include in the education for a client prescribed flibanserin (Addyi) for the treatment of sexual desire disorder? 1) "Do not drink alcohol while taking the medication." 2) "You may experience insomnia while taking this prescription." 3) "Abstain from dairy products while taking this medication." 4) "This medication increases desire by increasing endogenous estrogen production."

1) "Do not drink alcohol while taking the medication." p. 748

A client asks the nurse for emergency contraception. Which question should the nurse ask the client? 1) "How long ago did you have unprotected sex?" 2) "Did you use a condom during intercourse?" 3) "What kind of birth control have you used in the past?" 4) "Where are you in your monthly cycle?"

1) "How long ago did you have unprotected sex?" p. 737, 738

The nurse is preparing to obtain a history from a client suspected of experiencing the early stage of menopause. Which statements made by the client support the condition? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "I have experienced bouts of depression." 2) "I have a great deal of trouble sleeping." 3) "I have lost interest in having sex." 4) "I have been experiencing headaches." 5) "I have been leaking urine when I cough and sneeze."

1) "I have experienced bouts of depression." 2) "I have a great deal of trouble sleeping." 4) "I have been experiencing headaches." p. 739

A nurse is teaching a patient about the possible adverse effects of oral contraceptives. The nurse evaluates that the patient understands this teaching if which statements are made? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "I may experience increased acne while on oral contraceptives." 2) "If I experience chest pain, I will call the clinic immediately." 3) "If I begin to lose more hair than is normal, my dose may need to be adjusted." 4) "Any blurry vision or loss of vision should be reported immediately." 5) "If I notice swelling in my feet, hands, or face, I will notify the clinic."

1) "I may experience increased acne while on oral contraceptives." 2) "If I experience chest pain, I will call the clinic immediately." 4) "Any blurry vision or loss of vision should be reported immediately." 5) "If I notice swelling in my feet, hands, or face, I will notify the clinic." p.735

Which information should the nurse provide a client that has stopped taking oral contraceptives so that she can become pregnant? 1) "It may take several months for ovulation to return to normal." 2) "The incidence of miscarriage is slightly increased." 3) "It may take several months for your menstrual periods to become regular." 4) "The length of use can affect your fertility." 5) "If you are not pregnant within a year your healthcare provider will refer you to an infertility specialist."

1) "It may take several months for ovulation to return to normal." 3) "It may take several months for your menstrual periods to become regular." p. 734

The nurse has provided a postpartum client education about oxytocin (Pitocin). Which statement made by the client indicates an understanding of the information? 1) "Oxytocin will increase my uterine contractions." 2) "Oxytocin will promote fluid loss." 3) "Oxytocin will stimulate milk production." 4) "Oxytocin will increase the amount of milk I produce."

1) "Oxytocin will increase my uterine contractions." p. 745

Which information should the nurse include in the teaching for a client prescribed a progestin only oral contraceptive? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Progestin oral contraceptives have a higher failure rate." 2) "Progestin oral contraceptives inhibit plantation of a fertilized egg." 3) "Works primarily by producing a thick viscous mucus that discourages the sperms entrance to the uterus." 4) "You have an increased risk of a thromboembolism." 5) "You may notice your menstrual cycle will be more regular."

1) "Progestin oral contraceptives have a higher failure rate." 2) "Progestin oral contraceptives inhibit plantation of a fertilized egg." 3) "Works primarily by producing a thick viscous mucus that discourages the sperms entrance to the uterus." p. 732

A client calls the family planning clinic and states, "I had unprotected sex, and now I am afraid I will get pregnant." Which information about Plan B should the nurse provide to the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "You can purchase Plan B without a prescription." 2) "You cannot purchase Plan B until you have been examined at the family planning clinic." 3) "You may take two separate doses of Plan B." 4) "If you are already pregnant, Plan B will end the pregnancy." 5) "Plan B will prevent ovulation and implantation."

1) "You can purchase Plan B without a prescription." 3) "You may take two separate doses of Plan B." 5) "Plan B will prevent ovulation and implantation." p.737

Which prescription information should the nurse provide the client prescribed Premarin? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "You may notice a decrease in your libido while on this prescription." 2) "You may experience depression while taking the prescription." 3) "Do not become pregnant while on this prescription." 4) "If you add the herbal black cohosh to this therapy, the results will be better." 5) "This prescription will help prevent cardiovascular disease."

1) "You may notice a decrease in your libido while on this prescription." 2) "You may experience depression while taking the prescription." 3) "Do not become pregnant while on this prescription." p. 740

The nurse is preparing to provide education for a client prescribed an estrogen-progestin combination oral contraceptive. Which information should the nurse include in the teaching? 1) Inhibit ovulation 2) Inhibit the luteinizing hormone 3) Suppress the follicle-stimulating hormone 4) Suppress the growth of the follicle

1) Inhibit ovulation p. 731

Which should the nurse monitor the client for who is receiving hormone replacement therapy (HRT)? 1) Thrombophlebitis 2) Night sweats 3) Colorectal cancer 4) Fractures

1) Thrombophlebitis p. 739

When caring for a laboring client, which assessment finding indicates the oxytocin (Pitocin) infusion should be discontinued? 1) Uterine contractions that are continuous and sustained. 2) The vaginal exam reveals that the client is entering transition. 3) The client reports that the uterine contractions are strong in intensity. 4) Uterine contractions occur every 2 to 3 minutes and last 40 to 60 seconds.

1) Uterine contractions that are continuous and sustained. p. 745

The nurse has provided education for a client prescribed a transdermal patch for contraception. Which statement made by the client indicates an understanding of the teaching? 1) "I will change the patch every 4 weeks." 2) "I will change the patch every 7 days for the first 3 weeks." 3) "I will change the patch every 3 weeks and be patch free week 4) "I will change the patch every 7 days for the 4 weeks."

2) "I will change the patch every 7 days for the first 3 weeks." p. 733

The nurse teaches a class for clients in their first trimester of pregnancy. The nurse evaluates that learning has occurred when the clients make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Ovulation occurs on approximately Day 21 of the ovarian cycle." 2) "Ovulation is caused by a surge of luteinizing hormone." 3) "Ovulation is caused by a surge of human chorionic gonadotropin." 4) "Follicle-stimulating hormone causes ovarian follicles to develop." 5) "The pituitary gland secretes gonadotropin-releasing hormone."

2) "Ovulation is caused by a surge of luteinizing hormone." 4) "Follicle-stimulating hormone causes ovarian follicles to develop." p.730, 731

The nurse has completed the education for a client prescribed clomiphene (Clomid). Which statement made by the client indicates an understanding of the information? 1) "This medication increases my estrogen levels so I can ovulate." 2) "This medication stimulates LH (luteinizing hormone)." 3) "This medication stimulates FSH (follicle-stimulating hormone)." 4) "This medication stimulates gonadotropin-releasing hormone."

2) "This medication stimulates LH (luteinizing hormone)." p. 747

Which is responsible for the secretion of progestins? 1) Anterior pituitary 2) Corpus luteum 3) Ovarian follicles 4) Hypothalamus

2) Corpus luteum p.730

Which is progestin primarily prescribed to treat? 1) Breast cancer 2) Amenorrhea 3) Dysfunctional uterine bleeding 4) Menopause

3) Dysfunctional uterine bleeding p. 741

Which is responsible for the secretion of estrogen? 1) Corpus luteum 2) Anterior pituitary 3) Ovarian follicles 4) Endometrium

3) Ovarian follicles p. 730

The nurse has provided education for a client prescribed the contraceptive Seasonale. Which statement made by the client indicates an understanding of the information? 1) "After I have taken 21 pills, I will not take pills for 7 days." 2) "I will remove the ring at the end of 3 weeks." 3) "After I have taken pills for 84 days, I will not take pills for 7 days." 4) "I will change the patch each week."

3) "After I have taken pills for 84 days, I will not take pills for 7 days." p. 734

Which statement made by an older female client prescribed medroxyprogesterone (Provera) should the nurse be most concerned about? 1) "I have gained a bit of weight." 2) "I have had periods of feeling very sad." 3) "I have experienced moments of confusion." 4) "I have been experiencing bouts of nausea."

3) "I have experienced moments of confusion." p. 743

A male client prescribed estrogen for prostate cancer asks the nurse why they are receiving a female hormone. Which response should the nurse provide? 1) "It shrinks your cancer by causing the cells to die at a faster rate." 2) "It eliminates the testosterone that encourages the growth of the cancer cells" 3) "It suppresses secretion of the androgens that make your cancer grow." 4) "It keeps the cancer cells from receiving nutrients."

3) "It suppresses secretion of the androgens that make your cancer grow." p.741

The educator has reviewed the action of the biphasic estrogen-progestin oral contraceptive with the nurse. Which statement made by the nurse indicates an understanding of the information? 1) "The amounts of both estrogen and progestin in each pill vary in 3 distinct phases during the treatment cycle." 2) "The oral contraceptive contains estradiol valerate, a synthetic estrogen, and dienogest, a progestin." 3) "The amount of estrogen in each pill remains constant, but the amount of progestin is increased toward the end of the treatment cycle to better nourish the uterine lining." 4) "The oral contraceptive delivers a constant dose of estrogen and progestin throughout the 21-day treatment cycle."

3) "The amount of estrogen in each pill remains constant, but the amount of progestin is increased toward the end of the treatment cycle to better nourish the uterine lining." p.732

Which should the nurse include in the plan of care for a client receiving Ortho-Novum experiencing vaginal bleeding? 1) Ask the client if she has been having sexual intercourse recently. 2) Tell the client to go to the emergency department for medical treatment. 3) Ask the client if she is bleeding between cycles or if this is her regular period. 4) Tell the client not to worry if the bleeding resembles her monthly flow.

3) Ask the client if she is bleeding between cycles or if this is her regular period. p. 735

A client taking oral contraceptives tells the nurse she is experiencing nausea and breast tenderness and is afraid she might be pregnant. Which information should the nurse provide the client? 1) Instruct the client to take an at-home pregnancy test. 2) Instruct the client to come to the clinic to evaluate their birth control prescription. 3) Reassure the client that these symptoms can be a side effect of oral contraceptives. 4) Ask the client if she is premenstrual.

3) Reassure the client that these symptoms can be a side effect of oral contraceptives. p. 735

Which client behavior should the nurse be most concerned about for the client prescribed an estrogen/progestin oral contraceptive? 1) Multiple sexual partners 2) Pharmacological treatment for bipolar disorder 3) Smoking one-half pack of cigarettes per day 4) Drinking two glasses of wine a day

3) Smoking one-half pack of cigarettes per day p. 735

Which education should the nurse include in the teaching for a client prescribed a NuvaRing? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "This ring should be inserted into your uterus." 2) "Once inserted, this ring will provide contraception for 6 months." 3) "You should expect to replace the ring every 3 weeks." 4) "Contraceptive protection is provided for 3 weeks." 5) "The ring uses estrogen and progestin to provide contraception."

4) "Contraceptive protection is provided for 3 weeks." 5) "The ring uses estrogen and progestin to provide contraception." p. 733

A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client? 1) "Please come into the clinic immediately to have a pregnancy test done." 2) "You might consider another form of birth control if you keep missing your pills. 3) "If you have missed fewer than three of your pills, you do not need to worry." 4) "You should use an alternative form of birth control for the rest of this cycle."

4) "You should use an alternative form of birth control for the rest of this cycle." p. 732

A client receiving Depo-Provera as a method of birth control asks the nurse how long the prescription will be effective. Which response should the nurse provide the client? 1) 2 months 2) 6 months 3) 1 year 4) 3 months

4) 3 months p. 732, 733

Which initial step occurs in the process of the formation of the corpus luteum? 1) A surge of luteinizing hormone (LH) occurs. 2) Ovarian follicles mature. 3) Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are secreted. 4) Gonadotropin-releasing hormone (GnRH) is secreted.

4) Gonadotropin-releasing hormone (GnRH) is secreted. p. 730 ,731

Which describes the action of oxytocics? 1) Slow down uterine contractions 2) Increase the level of luteinizing hormones 3) Increase ovarian secretion 4) Stimulate uterine contractions

4) Stimulate uterine contractions p. 745