Childbearing Exam 1

Lisa, a 35 year old teacher and marathon runner, presents to the clinic with a complaint of irregular menses. She tells the nurse, "My husband and I want to start a family but it hasn't happened yet. We stopped using birth control 6 months ago. Should we be concerned?" What is the nurse's best response?

"Aging and extreme exercise regimens can negatively impact fertility."

The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statement indicates that teaching was effective?

"I might have infertility because of this infection." "It is important for me to finish my antibiotics." "Tubal pregnancy could occur after PID."

A nurse in a community clinic is counseling a client who received a positive test result for chlamydia. Which of the following statements should the nurse provide?

"This infection is treated with one dose of azithromycin."

The nurse has completed instructions on ways to improve the client's symptoms related to her rectocele. Which statement by the client indicates a need for further education?

"heavy lifting will not affect my rectocele"

Which client in the gynecology clinic should the nurse see first?

22 year old with fever, hypotensive, using tampons

A nurse in a clinic is caring for a group of female clients who are being evaluated for infertility. Which of the following clients should the nurse anticipate the provider will refer to a genetic counselor?

A client whose partner has von Willebrand disease

The nurse is providing genetic counseling for an expectant couple who just found out that their child has down syndrome. Which is the best way for the nurse to handle this?

Be supportive by answering questions and clarifying information and options.

The prenatal clinic nurse is designing a new prenatal intake information with pregnant clients. Which question is best to include on this form?

Do genetic diseases run in the family of the baby's father?

A 58 year old female tells the nurse she has started experiencing pain during intercourse. The nurse should document that the client is experiencing what?

Dyspareunia

The nurse is educating a group of preteen age girls about their changing bodies. The nurse understands that the group understands the teaching when a preteen girl in the group states:

I will get my period between ages 12-14

A client with a history of herpes simplex virus (HSV-2) infection asks the nurse about future sexual activity. Which response is the MOST appropriate?

Inform all potential sexual partners about the infection, even if it is inactive

The nurse reviewing charts for quality improvement notes that a client experienced a complication during labor. The nurse is uncertain whether the labor nurse took the appropriate action during the situation. What is the best way for the nurse to determine what the appropriate action should have been?

Look in the policy and procedure book, and examine the practice guidelines published by a professional nursing organization

Which best describes the signs and symptoms of trichomoniasis in women?

Malodorous, frothy yellow-green vaginal discharge

A female client with an intrauterine device calls the clinic because she is unable to locate the strings after her last menstrual period. What should the nurse counsel this client?

Schedule an appointment immediately

A nurse is administering patient education to a 23 year old patient, who has never been pregnant, about the recommendation for frequency of pap smears. The patient understands the information given when she states:

The current recommendation for pap smears is every 3 years unless otherwise specified by HCP.

The nurse is seeing clients in the women's clinic. Which client does the nurse expect to see orders to give an IM injection of ceftriaxone (Rocephin) and an oral dose of azithromycin (Zithromax)?

The one with chlamydia and gonorrhea

A client describes swelling and tenderness. What piece of data would be most important for the nurse to gather initially?

Timing of the symptoms

A 35-year-old pregnant, mother of 5 asks the certified midwife about permanent options available for birth control. What is the midwife's best response?

UNKNOWN

A 36 y/o female client comes into the clinic to request birth control. In her history, the nurse finds that she started her menses (period/menstrual cycle) 10 days ago. What questions are important to assess in her history? (Select all that apply.)

UNKNOWN

A new mother is asking the nurse about birth control options. Which statement by the client is correct about breastfeeding and contraception?

UNKNOWN

According to AWHONN regulations, which of the these professionals carries the licensure to deliver a baby? (Select all that apply.)

UNKNOWN

According to your text, which of the following are included in a women's health history? (Select all that apply.)

UNKNOWN

Before giving a client an oral contraception, which side effects should the nurse let the patient be aware of? (Select all that apply.)

UNKNOWN

The nurse is assessing a client who has a suspected cystocele. What signs and symptoms should the nurse expect? (Select all that apply.)

UNKNOWN

The nurse is reviewing contraception options for four clients. The nurse should identify which client is NOT a candidate for a combination oral contraceptive (COC).

UNKNOWN

A woman arrives to the labor unit at 1900 to be prepared for induction of labor, with hopes of delivering her full term infant the next day. The woman's partner, two sets of grandparents, and the woman's sister are all with her to bless the woman prior to labor. You hear them chanting. What is the nurse's response?

UNKNOWN - I know it is something about allowing them to do it as long as it doesn't cause harm but don't know exact wording

A postpartum patient is scheduled for a tubal ligation at 0900. She tells the nurse, "I have no idea what a tubal thingy even is, I hope it goes okay." Select the best response from the nurse.

UNKNOWN - something about obtaining informed consent, usually the physicians job

Which client coming to the women's clinic is a candidate for emergency contraception (EC)?

UNKNOWN of exact answer - something about the person who had unprotected intercourse within 72 hours

A nurse is teaching. client with infertility about the medication Clomid (clomiphene citrate). The nurse should instruct the client to report which side effect of clomid to her HCP?

Visual disturbances

The labor and delivery nurse is caring for a laboring client who has asked for a priest to visit her during labor. The client's mother died during childbirth, and although there were no complications during her pregnancy, the client is fearful of her own death during labor. What would be the best way for the nurse to respond?

Would you like me to contact your parish or our hospital chaplain to come see you?

A nurse is caring for a client who is considering several methods of contraception. Which of the following methods of contraceptions should the nurse identify as being most reliable?

an intrauterine device (IUD)

Prior to the onset of labor, which state of the maternal process is the mother considered to be in?

antepartum

A nurse is teaching a community health class of women and explains that an STI is associated with an increased risk of infertility in women. Which STI should the nurse identify?

chlamydia

Which of the following would the nurse include in the teaching plan for a 32-year-old female client requesting information about using a diaphragm for family planning?

diaphragms should not be used if the client develops acute cervicitis

The belief that one's cultural practices and beliefs are superior to those of others is defined in your textbook as:

ethnocentrism

A nurse is educating a patient on the basal body temperature method of family planning. The nurse should instruct the patient to take her temperature at what time?

first thing in the morning

A nurse in a college health clinic is speaking to a group of adolescents about toxic shock syndrome (TSS). Which of the following should the nurse include in the teaching as increasing the risk for contracting TSS?

highly absorbent tampons

A client in the women's clinic asks the nurse about available contraceptives. Before responding, the nurse makes which of the following assessments? (Select all that apply.)

how frequently the client has intercourse whether the client has a history of thrombophlebitis whether the client is in a monogamous relationship

Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse would assess the client for signs and symptoms of which of the following?

hypertension

A nurse is providing education to couples who are about to undergo fertility treatments. The nurse understands the couples understand the implantation process when they respond that:

implantation occurs 7-10 days after conception

When a nurse explains a procedure, the rationale for the procedure, and any associated risks to her patient, the nurse is protecting the patient's ethical right to:

informed consent

The nurse is providing education regarding the use of the diaphragm as a form of contraception. Which of the following should the nurse include in the instruction? (Select all that apply.)

leave in for 6 hours after intercourse do not leave in more than 24 hours due to TSS risk wash hands before placement to help reduce risk women with history of TSS should not use a diaphragm

The client reports using an alternative therapy that involves the manipulation of soft tissues. This therapy has reduced the client's stress, diminished pain, and increased circulation. Which therapy has the client most likely received?

massage therapy

A young couple is contemplating starting a family. What is the best time for genetic counseling?

now, before they become pregnant

The nurse is caring for a female client with a history of pelvic inflammatory disease (PID) who reports having difficulty conceiving after unprotected sex for over 2 years. Which deviation from the norm does the nurse recognize is most likely the cause of the client's infertility?

obstruction and non-patent fallopian tubes

The client calls the nurse and states she has not had a menstrual cycle in 3 months. What does the nurse know is the most common cause of dysmenorrhea?

pregnancy

A nurse is working with four clients desiring in vitro fertilization (IVF). Which clients would be good candidates for IVF? (Select all that apply)

the client with tubal blockage the client whose husband has a very low sperm count

A 16 year old female client who lives in a state without an emancipated minor law needs to have a procedure to decrease her postpartum bleeding, following the delivery of her infant. Who can legally give informed consent for the client to have this procedure?

the client's mother

A 17-year-old patient receives emergency contraception in a clinic. What is the priority nursing education for this patient at this time?

the need for further contraception because the emergency contraception is only temporary

A 36 year old female client presents at the women's clinic requesting birth control. The client has a BMI of 31, is monogamous, and does not smoke. The nurse understands that which contraceptive method is inappropriate for this client?

transdermal hormonal contraception

A nurse is assessing a newborn who has Trisomy 21 (Down Syndrome). Which of the following are common characteristics? (Select all that apply.)

transverse palmar creases protruding tongue low set ears

A nurse provides teaching for a patient scheduled for genetic testing. What should the nurse do to help the patient understand what is being taught? (Select all that apply.)

use simple vocabulary avoid the use of jargon speak slowly and clearly ask the patient to verbalize what was learned