Exam #6
Which food below is not a good source of iron? A) Milk B) Legumes C) Grains D) Beef
A) Milk Although milk is sometimes advertised as a near-perfect food, it is not high in iron.
A nurse is reviewing the symptoms of ovarian cancer with a recently diagnosed 60-year-old woman. Which are common symptoms of ovarian cancer? Select all that apply. A) abdominal fullness B) back pain C) decrease in urination D) abdominal pressure
A) abdominal fullness B) back pain D) abdominal pressure
A nurse explains to a client that although HPV infection is more commonly associated with cervical cancer, which cancer would the nurse identify as also a risk? A) vulvar cancer B) vaginal cancer C) uterine cancer D) ovarian cancer
A) vulvar cancer Classic VIN vulvar cancer is associated with HPV infection (genital warts due to types 16, 18, 31, 33, 35, and 51). It typically occurs in women between 30 and 40 years old. Simplex VIN usually occurs in postmenopausal women and is not associated with HPV.
A nurse is conducting a health promotion program, encouraging lifestyle changes to help clients prevent various benign and treatable conditions. Which suggestions would the nurse most likely include? Select all that apply. low-fat diet regular exercise high-impact aerobics high vegetable-fruit diet adequate fluid intake
ALL but high-impact aerobics
A woman who is HIV positive and receiving drug therapy comes to the clinic and says, "I have no appetite, and then when I do eat, I get sick to my stomach." Which suggestion would be least effective? A) "Try some high-protein drinks or foods." B) "Drink fluids with anything that you eat." C) "Eat some dry crackers when you feel nauseated." D) "Try eating small meals spaced throughout the day."
B) "Drink fluids with anything that you eat." Food and fluid intake should be separated to prevent overfilling. High-protein drinks and foods will provide quick and easy protein and calories. Dry crackers are helpful in alleviating nausea. Eating smaller meals spaced evenly throughout the day will prevent the client from feeling overfilled and bloated.
When describing the various types of reproductive tract cancers to a local women's group, the nurse would identify which cancer as the least common type? A) vulvar B) vaginal C) endometrial D) ovarian
B) vaginal Of the cancers listed, vaginal cancer is the rarest. Only about one of every 1,100 women will develop vaginal cancer in her lifetime. Vulvar cancer represents approximately 4% of female genital cancers. Endometrial cancer is the fourth most common gynecologic malignancy in the United States and sixth most common cancer globally. It accounts for 7% of all cancers in women in the United States (one in 40 women). Ovarian cancer is the fifth most common cancer among women and the most common cause of cancer deaths for women in the United States.
A nurse is conducting a class at a women's clinic about reproductive cancers. When describing the incidence of reproductive tract cancers in pregnant women, which information would the nurse include? A) Ovarian cancer is detected much later in the pregnant woman because of the hormonal changes that are occurring. B) Many cases of endometrial cancer are detected in pregnant women because of the increase in surveillance. C) Cervical cancer is more common in the pregnant population than other reproductive cancers. D) Reproductive cancers overall are more common in pregnant women.
C) Cervical cancer is more common in the pregnant population than other reproductive cancers. The most frequent malignancies diagnosed during pregnancy are breast cancer, cervical cancer, thyroid, hematologic malignancies (lymphomas and acute leukemia), and melanoma. Breast cancer is the most common cancer diagnosed in pregnant women which affects approximately one in 3,000 pregnancies. However, cervical cancer is more common in the pregnant population than other reproductive malignancies, and it can affect the woman's health status and the pregnancy. Ovarian cancer occurring during pregnancy is found at early stages and is associated with a good prognosis for both the mother and newborn. Few cases of endometrial cancer would be detected during the relatively young pregnancy population since routine screening is currently not recommended in the general population. Reproductive tract cancers can occur in a pregnant woman, but their incidence is highly variable.
A nurse is caring for a woman who has just been diagnosed with cervical carcinoma in situ. The nurse should prepare the women for which treatment? A) uterine artery embolization (UAE) B) hysterectomy C) cervical conization with follow-up Papanicolau test and colposcopy D) internal and external radiation therapy
C) cervical conization with follow-up Papanicolau test and colposcopy CIS is atypical and noninvasive; therefore, a conization with Papanicolau test and follow up is the treatment of choice. UAE is the treatment for removal of fibroid tumors. The other two treatment options are radical procedure, and the client's cancer is noninvasive.
The nurse is preparing a presentation for a local women's group about methods to reduce the risk of reproductive tract cancers. Which action should the nurse include? A) blood pressure evaluation every 6 months B) yearly Papanicolau test starting at age 40 C) condom use with every sexual encounter D) consumption of two to three glasses of red wine per day
C) condom use with every sexual encounter Staying healthy is a major way to reduce one's risk for cancer. Current recommendations include: using a condom with every sexual encounter; having blood pressure evaluated at least every 2 years; undergo a Papanicolau test every 1 to 3 years, if sexually active, starting at age 21; and consuming alcohol in moderation (not more than one drink per day), if at all.
A 23-year-old sexually active woman tells the nurse practitioner that she is worried because she has been having abnormal vaginal bleeding, dysuria, and weird vaginal discharge. What sexually transmitted infection would the nurse suspect? A) chlamydia B) syphilis C) gonorrhea D) HSV
C) gonorrhea Typical symptoms in women infected with gonorrhea include abnormal vaginal discharge, dysuria, cervicitis, abnormal vaginal bleeding, Bartholin's abscess, and PID
After teaching a group of young adult women on preventing pelvic inflammatory disease, the nurse determines that the teaching was successful when the group identifies which method as effective? A) using hormonal contraception B) using a vaginal douche weekly C) having infected sexual partners receive treatment D) obtaining routine treatment if at risk and asymptomatic
C) having infected sexual partners receive treatment Strategies for preventing pelvic inflammatory disease include advising sexually active females to insist their partners use condoms, discouraging routine vaginal douching, encouraging regular sexually transmitted infection screening, and emphasizing the importance of having each sexual partner receive treatment if infected.
Which medications are appropriate to treat chlamydia trachomatis? Select all that apply. azithromycin ofloxacin valacyclovir doxycycline acyclovir
azithromycin ofloxacin doxycycline
A client is seen in the clinic with symptoms of "dragging" and feeling like something is "coming down." During her assessment, the nurse should look at which risk factors for a prolapse? Select all that apply. vaginal birth repeated urinary tract infections (UTIs) advanced age increased body mass index diabetes
vaginal birth advanced age increased body mass index
A nurse is caring for a female client with symptoms of first-degree pelvic organ prolapse. Which instruction related to dietary and lifestyle modifications should the nurse provide to the client to help prevent pelvic relaxation and chronic problems later in life? A) Increase dietary fiber. B) Avoid caffeine products. C) Avoid excess intake of fluids. D) Increase high-impact aerobics.
A) Increase dietary fiber. The nurse should instruct the client to increase dietary fiber and fluids to prevent constipation. A high-fiber diet with an increase in fluid intake alleviates constipation by increasing stool bulk and stimulating peristalsis. Straining to pass a hard stool increases intra-abdominal pressure, which, over time, causes the pelvic organs to prolapse. Avoiding caffeine products would not help in the management of this condition. In addition to recommending increasing the amount of fiber in her diet, the nurse should also encourage the woman to drink eight 8-oz glasses of fluid daily. The nurse should instruct the client to avoid high-impact aerobics to minimize the risk of increasing intra-abdominal pressure.
When developing the teaching plan for a client who is HIV positive, the nurse would include which recommendation? A) Practice rigid adherence to drug schedule and dosage. B) Avoid caffeine and artificial sweeteners. C) Use transcutaneous electrical nerve stimulation. D) Adhere to scheduled weekly bladder instillation of dimethyl sulfoxide
A) Practice rigid adherence to drug schedule and dosage. The nurse should teach the client infected with HIV to strictly adhere to the prescribed drug schedule and dosage. Avoiding caffeine and artificial sweeteners, using transcutaneous electrical nerve stimulation, and having weekly drug instillations of dimethyl sulfoxide into the bladder are suggested for clients with interstitial cystitis.
A woman has been referred for laser therapy for her diagnosis of cervical cancer. The client wants to know more about the procedure. Which information regarding laser therapy should the nurse give to the client? A) The client may experience a watery brown discharge for a few weeks. B) The client may experience bleeding for 2 weeks. C) The client may experience urinary frequency. D) The client may experience abdominal cramping.
A) The client may experience a watery brown discharge for a few weeks. In laser therapy a high beam light destroys the cancer and vaporizes it. Women may experience a watery brown discharge for few weeks. This is the only after-effect.
A postmenopausal woman presents to the clinic with painless vaginal bleeding. The health care provider wants to assess for endometrial cancer. The nurse would anticipate the health care provider prescribing which procedure first? A) a transvaginal ultrasound B) an endometrial biopsy C) a hysterectomy D) chemotherapy and radiation
A) a transvaginal ultrasound Abnormal and painless vaginal bleeding is a major initial symptom of endometrial cancer. A transvaginal ultrasound can be used to evaluate the endometrial cavity and measure the thickness of the endometrial lining. If the endometrium measures less than 4 mm, then the client is at low risk for malignancy. A biopsy is not indicted when endometrial thickness is 4 mm in a postmenopausal client with bleeding, thereby avoiding invasive measures.
After teaching a woman with pelvic organ prolapse about dietary and lifestyle measures, which statement would indicate the need for additional teaching? A) "If I wear a girdle, it will help support the muscles in the area." B) "I should take up jogging to make sure I exercise enough." C) "I will try to drink at least 64 oz of fluid each day." D) "I need to increase the amount of fiber I eat every day."
B) "I should take up jogging to make sure I exercise enough." High-impact aerobics, jogging, or jumping repeatedly should be avoided to reduce the risk of increasing intra-abdominal pressure. Wearing a girdle or abdominal support helps to support the muscles surrounding the pelvic organs. The woman should consume at least eight 8-oz glasses of fluid daily and replace refined low-fiber foods with high-fiber foods.
The results of a Papanicolau test have been classified as atypical squamous cells with possible HSIL (ASC-H) as per the 2001 Bethesda system. Which interpretation of the result is correct? A) Repeat the Papanicolau test in 4 to 6 months, or refer for a colposcopy. B) Refer for a colposcopy without human papillomavirus (HPV) testing. C) Immediate colposcopy; follow up is based on the results of findings. D) No need for any further Papanicolau tests.
B) Refer for a colposcopy without human papillomavirus (HPV) testing. According to the 2001 Bethesda system for classifying Papanicolau test results, a result of ASC-H means that the client is to be referred for colposcopy without HPV testing. Atypical squamous cells of undetermined significance (ASC-US) means that the test has to be repeated in 4 to 6 months or the client has to be referred for colposcopy. Atypical glandular cells (AGC) or adenocarcinoma in situ (AIS) results indicate immediate colposcopy, with the follow up based on the results of findings.
A client is diagnosed with uterine fibroids. When reviewing the client's health history, the nurse would identify which finding as associated with the client's condition? A) diarrhea B) chronic pelvic pain C) amenorrhea D) upper back pain
B) chronic pelvic pain Findings associated with uterine fibroids include chronic pelvic pain, constipation, dysmenorrhea, and lower back pain.
A mother brings her 12-year-old daughter in for well-visit checkup. During the visit, the nurse is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees, and the daughter receives her first dose. The nurse schedules the daughter for the next dose, which would be given at which time? A) in 1 month B) in 2 months C) in 3 months D) in 4 months
B) in 2 months The HPV vaccine is administered intramuscularly in three separate 0.5-mL doses. The first dose may be given to any individual 9 to 26 years old prior to infection with HPV. The second dose is administered 2 months after the first, and the third dose is given 6 months after the initial dose.
The nurse working in the genitourinary clinic understands that the most common cause for women suffering from urinary incontinence is: A) urinary tract infection (UTI). B) pelvic organ prolapse (POP). C) estrogen replacement therapy (ERT). D) obesity.
B) pelvic organ prolapse (POP). The majority of the more than 13 million people in the United States who experience urinary incontinence are women with POP. Obesity and estrogen deficiency are both factors for developing POP. UTI and ERT do not cause POP.
A nurse is caring for a 32-year-old client for whom pessary usage is recommended for uterine prolapse. Which instruction should the nurse include in the teaching plan for the client concerning the pessary? A) Avoid jogging and jumping. B) Wear a girdle or abdominal support. C) Report any discomfort with urination and defecation. D) Avoid lifting heavy objects.
C) Report any discomfort with urination and defecation. The nurse should instruct the client using a pessary to report any discomfort or difficulty with urination or defecation. Avoiding high-impact aerobics, jogging, jumping, and lifting heavy objects, as well as wearing a girdle or abdominal support, are recommended for a client with prolapse as part of lifestyle modifications and may not be necessary for a client using a pessary.
While obtaining the history, a client reports that her mother was treated with diethylstilbestrol (DES) during her pregnancy. The nurse determines that this client is at risk for which cancer? A) vulvar cancer B) breast cancer C) cervical cancer D) endometrial cancer
C) cervical cancer Cervical cancer affects the lowest portion of the uterus and is associated with the risk factor of being born to mothers treated with DES during their pregnancy. DES is not a risk factor associated with vulvar or breast cancers. Endometrial cancer occurs in women who take estrogens without the addition of progesterone for 5 or more years during and after menopause.
A nurse is assisting with the collection of a Papanicolau test. When collecting the specimen, which action is done first? A) insertion of the speculum B) swabbing of the endocervix C) spreading of the labia D) insertion of the cytobrush
C) spreading of the labia For a Papanicolau test, the practitioner obtains a sample by spreading the labia; inserting the speculum; inserting the cytobrush and swabbing the endocervix; and inserting the plastic spatula and swabbing the cervix.
A pregnant vegan reports eating lots of dark green leafy vegetables, legumes, citrus fruits, and berries. To ensure that her infant's nervous system will develop properly, what foods should the nurse recommend that she add to her diet? A) Milk and cheese B) Carrots, sweet potatoes, and mangoes C) Nuts, seeds, and chocolate D) Fortified cereals
D) Fortified cereals The best source to recommend are the fortified cereals to meet the amino acid needs necessary for the development of her infant's nervous system during pregnancy. She should be encouraged to include fortified cereals to meet these needs. The carrots, sweet potatoes, mangoes, nuts, and seeds will add other nutrients to her diet. A vegan will not eat milk and cheese, as they are animal products.
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 client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe? A) penicillin B) tetracycline C) levofloxacin D) ceftriaxone
D) ceftriaxone The microorganism N. gonorrhoeae has become increasingly resistant to penicillin and tetracyclines, and fluoroquinolones (such as levofloxacin). Therefore, the current CDC (2006) recommendation for treating gonorrhea is a single intramuscular dose of a broad-spectrum cephalosporin such as ceftriaxone.
A pregnant client is complaining of a large amount of malodorous vaginal discharge that is foamy and yellow-green in color, vaginal itching and painful intercourse. When asked, she also reports that urination is somewhat painful. She is diagnosed with trichomoniasis. What treatment would the nurse anticipate the client receiving? A) ceftriaxone IM B) oral erythromycin C) benzathine penicillin G IM D) oral metronidazole
D) oral metronidazole Trichomoniasis is caused from a protozoan infection, which can cause preterm labor, low birth weight and premature rupture of membranes. Treatment is oral metronidazole because it is more effective in treating the infection than the suppository or creams.
A client has been diagnosed with condylomata acuminata and requires treatment for the condition. What would be the treatment of choice? A) cryotherapy B) antibiotics C) topically applied antifungal cream D) avoidance of sexual contact
A) cryotherapy The treatment of choice would be cryotherapy because it can penetrate deeper than other forms of therapy to eliminate the lesion. The client would be encouraged to stop sexual contact until the lesions are resolved.
A 30-year-old client asks the nurse about risk factors for ovarian cancer. Which risk factor should be included in client education? A) infertility B) less than 40 years of age C) menopause before age 50 D) breastfeeding
A) infertility Pregnancy decreases a woman's risk for ovarian cancer; infertility increases that risk. Risk increases in women older than 50 years and for women who experienced late menopause (older than 55 years). Breastfeeding may have a protective effect.
A nurse is teaching a client with urinary incontinence about fluid intake and the need to reduce fluids that may act as bladder irritants. The nurse determines that the teaching was effective when the client states she should avoid which fluids? Select all that apply. iced tea hot chocolate orange juice apple juice soft drinks
ALL but apple juice
A nursing student is studying gynecological cancers and is excited when she reads that birth control pills can have a positive effect on preventing which disease? A) uterine cancer B) ovarian cancer C) endometrial cancer D) vaginal cancer
B) ovarian cancer Risk-reduction strategies for preventing ovarian cancer include pregnancy, use of oral contraceptives, and breastfeeding. No research states that oral contraceptives help to prevent the other cancers.
A 24-year-old female client reports various issues. She admits to having unprotected sexual intercourse. Which findings would indicate a possible PID? Select all that apply. A) lower abdominal tenderness B) adnexal tenderness C) cervical motion tenderness D) constipation
A) lower abdominal tenderness B) adnexal tenderness C) cervical motion tenderness
A client is diagnosed with endometriosis. As part of the teaching plan, the nurse is explaining the condition, including the ways that the diagnosis would be confirmed. The nurse determines that the teaching was successful when the client states that which test would confirm the diagnosis? A) pelvic laparoscopy B) bimanual exam C) pelvic ultrasound D) Papanicolau test
A) pelvic laparoscopy A thorough history and pelvic examination may lead the health care practitioner to suspect endometriosis; however, the only certain method of diagnosing it is by visualizing it via a laparoscopy. A tissue biopsy can be obtained at this time and examined microscopically to confirm it. A Papanicolau test would be done to rule out cervical cancer. A pelvic ultrasound would not be definitive for endometriosis.
The nurse is assisting a woman in scheduling an appointment for a Papanicolau test. The woman's last menstrual period started on May 2 and ended on May 6. Which date would be mostappropriate for the appointment? A) May 7 B) May 9 C) May 17 D) May 30
C) May 17 A Papanicolau test should be scheduled at least 1 week after menses ends to increase the chance of getting the best sample of cervical cells without menses. In this case, the date would be May 17.