CH 26: Wellness and Health Promotion

Daily caloric requirements for proteins and fats

20-35%

At what age should the first pap smear test be done?

21

Daily caloric requirements for carbs

45-65%

The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A) "Currently there is no reliable screening test for ovarian cancer." B) "A Papanicolau test is almost always helpful in identifying this type of cancer." C) "There's a blood test for a marker, CA-125, that if elevated indicates cancer." D) "A genetic test for two genes, if positive, will identify the ovarian cancer."

A) "Currently there is no reliable screening test for ovarian cancer."

The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A) "Currently there is no reliable screening test for ovarian cancer." B) "A Papanicolau test is almost always helpful in identifying this type of cancer." C) "There's a blood test for a marker, CA-125, that if elevated indicates cancer." D) "A genetic test for two genes, if positive, will identify the ovarian cancer."

A) "Currently there is no reliable screening test for ovarian cancer." Currently there are no adequate screening tests for ovarian cancer. A Papanicolau test is used to screen for cervical cancer. The CA-125 marker may be elevated in women with ovarian cancer, but it is not specific for this cancer and may be elevated in other malignancies. Genetic testing via BRCA-1 and BRCA-2 provides information about a woman's risk but does not predict if the woman will develop cancer.

After a discussion on the HPV vaccine with a mother and her 10-year-old daughter at a well-child visit, the nurse recognizes the discussion was successful when the mother makes which statement? A) "My daughter will need three injections over a 6-month period." B) "She will need one injection every 5 years." C) "One injection will give her a lifetime of protection." D) "She will need to get a total of two injections in the next 3 months."

A) "My daughter will need three injections over a 6-month period." The vaccine is administered intramuscularly in three separate 0.5 mL doses over a 6-month period. The first dose is given prior to infection with HPV. The second dose is administered 2 months later, and the third dose is given 4 months later.

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

The nurse is educating a female client about lifetime risk for developing cancer. The nurse determines that the teaching was successful when the woman states that regardless of her risk factors, her chances for developing cancer are: A) one-in-three. B) one-in-five. C) one-in-seven. D) one-in-nine.

A) One-in-three Women have a one-in-three lifetime risk of developing some form of cancer with one out of every four deaths due to cancer. It is vitally important that nurses focus on proper screening and educating women regardless of their individual risk factors.

The nurse is helping a young mother with a toddler improve the daily diet for the family. What is one way the nurse could teach the mother to improve the daily intake of complex carbohydrates? A) Provide whole fruit instead of juice. B) Use sugar free cookies for snacks. C) Increase the servings of potatoes. D) Decrease the servings of green vegetables.

A) Provide whole fruit instead of juice. One way to increase the intake of complex carbohydrates and decrease simple carbohydrates is to increase more whole fruit into the diet and decrease the amount of fruit juice. Fruit juice is concentrated and contains more sugar. It is also refined so that it does not contain fiber. Using sugar-free cookies and crackers would not be beneficial because the decreased sugar means increased fat. Generally that fat is not healthy fat. Increasing the serving of potatoes would only provide complex carbohydrates (if the potatoes are sweet potatoes, not white potatoes). Green vegetable servings should be increased, not decreased.

A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity? A) administering HPV vaccine B) teaching about the importance of regular Papanicolau test C) educating about HPV testing in women over age 30 D) encouraging treatment for genital warts

A) administering HPV vaccine Primary prevention is aimed at preventing the disease or condition before it occurs, so giving the HPV vaccine would be a primary prevention activity. If the woman does not receive primary prevention with the vaccine, then secondary prevention would focus on education about the importance of receiving regular Papanicolau tests and, for women over age 30, including an HPV test to determine whether the woman has a latent high-risk virus that could lead to precancerous cervical changes.

A nurse is preparing a presentation for a group of women who are of age to have children about the risk for cancer during pregnancy. When describing the risk, which cancer would the nurse most likely include as being the most common cancer occurring during pregnancy? A) breast B) cervical C) lymphoma D) melanoma

A) breast

A nurse is preparing a presentation for a group of women who are of age to have children about the risk for cancer during pregnancy. When describing the risk, which cancer would the nurse most likely include as being the most common cancer occurring during pregnancy? A) breast B) cervical C) lymphoma D) melanoma

A) breast The most frequent malignancies diagnosed during pregnancy are breast cancer, cervical cancer, 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. Less common tumors during pregnancy are gastrointestinal, ovarian, urologic, and lung cancers.

A nurse is providing education to a client who is 8 weeks' pregnant. The client stated she does not like milk. What is a source of calcium that the nurse can recommend to the client? A) dark, leafy green vegetables B) deep red or orange vegetables C) white bread and rice D) meat, poultry, and fish

A) dark, leafy green vegetables Dark leafy green vegetables are a source of calcium. Red and orange vegetables contain a variety of vitamins, bread and rice contain carbohydrates, and meat and fish contain protein, but none of these foods are a good source of calcium.

A client presents for her annual Papanicolau test. She wants to know about the risk factors that are associated with cervical cancer. Which risk factor for cervical cancer should the nurse inform the client about? A) early age at first intercourse B) obesity (at least 50 lb [22.7 kg] overweight) C) hypertension D) infertility

A) early age at first intercourse Early onset of sexual activity, within the first year of menarche, increases the risk of acquiring cervical cancer later on. Obesity, infertility, and hypertension are risk factors that are associated with endometrial cancer.

The nurse is teaching a client ways to improve the diet. The nurse teaches the client that it us important to limit simple carbohydrates in the diet because these types of foods produce: A) increased blood glucose. B) decreased glycemic index. C) increased insulin resistance. D) decreased hemoglobin A1C.

A) increased blood glucose. The ingestion of simple carbohydrates such as sugar and white flour can lead to short-term spikes in the blood glucose level. Simple carbohydrates also produce a higher glycemic index. The hemoglobin A1C is a laboratory test that measures the levels of glucose over a 3-month time frame. Simple carbohydrates will not affect insulin resistance, which is caused by the pancreas.

A client has been diagnosed with cervical cancer during her second trimester of pregnancy. She decides to delay treatment until after the baby is born. The nurse prepare her for birth by explaining the birth will most likely be: A) via cesarean section. B) vaginally. C) per her choice. D) induced at 37 weeks.

A) via cesarean section In women with early-stage disease and absence of nodal involvement, there is an increasing tendency to preserve the pregnancy. The birth (when the fetal maturity is attained) should be performed using a cesarean section. Discussion with the client and her family is essential, and treatment must be individualized.

Which description would the nurse include when teaching a client about a scheduled colposcopy? A) "A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas." B) "A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument." C) "Scrapings of tissue will be obtained and placed on slides to be examined under the microscope." D) "After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples."

B) "A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument." A colposcopy is a microscopic examination of the lower genital tract using a magnifying instrument. Use of a microphone-like device over the abdomen describes an ultrasound. Obtaining tissue scrapings that are examined under a microscope describes a Papanicolau test. Insertion of a device under anesthesia near the umbilicus describes a biopsy obtained via laparoscopy.

A female client is found to carry the breast cancer susceptibility genes 1 and 2 (BRCA 1 and 2). The nurse would teach this client that routine screenings would include which tests? Select all that apply. A) Annual breast MRI starting at age 25 B) Clinical breast exam every year C) Annual breast ultrasound beginning at age 21 D) Mammogram twice yearly E) Breast biopsy every 2 years

B) Clinical breast exam every year A) Annual breast MRI starting at age 25

A nurse working in the Family Birthing Center is answering the nurse hot line phone. A client calls in to schedule her annual Papanicolau test. How could the nurse best educate the client before her procedure to make sure results are not affected? A) Make sure the appointment is 5 days after the last menses. B) Refrain from sexual intercourse 48 hours before testing to ensure clear results. C) It is safe to use tampons 72 hours before testing. D) The client may douche at least 48 hours before testing.

B) Refrain from sexual intercourse 48 hours before testing to ensure clear results. Nurses should use teaching guidelines with clients to optimize the Papanicolau test results. Strategies to educate would include: no douche, no tampons, no jellies, no spermicides, no intercourse. The optimal time for testing is 2 weeks after the first day of your last menses.

Which woman is at greatest risk for developing cervical cancer? A) a client who lacks access to or use of health care B) a client who comes from lower socioeconomic status C) a client whose high-risk HPV infection persists in genital skin cells D) a client who has a high intake of alcohol and nicotine

C) a client whose high-risk HPV infection persists in genital skin cells Women whose high-risk HPV infection persists in genital skin cells are at greatest risk for subsequently developing cervical cancer. Women who lack access to or use of health care, come from lower socioeconomic status, or have a high intake of alcohol and nicotine do not face an increased risk of developing cervical cancer.

A client with a family history of cervical cancer is to undergo a Papanicolau test. During the client education, what group should the nurse include as at risk for cervical cancer? A) clients with irregular menstrual cycles B) clients who have not had babies C) clients who have genital warts S) clients with fibrocystic breast disease

C) clients who have genital warts The presence of genital warts (condyloma) increases the risk of developing cervical cancer. Women with metrorrhagia or irregular menstrual cycles are at an increased risk of developing breast cancer, not cervical cancer. Clients who have never had a baby or those with a history of fibrocystic breast disease have an increased risk of developing breast cancer, but not cervical cancer.

A client has an abnormal Papanicolau test result that is classified as ASC-US. Based on the nurse's understanding of this classification, the nurse would expect which procedure? A) immediate colposcopy B) testing for human papillomavirus (HPV) C) repeat Papanicolau test in 4 to 6 months D) cone biopsy

C) repeat Papanicolau test in 4 to 6 months For the classification of ASC-US, the client would have a repeat Papanicolau test in 4 to 6 months or be referred for a colposcopy. A referral for colposcopy with HPV testing is indicated if the results indicated ASC-H classification. An immediate colposcopy would be indicated for atypical glandular cells and adenocarcinoma in situ. A cone biopsy would be used to evaluate the lesion and may be used as treatment to remove any precancers and very early cancers.

A client has an abnormal Papanicolau test result that is classified as ASC-US. Based on the nurse's understanding of this classification, the nurse would expect which procedure? A) mmediate colposcopy B) testing for human papillomavirus (HPV) C) repeat Papanicolau test in 4 to 6 months D) cone biopsy

C) repeat Papanicolau test in 4 to 6 months For the classification of ASC-US, the client would have a repeat Papanicolau test in 4 to 6 months or be referred for a colposcopy. A referral for colposcopy with HPV testing is indicated if the results indicated ASC-H classification. An immediate colposcopy would be indicated for atypical glandular cells and adenocarcinoma in situ. A cone biopsy would be used to evaluate the lesion and may be used as treatment to remove any precancers and very early cancers.

A nurse is preparing a woman for a Papanicolau test. The nurse has already washed her hands and gathered all necessary equipment (maintaining sterility). What is the next step in the procedure? A) Provide support to the client as the provider obtains the sample. B) Drape the client with a sheet, leaving the perineal area exposed. C) Transfer the specimen to a container or a slide. D) Position the client in stirrups or foot pedals so that her knees fall outward.

D) Position the client in stirrups or foot pedals so that her knees fall outward. During a Papanicolau test, the next step would be to position the client in stirrups or foot pedals so that her knees fall outward. This would be followed by draping a sheet over the client and leaving the perineal area exposed. Next would be to support the client while the sample is obtained. Lastly, transfer the specimen to a container or slide.

_______ is the most common bacterial STI in the United States

chlamydia

BV has a ____ odor?

fish

The term gender role refers to?

the attitudes and behavior that are expected of men and women in a society

colposcopy

the direct visual examination of the tissues of the cervix and vagina. Done when a pap smear comes back abnormal.