All sets-Q5

The nurse is on a panel at a conference discussing poverty and health care for those living below the poverty level. Which statements should the nurse include? Select all that apply 1. The poverty level is defined as a family of four living on less than $23,550 per year. 2. Two-thirds of Americans living in poverty are women and children. 3. The majority of single-parent families are headed by women. 4. The greatest number of people living under the poverty level are the elderly. 5. Parental race does not affect the level of poverty.

1, 2, 3 Explanation: 1. Increasing numbers of U.S. women and their children are attempting to live on $23,550 or less, which is the current income that defines the poverty level for a family of four. 2. Currently, two-thirds of Americans living in poverty are women and children. 3. The majority of single parent-families are headed by women, and these families are four times more likely to live in poverty than families with two parents.

The OB-GYN nurse is teaching a client at the clinic that use of a spermicide has an increased effectiveness if used with which other items? Select all that apply. 1. A non-water-based lubricant 2. A diaphragm 3. A contraceptive sponge 4. Prophylactic antibiotics 5. A condom .

2, 3, 5 Explanation: 2. Barrier contraceptives such as a diaphragm act by blocking the transport of sperm and are often used in conjunction with a spermicide. 3. Barrier contraceptives such as the contraceptive sponge act by blocking the transport of sperm and are often used in conjunction with a spermicide. 5. Barrier contraceptives such as the condom act by blocking the transport of sperm and are often used in conjunction with a spermicide

The nurse is instructing a young client on avoiding toxic shock syndrome. Education was successful when the client makes which statements? Select all that apply. 1. "I will wash my hands before inserting a tampon." 2. "I will change my tampon every 3-6 hours." 3. "I will not touch the part of the tampon I insert." 4. "I will just put the used tampon in the trash." 5. "I will take prophylactic antibiotics if needed."

: 1, 2, 3 Explanation: 1. Washing hands before inserting or removing a tampon is correct. 2. Changing the tampon every 3-6 hours will help prevent toxic shock syndrome from developing. 3. After the tampon is unwrapped, the client should avoid touching the portion of the tampon to be inserted into the vagina.

A pregnant client at 24 weeks' gestation is diagnosed with bacterial vaginosis. Her doctor orders Flagyl to treat the problem. What would be appropriate education for the nurse to provide? 1. The client must be careful to observe for signs of preterm labor. 2. The client should advise her partner to seek therapy as soon as possible. 3. The main side effect of the medication is a large amount of vaginal discharge. 4. A repeat culture should be taken 2 weeks after completing the therapy.

Answer: 1 Explanation: 1. Clients with bacterial vaginosis are at risk for preterm labor.

The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? 1. Age 30, treated for PID 2. Age 25, monogamous 3. Age 20, pregnant 4. Age 27, uses a diaphragm

Answer: 1 Explanation: 1. Exposure to sexually transmitted infections increases the risk of abnormal cell changes and cervical cancer.

The nurse is teaching nursing students about the different kind of hepatitis. Which statement is the nurse likely to make? 1. Hepatitis A and B have vaccines to prevent them. 2. Hepatitis A, B, and C have vaccines to prevent them. 3. Hepatitis C, D, and E are all bloodborne. 4. Hepatitis A, C, and E are all fecal-oral contamination.

Answer: 1 Explanation: 1. Hepatitis A and B are the only two types of hepatitis that have vaccines.

A woman has come to the emergency department with multiple bruises over her body and a small laceration over her upper lip. She says she fell down the stairs while doing her housework. Which observation would most likely cause the nurse to suspect that she has been a victim of battering? 1. The client is hesitant to provide details about how the injuries occurred. 2. The client was accompanied to the emergency department by her mother instead of her partner. 3. The client has sought care quickly after the incident. 4. The client does not seem to be in pain.

Answer: 1 Explanation: 1. Hesitation to provide detailed information about the injury and how it occurred is a common sign of abuse.

The nurse is working with a woman who is undergoing chemotherapy for breast cancer. The client states, "First, the cancer seemed unreal. Now I feel like I can cope." What is the nurse's best response? 1. "Women with breast cancer often go through several stages of adjustment." 2. "Women with breast cancer cope better than their partners cope." 3. "Women with breast cancer seek multiple opinions before starting treatment." 4. "Women with breast cancer become angry after treatment begins."

Answer: 1 Explanation: 1. The course of adjustment confronting the woman with cancer has been described in four phases: shock, reaction, recovery, and reorientation. The client's statement indicates shock followed by reaction.

The pregnant client employed at a factory asks the nurse whether exposure to chemicals can cause harm to her fetus. The nurse should advise that exposure to which substance can lead to neurological damage? 1. Lead 2. Latex 3. Formaldehyde 4. Benzene

Answer: 1 Explanation: 1. Women exposed to lead during pregnancy are at risk for spontaneous abortion, prematurity, low birth weight, intrauterine growth restriction, and brain, kidney, and nervous system dysfunction.

The nurse teaches a group of young women that self-care measures for dysmenorrhea include which of the following actions? Select all that apply. 1. Taking vitamins B and E 2. Decreasing salt intake 3. Using cold packs as needed 4. Using intermittent exercise 5. Taking FSH replacement

Answer: 1, 2 Explanation: 1. Some nutritionists suggest that vitamins B and E help relieve the discomforts associated with menstruation.

The nurse in the emergency department is admitting a 22-year-old woman who complains of watery diarrhea, dizziness, and vomiting. She is in the middle of her period, and has a tampon in place. The nurse suspects toxic shock syndrome, and assesses for the manifestations of which symptom? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Fever 2. Rash 3. Desquamation of skin 4. Bloating 5. Urinary frequency and urgency

Answer: 1, 2, 3 Explanation: 1. A fever presents initially. 2. A rash on the trunk presents initially. 3. The fever and rash on the trunk present initially, followed by desquamation of the skin, especially the palms and soles, which usually occurs 1 to 2 weeks after the onset of symptoms.

A nurse in the emergency department recognizes in the husband of a client one of which of the following common characteristics of batterers? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Emotionally immature 2. Tend to express their overwhelming feelings of inadequacy through violence 3. Feelings of insecurity and inferiority 4. A lack of respect in the community 5. Limited jealousy or possessiveness

Answer: 1, 2, 3 Explanation: 1. Batterers tend to be emotionally immature. 2. Because they tend to be emotionally immature and aggressive, batterers have a tendency to express their overwhelming feelings of inadequacy through violence. 3. Batterers are insecure, and feel inferior, often feeling that they are undeserving of their partner.

The nurse working in the emergency department of a hospital is caring for a woman whom the nurse suspects is the victim of domestic violence. The nurse knows that which of the following are contributing factors to domestic violence? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Experiencing or witnessing abuse as a child 2. Strong patriarchal family traditions 3. Linking masculinity to male honor 4. Low levels of marital conflict 5. Alcohol and drug abuse cause the violence

Answer: 1, 2, 3 Explanation: 1. Children who witness or experience abuse and battering are more likely to become batterers (men) or to be abused (women) in their own relationships. 2. Men raised in patriarchal families (those that encourage traditional gender roles) are more likely to engage in domestic violence. 3. Cultures that link definitions of manhood to dominance, toughness, or male honor are more likely to demonstrate violence against women.

The nurse is educating a group of women about the manifestations of benign breast conditions. What information topics will the nurse include? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Masses rapid in appearance or disappearance 2. Galactorrhea is common 3. Galactorrhea is seen with some psychiatric medications 4. Ulcerations or skin erosions are possible 5. An increased breast size with dimpling

Answer: 1, 2, 3 Explanation: 1. Fluctuations in size and rapid appearance or disappearance of breast masses are common in fibrocystic breasts. 2. Galactorrhea is a benign change often associated with hormone therapy. 3. Galactorrhea is often seen in women who have nursed, who have fibrocystic changes in the breast, or are on some types of psychiatric medication.

Lesbian and bisexual women are greater risk for health and social disparities, including which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Increased suicide risk 2. Increased risk of homelessness 3. Lack of screening for female-related cancers 4. Lack of screening for lung cancers 5. Increased divorce rates

Answer: 1, 2, 3 Explanation: 1. Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes increased suicide risk. 2. Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes increased risk of homelessness. 3. Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes lack of screening for female-related cancers.

The nurse working in the emergency department is admitting a woman who has been battered for a second time, and recognizes that the woman is again in the cycle of violence. The nurse knows that which of the following are characteristics of the phases of the cycle of violence? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Batterer demonstrates power and control 2. Active battering from some event 3. A loving, contrite period 4. Defeat and admission of guilt by the victim 5. Blame and punishment for inferiority

Answer: 1, 2, 3 Explanation: 1. In the tension-building phase in the cycle of violence, the batterer demonstrates power and control. 2. The acute battering incident is typically triggered by some external event or internal state of the batterer. 3. The tranquil phase in the cycle of violence is also sometimes called the honeymoon period. This phase may be characterized by extremely loving, kind, and contrite behaviors by the batterer.

Psychologic elder abuse includes, but is not limited to, which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Verbal assaults 2. Humiliation 3. Desertion 4. Intimidation 5. Failure to provide reasonable care

Answer: 1, 2, 4 Explanation: 1. Psychologic abuse includes verbal assaults. 2. Psychologic abuse includes humiliation. 4. Psychologic abuse includes intimidation.

The nurse is teaching a group of perimenopausal women about treatment choices for their symptoms. The nurse will include which information? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Importance of continuing contraception 2. Benefits of menstrual regulation with hormones 3. Increase in vaginal dryness with hormones 4. Decrease in acne and hirsutism 5. Increase in endometrial cancer risk

Answer: 1, 2, 4 Explanation: 1. Thirty-eight percent of pregnancies for women ages 40 and older are unplanned; some form of contraception is needed. 2. Regulation of menses with effective contraception is a benefit to the perimenopausal woman. 4. Women on hormones might experience less acne and hirsutism.

The nurse suspects that a pregnant client might be experiencing abuse when the client does which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Gives an inappropriate explanation for the injuries 2. Hesitates in providing detailed information about the injury 3. Makes eye contact with the nurse while answering questions 4. Allows her partner to answer the nurse's questions 5. Frequently calls to change appointment times

Answer: 1, 2, 4, 5 Explanation: 1. Whenever a client gives an inappropriate explanation for injuries, such as being accident prone, the nurse should suspect abuse. 2. Clients experiencing abuse often hesitate in providing detailed information about an injury and how it occurred. 4. The client experiencing abuse may show signs of increased anxiety in the presence of the possible batterer, who frequently does most of the talking or hovers around the woman. 5. If a client has injuries sustained from abuse, she will often delay reporting of symptoms or seeking care for injuries.

The nurse assessing a 50-year-old female client at an orthopedic center asks about the use of complementary and alternative therapies. Which of the following are among those women often try during menopause? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Vitamin and mineral supplements 2. Increasing caffeine intake 3. Soy and red clover 4. Selective estrogen receptor modulators 5. Salmon calcitonin

Answer: 1, 3 Explanation: 1. Vitamin and mineral supplements, especially calcium and vitamins D, E, and B complex, are used to control the symptoms of menopause. 3. Soy and red clover have shown to be effective for some women in controlling their menopausal symptoms.

A nurse is teaching a class on the different types of uterine bleeding. The nurse explains that which of the following is one of the causes of abnormal uterine bleeding? 1. Iron-deficiency anemia 2. Polyps 3. Heavy periods every 2 months 4. Spotting between periods

Answer: 2 Explanation: 2. A classification system has been developed for the causes of AUB using the acronym PALM-COEIN. The P stands for Polyps.

The nurse is caring for a client in the clinic whom she suspects has vaginosis. Which test best determines whether this sexually active woman has the disorder? 1. The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation 2. The addition of a 10% potassium hydroxide solution to the vaginal secretions 3. A vaginal pH of less than 4.5 4. A Gram stain positive for the fungus

Answer: 2 Explanation: 2. Adding a 10% potassium hydroxide solution to the vaginal secretion of a client with bacterial vaginosis, called a "whiff" test, produces a fishy smell.

The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority? 1. Encourage oral fluids 2. Administer cefotetan IV 3. Enforce bed rest 4. Remove IUC, if present

Answer: 2 Explanation: 2. Administration of medications to treat the disease is the first priority.

The nurse is answering the perimenopausal client's questions about hormone replacement therapy. Which client statement indicates a need for further teaching? 1. "Estrogen therapy will decrease my chances of developing osteoporosis." 2. "If I am taking estrogen therapy, I will not have to worry about my cholesterol being checked." 3. "Osteoporosis is a decrease in bone strength due to bone density and quality." 4. "Bone mass tends to decrease after menopause."

Answer: 2 Explanation: 2. Cholesterol levels should be checked regularly even when normal, so this statement indicates the need for more teaching.

The nurse is planning a community educational presentation for people living below the poverty level. The nurse knows that which of the following is the largest population in this socioeconomic category? 1. Adults in communal living situations 2. Young married couples under the age of 20 3. Single women with children 4. Single adults

Answer: 3 Explanation: 3. Of households headed by single mothers, 40% live in poverty.

The nurse is admitting a client who is 12 weeks pregnant and an IV drug user. She has had a number of sexual partners, complains of malaise, and has yellow in the eyes, nausea, and vomiting. Having obtained this history, the nurse suspects that the client has which condition? 1. Hepatitis E 2. Hepatitis C 3. Gonorrhea 4. Hepatitis A

Answer: 2 Explanation: 2. Hepatitis C is bloodborne, and found in drug users and those who have multiple sexual partners.

A client who is in perimenopause is having a number of severe symptoms. The nurse assesses this client and knows the doctor will likely prescribe what to assist in relieving the distress? 1. Calcium and vitamin D 2. A form of hormonal contraception 3. Prescriptive pain medication 4. Antibiotics

Answer: 2 Explanation: 2. Hormonal contraception is the correct answer, as pregnancy can still be a concern, plus the estrogen will relieve other symptoms, such as hot flashes and vaginal dryness.

The nurse is providing follow-up education to a client just diagnosed with vaginal herpes. What statement by the client verifies correct knowledge about vaginal herpes? 1. "I should douche daily to prevent infection." 2. "I could have another breakout during my period." 3. "I am more likely to develop cancer of the cervix." 4. "I should use sodium bicarbonate on the lesions to relieve discomfort." .

Answer: 2 Explanation: 2. Menstruation seems to trigger recurrences of herpes

The nurse who is taking a sexual history from a client should do which of the following? 1. Ask questions that the client can answer with "yes" or "no." 2. Ask mostly open-ended questions. 3. Have the client fill out a comprehensive questionnaire and review it after the client leaves. 4. Try not to make much direct eye contact.

Answer: 2 Explanation: 2. Open-ended questions are often useful in eliciting information.

The nurse's response to a client with a history of pelvic inflammatory disease who is trying to get pregnant is based on the knowledge that which condition can contribute to an infertility problem? 1. Hepatitis 2. Postinfection tubal damage 3. Pelvic abscess 4. Tubal infection

Answer: 2 Explanation: 2. Postinfection tubal damage is the most likely cause, as the infection causes tubal damage, which can lead to infertility.

A client comes to the clinic complaining of severe menstrual cramps. She has never been pregnant, has been diagnosed with ovarian cysts, and has had an intrauterine device (IUD) for 2 years. What is the most likely cause for the client's complaint? 1. Primary dysmenorrhea 2. Secondary dysmenorrhea 3. Menorrhagia 4. Hypermenorrhea

Answer: 2 Explanation: 2. Secondary dysmenorrhea is associated with pathology of the reproductive tract, and usually appears after menstruation has been established. Conditions that most frequently cause secondary dysmenorrhea include ovarian cysts and the presence of an intrauterine device.

The nurse at a women's clinic is reviewing a new client health information questionnaire. Which question does she find to be insulting and discriminatory toward lesbian client? 1. Who should be contacted in case of emergency? 2. What method of birth control do you use? 3. How often do you drink alcohol? 4. Do you feel safe in your relationship?

Answer: 2 Explanation: 2. The assumption that all women are in need of contraception for birth control is often cited as a reason that lesbian women may conceal their sexual orientation.

The nurse receives a phone call from a 25-year-old woman experiencing breast tenderness in the week prior to her menses, with palpable breast nodularity, without nipple discharge. What is the best response by the nurse? 1. "Please make an appointment at the breast cancer center as soon as possible." 2. "How much salty food do you regularly consume?" 3. "As long as you don't have nipple discharge, it isn't a serious condition." 4. "Eliminate caffeine and chocolate from your diet."

Answer: 2 Explanation: 2. The client is describing fibrocystic breast changes. A salt restriction with a mild diuretic taken the week before menstrual bleeding often improves the condition.

The nurse is seeing clients in the women's clinic. Which client should be treated with ceftriaxone IM and doxycycline orally? 1. A pregnant client with gonorrhea and a yeast infection 2. A nonpregnant client with gonorrhea and chlamydia 3. A pregnant client with syphilis 4. A nonpregnant client with chlamydia and trichomoniasis

Answer: 2 Explanation: 2. The combined treatment of ceftriaxone IM and doxycycline orally provides dual treatment for gonorrhea and chlamydia, which frequently occur together.

The nurse recognizes that what are the most common disabilities in women? 1. Asthma and headaches 2. Arthritis or rheumatism 3. Adverse kidney and nervous system functioning 4. Cardiovascular diseases

Answer: 2 Explanation: 2. The most common disabilities in women are arthritis or rheumatism and the incidence of disability increases with age.

The charge nurse is giving an in-service to the orthopedic and gynecology nurses concerning the relationship between estrogen and osteoporosis. Which is a statement the nurse would make concerning this relationship? 1. "Males have a higher incidence of osteoporosis than do females." 2. "Women who experience menopause at a younger age and have less bone mass could have more bone loss." 3. "Estrogen levels affect only bone mass, but they have nothing to with bone strength and bone density." 4. "Osteoporosis puts the client at a decreased .

Answer: 2 Explanation: 2. This is a true statement, as women who experience menopause at a younger age and have less bone mass lose the benefit of estrogen for more years

A client comes to the clinic complaining of a thick, white, tenacious discharge and vulvular soreness. Which medication treatment will the nurse teach the client about? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Silver sulfadiazine 2. Metronidazole 3. Clindamycin cream 4. Ceftriaxone sodium 5. Doxycycline

Answer: 2, 3 Explanation: 2. Metronidazole is the preferred treatment for vulvovaginal candidiasis. 3. Although less effective than metronidazole, clindamycin cream can be used to treat vulvovaginal candidiasis.

The nurse is about to tell a client that her Pap smear result was abnormal. Which statement should the nurse include? 1. "The Pap smear is used to diagnose cervical cancer." 2. "A loop electrosurgical excision procedure (LEEP) is needed." 3. "Colposcopy to further examine your cervix is the next step." 4. "Your cervix needs to be treated with cryotherapy."

Answer: 3 Explanation: 3. Colposcopy is an examination of the cervix through a magnifying device

The nurse interviews a 28-year-old client with a new medical diagnosis of endometriosis. Which question asked by the nurse is appropriate? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "Are you having hot flashes?" 2. "Are you experiencing pain during intercourse?" 3. "Is a vaginal discharge present?" 4. "Are you having pain during your period?" 5. "Have you noticed any skin rashes?"

Answer: 2, 4 Explanation: 2. The primary symptoms of endometriosis include dyspareunia. 4. The primary symptoms of endometriosis include dysmenorrhea.

The nurse is caring for a client diagnosed with endometriosis. Which statement by the client would require a need for perhaps another treatment option? 1. "I am having many hot flashes since I had the Lupron injection." 2. "The pain I experience with intercourse is becoming more severe." 3. "I have vaginal dryness, reduced libido, and my clitoris has become larger since taking danazol. Is this normal?" 4. "I've noticed I have not had my period on a regular basis since being on the GnRH analogs."

Answer: 3 Explanation: 3. Danazol is a testosterone derivative that suppresses ovulation and causes amenorrhea. It is intended for short-term therapy. Because of adverse effects, many clinicians have moved away from danazol to other treatment options.

The nurse has been talking to a woman about the reorganization phase following a rape. Which response would indicate that the client understands this phase? 1. "By using denial and suppression in this phase, I will eventually be able to accept what has happened to me." 2. "During this time, I won't talk much about the rape, because I am examining my inward feelings regarding the rape." 3. "During this time, I will repeatedly replay the role of the victim until I come to terms with the experience." 4. "My perception of a normal sexual relationship will be similar to my perception prior to the rape."

Answer: 3 Explanation: 3. During reorganization, a victim adjusts her self-concept to include the rape.

A 19-year-old woman comes to the gynecologist's office. When the nurse asks the reason for this visit, the client explains that she has never had a menstrual period, and that she is concerned there might be something wrong. What is the diagnosis that the physician is most likely to make based on this information? 1. Primary dysmenorrhea 2. Secondary infertility 3. Primary amenorrhea 4. Secondary amenorrhea

Answer: 3 Explanation: 3. Primary amenorrhea is the term for the condition when menses have never occurred.

A new nurse is teaching a class to expectant parents about environmental hazards at home. Which statement, if made by an expectant parent, would indicate the need for further teaching? 1. "Air pollution is an environmental hazard caused by the release of toxins into the air." 2. "Indoor air pollution poses the more serious threat to women's health." 3. "Radon, a naturally occurring radioactive gas, is the leading cause of lung cancer, which kills more women than any other type of cancer, including breast." 4. "Asthma is worsened by most forms of indoor air pollution."

Answer: 3 Explanation: 3. Radon is the second-leading cause of lung cancer. Smoking is the first.

The nurse is taking a history of a new client in the clinic. Histories tend to be lengthy, and the sexual part can be difficult for the client. The nurse should use what technique to make it easier for the client? 1. Let the client fill out a paper copy, so she does not have to talk about intimate matters. 2. Skip the sexual part until the next time the client comes into the clinic. 3. Start with the easier medical and surgical questions, and develop a feeling of trust with the client. 4. Leave the sexual part of the history for the doctor to ask about.

Answer: 3 Explanation: 3. Starting with easy-to-answer questions and then going to the sexual ones helps, as client might be at ease by then.

Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (PID)? 1. CBC (complete blood count) with differential 2. Venereal Disease Research Laboratory (VDRL) 3. Throat culture for Streptococcus A 4. RPR (Rapid Plasma Reagin)

Answer: 3 Explanation: 3. Streptococcus of the throat is not associated with PID.

The nurse is instructing a client in the use of combined oral contraceptives. The nurse knows that additional teaching is required when the client makes which statement about the risks of taking combined oral contraceptives? 1. "They will lower my risk for breast cancer." 2. "They will increase my risk for cervical cancer." 3. "They will lower my risk for ovarian cancer." 4. "They will increase my risk for uterine cancer."

Answer: 3 Explanation: 3. This is true. There is a reduction in the incidence of ovarian cancer.

A client who wants to use the vaginal sponge method of contraception shows that she understands the appropriate usage when she makes which statement? 1. "I need to use a lubricant prior to insertion." 2. "I need to add spermicidal cream prior to intercourse." 3. "I need to moisten it with water prior to use." 4. "I need to leave it in no longer than 6 hours."

Answer: 3 Explanation: 3. To activate the spermicide in the vaginal sponge, it must be moistened thoroughly with water.

The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (VVC), and knows the client understands when she makes which of the following statements? 1. "I need to apply the miconazole for 10 days." 2. "I need to douche daily." 3. "I need to add yogurt to my diet." 4. "I need to wear nylon panties."

Answer: 3 Explanation: 3. Yogurt helps reestablish normal vaginal flora.

A nurse is providing a client with instructions regarding breast self-examination (BSE). Which of the following statements by the client would indicate that the teaching has been successful? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "I should perform BSE 1 week prior to the start of my period." 2. "When I reach menopause, I will perform BSE every 2 months." 3. "Knowing the density of my breast tissue is important." 4. "I should inspect my breasts while standing with my arms down at my sides." 5. "I should inspect my breasts while in a supine position with my arms at my sides."

Answer: 3, 4 Explanation: 3. The effectiveness of BSE is determined by the woman's ability to perform the procedure correctly, by her knowledge of her own breast tissue, and by the density of her breast tissue. 4. The breasts should be inspected while standing with arms at sides.

A client asks the nurse about treatment for human papilloma viral warts. The nurse's response should be based on what knowledge? 1. An antiviral injection cures approximately 50% of all cases. 2. Aggressive treatment is required to cure warts. 3. Warts often spread when an attempt is made to remove them surgically. 4. No single treatment is best for all types of warts or for all clients.

Answer: 4 Explanation: 4. All atypical, pigmented, and persistent warts should be biopsied and treatment instituted promptly.

The client with limited English language skills has a black eye, and bruises across her face and arms. The client's husband has been acting as an interpreter for her, and answers all of the questions the nurse asks, often without talking to his wife first. The nurse suspects the client has been a victim of domestic abuse. What should the nurse do next? 1. Ask the husband whether he has beaten his wife. 2. Ask the husband to have a female friend come in with his wife. 3. Provide written materials in English for the client to read at home. 4. Ask the husband to step out of the room, and obtain an interpreter.

Answer: 4 Explanation: 4. Screening for women experiencing domestic violence must be done privately. An interpreter should also be provided as necessary.

A client arrives at the emergency department stating that she was raped, but she felt so "dirty" that she went home and showered. She states that she has on clean clothes but has her other clothes in a bag. What will the nurse tell the client? 1. "I understand why you felt dirty, but you know you should not have taken a shower." 2. "We will probably never find out who raped you because you destroyed evidence." 3. "Do you want an emergency contraceptive pill?" 4. "I understand that was important to you. We will see what we can get from your clothes, and give them to the authorities."

Answer: 4 Explanation: 4. This is the correct statement. This is not the time to tell her what she did wrong, as she is psychologically upset. The ability to collect evidence that is comprehensive, appropriate, and reliable contributes to successful prosecution of perpetrators of sexual assault.

A female client who is 36 years old, weighs 200 pounds, is monogamous, and does not smoke desires birth control. The nurse understands that which contraceptive method is inappropriate for this client? 1. Intrauterine device 2. Vaginal sponge 3. Combined oral contraceptives 4. Transdermal hormonal contraception

Answer: 4 Explanation: 4. Transdermal hormonal contraception is contraindicated because of the client's obesity.

A couple asks the nurse what is the safest method of sterilization. What should the nurse reply? 1. "Laparotomy tubal ligation." 2. "Laparoscopy tubal ligation." 3. "Minilaparotomy." 4. "Vasectomy."

Answer: 4 Explanation: 4. Vasectomy (male sterilization) is a relatively minor procedure.

A client asks her nurse, "Is it okay for me to take a tub bath during the heavy part of my menstruation?" What is the nurse's correct response? 1. "Tub baths are contraindicated during menstruation." 2. "You should shower and douche daily instead." 3. "Either a bath or a shower is fine at that time." 4. "You should bathe and use a feminine deodorant spray during menstruation." .

Explanation: 3. Bathing, whether it is a tub bath or a shower, is as important (if not more so) during menses as at any other time

There have been a number of historical trends that have contributed to this existing wage gap, including which of the following? 1. There was a perception that men were the sole breadwinners. 2. Women who were competitive in the work environment were viewed positively. 3. Women in past generations generally were not limited to certain occupations. 4. Increase in societal importance of women's intellectual traits.

Answer: 1 Explanation: 1. Historically, there was a perception that men were the sole breadwinners, thus higher salaries for men were justified to support a family.

The client has been a victim of a violent, sadistic rape. She is crying, and asks the nurse "Why would someone do something like that?" The nurse should explain that which of the following is the primary purpose of sadistic rape? 1. Take pleasure from the victim's struggle and pain 2. Express feelings of rage 3. Feel a sense of power or mastery 4. Relieve intolerable anxiety

Answer: 1 Explanation: 1. In sadistic rape, the assailant has an antisocial personality and delights in torture and mutilation. In this type of rape, the victim and assailant are generally strangers, and the assault is planned. Sadistic rapes cause the most injuries, including homicide.

A nurse is caring for a client admitted preoperatively for a bilateral mastectomy. Which statement indicates that this client is still in the shock phase of adjustment to her diagnosis? 1. "I can't understand why this is happening to me." 2. "I am so happy that my daughter graduates from high school this year." 3. "I know that breast cancer is now part of my life." 4. "I can't believe that I need to lose both of my breasts."

Answer: 1 Explanation: 1. In the shock phase, a client makes statements such as this.

A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be: 1. Oral acyclovir 2. Ceftriaxone IM 3. Azithromycin p.o. 4. Penicillin G IM

Answer: 1 Explanation: 1. Malaise, dysuria, and tingling or painful vesicles are indicative of a primary herpes simplex outbreak. Acyclovir treats herpes.

The nurse at a shelter is counseling a group of battered women. What will the nurse will emphasize? 1. Battering will not stop or decrease if the woman becomes pregnant. 2. About 1 of every 5 women will experience abuse in her lifetime. 3. When these women go back to the situation after the abuser has cooled down, it will be better. 4. The battered woman can readily leave the situation.

Answer: 1 Explanation: 1. Pregnancy does not stop the abuser, and sometimes it increases the intensity of the abuse.

When assessing a client asking about birth control, the nurse knows that the client would not be a good candidate for Depo-Provera (DMPA) if which of the following is true? 1. She wishes to get pregnant within 3 months. 2. She is a nursing mother. 3. She has a vaginal prolapse. 4. She weighs 200 pounds.

Answer: 1 Explanation: 1. Return of fertility after use may be delayed for an average of 10 months.

The nurse suspects that a client has been physically abused, but the woman refuses to report the abuse to the police. Which statement by the client suggests to the nurse that the relationship might be in the "honeymoon period" of the cycle of violence? 1. "My boyfriend says he will never hurt me again." 2. "My boyfriend only drinks alcohol on the weekends." 3. "My boyfriend yells less than he used to." 4. "My boyfriend has frequent bouts of insomnia."

Answer: 1 Explanation: 1. This is an example of a statement made during the honeymoon period of the cycle of violence.

A public health nurse, along with a student, is visiting the home of an elderly woman who is widowed and lives alone. Her 40-year-old son is her caregiver, and the public health nurses visit about once a week to follow up on her high blood pressure, recent surgery for a hip fracture, and diabetes. The nurse and student find the home dirty, sink full of dirty dishes, and the client in clothes that are extremely soiled. She cannot reach her walker to get up, and she has been incontinent. The nurse recognizes this as which type of abuse? 1. Neglect 2. Abandonment 3. Physical abuse 4. Financial abuse

Answer: 1 Explanation: 1. The abuse described is called neglect. Assistance and personal hygiene have not been provided.

A client describes breast swelling and tenderness. What piece of data would be most important for the nurse to gather initially? 1. Timing of the symptoms 2. Birth control method 3. Method of breast self-examination 4. Diet history

Answer: 1 Explanation: 1. The breast undergoes regular cyclical changes in response to hormonal stimulation. The nurse will want to determine when the swelling and tenderness occur within the menstrual cycle.

A nurse is providing contraceptive counseling to a perimenopausal client in a monogamous relationship. What comment by the client indicates that further teaching is necessary? 1. "The calendar method is the most reliable method for me to use." 2. "If I use the IUC, I will be at minimal risk for pelvic inflammatory disease." 3. "I should still use birth control, even though I had only three periods last year." 4. "The contraceptive skin patch contains both estrogen and progesterone."

Answer: 1 Explanation: 1. The client who believes the calendar method is the most reliable method requires more teaching. The menstrual cycle of perimenopausal women is irregular, and it is difficult to determine safe and unsafe times.

The lesbian woman who is pregnant by in vitro fertilization from an unknown donor comes to the obstetric clinic in her seventh month with her partner. When asked by the nurse why she has waited so long to come in, the client remarks, "Oh, you know why." What does the nurse suspect? 1. The client is experiencing a fear of discrimination on the part of providers. 2. The client is without insurance, and is afraid she will be turned away. 3. The client is in good health, and did not need to come in any sooner. 4. The client is independent in her health care, and opted for self-care until now.

Answer: 1 Explanation: 1. The woman most likely has a fear of discrimination due to her sexual orientation. Women's health services in particular have not shown acceptance of lesbian, bisexual, or transgender status.

The clinic nurse teaches the pregnant client being treated for trichomoniasis about the risks to her pregnancy due to this infection. Which statement would indicate successful teaching? 1. "I am at risk of having a preterm birth because of this infection." 2. "I might need to have my membranes ruptured because of this infection." 3. "I am at risk of having a baby with a high birth weight." 4. "I may have intercourse with my husband while bring treated for this infection."

Answer: 1 Explanation: 1. There is a risk of preterm birth and rupture of membranes.

The nurse is educating a client on intrauterine contraception (IUC). Which advantages of IUC will the nurse include? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. It is effective, continuous contraception. 2. It is relatively inexpensive over time. 3. It does not need to be inserted immediately prior to coitus. 4. Small amounts of estrogen are released daily. 5. It slightly increases the risk of ectopic pregnancy.

Answer: 1, 2, 3 Explanation: 1. One advantage of IUC is a high rate of effectiveness. 2. One advantage of IUC is that it is inexpensive over time. 3. It is non-coitus-related contraception.

The nurse is writing a care plan for a client with abnormal uterine bleeding (AUB). Which goals does the nurse include? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Preventing or treating anemia 2. Preventing endometrial hyperplasia 3. Restoring quality of life 4. Conducting pelvic exams monthly 5. Analyzing liver and kidney function

Answer: 1, 2, 3 Explanation: 1. One goal for the client with AUB is to prevent or treat anemia. 2. One goal for the client with AUB is to prevent endometrial hyperplasia. 3. One goal for a client with AUB is to restore quality of life.

The nurse is caring for a battered woman in the emergency department. Which nursing guidelines are used in the care of this client? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Letting the woman tell her story at her own pace 2. Anticipating ambivalence toward the batterer 3. Acknowledging the woman's feelings as reasonable 4. Letting the woman figure out how to identify specific problems on her own 5. Allowing her to believe in false beliefs if it makes her feel more secure

Answer: 1, 2, 3 Explanation: 1. The nurse should let the woman work through her story, problems, and situation at her own pace. 2. The nurse should anticipate ambivalence in the woman's love-hate relationship with the batterer. 3. The nurse should let the woman know that she is believed, and that her feelings are reasonable and normal.

The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statements indicate that teaching was effective? Select all that apply. 1. "I might have infertility because of this infection." 2. "It is important for me to finish my antibiotics." 3. "Tubal pregnancy could occur after PID." 4. "My PID was caused by a yeast infection." 5. "I am going to have an IUD placed for contraception."

Answer: 1, 2, 3 Explanation: 1. Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of PID. 2. Antibiotic therapy should always be completed when a client is diagnosed with any infection. 3. The tubal scarring that occurs from tubal inflammation during PID can prevent a fertilized ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy.

Pesticide exposure can be linked to a variety of adverse health outcomes, including which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Increased risk of cancer 2. Endocrine abnormalities 3. Liver damage 4. Birth defects 5. Cardiovascular diseases

Answer: 1, 2, 3, 4 Explanation: 1. Pesticide exposure can be linked to a variety of adverse health outcomes, including an increased risk of cancer. 2. Pesticide exposure can be linked to a variety of adverse health outcomes, including endocrine abnormalities. 3. Pesticide exposure can be linked to a variety of adverse health outcomes, including liver damage. 4. Pesticide exposure can be linked to a variety of adverse health outcomes, including birth defects.

The nurse teaching a group of new mothers and explains that barrier methods of contraception are appropriate if which of the following conditions exist? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Just started an oral contraceptive 2. Is opposed to systemic medications 3. Is lactating 4. Is unconcerned about using contraception 5. Does not smoke and is perimenopausal

Answer: 1, 2, 3, 5 Explanation: 1. A backup method of contraception is needed for a period of time when beginning oral contraceptives. 2. Opposition to taking systemic medications is a reason to use barriers for contraception. 3. Using a barrier method of contraception is appropriate in the early postpartum period or when lactating. 5. Being perimenopausal and smoking make barrier contraception an appropriate choice.

Among women who have been sexually assaulted, which of the following are the most frequently diagnosed sexually transmitted infections (STIs)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Bacterial vaginosis 2. HIV 3. Chlamydia 4. Syphilis 5. Gonorrhea

Answer: 1, 3, 5 Explanation: 1. Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (STIs). 3. Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (STIs). 5. Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (STIs).

When a woman seeks care for an injury, the nurse should be alert to which clues of abuse? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Defensive injuries 2. Immediate reporting of symptoms or seeking care for injuries 3. Lack of eye contact 4. Providing too much detailed information about the injury 5. Vague complaints without accompanying pathology

Answer: 1, 3, 5 Explanation: 1. Defensive injuries may be a sign of abuse. 3. Lack of eye contact may be a sign of abuse. 5. Vague complaints without accompanying pathology may be a sign of abuse.

A client comes to the reproductive health clinic and reports that she woke up in a strange room this morning, her perineal area is sore, and she can't clearly remember what happened the previous evening. The client says that she is afraid that she was a victim of a drug-facilitated sexual assault. Which statement should the nurse include when discussing this possibility with the client? 1. "Drinking alcohol can lead to uninhibited sexual behavior, which is not the same as rape." 2. "Some men use drugs mixed into a drink to subdue a potential victim prior to a rape." 3. "It is rare that a woman doesn't remember what happened if she is actually raped." 4. "We need to check for forensic evidence of rape before we can be sure what happened."

Answer: 2 Explanation: 2. Drug-facilitated sexual assault occurs when a drug such as Rohypnol, which dissolves easily and is odorless, is slipped into the drink of an unsuspecting woman.

The nurse educator is planning a class about contraception, and includes information about the effects of various contraceptive methods on sexually transmitted diseases. Which statement will the nurse include concerning spermicides? 1. "Spermicides are effective against gonorrhea and chlamydia, but not against HIV." 2. "Spermicides are not effective against sexually transmitted diseases, and can increase a woman's susceptibility to HIV." 3. "Spermicides are effective against HIV, but are not effective against the other sexually transmitted diseases." 4. "Whether or not spermicides are effective against sexually transmitted diseases depends on where the woman is in her cycle."

Answer: 2 Explanation: 2. Spermicides are not effective against any sexually transmitted disease. Spermicides have a negative effect on the integrity of vaginal cells, making them more susceptible.

The nurse has presented a community education class on recommended health screenings for women. Which statement about the Pap smear by a class member indicates that additional teaching is necessary? 1. "It is recommended for women 21 years of age and older." 2. "It diagnoses cervical cancer." 3. "Intercourse at a young age is a risk factor for an abnormal Pap smear." 4. "Detects abnormal cells."

Answer: 2 Explanation: 2. The focus of the Pap smear is the detection of high-grade cervical disease. It does not diagnose cervical cancer.

A client is using the contraceptive sponge as a birth control method. What action is important in order to maintain the sponge's effectiveness? 1. Insert the sponge at least 1 hour before intercourse. 2. Thoroughly moisten the sponge with water before inserting. 3. Spermicidal jelly must be inserted at the same time the sponge is inserted. 4. A new sponge must be inserted every time a couple has intercourse.

Answer: 2 Explanation: 2. The sponge is moistened thoroughly with water before use to activate the spermicide.

In providing community education about hepatitis, the nurse includes information on the chronic forms of hepatitis. A form of hepatitis that becomes chronic is which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Hepatitis A 2. Hepatitis B 3. Hepatitis C 4. Hepatitis D 5. Hepatitis E

Answer: 2, 3, 4 Explanation: 2. Unlike hepatitis A infection, hepatitis B infection is chronic. 3. Unlike hepatitis A infection, hepatitis C infection is chronic. 4. Unlike hepatitis A infection, hepatitis D infection is chronic.

The nurse educator is talking with a group of students doing their gynecological rotation. The nurse describes a number of symptoms that include anovulation, reduced fertility, either decreased or increased menstrual flow, and menstrual cycle irregularities. The nurse is describing what condition? 1. Intermenstrual bleeding 2. Hypermenorrhea 3. Menopause 4. Primary amenorrhea

Answer: 3 Explanation: 3. Anovulation, reduced fertility, either decreased or increased menstrual flow, and menstrual cycle irregularities are some of the symptoms of menopause.

The nurse is planning a community education presentation on battering. Which statement about battering should the nurse include? 1. Battering occurs in a small percentage of the population. 2. Battering is mainly a lower-class, blue collar problem. 3. Battered women are at greatest risk for severe violence when they leave the batterer. 4. If the batterer stops drinking, the violence usually stops.

Answer: 3 Explanation: 3. Battered women are at greatest risk for injury or domestic homicide when they leave the abuser.

The nurse in the emergency department is caring for a pregnant woman who presents with bruised breasts and abdomen. When asked how this happened, she states she fell down the stairs. The husband stays very close to his wife and does most of the talking. Of what is the nurse aware? 1. The client likely did fall down the stairs. 2. The husband is being attentive and trying to help her feel better. 3. The husband could have battered her and possibly caused her to fall down the stairs. 4. This client is safe to return home after her wrist is fixed.

Answer: 3 Explanation: 3. Battering may occur for the first time during pregnancy or may escalate in intensity if the woman is already being abused. The injury is frequently aimed at the breasts, abdomen, or vagina.

The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? 1. "She could become pregnant." 2. "She could have severe vaginal itching." 3. "He could get an infection in the tube that carries the urine out." 4. "It could cause us to develop a rash."

Answer: 3 Explanation: 3. Chlamydia is a major cause of nongonococcal urethritis (NGU) in men.

A 49-year-old client comes to the clinic with complaints of severe perimenopausal symptoms including hot flashes, night sweats, urinary urgency, and vaginal dryness. The physician has prescribed a combination hormone replacement therapy of estrogen and progestin. When the client asks the nurse why she must take both hormones, what is the nurse's best reply? 1. "Hot flashes respond better when replacement includes both hormones." 2. "You are having very severe symptoms, so you need more hormones replaced." 3. "There is an increased risk of tissue abnormality inside the uterus if only one is given." 4. "Your blood pressure can become elevated if only one hormone is used."

Answer: 3 Explanation: 3. Estrogen alone, in a woman with a uterus (unopposed estrogen), increases the risk of endometrial (the lining of the uterus) cancer by eightfold and, therefore, is never given without progesterone in these women.

The nurse is teaching a group of women about menopause at a community clinic. The nurse tells them that the best indicator of menopause is which of the following symptoms? 1. No menses for 8 consecutive months 2. Hot flashes and night sweats 3. FSH levels rise and ovarian follicles cease to produce estrogen 4. Diagnosed with osteoporosis 4 months ago

Answer: 3 Explanation: 3. Examining FSH and estrogen levels is a very accurate indication of menopause.

The nurse is caring for a client who is a lesbian. What should the well-educated nurse be aware of for this client? 1. She is at lesser risk for sexually transmitted diseases and cervical cancer than a heterosexual woman would be. 2. She is less likely to experience domestic violence than a heterosexual woman would be, and does not need to be asked about it. 3. She is at greater risk for breast cancer than a heterosexual woman would be. 4. She does not need to have a Pap smear as frequently as a heterosexual woman would.

Answer: 3 Explanation: 3. Lesbians are at a greater risk for breast cancer, especially if they have never given birth.

The nurse manager is preparing an educational in-service for staff nurses about elder abuse. The nurse manager develops a hypothetical situation: A wheelchair-bound client who lives with her daughter has experienced hunger because she cannot reach the cupboards to make lunch. Which category of elder abuse does this example describe? 1. Psychologic abuse 2. Physical abuse 3. Neglect 4. Financial abuse

Answer: 3 Explanation: 3. Neglect is a failure on the part of a caregiver, or any person having custody of an elder, to provide reasonable care, which is the degree of care that a reasonable person would provide.

Which of the following systems provides a uniform format and classification of terminology based on current understanding of cervical disease? 1. Levonorgestrel intrauterine 2. PALM-COEIN 3. Bethesda 4. BSE

Answer: 3 Explanation: 3. The Bethesda System for classifying Pap smears is a standardized method of reporting cytologic Pap smear findings and is the most widely used method in the United States.

A client asks the nurse, "Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy?" What response by the nurse is best? 1. "Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred." 2. "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation." 3. "Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur." 4. "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."

Answer: 3 Explanation: 3. The basal body temperature method is used to detect ovulation by an increase in the basal temperature during the menstrual cycle. It requires that the woman take her temperature every morning upon awakening (before any activity) and record the findings on a temperature graph, and is based on the fact that the temperature almost always rises and remains elevated after ovulation because of the production of progesterone, a thermogenic (heat-producing) hormone.

When the nurse is teaching a woman about the use of a diaphragm, it is important to instruct her that the diaphragm should be rechecked for correct size how often? 1. Every five years routinely 2. When weight gain or loss beyond five pounds has occurred 3. After each birth 4. Only after significant weight loss

Answer: 3 Explanation: 3. The diaphragm should be rechecked for correct size after each childbirth and whenever a woman has gained or lost 10 pounds or more.

When a woman who has been raped is admitted to the emergency department, the nurse caring for the woman knows that which of the following is the priority nursing intervention? 1. Explaining exactly what will need to be done to preserve legal evidence 2. Assuring the woman that everything will be all right 3. Creating a safe, secure environment for her 4. Contacting family members

Answer: 3 Explanation: 3. The first priority in caring for a survivor of a sexual assault is to create a safe, secure environment.

A client is at a physician's office following the end of treatment for breast cancer. The client is not scheduled to receive any more radiation or chemotherapy at this time. With treatment behind her, the client can now look again to the future. Which phase of psychological adjustment is this client experiencing? 1. Shock 2. Reaction 3. Recovery 4. Reorientation

Answer: 3 Explanation: 3. The recovery phase begins during convalescence following the completion of medical treatment.

The nurse educator is talking with the students in the clinical area about amenorrhea. She has discussed both primary and secondary amenorrhea and their possible causes and knows that her teaching has been successful when, upon being questioned, a student explains that amenorrhea can be caused by which of the following? 1. Malfunctioning of the pancreas and insulin usage 2. Lack of testosterone after the time for menses to start 3. Lack of vitamin D and calcium in the system 4. Dysfunction of the hypothalamus

Answer: 4 Explanation: 4. Causes for amenorrhea include dysfunction of the hypothalamus, pituitary, and/or anovulation.

The nurse in the clinic is seeing four clients. Which one is the best candidate for receiving an IUC? 1. An unmarried, 22-year-old college graduate 2. A married 24-year-old who has never been pregnant 3. An unmarried 25-year-old with a history of chlamydia 4. A married 26-year-old who has two children

Answer: 4 Explanation: 4. This client is the best candidate, as she is in a stable relationship, and has children.

The client has been diagnosed with hepatitis B. Which statement indicates to the nurse that the client needs more education? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "This infection could be sexually transmitted." 2. "I might get jaundiced from this illness." 3. "An immunization exists to prevent getting hepatitis B." 4. "I might have gotten this infection from food." 5. "The incubation period is 15-50 days."

Answer: 4, 5 Explanation: 4. Hepatitis B is found in blood and body fluids, and therefore can be sexually transmitted. Hepatitis A and E are foodborne, and transmitted by fecal-oral contamination. 5. The incubation period for hepatitis B is 45-160 days.

The nurse is teaching an in-service educational presentation about working with battered women. The nurse should explain that it is often frustrating for nurses to work with battered women for which reasons? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. There is little the nurse can really do to help. 2. Healthcare policies and practices are not supportive of abused women. 3. Both husband and wife must agree to therapy. 4. These women might return to the abusive situation. 5. Women often believe that they are the cause of the abuse.

Answer: 4, 5 Explanation: 4. Women often believe that escape is futile, or escape and then return when the crisis is over. 5. Women are often convinced by the abusers that it is their own behavior that causes the abuse.

When discussing the feminization of poverty, the nurse educator will inform the students of what fact? 1. The out-of-wedlock birth rate is above 40%. 2. In 2012, 25% of the households headed by single mothers lived in poverty. 3. Poverty is not directly linked to level of education attained. 4. Women work fewer hours for more pay than men do. .

Answer: 1 Explanation: 1. The reality is that many children will spend at least a portion of their lives in single-parent families

Which client in the gynecology clinic should the nurse see first? 1. 22-year-old with fever, hypotensive, using tampons 2. 15-year-old, no menses for past 4 months 3. 18-year-old seeking information on contraception methods 4. 31-year-old, reports increasing dyspareunia

Answer: 1 Explanation: 1. A client using tampons who has a fever, is dizzy, and hypotensive might have toxic shock syndrome.

The client's Pap smear result is ASC-US. Which statement is the best way for the nurse to explain this ASC-US result? 1. "Abnormal squamous cells of undetermined significance." 2. "Cancer has invaded the upper cervix." 3. "High-grade squamous intraepithelial lesion (HSIL), which includes CIN." 4. "The focus of the Pap smear is the detection of high-risk pregnancy." 5. "The cervical cells are abnormal and the reason why is severe dysplasia and carcinoma in situ."

Answer: 1 Explanation: 1. ASC-US stands for abnormal squamous cells of undetermined significance. Preferred management is HPV testing; if positive, refer for colposcopy; if negative, repeat HPV co-testing in 3 years.

Abdominal hysterectomy is generally recommended for which condition? 1. Severe endometriosis 2. Removal of the ovaries 3. Suspected or confirmed cancer removal 4. Abnormal uterine bleeding

Answer: 1 Explanation: 1. Abdominal hysterectomy is recommended for severe endometriosis.

The 12-year-old client reports that menarche occurred 5 months ago. She has had bleeding every day this month, and is very worried. The nurse should explain that the most common cause of this bleeding is which of the following? 1. Dysfunctional uterine bleeding (DUB) 2. Diabetes mellitus (DM) 3. Pregnancy 4. Von Willebrand's disease

Answer: 1 Explanation: 1. Adolescents often experience DUB during the first 2 years following menarche due to hypothalamic immaturity after menarche.

During a counseling session on natural family planning techniques, the nurse explains that cervical mucus at the time of ovulation should be of what consistency? 1. Egg white appearance and stretchable 2. Opaque and acidic 3. High in leukocytes 4. Lacking in quantity

Answer: 1 Explanation: 1. Cervical mucus at the time of ovulation has an "egg white" appearance and is known as fertile mucus; it is friendly to sperm because it assists passage through the cervix and uterus up into the fallopian tubes.

The nurse is interviewing an adolescent client. The client reports a weight loss of 50 pounds over the last 4 months, and reports running at least 5 miles per day. The client asserts that her menarche was 5 years ago. Her menses are usually every 28 days, but her last menstrual period was 4 months ago. The client denies any sexual activity. Which is the best statement for the nurse to make? 1. "Your lack of menses might be related to your rapid weight loss." 2. "It is common and normal for runners to stop having any menses." 3. "Increase your intake of iron-rich foods to reestablish menses." 4. "Adolescents rarely have regular menses, even if they used to be regular."

Answer: 1 Explanation: 1. Secondary amenorrhea can be caused by rapid weight loss, including the development of the eating disorders anorexia and bulimia. Runners with low body fat might have irregular menses, but amenorrhea is not a normal condition.

A client using oral contraceptives tells the nurse that her family is complete, and she now desires permanent contraception. Which statement should the nurse include in teaching this client about sterilization options? 1. "Essure becomes effective 3 months after insertion." 2. "Vasectomy is effective immediately after the procedure." 3. "Tubal ligation cannot be performed until the client is age 35." 4. "Oral contraception should be taken until menopause." .

Answer: 1 Explanation: 1. The insertion of Essure creates a tissue response that results in tubal occlusion in about 3 months

The nurse in the OB-GYN office is explaining the benefits and risks associated with Essure to a client and her husband. What statement made by the client indicates that additional education is needed? 1. "A stainless steel microinsert is placed into the distal section of one fallopian tube." 2. "The Essure method of permanent sterilization requires no surgical incision." 3. "The steel microinserts create a benign tissue response that occludes the fallopian tubes." 4. "Women allergic to nickel should consult their physician before placement."

Answer: 1 Explanation: 1. The stainless steel microinsert is placed in the proximal section of both fallopian tubes.

The nurse working in a women's clinic recognizes that which clients are most at risk for developing vulvovaginal candidiasis? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Clients using antibiotics 2. Immunocompetent clients 3. Pregnant clients 4. Multiparous clients 5. Diabetic clients

Answer: 1, 3, 5 Explanation: 1. A predisposing factor to yeast infections includes the use of antibiotics. 3. Predisposing factors to yeast infections include pregnancy. 5. Predisposing factors to yeast infections include glycosuria and diabetes mellitus.

Extended use combined oral contraceptives (COCs) reduce the side effects of COCs such as which of the following? 1. Cramping 2. Hypertension 3. Breast tenderness 4. Bloating

Answer: 2 Explanation: 2. Complications of COCs include: myocardial infarction, stroke, blood clots, and hypertension.

The clinic nurse is returning phone calls. Which call should the nurse return first? 1. The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month 2. The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day 3. The call from a 46-year-old mother of a teen wondering if her daughter should be on birth control 4. The call from a 34-year-old requesting information on douching after intercourse

Answer: 2 Explanation: 2. Using a single tampon for an entire day can lead to toxic shock syndrome, a potentially life-threatening condition. This client needs education on the danger of using one tampon longer than 3-6 hours.

The nurse in the community clinic instructs a client starting on a combined oral contraceptive that she must immediately report which of the following symptoms? Select all that apply. 1. Only four withdrawal bleeds per year 2. Speech problems 3. Unscheduled bleeding 4. Blood pressure of 126/84 5. New lumps in her breast

Answer: 2, 5 Explanation: 2. The woman using combined oral contraceptives should contact her healthcare provider if she develops speech problems. 5. The woman using combined oral contraceptives should contact her healthcare provider if she develops a breast lump.

The nurse is developing a teaching plan for a client undergoing a tubal ligation. What information should be included in the plan? 1. The surgical procedure is easily reversible. 2. Laparotomy is performed following a vaginal birth. 3. Minilaparotomy is performed in the postpartum period soon after a vaginal birth. 4. Tubal ligation can be done at any time the woman is either pregnant or not pregnant.

Answer: 3 Explanation: 3. A tubal ligation minilaparotomy is performed in the postpartum period soon after a vaginal birth.

The client diagnosed with endometriosis asks the nurse whether there are any long-term health risks associated with this condition. The nurse should include which statement in the client teaching about endometriosis? 1. "There are no other health risks associated with endometriosis." 2. "Pain with intercourse rarely occurs as a long-term problem." 3. "You are at increased risk for ovarian and breast cancer." 4. "Most women with this condition develop severe migraines."

Answer: 3 Explanation: 3. An increased risk for cancer of the ovary and breast is associated with endometriosis.

A client has been diagnosed with bacterial vaginosis. The nurse obtains a sexual history from the client, including contraceptive measures, number of sexual partners, and frequency of intercourse. What is the rationale for the questions? 1. Clients can infect their sexual partners. 2. The nurse is required by law to ask the questions. 3. Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted diseases more easily. 4. The laboratory needs a full client history in order to know for which organisms and antibiotic sensitivities it should test.

Answer: 3 Explanation: 3. The change in normal flora increases the woman's susceptibility to other organisms, making the client more vulnerable to sexually transmitted diseases, including HIV.

The nurse is providing instructions for a woman who has just had intrauterine contraception inserted. What is essential for the nurse to teach the client? 1. To palpate her lower abdomen each month to check the patency of the device 2. To remain on bed rest for 24 hours after insertion of the device 3. To report any pain during intercourse to the physician 4. To insert spermicidal jelly within 4 hours of every sexual encounter

Answer: 3 Explanation: 3. The client should report any pain during intercourse to the physician. This can be due to an infection.

A nurse is teaching a middle school health class on the different types of viral hepatitis. Which statement made by a student indicates the need for further teaching? 1. "Both hepatitis A and E are not chronic infections." 2. "Hepatitis A is characterized by symptoms of jaundice, anorexia, nausea, vomiting, malaise, and fever." 3. "Hepatitis B, C, and D have symptoms similar to those of hepatitis A, and can also include arthralgias, arthritis and skin eruptions or rash." 4. "Both hepatitis B and C have an incubation period of 45-160 days."

Answer: 4 Explanation: 4. Hepatitis B has an incubation period of 45-160 days, but hepatitis C has an incubation period of 14-180 days.

The nurse is interviewing a new client in the clinic. The client is premenopausal, but is concerned about the bone changes and osteoporosis that can occur, since she is getting close to menopause. The nurse tells the client that prevention is the primary goal. Which of the following would be a primary goal for prevention? 1. Eliminating all alcohol intake 2. Taking 500 mg of calcium each day 3. Use of sunscreen to assist with absorption of vitamin D 4. Regular weight-bearing and muscle-strengthening exercises

Answer: 4 Explanation: 4. Regular weight bearing of the long bones is a primary goal for the prevention of osteoporosis.

A nonpregnant client is diagnosed with bacterial vaginosis (BV). What does the nurse expect to administer? 1. Penicillin G 2 million units IM one time 2. Zithromax 1 mg p.o. b.i.d. for 2 weeks 3. Doxycycline 100 mg p.o. b.i.d. for a week 4. Metronidazole 500 mg p.o. b.i.d. for a week

Answer: 4 Explanation: 4. The nonpregnant woman who is diagnosed with bacterial vaginosis (BV) is treated with metronidazole 500 mg orally twice a day for 7 days.

A client in the emergency department is diagnosed with pelvic inflammatory disease. Before discharge, the nurse will provide the client with some health teaching about which topic? 1. Endometriosis 2. Menopause 3. Ovarian hyperplasia 4. IUD for contraception

Answer: 4 Explanation: 4. The woman who uses an IUD for contraception and has multiple sexual partners needs to understand clearly the risk she faces.

Which client would the nurse document as exhibiting signs and symptoms of primary dysmenorrhea? 1. 17-year-old, has never had a menstrual cycle 2. 16-year-old, had regular menses for 4 years, but has had no menses in 4 months 3. 19-year-old, regular menses for 5 years that have suddenly become painful 4. 14-year-old, irregular menses for 1 year, experiences cramping every cycle

Explanation: 4. Dysmenorrhea, or painful menstruation, occurs at, or a day before, the onset of menstruation and disappears by the end of menses. Primary dysmenorrhea is defined as cramps without underlying disease.