Exam 1 - Maternal

A client is to receive 3 million units of penicillin G intramuscular to treat gonorrhea. The drug is available in 1,500,000 units/mL. How many milliliters should the nurse administer? Record your answer using a whole number.

2 Formula of D/H X V 3,000,00/1,500,000 X 1 mL = 2 mL

A public health nurse is teaching a class on sexually transmitted infections (STIs). Which statements would the nurse include in the discussion? Select all that apply. A. "65 million people live with incurable STIs." B. "STIs are biologically sexist causing more complications among men." C. "After a single exposure, women are twice as likely as men to acquire a STI." D. "STIs contribute to cervical cancer." E. "STIs cannot be transmitted to the fetus or infant during childbirth."

A. "65 million people live with incurable STIs." C. "After a single exposure, women are twice as likely as men to acquire a STI." D. "STIs contribute to cervical cancer." An estimated 65 million people live with an incurable STI. STIs are biologically sexist, presenting greater risk and causing more complications among women than among men. After only a single exposure, women are twice as likely as men to acquire infections. STIs may contribute to cervical cancer. Certain infections can be transmitted in utero to the fetus or during childbirth to the newborn.

A woman has been diagnosed with trichomoniasis and asks the nurse when it would be safe to resume sexual activity. How should the nurse respond? A. "After treatment you must be symptom free to resume sexual activity." B. "You may resume sexual activity after you and your partner have been treated." C. "You and your partner must wait 10 days after you complete your treatment regimen." D. "When you have taken your medication and no longer have any discharge, then sexual activity is fine."

A. "After treatment you must be symptom free to resume sexual activity." Trichomoniasis is the most prevalent nonviral sexually transmitted infection. It is treated with metronidazole, usually a single 2-gram dose. For treatment to be effective all sexual partners of the client need to be treated. Sexual activity can resume after the partners have been treated and both the woman and partner are symptom free. There is no timeline for this to occur and treatment will not be effective if both the woman and her partner are not treated. The infection will reoccur.

After the nurse teaches a client about ways to reduce the symptoms of premenstrual syndrome, which client statement indicates a need for additional teaching? A. "I will make sure to take my estrogen supplements a week before my period." B. "I've signed up for an aerobic exercise class three times a week." C. "I'll cut down on the amount of coffee and colas I drink." D. "I quit smoking about a month ago, so that should help."

A. "I will make sure to take my estrogen supplements a week before my period." Lifestyle changes such as exercising, avoiding caffeine, and smoking cessation are a key component for managing the signs and symptoms of premenstrual syndrome. Estrogen supplements are not used. If medication is necessary, NSAIDs may be used for painful physical symptoms; spironolactone may help with bloating and water retention.

After assessing a woman who has come to the clinic, the nurse suspects that the woman is experiencing abnormal uterine bleeding. Which statement by the client would support the nurse's suspicions? A. "I've been having bleeding off and on that's irregular and sometimes heavy." B. "I get sharp pain in my lower abdomen usually starting soon after my period comes." C. "I get really irritable and moody about a week before my period." D. "My periods have been unusually long and heavy lately."

A. "I've been having bleeding off and on that's irregular and sometimes heavy." Abnormal uterine bleeding is defined as irregular, abnormal bleeding that occurs with no identifiable anatomic pathology. It is frequently associated with anovulatory cycles, which are common for the first year after menarche and later in life as a woman approaches menopause. Pain occurring with menses refers to dysmenorrhea. Although mood swings may be associated with abnormal uterine bleeding, irritability and mood swings are more commonly associated with premenstrual syndrome. Unusually long and heavy periods reflect menorrhagia.

A nurse is conducting a class for a group of young adult women interested in contraception. As part of the class, the nurse asks the group about their understanding about contraception and pregnancy. Which statement(s) would cause the nurse to address it as a misconception. Select all that apply. A. "If you douche after having sex, you will not get pregnant." B. "You cannot get pregnant if you have your menstrual period." C. "Birth control pills will not protect you against sexually transmitt

A. "If you douche after having sex, you will not get pregnant." B. "You cannot get pregnant if you have your menstrual period." D. "Pregnancy cannot happen if my male partner pulls out before ejaculating." E. "I cannot get pregnant if I am breastfeeding." Common misconceptions include the following: Breastfeeding protects against pregnancy; pregnancy can be avoided if the male partner "pulls out" before he ejaculates; pregnancy cannot occur during menses; and douching after sex will prevent pregnancy. Taking birth control pills does not protect against sexually transmitted infections, thus the participants are correct in their understanding.

When the nurse is alone with a client, the client says, "It was all my fault. The house was so messy when my partner got home, and I know my partner hates that." Which response would be most appropriate? A. "It is not your fault. No one deserves to be hurt." B. "What else did you do to make your partner so angry with you?" C. "You need to start to clean the house early in the day." D. "Remember, your partner works hard and you need to meet your partner's needs."

A. "It is not your fault. No one deserves to be hurt." The nurse needs to communicate nonjudgmental support and explain that no one deserves to be abused. Doing so helps to establish trust and rapport. Asking the victim what he or she did to make the partner so angry, telling the victim to clean the house earlier in the day, and telling the victim to meet the partner's needs all shift the blame to the victim and are thus inappropriate.

A woman is diagnosed with gonorrhea. The client asks why she needs to take two medications. How should the nurse respond? Select all that apply. A. "The medicines are needed to kill the bacteria causing the infection." B. "The medications help prevent the spread of the bacteria to your female organs." C. "Taking two medications will cure the infection faster." D. "The bacteria causing the infection is very strong, so two medications are needed." E. "The medications will stop the bacteria

A. "The medicines are needed to kill the bacteria causing the infection." B. "The medications help prevent the spread of the bacteria to your female organs." E. "The medications will stop the bacteria before it can cause complications." The antibiotic treatment for gonorrhea is a dual therapy with azithromycin and ceftriaxone. Dual therapy is recommended to prevent drug resistance and it is also effective against chlamydia. If left untreated or not treated adequately, gonorrhea can cause infertility, pelvic inflammatory disease, and ectopic pregnancy. The medications can cure the infection and help prevent spread to the pelvic organs. Taking two medications does not kill the bacteria faster nor is the bacteria so strong two medications are needed.

A woman has been prescribed doxycycline to treat a chlamydia infection. What instruction(s) should the nurse give this client? Select all that apply. A. "You must take all the 7 days of the medication." B. "You will need to be retested after you complete the medication." C. If the symptoms do not go away after the medication, you will need to return to the health care provider." D. "If you suspect you have another infection, you need to see the health care provider right away." E. "You will

A. "You must take all the 7 days of the medication." C. If the symptoms do not go away after the medication, you will need to return to the health care provider." D. "If you suspect you have another infection, you need to see the health care provider right away." Doxycycline belongs to the classification of tetracyclines. It is useful in the treatment of many types of infections and specifically chlamydia. The drug is given twice a day for 7 days. It is contraindicated with a known hypersensitivity to the drug. The medication may be taken during pregnancy. The client needs to be retested only if it is suspected or known the client did not complete the medication, if symptoms persist or if a reinfection is suspected. The client needs to return to the health care provider if treatment has been completed and symptoms persist. It is recommended for women to be screened annually for this infection.

A client has been diagnosed and treated for primary syphilis. What instruction should the nurse give this client about follow-up testing? A. "You will need to be retested again in 6 months." B. "You also will need to be tested for HIV in 6 months." C. "You do not need to be retested after treatment unless symptoms develop." D. "You need to retested if you have a new sexual partner."

A. "You will need to be retested again in 6 months." For the client treated for primary or secondary syphilis, retesting needs to occur at 6 months and at 12 months. If the client was treated for latent syphilis, then testing needs to be done at 6 months, 12 months, and 24 months. For latent syphilis, the testing also needs to include testing for HIV. The client does not to be retested if there is a new sexual partner, but the client should be instructed in safer sex methods to prevent a sexually transmitted infection.

A pregnant woman is diagnosed with chlamydia and asks the nurse, "How will this infection affect my baby and pregnancy?" Which responses by the nurse are accurate? Select all that apply. A. "Your newborn can be infected during birth." B. "Your newborn may have eye infections from this infection." C. "Your membranes may rupture earlier than normal." D. "Your newborn is protected from this infection." E. "It will not have any effect on your pregnancy."

A. "Your newborn can be infected during birth." B. "Your newborn may have eye infections from this infection." C. "Your membranes may rupture earlier than normal." STIs' effects on the fetus or newborn such as chlamydia include the newborn being infected during birth with eye infections (neonatal conjunctivitis), pneumonia, low birth weight, increased risk of premature rupture of the membranes (PROM), preterm birth, and stillbirth.

When developing a presentation for a local community organization on violence, the nurse is planning to include statistics on intimate partner violence and its effects on children. When addressing these statistics, what is the rate of the cases involving a parent and the children being abused? A. 1 in 8 B. 1 in 3 C. 1 in 5 D. 1 in 10

A. 1 in 8 In many cases when a parent is abused, the children are abused as well. Approximately 1 in 8 children are abused annually in the United States.

While obtaining a history from a woman at a regularly scheduled physical, the nurse notices various bruises on the client's upper extremity. The client dismisses the bruising and changes the subject. Which additional information about the woman as a victim would the nurse discuss with the healthcare provider when relaying the physical assessment data? Select all that apply. A. A dysfunctional family system B. A low academic achievement C. A victim of childhood violence D. Limited alcohol

A. A dysfunctional family system B. A low academic achievement C. A victim of childhood violence E. Economic stress Victims often will not describe themselves as abused. In battered woman syndrome, the woman has experienced deliberate and repeated physical or sexual assault by an intimate partner over an extended period of time. She is terrified and feels trapped, helpless, and alone. She reacts to any expression of anger or threat by avoidance and withdrawal behavior. Some women believe that the abuse is caused by a personality flaw or inadequacy in themselves (e.g., inability to keep the partner happy). These feelings of failure are reinforced and exploited by their partners. After being told repeatedly that they are "bad," some women begin to believe it. Many victims were abused as children and may have poor self-esteem, poor health, post- traumatic stress disorder (PTSD), depression, insomnia, low education achievement, or a history of suicide attempts, injury, or drug and a

A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for: A. DEXA scan. B. ultrasound. C. MRI. D. pelvic X-ray.

A. DEXA scan. Currently, no method exists for directly measuring bone mass. Instead, a bone mass density (BMD) measurement is used. BMD is a two-dimensional measurement of the average content of mineral in a section of bone. The client most likely will be having a DEXA scan, which is a screening test that calculates the mineral content of the bone at the spine and hip. Ultrasound, MRI, and a pelvic X-ray would be of little help in determining bone mass.

The school public health nurse is teaching a high school class on sexually transmitted infections (STIs). The nurse would include what information in the presentation? Select all that apply. A. Fifteen- to twenty-four-year-olds represent almost half of all cases of new STIs. B. Two in five sexually active teen girls have an STI. C. Adolescent females make up more than three-quarters of HIV diagnoses. D. Teens who are sexually active experience high rates of STIs. E. All groups of teens are

A. Fifteen- to twenty-four-year-olds represent almost half of all cases of new STIs. B. Two in five sexually active teen girls have an STI. D. Teens who are sexually active experience high rates of STIs. F. Adolescent males make up more than four-fifths of HIV diagnosis. ndividuals aged 15 to 24 years represent almost half of all cases of new STIs acquired. Two in five sexually active teen girls have a STI. Adolescent males make up more than three-quarters of HIV diagnoses among 13- to 19-year-olds. In the United States, teens who are sexually active experience high rates of STIs, and some groups are at higher risk, including African American and Hispanic youths, youths living in poverty, and those with limited educational attainment.

A nurse is teaching a group of college students about rape and sexual assault. The nurse determines that additional teaching is necessary based on which statements by the group? Select all that apply. A. Most victims of rape tell someone about it. B. Few individuals falsely cry "rape." C. Women have rape fantasies desiring to be raped. D. A rape victim feels vulnerable and betrayed afterwards. E. Medication and counseling can help a rape victim cope.

A. Most victims of rape tell someone about it. C. Women have rape fantasies desiring to be raped. The majority of victims never tell anyone about a rape. Almost two-thirds of victims never report it to the police. The victim feels vulnerable, betrayed, and insecure after a rape. Few individuals falsely cry "rape." Reality and fantasy are different, and dreams have nothing to do with the brutal violation of rape. Medication can help initially, but counseling is usually needed.

A woman comes to the clinic because she has been unable to conceive. When reviewing the woman's history, the nurse would least likely identify which factor as a possible risk? A. age of 25 years B. history of smoking C. diabetes since age 15 years D. weight below standard for height and age

A. age of 25 years Female risk factors for infertility include increased age older, smoking and alcohol consumption, history of chronic illness such as diabetes, and overweight or underweight, which can disrupt hormonal function

A client with trichomoniasis is to receive metronidazole. What should the nurse instruct the client to avoid while taking this drug? A. alcohol B. nicotine C. chocolate D. caffeine

A. alcohol The client should be instructed to avoid consuming alcohol when taking metronidazole because severe nausea and vomiting could occur. There is no need to avoid nicotine, chocolate, or caffeine when taking metronidazole.

When a nurse suspects that a client may be a victim of intimate partner violence, the first action should be to: A. ask the client about the injuries and if they are related to intimate partner violence. B. encourage the client to leave the abuser immediately. C. set up an appointment with an intimate partner violence counselor. D. ask the suspected abuser about the victim's injuries.

A. ask the client about the injuries and if they are related to intimate partner violence. The first step is to screen for intimate partner violence and identify the connection between the client's injuries and that abuse. Once intimate partner violence is detected, the nurse should immediately isolate the client to provide privacy and prevent retaliation by the abuser. Encouraging the client to leave the abuser immediately is not realistic. Setting up an appointment with a counselor would be appropriate once intimate partner violence is detected and the client is safe. Questioning the suspected abuser might worsen the situation.

A nurse is developing a plan of care for a victim of intimate partner violence. Which intervention would be least appropriate for the nurse to include? A. assisting the client to project anger B. providing information about a safe home and crisis line C. teaching the client about the cycle of violence D. discussing the client's legal and personal rights

A. assisting the client to project anger The goal of intervention is to enable the victim to gain control by providing sensitive, predictable care in an accepting setting. Assisting the client to project anger would not be helpful when the client needs support and education.

A young adult woman who is HIV-positive is receiving anti-retroviral therapy (ART) and is having difficulty with adherence. To promote adherence, which area would be most important for the nurse to assess? A. beliefs and education B. financial situation and insurance C. activity level and nutrition D. family and living arrangements

A. beliefs and education The most important area to assess initially would be the client's beliefs and knowledge about the disease and its treatment. A common barrier is a lack of understanding about the link between drug resistance and nonadherence. Once this area is assessed, the nurse can assess for other barriers, such as finances and insurance, nutrition and activity level, and family issues, including living arrangements (for example, the client may be afraid that his or her HIV status would be revealed if others see the client taking medication).

The nurse discusses various contraceptive methods with a client and her partner. After the discussion, the nurse determines that the couple understood the information when they identify which method as being available only with a prescription? A. cervical cap B. cervical sponge C. condom D. spermicide

A. cervical cap The cervical cap is available only by prescription and must be fitted by a health care provider. The cervical sponge, condom, or spermicide do not require a prescription.

An female adolescent is diagnosed with gonorrhea. When developing the plan of care for this adolescent, the nurse would expect that she would also receive treatment for: A. chlamydia. B. syphilis. C. genital herpes. D. trichomoniasis.

A. chlamydia. Clients with gonorrhea usually receive treatment for chlamydia as well because they often are coinfected. Coinfection with syphilis, genital herpes, or trichomoniasis is uncommon.

A nurse manager in a family planning clinic is conducting an in-service presentation for the nursing staff on contraception. After teaching the group about the different methods for contraception, the manager determines that the teaching was successful when the group identifies which contraceptive methods as mechanical barrier methods? Select all that apply. A. condom B. cervical cap C. cervical sponge D. diaphragm E. vaginal ring

A. condom B. cervical cap C. cervical sponge D. diaphragm Barrier methods include the condom, cervical cap, cervical sponge and diaphragm. The vaginal ring is considered a hormonal method of contraception.

A nurse is working with a victim of intimate partner violence, helping the client develop a safety plan. Which items would the nurse suggest that the client take when leaving? Select all that apply. A. driver's license B. Social Security number C. cash D. phone cards E. health insurance cards

A. driver's license B. Social Security number C. cash E. health insurance cards When leaving an abusive relationship, the victim should take a driver's license or photo ID, Social Security number or green card/work permit, birth certificates, any court papers or orders, credit cards, cash, and health insurance cards. The victim should avoid phone cards because they leave a trail to follow.

After teaching a group of young adults about sexual violence, the nurse determines that the teaching was successful when the group identifies which acts as a type of sexual violence? Select all that apply. A. female genital mutilation B. bondage C. infanticide D. human trafficking E. prostitution

A. female genital mutilation B. bondage C. infanticide D. human trafficking Sexual violence includes IPV, human trafficking, incest, female genital cutting, forced prostitution, bondage, exploitation, neglect, infanticide, and sexual assault.

A client is questioning the nurse about the various options for contraception. When explaining the implantable form, the nurse should point out it contains which form of contraception? A. progestin B. estrogen and progestin C. concentrated spermicide D. concentrated estrogen

A. progestin Implantable contraceptives deliver synthetic progestin that act by inhibiting ovulation and thickening cervical mucus so sperm cannot penetrate. Various options that combine estrogen and progestin include the transdermal patch and a vaginal estrogen/progestin (contraceptive) ring. Concentrated spermicide is inserted directly into the

A nurse is preparing a class for a group of women at a family planning clinic about contraceptives. When describing the health benefits of oral contraceptives, which benefits would the nurse include? Select all that apply. A. protection against pelvic inflammatory disease B. reduced risk for endometrial cancer C. decreased risk for depression D. reduced risk for migraine headaches E. improvement in acne

A. protection against pelvic inflammatory disease B. reduced risk for endometrial cancer E. improvement in acne The health benefits of oral contraceptives include protection against pelvic inflammatory disease, a reduced risk for endometrial cancer, and improvement in acne. Oral contraceptives are associated with an increased risk for depression and migraine headaches.

A nurse is working with a victim of intimate partner violence. Which intervention would be most important for this client? A. providing for the client's safety B. reassuring the client he or she is not alone C. documenting the violence D. educating about the cycle of violence

A. providing for the client's safety Although reassurance, documentation, and education are important for the client experiencing intimate partner violence, ensuring safety is the most important.

A nurse is conducting an in-service program on sexual abuse and violence for a group of nurses working at the community clinic. After teaching the group, the nurse determines that the teaching was successful when the group describes incest as involving which action? A. sexual exploitation by blood or surrogate relatives B. sexual abuse of individuals over age 18 C. violent aggressive assault on a person D. consent between perpetrator and victim.

A. sexual exploitation by blood or surrogate relatives Incest is any type of sexual exploitation between blood relatives or surrogate relatives before the victim reaches 18 years of age. Rape is a violent, aggressive assault on the victim's body and integrity. Rape is a legal rather than a medical term. It denotes penile penetration of the vagina, mouth, or rectum of the female or male without consent. It may or may not include the use of a weapon.

After teaching a group of adolescents about HIV, the nurse asks them to identify the primary means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which means of exposure? A. sexual intercourse B. sharing needles for IV drug use C. perinatal transmission D. blood transfusion

A. sexual intercourse HIV infections are increasing in adolescents and young adults aged 13 to 24 years predominantly trasmitted by sexual intercourse. Millions of US adolescents between the ages of 10 and 19 are living with HIV, and many do not receive the care and support they need to stay in good health. This is particularly significant because the risk of HIV transmission increases substantially if either partner is infected with an STI. Sharing of needles, perinatal transmission, and blood transfusions are less often means of transmission in adolescents.

A woman using the cervical mucus ovulation method of fertility awareness reports that her cervical mucus looks like egg whites. The nurse interprets this as which kind of mucus? A. spinnbarkeit mucus B. purulent mucus C. postovulatory mucus D. normal pre-ovulation mucus

A. spinnbarkeit mucus The client is describing spinnbarkeit mucus, the copious, clear, slippery, smooth, and stretchable mucus that occurs as ovulation approaches. Purulent mucus would be yellow or green and malodorous. Pre-ovulation mucus is clear but not as copious, slippery, and stretchable.

A physically abused pregnant woman reports to the nurse that her spouse has stopped hitting her and promises never to hurt her again. Which response by the nurse would be most appropriate? A. "That's great. I wish you both the best." B. "Remember, the cycle of violence often repeats itself." C. "He probably didn't mean to hurt you." D. "You need to consider leaving him."

B. "Remember, the cycle of violence often repeats itself." The cycle of violence typically increases in frequency and severity as it is repeated over and over again. The woman needs to understand this.

A sexual health public health nurse is presenting information on sexually transmitted infections (STIs) to adolescent girls and is asked, "Why are females more at risk for STIs?" Which statements by the nurse would best answer this question? Select all that apply. A. "Teenage females have sex as they feel they have power to control the sex act." B. "Teenage females lack communication skills to negotiate for safer sex." C. "The teenage female anatomy is mature, leaving them more susceptible to

B. "Teenage females lack communication skills to negotiate for safer sex." D. "The female genital tract makes you more sensitive to specific STI organisms." E. "Teenage girls are more susceptible to STIs due to their genital anatomy." Female adolescents are more susceptible to STIs due to their anatomy. During adolescence and young adulthood, women's columnar epithelial cells are especially sensitive to invasion by sexually transmitted organisms, such as chlamydia and gonococci. Adolescent females may perceive that they have limited power over when and where intercourse occurs with their partners. They typically lack negotiating skills and self-confidence needed to successfully negotiate for safer sex practices and thus are exposed to STIs.

A nurse is presenting a discussion on sexual violence at a local community college. When describing the incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a sexual assault in her lifetime? A. 1 in 3 B. 1 in 5 C. 2 in 15 D. 3 in 20

B. 1 in 5 According to the National Sexual Violence Resource Center (NSVRC), nearly one in five women and one in 9 men in the United States have experienced rape, physical violence, and/or stalking by a partner with IPV-related impact in their lifetimes.

A nurse is reading a journal article about sexual abuse. Which age range would the nurse expect to find as the peak age for such abuse? A. 7 to 10 years B. 8 to 12 years C. 14 to 18 years D. 18 to 22 years

B. 8 to 12 years Current estimates indicate that 1 of 5 girls is sexually assaulted, and the peak ages of such abuse are from 8 to 12 years of age. At every age in the life span, females are more likely to be victims of sexual violence by father, brother, family member, neighbor, boyfriend, husband, partner or ex-partner than by a stranger or anonymous assailant.

A nurse suspects that a client is experiencing intimate partner violence and uses a screening protocol to gather additional information from the client. When asking the client direct questions, which behavior by the nurse would be appropriate to elicit accurate information? Select all that apply. A. Look away from the client when asking any questions. B. Avoid the use of technical language. C. Minimize what the client says. D. Use leading questions. E. Wait patiently for the client to answ

B. Avoid the use of technical language. E. Wait patiently for the client to answer. When asking the client direct questions using the SAVE model, the nurse should maintain continuous eye contact with the client, avoid the use of technical or medical language, not dismiss or minimize what the client says, even if the client does so, use direct, to the point questions, not leading questions, and wait for each answer patiently.

A group of nurses are preparing a program about rape and sexual assault for a community health center. Which information would the nurses include as being most accurate? Select all that apply. A. Most victims of rape tell someone about it. B. Few people falsely cry "rape." C. Women have rape fantasies desiring to be raped. D. A rape victim feels vulnerable and betrayed afterwards. E. Medication and counseling can help a rape victim cope.

B. Few people falsely cry "rape." D. A rape victim feels vulnerable and betrayed afterwards. E. Medication and counseling can help a rape victim cope. The majority of victims never tell anyone about a rape. Almost two-thirds of victims never report it to the police. The victim feels vulnerable, betrayed, and insecure after a rape. Few women falsely cry "rape." Reality and fantasy are different, and dreams have nothing to do with the brutal violation of rape. Medication can help initially, but counseling is usually needed.

The sexual health nurse is presenting to a group of adolescents the government initiative that proposes to reduce the numbers of adolescents with sexually transmitted infections (STIs). What is the name of this initiative? A. Health For All B. Healthy People 2030 C. Onward to Health D. Healthy Communities 2030

B. Healthy People 2030 Healthy People 2030 proposes to reduce the proportion of adolescents and young adults with STIs. It also proposes to increase the proportion of sexually active persons aged 15 to 19 years who use condoms.

A woman who is using an intrauterine system for contraception comes to the clinic. When assessing the woman, which finding(s) would alert the nurse to a possible complication? Select all that apply. A. Absence of pain with intercourse B. String length shorter than on initial visit C. Reports of abdominal pain D. Menstrual flow lighter and shorter E. Oral temperature of 101°F (38.3°C)

B. String length shorter than on initial visit C. Reports of abdominal pain E. Oral temperature of 101°F (38.3°C) Warnings for potential complications for intrauterine system users include: late period, pregnancy, or abnormal spotting or bleeding; abdominal pain or pain with intercourse; exposure to infection or abnormal vaginal discharge; not feeling well, fever or chills; and a string length that is shorter, longer or missing. Intrauterine systems make monthly periods lighter, shorter, and less painful.

In addition to providing privacy, which action would be most appropriate initially in situations involving suspected intimate partner violence? A. Allow the client to have a good cry over the situation. B. Tell the client, "Injuries like these don't usually happen by accident." C. Call the police immediately so they can question the victim. D. Ask the abuser to describe his side of the story first.

B. Tell the client, "Injuries like these don't usually happen by accident." Communicating support through a nonjudgmental attitude and telling the victim that no one deserves to be abused are the first steps in establishing trust and rapport. Allowing the client to cry is appropriate after the client is safe, the client's privacy is protected, and the nurse has emphasized that there is a problem. Notifying the police is done once the assessment reveals suspicion or actual indications of intimate partner violence. Asking the abuser to describe the story is inappropriate because asking the abuser about the situation may trigger an abusive episode.

A nurse is listening to a client who is a victim of intimate partner violence. The client is describing how events would unfold with the partner. The nurse interprets the client's statements and identifies which action as characteristic of the second phase of the cycle of violence? A. The batterer is contrite and attempts to apologize for the behavior. B. The physical battery is abrupt and unpredictable. C. Verbal assaults begin to escalate toward the victim. D. The victim accepts the anger

B. The physical battery is abrupt and unpredictable. During the second phase of the cycle of violence, the violence explodes and the batterer loses control physically and emotionally. During the honeymoon or third phase, the batterer is contrite and attempts to apologize for the behavior. During the first phase or tension- building phase, verbal or minor battery occurs and the victim often accepts the partner's building anger as legitimately directed toward him or her.

What is the most important consideration for the nurse when communicating with an adolescent about sexually transmitted infections (STI)? A. Adjust information to the client's developmental level B. Use communication techniques that are direct and nonjudgmental C. Utilize audio and visual aids to reinforce teaching D. Design teaching for the best effect in the shortest time

B. Use communication techniques that are direct and nonjudgmental All of the answers are correct, but the most important consideration for a nurse communicating with an adolescent about STIs is to be direct and nonjudgmental. The style, content, and the message has to be aimed at the adolescent's developmental level. Any aids to help the adolescent learn should be used. The content should be designed to be delivered in the shortest amount of time because many clinics and health care provider offices are busy and do not lend themselves to long class times.

A nurse is describing the cycle of violence to a community group. When explaining the first phase, the nurse would include which description? A. somehow triggered by the victim's behavior B. characterized by tension-building and minor battery C. associated with loss of physical and emotional control D. like a honeymoon that lulls the victim

B. characterized by tension-building and minor battery The cyclic behavior begins with a time of tension-building arguments, progresses to violence, and settles into a making-up or calm period.

A sex trade worker is seen at the sexual health clinic reporting dysuria, mucopurulent vaginal discharge with bleeding between periods, conjunctivitis, and a painful rectal area. What sexually transmitted infection would the nurse suspect? A. syphilis B. chlamydia C. genital herpes D. gonorrhea

B. chlamydia Chlamydial symptoms include dysuria, mucopurulent vaginal discharge, and dysfunctional uterine bleeding. It can cause inflammation of the rectum and conjunctiva. Syphilis starts with a chancre on vulva or vagina but can develop in other parts of the body. Secondary infection is maculopapular rash on hands and feet with a sore throat. Genital herpes symptoms include itching, tingling, and pain in genital area followed by small pustules and blister-like genital lesions. Gonorrhea vaginal discharge is yellowish color and very foul smelling.

The nurse is presenting a class at a local community health center on violence during pregnancy. Which possible complication would the nurse include? A. gestational hypertension B. chorioamnionitis C. placenta previa D. postterm labor

B. chorioamnionitis Women assaulted during pregnancy are at risk for chorioamnionitis, placental abruption, preterm labor, stillbirth, miscarriage, uterine rupture, and injuries to the mother and fetus. Gestational hypertension is not associated with violence during pregnancy.

A nurse is caring for a recent rape victim. The nurse would expect this client to experience which phase first? A. denial B. disorganization C. reorganization D. integration

B. disorganization The acute phase of rape recovery is disorganization characterized by shock, fear, disbelief, anger, shame, guilt and feelings of uncleanliness. This is followed by denial (outward adjustment), reorganization, and finally integration and recovery.

Which finding would the nurse expect to find in a client with endometriosis? A. hot flashes B. dyspareunia C. fluid retention D. fever

B. dyspareunia The client with endometriosis is often asymptomatic, but clinical manifestations include pain before and during menstrual periods (dyspareunia), pain during or after sexual intercourse, infertility, depression, fatigue, painful bowel movements, chronic pelvic pain, hypermenorrhea, pelvic adhesions, irregular and more frequent menses, and premenstrual spotting. Hot flashes may be associated with premenstrual syndrome or menopause. Fluid retention is associated with premenstrual syndrome. Fever would suggest an infection.

When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which primary cause? A. poor dietary intake B. estrogen deficiency C. active lifestyle D. changes in vaginal pH

B. estrogen deficiency Hot flashes and night sweats are classic signs of estrogen deficiency. They are unrelated to dietary intake or active lifestyle. Changes in vaginal pH are associated with genitourinary changes of menopause.

Which finding would the nurse expect in a client with bacterial vaginosis? A. vaginal pH of 3 B. fish-like odor of discharge C. yellowish-green discharge D. cervical bleeding on contact

B. fish-like odor of discharge Manifestations of bacterial vaginosis include a thin, white, homogenous vaginal discharge with a characteristic stale fishy odor, vaginal pH greater than 4.5, and clue cells on wet-mount examination. A yellowish-green discharge with cervical bleeding on contact would be characteristic of trichomoniasis.

When obtaining the health history from an adolescent client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? A. hive-like rash for the past 2 days B. five different sexual partners C. weight gain of 5 lb (2.3 kg) in 1 year D. clear vaginal discharge

B. five different sexual partners The number of sexual partners is a risk factor for the development of STIs. A rash could be related to numerous underlying conditions. A weight gain of 5 lb (2.3 kg) in 1 year is not a factor increasing one's risk for STIs. A change in the color of vaginal discharge such as yellow, milky, or curd-like, not clear, would suggest an STI.

A client is admitted in the health care facility with pelvic inflammatory disease (PID). When reviewing the client's history, what would the nurse identify as a risk factor? A. gestational diabetes B. frequent douching C. genetic predisposition D. environmental exposure

B. frequent douching One of the risk factors associated with pelvic inflammatory disease is frequent douching. Women with gestational diabetes are at an increased risk for developing type 2 diabetes later in life. Genetic predisposition and environmental exposure are risk factors associated with breast cancer.

The nurse is assessing the laboratory test results of a client with abnormal uterine bleeding (AUB). Which finding should the nurse prioritize? A. negative pregnancy test B. hemoglobin level of 10.1 g/dl (101 g/L) C. prothrombin time of 40 seconds D. serum cholesterol of 140 mg/dl (3.63 mmol/L)

B. hemoglobin level of 10.1 g/dl (101 g/L) A hemoglobin level of 10.1 g/dl (101 g/L) suggests anemia, which might occur secondary to prolonged or heavy menses. A negative pregnancy test, prothrombin time of 40 seconds, and a serum cholesterol level of 140 mg/dl (3.63 mmol/L) are within normal parameters.

When developing a teaching plan for a community group about HIV infection, which group would the nurse identify being most vulnerable for HIV infection? A. Native American/First Nations people B. heterosexual women C. new health care workers D. Asian immigrants

B. heterosexual women The number of women with HIV infection and AIDS has been increasing steadily worldwide. Today, women account for one in four (25%) new HIV infections in the United States. Women of color have been especially hard hit and represent the majority of women living with the disease and newly infected ones. African American women suffer disproportionately from the HIV/AIDS epidemic. New health care workers, Native American/First Nations members, and Asian immigrants are not among those considered at high risk.

A nurse is assessing a rape survivor for posttraumatic stress disorder. The nurse asks the survivor, "Do you feel as though you are reliving the trauma?" The nurse is assessing for which effect of the trauma? A. physical symptoms B. intrusive thoughts C. avoidance D. hyperarousal

B. intrusive thoughts The question is used to assess the survivor for intrusive thoughts that reflect the client reexperiencing the trauma. Physical symptoms would be assessed with questions about sleeping, eating, palpitations and other problems. Avoidance would be reflected in questions involving withdrawal socially, avoiding situations that remind the survivor of the rape. Hyperarousal would be noted by irritability and an exaggerated startle response.

A group of nurses is preparing a violence prevention program. The group is researching information about risk factors for intimate partner violence related to the individual. Based on their research, which risk factors would the nurses expect to address? Select all that apply. A. dysfunctional family system B. low academic achievement C. victim of childhood violence D. heavy alcohol consumption E. economic stress

B. low academic achievement C. victim of childhood violence D. heavy alcohol consumption Individual risk factors associated with intimate partner violence include young age, heavy drinking, low academic achievement, and experience of or witnessing of violence as a child. Dysfunctional family system and economic stress are risk factors associated with the relationship.

A woman has opted to use the basal body temperature method for contraception. The nurse instructs the client that a rise in basal body temperature indicates which event? A. onset of menses B. ovulation C. pregnancy D. safe period for intercourse

B. ovulation Basal body temperatures typically rise within a day or two after ovulation and remain elevated for approximately 2 weeks, at which point bleeding usually begins. Basal body temperature is not a means for determining pregnancy. Having intercourse while the temperature is elevated would increase the risk of pregnancy

A nurse is working with a victim of violence to develop a safety plan. The nurse teaches the client about the necessary items to take when leaving. The nurse determines that additional teaching is needed when the client identifies which items? Select all that apply. A. photo ID B. phone cards C. most of her clothing D. cash E. health insurance cards

B. phone cards C. most of her clothing When leaving an abusive relationship, the victim should take the following items: driver's license or photo ID; Social Security number or green card/work permit; birth certificates for oneself and one's children; phone numbers for social services or shelter; deed or lease to the home or apartment; any court papers or orders; a change of clothing for oneself and one's children; pay stubs, checkbook, credit cards, and cash; and health insurance cards. Phone cards should not be used because they leave a trail to follow.

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: A. amniotic fluid. B. placenta. C. birth canal. D. breast milk.

B. placenta. The syphilis spirochete can cross the placenta after 9 weeks gestation. It is not transmitted via amniotic fluid, passage through the birth canal, or breast milk.

A couple comes to the clinic for a fertility evaluation. The male partner is to undergo a semen analysis. After teaching the partner about this test, which client statement indicates that the client has understood the instructions? A. "I need to bring the specimen to the lab the day after collecting it." B. "I will place the specimen in a special plastic bag to transport it." C. "I have to abstain from sexual activity for about 2 to 5 days before the sample." D. "I will withdraw before I ej

C. "I have to abstain from sexual activity for about 2 to 5 days before the sample." Semen analysis is the most important indicator of male fertility. The man should abstain from sexual activity for 2 to 5 days before giving the sample. For a semen examination, the man is asked to produce a specimen by ejaculating into a specimen container and delivering it to the laboratory for analysis within 1 hour. When the specimen is brought to the laboratory, it is analyzed for volume, viscosity, number of sperm, sperm viability, motility, and sperm shape.

While obtaining a health history from a male adolescent during a well checkup, the nurse assesses his sexual behavior and risk for sexually transmitted infections. Based on the information, the nurse plans to teach the adolescent about using a condom. What statement would the nurse include in the teaching plan? A. "You can reuse a condom if it's within 3 hours." B. "Store your condoms in your wallet so they are ready for use." C. "Put the condom on before engaging in any genital contact." D

C. "Put the condom on before engaging in any genital contact." When teaching an adolescent about condom use, the nurse should tell the adolescent to put the condom on before any genital contact. A new condom should be used with each act of sexual intercourse; a condom should never be reused. Condoms should be stored in a cool, dry place away from direct sunlight and never stored in wallets, automobiles, or anywhere they could be exposed to extreme temperatures. Only water-soluble lubricants should be used with latex condoms. Oil-based or petroleum-based lubricants can weaken latex condoms

A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate? A. "There is a new vaccine available that prevents the infection from returning." B. "All you need is a dose of penicillin and the infection will be gone." C. "There is no cure, but drug therapy helps to reduce symptoms and recurrences." D. "Once you have the infection, you develop an immunity to it."

C. "There is no cure, but drug therapy helps to reduce symptoms and recurrences." Genital herpes is a lifelong viral infection. No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. A vaccine is available for HPV infection but not genital herpes. Penicillin is used to treat syphilis. No immunity develops after a genital herpes infection.

A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). What information would the nurse need to stress to the group? Select all that apply. A. ECs induce an abortion-like reaction. B. ECs provide some protection against STIs. C. ECs are birth control pills in higher, more frequent doses. D. ECs are not to be used in place of regular birth control. E. ECs provide little protection for future pregnancies.

C. ECs are birth control pills in higher, more frequent doses. D. ECs are not to be used in place of regular birth control. E. ECs provide little protection for future pregnancies. Important points to stress concerning ECs are that ECs do not offer any protection against STIs or future pregnancies; they should not be used in place of regular birth control, as they are less effective; they are regular birth control pills given at higher doses and more frequently; and they are contraindicated during pregnancy. Contrary to popular belief, ECs do not induce abortion and are not related to mifepristone or RU-486, the so-called abortion pill approved by the FDA in 2000.

A woman is diagnosed with premenstrual dysphoric disorder. To address the woman's behavioral symptoms, which class of agents would the nurse anticipate needing to be addressed in the woman's teaching plan? A. Diuretics B. Nonsterioidal anti-inflammatory drugs (NSAIDs) C. Selective serotonin reuptake inhibitors (SSRIs) D. Vitamin supplements

C. Selective serotonin reuptake inhibitors (SSRIs) Although diuretics, NSAIDs, and vitamin supplements may be used as part of the treatment plan for premenstrual dysphoric disorder, SSRIs are commonly prescribed to address the behavioral and mood symptoms of this condition.

The nurse is reviewing the medical records of several clients. Which client would the nurse expect to have an increased risk for developing osteoporosis? A. a Black woman B. a woman who plays tennis twice a week C. a thin woman with small bones D. a woman who drinks one cup of coffee a day

C. a thin woman with small bones A woman with a small frame and thin bones is at a higher risk for osteoporosis. White or Asian women, not Black women, are at higher risk for the condition. A woman who plays tennis twice a week is active and thus would be at low risk for osteoporosis. Women who ingest excessive amounts of caffeine are at increased risk.

Assessment of a female client reveals a thick, white vaginal discharge. The client also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has: A. trichomoniasis. B. bacterial vaginosis. C. candidiasis. D. genital herpes simplex.

C. candidiasis. A thick, white vaginal discharge accompanied by intense itching and dyspareunia suggest vulvovaginal candidiasis. Trichomoniasis is characterized by a heavy yellow, green, or gray frothy or bubbly discharge. Bacterial vaginosis is manifested by a thin, white homogenous vaginal discharge with a characteristic stale fish-like odor. Genital herpes simplex involves genital ulcers.

The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for: A. infertility. B. dyspareunia. C. cervical cancer. D. dysmenorrhea.

C. cervical cancer. Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer. Therefore, the client needs continued follow-up for routine Papanicolaou testing. HPV is not associated with an increased risk for infertility, dyspareunia, or dysmenorrhea.

After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)? A. oral contraceptives B. tubal ligation C. condoms D. intrauterine system

C. condoms Condoms are a barrier method of contraception. In addition to providing a physical barrier for sperm, they also protect against STIs. Oral contraceptives, tubal ligation, and intrauterine systems provide no protection against STIs.

The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only by prescription? A. condom B. spermicide C. diaphragm D. basal body temperature

C. diaphragm The diaphragm is available only by prescription and must be professionally fitted by a health care provider. Condoms and spermicides are available over the counter. Basal body temperature requires the use of a special thermometer that is available over the counter.

A nurse is working with a group of clients who are victims of intimate partner violence. The nurse focuses interventions on which area as the primary goal? A. convincing them to leave the abuser soon B. helping them cope with their life as it is C. empowering them to regain control of their life D. arresting the abuser so he or she cannot abuse again

C. empowering them to regain control of their life The goal of interventions is to enable the victim to gain control over life. Although the nurse can encourage a victim to leave an abuser, the choice to leave must be made by the victim. The nurse can provide support and assistance with coping, but the ultimate goal is for the victim to become empowered. Arresting the abuser does not necessarily stop the abuse.

The nurse is developing a plan of care for a client who is receiving aggressive drug therapy for treatment of HIV. The goal of this therapy is to: A. promote the progression of disease. B. intervene in late-stage AIDS. C. improve survival rates. D. conduct additional drug research.

C. improve survival rates. Aggressive anti-retroviral therapy aims to reduce HIV morbidity and mortality, thereby improving survival rates. Drug therapy also aims to decrease the HIV viral load, restore the body's ability to fight off infection, and improve the quality of life. Drug therapy does not promote the progression of the disease. It is started at the time of the first infection, not in late- stage AIDS. Treatment advances have been based on research, but drug therapy is not prescribed to conduct additional research

A nurse is preparing a teaching plan for victims who are recovering from intimate partner violence. The nurse would focus the teaching on ways to: A. enhance their personal appearance and hairstyle. B. develop their creativity and work ethic. C. improve their communication skills and assertiveness. D. plan more nutritious meals to improve their own health.

C. improve their communication skills and assertiveness. Providing reassurance and support to victims of intimate partner violence is key if the violence is to end. Appropriate actions can help victims express their thoughts and feelings in constructive ways and strengthen their control over their lives. Although interventions related to personal appearance and creativity can enhance the victim's self-esteem, they are not helpful in dealing with intimate partner violence. Planning nutritious meals helps to promote a healthy lifestyle but is ineffective in dealing with intimate partner violence.

A client comes to the clinic with abdominal pain. Based on her history the nurse suspects endometriosis. The nurse expects to prepare the client for which evaluatory method to confirm this suspicion? A. pelvic examination B. transvaginal ultrasound C. laparoscopy D. hysterosalpingogram

C. laparoscopy The only certain method of diagnosing endometriosis is by seeing it. Therefore, the nurse would expect to prepare the client for a laparoscopy to confirm the diagnosis. A pelvic examination and transvaginal ultrasound are done to assess for endometriosis but do not confirm its presence. Hysterosalpingography aids in identifying tubal problems resulting in infertility.

When reviewing the medical record of a client diagnosed with endometriosis, the nurse would identify which finding as a risk factor for this woman? A. low fat in the diet B. age of 14 years for menarche C. menstrual cycles of 24 days D. short menstrual flow

C. menstrual cycles of 24 days Risk factors for developing endometriosis include increasing age, family history of endometriosis in a first-degree relative, short menstrual cycle (less than 28 days), long menstrual flow (more than 1 week), high dietary fat consumption, young age at menarche (younger than age 12), and few (one or two) or no pregnancies.

A nurse is describing the criteria needed for the diagnosis of premenstrual dysphoric disorder (PMDD). Which would the nurse include as a mandatory requirement for the diagnosis? A. appetite changes B. sleep difficulties C. persistent anger D. chronic fatigue

C. persistent anger For the diagnosis of PMDD, the woman must exhibit one or more of the following: affective lability such as sadness, tearfulness, or irritability; anxiety and tension; persistent or marked anger or irritability; and depressed mood and feelings of hopelessness. Other symptoms, although not mandatory for the diagnosis, include increased or decreased appetite, sleep difficulties, chronic fatigue, headache, increased or decreased sexual desire, constipation or diarrhea, and breast swelling and tenderness.

During a follow-up visit to the clinic, a victim of sexual assault reports changing jobs and moving to another town. The client tells the nurse, "I pretty much stay to myself at work and at home." The nurse interprets these findings to indicate that the client is in which phase of rape recovery? A. disorganization B. denial C. reorganization D. integration

C. reorganization During the reorganization phase, the survivor attempts to make life adjustments by moving or changing jobs and uses emotional distancing to cope. The disorganization phase is characterized by shock, fear, disbelief, anger, shame, guilt, and feelings of uncleanliness. During the denial or outward adjustment phase, the survivor appears outwardly composed and returns to work or school and refuses to discuss the assault and denies the need for counseling. During the integration and recovery phase, the survivor begins to feel safe and starts to trust others.

When describing an episode of intimate partner violence, the victim reports attempting to calm the partner down to keep things from escalating. The nurse interprets this behavior as reflecting which phase of the cycle of violence? A. battering B. honeymoon C. tension-building D. reconciliation

C. tension-building During the first phase of intimate partner violence, tension-building, the victim attempts to keep the situation from exploding based on the belief that the partner's anger is legitimately directed at him or her. The battering phase involves the explosion of violence. The honeymoon or reconciliation phase is manifested by a period of calm, loving, contrite behavior on the part of the batterer. The batterer may be genuinely sorry for the pain caused.

Which instructions would the nurse include when teaching a woman with pediculosis pubis? A. "Take the antibiotic until you feel better." B. "Wash your bed linens in bleach and cold water." C. "Your partner doesn't need treatment at this time." D. "Remove the nits with a fine-toothed comb."

D. "Remove the nits with a fine-toothed comb." The nurse should instruct the client to remove the nits from the hair using a fine- toothed comb. Permethrin cream and lindane shampoo are used as treatment, not antibiotics. Bedding and clothing should be washed in hot water to decontaminate it. Sexual partners should also be treated, as well as family members who live in close contact with the infected person.

When developing a teaching plan for a couple who are considering contraception options, the nurse would include which statement? A. "You should select one that is considered to be 100% effective." B. "The best one is the one that is the least expensive and most convenient." C. "A good contraceptive doesn't require a primary care provider's prescription." D. "The best contraceptive is one that you will use correctly and consistently."

D. "The best contraceptive is one that you will use correctly and consistently." For a contraceptive to be most effective, the client must be able to use it correctly and consistently. Even if a method is considered 100% effective, it is not the best choice if the couple does not use it correctly or consistently. Cost is a consideration, but the least expensive method is not necessarily the best choice. The need for a prescription is not relevant to the couple's choice.

A nurse is working with a victim of violence. Which statement would be most appropriate to empower the victim to take action? A. "Give your partner more time to come around." B. "Remember—children do best in two-parent families." C. "Change your behavior so as not to trigger the violence." D. "You are a good person, and you deserve better than this."

D. "You are a good person, and you deserve better than this." To help the victim gain control over his or her life, the nurse should emphasize that violence is never okay and that the victim did not deserve the violent attack or ask for it. Telling the victim to give the partner more time, saying that children need two parents, and suggesting that the client change his or her behavior do not promote control, rather they attempt to excuse the partner's behavior.

The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which count would indicate to the nurse that the client has AIDS? A. 1,000 cells/mm3 B. 700 cells/mm3 C. 450 cells/mm3 D. 200 cells/mm3

D. 200 cells/mm3 When the CD4 T-cell count reaches 200 or less, the person has reached the stage of AIDS per the CDC. A CD4 T-cell count between 450 and 1,200 is considered normal.

Which approach would be most appropriate when counseling a client who is a suspected victim of intimate partner violence? A. Offer the client a pamphlet about the local shelter for victims of intimate partner violence. B. Call the client at home to ask some questions about the marriage. C. Wait until the client comes in a few more times to make a better assessment. D. Ask, "Have you ever been physically hurt by your partner?"

D. Ask, "Have you ever been physically hurt by your partner?" If intimate partner violence is suspected, the nurse must use direct or indirect questions to screen for abuse. Asking the client if he or she has ever been physically hurt by the partner is most appropriate. Offering the client a pamphlet, calling the client at home, or waiting until the client returns are inappropriate and do not validate the suspicion.

A client who has come to the clinic is diagnosed with endometriosis. What would the nurse expect the primary care provider to prescribe as a first-line treatment? A. progestins B. antiestrogens C. gonadotropin-releasing hormone analogues D. NSAIDs

D. NSAIDs Although progestins, antiestrogens, and gonadotrophin-releasing analogues are used as treatment options for endometriosis, NSAIDS are considered the first-line treatment to reduce pain.

A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventive measure for which sexually transmitted infection (STI)? A. genital herpes B. hepatitis B C. syphilis D. gonorrhea

D. gonorrhea To prevent gonococcal ophthalmia neonatorum, erythromycin or tetracycline ophthalmic ointment is instilled into the eyes of all newborns. This action is required by law in most states. The ointment is not used to prevent conditions related to genital herpes, hepatitis B, or syphilis.

When discussing contraceptive options, the nurse would recommend which option as being the most reliable? A. coitus interruptus B. lactational amenorrheal method (LAM) C. natural family planning D. intrauterine system

D. intrauterine system An intrauterine system is the most reliable method because users have to consciously discontinue using them to become pregnant rather than making a proactive decision to avoid conception. Coitus interruptus, LAM, and natural family planning are behavioral methods of contraception and require active participation of the couple to prevent pregnancy. These behavioral methods must be followed exactly as prescribed.

Which measure would the nurse include in the teaching plan for a woman to reduce the risk of osteoporosis after menopause? A. taking vitamin supplements B. eating high-fiber, high-calorie foods C. restricting fluid to 1,000 mL daily D. participating in regular daily exercise

D. participating in regular daily exercise Measures to reduce osteoporosis after menopause include daily weight-bearing exercise, increasing calcium and vitamin D intake, and avoiding smoking and excessive alcohol intake. General vitamin supplements may be helpful overall, but they are not specific to reducing the risk of osteoporosis. A diet high in calcium and vitamin D, not fiber and calories, would be appropriate. Restricting fluids would have no effect on preventing osteoporosis.

After teaching a class at a local college campus on date rape, the nurse determines that the teaching was successful when the class identifies which substance as the most common date rape drug? A. gamma hydroxybutyrate B. liquid ecstasy C. ketamine D. rohypnol

D. rohypnol Rohypnol is the most common date rape drug. Others include gamma hydroxybutyrate (or liquid ecstasy) and ketamine.

A 40-year-old woman is being discharged from the walk-in health care clinic after a diagnosis of pelvic inflammatory disease. Which health teaching topic should the nurse address? A. symptoms of menopause B. pain control for endometriosis C. fertility issues D. sexually transmitted infections

D. sexually transmitted infections STIs are responsible for genital tract infections that may lead to later complications in women such as pelvic inflammatory disease (PID). The other topics do not relate to PID.

Which action would the nurse emphasize when teaching postmenopausal women about ways to reduce the risk of osteoporosis? A. swimming daily B. taking vitamin A C. using hormone replacements D. taking calcium supplements

D. taking calcium supplements Osteoporosis is a condition in which bone mass declines to such an extent that fractures occur with minimal trauma. Increasing calcium and vitamin D intake is a major preventive measure. Other measures to reduce the risk include engaging in weightbearing exercise such as walking. Swimming, although a beneficial exercise, is not a weightbearing exercise. Taking vitamin A supplements would have no effect on preventing bone loss. Recent studies have shown that the overall health risks associated with hormone replacement therapy exceed the benefits, increasing the woman's risk for heart attacks, strokes, and breast cancer.

After teaching a group of students about premenstrual syndrome, the instructor determines that additional teaching is needed when the group identifies which finding as a prominent assessment finding? A. bloating B. tension C. dysphoria D. weight loss

D. weight loss Irritability, fatigue, bloating, tension, and dysphoria are the most prominent and consistently described manifestations of premenstrual syndrome. Weight gain, not weight loss, is associated with this disorder.