Exam 1 Practice Questions
Gonorrhea drug treatment?
-Ceftriaxone 250 mg IM single dose
A 30 year old nurse is pregnant with twins. She tells the nurse that twins runs in her family. She has a twin brother, her mother is a twin, and many relatives have twins. The nurse explains that this type of twinning is most likely: -identical -monzygotic -dyzygotic -monoamniotic
-Dyzygotic
The slow increase of which hormone stops menstruation?
-Estrogen
A hystersalpingiogram is an infertility test performed on a man. True or false
-FALSE -done on women to check for tubal patency
What is the first thing that should come to your mind if a 19 year old comes in with a painful vulvar bump?
-HSV -HPV or syphilis are not painful
The nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why he fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's best response?
"it promotes the fertilized ovum's normal implantation in the top portion of the uterus"
PID drug of choice?
-Ceftriaxone 250 mg
How do you treat HIV/imuunocompromised patients with Parovirus?
-immunie globullins
Which of the following is true regarding identical twins?
-same genotype
The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. Which statement by the student indicates an understanding of the ductus venosus?
It connects the umbilical vein to the inferior vena cava
Once oogenesis is complete, the resultant gamete contains how many chromosomes?
23
What secretes progesterone?
Corpus Luteum
Dont use what drug after 36 weeks of pregnancy?
Bactrim
How do you treat infants born with Varicella?
-VZIG
Which of the following statements tells you that a client needs further teaching? "To become pregnant, we should:" -have intercourse on the 14th day of menstrual cycle -have intercourse when by basal body temperature rises -have intercourse every other day during the week before and after ovulation -abstain from intercourse for the month prior to the month we want to conceive
-"Abstain from intercourse for the month prior to the month we want to conceive"
A client asks the nurse about the gamete intrafallopian transfer (GIFT) procedure. Which of the following responses would be appropriate for the nurse to make?
-"fertilization takes place in the woman's body"
The nurse is teaching a class on reproduction. When asked about the development of the ova, the nurse would include which of the following?
-"meiotic divisions begin during puberty" -rationale: meiosis 1 occurs during puberty
A pregnant client tells the clinic nurse that she wants to know the sex of her baby as soon as it can be determined. The nurse informs the client that she should be able to find out the sex at 12 weeks' gestation because of which factor?
the appearance of the fetal external genitalia
A couple visits the genetic counseling clinic regarding a family history of cystic fibrosis, an autosomal recessive disorder. They ask the nurse, "what are the chances that they will have a child with cystic fibrosis?" Which response by the nurse is best? -it would be better not to have children because they could all have cystic fibrosis -the disorder occurs at random and there is no way to calculate the risk -there is a 50% chance that you will have a child with cystic fibrosis -there is a 25% chance you will have a baby with cystic fibrosis
-there is a 25% chance you will have a baby with cystic fibrosis
The nursing student is preparing to teach a prenatal class about fetal circulation. Which statement should be included in the teaching plan?
-two arteries carry deoxygenated blood and waste products away from the fetus to the placenta
Only syphilis drug treatment for pregnancy?
-Benzathine Penicillin G -must desensitize an allergic pregnant woman: occurs in hospital and only effected for the intended dose
Syphilis primary, secondary, and early latent drug treatment?
-Benzathine Penicillin G 2.4 million units IM single dose -if allergic to penicillin: doxycycline 100 mg PO BIG for 14 days or Tetracycline 500 mg PO QID for 14 days
Syphilis late latent, unknown duration, or tertiary drug treatment?
-Benzathine Penicillin G 7.2 million units in 3 doses of 2.4 million units each, IM at one week intervals
What does progesterone do to the built up uterine lining?
-stabilizes it
A patient asked the healthcare provider about the benefits of receiving the HPC vaccine. Which statement is the most appropriate response by the healthcare provider?
-the HPV vaccine cal help prevent cervical cancer
Drug treatment for Varicella?
-Antivirals such as Acylovir and Valacyclovir
Considerations when taking Nitrofurantoin?
-don't give to breastfeeding mothers of babies < 1 month
A nurse is explaining to a client about monthly hormonal changes. Starting with day 1 of the menstrual cycle, please place the following hormones in the chronological order in which they elevate during the menstrual cycle
-gonadotropin releasing hormone -FSH -LH -progesterone -rationale: gonadotropin releasing hormone stimulates the production of FSH and LH. FSH rises first and LH follows. After ovulation, progesterone rises
A woman, whose menstrual cycle is 35 days long, states that she often has slight pain on one side of her lower abdomen on day 21 of her cycle. She wonders whether she has ovarian cancer. Which of the following is the best response?
-"women often feel a slight twinge when ovulation occurs" -rationale: the statement is true and the discomfort, at the location of the location of the ovary where ovulation occurs, is called mittlschmerz. Ovulation usually occurs 14 days before the first day of menses
It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states her cycle is usually 31 days long. Which of the following is an appropriate reply by the nurse?
-"you are probably ovulating"
A pregnant woman and her husband are both heterozygous for achondroplastic dwarfism, an autosomal dominant disease. The nurse advises the couple that their unborn child has which of the following probabilities of being born of normal stature?
-25%
Chlamydia drug treatment?
-Azithromycin 1 gm PO single dose -Doxycyclin 100 mg for 7 days
Which of the following hepatitis is transmitted through the oral-fecal route?
-Hepatitis A
A female client is considering IVF and GIFT. Which of the following statements indicates that she needs additional information? -I will give myself injections to cause my ovaries to ripen more than one egg -my husband will need to produce a sample of his sperm the day my eggs are retrieved -I will be in the hospital overnight for this procedure -I can expect to have some discomfort after the procedure
-I will be in the hospital overnight for this procedure
A patient diagnosed with trichomoniasis is being treated with metronidazole (Flagyl). When teaching the patient about this medication, which of the following will the healthcare provider include?
-do not drink alcohol while you are taking this medication
A client who has PID caused by chlamydia trahcomatis is at risk for which of the following? -anovulatory menstrual cycle -ectopic pregnancy -multifetal pregnancy -cervical dysplasia
-ectopic pregnancy -rationale: chlamydial PID causes scarring of the fallopian tubes, thus increasing the incidence of ectopic pregnancy
In analyzing the need for teaching sexual health in a client who is sexually active, which of the following questions is important for the nurse to ask?
-"with whom do you have intercourse?" -rationale: this question is the most important for the nurse to ask. The nurse is trying to learn whether or not the client is having intercourse with more than one partner and/or whether the client has intercourse with men, women, or both
A patient is diagnosed with primary syphilis (stage 1). When assessing the patient, which of these findings will the healthcare provider anticipate?
-firm and painless genital ulcers
An infertile woman has been diagnosed with endometriosis. She asks the nurse why that diagnosis has made her infertile. Which of the following explanations is appropriate for the nurse to make?
-"scarring surrounds the ends of your tubes, preventing your eggs from being fertilized by your partner's sperm"
Neurosyphilis drug treatment?
-IM or IV penicillin for 10-14 days
A 68 year old female client presents to the gynecology clinic with complaints of painless vaginal bleeding. The nurse anticipates the client will be tested for which condition?
-cervical or uterine cancer
The nurse explains to a male client with a vas deferens blockage to expect which of the following problems? -frequent urination -decreased sperm in seminal fluid -inability to achieve or maintain an erection -decreased sexual drive
-decreased sperm in seminal fluid -rationale:a vas deferens blockage will prevent the sperm from being ejaculated, resulting in a deficiency of sperm in the seminal fluid
While the nurse is preparing a client for the pap test, the client asks why the pap test needs to be done. Which reasons should the nurse include in a response?
-detect the presence of STIs -detect abnormal cells in the cervix -detect hormonal changes
Which of the following statements made by the client scheduled for in vitro fertilization would indicate the need for further teaching? -the egg retrieval procedure may be uncomfortable, but medication will be available for me -the fertilized egg will be implanted into my uterus 2-3 days after the egg retrieval -i will need to limit my activities the day of the egg retrieval and the day if implantation -I will have 8 embryos implanted to maximize my chance of carrying a baby to term
-I will have 8 embryos implanted to maximize mu chance of carrying a baby to term -rationale: 4 embryos are planted
Which maternal immunoglobulin is responsible for protecting the fetus from pathogens?
-IgG
Which infertility treatment method involves the egg being fertilized with one sperm through injection?
-Intracytoplasmic sperm injection
UTI drug treatment?
-Kefelex 250 mg Q 6hr for 7 days -Nitrofurantoin (microbid) 100 mg PO BID for 7 days
Trichomoniasis drug treatment?
-Metronidazole 2 gm PO X 1
BV drug treatment?
-Metronidazole 500 mg orally BID for 7 days -Metronidazole 250 mg PO TID for 7 days
What drug can you start using for UTI after 38 weeks?
-Nitrofurantoin
A client with underlying ductal carcinoma can exhibit signs of what?
-Paget's disease
Which TORCH infection could be contracted by the infant because the mother owned a cat?
-Toxoplasmosis
A deficiency in which vitamin can cause infantile seizures?
-Vitamin B
Medication for pregnant woman with HIV viral load > 1,000 copies?
-Zidovudine IV 4 hours prior to c-section
Medication for pregnant woman with HIV viral load < 1,000 copies?
-Zidovudine IV during labor -oral antivirals continued after labor
The nurse determines that which of the following clients in the infertility clinic need to be seen first? -a 27 year old being seen for an initial infertility exam -a 34 year old man for semen analysis results -a 32 year old woman in Pergonal and HCG complaining of severe abdominal pain -a 30 year old woman in for a pregnancy test following implantation of in vitro fertilization and GIFT
-a 32 year old woman in Pergonal and HCG complaining of severe abdominal pain -severe abdominal pain during a cycle of induced ovulation may indicate hyperstimulation of ovaries. The ovaries could rupture, leading to death.
The client is scheduled for a hysterosalpingogram. Which of the following should the nurse include in the preoperative assessment? -history of sexually transmitted diseases -allergy to iodine or shellfish -presence of metal implants -difficulty swallowing
-allergy to iodine or shellfish -rationale: iodine based dye is instilled into the uterus
The nursing instructor asks a nursing student to list the characteristics of amniotic fluid. The student responds correctly by listing which as characteristics of amniotic fluid?
-allows for fetal movement -surrounds, cushions, and protects the fetus -maintains the body temperature of the fetus -can be used to measure fetal kidney function
What do you ALWAYS do before intervening?
-asses
A nurse teaches a woman who wishes to become pregnant that if she assess for spinnbarkeit she will be able to closely predict her time of ovulation. Which technique should the client be taught to assess for spinnbarkeit?
-assess her vaginal discharge for elasticity and slipperiness -rationale: spinnbarkeit is defined as the "threat" that is created when the vaginal discharge is slippery and elastic at the time of ovulation. The changes are in response to high estrogen levels. The woman inserts her index and middle fingers into her vagina and touches her cervix. After removing her fingers, she separates her fingers and "spins a thread" between her fingers. When she is not in her fertile period, the mucus is thick
The nurse would include which of the following nursing interventions when planning care for an infertile couple? -assistance in dealing with feelings of guilt and shame -helping to determine which partner is to blame -referral to a psychiatrist for family therapy -discussion of the advantages of adoption instead of infertility treatment
-assistance in dealing with feelings of guilt or shame
A client complaining of secondary amenorrhea is seeking care from her gynecologist. Which of the following may be contributed to her problem?
-athletic activities
Considerations when taking Metronidazole?
-avoid alcohol with meds for 24 hours after -without breastfeeding 24 hours after single dose treatment
A woman is menstruating. If hormonal studies were to be done at this time, which of the following hormone levels would the nurse expect to see?
-both estrogen and progesterone are low -rationale: when the ovum is not fertilized, both estrogen and progesterone levels drop. The hormonal drop is followed by menstruation
Sedentary can increase a woman's risk of getting which cancer? What kind of risk is this considered?
-breast cancer -environmental
The nurse reinforces the physician's explanation that a client with fallopian tube blockage would be a candidate for which of the following methods of achieving pregnancy? -natural family planning -in vitro fertilization -tubal ligation -sperm washing
-in vitro fertilization -rationale: the blockage will prohibit sperm from traveling through the fallopian tubes to reach an ovum and fertilize it. In vitro involves harvesting ova and placing them with sperm in a petri dish. The resultant embryos are then returned to the uterus
Which purposes of placental functioning should the nurse include in a prenatal class?
-it is the way the baby gets food and oxygen -it provides an exchange of nutrients and waste products between the mother and developing fetus
What does it mean if a patient has a prophylactic mastectomy?
-it means she has the BRCA 1 & 2 gene -it does not mean she has breast cancer -she is okay to have HRT therapy
The nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's best response?
-it promotes the fertilized ovum's normal implantation in the top of portion of the uterus
Which of the following is not a contributing factor to male infertility?
-late onset menarche
When a nurse is teaching a woman about her menstrual cycle, which of the following is the most important change that happens during the follicular phase of the menstrual cycle?
-maturation of the follicle -rationale: FSH is elevated during the follicular phase and the follicle matures
The nurse is evaluating a client for breast cancer. The nurse explains the risk factor for the development of the disease. Which information should the nurse include in the teaching?
-menarche before age 12 -menopause beginning after age 55 -giving birth to first child after age 30
When teaching a group of students about chlamydia, which of the following points is most important for the healthcare provider to emphasize?
-most people infected with chlamydia are unaware they are infected
Where is the fundus located and what is its shape?
-on the top of the uterus -it is dome shaped
Infertility increases a client's risk for which of the following diseases?
-ovarian cancer -rationale: infertility has been shown to increase in a woman's risk of developing ovarian cancer
In the menstrual cycle, estrogen develops both _______ and ___________?
-ovarian follicles -uterine lining
A woman's temperature has just risen .4 degrees F and will remain elevated during the remainder of her cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the changes?
-progesterone -rationale: progesterone elevation occurs after ovulation. Progesterone is thermogenic-that is, heat producing. Progesterone is the reason women's temperatures are elevated during ovulation
How do you elevate the arm to let lymph nodes drain?
-propping it on a pillow to increase circulation
The nurse is working in an infertility clinic explains to an infertile couple that they will likely have which of the following tests ordered? -semen analysis -pap smear -colposcopy with endocervical biopsy -sexually transmitted infection testing -hysterosalpinogogram
-semen analysis -hysterosalpinogogram -rationale: inadequate number of motility of sperm and tubal anomaly or blockage are the most common causes of infertility. Semen analysis will provide information on number and motility of sperm, and hysterosalpinogogram will detect urine or tubal abnormalities or blockage
A 54 year old client calls her health care practitioner complaining of frequency and burning when she urinates. Which of the following factors that occurred within the preceding 3 days likely contributed to this client's problem?
-she had intercourse with her partner
A nurse is discussing sexual arousal during a pre-adolescent boys' sex education class. Which of the following should the nurse base her reply when a boy asks "what exactly happens when my body gets aroused, anyway?"
-the corpora of the penis becomes engorged -rationale: when arousal occurs, the penile blood vessels become engorged and an erection is achieved
The nurse is preparing to teach a prenatal class about fetal circulation. Which statement should be included in the teaching plan?
-the ductus arteriosus allows blood to bypass the fetal lungs -one vein carries oxygenated blood from the placenta to the fetus -two arteries carry deoxygenated blood and waste products away from the fetus to the placenta
What is a total (simple) mastectomy?
-the entire breast is removed but not the lymph nodes
The nurse interprets that partner sperm intrauterine insemination is likely to be indicated for couple when which of the following has occurred? -the male partner has a varicocele -the female partner has irregular menses -the female partner produces anti-sperm antibodies -the male partner has HIV
-the female partner produces anti-sperm antibodies -rationale: anti-sperm antibodies can develop in the vaginal and cervical secretions. Inserting the sperm directly into the uterus via interuterine insemination bypasses secretions so that the sperm are not destroyed
The client is scheduled to have a hysterosalpingogram. Which of the following questions does the nurse need to ask? -do you have any metal implants? -when was the last time you had intercourse? -when was the first day of your last menstrual cycle? -what was your age at menarche?
-when was the first day of your last menstrual cycle? -rationale: hysterosalpingograms are preformed in the follicular phase of the cycle to avoid disrupting an early pregnancy